Thursday, June 26, 2008

Peer Counseling, The Middle Days

I'm still digesting, so much.
I need to go through it all and shake it out, put it in order start to finish.
My life's been very heavy on the Stretch and light on the Stabilize in recent weeks.
Here's the next installment on the notes.



We got a guided tour of the Big Binder-- our full text for the week and a polar opposite in size to the little red book.

We also got a guide through the Mental Health system, its many acronyms, and the laws most relevant to us. I learned that our state law is the RCW Revised Code of Washington and that the commentary with all the specifics on how to make the RCW work is the WAC Washington Administrative Code, names and details I was horrified to realize I didn't know despite living here my whole adult life.

It slowly started to filter through to me how public-health oriented all this was, that my turf in the below-poverty arena-- Basic Health instead of Medicaid, minimum wage instead of SSI/Disability-- was too upscale for most of the programs and agencies. Which didn't offend me-- one has to start somewhere-- but I'm just flummoxed by the weeklong steady accumulation of evidence that the sharpest cutting edge of the whole mental health industry is the bottommost rung. So much so that one of our speakers who is in a position to know states with bald confidence that the mental health care available in Monroe State Prison is better treatment than at Washington State Hospital.

I don't really have a place to put that yet, mentally.

Whether you are on Medicaid or not you *have* to be treated for any life-threatening illness including severe mental illness.

For failures to give such treatment, nonconsenual treatment, breach of confidentiality, and other forms of abuse or neglect by mental health care providers,
tell these people:
King County Office of the Ombudsmen
Dave Black, Matthew Wilson, Rosea Adams
1-800-790-8049, 206-208-5329
ombuds.mhd@kingcounty.gov

The better part of the afternoon went to a remarkable woman who has been the parent of a consumer for years and has started using mental health services herself after the lateness crisis. Her focus with us was on honing the two unique kickass "power tools" of peer counselors:
sharing stories, and
spotting strengths.

On sharing stories: As I'd write later, I am a fact, not a theory. Right up to meeting a peer counselor, most consumers have gotten only opinions, predictions, theories about mental illness and recovery. The Peer Counselor is one living, breathing, truth of what recovery can look like. Sharing parts of our stories form a powerful reminder that what the consumer is going through now will, over the long run, just be one part of their story. My shorthand notes call this being a "Role Model for Hope and Wellness". Even beyond this, speaking to directly to someone who's actually had detailed similar experiences is huge for a consumer, because it may mark their first chance to feel understood.

Spotting strengths is where the experience of recovery really comes in. A peer counselor who has faced down existence as a battle, knows both how being mentally ill trashes one's perspective until one can't actually recognize one's one accomplishments and strengths and we also know how to spot, adapt, and harness those invisible strengths. You simply cannot train a mental health professional to do this with the acuity and understanding of a fellow consumer.

So we had exercises working on how much story told how was appropriate under different situations, because of course one never wants to go so far that the consumer feels overwhelmed rather than connected, and we had exercises on spotting strengths, which hurt like hell. Literally. Thought my hand was going to fall off from writing and did run out of paper on my sheet to note strengths as my partner told their story. Friggin' superhero, I am telling you. One of many among us, I later learned.

We started Day Two with collective definions of Hope and Empowerment. Here's a tip, if you ever want 24 people to define empowerment, don't ask them to define "empowerment". Ask them to define "to empower". Otherwise one ends up with a very muddled set of images, followed in our case, I'm sorry to say, by equally muddled exercises for the lack of a clear common understanding of what we were trying to do. Ultimately my touchstone became "empower is the true opposite of enable". The best anchor I walked away with was the simplest definition: to empower is to alert someone to the power they already have.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/
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Wednesday, June 25, 2008

Mental Health and Mortality

Per our last post, we reported that in Oregon one-third of people treated for mental health diagnosis die before age 50. If you add “co-occurring disorders”, 89 percent of people treated for both mental
illness and substance abuse die before age 50. These numbers are in line with but also in excess of the national data regarding mortality and mental health.

It’s important to note that the figures are based on people who are receiving treatment. It’s also key to point out that these mortality statistics are getting worse not better. Add to these findings the fact that the most significant factor involved in recovery from mental illness is the length of time one has received treatment; that is to say that the longer one receives treatment, the less likely they are to recover.

What conclusions can be drawn?

  1. Mental health treatment is possibly preventing people from getting well and
  2. Our advances in treatment (new drugs, etc.) are killing us faster and faster.

Is anybody listening? Not much, it would appear. In Oregon we are building a new state hospital system at a cost of half a billion dollars. Our mental health treatment centers and support agencies are stuck in a time warp, oblivious to the facts, ignorant of the potential for recovery and blindly pushing the drugs that are killing us at a rate unprecedented for any other major public health issue.

(Note on the incredibly simpleminded continued reliance on large public institutions: I am of the opinion that as long as we have a system that believes that “some people just have to kept in institutions”, we will have a system that incarcerates a large number of people in these settings. It is only when we say that “no one should be treated this way” that we will begin the to take meaningful steps toward an effective community approach to treatment and support. The state hospitals will continue to suck up the majority of the resources at the expense of real treatment, real recovery and real self-determination. The old arguments that we need these places because of “court mandated patients”, “public safety” and the less acknowledged factor of state employees’ unions who resist the shift to community agencies and settings are are all red herrings and scare tactics with no real value in the discussion. Between 1987 and 1999, with fits and starts, the state dismantled it’s large public institutions for people with developmental disabilities (Fairview Hospital and Training Center/ FHTC, the last and largest). The biggest factor in the process taking so long was the repeated arguments mentioned above. In the end, these all turned out to be empty threats that had no value other than their ability to slow things down. Meaningful, secure and recovery based supports can be engineered in the community. Oregon has already done it before. Some of you may say that their is no correlation or equivalence between these populations but that is also just a lie perpetrated by those who would hold back the future. Fairview held hundreds of individuals with mental illness, hundreds who were court-mandated and thousands of unionized staff. It was once a small city; It is now a field of weeds and grass. I was there. I worked at part-time Fairview in the 1970s and was involved throughout the process of it’s closure.)



Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Notes from the Recovery Front

from Gerald Butler:

6/13/2008

I recently came upon two consumers (I’ll call them James and Ralph) discussing the pros and cons of recovery. James was telling Ralph that (after 35 years in the system) he felt so much better about himself since getting into recovery. On the other hand, Ralph was saying that unless his doctor sat him down and told him do so, he felt recovery was a bad idea. Although we have made some great strides over the last few years, we still need to do more to assure that every one who needs it, has the opportunity to hear the message of hope and recovery. The system wide change needed for this to occur is happening on an individual, person by person basis. Consumers and administrators alike are beginning to see that when we work together, recovery is possible.

Helping to spread this message of hope is the sole purpose of the ‘Recovery Band’. We recently have had the privilege of playing such events as: The Michigan Association of Community Mental Health Board’s Spring Conference at the Hyatt, The Grosse Pointe War Memorial for Northeast Guidance Center, Synergy’s Award Ceremony at the Gem Theatre, and The International Self Determination Conference at the Marriott/Downtown Detroit. What a special honor it is for a consumer band to be asked to provide entertainment at such prestigious events. System transformation occurs when leaders of the system support us, while we work on making our dreams a reality.

Just when it seemed things could not get any better, on May 29th we played the CFAC Awards Ceremony. This was an event put on for consumers and before we played our first note, we were reminded of what the recovery band is all about, the Consumers. It was like coming home and playing for family. The 30th of May was the 3rd annual Empowerment Day/ Recovery is Possible celebration of recovery and it was by far the best. We must first apologize to those we had to turn away, and promise a bigger place (with room to dance) next year. Empowerment Day is an event put on by consumers for consumers, and short of paying the vendors; consumers did everything from designing the flyers and brochure to registration, contacting consumers and staff, ETC. all done by consumers.

As we move into a transformed system one thing is becoming obvious: consumers can do great things when we are allowed to. True transformation is not in the books as much as it in the minds and hearts of those who have made a personal commitment to recovery. This applies to consumers as well as administrators. We must no longer be seen as statistical numbers meant to make an organization look good on paper, but real human beings. Because we are human beings, roadblocks to recovery such as ‘Policy’ must become more flexible and geared toward the individual. When consumer efforts are no longer discouraged but instead are supported in the same manner as the Recovery Band has been supported, then we can say we have a transformed system. Our goal is to spread the message of recovery to as many people as possible

The Origin of Empowerment Day

A little over 3 years ago Darryl Cornwell (Consultant/Detroit East) asked me what I would do for consumers if I had my wish. I told him I would give consumers one day a year: a day free of worries, a day dedicated solely to them, not meant to make any organization look good. A day designed to celebrate how far they have come in recovery. Two days later I was sitting in front of Marylyn Snowden (Chief Executive Officer/ Detroit East) telling her of my dream, and she was saying she could make it happen. I left the meeting thinking ‘yeah right’. While planning the event, each time an issue arose I just knew deep down that I should not get my hopes up. But Ms Snowden would tell me to stop fretting, then she would make a call and suddenly, the sky was no longer falling. She believed in me more than I believed in myself. As everyone knows, the 1st Empowerment Day was huge success.

Last year we had Detroit Wayne County CMH Customer Service help us with the event. This year we arranged for the Peer Support Specialist Empowerment Committee to plan the event, and even I was surprised at how talented consumers can be when they are supported. The computer graphics in the flyers and the brochure, registration, contacting the consumers and staff, decorating the venue, locating, pricing, and selecting the vendors, the entertainment, the agenda, Keynote speech, even lunch was catered by a consumer. The Peer Support Empowerment Committee of Wayne County is proud to join other consumer directed programs across the Nation in being examples of what occurs when we take control of our destiny, and systems support us.

Gerald Butler

Neighborhood News: Detroit East’s “Summer Blast” is set for the 12th of July. This is an ideal event family event and the Recovery Band promises plenty of dance music. Speaking of dancing, consumers at one of the Clubhouses are working on holding an old fashioned dance like we used to have in high school. This is slated for sometime in the fall.



Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Tuesday, June 24, 2008

Update: Senate And House Reach Historic Agreement On Mental Health Parity

Work of the United States Senate, Credited to the US Senate Photo Studio.Image via Wikipedia

From the Depression and Bipolar Support Alliance Action Alert I received last night:

We are delighted to announce that the Senate and the House negotiators have reached a historic agreement on the Mental Health Parity compromise bill. Since early March, when the Senate passed its own version of the bill, S. 558, the House and Senate have been engaged in intense negotiations to reconcile differences between the two bills. (The House bill, H.R. 1424 - passed in early March).

Now the bill must go for one more, final vote in both chambers and then goes to the President for his signature.

You are all amazing! For many years, you have hung in there for the long haul - the mark of a true advocate. Now we need to rally once more so that the bill is passed quickly in the House and Senate.



Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/
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Thursday, June 5, 2008

June 13-16: NAMI National Convention In Orlando

Who: National Alliance on Mental Illness (NAMI) is the nation's largest grassroots mental health organization dedicated to improving the lives of individuals and families affected by mental illness.

When: June 13-16, 2008

Where: Rosen Centre Hotel
Orlando, FL

9840 International Drive
Orlando, Florida 32819
Phone: (407) 996-9840

Why: Get the latest news on scientific research, innovative mental health programs, problems in the healthcare system, and human interest stories. Cover veterans, children and multicultural issues and hopes for recovery for all people living with PTSD, depression, schizophrenia, bipolar disorder and other illnesses.

Full Schedule: http://www.nami.org/convention/program

Vip Speakers And Honorees

- Jane Pauley, TV journalist
- Thomas Insel, M.D., director, National Institute of Mental Health
- Nora Volkow, M.D., Ph.D., director, National Institute on Drug Abuse

Florida Speakers And Programs

Topics for state and local stories:


- Judge Steven Leifman, 11th Judicial Circuit, Miami-Dade County
- Judge Mark Speiser, 17th Judicial Circuit Court, Broward County
- Louis de la Parte, Department of Aging & Mental Health, Florida Mental Health Institute at the University of Southern Florida
- VA Sunshine Healthcare Network (VISN 8), Bay Pines
- Polytrauma Center, VA Medical Center, Tampa
- Florida Partners in Crisis, Orlando
- Florida Borderline Personality Disorder Organization, St. Petersburg
- GEO Care, Miami
- Treasure Coast Forensic Treatment Center, Indiantown
- South Florida Treatment and Evaluation Center, Miami
- Vincent House, Pinellas Park
- Aspire Behavioral Health, Inc., Osceola

Ask-The-Doctor Sessions On:

- Anxiety Disorders
- Bipolar Disorder
- Borderline Personality Disorder
- Depression
- Medications
- Mood Disorders Across the Lifespan
- PTSD
- Schizoaffective Disorder
- Schizophrenia
- Kids Get to Ask the Doctor

National Alliance on Mental Illness

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Sunday, June 1, 2008

Recovery as Art, Part Three

Artistic creation, regardless of type, uses incremental acts to support a whole (non-incremental) purpose. As each step is taken, the artist reviews how well the current pattern fits into the intuited pattern.

Life is like that. We build ourselves through individual actions, constantly learning, and comparing ourselves with our goals.

Recovery is also a journey of discovery, as we move toward a partially seen future. We make choices everyday, many times a day, and, to some extent, each choice either supports or undermines our journey of recovery.

We must keep recovery in mind, so that it can affect all those decisions to the extent the decisions either support or undermine our purpose.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/