Don’t Give Up on People in Adult Care Homes!

An opinion article in the Raleigh News and Observer, “Community Housing for the Mentally Ill Still Scarce” (December 7) begins with a statement that the Department of Justice/North Carolina agreement requires that people living in adult care homes be moved into independent housing in the community. This is simply not true. In fact, the entire “in-reach” process is generally done by specifically trained Peer Specialists who themselves have once struggled with serious mental health challenges but who have since recovered meaningful lives by living actively to manage their health. Their efforts are aimed at engaging people in these facilities in order to offer them the information, the support, and as necessary, the advocacy they may need to help them find a different home in a community—IF they wish to relocate.

In fact, many people are so disabled by the very passive lifestyle North Carolina has allowed to develop in these places that they are afraid of the world beyond the parking lots. They have less resilience and may lose initiative toward growth and change. Many years before this settlement between the federal and our state government, community members tried to give input to rules developed by the Department of Health and Human Services so these places could offer more support health and growth, yet our attempts were neglected.

Perhaps readers do not realize that we are not talking about assisted living in the usual sense of the word where there are Activity Directors, van drivers for non-medical outings, and medical oversight. No holistic approach here, and insufficient medical care! Under-qualified staff are given just a few hours training before they are tasked with dosing medications to patients. And very few of these settings have ensured that staff have training in responding to mental health related needs.

I once visited an adult care home in Yadkinville (and have been in many since). This “home” had 190 beds and, while our policies had once assumed these settings would be for the “frail elderly” I saw very few of these. There were, in fact, young people in their 20s, 30s, and 40’s as the majority of the population. They were very eager to talk and have company, and I could not imagine why they were in such a setting that snuffs hope, does not cultivate engagement, does not offer exposure to new interests, etc. I could only think of two things: 1) these individuals are seen as without hope for a more meaningful life and therefore exhausted families and under-resourced systems have resigned themselves (and these residents) to this lifestyle in the name of safety and 2) this unregulated industry must have continued to grow because somebody else’s (or several somebodies’) interests are involved.

I am a person who has a psychiatric diagnosis. I spend much of my week with people who hope for more value in their lives in spite of their diagnoses. Through a locally operated peer center, they are connecting, learning self-help skills, recovering their own lives and may well be on their way to employment and more! (Many of us with psychiatric diagnoses do get well enough to work and contribute!) Yet many of these have also had families that were eventually exhausted by them and others who gave up on them.

I encourage readers not to give up on us. We do have the capacity to grow, to heal enough from the trauma that has often been a triggering event in our lives that we can become courageous and learn how to manage our lives so that we stay healthier! And I encourage communities to support recovery in the lives of as many of their citizens as possible! Don’t hide us away, and don’t take away our hope, our sense of person.

I am one who looks forward to North Carolina continuing to focus the rights and the full humanity of citizens with mental health challneges. Each individual should have the right to be welcomed back into our communities if they should choose to come, and we should welcome them with hope and expectation, because communities can offer far more than pills to help people regain dignity and well-being.

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On Recovery: Work at DHHS

It is easy to lose track of the work going on at the State level that impacts our lives, our advocacy, and our work.  Here are some updates.

The Governor’s Mental Health and Substance Use Task Force:
There has not been much news on the efforts of this Task Force. It is known that at least two persons with lived experience of mental illness and recovery applied to serve but were not selected.  Perhaps there are persons who live in recovery after substance use challenges are serving, but we do not recognize any names that we know.  (Whoops!  I now see that a liason between the group and the State CFAC is listed).   I admit that the only information I have to go on is that from the following web page:  http://www.ncdhhs.gov/about/department-initiatives/task-force-mental-health-substance-use Readers should check out this page to see the Six Tasks for the group.
 
What should concern us?  There is no use of the word recovery or any concepts that relate to recovery or resilience in the list of the six tasks assigned to the group.  Yet so many of these tasks would yield a clearer scope of actions that would truly help in reducing crises if this exercise was being done through a lens of resilience and recovery.  
 

To advocate for inclusion of consumer input and a focus on recovery, please contact Sonya Brown, DHHS staff to one of the committees (sonya.brown@dhhs.nc.gov ) or Dr. John Santopietro(who spoke at our recovery conference last year and who chairs the adult services committee of the task force–email:  john.santopietro@carolinashealthcare.org ).  Also, copy your email to Courtney Cantrell at courtney.m.cantrell@dhhs.nc.gov .  Tell them that it is misguided not to look at issues of high emergency department and justice system utilization without considering the need for developing a system that engages people and their potential to recover and ensuring we have supports for this in our communities.  Remind them that peer support is vital to reducing high intensity service needs!  Ask them to include written recommendations submitted by recovery advocates as they undertake their work, and send some!  THANKS!

 
Crisis Solutions Coalition:   To see a review of some of the initiatives that have come out of this initiative in the past couple of years, please check this web site:
The next meeting is to be December 14, and NC CANSO will be there!  Here is a note on the meeting focus:  Our first speakers will review the legislation, and associated requirements, which broadens the group of professionals who can perform first examinations in the involuntary commitment process.  Expanding our capacity effectively in this area is consistent with the development of our behavioral health urgent care centers and other crisis response initiatives across the state.  Then, our second guest speakers will discuss roles for certified peer support specialists throughout the crisis intervention continuum.  We expect both topics will benefit from your thoughtful discussion!  
Remember, you read about it here with NC CANSO!

Annual Recovery Conference a Hit!

North Carolina’s “One Community in Recovery” Annual Conference NUMBER 7 was held in mid November, and as in previous years, each year just gets better than the ones before!  Nearly 200 people came from across the state to Clemmons, NC, just west of Winston-Salem, for fresh new understanding, to find friends who share the hope for recovery from mental health and substance use challenges, and just to celebrate together!  This year the planning committee was mindful of developing a conference that would appeal to recovery supporters from both the mental health and the substance use experience.  We feel we accomplished a good balance with the variety of keynote speakers and break-out session topics.  Below are some highlights from the three day event.
 
Supported Employment Pre-Conference:  The pre-conference track on supported employment in North Carolina included spokespersons from the various agencies.  The Individual Placement and Support (IPS) model was especially highlighted in this panel discussion because North Carolina has been compelled through an agreement with the Department of Justice to help persons find employment as a means of gaining tenure in the broader community since so many of our citizens have been away from community in adult care homes.  One hundred twenty-five people registered for the pre-conference, meaning that we have many providers, administrators, and peers interested in helping more North Carolinians find employment after having had a mental health challenge.  Possibly one of the most enduring messages through this session came from Brandon Tankersley, who is now employed full time after having a life-altering accident in his teen years.  He believes that we must encourage people not to sit and wait for opportunity to come to them, but to encourage people to be more assertive about their lives, going out and finding the opportunities, then grabbing them!  This should be challenge for all  of us.  How do we support rather than contribute to disabling people in a society where stigma and wrong assumptions drive so much?  Let’s be thinking about this!
 
Full Conference Highlights:  The two keynote presentations were vastly different and covered diverse areas and needs, while both contributing to the overall goal of challenging our thoughts about recovery.  Thursday morning began with Bud Mikhitarian, a filmmaker and author who wrote “Many Faces, One Voice:  Secrets from the Anonymous People. Mikhitarian shared many lessons learned from becoming so intimate in the understanding of people’s experience as they recovered from addiction.
 
On Friday morning, our thinking about mental illness was challenged by Oryx Cohen, Executive Director of the National Empowerment Center, who shared about his own recovery path and alternative meanings of extreme experiences.   What if hallucinations are not merely symptoms of faulty biology?  What if they are extreme responses of brilliant, sensitive minds to trauma or confusion in a world whose values are often not very humane?  We know from theOpen Dialogue model that Cohen shared about that many people having troubling mental experiences are helped through dialogue which clarifies and demystifies what is truly going on in a person’s mind and brain. Where Open Dialogue defines the public mental health systems in parts of Scandinavia, very little medication is used. This must cause us to re-think assumptions in our society. Cohen’s presentation stirred a lot of dialogue and a desire to work together to advocate for progress!
 
There is not space to address all the great presentations (more than 20 of them!), and we know that there were almost twice as many great proposals for presenting. Next year promises even more as Recovery is no longer just an idea, but the focus of practice by so many in our state!  
 
If you would like to be involved with planning the next recovery conference, please contact Ellen Kesler at ekesler@wakehealth.eduor Reid Smithdeal at reid.smithdeal@MeridianBHS.org.