Beyond the Bed: Care as Partnership 

When someone leaves a state hospital and returns to their community, recovery doesn’t pause — it often becomes more complicated. Housing, connection, medication, transportation, stigma, isolation — the real work of healing often begins outside the hospital walls. 

In this episode, we explore the question: What if discharge isn’t an endpoint — but a handoff? What if care doesn’t end at the hospital door, but expands into a community network designed to sustain recovery? Colleen Gallion, interim executive director of the National Alliance for Mental Illness Central Texas (NAMI), and Stacy Mendelson, PhD, chair of Friends of Austin State Hospital (ASH) , discuss how their organizations’ partnership is building a bridge between inpatient care and community life “beyond the bed.” 

Friends of ASH and NAMI Central Texas 

Friends of ASH, formerly known as the Volunteer Services Council, is a nonprofit organization dedicated to enhancing the quality of life of hospital patients and the staff who serve them. 

“We volunteer to help the inpatients of the hospital and also the staff,” says Stacy. “A lot of what the state provides is awesome –like therapy and medication. But there are a lot of programs that are outside of the state’s budget. So, Friends of ASH raises money to provide these different programs.” 

For example, the organization coordinates Family House, which offers low-cost overnight accommodations for up to four families of patients at the hospital and is available 24 hours a day, seven days a week. They also coordinate Pet Partners, a seven week, no cost training program that prepares dogs and their handlers for volunteer work in offering emotional support to patients.  

Serving Travis and Williamson counties, NAMI’s mission is to improve the lives of individuals and families affected by mental health conditions through education, support, and advocacy. They offer free programs and resources to anyone navigating mental health challenges, as well as those who love and support them. 

“We provide non-clinical support. That’s where our partnership with ASH comes in,” says Colleen. “If you have a loved one who is an inpatient, you would be welcome to join one of our family support groups where you’re going to be with other people who have loved ones who are on their own mental health journey. And in those support groups you’re going to find resources, you’re going to find support, you’re going to be able to be honest about your experience in ways that you really can’t be outside of that context.” 

Peer-to-Peer, a free eight-session program for adults with mental health conditions who are looking to better understand themselves and their recovery, is one educational offering. Another program, Family-to-Family, is designed to help family members be better advocates and change agents on behalf of a family member experiencing a mental health crisis, says Colleen. 

Sustaining Recovery Beyond the Bed 

While Friends of ASH and NAMI supplement the hospital’s clinical care with these valuable non-clinical programs, Stacy and Colleen recognize that gaps remain in the support available to patients and caregivers after inpatient care. Hoping to address those gaps, their work extends into advocacy for increasing services for individuals and caretakers during the transition back into community life. 

“The lack of a continuum of care is one of the biggest challenges that we see,” says Colleen. “And it’s where a lot of our advocacy energy goes.” 

Structured, intermediate services, or “step-down” services, that would benefit individuals as they transition from inpatient care to community living include supportive housing options and education for caregivers. 

“It would be great to have a “step-down” program,” says Stacy. “I’ve seen that when some patients are released, they might not have a supportive family to go to. They don’t have a good place to finish up their care.” 

Step-down services would go far in preventing relapses and reducing the likelihood that individuals cycle through a “revolving door” between emergency rooms or jail cells and institutional care, she says. 

Services for caregivers also play a vital role in stabilizing mental health after leaving the hospital. Without continued support, family members who take on the role of caregivers often face more than just overwhelming logistical challenges. 

“The biggest thing we see is the feeling of anger and frustration and, in some cases, despair at how difficult it is to get the basic level of support that they need or that their family members need, says Colleen. “We’re noticing that with the stress and the overwhelm and the challenges of living with someone who has a mental health issue, over time, those caregivers are starting to need their own mental health support.” 

Partnering in Advocacy 

As they work in tandem to provide services and resources that improve the health and well-being of inpatients, Friends of ASH and NAMI Central Texas will also continue to partner in advocating for programs that help sustain long-term recovery beyond the hospital. Representatives from the state-level NAMI organization will join them in a shared space onsite at the hospital. 

“We can all partner for advocacy when it comes to statewide legislation to help get the resources in the right places,” says Colleen. “And advocate to have a better safety net, whether it be after someone gets out of jail or after they get out of the hospital, to make sure individuals are getting the care they need to not end up back in jail or back in the hospital.” 

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