Focus Group: Safety, Violence Prevention, Therapy and Mental Health

• Participants:
• Noah Luken (WKA) (He / Him)
• Latonya Maley (She / They)
• Charity Tolliver (She / They)
• Sarah Daoud (They / Them)
• Phylon Moore (He / Him)
• Dawnisha Lott (They / Them)

Violence Prevention Overview

The violence prevention group (Charity)  keeps an eye on the drop-in users to ensure that people’s moods are well-regulated.   The ‘neighborhood’ for this group includes the drop-in space, the waiting rooms, and the therapy areas.  Charity’s office is next to Sarah’s in the existing building. There are 3 stages of the process:

1. 1) Addressing the crisis – someone who is unstable, about to hurt themselves or others – safety intervention
2. 2) Engaging in de-escalation processes crisis conversation – where are they, what do they need?, stabilizing, helping people with DCFS, other services, care planning, court dates
3. 3)  If a young person requests and is ready, arrange ongoing therapy with Behavioral Therapy Group (Sarah’s group)

Charity’s main ‘logjam’ is with people who need ‘peace’ rooms – a place to cool off after an argument, altercation, or other event.  Drop in can be too loud, too much.

“There’s too much going on in here, can I go somewhere?”

Peace Rooms

These should be located near the drop-off space, for young people who, for whatever reason, need a place where they can feel calm, quiet, and safe.  Assume design standards for a calm, sensory room – similar to one that might be therapeutic for someone on the autistic spectrum.  Acoustic isolation is important from the drop-in space, as well as from each other.  Staff will often accompany you people in this room – a flip down desk for writing, laptop, etc. would be helpful.. Rooms can hold more than one person (maybe 2 or 3), as long as everyone has enough space to feel comfortable.  Room needs to feel large enough that people do not feel like people are right next to them.  Feel welcoming. Natural light a priority, needs to be dimmable / shadeable for comfort levels. Could be more than one peace room (different light levels,)

Drop-In Space

• A major issue with violence is due to people being too close to each other – intruding in each other’s activities.

• In the ‘old’ drop-in space was large enough that there was room for multiple groups of people in one space – space for TV watching, game playing, relaxing, without being on top of each other.  When the TV is playing, anyone who talks is seen as disruptive.

Exterior windows into the Drop-In space are not beneficial.  Conflicts can arise when someone outside of the Drop-in space (or outside of the Broadway Youth Center) can see into the drop-in space and see someone with whom they have an issue..  This same issue applies to visibility from the trains / train platform on the south side of the proposed site.  Natural light should be prioritized, but individual privacy must be maintained.

Staff need multiple ways to see into / monitor activities in the drop off space.

Drop-in space could be on an upper floor.  There is not a requirement that it be on the main floor, though this allows easy access for emergency services, escalations, and removing / relocating people who are having health or other behavioral issues.  There could be upsides for having the drop-in space be its own floor, and being able to control access at stairs and elevators.  There are typically quite a few in-and-out trips (3 allowed per day) by drop-in users for smoke breaks, so rooftop, balcony access would be helpful.

Privacy

There needs to be a ‘Veil of ignorance’ between the waiting room and the drop-in space, and between the drop-in space and therapy and medical spaces – people need privacy once they enter the drop-in space, and once they go from drop-in space to therapy / care areas.  Once someone enters these spaces, staff does not report who or where that person is to other young people.  This is due to HIPAA regulations but is also in place for the safety of the young people.  At times. this policy has been used to enable people in abusive relationships to extricate themselves.

Behavioral Therapy

Therapy group (Sarah) is currently a team of 1, and will end up being a team of 3, possibly larger.  Currently in a 60 SF ‘therapy’ room that doubles as Sarah’s office. Not a lot of technology in therapy rooms – discussions are often without technology, with write-up on a laptop being later, at a different location.

Therapy sees people from several main ‘sources’:

1. 1) People identified and coming from the drop in space.  This could be part of a de-escalation process or just through discussion and connection with the 
2. 2) People coming from BYC medical services – a patient identifies an issue and the medical team suggests behavioral therapy and the patient agrees.
3. 3) ‘Cold calls’ – people who see the services identified on the website and come in directly from waiting room.
4. 4) ..and also other medical and therapy partnerships, Edvoke, other staff members

Therapy sesssions can vary in time, but assume 30-40 minutes average.

Preference is for therapists to come and see patients in medical in the exam room – not transport them to a different therapy room – this can be difficult from a logistical standpoint.

1 on 1 Spaces

1 on 1 spaces need to be larger than shown – more often than not include either children or a friend or partner who accompanies the patient. 

1 on 1 spaces need to be spread out throughout the facility – need an office and/or a 1 on 1 room on the main floor (adjacent to the drop-in) and some on the medical exam room floors.  Therapy offices and spaces could be on middle or upper floors.

Trauma informed care should have natural lighting options.  Institutional ceiling grids and lighting feels stimulating, institutional, and potentially triggering.

Safety / ‘Front Vibes’

Phylon is stationed standing in the waiting room (there are 4 staffers at the waiting room desk, so no additional room), and is in charge of the front of the building, keeping track of people, dealing with escalations, police, keeping tabs on the ‘vibes’ of the front of the house to de-escalate any issues that arise.. 

Need to think about routes for escalation – how emergency responders get in, and how young people can be moved to safety in escalation situations.

Phylon would like a portable ‘door buzzer’ that would allow him to see and buzz in people through the front door without having to be physically present there.

‘Back Vibes’

There is a staff member in charge of bringing drop-in young people to the washer / dryer, shower, and supply room, and then escorting them back to drop-in.

Shut downs

5 minute drill: during lockdown, escalation, police presence, everyone leaves via the back door.

Whole floor is shut down during escalations – how does that work for new building?

Morning Sequence

Drop in is from 9-3, but clinic is open later (until 7?) and therapy activities often go longer as well.  

Drop in is 15 people at 9am and then the capacity goes up at 11am because more staff arrive.  Breakfast is served to all, and people who aren’t in drop-in eat in the waiting room. Staffers will start taking names at 8:30AM or so, and then tell the other people to come back at 11. Young people who are turned away will often head to medical for treatment / care until 11am, when the capacities go up again.

After 3, young people are not allowed to be in the building unless in 1 on 1 or in programs, due to staffing. (lunch breaks ,etc)

Weekly Group programming 

Right now, there are 2 main activity rooms (drop in space, after 3 pm and meeting room / storage room, which is first come first served.)  The new building needs to include spaces for weekly cohort based progamming.. Peer advocate training is one of the activities in these rooms  Groups of young people (10-15) who are paid, get intensively trained, and work with staff in the space or out of the space. Current peer advocate training is for peer mediations (1 on 1) or circles (group based).

Coordinator / champion – when we do run it, where do we run these meetings?

There are also other meetings on monday – Therapy, Psychiatry, Medical

Huddle Spaces / Office Definitions

Offices:  the 3 person office is likely for administration

The 4 person office is likely for floating office interns

Huddle rooms are rotating staff offices. – 2 people per ‘huddle room’ 

Digital / Technology

Current system is Centricity(sp?) 

Medical is on laptops, and other caregivers are not; so don’t get emergency alerts quickly enough.  Much communication is through group chats, other informal means.

• An online system should be able to show staff to know where staffers are currently located, and to identify, in a non-triggering way, different types of alerts and emergencies. 
• Each room to have a screen that could display alerts rather than hearing a crash and running toward it.

Storage

Project should include many more full size lockers for young people – not enough, not nearly large enough.  Lockers used for daily storage, continuously for years.

Staff Lounge

 A place to unwind, relax.  Couches, a TV,  Adjacent to rooftop garden

Exterior Space / Rooftop garden

• Second inconspicuous ‘back door’ to fenced garden may be desirable for entrance as well as exits
• Firepit sometimes used for different ‘cleansing’ rites
• Outdoor space under the train tracks would be useful for smokers
• Barbeque?  Small athletic space for basketball?
• Bring your kids outside, they play in one area, you smoke in another.
• Rooftop garden for young people would be highly desirable
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• Utility

• The building does not have a dedicated trash / recycling pickup service – trash is bagged, stored, and then taken to Thorek.