As many librarians will tell you, helping people find the information they need—and especially information they didn’t even know they needed—is often the most satisfying part of their job. A less rewarding aspect can be interacting with the visitors a librarian may not be trained to help, such as people with serious mental health problems. In some cases, a librarian may need to escort a patron off the premises—an outcome no one wants that can leave the librarian feeling guilty, frustrated and burned out over time.
In an effort to address this long-standing problem, libraries are increasingly working to educate library staff and the public about ways to support people with mental health and substance use conditions.
“Libraries are now serving as community centers, as gathering places for people across neighborhoods, and not just a place for books,” says Kathryn Gardella, project manager for the Mental Health Initiative in California, a public library partnership supported by the Institute of Museum and Library Services. “Because of that shift, staff need to be better equipped to provide excellent service to all patrons.”
To meet this need, mental health professionals have started sharing their knowledge in the library setting through lectures for the public, training programs for library staff and sometimes by working directly with patrons who have mental health conditions. The Public Library Association, for example, formed the Social Worker Task Force to identify best practices for addressing the social service needs of library patrons.
“Momentum has definitely picked up in the last five years to find ways to help libraries support the increasing volume of patrons who are experiencing homelessness, substance use conditions and mental illness,” says the association’s president-elect, Michelle Jeske.
While progress has been made, libraries still need more mental health support—a ripe opportunity for psychologists’ expertise.
Training and outreach
San Diego public librarian Joseph Miesner is among those who’ve been trained in mental health first aid, thanks to the California Mental Health Initiative. Through the course, he learned about the prevalence and symptoms of mental illness and about de-escalation strategies. “It helped me understand that disruptive behavior is not a personal affront,” says Miesner, who has worked for the library system for 28 years. “My ability to assist people has improved immensely because I have a better understanding of mental illness, and I’m more empathetic.”
He tapped that training when he interacted with a distraught woman who was yelling in the library. Rather than asking her to leave, he sat down with her and said, “I can see that you are very upset. Is there anything I can help you with?” The woman cried as she shared that she had been robbed, that she did not trust the police and that she did not want medical assistance. “I just spent time listening to her, and eventually she gathered her belongings and walked away quietly,” he says.
Miesner and three other librarians also learned how to teach mental health first aid, and they have trained nearly 250 San Diego Public Library staff in the last three years.
While librarians like Miesner appreciate feeling more equipped to interact with patrons, library systems are also starting to work directly with personnel who have mental health training.
In New York City, social psychologist Wendy Viola, PhD, is evaluating the city’s new Spaces to Thrive program, a partnership between the New York Public Library and the mayor’s Office of ThriveNYC that aims to increase public access to mental health information and support. The program, which began in December in 13 branch libraries, includes mental health workshops for the public about suicide prevention, social-emotional learning, social stigma and the relationship between social media and mental health.
The libraries have also started offering training in how to use naloxone (Narcan) for opioid overdose reversal, and participants can take home Narcan kits. Each site also dedicates several shelves to autobiographical, nonfiction and fiction books about mental health. Viola, who is the director of research at ThriveNYC, will be collecting data about the number of attendees at workshops and resources distributed, including brochures about the city’s crisis helpline and the Narcan kits, to capture how people are using the library to understand mental health issues.
Social workers are also playing a critical role. In 2009, the San Francisco Public Library became the first public library system in the nation to hire a social worker. Now, dozens of libraries across the nation have social workers on staff.
“We build relationships with people and become a familiar face, so when patrons are ready for help, we can connect them with organizations that provide counseling, medical care, housing and other services,” says Leah Esguerra, LMFT, who works in the San Francisco Public Library system. Her team frequently encounters people who are sleeping, which is not allowed in the library system, and they ask these patrons if they are OK. “This question can open up a conversation,” she says.
One regular library patron who Esguerra assessed was a veteran who had worked as a nurse. She suffered from post-traumatic stress disorder and a degenerative health condition and had been experiencing homelessness for years. Esguerra met with the woman weekly to provide brief therapy, and after making a few calls, she was able to secure housing for the woman through a local organization. To date, Esguerra has helped find stable housing for more than 200 library patrons.
Beyond large cities
While innovative mental health programs in large, metropolitan libraries are attracting attention, a similar momentum is building in university and suburban library systems. Dawn Behrend, who worked as a full-time master’s-level therapist before becoming a librarian, started offering mental health training to her co-workers soon after she began working at the library at Lenoir-Rhyne University in Hickory, North Carolina. “When librarians on staff and at conferences heard about my psychological background, they wanted to know how to handle difficult patrons and practice self-care because their jobs had become so stressful,” she says.
Although the university librarians were not typically seeing patrons experiencing homelessness, they were unsure about how to deal with disruptive behaviors among some students who have autism spectrum disorder (ASD). So Behrend started teaching an online professional development course to educate librarians across the country on how ASD presents in children, adolescents and adults, and how to communicate with these individuals. Participants learn that pacing and making loud noises can be methods of self-regulation and that overly bright lighting can also be difficult for these patrons to manage.
“Librarians should review their existing facilities and make adjustments to suit the needs of patrons who are neurodiverse,” she says.
Behaviors related to anxiety, such as frustration and anger, are also common in a university library—especially when finals are approaching, Behrend says. She teaches staff how to express empathy and avoid power struggles with students by offering alternative materials, services or spaces to help them deal with their frustration.
At Avon Free Public Library in Avon, Connecticut, where 40% of the city’s population is age 50 or older, librarian Tina Panik decided to partner with the senior center to offer more education about mental health. Through funding from the National Network of Libraries and Medicine, the library offered a series of 16 programs on such topics as memory loss, depression and grief. The most popular session focused on how to deal with hoarding behaviors, and was presented by psychologist David Tolin, PhD, director of the Anxiety Disorders Center in Hartford, Connecticut. “Libraries are a great forum for the sharing of information,” Tolin says.
Nearly 400 people attended the sessions, with many participants talking openly about mental health issues. For Panik, the series confirmed the need in the community to create safe spaces to discuss struggles that can often remain hidden.
“We are trying to erase the stigma surrounding mental health,” Panik says. “Libraries and senior centers are trusted by the public, and we are showing that we are not afraid to talk about these issues.”
