From the Desk of Susan Coyle, RN, MPH, CEO of Chartiers Center
Early in my career as a case manager at UPMC, I began to notice a pattern that has stayed with me.
Individuals with mental health challenges would be discharged from the state hospitals with hope and determination, ready to rebuild their lives. While they did leave with a place to go, too often, the placement didn’t fully support long-term recovery or other fundamentals that most adults expect. Housing options were frequently limited and highly structured, which made it difficult for people to build the independence and confidence needed to live on their own terms.
At the time, providers were deeply committed, but our approach to community integration was still evolving. Over time, we have learned—largely from the people we serve—that recovery is not just about stability in a clinical sense, but about having a stable, self-directed life.
That understanding continues to shape how we think about systems of care and how to do things differently at Chartiers Center, including the creation of our Janus program.
Janus flips the traditional model. It is a voluntary approach that prioritizes securing stable housing before focusing on clinical recovery. Since its inception in 2023, Janus has received nearly 250 referrals, with 76.5% of participants being successfully housed prior to discharge.
At the heart of Janus is a commitment to dignity and autonomy. Participants choose where they live and the communities they join—just as any of us would. That choice is foundational, as recovery is not something that happens to people. It is something they build for themselves, with the right supports in place.
And those supports must extend beyond clinical care.
Recovery happens in more places than clinical settings with therapists and providers. Recovery happens in the everyday moments that many of us take for granted: grocery shopping, managing a budget, maintaining a home, building relationships with neighbors, and finding meaningful work. Today, nearly 29% of current Janus participants are actively employed across a variety of industries, an outcome that speaks to renewed purpose and connection.
The name “Janus” comes from the Roman god of transitions—of doorways, beginnings, and endings. For the people we support, housing represents far more than shelter. It is a turning point where stability takes root, and a new chapter can begin.
Transforming mental health outcomes requires a fundamental shift in how we design our systems of care. Stable housing is the foundation that makes recovery achievable and sustainable.
And when we get that right, everything else becomes possible.
