[dropcap]I[/dropcap]n 2013, 35-year-old Ryann Hancock was busted for manufacturing methamphetamine. She lived in Dawson, Georgia, her life had been off track for some time, and she lost custody of her son after being charged with a felony.

Ryann Hancock
After a felony arrest for manufacturing methamphetamine and court-ordered substance-abuse treatment, Ryann Hancock ended up with a job offer at Aspire Behavioral Health in Southwest Georgia. Her peer counseling work is devoted to helping people overcome stigma and begin recovery.

That same year, 80 miles away in Thomasville, the 45-year-old Southwestern State Hospital was shut down by the state. It housed about 100 people, about half with serious developmental disabilities, and had a few beds for people in crisis – usually psychosis or substance abuse – who needed a few days of stabilization. But it was old, expensive to operate and a contradictory model to the state’s recent push to transition mental health and developmental disability services to communities per a 2010 agreement with the U.S. Department of Justice.

After Southwestern long-term residents were moved to group homes across the state, some of the hospital’s funding was reallocated to regional service providers for 24-hour a day crisis centers—like the 34-bed unit at Aspire Behavioral Health, the Albany-based agency that provides mental health and substance abuse services to eight southwest Georgia counties.

The windfall enabled Aspire to help patients who might once have been hospitalized, says director Kay Brooks, and to manage their needs in ways that favor prevention over institutionalization.

Brooks says successful community-based support relies heavily on people like Ryann Hancock, who is now a certified peer specialist at the agency she credits with saving her life.

Hancock works every day to give people the hope that took her thirty-five years to find. She leads detox groups and teaches newly hired staff how to interact with patients in crisis. She advocates at the state capitol and community board meetings. If there’s a recovery event anywhere in the state, she’s there.

“There used to be jails, institutions or death,” she said, “but now recovery happens.”
The criminal charges against Hancock were heard by the Pataula Judicial Circuit drug court, which supervised her substance abuse recovery and insisted she be treated for post-traumatic stress disorder resulting from childhood abuse. She got a job doing administrative work for a lawyer, who found her ability to relate to his clients highly effective. She fought hard to get her son back, and regained custody last year.

When Hancock was offered a job by Aspire, she initially assumed she wasn’t qualified because her past was such a mess. But then she thought about things from the client’s perspective.

“If I’m in a hole, I don’t need anybody else to tell me I’m down here, because I got myself here,” Hancock said. “I only need someone to show me the way out, and who better to show you the way out than somebody that’s been in that same hole?”

A lot has changed in the southwest corner of Georgia since the Thomasville hospital closed three years ago.

“Of course the volume of patients we see has increased,” said Brooks. The mix of patients is also different, with more patients in need of emergency intervention and more who need long-term help.

Georgia’s Department of Behavioral Health and Developmental Disabilities has previously partnered with regional agencies like Aspire to provide outpatient services for mental illness and substance abuse, but since 2013 the southwestern region has created three fixed crisis centers with inpatient beds and four crisis teams on wheels, as well as mobile case management squads. The centers are staffed by professionals who offer outpatient services as well.

Between Aspire’s beds and the Thomasville and Valdosta agencies’ 48 more, the sprawling 24-county region has more than doubled it’s capacity for behavioral health crisis beds from the former state hospital’s facility, and they’re easier to get to.

People are admitted because they need to be stabilized during a psychotic episode, for detox, and for a range of other purposes. The goal is to stabilize patients close to their home and family, in a location they can revisit for continued care. Each location also offers a few shorter-term temporary observation beds as well.

When a child or adult in a remote area poses a threat to themselves or others, specially trained staff speed to help in one of four well-equipped mobile units. The goal of the mobile units, says Brooks, is to intervene before hospitalization is necessary and to connect people with services that can help. Satellite locations are spread across the eight-county region, so most people don’t have far to go.

The closest public psychiatry hospital is in Columbus, but Brooks has sent only 22 patients there in the past two years.

Back when people in crisis were routinely committed to Southwestern State Hospital for short stays, they were discharged into communities where gaps in care meant they would almost inevitably have another crisis and boomerang back to the hospital.

“They could fall in a deep hole in between Thomasville and Albany without any follow-up care,” Brooks said.

Access to care is better now, Brooks says, but the fact is that poverty, addiction, and untreated health issues continue to plague southwest Georgia as they do other American communities.

“I don’t know a family who hasn’t been impacted by tragedy, mental health or substance abuse issues,” she said. Unfortunately, it’s hard for people to acknowledge these problems.

Hancock says that a big part of her peer counseling work is devoted to helping people overcome stigma and begin recovery.

“My skeletons didn’t just come out of the closet, they came out and did a Vegas show with a Rockettes line!” she said.

As shameful as it was to have her name trumpeted on the nightly news for weeks, the circus surrounding her arrest helped her move past the humiliation and start a new life.
“I don’t say I was arrested, I say I was rescued,” she said. “That day was the beginning of my life.”

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Erica Hensley is a Health & Medical Journalism graduate student at the University of Georgia. She specialized in reporting mental health and other health care stories that are often overlooked or oversimplified.

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