The poor ask, who will care for us?


In the Sunday Milwaukee Journal Sentinel the front page story asks, are health systems failing a moral test? My question is simpler, who will care for the poor? I have worked in several levels of mental health including apartment programs, the crisis resource center, the mental hospital and case management, for more than 10 years.  And much has changed during that time. The most dramatic is the downsizing of the mental hospital which now sites half empty. At the same time resources have been shifted towards improving people’s access to resources in the community. There are more organizations dedicated to ensuring that people don’t need the things that inpatient care provides.

When I worked at the hospital, nursing staff morale was low because they saw where it was going. I saw former nurses at a recent listening session held by the Milwaukee Mental Health Board. It was hard not to feel some sympathy for them as they talked about the end of their careers while in their 50s and early 60s.

There are multiple sides to this story. There are tragic stories of people who died at the mental health complex. There are people who did not need to be housed in the long term care units who were assisted in transitioning into the community. There are some acutely ill people being turned away from the mental hospital because there are not enough beds and not enough staff to care for them.

The Milwaukee County Mental Health Complex has always served as the safety net for the sickest and poorest of our residents. The Milwaukee Journal Sentinel asks which of the profitable existing private hospitals will take it over and serve their patients. People who had no insurance always knew the the county was there for them. But those days are rapidly coming to a close. They asked the advocates what they hoped for but I don’t recall anyone asking the people who sometimes become too ill in the community what they would like to see.  If I was a poor person looking at these choices, I would be afraid. And the nights are still cold.

This American Life creates traffic

certified peer support coming to your mental health program
certified peer support coming to your mental health program

I have written about 2 stories featured om This American Life, one of my favorite public radio programs. It reaches more than 2 million people each week and its host is Ira Glass and produced by WEBZ public radio. It was the built on the simple power of storytelling and is able to look at several stories linked a them each week. The two stories that gripped my attention were about Adrian Schoolcraft, a former New York City police officer who exposed corruption within the ranks. A conspiracy caused by the use of technology to keep track of crime in our cities. The New York police were downgrading crimes to make it appear crime was less serious than it really was.

On Sunday I found a story about a school board in the New York City area that was taken over several years ago by a growing population of Hassidic Jews who did not attend the schools and were concerned that their property taxes had grown too high over the years. It was a gripping story, called A Not So Simple Majority. It combined elements of crime, democracy and seeking justice. I believe that in the end children’s education suffered and the social contact between communities was broken.

I would not have wanted to live in the shoes of Adrian Schoolcraft or the people in New York State whose schools are being slowly eroded by divisive tactics. This is my American life.

It’s not about shrinking the size of government, but shifting it

The US blundered into Iraq and Afghanistan ill-prepared for either war and stayed far beyond anyone had expected. We exhausted the troops and the capacity of the veterans services to assist the people who fought. Now we must pay the price. We outspend the world on our military and yet we have unacceptable waiting periods at the Veterans Administration to resolve claims for services. And beyond the claims there is a need to improve the facilities where veterans receive services. That will cost real money. Some of the states like Texas where fools are talking about secession are going to be the most in need for help.

Texas youth enter the military at a high rate, I I know this from hearing the names of the war dead. The fool who was defeated for president wanted to spend even more money on the military while simultaneously babbling about shrinking the size of government. Like Bill Clinton said, there was an arithmetic problem. I am hoping that we will be able to achieve real cuts in military spending back to the levels that existed when Clinton was in the White House.

At the same time we ought to return tax rates to the Clinton numbers. There has been a flood of money going into homeland security gadgets and maintaining an empire overseas that is just down the drain, as far as I am concerned. We’ve got to rebuild those levees in New Jersey. We have outdated infrastructure, schools that need to be down down and subways to be repaired. If we make America our priority we can do this without spilling any more innocent blood overseas.

Syria is not our fight. Assad is a horrible dictator but it’s not our job to remove him. I’d rather have a light rail system. Or shiny new facilities to assist brain injured veterans. It’s nation time in Newark, Buffalo, Toledo, Detroit and Milwaukee and the time is now.


Billing is how we get paid

I am growing in my professionalism and take great pride in the progress notes I write about the people I am assisting. But my latest focus is about something I touched on a few weeks ago. What made it possible for peer specialists to begin earning livable wages was the factor of billing for our services. So I want to make certain that I am billing as accurately and completely as possible. For those who want to do peer support without doing progress notes or billing, I won’t discourage you but I doubt that you can sustain yourself on that kind of strategy.

I paid very good attention in the documentation class that I took at Milwaukee Area Technical College. And I encourage my co-workers to read my notes and critique them. Part of the process of creating the notes involves estimating the amount of time we spend on each person. We work directly with people and on their behalf and we have to account for all of that time, otherwise we are doing ourselves a disservice.

As I am writing I am completely aware how very different I am from when I began my professional career as a librarian. I was a government employee and I could take work home and not be all that concerned with who was paying the bills. Suddenly, by chance I became involved in a grant proposal to help fund a program to improve our student retention. That was the beginning of my journey toward billing. And away from the ideology that had guided my early adulthood. That is probably why professionals rarely make good revolutionaries. We would have to develop a kind of split brain mentality separating our work lives from our political ones.

Having said that, the best way we can uphold our ideals of offering well funds peer support is by being as good with the numbers in our computers as we our in using our words with our peers. There is no shame at all in being able to pay the bills. In fact, the only shame would be in not making the effort because we were too afraid.


Punished for working

V.I.D.A. (Photo credit: Pensamentos Filmados)

This may seem like an oxymoron but often the best response to crippling mental illness is to work. When we were reviewing information about peer specialist programs, the things we saw about the impact of work  really jumped out at us. It turned out that one of the best things to do in recovery was to find or seek employment. I have a friend who got into the school system and began a career that offered her help when she needed it and has been able to survive the budget cuts that have eliminated positions at so many public schools. I used to go to meetings where the benefits that the school system offered its part-time employees were called “cadillacs.”

That is to say, there is no private sector equivalent to treating workers  with respect. Naturally, the first thing Scott Walker did was to attack those very benefits that help workers stay on their jobs.

So here I am years and even more than a decade after our divorce I am still thinking about mental illness and recovery from a woman who taught me more about either than any psychologist or psychiatrist I ever consulted.There is a stigma attached with mental illness at a time when there are more people than ever being diagnosed. And there are stories of those who are receiving benefits for mental health disability who are struggling and seeking employment finding their benefits eliminated or greatly reduced and facing hardship as a result.

Those of us who are working as peer specialists are facing hard times as prices for the things we need rise more than the benefits we receive. If you are poorly paid, food stamps can help you keep food on the table, but the cutoff point eliminates benefits for the near-poor in order to shelter billionaires from their fare share of the tax burden. And there is a wide gulf in between being assisted by what remains of the social safety net and the abyss into which we send people who are not deemed worthy of  our help under the current social welfare system.

Beware of receiving government assistance and working, especially because these agencies can turn around years later and claim that they did not know you were working. Send multiple copies of your proof of income and make them acknowledge receiving the documents. They may try to psych you out in the end.

Occupy Australia

If President Obama was playing basketball with the American people, the play by play might go something like this. “The President fakes left, ending Don’t Ask Don’t Tell.” Next he goes far right, ignoring the execution of Troy Davis. He dribbles between his legs, passes the ball to Leon Panetta who explains we could go back to Iraq if their leaders requested it.  Then as the Republican candidates makes assess of themselves,  the President dunks as he announces America is going to occupy Australia.

Yes 2500 troops will go to the land down under on a mission to supposedly watch Chinese naval movements. The President taps into that vast reservoir of funds and goodwill regained as the rich started paying their fair share of taxes to pay for another military occupation. Instead of taking my advice and realizing this is a hell of a long time to be occupying Asia,  the Big O goes deep and rushes to the aid of Australia, a small struggling third world country.

Actually, they’re a rather powerful and well developed nation.

The economy of Australia is a developed, modern market economy with a GDP of approximately US$1.23 trillion.[10] In 2011, it was the 13th largest national economy by nominal GDP[11] and the 17th largest measured by PPP adjusted GDP, representing about 1.7% of the World economy. Australia was also ranked the 19th largest importer and 19th largest exporter.

Australia is a member of the APEC, G20, OECD and WTO organisations. Australia has also entered into free trade agreements with ASEAN, Chile, New Zealand, Singapore, Thailand, and the United States.[12] The ANZCERTA agreement with New Zealand has greatly increased integration with the New Zealand economy and there are now plans to form an Australasian Single Economic Market by 2015.[13]

Sounds like a country that could afford to take care of itself. Ya think? Meanwhile, yes, I was kidding about that money from the rich, they’re placing bets on who to elect next November.

You might have noticed that at the same time President Obama declare that defending Australia was key to our national security, he re-assured China that we were not somehow tracking their naval expansion.  Our stores are filled with goods from China. The biggest beneficiary of the American “Black Friday” will undoubtedly be China as the consumer orgy floods our homes with more Chinese goods and services.

The Grand Game is on as bets are placed regarding the future of Social Security, Medicare and the  Health Care Law. Will the bloated US military escape the so-called draconian cuts scheduled to go  into effect if the Super Committee cannot find compromise?

Those of us on the left with our Occupy signs probably did not see President O’s latest right wing move coming. But we should have known that the moment the people start talking about occupy, the mis-leaders will  turn that into an opportunity to occupy another large landmass. Let’s Occupy the White  House.

Disappointed and outraged

Hillary Rodham Clinton (Wellesley College)
Image via Wikipedia

I graded President Obama an F for his performance last night. I was so outraged that I did not bother to watch. But I read about it. Today I am reading about how the Chairman of the Joint Chiefs of Staff considered it too risky to make even a half-hearted attempt at reducing the number of troops in Afghanistan. According to the President 2014 is the target date and even then there will probably be troops remaining in some other capacity. WTF? We’re going to have troops but we’ll call them something else? Maybe they will be ice cream vendors?

And what about our needs at home, as the nation’s mayors spoke of this week in urging that the money wasted on war be brought home? They were largely ignored. The president had to fend off the hawkish Secretary of State Hillary Clinton to make his modest reduction. We we still have more troops in Afghanistan than were in that hellhole when President Obama took office.

And yet, we’ve largely accomplished our mission? Go figure.