This is part of our Better Baltimore series, which aims to use readers’ feedback and ideas to hold government agencies and powerful entities accountable. We’re also interested in stories about readers and communities driving change on their own. Have a tip? Tell us.
While in treatment for a substance use crisis, Steve Hall found comfort in writing rap lyrics.
One of these days/ I’mma fly away/ You feel like you want to die today/ Know that I’m the same/ It’s kinda strange/ That I don’t mind the pain/ Maybe I’m insane
The exercise came at the suggestion of Hall’s then-counselor, Sam Woldemichael, who recognized Hall’s gifts could be a part of his recovery. The more lyrics Hall wrote, the greater he felt an internal shift toward something that felt closer to peace, he said.
“He drilled me to keep creating, and at first I thought he was doing it for his own entertainment. But then what happened was, I started to be reminded of the spark I had,” Hall said. “And it reminded me of the power in me.”
More than a decade later, Hall, a musician who goes by the name Grey Smith, is the CEO of a new outpatient mental health treatment center in Howard County that combines elements of art therapy, group therapy and intensive outpatient therapy to help fill what he sees as a gap in the services provided in the Baltimore area. He hopes to help make mental health care more palatable and relatable to other artists, professionals and other creatives.
With the help of a staff that includes Woldemichael as clinical director, the organization has designed its own curriculum with an approach that the staff says serves as a supplement to the more spiritually focused 12-step programs.
The center, called Glass House, opened late last year and has grown to serve about 20 patients with complex mental health needs and drug and alcohol dependency. The facility is licensed to operate by the state’s behavioral health administration and accredited by the Joint Commission, a health care organization accreditor. Glass House also has a housing component so that people who are unhoused or who live out-of-town have a place to stay as they go through the programs.
“It’s a treatment center for creatives, and for people who are weird or smart,” said Sarah Kitlowski, who quit her executive job at a Florida biotech firm and moved back to Maryland last year to help found the organization. She is now Glass House’s chief development officer. “The idea is to be a comprehensive mental health facility that doesn’t feel like a punishment. We very much encourage the group tribe dynamic, where you learn to be of support and supportive to community.”
As part of our Better Baltimore series, which asks readers for feedback about what’s going well in the region and what stands to be improved, we looked into the efforts of Glass House, which seeks to create an alternative and de-stigmatized treatment environment for people with complex mental health needs. Hall and Kitlowski said they are building the facility they wished they had access to while undergoing their own treatment for substance use crises.
The two met on Facebook in 2020 and quickly developed a friendship over their shared experiences from the past. Hall pitched her on the idea of starting a new facility that distanced itself from what he refers to as “the antiquated, dogshit clinical approaches” in favor of edgier clinical content that resonates with a new generation of patients.
“I’m contending with all the chaos and all the madness in their head, and their phones,” said Hall. “We had to do something different; [overdose] fatalities keep going up. The drugs keep getting better but the treatment options don’t.”
The center’s work comes amid what behavioral health specialists, researchers and academics have billed as a mismatch in supply and demand for mental health care. Psychiatric hospital bed occupancy rose in Maryland during the coronavirus pandemic, according to state figures. And nationally, overdose deaths are up 15% from 2019, according to the 2021 accounting, after rising 30% in 2020.
In Maryland, the total number of accidental intoxication deaths from January to September of 2021 increased by about 3% compared to the same period the year before. The number of opioid-related deaths, fentanyl deaths and prescription opioid-related deaths in the same period rose by about 2%, 3% and 4%, respectively. Meanwhile, 2022 so far has seen fewer fatal overdoses than 2021 when accounting for all substances, according to state data, a decline of about 27%.
In Howard County, police spokesman Seth Hoffman said that as of Aug. 28 there have been 62 nonfatal overdoses and 13 overdose deaths, with an additional 12 suspected fatal overdoses awaiting autopsy results. In the same period a year ago, there were 99 nonfatal overdoses and 13 fatal overdoses.
Encouragingly, county deaths due to overdoses have declined by 50% compared to 2017, said Dr. Maura Rossman, health officer of the Howard County Health Department.
Rossman declined to comment on Glass House’s approach because she is not closely involved in its operations. But she said there is a need for inclusive programs that meet the needs of different populations.
“Five years ago, we didn’t really talk openly about substance abuse; we’ve come a long way. There’s more work to do, yes, but there’s more people talking about it,” said Rossman. “There are lots of people trying to access treatment, and we’ve struggled with inpatient as well as outpatient care, and over the last several years we’ve increased the number of providers and recovery housing.”
Glass House’s founders chose to locate in Ellicott City because they consider it central to much of the state’s population and detached from other busy urban areas. They see it as a supplement to programs like Alcoholics Anonymous or Narcotics Anonymous, which may not be right for everyone.
“We’re not here to change that or replace that,” Kitlowski said about 12-step programs. “If anything, we complement it.”
Dr. Neeraj Gandotra, chief medical officer at the Substance Abuse and Mental Health Services Administration, said it’s important to help people connect to treatment, which helps determine long-term success.
Certain populations may have different needs during treatment than others, Gandotra said. For example, pregnant people may need to be around other parents or have a child care component within the programming.
There’s also value, he said, to tailoring treatment programs to suit different “tribal communities,” which can help people stay engaged with the recovery process.
“There have been many programs, individuals and researchers that have looked at ways to modify treatment paradigms to fit different populations,” he said. “As long as their practices are grounded in evidence-based practices and verifiably strong and repeatable actions where they can get consistent results, that is considered the hallmark of a good program where they’re meeting patients where they’re at.”
At the same time, he said, there are risks associated with any treatment program, including financial risks as well as the risk of deviating too far from evidence-based practices. “Even though we would certainly encourage modification of existing programs, they have to remain firmly connected to the basic principles,” he said.
Kitlowski described the center’s curriculum as evidence-based in theory and practice, but with fresh takes on how the concepts are presented. For example, a session called “Lonely in a Crowded Room” deals with social anxiety and isolation; another called “Zombie Film in Reverse” asks patients to visualize how they could rebuild a more stabilized self. Patients often are asked to write, create or design something and share what they’ve produced with the rest of the group.
“We knew our curriculum would be different. We knew that the relationship between clinicians and clients would be different, and that we will be stepping out of the ivory-tower model,” said Kitlowski. “It never has the whole teacher-student, lecture-type vibe. We never do handouts. It’s always interactive.”
Glass House patients have varied backgrounds, Hall and Kitlowski said, but many are artists or young professionals. They are as young as 18 and as old as 65. The center currently runs an intensive outpatient program and a full-day partial hospitalization program, and accepts most forms of insurance as well as Maryland Medicaid.
Hall, a supervised certified alcohol and drug counselor, said while he and his colleagues have a special interest in understanding the creative mind, they are qualified to reach and serve anyone who walks through their doors.
Eventually, Hall and Kitlowski said, they hope to open additional centers to deepen their impact. They can’t accept all who apply, they said, signaling the dearth of options for comprehensive mental health care.
Few patients who have enrolled have left the program, they added, and many have returned even after completing their treatment programs to help mentor new patients.
One patient, Joe, a musician who asked to be identified by his first name to keep his mental health condition private, said Glass House’s encouragement of his talents has helped him stay the course. He said the staff are both kind and candid and don’t appear to be monetarily driven, unlike other treatment programs he’s gone through.
“They’ll be direct with you and your growth, whereas in other places they would kind of let you do your own thing and wouldn’t really call you out on your [bullshit],” he said. “This place is very real and they tell it how it is.”
For Kitlowski, experiences like Joe’s get to the heart of what the center hopes to accomplish.
“How do you build a spirit that you don’t want to escape from? How do we show people that they can fight through the dark?” said Kitlowski. “Methadone doesn’t teach you how to cope with the fact that your parents weren’t good at teaching you what healthy relationships look like. We go into intense subjects, and we’re always balanced out with creative inspiration, a lot of humor. You have to have humor. You need people to be able to be comfortable so that way they can move forward.”
Recovery from addiction is possible. For help, please call the free and confidential treatment referral hotline (1-800-662-HELP), or visit findtreatment.gov.