It's Just a House. It's Also a Revolution.
In Western Massachusetts, Anemoni House is a first-of-its-kind LGBTQ-centered safe house, one that could model a way for many more.
portrait of Anemoni by Daeg Hamilton
by Sandy Ernest Allen
“This house is my baby,” said Ephraim Akiva, director of Anemoni House in Holyoke, Massachusetts, as he began the story of how the house came into being. Ephraim, who’s both trans and has been a patient in the traditional psychiatric system, is one of many such people who’ve helped create the house. It exists as an alternative to the traditional psychiatric system for queer people in need of respite.
For trans people there are entirely sane reasons we may fear interaction with the traditional psychiatric system. “I don’t know anybody who goes to a clinical setting who feels like it’s a good thing,” Ephraim said, “But when you’re trans that obviously that adds extra things, because they can take your medication away, they can strip search you, they could deadname you, stick you with somebody of the wrong gender as a roommate because they are segregating but still not recognizing who you are.”
Anemoni House was born out of this, during our bleak present, when trans healthcare and trans lives are under such relentless attack. “Our own community needs each other and we need to show up for each other,” Ephraim said. “We can’t count on the cis hets to show up for us. They’re not going to.”
The house opened its doors one year ago this April. As someone who’d long been interested in how trans and queer communities can endure these times, and in peer-driven alternatives to traditional mental health care, I was very curious to see what they’d created. A few months ago, I drove the couple of hours to Western Massachusetts to check out the house for myself.
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As a journalist, I’m no stranger to madness. It’s been my primary focus for over fifteen years. I’m also no stranger, these days, to being the person in question who needs this sort of care. A bottom line medical truth, however uncomfortable it is to face, is that anybody could go mad, at any time, regardless of their prior history, full stop. For some of us, given our histories, we just know it’s likelier we’ll wind up (again), in such a vulnerable place. Hence like many people, I’ve wondered a lot about what a more compassionate and humane mental health care system might consist of.
Let's say someone is experiencing psychiatric distress of whatever sort. Where are such people safe? Where will they actually find the help they need? In this country, individuals experiencing psychiatric emergencies — or their loved ones, or concerned bystanders — are typically left with one (often bad) option: Calling 9-1-1. For too many Americans, the “mental health care” that follows comes in the dangerous, even deadly, form of police, sheriffs, jail cells, even bullets.
At best, the authorities who are summoned to a psychiatric crisis have been trained in deescalation tactics and can funnel people into the psychiatric system — often starting in emergency rooms, which are under-funded, over-worked, and in general not designed for these sorts of emergencies. Our country has defunded public psychiatric hospitals for the last half-century, while funding more prisons and other detention settings. These days literal prisons and jails are now our nation’s largest mental health providers — something I unpacked in my first book.
An interaction with our contemporary status quo psychiatric system may involve a temporary hold. In Massachusetts, as in many states, this typically lasts 72 hours, during which time folks may be detained involuntarily even if they walked in a hospital’s front doors seeking help. Those inside can realize too late they’ve lost rights. They’re often stripped of basics like their cell phones, even their shoe laces. This experience can be traumatizing, amongst whatever else individuals might experience, from coercive medication to electroshock. After a brief stay, individuals are often released with a new prescription or several, but, depending especially on their means, little else in the way of ongoing support. Alternatives, like “peer respites” such as Anemoni, offer another way, especially for those who’ve tried what’s on offer traditionally and haven’t found it of help.
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Some basics: Anemoni House is just a house. It is just a house on an unassuming residential street in this smallish post-industrial city in Western Massachusetts’ Pioneer Valley. The house’s exact address is kept confidential. Those who want to come stay here fill out an online form. They aren’t made to show ID nor insurance information. They get a private room. Typical stays last two weeks. It’s all totally free to those who stay there.
I’ve found it can be a challenge to communicate to anyone who hasn’t paid attention to this niche question of what a better mental health care future could look like just how radical a space this is, how potentially exciting. On some level it might seem too simple.
Like many advocates who do this sort of work I’ve come to know through the years, the opinions Ephraim shares about the question of our status quo mental health system versus alternatives are nuanced. “I’ve taken pills at times in my life to get through hard times because I couldn’t feel the things I was feeling,” he said, “particularly in this sort of capitalist hellscape but that’s not going to make me want to live,” as he put it.
When I first arrived that day, the house’s assistant director Juniper Holt was out on the front porch, chatting and smoking a cigarette with someone staying there. I was led on a house tour by Ephraim along with another person who had just arrived.
Ephraim showed us: The living rooms, up and down, the kitchens, the bathrooms, the laundry facilities. In other words: All pretty standard house stuff. If you didn’t know otherwise and stumbled upon this scene, you wouldn’t guess “alternative to psychiatric hospital.” You’d maybe guess “queer commune” or something, as newcomers.
In recent decades, studies (particularly out of Europe), have supported the promise of such a model, a more person-centered “post-psychiatry” or “social psychiatry” model of mental health care. Research suggests this model has better outcomes for patients in a variety of senses. Alternatives like Anemoni House are slowly bringing this model based on connection and care to America. While it requires more genuine person-to-person connection, it actually costs less, per bed per night for the taxpayers, than a traditional psychiatric hospital stay.
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For nearly fourteen years, Ephraim has worked for the organization behind this house, the Wildflower Alliance (which I’ve written about previously). In particular, Ephraim spent years working for Wildflower’s original peer respite in Northampton, called Afiya.
About a decade ago now, I got to tour inside of Afiya itself. Ephraim describes Afiya, which offers free stays to people experiencing psychiatric distress, as “the gold standard of peer respites” (and I’d agree). At Afiya and at Wildflower’s various community centers throughout the region, those working there are people with “lived experience,” meaning experience with psychiatric distress, the psychiatric system, or both.
Years ago, Ephraim also co-founded Wildflower’s original LGBTQIA support group. The support group, Ephraim reflected, was “magical,” but it only lasted an hour and a half a week (these days on Zoom).
For context, in describing how this second, queer-focused house was conceived of, Ephraim first explained that these last years, he’s had a lot of surgeries. “I was on my way to one of these surgeries when I had this just random epiphany and I was like what if,” Ephraim recalled, “What if we took the idea of the group and we took the idea of Afiya and we meshed them. What if we specifically made a trans and queer peer respite.”
He began texting colleagues right away, as he was literally on his way into surgery, and they got to work. They envisioned a house both for queer and trans people wanting an alternative respite for psychiatric emergencies, as well as surgery recovery.
It took years to get the funding together (mostly through the state), and to find the house itself (one the Department of Mental Health already owned), and to get it all remodeled and actually opened.
“When it was just offered to us as a possibility, I came in here,” Ephraim said, “I was like, alright, well I guess it’s a house. It was dank in here, it was dismal, it was so dark.”
“Dank” and “dark” felt hard to believe as we sat chatting in the house’s bright and cheerful second floor living room — Ephraim, Juniper and I.
I was sinking into an enormous white-ish sofa Ephraim said they call “the marshmallow couch.” The walls were painted many shades of purple and pink and blue, and there were pink-to-blue ombre curtains on the windows. “I was so into the queer and trans sheers, they’re in every bedroom too,” Ephraim said about the curtains.
Artworks created by folks who’d stayed at the house covered the walls. An in-progress mural in the hallway featured mer-people of various genders and races and body sizes and abilities and so forth. The effect overall, as I observed aloud, was homey, very much the opposite of clinical. Ephraim said: “Everything in here was a very intentional decision and there was a lot of joy in that.”
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The people staying at Anemoni House aren’t given loads of protocols or rules. If they want to be left alone; they’re left alone. If they want company; there are staff available all day and night.
Anemoni is offered both to those needing mental health type stays (of two weeks duration, typically), and also others staying post surgery. Post-surgical stays can be booked in advance, for up to one month — again totally free of charge. Those working there can’t do medical things like change someone’s dressings — yet. They hope to hire a nurse if they can get the funding, Ephraim explained.
Of the five bedrooms for those staying here, the downstairs bedrooms have lifts, for post-surgical stays. “We’ve actually had three people who were recovering from surgery stay at a time previously,” Ephraim said, “which was kind of great because people were going through the same thing and they could kind of help each other.”
Surgery, as many trans readers will already know, is challenging, including psychologically. “It’s isolating, it’s depressing” Ephraim described, “All anyone ever thinks about is ‘Oh, trans surgery is joy!’ Except not when you’re having lots of complications, not when you’re treated like garbage in the medical system, not when you don’t have support at home, not when you have friends that you can’t talk to about this.”
Other houses for trans folks recovering from gender-affirming surgery do exist (there are some examples out West for example). And in general, a smattering of mental health-focused peer respites exist internationally and even in America. The novelty of Anemoni is in combining the two — supporting trans and queer people in this breadth of ways.
Too often our culture can misunderstand mental health and health as being different — and in this house the two are reunited under one roof, stripped of the shame and shunning that can come with needing and/or seeking psychiatric intervention especially.
“What we’re doing is nothing more than every marginalized community has done for ages,” Juniper said, “It’s mutual support in the grand scheme of things.”
This approach is about centering, remembering, our humanity: “It seems almost too simplistic that we do what we do and people can’t really understand it, but I also think that it’s incredibly hard for people to remember to be human beings,” Ephraim had observed, “We’re living in a time when everybody is so divided and hateful and unable to, like trans people are getting dehumanized. Folks who are immigrants, asylum seekers, they’re also getting dehumanized. To remember one’s humanity is really difficult in this time period, that is actually all we’re doing.”
Anemoni also employs a mobile support team, who operate in three counties. The house itself is available to anyone within the state of Massachusetts. Ephraim discussed how they’ve been lobbying and hope to soon see legislation passed to fund additional peer respites in every county across Massachusetts. This will hopefully include an additional queer support house, in the greater Boston area, and two BIPOC peer respites too, one for each side of the state.
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The bedroom doors all had keypad locks I noted, but this wasn’t so anyone could be locked inside (as in institutional psychiatric settings). Rather, this was for the privacy of those staying there; Juniper added they don’t even know the codes. Those working were dressed like regular people, I also noted, regular trans people I suppose — whatever that means (I did admire their fashion, their stylish glasses each, Ephraim’s hair dyed half black and half magenta).
As with all of Wildflower’s support offerings, the point is that they are just regular people. Their expertise stems from their ‘lived experience,’ from having been there, themselves. They have about fifteen people working there now, on a 24/7 hour rotation, meaning someone is always available to just be there.
Juniper described the approach this way: “I’m not here to put a ladder in the fox hole and tell you to walk up it or put a rope in and pull you out of the fox hole,” she said. “My job is to put that ladder, climb down in the fox hole and sit next to you.”
“What that looks like is somebody saying ‘I just need somebody to sit with me while I make a phone call.’ ‘I just need somebody to talk to.’ ‘I need somebody to listen to this music with me,’ ‘I need somebody to watch this TV show with me,’ ‘I need somebody to just be quiet with me,’ ‘Will you be with me while I’m eating?’, ‘Will you be with me while I’m cooking?” she said.
People staying here take a lot of walks. They sit on the porch and have a smoke and talk. A lot of the care is about that, just hanging out and talking. As Juniper said, “Our training centers around the conversations.”
Ultimately, the healing that happens at Anemoni is built on that person-to-person connection, not control. Love, not fear. “Having conversations like we have here, those are the things that actually make me want to live,” said Ephraim.
Perhaps especially for trans and queer people, sharing space with others like us in particular can be so affirming, even healing. “It is the affinity that makes such a big difference,” Juniper said. “I might not be quite as broken as I am if there had been a queer and peer respite in West Virginia,” she said, referring to where she’s from.
Sometimes, Juniper said, it can take newcomers a while to warm up to the premise here — they might stay in their room that first day or even week. Juniper recalled someone after the fact telling her, “‘I thought this was all bullshit but it was a place where I could have a room to myself and be what I needed to be,’” and then “‘in a couple days I realized it wasn’t and I realized it was okay to come out and talk to people and I realized it was okay to be vulnerable.’”
As Ephraim put it: “People are able to get here things that they’ll never get in a medical or mental health facility. If people need to scream, they can scream. If people need to cry, they can cry. They can talk about wanting to die.” He added: “I think that a lot of my job sometimes is just being with someone during maybe the worst moments of their life and just holding that with them.”
What if someone staying here is really out of control, I raised objections one might have, learning of this premise. Like, how is this safe?
Ephraim shared a story, from years ago: “Early into my career at Afiya, I had a night with someone where I thought they were going throw a chair out the window. It seemed obvious,” he said. “The person was just in a different reality than me and was really upset, rightfully so, and the person kept putting their hands on the chair and sort of debating its weight was my understanding. I was sitting on the couch.” In a situation like this, he said, you have to be really present; he couldn’t leave the person for even a moment. He contemplated what was happening.
“I had the thought what if the chair goes out the window?” he recalled thinking: “What will I do when the chair goes out the window? Because I think it’s going out the window. I was like, okay this room can shut off from the rest of the house so it won’t get super cold in here. It’s like 3 in the morning, I could call ‘on call’ in a few hours.” He therefore determined: “Okay, the chair going out the window is actually not the worst thing that can happen.” Eventually he observed to the person in question: You seem really sad. “The person just sat down and was like ‘I am really sad’ and just started crying and that was it, chair never went out the window.”
In some more typical institutional setting, no doubt, staff priority would have been getting this person away from this chair and this window, shutting this down. But a chair, a window — these are just things, Ephraim continued: “Things can be replaced. People can’t be replaced.”
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Anemoni is named in memory of someone he and others in their community knew, who was trans. “She was somebody who had stayed at Afiya and who came to our centers and had personal relationships to multiple of us,” Ephraim said; Afiya had been a place she had felt safe. “And at the start of the pandemic, when she couldn’t get into Afiya, she actually ended up killing herself.”
When they were opening the house named in Anemoni’s honor, they held a dedication, five years after her death. Her family even came. “Her mother spoke at it and said because she died during COVID they didn’t get to have a funeral and this felt like them being able to have that,” Ephraim recalled.
During a tour of the house on the day of the dedication, Ephraim said, “One of Anemoni’s dearest friends actually said to me, ‘Wow it feels like she’s here, now.’”
“It just feels really important to be able to have this with her name on it because I think it’s a pretty fucking tremendous legacy,” he added.
They have had 78 people stay with them so far — actually 79, Juniper corrected, accounting for the person who’d just arrived. The hours we sat talking, folks staying there would walk through the living room, some briefly saying hello to me (they’d evidently been told I’d be around). I asked if it usually felt so chill around here. “It’s usually pretty chill,” Ephraim affirmed.
I wondered aloud if the neighbors got what was going on here, if they were alright with it. Juniper said she’s the one who often winds up talking to neighbors, who in general, yes, know what this place is and are fine with it, even supportive. The neighborhood already has lots of trans people, they said.
But in general, nothing about this house nor its environs felt that special, would be my observation, overall . Given my years of reporting about the peer respite movement and other alternatives, this doesn’t surprise me either.
Nor do its creators want Anemoni to be ‘special.’ As Ephraim had put it, he didn’t want Anemoni House to be “the first trans queer respite in the world, only one!” he said. “I wanted it to just be a model that could be replicated, so that they could exist everywhere because they’re needed everywhere.”
But how do we do that, I wondered. What advice would they offer others seeking to replicate this in their own communities?
“Well first of all they should reach out because we would love to support them,” Ephraim replied, “I’ve done a lot of consulting with different states on peer respite.”
Wildflower has had delegations from other countries as well who’ve toured this house and Afiya — from Australia, from New Zealand, from South Korea, some came this March from Iceland. There are also precedents in history for having ‘a supportive house’ as mental health care — from the Soteria of the Bay Area back in the 1970s and the other such houses that have followed since.
‘Just’ supporting people recovering from even extreme psychiatric crisis with a house and other basics is simple but revolutionary. It’s novel but it’s also nothing new.
Ephraim’s main fear, he said, is of this house being so unique. How, in this era especially, it can all feel “tentative.”
“It’s one of those things that’s too good to be true,” he said, “You’re constantly waiting for the other shoe to drop.”
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The three of us were trans people in our late thirties and early forties. As we chatted, I discerned something else we had in common. “I’m somebody who feels like I want to die all the time, it’s just like a norm for me,” Ephraim had said at one point during our conversation. Juniper as well, had spoken of “my own ideations, my own suicidality, which is a near constant thing for me to be honest, some days are better than others.”
This is my normal as well, I mentioned eventually. How unusual it was, for me, to disclose this to people I’d just met while I’m doing my job. But here, on this couch, talking to them, in so many senses I felt entirely comfortable to bring my full self.
It can make such a difference, as Ephraim observed, “to have a space where you can just talk about it. ‘Hey yes I did try to kill myself and yes I do want to kill myself still and this is why.’”
Juniper described how she’s an “elder” to the many younger-than-her people she does support these days. “I still don’t like being called old or an elder but I’m you know, supporting people who are so much significantly younger than me,” she said. “I know I don’t have queer elders. So many of us don’t make it to our age.”
Being real: I’ve had a hard time of late as regards all this staying alive on earth business. My thoughts have been dark, given our country, given these times, given specifics I have going on in my life. Driving to Anemoni that day, crossing the Berkshires on I-90, a steep and treacherous stretch of interstate, I had thought about death, as I admit I am doing more often than I’d like lately.
My time at Anemoni, meeting these people, our conversation, seeing what they’ve begun — it did give me genuine hope. In my bones I feel how desperately I’d love to have safe houses for everyone everywhere, including in my own community, not only for others but for my future self, too, should I ever need it. I drove away feeling less alone.
Sandy Ernest Allen is an author, essayist and journalist whose work focuses on mental health and gender from a human rights perspective.