Occupational Therapist Shares Joy of Watching Lives Change

Lila Nappi, OTR/L, an occupational therapist in the Department of Psychiatry at University of Maryland Medical Center, wrote a moving letter to her colleagues after the culmination of a project they had worked on for more than three years. Last November, 14 adults became the first graduating class of the Academy of Independent Living, a unique program developed by the Division of Community Psychiatry. To read more about the event, see the previous post, Life Lessons for Independent Living Within a Community.

Dear All,

I just wanted to take a moment to share a few thoughts I have had since the graduation.

This has been quite a pilgrimage we have been on and, given the season, I just wanted to thank each of you for the privilege.  It is days like 10/10/12 and 11/14/12  that make it possible for me to be very proud to work for an organization that supports programs that transform people’s lives, members, family and staff alike.

Consistently, I heard from members and staff that they took the risk of getting outside their comfort zone in one way or another and were all the better for it.  I am struck by how we have learned to lead by example from the top down.

One example of this is Jill pushing us all to dream big. And then having the audacity to set the example and invite Kay Jamison. (Editor’s note: refers to academy founder Jill RachBeisel, MD, and keynote speaker Kay Redfield Jamison, PhD) I hear through the grapevine she is sending the graduates an autographed signed copy of her book — simply a class act.

Not to mention her inspiration, which was palpable on Wednesday. I kept looking at our graduates wondering what they were thinking and feeling and so hoping this is a turning point in their lives. Again we all made the seemingly impossible, possible. I hope as a result you see the world a little differently. We did not let fear, obstacle or negativity stand in the way of our goals and as a result we met them with meaning and purpose for all of us.

I have worked very hard during my 25-year career to create joy at work but I have never known joy like this. And for that, I thank you. It is role fulfillment I could not have imagined.

Best wishes for a wonderful holiday season and look forward to seeing you in the new year.


Lila Nappi

Life Lessons for Independence Within a Community

By Anne Haddad

UMMC Publications Editor

A brass ensemble played “Pomp and Circumstance” as the 14 graduates proceeded up the aisle. Family and friends wiped away tears of joy. One graduate, Richard Turnage, 31, spotted his mother, Tangera Keene, and stopped just long enough for her to snap a picture.

The proud moment was the culmination of a unique community mental health program that Turnage and his fellow graduates completed – a nine-semester curriculum focused on the skills and experience they need to make the transition to independent living.

Bryan Baird, the student speaker at the graduation, reminded his fellow graduates of all they had done.

“We learned how to interview for a job,” he said. “We learned how to cook meals [and] how to open a bank account. We went to the library and took public transportation.”

“Most of these patients were very young at the onset of their illnesses, which include mood and cognitive disorders. That greatly interfered with daily life,” said Jill RachBeisel, MD, (pictured above, center) associate professor of psychiatry at the University of Maryland School of Medicine and director of community psychiatry at University of Maryland Medical Center.

“In their teen years, at a stage when most of us learn our social skills, they were just hanging on for dear life,” RachBeisel said. “We wanted to develop a holistic, structured program to teach these skills that the majority of adults take for granted.”

Reaching Stability, then Gaining Skills

Before members of the academy progressed to residential rehabilitation, mental health treatment had allowed them to achieve stability. But even with this stability, the patients still had gaps in their experience and knowledge that might thwart their attempts to land a job, rent an apartment, get along with their neighbors and bosses or even to emotionally navigate a large family get-together.

Keene said she sees a big improvement in her oldest son, Richard Turnage, who was in the academy’s first graduation class this year.

“He is much better with his cousins, nieces and nephews when we all get together now,” Keene said. “There’s a big difference.”

“I’ve learned to manage my anger,” Turnage said.

RachBeisel developed the Academy of Independent Living three years ago. The learning and living both happen within each of the 19 single-family homes UMMC owns or rents in West Baltimore neighborhoods. The homes are run by UMMC Community Psychiatry’s residential rehabilitation program, Harbor City Unlimited.

Presentations are made in a classroom setting, and students then go out into the community to practice what they have been taught, and in some cases, even rehearsed, such as ordering food in a restaurant.

A Real Graduation

In some respects, the first-ever commencement ceremony of the Academy of Independent Living felt like that of any school, which is what the graduates wanted. Most had never had the opportunity to wear a cap and gown. In their teen years, when they might have gone to the prom and finished high school, the struggle with severe psychiatric disorders consumed their emotional and physical energy.

Their keynote speaker, scholar Kay Redfield Jamison, PhD, (above, left) professor of psychiatry at Johns Hopkins University, is internationally known for her writings on managing life with severe mental illness.

The graduates wanted as much of the pomp and circumstance as they could get, starting with a formal dance a month before the graduation at the University of Maryland, Baltimore.

AIL Formal Dance

Stella’s Bridal Fashions and Value Village donated elegant gowns that retail for hundreds of dollars and Horton’s House of Tuxedos donated rental tuxedos or suits for the men. Elegant catered appetizers, cheeses, fruits and desserts were set on lovely tables. Everyone danced and celebrated. Staff noticed the students, in their formal attire, were standing taller and more poised than ever.

“Most programs have bits and pieces of this. But none that I know of is as comprehensive and organized as ours,” RachBeisel said. “Everyone would agree with the concept, but it is having the skill sets available in the staff to execute all of it. Our use of occupational therapists in the program has brought a skill set that can help train the existing staff to carry out this program moving forward.”

“Her collaborations with all staff have made it possible for members to participate in transformational opportunities for a population that is so frequently left in the shadows,” said Lila Nappi, OTR/L, director of occupational therapy in the Psychiatry Department.

In addition to teaching skills, the program allows the residents to develop relationships with neighbors and supports their transition back into the community. The academy embraces the mission of “recovery in mental health treatment,” RachBeisel said. Individuals learn to manage their illnesses so they can recover their lives.

Nappi and other occupational therapists such as Mark Karolkowski, OTR/L, and Chris Greseth, MS, OTR/L, (pictured below, on either side of Nappi) were among the staff who celebrated at the formal and at graduation. They were central to the development of the curriculum and training other staff to teach the students life skills to be able to live on their own, get and keep a job, and interact with coworkers and others. Read a letter Nappi wrote to her colleagues about the joy she felt watching the students graduate.