A friend is feeling sad these days because of the loss of her long time companions. People who know you from 30 or more years ago are really special. The people who were there through different hair colors, relationships, songs, concerts, having children and having grandchildren and stuff in between. The ones who you could tell anything. People who know what to bring and what not to say.
We meet these people at a certain stage, maybe when we have just arrived in the city and are wondering what will happen. Or maybe we meet them when they move into our neighborhood at a potluck and ask, who made that dish. And before weknow it we are sitting down and talking together.
A lot of this is theory for me because I have difficulty maintaining close friendships. I remember an old girl friend asking me about who were my close friends and not being able to figure that out. But for people who do remain close over a long time, letting go is so painful. But at some point our bodies give way. It can be sudden, in an accident or it could be the gradual wearing away due to diseases. And then there is sadness.
You will always have those many years of memories but you won’t always have those friends. This is the circle of life. Farewell, old friends. Know that you are loved and will be in one another’s dreams.
by Simon and Garfunkel, who ironically, were not friends
Old friends, old friends,
Sat on their parkbench like bookends
A newspaper blown through the grass
Falls on the round toes
of the high shoes of the old friends
Old friends, winter companions, the old men
Lost in their overcoats, waiting for the sun
The sounds of the city sifting through trees
Settles like dust on the shoulders of the old friends
Can you imagine us years from today,
Sharing a parkbench quietly
How terribly strange to be seventy
Old friends, memory brushes the same years,
Silently sharing the same fears
I enjoyed myself last night at the holiday party for a mental health organization.The party was held in the hotel also owned by the organization. This is a for profit business owned by a man who immigrated from Malawi, a landlocked country in southern Africa. The company has successful mental health and drug rehabilitation operations. But the most remarkable part of the company is the Days Inn located near 6th and Walnut. The hotel replaced a run down facility for people with developmental disabilities. The very modern website boasts of their conveniences and location near downtown. The building was filled with horny young white men last night. The staff is diverse, the beds are firm and the appetizers are fresh. Although I brought a dish not to be shared, the staff had prepared a feast with spicy Hispanic food.
I am thinking it might be a good place to have some of these mental health meetings instead of using Serb Hall, where I nearly froze my cojones in the restroom. The rooms were very reasonably priced and I witnessed a young woman from Illinois checking in with a friend and asking about where to get breakfast. When you go someplace other than where you might normally venture, you learn something new about Milwaukee. We are a city where many of those who are most in need to services can’t find people who look like us when we are most vulnerable.
I say, let’s look around and see what the barriers are to a culturally intentional mental health workforce. But we aren’t going to get there with meetings in which I am the only African-American male. Let’s include the black man who attended social work school with me at the University of Wisconsin-Milwaukee and now works for the Center for Veterans Issues. Is there another black male peer support specialist? If so let’s find him and groom him to take over my role someday. And let’s not forget other peoples of color who have been missing from the discussion.
We need advocates who look and sound like the people for whom they are advocating. It’s not enough and nor is it appropriate to have all white staffs who look as though they were cut from the same mold. Spend a day and spend money with others and hear their stories. There is more. Come find us.
Because I work such long shifts I don’t always check my voicemail. this stems from the reason that I hated buying a cell phone in the first place. I didn’t want people to be able to reach me all the time. It was so much easier having a home phone that people would call and reach me about 25% of the the time leaving their dreary messages. Now, anybody can call me: Russian mobsters, presidents, central bankers, girl friends, wives, and the guy I rented that tuxedo from last week.As you can well imagine, I have a certain reluctance to answer the phone.
So you can image my surprise today when I checked the voicemails this evening and found that the Veterans Administration had called to remind me that I had missed my appointment this afternoon. When I checked the snail mail I found a letter cancelling said appointment. It was as if the left and right hands of the hospital were not in sync with one another. The VA is full of signs reminding patients about the cost to the VA of our failure to arrive. In fact, when I arrived on Monday, I was perky, received excellent care and was told that today’s appointment would be cancelled. In fact I have had this problem twice. Now that it is too late, I feel a certain reluctance to to call the VA and remind them that they had cancelled my appointment. What if they try to call me back and their message goes in between my ex and present very wonderful wife?
On twitter I saw a link to Pro Publica, an independent news organization, about the best reporting on mental health in prison. The first item, My Name is Not Robert, was an investigation into the way Kerry Sanders was wrongfully picked up by police in Los Angeles and extradited to New York State. There he languished in prison three years for crimes committed by Robert Sanders.
The New York Times article about the case showed that common sense procedures of identification, including finger printing, were not followed in this mis-carraige of justice. It would have been possible to identify Kerry Sanders within one hour after he was arrested. His public defender served only to convince Kerry to waive extradition. And all the prison guards, social workers and psychiatrists who heard Kerry say that he was not Robert and had done nothing wrong, all denied any responsibility for their part. If the real Robert Sanders had not been picked up in Cleveland, no one would have lifted a finger.
Kerry’s mother had desperately searched the streets of Los Angeles looking for him. Then, after the authorities in Cleveland contacted New York State, the prison officials asked Kerry the questions that could have been answered wen he first arrived in their custody. They tracked down Kerry’s mother and whisked him back to her without any explanation.
Even after he returned to Los Angeles, the nightmare did not end, as Kerry was picked up once more as Robert Sanders. This time, New York State, told them, “you’ve got the wrong guy.” At this point I should reveal a few salient points about this story and my interest in it. Kerry Sanders had been diagnosed with paranoid schizophrenia and was collecting disability benefits. His speech was often disorganized and seemed to be having trouble maintaining his grip on reality. He responded to both names, Kerry and Robert, while in prison. Robert, on the other hand, had no psychiatric history; he was simply a criminal. He also had several tattoos compared to one small tattoo for Kerry. The one New York prison official who spoke to the New York Times reporter suggested that at least Kerry had a warm place to stay and received three meals per day during his wrongful incarceration. Asked whether he felt any responsibility to help determine whether the state had imprisoned the wrong man, he said “not my job.”
Kerry was able to connect to mental health services in Los Angeles and an attorney helped obtain a large cash settlement for the ordeal he had experienced. This story illustrates the stigma attached to mental illness, where his protests of innocence were considered more more signs of paranoia. physical reseml
On NPR today I heard two stories that point to smarter ways of looking at the regulation of marijuana through capitalism. In the first, Uruguay, a small South American county, realized that there was a contradiction in its laws. While the country had de-criminalized marijuana use, obtaining the drug had been a crime. This forced buyers to obtain it through illegal means, which fed the coffers of organized crime. Now, Uruguay has a new law that will create a state monopoly that allows the government to regulate and collect taxes much like alcohol is taxed. The law faces opposition from people using things like the tired old “marijuana is a gateway drug” myth. For years, this idea has been promoted without a shred of evidence to promote it. What we do know is the incredible cost of the war on drugs in South America and the United States. Thousands of people have been killed, hundreds have been imprisoned and yet marijuana grows more popular with laws to legalize medical and recreational use of the drug.
The second marijuana related story follows from the legal marijuana industry in the United States. Justin Hartfield has a new business that invests in marijuana related companies. It’s old fashioned capitalism. The one elephant in the room that could wreck this business model is federal marijuana law enforcement. And there are many vested interests including the prison guards who like things just the way things are, with laws that reduce a judge’s flexibility in dealing with people who are convicted of a crime and too many non-violent drug offenders in prison. Potentially there are billions of dollars at stake in taking an approach of regulating and taxing marijuana and abandoning our expensive and unsuccessful current strategies. Let Hartfield help grow the pot industry and create jobs in a whole new area while letting thousands of people become productive citizens.
Yesterday I finally accessed my HealthEvets website. I had originally signed up for the site several years. I don’t know why I did it. I was probably fairly new in my career as a peer support specialist and was living in rather poor conditions. I had a lot of concerns about being able to access my care team at the VA. It’s one thing to be living in vets housing and you just have to go downstairs to the nursing office to make an appointment. It’s quite another to be off in the community taking care of things and needing to figure out things on my own.
So a lot of things I was doing did not quite fit together. I must have heard about the HealthEvets at an appointment and decided why not? This could be a lifeline. Flash forward to the Obama administration which seems to be making more efforts to promote accessing your health records over the internet. This includes lab tests, immunizations and self reported health data. Curiously, mental health information is not yet available. This may seem a little contradictory given what I said yesterday in my post about the greater emphasis on preventing suicide among vets and active duty personnel.
My latest experience with the HealthEvets program was last week when I went to the VA for a flu shot and a TB skin test required for work. There was a guy near the front door (one of our favorite sayings at work is “shut the front door” which we use instead of cursing) who had a beard that reminded me of the guys on the old cough drop packages. I figured that he doesn’t eat spaghetti or if he does, it was a major production. He also had a prosthetic left hand probably a result of his military experience. As I was passing by him thinking about going back to work, he called out and asked whether I had signed up for HealthEvets. I told him that I had not. So he asked me to come over and it would take just a few minutes to complete the application.
I was more interested in the oatmeal cookies on the table that looked so enticing. The process was fairly quick, as he had promised and he was efficient with his typing. That is, until we came to a glitch. It seemed that I had already signed up for HealthEvets because he was able to find my name. Unfortunately I was unable to recall my answers to the secret questions that I had entered years ago. He gave me the name and contact information for the program coordinator to help me figure out what had gone wrong and sent me on my way.This week I decided to try registering again. This may be typical male behavior. If something doesn’t work the first or second time, we try it again. And again the system said I was already registered. I called the national HealthEvets program and the local office to figure out what I had been doing wrong. They helped me find the answers I had given when I signed up for the program and get access to my records.
By Friday afternoon I had a full report at my fingertips. I also sent an email message to my care team and got a response. I printed out a health card that carry in my wallet and it gives me an added level of protection. I need to find the information about my blood type and add it to the card. This will be handy in case I am unable to speak. I am happy and hoping that the glitch in the system as far as not having access to mental health data will be fixed. After all, a mind is a terrible thing to waste.
One of the most frustrating and contradictory parts of the community mental health field is that for a hard core individuals in crisis, the more services that are offered, the more they will resist. Show them opportunities to lives comfortably in an apartment and they will still show up at the psychiatric crisis services claiming to be homeless. If you listen, they will stop talking. If you walk away they will say you abandoned them. It was a common them in the report on the Milwaukee mental health redesign that people ended up in crisis repeatedly not because no one reached them but because they resisted being reached.
When we talk with candidates we need to find out their ideas and views about mental health because these problems will not solve themselves. We have families struggling with their relatives and going back and forth over whether to put them out or go look for them. Sometimes you can’t even find these individuals to be able to offer them help. I’ve seen people scream obscenities at their case managers. In peer support training we are told to roll with resistance, but in some cases, the resisters just try to roll faster.
By the way, we are used to talking with people about Medicare and Social Security as programs to assist the elderly, but they can be lifelines for people experiencing sever mental illness. Together with food stamps and section 8 housing vouchers they are the core of protection was can offer people. There are various levels of housing available that we can assit people in obtaining. The most important program around is people. People as peer specialists, family loved ones, friends and fellow travelers. Maybe the bus driver, the librarian or aother non-mental health professional who encountered a person in distress while on the job. How did you respond? What did you say?
Sometimes it can be like pulling teeth to get people to tell you what is on their minds. It may also be an unpleasant experience because of the person’s poor hygiene. Get over it. There but for fortune, go you or I. So even though this entry started out sounding rather bleak, upon further reflection, I know that I will still keep trying.