A witfree friend of the mentally ill left a comment at ama’s blog, claiming that the SPMI have all but been abandoned by the “consumertocracy literati.” Doesn’t that just roll off the tongue. The myth that we are hippie pomo philosophy majors with no real world knowledge of what we denounce is standard low-hanging fruit, but for the sake of clarity I’ll have at it. I look for how oriented people are to this debate, and that’s the sort of comment I hope will someday be seen as instantly dismissible, but better to go over the ground again than wish you had. Too much at stake to leave potential allies lost in TEH bewilderness.
As I see it, our current location begins a few years back, when the president’s New Freedom Commission declared the US mental health system a shambles. Then came the SAMHSA Transformation grants, awarded to nine states, as a mandate of TRANSFORMATION, from decades of inertia to a “Consumer-Directed, Trauma-Informed Recovery-Based MH system.”
SAMHSA has a definitional page on Transformation:
The scale of desired change is large and will result in a significantly different enterprise
Reinvention implies “something tantamount to changing the very ‘DNA’ of public organizations”
It is complex and chaotic in nature
It requires years to complete, with multiple phases and stages of major changes
The rules of the game change, including the norms, guideposts, values, and guides to behavior.
Enterprise redesign is depicted as revolutionary rather than evolutionary.
Under the grant several US states have been charged with a five year project to overhaul their MH system, and create changes that will lead the nation’s TRANSFORMATION from abuse to empowerment. In other words, we are in process. Systemic Transformation is the mandate. What has been inert is now in motion. Change is difficult. Many will resist. Boo-fucking hoo, we will roll over you.
Vermont, for instance, has applied for a transformation grant, and its new State Commissioner of Mental Health is one of many public servants now talking the proper talk. The following excerpt is from the Winter edition of Vermont Counterpoint, an interview with consumer advocate Steven Morgan:
As the top leader of mental health services for the state of Vermont, Michael Hartman brings to the role a wealth of experience and keen vision for how the system should progress.
He sees a definite role for people with psychiatric diagnoses to be involved in the system and “shape what services look like,” whether through employment, voluntary organizations, or participation on influential committees.
“The mental health department really needs to be pushing the agenda that services by people who are or have been consumers is an important aspect for services and recovery, and for consumers.”
He said that in many cases, “peers hold
other peers responsible for things at a much higher level than other professionals do,” and they may push each other to achieve more than is traditionally expected.
On trauma-informed care, he noted, “the first step is getting people to recognize that you need it, (that) the system as a whole sees the need for trauma-informed care.”
Trauma histories often present as psychiatric illness, which complicates diagnosis and the ensuing treatment, he said.
“The trauma kind of weaves in and out of various areas,” he pointed out.
Further, without an awareness of and sensitivity to an individual’s history, care providers may unintentionally trigger and re-traumatize someone without recognizing why or how they are doing
so. There is a need for more awareness around these issues, and how involuntary treatment may play a damaging role for trauma victims, Hartman said.
“There’s likely no involuntary treatment that wouldn’t be a trigger to a trauma victim,” …and it isn’t an issue he takes lightly….the taking away of civil liberties is “least ideal.”
…“When we are not giving enough options and involuntary treatment is the outcome, that’s a need that the system has to try and create more options.”
So much for the fancy divisive head-in-the-cloud elitist consumertocracy. Of course there is a concerted and bankrolled attempt to polarize, silence, fragment and obscure. This Republican State Representative lays it out with kitchen table plain-speak in an op-ed entitled, hallo
Involuntary medication acts to divide
We have begun to recognize how much the pharmaceutical industry is driving medical decision-making, both through conscious marketing to us, and more subliminal impacts upon physicians. Those same companies provide substantial funding to national public advocacy groups as well as to political lobbyists.
…Instead of spending the time to work towards mutual agreement on a treatment plan, many more Vermonters would be forcibly injected with risky drugs to get them out of a hospital faster. Some of those same drugs are now known for such side effects as diabetes, a chronic, debilitating and expensive illness – one of those facts that pharmaceutical companies knew and hid and for which they are now paying out billions in damages.
…Instead of progressing on parity of treatment approaches and integration of care, we now look to divide further, and to conquer by force.
As David Byrne put it, don’t worry about the government, I know when it is on my side, now I can relax with my loved ones.
I see the states, across this big nation
I see the laws made in Washington, D.C.
I think of the ones I consider my favorites
I think of the people that are working for me
P/S: Steven Morgan is a name to watch. His open challenge to NAMI has been making the rounds, and can be read here in all its unwarranted, open-hearted and diplomatic goodness.