February 2015 Edition Shining a spotlight on Potter County Jail By Tony Foster As Executive Director of Amarillo Area Mental Health Consumers, I was fortunate enough to be invited to a Criminal Diversion presentation hosted by NAMI Texas Panhandle and Randall County’s Criminal Diversion representative from Texas Panhandle Centers. Among those present were Potter County Judge, Nancy Tanner, a Potter County Jail Mental Health representative, and the leadership of NAMI Texas Panhandle and Texas Panhandle Centers. After a compelling presentation, a recent inmate with mental illness gave a disturbing account of her experiences in Potter County Detention Center. During her incarceration 2 months ago, she stated that she was not getting all of her previously prescribed medications, and that the mentally ill inmates had few supports that would help them transition into “beyond the bars” living again. (continued on page 2) During a mental breakdown, the young lady said she was shoved into a padded cell, naked, with only a hole in the ground to use the restroom in; there were no bathroom facilities, showers, or running water, and she soiled herself on more than one occasion. In disbelief, I approached the Potter County Jail Mental Health Representative to check the veracity of her claim and probed why such medieval practices were being used in Potter County lockup. The mental health representative stated that the seclusion room does exist as described and is used as a decompression device to calm mentally agitated/suicidal patients. She did say that one thing had changed since the young lady’s confinement. At present, inmates are afforded a blanket or a gown. But my question is how long has this practice of placing unveiled inmates into a padded room been going on? Moreover, are some of these inmates agitated because they only receive part of their medications or a poorly calibrated mixture of psychotropic agents? Such experiences hearken back to the early twentieth century when mental health activist, Dorothea Dix, investigated the U.S. prison system and found people with mental illness underfed, naked, and surrounded in the stench of their own waste. Dix was an early champion of criminal diversion and advocated to get mental health hospitals constructed so those with a psychiatric illness could be transferred from jail into humane treatment facilities. Yet it seems we are turning back the clock at Potter County jail. It’s questionable whether seclusion techniques such as these alleviate symptoms or exacerbate them. In this young lady’s case, she fared no better from the intervention, and after her release, she was told by a mental health practitioner that she has PTSD symptoms. If agitation or suicide is a concern, a more humane solution would be to leave the inmate with the dignity of his/her clothes and a lavatory while having a same gender guard assigned to monitor the inmate; perhaps through a glass window. However, diverting inmates with mental illness to the Pavilion Psych ward is the best solution because this intervention actually has a better chance of treating the root of multiple incarcerations in some cases. In sharp contrast, Randall County jail has a robust mental health program operated under the auspices of Texas Panhandle Centers, and from the time an individual is apprehended to post release, he or she is receiving critical care. Many individuals are regularly diverted to treatment, psychiatric medications are given, and counseling is provided as a safeguard to recidivism. The Texas Panhandle Centers representative gave positive testimonies of how these interventions are keeping people with mental illness out of jail and saving taxpayer money. So the question is how can we apply pressure on Texas Panhandle Centers and other organizations to extend their successful mechanisms to Potter County jail? How can we encourage Potter County jail to network with these organizations as opposed to warehousing people with mental illness? What can we do as a community to usher these changes through in the 21st century? What can our newly elected Potter County Judge, Nancy Tanner, do to address the inhumanity and revolving door of mental health patients at Potter County Detention? Ultimately, we have to ask ourselves is jail solely about punishment, or is it about rehabilitation? Recidivism comes with a price tag: human suffering and taxpayer cost. Peer Support in Mental Health: Exploitive, Transformative, or Both? Author: Larry Davidson, PhD., Director of the Yale Program for Recovery and Community Health. The first time I tried to write about peer support—that emerging form of “service delivery” in which one person in recovery from what is described in the field as a “serious mental illness” offers support to another person who is in distress or struggling with a mental health condition—was in 1994. The manuscript was summarily rejected from an academic journal as representing what one of the reviewers described as “unsubstantiated rot.” That same article was eventually published 5 years later,1 and used by the President‟s New Freedom Commission on Mental Health to support its recommendation that peer supports be implemented across the country. 2 Now, more than a decade later and as peer support arrives at something of a crossroads, both of these reactions remain instructive. First, there continues to be a large, unmet need for peer support across the country. Over thirty states have already secured Medicaid reimbursement for peer support, and many other states have found ways to fund peer support without Medicaid. Yet there remains a tremendous need for people to receive the message that recovery is real and possible for them, and to benefit from the support peers can provide. At the same time, there remain influential people in mental health systems (and government) who continue to think that peer support—along with anything else related to the concept of “recovery”—is nothing more than “unsubstantiated rot.” Perhaps this situation is no different from that of the diffusion of other innovations in medicine or society at large—like the transition from horse drawn carriages to cars—but it strikes me as an important consideration in deciding the future of peer support. And that is what I would like to address in this piece. What is the nature of the crossroads at which peer support currently finds itself? As the discipline grows, so do concerns that persons in recovery are increasingly being exploited by their employers to provide more of the same unhelpful services that were already being provided by mental health staff but at a lower cost, with the added benefit of giving their agencies the appearance of being “recovery-oriented.” This reality was reflected all too clearly in a recent article in which peer staff were touted as a cheap way of helping “people with mental illness stay on their medications.” Medications are indeed helpful, but the recovery model speaks to so much more than being a patient and taking medications; it‟s about being a participant in life again. These kinds of developments provide further evidence to self-help/mutual support advocates that peer support should not be provided within the context of mental health services at all, but should remain separate and apart from the mental health system, continuing to be the valuable “alternative” to treatment mutual support has been since the 1960s. From such a perspective, persons in recovery who occupy provider positions in conventional mental health programs are seen as committing a kind of betrayal. They are allowing themselves to be exploited (for pay) as a means of making it possible for systems of care not to have to change the same practices that harmed them in the first place; an instance of what Freire observed as the oppressed becoming oppressors. There is no question that this does happen. I have seen it firsthand, and have been deeply disturbed by the ways in which peer staff have been under-used, misused, and unwittingly co-opted by mental health agencies that see no reason to change how they do business. But this is only one side of the equation. At the same time, but in different settings, I have seen the transformative impact that peer staff can have on the culture of mental health agencies. I have seen those people who viewed the introduction of peer staff as “unsubstantiated rot” become converts by witnessing the effects generated by these staff in the persons whom they support—people the staff had given up on as hopeless, impossible to work with, too “high risk,” or too disabled. One psychiatrist who had openly laughed in my face when I first suggested hiring peer staff acknowledged recently that he has become a staunch advocate of peer support because he has seen how much more peer staff can do with people than he ever was able to do as their physician. And he sees how much easier his own job has become as a result. So, why not just tear the mental health system down and replace it entirely with peer-based supports? Why bother to transform a fragmented, over-medicalized, under-funded, and frequently toxic system—in part through the introduction of peer support—when it might be better just to offer caring, reciprocal, genuine human relationships? The answer to which I have come thus far is that we need both. Peer support, like other innovative supports (e.g., supported employment), reaches only a small fraction of those persons experiencing distress or struggling with mental health issues. Even were funding for peer positions radically increased overnight, there would remain a need for other forms of care as well. That is because, compared to the large number of persons presenting for mental health care through conventional channels, very few people make use of self-help or mutual support options available to them in their community. This is not only due to the medicalization of distress, the resulting social habits, and a history of disproportionate funding (although these remain significant influences), but also due to the fact that people do not necessarily want to become part of a cause or a(nother) community, especially ones with which they do not identify personally. The majority of people fighting against mental health care are people who have been hurt by it. Other people, who may not yet have experienced such trauma at the hands of „helpers‟, may not necessarily want to advocate for or against anything. They may simply want to get on with their own lives as best they can. For those people, and for the even larger number of people who experience mental distress and neither seek nor receive any help at all—formal or informal—new and other approaches are sorely needed. And, importantly, people need to have the opportunity to choose those forms of care and support that they will find most safe, comfortable, culturally relevant, and effective for them. The partnership between peer supporters and non-peer (or non-disclosed) mental health staff is still early in its evolution. Before abandoning the mental health system, the millions of people who already rely on it, and the millions more people who do not yet seek help or derive any benefit from it, let‟s see if we can make it better—in part through the efforts and influence of people in recovery. People in recovery know three very important things: 1) the ways in which mental health systems currently help people; 2) ways in which mental health systems currently fail and harm people; and 3) ways in which mental health systems could be better at educating, engaging, and supporting people and their loved ones in their own recovery journeys. If we can invite, value, and benefit from their accumulated wisdom, ideas, and energy, we might be able to create together a system that is more accessible, respectful, and responsive to all those in need—whether or not they choose to join, or to become invested in helping to further improve, the system that cared for them. At the end of January, NAMI-Texas Panhandle and Amarillo Area Mental Health Consumers/Agape Center will be moving down the sidewalk to 1705 S. Avondale. Texas Panhandle Centers will be moving their Peer Support program to their new Crisis Respite Center on Hardy Street. Our next NAMI monthly meeting will be on Saturday, February 28, from 2-3 pm at our new location. NAMI has general meetings the fourth Saturday of each month from 2-3 pm. Our next Family-to-Family Class will be held from March 19 to June 4, 2015 in our new 1705 S. Avondale location. Family-to-Family is a nationally recognized, evidence-based program for family members and loved ones of those living with mental illness. It will meet on Thursday evenings from 68:30 pm. This class is free and all materials are provided, but it is limited to 20 people. Register by calling Margie at 678-7385. Learn more at http://www.nami.org/template.cfm?section=family-to-family. Our free Family Support Group meets the first Monday of each month from 6-7:30 pm. This support group is for loved ones of those living with mental illness. Our next meeting will be on Feb. 2in our new location. Drop-ins are welcome. NAMI’s Connection Recovery Support Group meets each Tuesday from 12:30-2:00 pm in our NAMI space at 1705 S. Avondale. This is a free, peer-led support group for individuals living with mental illness. Drop-ins are welcome, and van transportation is available. Call 373-7030 a day in advance to request transportation. NAMI has free In Our Own Voice presentations available for community and workplace groups. This is a 35-40 minute presentation given by two individuals living with mental illness to educate others and reduce stigma. Call Margie at 678-7385 to arrange a presentation. "Like" us on Facebook to keep up with all our events and mental health news: www.facebook.com/NamiTexasPanhandle Notice: Agape Center is Moving to 1705 S. Avondale Our New Phone Number Is 1-806-373-7030 Art Lessons Every Wednesday, 10:00 AM to 12:00 PM, And the First Monday of the Month (art supplies provided) Biography: Local Artist, Marcia Morgan, has 20 + years of experience in a wide array of mediums, including pencil, pastels, charcoal, acrylics, and oil paints. Art students respond to Mrs. Morgan’s teaching style because she builds on their natural abilities to create a personal skill set that releases their innermost creativity. Students find healing as they spill all of their emotions onto the canvas. Mental Health Consumer Art Work T.F.’s “Chinese Pug” (Colored Pencil) P.A.’s “Rainbow Collage” (Acrylic) February 2015 Needing a ride? Please call a day ahead, during office hours, to make a reservation, 373-7030. ($S-bring money for activity) Note: (Center does close due to inclement weather conditions such as heat waves, ice, heavy snow, or tornado weather.) MON TUE WED THU FRI AGAPE Hrs: 10am – 4pm AGAPE Hrs: Noon - 3pm AGAPE Hrs: 10am- 4pm AGAPE Hrs: 6:00-8:00pm AGAPE Hrs: 10am - 4pm 2 3 Art Class 10:00-12:00 Computer 1:00-2:00 Yoga 2:00-3:00 Center Clean up 3:45-4:00 9 NAMI Connections Group 12:30-2:00 10 Anger Management 11:00-12:00 Computer 1:00-2:00 Yoga 2:00-3:00 Center Clean up 3:45-4:00 16 NAMI Connections Group 12:30-2:00 17 Assertiveness 11:00-12:00 Computer 1:00-2:00 Yoga 2:00-3:00 Center Clean up 3:45-4:00 NAMI Connections Group 12:30-2:00 Advocacy Group Meeting 2:15 23 24 Housing-Organization 11:00-12:00 Computer 1:00-2:00 Yoga 2:00-3:00 Center Clean Up 3:45-4:00 NAMI Connections Group 12:30-2:00 4 5 6 Art Class 10:00-12:00 Challenge 1:00-2:00 Say Yes To Recovery 3:00-3:45 Center Clean Up 3:45-4:00 11 Art Class 10:00-12:00 Friendship 1:00-2:00 Say Yes To Recovery 3:00-3:45 Center Clean Up 3:45-4:00 18 Art Class 10:00-12:00 Friendly Concerns 1:00-2:00 Say Yes to Recovery 3:00-3:45 Center Clean Up 3:45-4:00 25 Art Class 10:00-12:00 Challenge- Check In 1:00-2:00 Current Events 3:00-3:45 Center Clean Up 3:45-4:00 AAMHC Bingo 6:00P.M. 12 GED Class 10:00 –12:00 Center Clean up 12:00-12:15 Mall Outing Center Closed 12:15-4:00 13 AAMHC Guest Speaker Epilepsy Foundation 6:00 P.M. 19 Valentines Party Chicken Enchilada Cook-off and fixings 6:00-8:00P.M. 20 AAMHC General Board Meeting 5:00 P.M. Center Closed Staff Training Saturday 21st NAMI Meeting 2:00 – 3:00 PM 26 27 AAMHC Birthday Celebration 6:00 P.M. GED Class 10:00-12:00 More Than A Patient 1:00-2:00 Craft-Crocheting 3:00-3:45 Center Clean Up 3:45-4:-00 S S A U T N AAMHC P.O. Box 44 Amarillo, TX 79105-0044 RETURN SERVICE REQUESTED AAMHC Board of Directors AAMHC Staff Chairman: Adrian Gonzalez Vice Chairman: Sandy Huskey Secretary: Kerry Anderson Treasurer: Keith Nishimura Asst. Treasurer: Open Asst. Secretary: Open Advocacy Committee Chairman: John Mcduff Angel/Outreach committee Chairman: Melinda Urenda Program Chairman: Open Member-at-large: Bill Weir Member-at-large: Anne Marie Washington Member-at-large: Open Executive Director: Tony Foster Center Director, PSS: Bonnie Taylor Driver, Peer Support Specialist: Billie Jean Jones Administrative Assistant: James Thomas Art Teacher: Marcia Morgan Yoga Instructor: Margie Waguespack Secretaries: Shirley Otto, Stephen Waguespack, Roberto Padilla GED Teacher: Tony Foster Volunteer Facilitators: Pam Ashmead This publication is funded by a grant from the Department of State Health Services and contributions from readers like you. Views expressed in these newsletters do not necessarily reflect those of all AAMHC members or our funding sources. Feedback is always welcome. Website: www.aamhc.us Email: [email protected]
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