Human connection is essential to well-being. For people living with serious mental illness (SMI), connection to others, meaningful roles, and broader community life is especially vital. Yet many individuals with SMI lack the support, opportunities, and sense of belonging needed to feel safe, healthy, and valued, often leaving them feeling isolated and hopeless. Supporting people with psychiatric disabilities in building meaningful, fulfilling lives as equal members of their communities is an important next step for recovery-oriented mental health systems.

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Therapeutic communities offer a promising solution by providing safe, structured environments where residents and staff work, live, and socialize together. Established across the United States and internationally, therapeutic communities have demonstrated positive outcomes, including improved access to care, higher quality of life, fewer hospitalizations, and increased employment rates. At their core, these communities emphasize purposeful activities, meaningful relationships, and shared responsibility as essential components of recovery and well-being.

While Washington State's Health Care Authority recognizes the right of Adult Family Home residents to receive care that enhances or maintains their quality of life, there is limited guidance on how to achieve this in practice. Although many existing programs and housing options incorporate elements of therapeutic communities, there is currently no centralized approach to sharing knowledge, supporting implementation, or expanding these practices across the state.

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The Therapeutic Community ECHO Program is a first-of-its-kind initiative in Washington State designed to expand knowledge, strengthen collaboration, and build capacity for implementing therapeutic community values, principles, and practices for people living with SMI.

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Using the established ECHO model and its "All Teach, All Learn" philosophy, the program will create a collaborative learning environment where experts, peers, service providers, and community partners share knowledge, exchange practical solutions, and build local expertise.

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The program aims to:

• Foster cross-sector collaboration by bringing together housing providers, supported employment programs, Clubhouses, policymakers, community advocates, individuals with lived experience, families, and others interested in developing therapeutic communities or incorporating their principles into existing programs.

• Expand access to expertise and support, particularly in rural and underserved communities, by connecting staff and organizations with peers, resources, and effective approaches that can be adapted locally.

• Build local capacity through shared learning opportunities featuring therapeutic community experts from around the world, with an emphasis on practical implementation and sustainable practices.

• Address real-world challenges through collaborative discussion of individual and program-level cases related to establishing, operating, and sustaining therapeutic communities.

• Strengthen recovery-oriented systems by empowering local leaders to integrate therapeutic community principles into existing services, housing programs, and neighborhoods, improving individual outcomes and strengthening community mental health systems.

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By connecting people, sharing expertise, and supporting the implementation of therapeutic community practices, this initiative seeks to create more opportunities for individuals living with serious mental illness to experience meaningful relationships, purposeful lives, and a stronger sense of belonging within their communities.