Jane Roberts was living in Hawaii, working full time as a scuba instructor. Barely on the cusp of her 30th birthday, she seemed to have the perfect life, yet there was a side to her most people didn't see.

"I had pretty much given up on life. I wouldn't say I was suicidal, but I didn't care if I lived or died. I was at my wit's end." She realized she needed to make significant changes in her life - namely, leaving her job, leaving the destructive romantic relationship in which she was mired, and leaving Hawaii. With the help of her mother, she spent three days packing up her belongings, including her car and two cats, and shipped them back to the mainland. Her new destination would be her family's hometown on the outskirts of Baltimore, where she would start over. Both of her parents encouraged her to look into a local treatment program called The Retreat by Sheppard Pratt, part of the Sheppard Pratt continuum of care, in the Baltimore suburb of Towson.

Out of the Darkness

After her intake and interview process, she believed she had found the right place to help her overcome her depression and rediscover her will to live.

At The Retreat, Roberts discovered a vibrant therapeutic community, where residents sought effective treatment for various mental health disorders or "failure to launch" syndrome. Like every resident, she found comfort in having her own devoted treatment team - including Thomas Franklin, MD, medical director of The Retreat, as her primary physician - to forge a path that would lead her out of the darkness.

“When I got there I was a walking zombie,” she remembers. “They paired me up with Dr. Franklin. He diagnosed me with depression and borderline personality disorder, and he changed my medication and got the dosage right. I was also in group psychodynamic therapy and meeting with doctors five days a week. I was there to change my behavior, and they taught me to think about life in a different way. I had been struggling with depression for most of my life, and this was the most effective treatment I’d ever received. I finally started feeling better by the end of that first week.”

Ready for a Life-like Environment

She had entered The Retreat on September 1, 2012, and by mid-October her team agreed she was ready to “step down” to Ruxton House, a transitional living space shared by a small group of residents in a beautiful neighborhood only a few minutes away from Sheppard Pratt’s main campus. Ruxton House provided a more intimate, home-like environment that more closely resembled everyday life, where she could benefit from extended care as she continued loosening depression’s grip. To ease her transition, the staff allowed her to add a few “personal touches” to the home, including a goldfish as a sort of surrogate for her two cats.

Every day she experienced the continuity of care for which Sheppard Pratt has become known. She maintained regular interaction with Dr. Franklin, among other specialists from The Retreat, and she continued her daily group therapy. She was particularly fond of dialectical behavior therapy (DBT), which is a specific form of cognitive behavioral therapy that emphasizes the psychosocial aspects of treatment. Through DBT, she learned effective ways to interact with others and form healthy relationships.

“These psychodynamic group meetings take place in an atmosphere of mutual support, respect and empathy,” says Miles Quaytman, MD, medical director of Ruxton House and associate medical director of The Retreat by Sheppard Pratt. “We cultivate a culture where people form critical bonds that tend to last long after they have returned home. Psychiatric illnesses, whatever their cause, limit a person’s capacity to relate to others and adversely affect their self-esteem.

“When the day comes that they are ready to take the next step and return home, it is remarkable how many residents reestablish their new residence near us,” he continues. “Even after they leave, residents can continue with whatever parts of the program they feel valuable. The wonderful thing about being part of Sheppard Pratt is that we have the resources of the entire health system right here. It’s a team effort, and it often requires more than one approach.”

Roberts participated in formal and informal social interactions, such as family-style dinners, and she also had the independence to pursue interests away from Ruxton House, such as spending time in nature. She found the increased freedom incredibly helpful, and she gained confidence knowing she had around-the-clock access to Ruxton House staff members, if needed. One of them was Lane Hicks, then a member of the direct care staff who has since become program manager for Ruxton House.

“At Ruxton House, everyone knows they are in a stage of treatment that is not going to last forever, and the treatment team presents a united front to make sure residents keep moving forward,” Hicks says. “There’s only one Ruxton House; it’s bright, airy and open, and it fosters this wonderful sense of community. It’s an amazing place.”

Re-entering the World

As part of the process of moving forward, Ruxton House residents must take practical and proactive steps to “reenter the world,” often with guidance from Ruxton House staff members. This includes fine-tuning résumés, seeking employment opportunities and scouting for housing options, as well as making connections for future mental health care once residents return home.

In Roberts’ case, she had spent four months at Ruxton House when her treatment team agreed she was ready to live on her own again. By that time, she had secured a new home and a job as a sales associate for a local sporting- goods retailer.

“In a lot of ways, stepping down from The Retreat to Ruxton House was hard for me,” she says. “You have the support of the staff, but you have to deal with more on your own, and it forces you to be accountable for your thoughts and feelings. They don’t want to keep you there; they want you to have a normal life. Dr. Franklin and other members of the team told me, ‘We’re still here for you. If you want to see us, just let us know.’”

For the past two years Roberts has been living independently in a house not far from the Sheppard Pratt campus. Now 32, she describes her depression as “very manageable,” and she’s in “a very healthy romantic relationship.” She exercises often—swimming, running, mountain biking, etc.—and has joined a number of Meetup.com groups. In addition to her job, she is scuba diving again, working as an instructor on a contract basis. Also, this summer she started working as a camp counselor for an outdoor learning center.

“I’m very thankful for my experience at The Retreat and Ruxton House,” she says. “It wasn’t a place that pats you on the back to try to make you feel better. At times I didn’t like that it was hard, but it was hard because the staff really wanted you to get better and work for it. I was very lucky to have the support I had at Ruxton House and The Retreat. They basically saved my life. I don’t know where I would be otherwise.”