Austen Riggs Center: Fostering Self-Direction through Understanding and Connection

Riggs was founded over a hundred years ago. It has had all that time to develop its treatment program. It's located in Stockbridge, Massachusetts in the Berkshire Hills, 2 hours west of Boston and 2 and 1/2 hours north of New York. It's located in a small, friendly town on Main Street. It's a community that our patients can get engaged in and be part of the town at the same time as they're carrying out the treatment.

So, what's unique about Riggs is us having the time and resources to slow down and really take the time to look at the root of people's troubles, not go for quick fixes, but instead to understand what kept people stuck and then also to take time to help them get better. And the system of step-down programs at Riggs in combination with four times a week individual psychotherapy with a doctor on our staff, is really set up to help somebody take that time and make those adaptations in an environment that is supportive and nurturing.

Many of our patients come to Riggs having been given a large number of medications. Medications are very helpful in reducing symptoms, but they have a meaning too. And sometimes patients rely on the drugs not for their biological effects, but for their meaning. And sometimes the excessive numbers of medications get in the way of their gaining perspective on their lives. We work with both sides of the patient's problem, both the biological side and the psychological side.

The Austen Riggs Center really looks at each individual to see if this would be a good fit. Commonly, we see patients with maybe co-occurring mood and personality disorders, perhaps a history of substance use, often in the form of self-medicating, you know, their mental health issues, but someone who's motivated for treatment, who has found that other treatments just really haven't been enough for them.

At Austen Riggs, when a patient is admitted, they are assigned to a nursing care coordinator who stays with them over the course of their treatment. So, the opportunity to get to know somebody and work with somebody over a long period of time, that's definitely a different experience as a nurse here at Austen Riggs.

All patients start at the Inn uh in the Inn Residential care with a 24-hour nursing available and all the supports there when the patients need it. When they are ready to move towards more independence, we have the outer programs where patients both work on living independently and also work on certain other tasks. And then when they're finally ready to move out of Riggs more into the community, we have Day Treatment Program and Aftercare. So they live off campus but still come to Riggs for services.

In our open setting where patients are free to come and go. No restrictions, no seclusion. Their safety is negotiated with us with their families. The patients take increasing authority for their lives and as they develop a language for what they've been struggling with, they can make coherent choices about their directions.

Riggs is really different in a lot of ways. One is the open setting. It's to be in treatment at a hospital and yet have the freedom to walk down the street and get an ice cream cone or go get dinner with a friend or um take a walk. And this is a I think a really radical difference from most locked units um which is where I was before Riggs. You can't tell who the doctors are and who the patients are, or who the nurses are and who the patients are. That sense of um we're all sort of in this togetherness is really different than at any other place I'd been to.

And many people ask us, how do we know that this kind of investment in our family member or in ourselves, how do we know that it's going to have an impact? So, we have done careful follow-along study to answer that question. It's an important question. We have to answer it. And what we found is that a massive percentage of our patients, maybe over 85% find an increase in resilience, an increase in reasons for living, and a significant decrease in suicidal ideation and decrease in emotional pain and anguish.

Because we have the ability to work with people over a long period of time, we see the ways that the treatment has ebbs and flows. And so, you know, I do see people get better, feel better, understand things about their troubles, what brought them here and find ways to tolerate sometimes what feels intolerable.

One thing that makes me excited about this place is the opportunity to slow down and do deep, transformative work. Another aspect of it is the community is really vibrant and that's both patients and staff.

At Riggs, we are serious about the fact that mental illness is pervasive in all of us. Some of us have worse trouble than others, but each of us deserves the respect that being part of the human condition gives. We write about the nature of our work. We publish it. We talk about it. We are carrying a mission of treating patients with respect. Helping patients take charge of their lives. helping patients emerge from the dangerous stigma that can be laid on psychiatric illness by all of us actually. But we learn from our patients to be able to convey that kind of respect and appreciation for the human struggles that we all grapple with.

(Note: No current patients or family members appear in this video. To protect privacy rights, these roles are portrayed by actors.)