Editor’s note: Prior to publishing the editorial “Coming clean” on April 16 (see www.gaylesbiantimes.com/?id=14431), we offered Stepping Stone the opportunity to write a guest commentary. The following guest commentary is an unedited letter to the editor in response to our editorial, in which we refer to the April 1 suicide of Stepping Stone’s Enya House resident.

Publisher/Editor

Submitted to Gay Lesbian Times Monday, April 27, 2009 9:00 am

I am writing to inform your readers of the information which was shared with the Times prior to the publication of your recent editorial Coming clean, which was critical of Stepping Stone. When a Stepping Stone board member, the supervisor of Enya House and I met with Times staff prior to publication, we believed that it was important for you to have this information in order to arrive at a full understanding of the circumstances surrounding the recent suicide of the Enya House tenant. That you chose not to publish this information denies your readers the opportunity to arrive at their own conclusions about Stepping Stone’s response to this sad event.

The entire Stepping Stone family is saddened by the loss of this individual. Our staff makes heroic efforts on a daily basis to live up to our mission saving lives. Sometimes, despite our best efforts despair overtakes hope.

FACT #1: Enya House in an unstaffed, transitional housing facility where individuals well-established in their recovery live independently while preparing to re-enter society. It is regulated by a federal agency called Housing Opportunities for People with AIDS. It is not a treatment program and Stepping Stone is actually prohibited from providing services there by our facility use permit. Some residents of Enya House receive additional services from Stepping Stone, but the individual in question did not. The suicide did not occur at Enya House but at a hotel in Pt. Loma.

FACT #2: Prior to 9:00 pm on the evening of March 30, no Stepping Stone staff were aware that the tenant had ever expressed suicidal intent. Some of his friends had known for some time that he was possibly considering ending his life, but this information was never shared with a Stepping Stone staff.

FACT #3: When one of our staff did receive a telephone call that night alerting him to an overheard statement made by the resident that could be interpreted as “suicidal,” four different Stepping Stone Staff spent the next 2 hours making 16-20 telephone calls to try and find the individual to assess the situation. All of these calls to Enya House and the resident’s friends went unanswered. The next day one of our counseling staff talked with the individual who assured him that he was fine.

FACT #4: In the days following, we interviewed at least a dozen staff and residents to try and reconstruct the events leading up to and following the suicide. We received secondhand information, all of which pointed in the direction of a person who was intent of taking his life in a manner that was private and for the most part intended to spare his friends and caregivers prior knowledge of the event. The individual’s health had been deteriorating and there were reports that he had received very bad news about his prognosis on the 30th.

FACT #5: On the evening of the 30th, because of the secondhand report we initiated our comprehensive residential protocol to respond to clients who express suicidal ideation. The first principle of this set of procedures is not leave the person alone and then to assess the seriousness of the person’s intent before taking any actions that might result in breaching confidentiality or restricting the freedom of the individual.

FACT #6: Upon hearing of the client’s passing we had a counselor stationed at Enya House with backup from our psychologist to support residents in their grieving. We have also spent considerable staff time discussing this loss and what we can learn from this tragic situation.

Stepping Stone is able to provide services because our funders (foundations, city, county, state and federal agencies) monitor, measure and renew our contracts on a regular basis. We are subject to site visits, program and fiscal audits, and continuous oversight from a half dozen regulatory agencies. We consistently receive high marks for the quality of the services we deliver, which is why our contracts and grants are regularly renewed. As a person in long term recovery and an administrator of addiction treatment and recovery services for more than 30 years, I can say unequivocally that despite what the publisher and editor of your newspaper believe, Stepping Stone is one of the best, and keeps getting better.

Community members who wish to learn more about Stepping Stone or who have questions about our operations, are invited to contact me directly at (619- 278-0777 ext. 132 or johnd@steppingstonesd.org; 3969 4th Avenue, Suite 201, San Diego, CA 92013. John de Miranda, Ed.M.