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Thursday, June 17, 2010
Friday, April 9, 2010
Book Review: Mental Health, Naturally
Mental Health, Naturally is a book written by an M.D., and is part of what I would call "soft" mental health treatment. It deals with the issues that families run into with their kids, and it is medically oriented.
On the other hand, the author is familiar with a lot of nutritional and life style approaches to mental illness and what we would call "recovery". If you can get past the warm and fuzzy language and the medical view of mental health, there is a wealth of information, tips, and techniques that could be useful for anyone working on their recovery.
Reading through this book reminded me of my experiences with Orthomolecular Psychiatry in the 70's and the way OP affected the substance abuse community and people with severe mental illness. When I get the time, I'll post some of those stories.
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/
On the other hand, the author is familiar with a lot of nutritional and life style approaches to mental illness and what we would call "recovery". If you can get past the warm and fuzzy language and the medical view of mental health, there is a wealth of information, tips, and techniques that could be useful for anyone working on their recovery.
Reading through this book reminded me of my experiences with Orthomolecular Psychiatry in the 70's and the way OP affected the substance abuse community and people with severe mental illness. When I get the time, I'll post some of those stories.
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/
Saturday, April 3, 2010
Firewalkers
"Firewalkers: madness, beauty & mystery" is a book of recovery journeys developed by VOCAL, a recovery community non-profit. The power of the book lies in the inclusion of solid descriptions of "emotional turbulence and altered states; visionary melt-downs and spiritual breakthroughs; ecstatic visions and crazy blessings", as the back cover describes them.
Each of the seven stories is as different and unique as you would expect. They reflect the real experiences and journeys of their authors, the good, the bad, the ugly, and the lessons. They also reveal the great risks they underwent.
The book is rounded out with questions about the authors experiences and their views on stigma and the truth they have learned from their mental experiences.
The openness about mental experiences and the lessons they contain reminds me of the 60's and early 70's when there was a greater acceptance of unusual experiences. Unfortunately, at that time, recovery was only an individually discovered, and locally supported, notion without the exploding social network and community movement we have now.
Well worth purchasing, and well worth a read. And you'll be helping VOCAL in its recovery community work.
Paperback, $14.95
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/
Each of the seven stories is as different and unique as you would expect. They reflect the real experiences and journeys of their authors, the good, the bad, the ugly, and the lessons. They also reveal the great risks they underwent.
The book is rounded out with questions about the authors experiences and their views on stigma and the truth they have learned from their mental experiences.
The openness about mental experiences and the lessons they contain reminds me of the 60's and early 70's when there was a greater acceptance of unusual experiences. Unfortunately, at that time, recovery was only an individually discovered, and locally supported, notion without the exploding social network and community movement we have now.
Well worth purchasing, and well worth a read. And you'll be helping VOCAL in its recovery community work.
Paperback, $14.95
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/
Wednesday, March 31, 2010
Comments on Health Reform Goodies
Now that health reform has passed, what can we expect?
In the Near Term:
- In 90 days, a temporary high risk pool for people with pre-existing conditions. High risk pools only work for people with chronic conditions if the premiums are controlled. Otherwise, the premiums tend to drift up and make the pool not affordable.
- Parents can cover their kids up to age 26. I think, but am not sure, this adds a year and broadens already existing practice for some carriers.
- No more life time limits on dollars of coverage.
- Better coverage of preventive services
- Better monitoring of carrier use of funds, and better investigation of big rate increases
- Medicare Donut hole rebate for the near term, and elimination of the donut hole by 2020
- Expanded Medicare coverage for people exposed to an environmental emergencies
- Improved care coordination for people who receive both Medicare and Medicaid
- A 10% tax on tanning services(!)
A couple of other interesting things:
- Section 2402 and what follows seem to allow home and community based services in a waiver to easily use 300% of SSI as the income limit. This would broaden eligibility for waiver services in many waivers.
- An interesting project on shared medical decision making
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/
Monday, March 22, 2010
Recovery Council Six
Rich Casteels gave a report on the Michigan Recovery Center of Excellence. Many, many activities and information tools at http://www.mirecovery.org/
Rich reviewed web use data, as well. They have done a variety of online trainings. He also pointed out that their technology could be used by MRC and MDCH for any recovery related events.
Rich asked the Recovery Council to form a Steering Committee to guide the work of the Recovery Center.
Volunteers made their willingness known, and Marlene voluntold a couple of others.
Comments covered a wide variety of things. Northern Lakes channel on YouTube has a recent video work from NLCMH. Also, how do deal with cuts in services.
Meeting Adjourned.
Rich reviewed web use data, as well. They have done a variety of online trainings. He also pointed out that their technology could be used by MRC and MDCH for any recovery related events.
Rich asked the Recovery Council to form a Steering Committee to guide the work of the Recovery Center.
Volunteers made their willingness known, and Marlene voluntold a couple of others.
Comments covered a wide variety of things. Northern Lakes channel on YouTube has a recent video work from NLCMH. Also, how do deal with cuts in services.
Meeting Adjourned.
Recovery Council Part Five
The 4th Work group has set up a wiki at http://www.copower.org/milawswg/ to allow comments on laws and rules over the next few months.
The fifth work group focused on stigma, trauma, and health/wellness. Sara went over the ladder of meaningful involvement from consumers are manipulated to Consumer directs the Recovery Meeting.
The WG wants to gain an understanding of existing efforts, generate positive messages of recovery, and increase frequency of training.
Ideas include awareness campaign, prevention and early intervention, and how education credits work.
They have reviewed what is being done now. They have established some goals and next steps for each area. They are linking with other groups that focus on these same issues.
They will be requesting training proposals for trainings and trainers.
The fifth work group focused on stigma, trauma, and health/wellness. Sara went over the ladder of meaningful involvement from consumers are manipulated to Consumer directs the Recovery Meeting.
The WG wants to gain an understanding of existing efforts, generate positive messages of recovery, and increase frequency of training.
Ideas include awareness campaign, prevention and early intervention, and how education credits work.
They have reviewed what is being done now. They have established some goals and next steps for each area. They are linking with other groups that focus on these same issues.
They will be requesting training proposals for trainings and trainers.
Recovery Council Part Four
The work groups are updating the Council on their progress and next steps. The first group found many, many policies on Recovery and will borrow freely from them. Pat Baker reviewed some longitudinal research that has shown how much more important the person's view of recovery is in reaching good outcomes. Planning must be driven by the person, and the role of other people in the mental health system is supporting that person driven framework internalized.
How well do we do recovery management planning in this light? Pat believes that we need a state initiative to improve system approach to this planning area.
The second group explored the possibility of a survey to agency staff about their recovery experience and its impact on recovery policy in their organization.
The third group is focusing on the ARR and how it is being implemented. They reviewed the meaning of Renewal and Re-commitment. They also went through the 11 sections of the ARR, and reviewed the principles embedded in them.
LUNCH TIME!!
How well do we do recovery management planning in this light? Pat believes that we need a state initiative to improve system approach to this planning area.
The second group explored the possibility of a survey to agency staff about their recovery experience and its impact on recovery policy in their organization.
The third group is focusing on the ARR and how it is being implemented. They reviewed the meaning of Renewal and Re-commitment. They also went through the 11 sections of the ARR, and reviewed the principles embedded in them.
LUNCH TIME!!
Recovery Council Part Three
Community Block Grant RFA process will be reviewed.All CMHs are eligible to apply, and Irene is hoping to get a proposal from every one. $70,000 per year for up to 2 years. Applications due in May.
Available to support recovery for people with severe mental illness and co-occurring disorders. They will require partnership with consumers in the application. Another focus will be barriers to Recovery. They expect concrete changes that include PCP and Recovery concepts, such as incorporating PSS in new places, expanding self determination opportunities, improving PCP processes, expanding opportunities for integrated employment, ARR goals attainment, and expanding community partnerships. bot GF and MA funds can be the target of self-determination control proposals. There are a lot of other suggestions and examples, as well as a format for the proposal narrative.
May 11 is the probable deadline. Will not require match or the usual sustainability (money) criteria for the proposals because of the problems with GF. However, they will look for policy change that is permanent and capability improvement that is permanent. Irene wants everyone to use this opportunity to improve their recovery agenda.
Irene asked for volunteers to review proposals. There is enough money that each CMH can have a grant.
Available to support recovery for people with severe mental illness and co-occurring disorders. They will require partnership with consumers in the application. Another focus will be barriers to Recovery. They expect concrete changes that include PCP and Recovery concepts, such as incorporating PSS in new places, expanding self determination opportunities, improving PCP processes, expanding opportunities for integrated employment, ARR goals attainment, and expanding community partnerships. bot GF and MA funds can be the target of self-determination control proposals. There are a lot of other suggestions and examples, as well as a format for the proposal narrative.
May 11 is the probable deadline. Will not require match or the usual sustainability (money) criteria for the proposals because of the problems with GF. However, they will look for policy change that is permanent and capability improvement that is permanent. Irene wants everyone to use this opportunity to improve their recovery agenda.
Irene asked for volunteers to review proposals. There is enough money that each CMH can have a grant.
Recovery Council Two
Several great recovery stories. Mike head talked about the passage of the Health Care Reform bills. Expansion of Medicaid availability is one. Bad news is that the Senate cut 20% of General Fund dollars from the proposed budget. There is a hearing today in Detroit on the cut. There seems to be energy for finishing the budget early, but there has been no real effort to solve revenue issues. Caretaker relatives and 18-19 year olds have been removed from the Medicaid options. Small Board administration will likely go as well as CMH's are integrated into PIHPs. The physician tax will likely not go through. Stimulus will be extended into 2011, so that will help. PIHPs will be held accountable for assuring that each Medicaid beneficiary has the same expectation for services regardless of location. Mike has become at least a temporary Spartan fan.
Recovery Council One
We are at LCC West for the March Recovery Council Meeting. It appears there will be a large turnout. The work groups on Council Strategy will report on their progress, and we will review policy issues.
More later.
More later.
Tuesday, February 9, 2010
Jeff Guthrie: How Self-Determination has made a difference in my life
Jeff is presenting a slide show:
Jeff's interests include computers, video games, etc. Jeff has been received treatment for depression and chizo-effective disorder. He was the first person with MI to use self-determination under a pilot program using his PCP.
He talked to people he trusted, and found them to be very supportive of SD. He pulled his circle and an independent facilitator. It was a powerful experience. A core was the understanding of how much money was being spent, and the possibilities if those funds were re-directed.
Jeff's goals: move out on his own and get a job. He has done both of them. He hired a staff person to support his goals, especially menu planning, food shopping and cooking. He is very proud of himself.
Jeff has learned that networking is a useful tool, and spoke about his desire for a job during a presentation. He got two job offers on the same day and accepted both! He has met lots of people through his work.
His shyness has dropped away, opening up other doors. He believes that taking risk is necessary to truly experience life.
Jeff believes that SD means focusing on what you like to do and what you want to do.
Jeff is a leader in Michigan Partners for Freedom.
Jeff's interests include computers, video games, etc. Jeff has been received treatment for depression and chizo-effective disorder. He was the first person with MI to use self-determination under a pilot program using his PCP.
He talked to people he trusted, and found them to be very supportive of SD. He pulled his circle and an independent facilitator. It was a powerful experience. A core was the understanding of how much money was being spent, and the possibilities if those funds were re-directed.
Jeff's goals: move out on his own and get a job. He has done both of them. He hired a staff person to support his goals, especially menu planning, food shopping and cooking. He is very proud of himself.
Jeff has learned that networking is a useful tool, and spoke about his desire for a job during a presentation. He got two job offers on the same day and accepted both! He has met lots of people through his work.
His shyness has dropped away, opening up other doors. He believes that taking risk is necessary to truly experience life.
Jeff believes that SD means focusing on what you like to do and what you want to do.
Jeff is a leader in Michigan Partners for Freedom.
Possibilities
More community options; academic and vocational training; assistance with accessible transportation and vehicle purchase; how we talk about purpose and SD; Co-payment systems; eliminate spend down; flexible and coordinated crisis support; a real crisis plan; financial crisis planning; Use b3's for people with MI; eliminate non-useful regulation and documentation requirements; more measures on outcomes, and less on docs; one stop for supports; cross system supports management; communication between DHS and CMH; social security needs to be a strength based system; eliminate redundancy in applications for supports; making communications from systems easy to understand; alignedservice systems;
Barriers to SD
Funding, # of people supported; substance abuse, caseloads; learned helplessness, people don't think in SD terms, resistance to change, no consensus on medical necessity definition, how b3 services are interpreted,
President's New Freedom Report
The 10 Fundamental Components of Recovery:
1. Empowerment
2. Holistic
3. Non-Linear
4. Strengths Based
5. Respect
6. Responsibility
7. Individualized and Person Centered
8. Self-Direction
9. Peer Support
10. Hope
1. Empowerment
2. Holistic
3. Non-Linear
4. Strengths Based
5. Respect
6. Responsibility
7. Individualized and Person Centered
8. Self-Direction
9. Peer Support
10. Hope
Amount, Scope, and Duration
Medicaid don't pay if you don't record this information accurately, in order to generate a documented encounter code.
Is there a more transparent, shorter, easier way to generate this necessary documentation?
Good plans are about your life, about the person, a map of outcomes, based on strengths, changing and evolving, and developed in more than one hour.
PCPC is a process, not a document, not a meeting, etc.
The more empowered the peer is in creating the PCP, the better the outcomes will be.
For our community, Self-determination is a journey of healing and transformation based on a foundation of recovery.
Is there a more transparent, shorter, easier way to generate this necessary documentation?
Good plans are about your life, about the person, a map of outcomes, based on strengths, changing and evolving, and developed in more than one hour.
PCPC is a process, not a document, not a meeting, etc.
The more empowered the peer is in creating the PCP, the better the outcomes will be.
For our community, Self-determination is a journey of healing and transformation based on a foundation of recovery.
Self Determination for Peers
I'm at a workshop to discuss self-determination for peers in Michigan's mental health system. We have discussed barriers and ways to promote SD, and Pam Werner is now reviewing the history of attempts to get SD to work in our community.
She has mentioned paperwork, and failure to implement as the two biggest problems. She is focusing on the Person centered plan as being subordinate to the ultimate goal of "getting a life"
The ultimate question is "What is my dream"?
Look at Community Inclusion, Participation, Independence and Productivity.
She has mentioned paperwork, and failure to implement as the two biggest problems. She is focusing on the Person centered plan as being subordinate to the ultimate goal of "getting a life"
The ultimate question is "What is my dream"?
Look at Community Inclusion, Participation, Independence and Productivity.
RCSD Final: Next Steps
Because we broke into work groups for the final effort around priorities, I'll wait to post on the outcomes of the strategy planning for the minutes and other documents. But the results were pretty good. More later on this, and I'll be reporting from a Self-Determination Workshop focused on peers today!
Monday, February 8, 2010
RCSD7: Aftermath
We have settled on 6 priorities, and have finished coming up with some initial steps for one of the priorities. We just finished a good lunch and are regrouping for the rest of our planning. The objective we have finished is the "Statewide" Recovery Policy".
RCSD6: Top Priorities
We are rating the priorities from last meeting and coming up with an initiating activity for each. More later
RCSD5: More Vision
Respect is the way you tell whether the system is transforming; Every part of the system needs to be flooded with recovery; it needs to be seen everywhere.
We need an operational model of recovery to impact the system as an infrastructure; Boards need to be immersed in recovery;
We need an operational model of recovery to impact the system as an infrastructure; Boards need to be immersed in recovery;
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