Peer support in the community support programs

I am part of the new wave of peer support being offered in the community mental health programming in Milwaukee County. The county contracts with agencies who provide case management for clients to help them lead better more productive lives. the case managers provide advocacy, assistance in securing resources such as housing, food stamps, medications and help for their consumers. often numerous  physical problems. They meet with people sometimes on a daily basis depending on the severity of the difficulties and challenges facing consumers. Despite these efforts, we still find that a lot of people cycle in and out of crisis, showing up at various hospitals. Would it surprise anyone to learn that the individuals seeking help the most often are also the least likely to accept it? They may leave shortly after undergoing an extensive intake process The question of whether programs are resistant to consumers or consumers are  resistant to consumers seems like a kind of chicken and egg problem to which the only logical answer is yes and so what.

A more useful question might be, how well does this system promote recovery? And  how do we measure it? This is the model that we are using and which I have joined. As a peer specialist in housing I had very little clear  idea  of how case management operated. At the same time, the case managers had to be educated about our function. Now with this effort to integrate us into case management, it may become clearer how we are supposed to operate as a team.

It will be good to learn how Milwaukee County monitors our progress. I am wondering who else has been hired and at what agencies? In addition, what has been the experience of peer specialists working in community support programs across the country. I am interested in learning more about what is happening. Maybe some local oddball will respond to me.

After 15 months, it is becoming clearer what Milwaukee has decided that it wants peer support to become. One of our major tasks will be to help roll out Wellness Recovery Action Plans. Currently there are only 2 certified WRAP facilitators in the County. Years ago I did some WRAP training, but most of the people with whom I completed those WRAPs became peer specialists. It did not catch on throughout the mental health system. At the same time there were a few people who took the WRAP and ran with it. They went through the Mary Ellen Copeland Center which was expensive. Now we are supposed to be offering WRAP at the mental health complex and in a community linkage and support program. The next step will be expanding WRAP through the community support programs like mine. Consumers can become more anxious as they attempt to make changes in their lives, which results in hospitalization. They worry about losing their benefits, they fear that they are disappointing us and they become so afraid of mania that deep depression seems more comfortable.

As the mental health complex continues to downsize, the question remains, will these community supports be enough to hold up the hope for people? One idea of an innovative approach is to reconsider the way that we respond when someone reports hearing voices. Yesterday I watched a remarkable TED talk by Eleanor Longden “Why I Thank the Voices in My Head.” The talk has been viewed more than 500,000 times. I posted a link to it in a blog entry and I encouraged a co-worker to view yesterday. The next question we ought to be asking is, do you hear what I hear? There is a growing number of people in the hearing voices network and it would be exciting and challenging to create such a network in Milwaukee utilizing peer support specialists.

Another thing to consider is that not everyone can do everything. Some may be most comfortable doing WRAP plans. Fine, do WRAP. Some people prefer Emotional cpr, which I was certified in last year. I would not be appropriate for hearing voices because I don’t share that experience. Perhaps someone who does hear voices will view Eleanor Longden’s talk and be inspired.

 

What is the evidence on anti-psychotics

Earlier this week I wrote about an article I found in Mad In America about the use of anti-psychotics. Today I read summaries of important studies that looked at the outcomes of people using these medications compared to those who do not. The studies showed that outcomes of people who became long term users declined compared to those who never used them or weaned themselves off the medications. All of this continues to poke holes in the theory that people who have had experience of mental illness suffer from a kind of chemical imbalance in their brains that must be corrected.

If anything, the opposite of what is currently believed may be true. That is, powerful psychiatric medications may be creating chemical imbalances in brains that worsen over time. Falling in love, developing close friendships, living in a supportive environment and getting regular exercise are far healthier and enjoyable.

So, check out these studies and let me know what you think. http://www.madinamerica.com/2010/04/schizophrenia/

Wikipedia: N is the fourteenth letter in the ISO basic Latin alphabet.

They’ve Given You a Number and Taken Away Your Name

Published by the American Psychiatric Associat...
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In the Johnny Rivers song Secret Agent Man http://www.youtube.com/watch?v=l0CQ8iaK5s8, there’s a line “they’ve given you a number and taken away your name.” Last weekend I heard about a similar kind of number. It’s the Global Assessment of Functioning http://depts.washington.edu/washinst/Resources/CGAS/GAF%20Index.htm. This scale of 1 to 100 is included in the DSM IV used by clinicians. The people scoring the lowest are increasingly delusional and at extreme risk of  harming  themselves or others.

This tool is increasingly popular in use. For instance the US military is testing soldiers to help weed out soldiers who may be unfit for duty. http://www.forthoodsentinel.com/story.php?id=5781. I have suggested that the the military stop conducting unnecessary and illegal wars which stress out soldiers and civilians. These demands were summarized in our slogan from the 1960’s “Make Love Not War.” http://www.youtube.com/watch?v=dmkAuTQ8Sc4

There are some other interesting numbers that may relate to global functioning. What is the black unemployment rate by year in America? According to CNN,  it was the highest in 27 years. http://money.cnn.com/2011/09/02/news/economy/black_unemployment_rate/index.htm What if we had taken a fraction of that money we gave  to  carry out these wars and spent it helping people re-enter  the job market? Isn’t it possible that some of those people who scored in  the 40’s and 50’s would have improved their functioning?

Another number we should know is the black graduation rate from high school. http://www.thegrio.com/specials/making-the-grade/grim-graduate-rates-for-black-males-highlight-racial-gap-in-schools.php. I have encouraged black peers to return to school and get jobs  and a few of them have taken my advice. They paid attention to the scores on the GED tests and they reflected their pride in their smiles.

I believe that our global functioning changes daily. I’ve never seen the number that was assigned to me and I  don’t think it would offer much insight. These numbers can be affected  by government use or misuse of resources. If you have grown up in an area with wealthy schools, you will be at the top of that scale and any other scale we have in this society.

We must understand that these scales are merely snapshots of how you were at any given day but they are not predictors. You might encounter a peer specialist who helps you to change. You  might see a friend who has seized an opportunity and gone far beyond the barriers that were erected. We must work globally to assess the functioning of our government to reduce the amount of money wasted until we get the kind of government that we deserve. When we get there, I’d like to play in that number.

Thankyoufalettinmebemyselfagain

Family Affair (Sly and the Family Stone song)
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Fresh (Sly and the Family Stone album)
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It’s Saturday the end of a good week. A friend called and invited me to meet her at the movies at UWM.  Yesterday I accepted a job offer and I will be getting my new hire packet next week.  I started my internship at Bread of Healing Health Clinic and I made a new friend. Actually several new friends. some of these were fellow students from UWM that I took the opportunity to talk with about our ideas and goals. One of these students lives with a young person I met several years ago. Another friend was someone I have been getting to know through the Internet. Still more people were at the Bread of Healing Clinic.

Yesterday I added to my planner the notation: what am I doing with other people today? I want to use that as a reminder to look around and take advantage of opportunities to create community.

I was pleasantly surprised today when I mentioned This I Believe to a group of people I have been meeting with off and on over several months. Several people mentioned that they had listened to some of these essays. One one said she had written an essay. what this taught me was that nobody owns a coping strategy. I offered my interpretation of the experience, saying that the process of writing and reading these essays was not necessarily religious. But one woman disagreed. The truth is, we’re both right.

This is a subjective experience and her truth is as valid to her as mine was as valid to me. That is how we create community by sharing our ideas and our lives.

I believe that my moods affect my cat and the way she responds to me.  The cat is busily playing with the stuffed animal sprinkled with catnip as I channel Sly and the Family Stone. I do a lot of quiet things like writing on the computer that don’t involve the cat. But I believe she can tell when I am upset and I think some of the things she does reflect her annoyance or happiness. Today she is happy and that means something to me.

This was a week that included me being pro-active and taking care of my needs for community, income and security.  A minister I used to work with used to tell me: you have not because you ask not. When I withdraw, I am accepting a mental suggestion that these people don’t want me around so I will just reject them before they have the chance to reject me. As a result, I end up suffering and people don’t learn what I have to offer. A woman who I used to love used to ask me about whether I had friendships and I was proud of having very few close friends. Eventually I lost her from my life, too.

This week I continued to shift the paradigm. I even found entertainment in the form of several videos from UWM . I watched the videos after completing my homework and then wrote about them on my blog so that others could learn about them.

I used community services to help improve my life. And I shared in a positive and helpful way with my new friends about the things I was doing that were helping me. I thank myself from the bottom of my heart and the week is still not over. I knew you could do it, Kenyatta. Good job. I encourage everyone who reads this to use any and all of these coping ideas and to pass them along to their friends and family.