What It's Like Serving "the Least of These" at San Diego's Top Mental Hospital

Tiffany Mead, AMFT, joined Integrity Counseling Group at the beginning of the year. Prior to joining our practice, Tiffany was an intern therapist at Sharp Mesa Vista Hospital, which has a reputation as one of the best mental health facilities in San Diego.

We asked Tiffany to share a little bit about her experience as an intern therapist at Sharp Mesa Vista. It’s such a unique setting with a range of mental health services and has more than prepared her for the challenges of working with clients at Integrity Counseling Group.

Tiffany is a graduate of San Diego Christian College and Point Loma Nazarene University. We’re thrilled to have her on board. She works with teens, individuals, and couples who are dealing with depression, anxiety, and trauma.

Q: Working in a mental hospital has to be one of the most challenging jobs a therapist can take. Why did you choose to do your internship there?

A: I heard about all their amazing learning opportunities when I heard one of their site leads speak at a job fair at Point Loma Nazarene University, where I went to graduate school. They explained that I would be working with some of the best therapists in San Diego and get experience with a variety of patients.

Q: What positions did you hold at Sharp Mesa Vista Hospital?

A: I worked mostly in their thought disorder program, which provides services to people with disorders like schizophrenia and schizoaffective disorder.

A lot of therapists don’t want to work in this program, because they assume thought disorders are the hardest to treat. I am always advocating for the “outcast” or the people no one else wants to work with. Once my patients were on medication and had gained some self awareness, their authentic, sweet selves were able to come out. Sometimes things got out of hand, but I learned quickly how to diffuse those situations.

Our program was outpatient, which means the patients lived offsite, usually in assisted living facilities around San Diego, but came to Sharp Mesa Vista during the day for treatment. I taught mindfulness and cognitive behavioral therapy (CBT), a type of therapy that is also widely used for anxiety and mood disorders. I also led group therapy with up to 15 people at a time.

Q: What was a typical day like at the hospital?

A: A typical day consisted of a morning huddle with all of our therapists, nurses, and social workers. Then I would lead my first “check-in” group and see how everyone was doing. The first group is getting a feel for all the patients and checking in on them.

The second group is where I taught skills and coping strategies. I always had something CBT-related to teach, but the specifics depended on what the patients needed that day. I specifically remember them liking me teaching existential therapy and where it originated from. We also read articles about Dr. Viktor Frankl’s life, and then had great discussions about the purpose and meaning in life when in the midst of suffering, or when learning to cope with a chronic mental illness.

The last group of the day I always taught some form of mindfulness. Depending on the day, I would play a small video or audio clip that would explain a mindfulness technique and then we would try it out and talk about its benefits. Other days, I would have the group take a small walk with me around our parking lot or engage in some stretching while listening to music, and then we would have a discussion around the benefits of movement.

I would end my day by taking notes and planning for the next day.

Q: What was it like leading groups for the first time?

At first, leading and teaching in group sessions was so intimidating. I felt scared due to all of the stigmas I had about patients with schizophrenia. However, once I started seeing what they were like for myself and learning more about my patients as people, those stigmas broke. My faulty perspective needed to change before I could actually help. I wanted to be a group leader that not only held hope for these people, but also a group leader that believed my clients were capable of growing into better people, even while coping with a chronic illness.

Q: What was the hardest thing you experienced there?

A: The hardest thing I experienced while working there was when COVID-19 started happening. Many, if not all, of the patients came from assisted living facilities. To ensure everyone’s safety, we had to switch to telehealth. Unfortunately, technology can be a trigger for many individuals with schizophrenia, so some people weren’t able to continue treatment.

Q: How do you feel your internship prepared you for your current role at Integrity Counseling Group?

A: I feel like Sharp Mesa Vista prepared me to truly care for any and all people. Due to my experiences at the hospital, I feel like I am equipped with tools and a solid foundation that will allow me to make a difference in people’s lives going forward.

Q: What did you learn about yourself at Sharp Mesa Vista Hospital?

A: Other than evidenced-based modalities, skills, and tools, I learned that there definitely will be off days in this field. Our clients are far from perfect and neither are we “the professionals.” Not every session is going to be life changing, but every session is part of the life-changing process of therapy. I also learned that I care deeply about people and, though that is great, I have to establish boundaries around that as well. I am called to provide a safe space and carry their burdens during my time with them. Once that time is done, I have to surrender that space and their burdens because they are not mine to hold onto.

Q: How did being a Christian inform your work?

A: A lot of my patients identified as Christians, so the topic of Christianity came up quite a bit in groups. One of the things my patients always raved about to my supervisor was that I allowed them to bring all aspects of who they were into our group meetings. I never stopped them from speaking about their beliefs. However, I always stepped in if they started pushing them on other patients. I always allowed my actions to speak for me without being overbearing or “preachy.”

I also think my faith is what makes me concerned about serving “the least of these.” People with mental illness are definitely marginalized in our society, and it’s a part of my faith to make sure that they get the best care possible.

Q: What is one thing the healthcare system could do better to support people with mental illness.

A: I think medical doctors need to know when to refer someone with mental illness. Many treatments are not in the scope of an MD, PA, NP, etc. For example, just like it is not within my scope of practice to tell someone they have a broken arm or how to treat it, people outside the mental health field should think twice before giving someone a diagnosis and pills to take. People need to know they have different options in regards to treatment, and the healthcare field needs to validate mental health treatments.

Q: Why did you decide to transition to a private group practice?

I wanted to learn a different way to provide therapy. Providing therapy at a hospital is wonderful but it also has its weight and stressors. I wanted a change of pace and to learn and utilize different skills.

I heard about Integrity Counseling Group through one of my professors at Point Loma and connected with Cory through LinkedIn. Integrity Counseling Group appealed to me because of its focus on Christian counseling and the community it provides. I like that my colleagues are part of the same team, not just coworkers.

Want to find a great Christian counselor in San Diego? As you can tell, Tiffany is not only a skillful associate therapist, but also has a real heart for those suffering from mental illness. Tiffany is currently accepting new clients. To schedule an appointment with her, please contact our intake specialist at (760) 283-7000. Tiffany is supervised by Cory Anderson, LMFT.