Newsletter Spring 2010

Crisis Support Matters

A Semi-Annual Newsletter of Crisis Support Services of Alameda County

From the Executive Director

Dear Friends,

I don't know about you, but I am glad that spring has arrived. I feel invigorated when there are longer hours of light, more sunshine and new life springing forth. However, the change of season impacts on all of us differently. Oftentimes, during the winter time many of us feel blue. We are tired of the longer hours of darkness and rainy weather.

When someone is suffering from depression, they may feel less isolated in the winter, because many of us have the blues. When springtime hits and others are feeling better, someone suffering from depression does not, and that may actually put them at a higher risk for suicide. It is during the spring that the rate of suicide often increases.

This is the time of year when our services are more important than ever. For our seniors who are homebound and oftentimes isolated, for members of our community that are suffering from grief, and for those suffering from depression spring can be a very difficult time.

This newsletter focuses on our services that are specific to our senior population and also gives you information about the array of support groups that Crisis Support Services provides to our community.

We continue to be thankful for your generosity that supports these important programs. No one is turned away for their inability to pay for services, and it is your ongoing support helps make that possible.

Best Always,

Nancy Salamy

A Message from Senior Program Director Devah DeFusco, MFT

Included in this newsletter is statistical data on our Senior In Home Counseling Program. The numbers reflect the expanse and concentration of the work we do on behalf of Alameda County. What they don't specify and what may be difficult to imagine are the individuals who reach out to CSS and take what they need from the services we offer.

For instance, one of our clients is a recently widowed woman with adult children living far away, grieving, frightened and unprepared to live the rest of her life without her husband. We are there with supportive grief counseling, in-home support services, referrals and 24 hour availability via our crisis line. She knows she doesn't have to be in crisis to call, only in need of contact with some one who cares, is comforting and calm.

I have found that people are generally very strong and not fragile. People commonly carry incredible burdens of loss, discrimination, and heartbreak and do so without losing their humanity or their sanity. What I find does drives people over the edge is whatever burdens they carry coupled with a feeling of isolation, of being totally cut off from others.

Our staff and volunteer counselors are trained to move closer to suffering. They are not afraid of despair and so clients need not be alone with their pain. Relief is found in connection, in feeling reconnected to someone, of belonging. I often say we here at CSS are like the friends and family we so much rely on, in that we offer Alameda County a comprehensive safety net, which exists to be of service to all members of our community who would otherwise suffer alone.

Imagine.

CSS Senior In-Home Counseling Program Serves Frail Elderly in Alameda County

Elders, 65 and older, account for 20% of all suicides in the US, even though they only account for 12% of the population. For older adults, precipitating causes for suicide include declining health, ageism, social isolation, grief, loss, family discord and financial uncertainty. In addition, loneliness, and isolation place seniors at a high risk for depression and substance abuse. Frail elderly have a serious lack of in-home options for treatment of the mental health issues that may lead to suicide. This lack of in-home supportive services, coupled with the added burden of care, often creates a tremendous strain on family.

CSS is dedicated to providing geriatric mental health services, crisis intervention, and support services to the elderly on our 24 hour crisis line and through our direct senior counseling programs. The Senior In-Home Counseling program provides free counseling and emotional support to isolated, frail, homebound seniors who would not otherwise have access to mental health supportive services that could increase their opportunities to safely age in place.

Our clients are typically low income, homebound, socially isolated, culturally diverse elders facing a multitude of challenges. Since 1993, the Senior In-Home Counseling Program has provided the only free, on-going mental health service available to this population in Alameda County.

Currently, the Senior In-Home Counseling Program serves more than 100 home-bound seniors living at, or below, the poverty level. Clients are referred to CSS by social workers, advocates, senior centers, Adult Protective Services and community groups. The program includes an initial assessment to determine client eligibility and need, weekly 1 hour in-home supportive counseling sessions, telephone contact as appropriate, coordination with care providers and family, and assessment of problem areas that are better addressed by other community based resources , and referrals to those agencies as appropriate.

Much of the program is delivered by trained volunteer counselors, often interns, under the supervision of licensed clinical supervisors. These in-home counseling sessions play a key role in reducing social isolation and increasing the overall sense of well-being for the senior client by directly addressing the mental health needs of seniors who might otherwise not have access to supportive mental health services. The program helps the client identify and overcome obstacles to access additional home-based services and positively impacts their ability to safely remain in their homes.

In 2006, we expanded our senior services by adding an on-site counseling program to accommodate the request for services from older clients who did not qualify as home bound and might be able to come in to our North Oakland office. However, participation had been limited for some older clients as accessing public transportation presents an increasingly difficult challenge for many seniors.

In response, CSS secured funding from the East Bay Foundation on Aging in 2009 to begin a pilot project offering taxi vouchers to seniors in the program. The program was a great success and has been funded for a second year. For more information or to learn how to access services through the Senior In-Home Counseling Program, contact Senior Program Director Devah DeFusco, MFT at 510 420-2475.

Real Life Outcomes

Over the past year, The CSS Senior In-Home Counseling Program has reached 109 seniors with supportive mental health services necessary to help them safely age at home.

• 85 homebound senior clients received 1407 counseling visits in their home
• Counselors made 1250 outgoing calls to our senior clients, often just checking in to reduce social isolation
• CSS provided on-site counseling services to 24 seniors experiencing bereavement, grief or other loss
• Our on-site clients received a total of 201 individual counseling sessions
• Counselors made 212 outreach and follow-up calls to seniors accessing on-site services

Clients self-reported significant improvements in their levels of depression, anxiety, panic and anger. Most notably, thoughts of suicide declined, with senior clients reporting at the completion of counseling that they were experiencing no suicidal urges.

We asked some of our clients about their own experiences with CSS Counseling Services for Seniors and heres what had to say:

• Receiving Crisis Supports Counseling Services in my home has impacted me in every way. I feel like I have a family. I recommend it. It has been so helpful to me.
• Before counseling I was a nervous wreck. Since starting counseling with CSS I have been helped so much. I feel calmer. My counselor listens and helps me work through my problems. We kid a little which always makes me feel more relaxed. Ive been helped a lot! I always feel better after our sessions.
• It's helped immensely to talk about things. It's not so bottled up anymore. I am able to talk about it, and able to talk with family. I think it has impacted me on the positive side.
• It's been a lot of help. Its really helpful to have neutral people to relate to on different issues. It's been good advise and valuable feedback. I have been able to focus on problem areas. The crisis line has really been a great help too. It's especially helpful if you are suicidal.
• I feel much less stressed and isolated. Isolation is a prison.

CSS Support Groups Encourage Healing from Grief, Loss and other Life Transitions

Support groups bring together people facing similar issues, whether that's illness, grief, relationship problems or major life changes. While not everyone wants or needs support beyond that offered by family and friends, many find it helpful to turn to others outside their immediate circle. A support group can help you cope better and feel less isolated as you make connections with others facing similar challenges. It can be helpful just getting to talk with other people who are in the same boat.

Crisis Support Services offers a number of supportive counseling groups both on-site and in the community. Groups for the Survivors of Suicide bring together those, often family members and friends, who have lost a loved one to suicide. Unfortunately, many survivors of suicide suffer alone and in silence. Because of the social stigma around suicide, survivors feel the pain of the loss, but may not now how or where to express it. Grief following a suicide is extremely complex and survivors don't just get over it. The support that comes from a group of people who have shared the same experience is a critical helping tool towards healing.

Similarly, CSS also offers group counseling for suicide attempters and expects to have another group starting over the summer. While these groups are not meant to replace individual psychotherapy for the attempter, the non-judgmental emotional support from others who have experienced distress, despair and suicidal feelings can be extremely helpful in the healing process.

Support groups for Healing from Grief and Loss and for (Senior 60+) Women in Transition help create an extremely helpful and supportive environment for dealing with some of life's most challenging transitions.

Healthy support groups offer a variety of benefits, from the emotional to the practical. The benefits of support groups include:

• Making connections. Meeting others with depression, a similar situational crisis or a common mental health condition may make you feel less alone or isolated. A safe and welcoming environment, filled with compassion and understanding, can also reduce any stigma you may feel.
• Improving your coping skills. Support groups offer the chance to draw on collective experiences. Others who have 'been there' may have tips or advice about coping with your situation that hasn't occurred to you. Brainstorming with others may inspire even more ideas.
• Getting motivated. Support groups can encourage you to seek professional treatment if you haven't already. They may also encourage you to take a more active role in coping with your situation. And they may help you tap into community resources.
• Finding hope. Sharing experiences and making connections can make you feel better about life in general. Seeing others make strides towards regaining their health may give you hope about your own future.