Helen & Alison’s US Blog

At Hafal we are currently developing a new in-patient service – our Gellinudd Recovery Centre – which is due to open within the next two years. The Centre will offer ambitious, recovery-focused support and treatment for people with a serious mental illness.

The US has some of the most innovative in-patient services in the world, and our Recovery Centre Director Alison and Recovery Centre Development Consultant Helen are visiting a number of these services in the next three weeks as part of a fact-finding tour.

Keep visiting this page for the latest updates from Alison and Helen…


Monday 13th July – On Friday we visited the New York Clubhouse. We were taken around all the different areas of the Clubhouse with several other people. It was set up in 1943 and the buildings were donated to the organisation. Alison and I have some reservations about the model used and we felt quite uneasy during the tour as we felt we were intruding on people’s daily lives.

We then had a telephone conference with Dr Bansil who was very interested in the development of the Recovery Centre and wants to be kept up to date with how it progresses.

We fly home tomorrow evening and will be back on British soil all being well at 8am on Tuesday morning!

Friday 10th July 2015 – We went to the NAMI conference yesterday and spent a very interesting day in different workshops and networking with lots of people.

Alison went to the workshop on early intervention and WRAP I went to the workshop on how to get employment opportunities and rights and then Ask a Cop which was about crisis.

The posters, etc. were really good and we have lots of contacts for when we return. We managed to meet Jack Yatso who leads on the Clubhouse model, he gave us a number of resources which will be coming with us back to Wales.

Got back late to the accommodation and then had to pack to be at San Francisco airport by 7am to catch the flight to New York.

Tuesday 7th July 2015 – We spent the day yesterday with Tod Nicosia from Osuka: he kindly picked us up and we went out to San Jose in Clare County. He explained about the Californian funding streams and the various organisations who they work with.

We then went to meet Eleanor Pace who runs Momentum which is a mental health organisation mainly dealing with Crisis.

She kindly took us to what would be the equivalent of a bail hostel in the UK. It caters for individuals coming out of prison who are deemed to have a serious and enduring mental health problem. We then went to another project for individuals where the insurance pays for them to be having some residential care which is short-term. The house is very old and listed (see photos). Momentum deal with many homeless individuals and have a number of houses across San Jose.

Off to the NAMI conference today and then back to New York very early tomorrow morning on the last leg. We are a bit tired to say the least!

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Monday 6th July 2015 – Got the train from South Station, Boston to the Big Apple and from there we caught a plane to San Francisco.

We are staggered by not only the homelessness issue which was very apparent all day today with individuals sleeping in parks, on the street and begging; but also the level of untreated mental illness by which we have been surrounded throughout our trip into the city.

We are off to a place called Momentum for Mental Health in San Jose and then to a Crisis residential programme.

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Racking up the air miles: Helen and Alison flew from New York on the East coast (left) right across the US to San Francisco on the West coast

Friday 3rd July 2015  – We had a really good day St Gould a Farm after a long drive to get there. We arrived at a 900 acre estate where all staff live on site in their own accommodation. The families all go for communal meals with the guests. There are 40 guests and everyone works together as part of the community.

They have forests and gardens, a working farm which provides food, milk and lots of cheese etc for the Gould farm community plus the local community. A very thriving bakery: all the produce feeds the community and goes to the local markets as well. There is also a roadside cafe run by the Gould Farm community and the maintenance workshop that keeps all the machines and vehicles going.

When we arrived there was a yoga class going on. Each Tuesday and Thursday specific wellness classes are held. The community employ individuals with many skills. The guests participate in the running of the community, starting with the forest and gardens and finding their niche in any of the areas of work. The stay for a guest is usually about 6 months but that is flexible.


Wednesday 1st July 2015 – Yesterday we went to 3 destinations. Firstly we went to two projects run by Loft Housing: the first project was for mental health, drug and alcohol and HIV. It has a number of funding sources. It is a residential placement with 10 beds, some of which are for short-term respite. This project was in downtown Toronto and managed and run by Kay Rosslein who was inspirational and very committed to her work, she had been there 23 years. She has a team of staff who do outreach across the locality and manage people in crisis.

Caseload sizes for that work are 1 worker to 11 or 12 consumers. For outreach the caseload sizes are above 20. Demand for beds is high and they now take referrals from statutory services. Many individuals are/ have been homeless but they have seen positive outcomes re: reduction in emergency department referrals and relapse. The out of town project is run along the same lines by Steve Keeble.

In the afternoon we went to the Gerstein Crisis Centre in downtown Toronto run by Sue Davis. It is a charitable organisation and the crisis house has been in place for 25 years and takes people in crisis by self referral or other agency referral. The work has expanded and there is now another crisis house for individuals with drug and alcohol crises. Both services have outreach and see people in their own homes to try and manage the crisis where possible where individuals are most comfortable. They rarely have empty beds, there are 10 in total.


Sunday 28th June 2015 – We explored and were very aware of the extreme poverty and deprivation in the Detroit area and the huge challenges services have. Just to add there were two shootings on our first night here just down the road and last week there were seven. We were made very welcome but can’t wait to go to Canada tomorrow.


Saturday 27th June 2015 – Well we travelled to Detroit yesterday. We made our way to a project called “The Living Room” which was a drop in run by peers. Patricia was passionate and totally committed to the work and was fighting hard for funding.

We were then taken to a 24-hour drop in for substance misuse but also dual diagnosis run by a guy called Andre who was amazing. They provided services for individuals leaving custody and from the courts on drug rehab programmes and ran specific drop in for street girls and had cannabis groups. Age range 18 upwards with oldest being about 75.

We then went to “Our Place” drop in which was more of a 9-5 place ; CEO Bill Nowacki seems to have been instrumental in policy with the Detroit Wayne Mental Health Association. Donna Coulter was our main host and she was an inspirational person, very instrumental in all the peer work across Detroit and beyond. She was accompanied by Darrell (advocate), and two other ladies, one of whom ran a “clubhouse”

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Friday 26th June 2015 – As we said yesterday something big was going down in Washington yesterday, well it certainly was, Barack Obama managed to do some historic things – Medicare (Obamacare as it is known) is now in a Statute and he has also managed to pass same-sex marriage. Feel really proud to have been here for this momentous occasion.

Had a brilliant day in Baltimore today. We arrived in Baltimore and met Bernard from the Baltimore behavioural health system. They manage the funding for mental health and substance misuse in what would be the Third sector in the UK. We visited two projects.

The first project was the HOPE centre which is run by a guy called Thomas. It is open 7 days a week from 8am – 8pm. They have two managers and four peers plus volunteers. All the projects are Peer led and managed. Thomas had spent quite a time in the criminal justice system as well as having mental health problems. The HOPE centre sees up to 400 people a week, most of whom are homeless. They provide most services and run courses, provide peer training and have peer led community support services. They also take women with young children and provide care for children while women attend courses etc. They also have a clothes and shoe bank to provide if required. All the projects are overseen by an inspirational lady called Monica who has lived experience.

We then visited “On our own incorporated”, run by peers and support individuals linked with services and provide after hour support and socialisation. This is managed by Tony Wright. It’s a recovery focused service with pets encouraged and they have a live-in cat called Spider.

Then we went to meet Ken Wireman from Main Street Housing. They are an organisation run by individuals with a lived experience and provide tenancies for people with mental health difficulties, this includes women with children or partners, one of whom has a mental health issue. Houses hold no more than two people. Each has a bedroom, living room and bathroom. The properties are in areas that would have been previously for middle class black Africans. All properties are close to transport and shops, this is the criteria.

Went back then to Main Street headquarters and met Katie Rouse (operational manager) and Judith who runs the anti stigma campaign and Mike, also a manager. They gave us loads of information but were also very interested in the Mental Health (Wales) Measure, Time to Change Wales, book prescription and the Hafal campaigns. We have promised to keep in touch as keen to link re: research but Ken also keen for us to use their name for any move-on projects with housing. We felt there would be an opportunity for “twinning” with them.

Thursday 25th June 2015 – Well we have arrived safely in Washington DC! The whole feel of Washington is much more gentile, not such evident poverty, rootlessness or homelessness. Our views may change tomorrow after visiting projects.

Got to the White House and there seemed to be a lot of action but Obama has been influencing policy today.

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Wednesday 24th June 2015 – Well Wednesday was a really full on day in Philadelphia but really interesting.

Found our way to the first rendezvous and were greeted by Wes Lilly – Program Manager, A New Life Recovery Education Centre – who kindly took us to two projects.

The organisation, the Mental Health Association of Southeastern PA, employs about 250 people. They run Peer led services.

First project we went to is called “In one place” and is for the homeless; none of the individuals engaged with statutory services. Homelessness a very big issue in Philadelphia, with an increasing number of homeless young people and also an increasing number of vulnerable women. The project runs structured teaching for the homeless and provides help with housing, socialisation, personal skills and support. Individuals can take a 16-week course equipping them with survival skills and wellness skills. They also provide an outreach service and “cafes” which are overnight accommodation when required. Met some really lovely dedicated people and inspiring people.

The second project was called “The Well”. This is a peer-led centre which provides education. Individuals who attend The Well are known to statutory services. Certificated Peer Specialists are employed, they have done a two-week course linked to an education provider – the Institute of Recovery. There are some opportunities to link with the Director of the Institute. They have a service called Peer Net. Trained Peers go out and do outreach in the community, visiting individuals at home. They link with statutory services and are well accepted. Doing research with Philadelphia Temple University around outcomes for individuals. At The Well we met David Young who is the Director of Peer Services. Also met Yvette Pate who runs Peer Net.

We left The Well and made our way to meet Rose Carvalho and Yolande at NAMI. We arrived and were plunged into the last meeting of a course run for families, called Family to Family. Everyone was very welcoming and we witnessed the presentation of certificates for individuals completing the course. We had some American food, fried chicken, cakes etc.

Just packing up ready to go to Philadelphia station to catch the train to Washington DC…

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Tuesday 23rd June 2015 – Woke very early and started the day in the cool of the Bees Knees for coffee and croissants.

Got the Amtrak to Philadelphia which was wonderful really comfortable, air conditioned and we had nice views of countryside plus nice company. Got to Philly station which is one of the oldest in the U.S. We met a lovely chap singing and listening to Frank Sinatra at his shoeshine.

We then arrived safely in the district we are staying and walked in the heat to try and find a cafe for a drink, at least an hour in the intense heat, 89 degrees didn’t do us much good. Checked into our accommodation.

We chilled yesterday evening and went to an original American Diner, Alison had always wanted to eat at one. The size of the portions staggering, but the staff and everyone really friendly. What I forgot to mention was the storm with thunder, lightening and torrential rain and high winds before we went out for supper.

Off to projects to see peer-led services this morning and going to NAMI Philadelphia base this afternoon…


Monday 22nd June 2015 – Flew to New York, had a film fest during the flight but Alison’s concentration distracted by strange behaviour of two fellow passengers, let’s just say she was thinking terrorist action!

We arrive late into the Big Apple and are greeted with unusually hot and humid weather. We braved the trains and subway and ended up in Grand Central station. It is an amazing building.

Got to our accommodation via yellow taxi. Met one of our hosts in the Bees Knees cafe which was a delight, good iced coffee, cake and air conditioning!!

Everyone was delightful in New York, really helpful and happy.

Sunday 21st June 2015 – We travelled to London and spent what felt like a very few hours in a hotel before getting the flight to the Big Apple.