By Brian Coopper,
Senior Director, Consumer Advocacy
Satisfaction with services and quality-of-life is improved when
people with sensory and physical disabilities are able to choose
for themselves who should be hired to serve as their personal
assistants, according to a recent study by the Robert Wood Johnson
(RWJ) Foundation and the Department of Health and Human Services
(HHS).
In addition, the Arkansas “Cash and Counseling” demonstration
program reported that the proportion of people who reported high
levels of satisfaction with their overall care arrangements increased
from 42 percent to 71 percent when participants were permitted
to decide who to choose for service providers. “Cash and
counseling” is a program in which cash allowances, coupled
with information services, are paid directly to disabled persons,
allowing them to arrange and purchase the services they feel
best meet their needs.
Capitalizing on these results, a group
of current and former consumers of mental health services, service
provider organizations and representatives of governmental agencies
met in April to discuss how a self-determination model can be
adapted for people with mental illness and co-occurring disorders.
Self-determination is defined as the right of people to have
full power over their own lives, regardless of the presence of
illness or disability.
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The group called for change at three
levels—system, collaboration and with the individual.
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After the group finished its meeting, it
submitted a recommendation to the President’s New Freedom
Commission on Mental Health, urging federal support for the development
of a self-determination
initiative for people recovering from mental illness and/or
co-occurring substance use disorders. The commission was established
in April
2002 to eliminate inequality for Americans with disabilities.
President George W. Bush directed the commission to identify
policies that could be implemented by federal, state and local
governments to maximize the utility of existing resources,
improve coordination of treatments and services, and promote
successful
community integration for adults with a serious mental illness
and children with a serious emotional disturbance.
The group called for change at three levels—system, collaboration
and with the individual. The group also says that training for
consumers, family members, providers, funders and other constituencies
is an essential first step in achieving self-determination.
The RWJ/HHS study findings are available on the Web at www.healthaffairs.org/WebExclusives/Foster_Web_Excl_032603.htm.
More information on the “Cash and Counseling” demonstration
project is at www.umd.edu/aging. |
By Brian Coopper,
Senior Director, Consumer Advocacy
More than 150 people die each year as a
result of being placed in restraints. To address this horrific
problem, a historic meeting was held May 5 in Washington, D.C.,
titled “A National Call to Action: Eliminating the Use
of Seclusion and Restraint.” The Substance Abuse and Mental
Health Services Administration and the National Association of
State Mental Health Program Directors sponsored the meeting during
which participants discussed how the use of seclusion and restraint
in mental health treatment settings can and should be eliminated.
The meeting participants agreed that the use of seclusion and
restraint must no longer be viewed as therapeutic but instead
as a failure of prescribed treatment modalities. Many participants
recounted their own experiences of being forced into restraints
as unforgettable and traumatic experiences. For those with histories
of physical or sexual abuse (which various studies show encompasses
60 percent to 97 percent of people with diagnosed psychiatric
disorders) these experiences are especially harmful.
Some participants explained how improving training in restraint
techniques could lessen the likelihood of injury or death to
clients, others spoke eloquently abut the need to identify seclusion
and restraint as human rights violations and called for an outright
ban on their use. Because such practices as seclusion and restraint
are often covered up, mandatory reporting was presented as a
possible solution. Facilities would be required to publish data
on seclusion and restraint incidence. The meeting participants
also identified the need for increased resources for the federally
funded protection and advocacy agencies and the importance of
including current and former mental health consumers in all aspects
of the planning, design, implementation and evaluation of seclusion
and restraint programs.
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Let's Get Creative!
The University of Illinois at Chicago National Research and Training Center
hosted its latest workshop “Using the Arts to Enhance Self Determination
for People with Psychiatric Disabilities as part of its national self-determination
workshop series on May 16, 2003 in Chicago, IIl. Nationally respected speakers,
Gayle Bluebird, a consumer advocate and artist, and Robert Lundin, a poet,
addressed how people with psychiatric disabilities and their supporters use
the arts to foster individual and collective self-determination. The session
included artmaking, improv, open mike and writing exercises. To learn more
about self-determination and the arts, visit the Center's Web site at www.psych.uic.edu/uicnrtc/sdworkshop4.htm.
The Seven Beliefs
Read an excerpt See Belisa on Tour The Seven BeliefsA Step-by-Step Guide to
Help Latinas Recognize and Overcome Depression by Jorge Petit and Belisa
Lozano-Vranch
Believe in YOURSELF
Believe in SIGNS
Believe in CHANGE
Believe in TRADITIONS
Believe in your BODY
Believe in your SPIRIT
Believe in the FUTURE For many Latinas, fighting depression is a lonely, life-draining
battle. Afraid of being considered crazy or “loca,” Latinas
go to great lengths to deny the toll depression takes on the
quality of their lives and their relationships. Whether it enables
the recognition and understanding of depression in themselves
or a sister, best friend, or cousin, THE
SEVEN BELIEFS opens
the door for healing in a poignant, powerful way.THE
SEVEN BELIEFS shows
Latinas that confronting and overcoming depression is possible
if they look at each aspect of their lives, stepbystep. Now
available in bookstores everywhere! from
Rayo
Agency Seeks Rehabilitation
Comments
The Interagency Committee on Disability Research (ICDR),
an organization mandated to promote coordination and cooperation
among federal departments and agencies
that conduct rehabilitation research programs, seeks comments from the public
on research needs related to disability and rehabilitation. Identify your
needs and issues and influence future research by linking
to and completing the comment
form. ICDR appreciates the time that many respondents have already taken
to complete and submit comments. To date ICDR has received
over 600 responses,
which it will analyze. The committee will then present summary information
and post highlights about the comments on its Web site at http://www.icdr.us/.
This feedback provides ICDR with valuable information to help shape the direction
of future research related to disability and rehabilitation.
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New
Study Highlights Effective Treatment for Co-Occurring Disorders
A new report issued in May outlines
effective treatment strategies for people who suffer from both
mental illness and substance abuse disorders, or “co-occurring
disorders.” The Substance Abuse and Mental Health Services
Administration (SAMHSA), the National Council for Community
Behavioral Healthcare (NCCBH) and the State Associations of
Addiction Services (SAAS) released the report, which contains
descriptions of programs in diverse settings that deliver effective
treatment for different types of people who have co-occurring
disorders.
This report, titled, Strategies for Developing
Treatment Programs for People With Co-Occurring Substance Abuse
and Mental Disorders, includes strategies that are simple, inexpensive
and replicable. It describes various other useful programs and
steps the program staffers could take to access and leverage
local, state and federal funds that provide basic support for
treatment.
“The systems of services thathelp
make recovery possible have evolved in exciting ways over the
past few decades,”said SAMHSA Administrator Charles G.
Curie “This new report offers creative and innovative ways
to initiate change and develop innovative programs that provide
services for individuals of all ages who have co-occurring disorders.”
“This represents the first time to
our knowledge that a co-occurring inquiry of this size has been
undertaken by representatives of both the mental health and substance
abuse provider communities,” said Charles G. Ray, NCCBH
president and CEO. “The result is a candid assessment,
from various points of view, of what works and what does not
work.”
David Faulkner, president of SAAS commented, “This
report highlights what treatment providers are all too aware
of: that our regulations, funding streams, organizational structures,
and patterns of practice were not designed to facilitate treatment
of clients with co-occurring disorders. But the report also indicates
that determined and creative leaders can overcome those obstacles.”
The report makes the following recommendations:
- Strengthen systems of care at state, county, and regional
levels
- Foster workforce development strategies
- Develop roadmap products that will build on current knowledge
for developing treatment programs and systems of care
- Promote networking among participants and other stakeholders
involved in building treatment programs and systems of care
for people with co-occurring disorders
- Enable groups to share information and tools more easily
- Increase program support, especially as programs transition
from grants to ongoing sources of revenue
- Establish new approaches to funding issues
NCCBH is the country’s oldest and
largest membership organization dedicated to ensuring appropriate
and affordable mental health and substance abuse service for
the most vulnerable populations. SAAS is a nonprofit organization
whose membership consists of state drug and alcohol abuse prevention
and addiction treatment associations. The state associations
offer education, training, advocacy, information dissemination,
and technology transfer services for their member community-based
service providers.
The report is available online at: www.nccbh.org/cooccurringreport.pdf,
at www.saasnet.org.
Copies are also available a twww.samhsa.gov,
or for a hard copy, call SAMHSA’s Clearinghouse at 800-789-2647.
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