Can Radical Hospitality Change Our Mental Health System?
We are on the precipice of an important year. In 2020, a foundation will be laid for a new way forward in our Los Angeles County mental health system. Laying a foundation means starting afresh; building something new, not fixing the old. Imagine applying something as simple as a plumb line to guide our design. What if the plumb line of radical hospitality could transform the way in which we connect with our brothers and sisters who live with mental disorders in our community?
At the beginning of this year, as I stepped away from a job that consumed my every waking thought for over two decades, I had the good fortune to travel to Trieste, Italy to spend a month embedded in their remarkable mental health system. It was my intent to observe carefully what it was about their culture that contributed to such remarkable outcomes in the lives of their residents who are mentally ill. Trieste is recognized by the World Health Organization (WHO) as a global best practice for their commitment to caring for the whole person in a community environment. It is a pilgrimage site for many around the world who look for inspiration on how to do better back home.
I had a hunch entering into that experience that the secret sauce was hospitality, and I snagged that word – in Italian – for the blog I created to chronicle that experience and my continuing thoughts upon returning home. The English word “hospitality” which conjures up images of hotel franchises and backyard dinner parties does not do justice to the Italian concept of accoglienza which is expansive in its embrace of welcoming, safety, refuge and accommodation.
That said, in 2020, as we build out the details of the Hollywood mental health pilot, what if we asked this question: Does this move us closer to radical hospitality or away? Five steps closer will be an improvement. Five more steps, an achievement. Five more might signal a culture shift.
In technical design, the plumb line represents an imaginary line that runs straight to the center of the earth
So, some definitions to start. What is a plumb line? A plumb line is a simple tool, dating back to ancient times, which allows for construction of a structure that is centered and straight. It is a weight, suspended from a string, used as a vertical reference which is powered by gravity.
And why radical hospitality? Radical implies out of the ordinary, revolutionary, transformative.
I am not creating something new here. I am standing on the shoulders of many who have used this term as a basis for a spiritual way of life, or community building. Google “radical hospitality” and many books, blogs and even Benedictine wisdom will come to life.
Radical hospitality is not a hard concept to understand. We know it when we experience it. Deep down, we know it when we don’t do it or we don’t feel it. For me, that is quite often. I find all of this to be personally quite convicting and I do best when I can practice alongside others who will help to carry me.
Over 14 million references to radical hospitality. This is not a new concept.
In our American individualistic culture, it is arguably a hard concept to put into action. It is not our natural default, and in our institutional settings, there are actually laws and rules which preclude radical hospitality.
So, all the more reason to turn toward radical hospitality as our plumb line as we imagine a better way forward for our American mental health system, in the demonstration project that will be the Hollywood TRIESTE pilot. Instead of gravity as the grounding force, the plumb line will be grounded in our shared humanity. (This is the reason behind our hashtag #heartforward – a word first coined by Dr. Jonathan Sherin of the L.A. County Department of Mental Health.)
Our challenge will be to let this plumb line guide decisions about how people will feel welcomed into the community and the agencies, institutions, businesses and venues that serve them. Radical hospitality will require that we move toward a time when one might say:
I am seen.
I am heard.
I am not forgotten and left to drift through the system.
I am a person with worth and plans and purpose.
I am equal. My relationships with people who provide service are horizontal, not hierarchical.
I am part of the community.
I have a place to live where I feel safe.
Hospitality Originates at the Community Mental Health Center
What I have learned from my five travels to Trieste is that the “mother ship” of this remarkable system is the community mental health center. It is a welcoming place where radical hospitality is demonstrated. This is the 24/7 place of access and engagement for users of the system. It is defined by particular physical characteristics: it does not look like a clinical setting; it is accessible at street level. There is no security guard as the primary greeter. Waiting lists and delayed appointments are seen as impediments to service. Services are not limited to the center, as staff move freely through the community, engaging with users where they feel comfortable and responding to crises without involving law enforcement, when possible. Family members are welcome to meet with staff; to have their questions answered.
People will say to me, “why are we looking to Italy for inspiration?” My answer: Of course, we cannot replicate this brick by brick. Of course, American culture is different from Italian culture. But we are all people first. It is impossible to not be inspired by the human values that undergird their accoglienza approach. If we had a chance to design a mental health system in a community where all of us felt welcomed and safe and equal, what would it look like? In 2020, we have that chance.