The Connecticut Department of Mental Health and Addiction Services (DMHAS) released a request for proposals (RFP) to open and operate a peer-run respite house in Connecticut, something mental health advocates and nonprofits have long sought to offer a caring and compassionate alternative to locked psychiatric units.
However, the RFP issued by DMHAS has dashed some of those hopes, according to letters sent by Connecticut’s mental health nonprofit and advocacy groups, who say what is being proposed by DMHAS is not what they had in mind, nor what studies and experience in other states show is best practices.
Peer-run respite houses allow individuals experiencing mental health issues to stay in a home-like setting for upwards of one week as a respite from the pressures of their daily lives. Those individuals can come and go as they like and can utilize the support of staff members who have experienced their own mental health issues and lead lives of recovery called peers.
“This is not the RPF that we needed in Connecticut,” said Jordan Fairchild, coordinator and community organizer for the Keep the Promise Coalition, a coalition of mental health organizations that began following Connecticut’s closure of mental health institutions. “The whole purpose of peer respite is that it’s voluntary and community based and what we’re seeing in this RFP is that it’s making many requirements that are overly prescriptive and really conflict with the national models around peer respite.”
According to the RFP by DMHAS, the peer respite house would house six clients and be always staffed by at least two employees. Under the terms, total funding of $500,000 per year would be supplied for a three-year contract through the federal government’s Safer Communities Mental Health Block Grant.
Fairchild says the most obvious concern is that the proposed site would be located at Southeast Mental Health Authority, making it appear and feel like a clinical setting rather than a community setting, which may cause potential visitors to associate the respite house with more typical inpatient psychiatric stays.
Additionally, the respite house would not be allowed to take individuals just released from inpatient psychiatric care or emergency departments, which Fairchild says is a time of heightened risk for suicide attempts.
In a May 2, 2023, letter to DMHAS Commissioner Nancy Navaretta, the Keep the Promise Coalition expressed their concerns over the RFP, including its location at a predetermined site, a minimal requirement for experience in peer support services, and an unclear policy regarding referrals by clinicians or law enforcement.
“We hope that DMHAS will consider putting forward a less prescriptive RFP which allows peer respite staff and clients the ability and flexibility to independently set goals and shape their respite stay in a useful, contextually, and culturally appropriate manner,” the letter concludes.
It was not the only disapproving letter DHMAS received in response to the RFP. The Wildflower Alliance, which runs Afiya House in Northampton, Massachusetts, also registered their concerns, particularly after their executive director Sera Davidow helped author a 67-page document for DMHAS to help support the development of a peer-run respite. Additionally, DMHAS held two town hall meetings in 2022 with mental health stakeholders regarding a peer-run respite house.
“I ask that you reconsider for the sake of all people struggling now and who would benefit from a peer respite in Connecticut,” Davidow wrote in a letter to Navaretta, which was shared with CII via email. “The RFP that was released does not describe a peer respite. It describes a clinical crisis stabilization unit that integrates peer support. To proceed with it as is would be a profound example of co-optation, and will be received the peer support community as a demonstration of the lack of value the state sees in their work.”
Davidow included additional concerns including clients having to share rooms, and funding and staffing requirements that would mean “unsustainably low payrates,” for workers who would staff the house 24 hours a day, seven days a week.
Naveretta responded, thanking Davidow for her input but saying, “I’m sure you understand that I cannot comment as we are in active procurement and the rules are very strict.” Fairchild says she received a similar response.
But the lackluster response from the mental health community, particularly those like Keep the Promise and the Wildflower Alliance who have actively pushed for a peer-run respite house in Connecticut for some time, may leave few in the peer space willing to bid on operating the house.
“As the peer advocacy community, we would really prefer that this is run by a peer-led organization but as it’s written now, the requirements it makes just seem incompatible with a lot of the peer organizations that we were hoping would respond to the RFP.”
“The way this RFP is written, it really makes me wonder whether there were any peers or members of the recovery community involved,” Fairchild said. “This seems to really conflict with a lot of the recommendations made by the peer community and other people in recovery, including recommendations that were made at two town halls regarding peer respite in 2022.”
The Connecticut legislature just last year passed a bevy of bills aimed at mental health in Connecticut following the pandemic which left many in dire need and hospitals overflowing with mental health admissions, but according to reports, some of those initiatives may face funding risks as the General Assembly and Gov. Ned Lamont iron out a new budget.
