Special to the Philanthropy Journal

By Ruth Christopherson, Mindy Bernstein, Christen Gonzalez, Orlando Montes, Diana Figueroa

The Cost of Mental Illness in America

Approximately one in four Americans (61.5 million) experience mental illness in a given year, with one in seventeen (13.6 million) Americans experiencing a serious mental illness. The cost for mental illness in the United States is seen both in the direct cost of mental health services and treatment as well as the indirect cost of lost earnings and the public expenditure for disability supports. For individuals living with mental illness, gainful employment is something that reinstates hope and is often essential to the recovery process. Community run psych-social training programs are essential to supplement the lack of any state-run vocational training programs for citizens recovering from a mental illness. This is where Coyote TaskForce Inc. steps in.

What is Coyote TaskForce Inc.

Coyote TaskForce Inc. was started by a group of concerned Tucson stakeholders, community members experiencing mental illnesses, family members, advocates and mental-health workers. The organizational mission has been to provide vocational and pre-vocational services in a safe environment for adults recovering from serious mental illness who are enrolled in the State Indigent Behavioral Health Care system. Simultaneously, the organization strives to combat the prevalent societal stigma associated with mental illness by reintegrating individuals living with mental illness into the working population. One of Coyote TaskForce Inc.’s first acts as an agency was to bid for the contract to oversee Our Place Clubhouse. Despite being bid on by other highly respected providers, Coyote TaskForce Inc. won the bid to run the Clubhouse and appointed Mindy Bernstein as the program director on November 2^nd, 1992. Mindy has run the organization with diligence and compassion for the last twenty- three years.

Mindy Bernstein was the ideal candidate for this job as she has always had an interest in helping others. She comes with a family history of mental illness and is in recovery herself. When Mindy was just nine years old she made a vow that as an adult, she would work with special needs people. She did not know this vow would take her into the field of mental health recovery, but her education, background and ideals led her to the population that needed her the most. “When I started to work in the field back in 1986, things were really different. Nobody talked about trauma and my own illness was never part of my professional persona until I realized people feel safe when you open up your own heart’s story to them.” Having personally experienced living with mental illness, Mindy set out to improve the marginalized lives of the indigent mental health population and she got her chance to work with special individuals when she was appointed as the executive program director for Coyote Task Force’s Our Place Clubhouse.

Our Place Clubhouse: Finding a Community

The Clubhouse model originated in 1948 with the creation of Fountain House in New York City and is internationally recognized by The Substance Abuse and Mental Health Services Administration (SAMHSA) as a best-practice non-clinical program to empower and support individuals with serious mental illness in their recovery process. The model follows a unique set of standards focusing on an all-inclusive approach to recovery. Our Place Clubhouse, an Accredited Clubhouse Model, opened in May of 1989.

Our Place Clubhouse follows the international standards as Clubhouse clients, identified as members, work side-by-side with staff to complete tasks in the work-ordered day while simultaneously developing self-esteem, confidence, and friendships. Membership is completely voluntary and lasts a lifetime; any member at any time can go to the Clubhouse for support or meaningful activities. The Clubhouse gives members a sense of family and peers to interact, learn and work with. When speaking about the mission of the Clubhouse,  Bernstein states, “It’s a civil rights issue; I want to see equal opportunity rights for our Members to have access to employment services while recovering. The Clubhouse puts everyone on the same playing field. It’s a non-clinical model that truly allows for people’s self-esteem to improve as they find a community that believes in their abilities to recover.” All organizational decisions in the Clubhouse are made with full community consensus at program and community meetings, all members have a voice and are heard. The members of the Clubhouse are collectively able to work productively and have socially satisfying lives while recovering from mental illnesses.

The Clubhouse strives for equality in every aspect of its structure with members and staff working together throughout the work ordered day in five different units. Christen Gonzalez, Program Director, spoke on the culture of equality, “one of the most important aspects of the Clubhouse is that everything is voluntary and members can always come back and be welcomed, with no waiting lists or delays.” Each of the five units– Membership Services, Employment and Education, Re-Threads Thrift Store, the Clubhouse Cafe, and Resource and Advocacy Unit– offers different opportunities for members to utilize their personal strengths. Every task is available for any member to participate in, regardless of skill-level or experience. The organization provides structured unpaid work experiences in a safe environment where individuals can utilize their inherent talents and regain confidences as they work toward finding employment in the local Tucson workforce. When members express their desire to begin looking for work, the Clubhouse offers a variety of supported transitions into community-based employment. The agency works closely with local businesses, behavioral health agencies, families, friends and fellow advocates to create a network for people in recovery to be given equal work opportunities. At any time, members can engage with Our Place Clubhouse for work support to assist with acclimation to a new position while staying connected and continuing to manage their recoveries. Bringing individuals experiencing mental illness back into the community alternately acts to combat the prevalent stigma associated with mental illness through direct integration back into the community work-force.

Café 54: Interacting with the Community through Vocational Work Training

After securing a solid community organization at Our Place Clubhouse, Coyote TaskForce Inc. continued its mission of providing equal working opportunities to the mental health community by starting a peer-run restaurant, Café 54. They accomplished this project by buying the building next to the Clubhouse with funding from Community Partnership of Southern Arizona (CPSA) and Rehabilitation Services Administration establishment grant. In 2004, Café 54 opened its doors as a restaurant where community members experiencing mental illness could find vocational training. Orlando Montes was appointed as the Program Manager for Café 54 in 2012, and was able to bring his own lived experiences with familial mental illness and fulfill a long-held dream of improving the lives of the indigent mental health community having grown up in a home with a single mother experiencing domestic violence and a diagnosis of schizophrenia. His earliest memories were of her standing in the doorway speaking to people that were not there, pacing the apartment for days with no sense of relief. “She really wanted to be present and emotionally available; she wanted to have some sense of worth as a mother and member of the Tucson community. I remember her longing to work and be part of making a life for us, regardless of her illness.” After coming to an understanding of his mother’s illness, Mr. Montes graduated from high school and immediately began working in the behavioral health field. He wanted to work with the marginalized mental health population to improve individuals’ sense of self-worth and give people equal work opportunities his mother never had.

The mission of Café 54 is three-fold; to assist citizens with mental illness in becoming tax-paying citizens, to provide the community with a pool of reliable employees who have had training and first-hand experience working in a real employment setting, and to reduce the stigma surrounding mental illness by shifting focus from disabilities to abilities. Individuals accepted into the program are afforded one-on-one on-the-job training in a variety of restaurant positions and job coaching. Each trainee in the program possesses varying levels of expertise and the Café’s goal is to work with individuals on building up old and new skills to help individuals regain lost confidences. A strategically limited number of staff members are employed as job coaches so that the success of the restaurant depends on the participation and success of the trainees. Individuals are expected to practice appropriate work ethics including arriving on time, maintaining a socially acceptable appearance and behaviors while working. Once a trainee becomes part of the team, work becomes a part of their daily recovery and the transformation from initial recalcitrance to confident professional can be astonishing. As stated by Mrs. Bernstein, “Café 54 truly believes in their trainees’ success and expects to see them succeed, it is truly amazing to watch the journey each trainee takes as they regain their self-assurance and independence.” Café 54 works daily to form an inter-connected community to help invest in the well-being and quality of life for individuals experiencing mental illness. When trainees are ready, the job developer works closely with each member to create a resume and career goals as individuals begin to reenter the larger Tucson working community as contributing tax-paying citizens. Every dollar that goes into training an individual is paid back to the state three-fold in tax money when the individual finds employment.

The Café 54 program works because it encourages individuals to engage in work based on their current skill-sets. In 2015 alone, Café 54 has seen a success rate of 46%, with eleven trainees successfully finding work in the community. One of those successes comes from Mary. Mary came to Café 54’s Work Adjustment Program in January of 2015 and spent a successful eight months recovering, working with job coaches, and regaining confidences. Upon her first arrival, Mary displayed low confidence levels, unsure she was even qualified to roll silverware into napkins for service. After she started working in the Café, Mary immediately began regaining some of her lost self-assurance as she proved herself as a valuable employee able to perform all necessary job duties successfully and proficiently. After a few months, Mary truly began to thrive at the Café, displaying new levels of confidence and assertiveness as she began recognizing her own needs and verbalizing those needs to staff. This new found confidence led her to speak with job coaches to solidify a future plan that included training to find a job in a field she had experience with and was passionate about; behavioral health. There has been a strong push in behavioral health recently to provide peer support as a best practice and Mary was determined to provide that support to her peers.

Truck 54: Entering the Community & Eliminating Stigma

While the majority of individuals recovering from mental illness want to work, only 1.7% of the population received supported employment services from the government in 2012. The lack of funding and support for employment programs is largely the result of the stigma mental illness still encounters on an individual and national level. Prevalent in today’s society is the view that mental illness is a threat, an attitude that fosters stigma and discrimination towards people with mental illnesses. To further fight against the mark of stigma, Coyote TaskForce Inc. decided to take the message and people of Café 54 to the streets of Tucson with the purchase and design of a food truck in August 2014 under the guidance of Diana Figueroa. Truck 54 dynamically engages with the Tucson community, exemplifying the public need for equal employment opportunities for all. Growing up, Diana watched her father suffer from military induced PTSD. This illness would lead to the displacement of her father’s job, home and ultimately the violent loss of his life. Since this tragedy, Diana’s personal and professional goal has been to take a message of hope and equal opportunities to the mental health community and homeless population of Tucson. She has embraced Coyote Task Force’s mission of equal work opportunities and has been actively reducing the stigma of mental illness as she works alongside trainees in the community.

Truck 54 successfully takes Café 54’s trainees out of the kitchen and into the community, advocating for the idea that individuals recovering from mental illnesses are valued members of society who should be treated with the respect afforded to other community members. Truck 54 simultaneously provides valuable training opportunities for the trainees of Café 54. Although the space is much smaller than a regular kitchen, trainees and job coaches work together on the truck whenever there is a scheduled community event where Truck 54 has been retained. The truck arrives at the scheduled site, sets up its mobile kitchen and eating areas, serves fresh food to customers and promotes both Café 54 and Our Place Clubhouse in the process. Trainees learn to interact with people outside of the Café’s secure environment as they proudly represent and educate community members about the training process. The response has been phenomenal and the community has rallied around the truck, booking weekly events. Each time the truck goes out it helps reduce stigma, replacing it with hope and equal work opportunities for the indigent mental health population throughout the city of Tucson.

The Future of the Coyote Task Force Programs

Going forward, Coyote TaskForce Inc. would like to continue developing the innovative training programs they have modeled throughout Arizona and expand their own organization to include a housing program and a handmade paper mill. This would be achieved by accumulating the right staff members for the cause and appropriating the correct amount of funding for expansion. Unfortunately, a changeover in the payer source from the Department of Behavioral Health Services (DBHS) to the Arizona Health Care Cost Containment System (AHCCCS) has resulted in a sudden and sharp decline in State funding dollars for the Coyote TaskForce Inc. programs. As a result, Coyote TaskForce Inc. is moving towards finding additional funding sources including Vocational Rehabilitation Federal Dollars and new private funding sources. The organization is now dependent on finding funding sources outside of the government to keep their important programs running. While Our Place Clubhouse, Café 54 and Truck 54 continue to function, they are currently in urgent need of support and have been seeking it through a community-wide fundraising campaign. Coyote TaskForce Inc. hopes that a yearly campaign will help balance out the loss of Medicaid dollars and help keep its mission of equal work opportunities alive and autonomous.

The support and motivation offered to trainees and members in the Coyote TaskForce Inc. programs has led individuals to make an unprecedented commitment to the program as trainees continue working in spite of a decline in state funding prospects. The work opportunities provided to the members of Café 54 are so important to their recovery process that the trainees continue to support the program in the face of this adversity. Mindy spoke with the members of Our Place Clubhouse and the trainees of Café 54, “It is truly inspiring to witness, you are the reason we are here fighting stigma and finding hope in daily experiences. It is with that same hope and love that I say people recovering from serious mental illness can achieve so much more for themselves and for their community if given the right tools and encouragement; our people prove that every single day.” Living and working with mental illness can often be a challenging and isolating experience. The Coyote Task Force programs help to reduce the State’s cost for mental health treatment and forms a community for individuals recovering from serious mental illnesses to live and experience equal work opportunities while reducing the stigma surrounding these inspiring individuals.

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Coyote TaskForce Inc. is a 501(3)(c) nonprofit that has been using employment to fight the stigma of mental illness and reinstate hope in the lives of Tucson Arizona’s citizens recovering from mental illnesses for the past 23 years. Mindy Bernstein is the Executive Director of Coyote Taskforce and has run the organization for 23 years.