National Empowerment Center on the West Coast (NEC-West)
Teleconference – April 5th, 2001 5:30 pm PDT

Present:

Carol Patterson, NEC-West
Mark Karmatz, Los Angeles, CA
    with Katherine Barnes, Ron Schraiber and Gwen Lewis Reed
Gail Green from Discovery Center
    with Jay Hill, Dual Diagnosis liaison for the Discovery Center
Chris Teal and Chuck Latin
Sylvia Wright, Hayward, CA
Penny Menefee, San Francisco, CA
Mitchell Eisenberg, Los Angeles County Client Coalition
Jessica Martinez, Patient’s Rights Office in LA County
Nancy Thomas, Alameda County Network of Mental Health Clients
Susie Bowerman, LCSW, Sacramento Mental Health Board
Claudia Center, Employment Law Center, San Francisco, CA
Dahlia Liang
Maureen Schat, Independent Living Center in Auburn, CA
    with Dawn, Jerry and Steve.
Jyoti Ananda, Progress Foundation, Peer Counseling class graduate
Chuck Elliot, San Diego, CA, Mindstar.org
Susan Phipps, Juneau, Ak
Jim Gottstein Alaska Mental Health Consumer Web in Anchorage, Alaska
    with Katsumi Kenaston, Jimmy’s my partner
Almas Grace of Selowick, AK
Ken Stockamp, Wilsonville, OR
Bill Slocom, Palmdale, CA Discovery Center
    with Outreach Specialist Al Holloway
Carole Ford, Sacramento, CA at CNMHC
Glade Marshall
Mike Feeney - Lake County
Bob Hiltner- Colorado Springs, CO

******************************

In Alaska, Katsumi just hired the six consumer specialists, and has a position open for a trained consumer specialist. For more info, go to the web site, www.AKMHCweb.org. We’ve also got some facilities for listservs, chats and can do a number of things with the web site. Anything we can do to help coordinate or disseminate via the internet we’ll be happy to do.

In Hawaii: We’ve got some people trained and relatively ready to go as soon as we can pay the phone company for the lines for our Warm Lines. (I hear the warm line is now in operation!)

(A lot of grants for services require Consumer Driven services, and there’s some debate about what that means.)

-Consumer run.

-consumers take care of things and help each other, self-help groups

-We’re in charge of everything. We do everything ourselves.

-Groups that are run by consumers for consumers

-I think there’s a difference between consumer run and consumer driven. Counties call their programs consumer driven which means the consumer sits down with the professional and basically drives their own case management plan, and there are professionals involved.

-Consumer run is everything done by the consumers from management or supervisor, all the way.

 -Consumer-driven is the consumer says what they want and the professionals usually take over from that point.

-Consumer driven is "we’re going to provide the services that consumers want so if consumers won't go to a day-treatment program we not going to have a day-treatment program".

-I have a real concern about how professionals work with us.

-With a diverse immigrant population, its better to be consumer run.

-Consumer driven means that the needs of the consumer drive what services the mental health system provides to those people. Two groups decide what the needs are: the consumers, with feedback through the mental health board. We can’t ignore the professionals and all their years of training.

-Consumer driven has to mean consumer choice. If you’re letting someone else decide what the needs are then it’s not really consumer driven.

-Choice is really important. You can’t have choice without services being voluntary and without a range of services being available so that people can pick and choose what works for them.

-On consumer choice under the consumer driven model: here is a comment that I recently heard from a professional. "Yes, it’s OK for consumers to make their own choices until they decompensate". So when do you get to make choices?

- We're just starting consumer run services here in Colorado. There’s one drop-in center, that you can say is consumer run. It’s owned and operated and it’s been completely separate from the system. Right now they’ve got a contract with the local managed care company to provide psycho-social rehabilitation services, but it’s an arm’s length contract. We’ve got about a dozen other drop-ins that are getting going, and they are more like consumer driven because a lot of the management decisions are being made by the managed care company, the community mental health centers. For instance in terms of what the budget is, and what kinds of staff they’ll have, and hiring–those sorts of things are being done by the managed care company. But in terms of a board that decides what goes on at those drop-ins those decisions are being made by local consumer boards. I can see the distinction between consumer run and consumer driven. My goal is over time to see those drop-ins get their non-profit status and slowly wean themselves and become consumer run.

-Consumer driven services are services that are for and by the consumers and the decisions have to be ultimately made by the consumers. Professionals make recommendations but the consumers make the decisions regarding their treatment and the kind of care that they receive. I would consider an organization consumer driven if that organization is governed by a board of directors that are consumers. The center can hire a professional to do certain activities but the governing board, the people who really govern the organization are the consumers.

- What members want, not what the professional wants.

- I belong to a program that is run by professionals. And the last years that I’ve also been involved with Project Return, I’ve gotten more out of it that I did out of the ten years that I’ve been in the professional help group.

-It’s really important in consumer driven systems to make sure that consumers get equal pay and the same type of educational training opportunities as the "professionals". It’s a real indicator of how serious a person is going to be taken. Consumers need to be involved in policy making.

-When you take on the label of being a consumer you don’t give up your hat of also being a professional. You should be viewed on the same plateau as professionals.

-I’ve got consumers who’ve been working for five and ten years at $10 an hour and yet they’re doing a lot of the same stuff as a case manager, who makes $40- $50,000 a year. But Case Managers can bill and so the system likes them because they’re revenue generating. I don’t know if we’re ever going to be able to revenue generate unless there’s an MSW or an MFCC, or whatever the bottom line is so you can bill MediCal or MediCare or whatever.

-Our county really supports us as far as our drop-in center’s concerned with the funding. They’re letting us choose what we’re going to offer there so far - we’re just about ready to open up full time. They’re saying, "Go ahead, go out and get educated". We run it and facilitate it. As far as the funding goes, the funding stream comes from the county so we’re not completely separate from a mental health department. They are making some of the decisions like who’s gonna be hired, but they’re hiring consumers. So I would say it’s driven and it’s semi-run by consumers but we’re not in the management position and we’re not fully autonomous from the county.

-Consumer driven leaves the principals to the people on their own terms.

-Consumer run is peer self help and I agree that really helps, and 12-step groups help too. With consumer driven, I picked up a lot of hostility toward professionals. I’m professional mental health, have been for a long time, but I’m also a current client, and have been for a long time and went through the mill. The prejudice I have experienced has been amongst the worst, because I’m not starting at a level below, I’m starting at the level up above. I feel that the consumer driven is not that it’s driven or can’t be driven by both, it’s the question of the values it’s driven with. I think we’re starting to reform the system but first we have to do away with force. And allow participation and make the consumers people, not just mentally ill people.

-Our Center is consumer run- everybody who works in here is all consumers, and I don’t see why consumers cannot run their own center. We have dual diagnosis liaison, we have other things going on helping other consumers, we don’t need to have professionals helping us do this. Professionals helping is not self-help. That’s maybe called blended help!

-We have a blended model where very strong consumer run programs are being changed into blended models of system of care. It’s going to be all consumer run, but to me the context is so important. If you go to a clinic or a place that still has forced treatment as part of its continuum of care, where are the trust issues? Where are the power dynamics? "Oh! we’re going to blend in self-help because we think consumers work well with each other, but we’re going to now include the Voc. Program, and getting people back to school, and getting people to work and have a valued social role. People who’re doing well in the system have a vested interest in making sure that the system works. I want to run a true alternative where clients do everything, and to me that’s a harder system to maintain and run and grow than a blended model.

-Our county got new money to do outreach to homeless people- The AB 2034 (California) programs. Even though the law doesn’t say that it has to be PACT (the Program of Assertive Community Treatment) there is strong pressure on counties to go PACT. In our county they’re taking the PACT program, which can be extremely coercive leading to forced treatment, and they’re going to incorporate the Recovery model, which is more about choice, self-help, into it. I’m not sure how this is gonna really turn out.

-We have to understand that mental health care professionals have a vested financial interest in maintaining their role in mental health and a professional interest. That’s why you see these blended models coming into play. Recovery and PACT are coming into play because they’re trying to mediate both interests.

-There’s a drop-in center in Colorado and they’re consumer driven for sure, but they’re closely connected to a clinic and they each have their own boards. According to the by-laws, the two boards have a veto power over the other boards’ decisions. To my knowledge, neither board has exercised that veto, but it’s an interesting combination. The drop-in pretty much determines what it does, its budget is basically determined by how much money is available to provide services and they’re very creative about fund raising - the consumers are in control. They do the hiring and firing, the budget, determine what programs are available. Theoretically there is that veto power that each board has. But they work in close conjunction with each other and they’re one of the few organizations that really does effective outreach to the homeless. I don’t think that the consumers feel themselves to be particularly constricted.

-Consumers do not have professional ladders yet. Where can we acquire continuing education units like professionals do? Could CMHS begin thinking about how to build that into Federal RFPs?

In Alaska, we developed the PACT into something that doesn’t even look like a PACT, called "Recovery by Choice".

-I don’t think the terminology consumer run and consumer driven is as important as consumers like me having plans for when I am less well. Having people who work with me, who I trust, know what the plans are and for me to be able to say: "let’s go with plan B." The consumer owns the responsibility to think ahead to times when–they're less well. Using the WRAP model, I know when I’m doing OK, what I have to do everyday, knowing what signs there are that I’m not doing so well and having planned who helps me when that happens. That is really consumer directed. It includes people in our mental health clinic system, but it also includes friends, and other professionals I’ve met along the way who are friends now, so that I don’t have to totally trust the system.

-It sounds like you’re talking about something that isn’t necessarily a system but you’ve surrounded yourself with, what your plan is, what you need, and the people to do it. You’ve kind of created your own support system.

- I feel the Wellness Recovery Action Plan (WRAP) sets you up to think about crisis. I wonna run my life in a planned way and a non-crisis based way. I’m ready to take responsibility for all my life. I agree that you need to have supporters and plans for what to do when things aren’t going right, but I also think there need to be plans for things like retirement, vacations and things that people do on a regular basis. We’re so mired in symptom management and relapse prevention. I’d like to get out from under the medical model. The other day someone said, "I think the WRAP is wonderful because it has the client telling me how they want their treatment." Well wait a minute, I want my life! I want to know who, in the community, supports me whatever state I’m in, mental, physical or otherwise. I don’t think the mental health system necessarily is the best broker of all the needs I have. I don’t want them brokering my spirituality. I’ll go to a church or a medicine man or whoever, for that part of my life. I don’t want them brokering my education. I’ll go to school or something else. It seems like with WRAP everything has to have a mental health balance to it: "Oh, you’re going back to school because that’s part of your WRAP plan."

-In our county it seems to be the new thing that every client has to have. It’s a big thing in places where supposedly it’s totally client driven, but it smells to me like a service plan.

-The WRAP is a plan where you start talking about this is how I am when I’m well. You might even take a picture of yourself when you’re doing well. This is what I look like. This is what I have to do to stay well.

-I think the problem that some people are talking about, with the WRAP plan has to do with the way it’s implemented and who’s doing it. We had one of the state employees here went to Vermont to take the training in it. She’s been leading regular training sessions to train consumers to go out and start WRAP groups.

-We’ve been doing this for about a year and a half now and it’s being implemented primarily here by consumers. I think it’s being run the right way, where you start with a snap-shot of what you’re like when you’re doing really well and then you work backwards to find out how you slipped into being not well. Then you put together some plans on how do you avoid slipping into being not well.

-In California, we also have the Living Will. With the Living Will you make out your own plan as to when you get sick, what you want done, and you have to have a... My son is my provider (AKA agent).

-We’re also looking at Advanced Directives in California, that’s at the very extreme end of the WRAP. You start with when you’re well and what you need to do to stay well and the very end of the WRAP us: "Should I ever get to a point where I am not competent to determine my treatment or I’m unable to communicate my wishes, then I’d like X, Y and Z to happen."

-The WRAP, however, is not a legal document at this point

-The Living Well is a legal document.

-We have a uniform health care decisions act, in Hawaii, that was passed in the early 90's. We also have a separate law to allow people who are diagnosed with psychosis to have special advanced directives. We’ve been trying to get that distinction removed and to incorporate the two and to get facilities and medical people to recognize that this has been legally signed, this is what we want and so it needs to be followed. When I got a provider that I'd already said does not work for me, I was able to say: "My medical records please", and when they said "I don’t see anything about that provider" I pointed to the name in the document and they got me another provider. You can go the legal route, but it requires help. We’re working with our local P & A to come up with a form which will do both end of life and during life help for when we are much less able to make our own decisions or to indicate what it is we want.

-WRAP is basically knowing one’s triggers. What will set me off.

-If someone doesn’t want to be WRAPed they shouldn’t have to.

-Do things like the WRAP plan incorporate some guarantees that all the reasonable regular medical suspicions have been addressed?

-Values are really important. You can have consumers in these positions but that doesn't mean they have the values.

-Management people have to have, not only the experience but they have to have professional knowledge to gain respect by the others in order to negotiate.

-They have to have the values.

-Humanistic values.

-Participation and choice.

-Participation, volition, humanistic, informed consent.

-I’ve found that there’s less stigma involved in a consumer run organization than there is in a professional run organization. For some reason there seems to be a lack of understanding among many professionals of mental illness and there’s stigma involved in the communication. It’s much better between people who know each other, who know what they’ve gone through and everything. I think it’s much better for consumers to do what they can for consumers for that reason.

-In a professional run organization, there’s a lot of misunderstanding and ignorance among professionals. Consumers can communicate with each other better than professionals can.

-Can not a professional be a consumer? Aren’t there many public consumers who are professionals? And some of them are probably closet consumers.

-Only for a short time have I really been out of the, "out of the closet" as a consumer. In Patient’s Rights, the other clinical professionals, most of which are LCSWs and doctors, seem to really respect me, and value me a lot. I feel just as comfortable with the Office of Consumer Affairs, as I do with, a patient’s rights organization run mainly by, "professional people" that don’t identify as consumers. I have equal education to people in my office, ... but I am a consumer. I feel there’s a lot of understanding, a lot of compassion and there’s the values. The people in my office have good humanistic values. I think the values are more important than anything. I think consumers can be prejudicial towards each other just as much as professionals can be prejudicial towards consumers.

-I’ve been trained as a professional. I was a consumer first and sometimes when I come out as a consumer people respect that because they feel it’s important for consumers to have a voice and empowerment. At other times in my life I’ve been aware of when I was doing a no-no by disclosing that. I’ve also had the experience where I’ve been out as a consumer for so long that many people don’t know that I have any professional training. I went to a workshop where there were a whole bunch of professionals and I started out by saying: "I’m a consumer, and by the way I have all these degrees." It really shakes them up.

-We don’t have a lot of the antagonism between the consumers and the system here. I’m trying very hard to develop an attitude that consumers can be professionals. We’ve got a case manager aide program, where consumers are trained to be case manager aides and it’s part of voc. rehab. We’ve gotten into a discussion here recently, the professionals have, over problems with consumers as employees and also as consumers and it brings up dual relationship problems.

And it seems to me that’s the crux of the difference between consumers as professionals and professionals as professionals. That is the fire-wall that professionals have built into their training, that they don’t establish dual relationships. It seems to me the power we have to bring, particularly to things like peer counseling and self-help support is self-disclosure, and the extent to which we are part of the community. We are trying to help our fellow consumers and so the issue of dual relationships with professional consumers comes up. If we can get the mass of consumers going into the schools and getting some professional training it’s going to have to change the nature of the training of the professionals and that’ll make a difference in the whole system.

-How do we develop professional standards for peer run services, what are the dual relationship issues for a peer counselor? At what point is it damaging for a peer counselor to have other kinds of relationships with the people in the general population of the drop-in center that they’re working in?

-A dual relationship is when you’re a peer counselor and you’re peer counseling someone who is a room mate, or you’re peer counseling someone who is a friend. That’s not really a problem unless you’re in an environment where you're working as a peer counselor, and that’s your job title. On the other hand, it would be great if we used peer counseling with our personal relationships, it would make things go better, but there’s not the role of the peer counselor, of being someone who is being there for the other person.

-I’m very confused because "being there" seems to be a friend and that doesn’t seem to be what one would define traditionally as professionals since you’re not supposed to be a friend, apparently. I was always a professional who was a friend. And professionals that helped me, even psycho-analysts, were friend first. They maintained a professional ability to do the process. It didn’t mean they weren’t my friend. Those are boundaries and maybe they’re set up for clarification of roles. But they’re not impenetrable depending on your own values.

-When do you need to be a fellow client and a peer and when do you need to be a professional if you continue along this thing where clients wind up with more and more training. I dislike that consumers were training to be case manager aides, as it almost implies that they’re not capable of becoming case managers on their own.

-How about consumers who just move on to the regular work force. I used to work in the mental health system, as a peer counselor, and as an advocate. But right now I have given up on that and now I work a regular job.

-Was there a certain freedom, when you moved on and left the mental health system, and left that kind of identity?

-A clinician here in Colorado developed a peer counseling training program. There’s a lot of role playing involved and by the time you go through the training program you feel like you’ve been doing counseling for several months. The people coming out of the program are raring to go, and feel pretty confident in their ability. The training manual is really growing in credibility with the professionals.

-When it comes to the Case Manager Aide (CMA) program somebody talked about them being aides and not case managers, this is a six month training program and the regular case managers feel like that’s not a whole lot of training. This CMA program’s been going for about ten years now and over the course of time a lot of these CMA’s are going to school, getting advanced degrees and there’s quite a number of them have become regular parts of the system, making the same money and holding the same positions as other professionals in the system.

-12-step programs for AA and NA are really advanced and progressive in hiring people who are recovered, or who are ex-users, or ex-alcoholics. AA recovery programs, substance abuse treatment programs, have a better acceptance of the counselors who are also in recovery themselves. They put more value on the experience of the person. In alcohol recovery centers, they actually have counselors who are ex-alcoholics themselves and they are very valued people and they are equal paid, they don’t seem to have the issues that mental health people have. In the mental health system we have right now, the peer counselors are not getting paid right, there are territorial issues and class issues. The AA and NA programs seem to have a better system.

-On the one hand the system says we’re a system of care, we’re a mental health system and yet so much of the services they deliver are under lock and force. I would like them to separate the two out and be honest about it so that I could choose.

-A stress motel that be a place that I could come when I’m really under the stress, and check myself in like a hotel. They provide services like a hotel, like hospitality, and places that I could go and talk all night if I needed that, or do art, or meditate, or swim, or whatever. But I would be able to decide when to check in and to check out and I could have a key to my room. And have peer counselors, or somebody who wanted to listen to me, and help me process some of my crazy dreams or whatever. I don’t know if that’s ever going to be possible in a managed care setting that says you’ve gotta have medical necessity to be here, you’ve gotta be a danger to yourself or others, or gravely disabled. If they call that consumer driven, I want to run away as fast as I can and that’s why it’s hard for me to ask for help. I’m lucky enough to have self-help where I do feel comfortable and in charge. Power-dynamics are different in a client run setting where you say: this is my experience, take what you want from it, leave the rest. I don’t have any magic knowledge about you, or your symptoms, or your whatever it is. I can’t cure you, fix you, or anything else, but I’m here to listen, and maybe I can help with a couple of services I know about. In the last couple of years, everybody’s got medicalized again. We talk too much about symptoms and we don’t talk about homelessness. I wonna see people asking those questions: where’s the housing? Where are the real support systems that people need to live in the community? If we’re constantly focusing on our own symptoms, and our own plan for when we decompensate, to me that’s just the old system again, but now we’re supposedly in charge. I wanna stay out. I’ve stayed out now for fifteen years and I wanna keep it that way and I wanna make sure that other people have that alternative. And the only way that I see that that’s gonna happen is by people saying: "I want co-housing, a stress motel room, or I want housing period".

-I don’t think anything should be forced.

-A supported residency, like a big apartment building where everyone there is a client but there’s also a central place where they can get together and work with each other and get support from each other.

-Equal employment opportunities that provide both privacy and reasonable accommodations. A lot of mental health consumers that are hired into the system, their privacy on the job is not respected and they’re not given access to reasonable accommodation.

-I’ve been out of the mental health system for thirty years. I consider myself a survivor for sure. I keep getting into bad working environments where the materials we work with hurt you physically. Bill Moyers did a trade secrets program showing how we’re surrounded by materials that can cause aberrant behavior and everything. My wish would be that you wouldn’t just get thrown into the waste basket as far as diagnosis, and there’d be more of a scientific interest in what causes aberrant behavior.

-An ideal helping service or system is one that you can leave it and go into the world and be a regular person. Instead of having to always live your life as a mental health client, being labeled.

-My wish list would be support for people like myself who have moved on to the regular work force and are not dealing with the county mental health system, but are now dealing with private insurance, the private sector. When I was in the system, I had all the resources of you guys... But when I’m in the private sector, I don’t have those resources any more. In the event I have problems, what am I gonna do?

-I went to a mental health court to see how it was operating. It was the source of my real problem years ago. What I noticed was the judge was not talking to the mentally labeled person. When the judge needed more information, he would then send them to a forensic psychologist. He wouldn’t even ask them. My wish would be that there would be some ability for this mental health court to treat the person as if they weren’t incapable and incompetent to speak for themselves. The consumer would be able to have their friend, mental health advocate, care advocate, or peer advocate, go with them to court and speak with them, or let them speak, just being support. It would give me a sense that they're protecting the rights of the person. The mental health court is the first beginning, but it’s got a function. At the MH Court, one person was trying to get out of Napa State Hospital. He wasn’t there, but he had sent information to the judge and the judge didn’t take it lightly. He was a voluntary patient at Napa, and they were trying to commit him. The judge actually ordered the Napa State Hospital to let him go. There is $850,000 each year for three years in Placer County for the homeless mentally ill project. That would be my wish: seeing the people having the rights they should, to speak for what they want.

-It sounds like what happens because they’re in mental health court and they’ve got this label then they’re not seen as people who can speak on their own behalf. Would they be treated differently if they were in just a regular court?

-I was in a regular court. You’re charged with incompetency. You spend three months in jail without bail. Then you might get sentenced to a state hospital for six months, all because of trespassing.

-The mental health court is an improvement but it’s only one step. The judges have to be educated, the public defender didn’t even talk to the consumer, it was like the consumer was non- existent. He sat beside them, but never had a pre-conference with them, the way you do in regular court. Of course in the regular court there are not many choices. The only choice is being labeled incompetent.

-My wish would be that we would get away from, this categorical way of looking at our lives and ourselves. How we separate ourselves whether it be as women versus men, people of different races. I think that being socially constructed as a consumer, mental health client, it’s really important for us to get beyond these types of categories in the world. These categories, ways of looking at ourselves, identifying ourselves and our experiences are very confining and add to a lot of the problems that we seem to be in the middle of.

-A healing setting where there’ aren’t those distinctions or categories.

-People like to say "Well OK, there’s anxiety, there’s depression in the world, the people that have anxiety and depression have a mental illness, or are mentally disturbed." I think it’s an issue of functioning and a matter of degree in terms of how this is going to affect your functioning. I think that for us to separate ourselves out into these different kind of hierarchies and roles, is very problematic. There’s just different ways of understanding these conditions and these states beyond using, Western psychology. I hope that as consumers we’re not confined to any professional way of looking at experiences. The world has gone on for thousands of years without psychology, psychologists, social workers and case managers and I think we need to bring the discussion into history, culture, society and politics, expand it beyond the narrow confines of psychology which I think dominates and limits human possibility in our world in the modern age.

-In my perfect world no one would have to die because they’d run out of options, or die on a 5150 (involuntary commitment in California). We should be well beyond looking at the survival of the fittest. That should be relegated to the animal kingdom. We have the capacity and the gift to go way far beyond that. I’m hoping that in the future we can be there to support our most vulnerable folks.

-My wish is to end discrimination towards mental illness.

-I’d like to see the end of hate crimes perpetrated against the mentally ill.

-I wish that everything we’ve talked about in this conference, the powers that be would put a dollar value on it. There’s an abundance of very well-trained peer counselors out there who have no place to use their skills--the money’s not quite there. Which has to do with the cultural acceptance of the mentally ill. As soon as a few movie stars went into Betty Ford Centers, drug rehab was more acceptable, and so more money went into it. That’s not happening yet with the mental health system. There just isn’t money out there because so many people just don’t care.

-My wish would be that the psychology departments of the universities, colleges, junior colleges in this country would be permeated, saturated with consumers going to school and that over time that would force a complete rethinking of how we deliver services from top to bottom. I think that’s the way we fundamentally change the way this system operates. I think it would force recognition that we bring something unique to the table when we’re talking about providing services.

-The universities need to be more inclusive of mental health consumers.

-We could say that we do not want to see things, we do not want to hear things, we do not want to imagine things that are coming from the radio and the TV. We do not want to be delusional.

-I didn’t know that my neighbor didn’t respect me until she said something like "Take your psych medication, Sylvia." I hadn't been on psych medication for twenty years. I think mental illness should be taught to the common person, like alcohol and drug abuse is being taught. My wish is: please respect a mental health person. Teach that to the people.

-Amy Goodman, from her show on Pacifica has several people dealing with mental health but there was not any consumer on that show and we needed to be there in order to have a balance. So the wish is that maybe we can get more into the discussion.

- Have CHMS use "people first" language

-Use the word discrimination instead of stigma. We need to begin replacing the words in language, in literature, in conference titles, and workshop titles. To let people know that stigma is discrimination, a civil rights issue.

-Culturally competent people who speak other languages who also have to have the mental health training to understand what the real issues are. Inclusion of outreach services to minority groups for the grants and proposals that are being sent out of CHMS and SAMHSA.

-I’ve got a definition of empowerment: everybody is treated as a valuable human being with an important contribution to make.

-One of the most important things above all, is relationship, it takes two to bring out truths. One to speak it and one to understand it. I don’t think the concept that is now being pushed, that people who are labeled as mentally ill can’t learn is correct. It’s relationships in which we learn. Community based ACT teams don’t allow people to relate to one person. They don’t have continuity of a relationship, and I think that’s destructive. So my wish would be that there is a peer counselor or whomever, to be a regular educative force, a human resource for relating. Because it’s the relating that will allow some of the dreams: shelters and hotels, and places away from stress. It’s relationship that is a human...I would like to see a human embodiment of stress relief.

-Typical insurance policy plans for employees have such meager mental health benefits.

My wish is that mental health would just be called health. A health benefit.

Notes taken by Felicity Wallis and Carol Patterson

1.  NASMHPD Position Paper on Consumer Contributions to Mental Health Delivery Systems

2.  WRAP Crisis Planning by Mary Ellen Copeland

3.  Housing Advance Directive created by the California Network of Mental Health Clients

4.  Moral Therapy

5.  Crisis Hostel: Alternative to psychiatric hospitalization

6.  Stepping Stone crisis respite program will offer compassionate alternative by Shery Mead

7.  Warm Lines: An alternative to hospitalization by Daniel Fisher

8.  Service dogs help people get back out into the community by Patricia Deegan

9.  Personal Care Attendant (PCA) services available to people with psychiatric disabilities by Patricia Deegan