Wednesday, April 30, 2008

DAJ ONLINE/ APRIL 30, 2008

April 30, 2008/ EDITION
Rather than writing twice a week on Mondays and Thursdays I have decided to change it to a weekly schedule. I have also changed the name to the DREAM AGAIN JOURNAL ONLINE. We published the DREAM AGAIN JOURNAL for a few years in the 90’s and so this is the resurrection of an old endeavor for Project Dream Again. The DAJ Online will come out on Wednesdays. Along with those folks who receive it by email it will be posted at the sites listed above.
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According to findings published in the Proceedings of the National Academy of Sciences outdoor activities is on the decline while people spend more time online or in front of the TV. For example fishing peaked in 1981 and by 2005 had dropped 25%. Visits to U.S. national parks are down 23% from their high point in 1987. Why does any of this matter? I could give you reasons like if you aren’t out in nature you will not be as interested in the conservation of it. However, let me see if this one finds it way into your inner being. Have you ever been feeling low and heard a bird singing and the sound lifted your spirit? Nature can nurture your very soul. Merriam-Webster Online defines nurture as “the sum of the environmental factors influencing the behavior and traits expressed by an organism.”
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Mark Penn has written a book titled Microtrends: The Small Forces Behind Tomorrow’s Big Changes in which he argues that it is the little things that shape the big things of the future. I want to share just a couple of things from the book. (1)The top 1% of American pets live better than 99% of the world’s human population. (2) 54% of black 12th graders said religion played a very important role in their lives, compared to only about 27% of white students, and their church attendance correlates with lower drug and alcohol abuse, later sexual activity, and altruistic attitudes. [Seems if they make it to the 12th grade their religion played a major role] (3) Ten times more men regularly visit Internet pornography sites than regularly watch baseball.
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Reinhold Niebuhr was one of the seminal religious thinkers of the 20th Century. As a theologian, ethicist, and pastor, he worked to make the Christian faith comprehensible to and responsible for the modern world. The legacy of Reinhold Niebuhr, along with his brother, H. Richard Niebuhr, is a socially engaged tradition of thoughtful Christian activism, and a realistic and sober recognition of the limits and possibilities of human aspirations.
Niebuhr began his career as the pastor of a German Reformed congregation in Detroit, but very quickly grew to national prominence as a writer and speaker on the issues of his time -- war, poverty, racism, and social inequality. He stood for a progressive Christianity that believed in making a positive difference in the world.
As his theology matured, he came to argue that the human capacity for evil could not be easily overcome by simple appeals to the love of God and neighbor. In rejecting those versions of the Social Gospel movement that seemed to be too reliant on a naively optimistic assessment of human nature, he began to develop his own approach, which came to be known as "Christian Realism." This realism stood in contrast both to the idealism of Christian pacifists and socialists who believed that social change could be brought about by pure moral suasion, and the cynicism of the more Machiavellian brand of realism, that believed that politics was a realm of power not subject to moral critique. Niebuhr sought a middle way between these two positions, recognizing politics as the realm of the struggle for power, but affirming the need for principle to underlie and uphold the human conscience in that struggle.
We need some of his realism today. We can’t afford more talk or study groups. We need action based on realism. What is really going on with real people in their daily lives? To learn to Dream Again and begin the recovery journey takes looking realistically in the mirror not rhetoric from Raleigh.
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org
www.ffcmh.org

Thursday, April 24, 2008

FAITH FAMLIES

I am not sure if my parents were happier the day I was born or the day a psychiatrist in Atlanta told them I had a brain disease called bipolar disorder and that all my problems were not their fault. You see before that day they had been blamed for my actions and how I turned out.
It seemed to weigh harder on my father than even on my mother. My mom told me more than once how hard my birth was on her and I was never really sure she forgave me. Dad seemed more concerned about how my behavior looked to the community. He was a minister, missionary, school principal and church leader. Having a son who did not conform to the norms of the day was not a comfortable feeling for him to say the least.
In our society today we place so much emphasis on the individual it may be hard for some of you to understand what I am talking about. Hebrew tradition and the fifth commandment says “Honor thy father and mother”, but we have mostly pitched that out with the other ideas we consider archaic in favor of making sure we do not infringe on individualism.
In Christian teachings we find in the 6th Chapter of Ephesians the same words as in the Hebrew fifth commandment. When Dad would remind me of this, I would quote from the 4th verse of the same Chapter where it says “Fathers do not provoke your children to anger” and he never seemed to find any humor in my response.
Along with the fact that Mother’s Day is almost here and Father’s Day is not far off there is another reason I am talking about family. Those of us with disabilities are going to need our families. We are going to need our extended families which include our FAITH FAMILIES.
We are in what I call silly season. Other people refer to it as election time. Right during election (silly) season President Bush has decided to cut Medicaid funding. These cuts could cost North Carolina almost 12,000 jobs and over a ½ billion dollars in Medicaid funding.
I have been writing, speaking and teaching about natural supports for years. Natural supports are things like family and faith communities that folks like me can rely on for help and support.
I don’t care how you vote or what party you belong to. This is not a political blog. I am saying we had better stop making the individual the focus and make our communities the focus. The early church practiced something I would call communal democracy. They took care of each other. It might be wise to look back to the early church and to Hebrew law and traditions and take a second look at the idea that maybe community is more important than the individual. Maybe the whole is greater than any single part. Maybe the least is the greatest. All I know for sure is we are going to need our families. Yes, our FAITH FAMLIES TOO!
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org
www.ffcmh.org

Monday, April 21, 2008

A RESPONSE

This is one of the responses I got to my last blog.
Hi Ed:
I had to look up this article; I also looked at the review article written by Compton et al from which he quotes. Reading between the lines it would seem the esteemed Dr. Geller has something personal against CIT—but hey, that’s just an opinion. The disdain for “many folks who are the ‘beneficiaries’ of frequent police pickups which lead to jail, emergency room, psychiatric hospital, or shelter…” is obvious. After all, “In a short time they’ll be back on the streets, and the play will repeat itself.” In other words, CIT is a waste of time and money because training cops to take people to treatment when the people don’t want it doesn’t work. It didn’t make the hairs on the back of my neck stand up; it turned my stomach. But you can ask Dr. Geller any question you want. At the bottom of the first column on the first page of the article is his contact information:
Jeffrey L. Geller, MD, MPH
Department of Psychiatry
University of Massachusetts Medical School
55 Lake Avenue North
Worcester, MA 01655
Better yet, his email is jeffrey.geller@umassmed.edu
I’m too pissed to email right now; if I ever do, I would ask what he would recommend, in light of the numbers of people who are on the streets untreated. And I would disabuse him of the delusion that treatment is readily available and accessible, because you and I know that it is not. And I would remind him, because he might have forgotten, that mental illness is a relapsing, chronic condition, and that we are prone to setbacks. Unlike superior specimens like him, of course, who have no need of professional help and who never have encountered the criminal justice system from the bottom side. By the way, his disdain is not only for consumers—did you catch the “I’ve trained police officers, and those who are interested pay attention; those who are not, do not.” This, obviously to him, is because police officers are different than other people? I know lots of psychiatrists who don’t listen or pay attention to their own patients!
What, I wonder, does he really want? Maybe he thinks cops should just be cops, and leave the treatment of mentally ill persons to the professionals.
He is a pompous ass. All that intelligence and all that ability, and this commentary is nothing but a mean spirited criticism of people who are trying to help. There is not a single positive recommendation, not a shred of evidence of concern for consumers, or for police officers, or family members, or anyone. I think we do need research. Evidence-based is always best. Always. I think CIT can be improved. So---we wait and do nothing until someone conducts a multicenter, randomized, double-blind study?
E-mail him if you must, Ed, but let’s not you or I spend too much time fretting over this. We have our own recovery to work on, and lots of friends to support in their recovery.
Jana
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org
www.ffcmh.org

Thursday, April 17, 2008

QUESTIONS

When you read an article you can’t ask the author questions. I would like to ask Dr. Jeffrey L. Geller a few questions about his article “Commentary: Is CIT Today’s Lobotomy?”. {I found the article online in the Journal of the American Academy of Psychiatry and the Law Online} Dr. Geller, MD, MPH is a Professor of Psychiatry, Department of Psychiatry, University of Massachusetts Medical School and I am person with less than two years of college. So let’s come up with a title for me. I am an ordained minister, but that does not get me into this discussion. I am a primary consumer ( meaning I have a mental illness) and a family member ( meaning one or more of my family members has/have a diagnosis), but that does not get me in the discussion either. Maybe if I called myself a folk anthropologist I could get into the discussion. Well I declare myself a folk anthropologist. Do I now qualify for the larger discussion or am I still on the sidelines?
“Being in favor of educating officers of police departments about mental illness and mental health services is like being in favor of motherhood and apple pie. Who could be against it? Refining this educative process to cadres of selected officers who become informed, benevolent interveners on the streets of our cities (and maybe even our towns and villages), saving from jail those whose mental illness-driven behaviors bring them to police attention sounds even more right. It is this first-blush appeal that accounts for the proliferation of Crisis Intervention Teams (CIT) from their origin in Memphis, Tennessee, in 1988.”
That was how he began his article. He ended it like this.
“Finally, there's the cost of CIT. First, to train officers, police departments must carry part of their workforce on overtime since the officers in training are in addition to the normal workforce. This, in and of itself, hinders police departments from endorsing CIT. Second, there is a cost to the mental health system, since it is burdened repeatedly by receiving those who do not want services. Hospitals are called on multiple times each year to provide care and treatment to the same cohort of unwilling consumers CIT delivers to it. This is, in part, because CIT is an unleveraged process. There is no contract, the prospective patient has no responsibility, and there are no consequences. For many folks who are the "beneficiaries" of frequent police pick-ups which lead to jail, emergency room, psychiatric hospital, or shelter, the immediate outcome is irrelevant. In a short time they'll be back on the streets, and the play will repeat itself. For far too many, "CIT" might just as well stand for Consecutive Interventions without Treatment.”
Is this a sound argument? It sounds right. It is well written. It is argued by a prolific author and a highly regarded man in this field. Why do the hairs on the back of my neck stand up? It almost seems like in the end he stops writing about CIT and takes a shot at us. If we were not on the streets we would not be costing so much.
Well as he points out in his article we have been guinea pigs for many ideas over the years and eventually we seem to be resented for our mere existence.
My question to Dr. Geller and to my readers is very simple. As I have revealed before in this blog, I have spent lots of time on the streets too sick to even know my name at times. Do you think I would have rather been confronted by a trained CIT team or a SWAT team when I was so sick and living on the streets?
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org
www.ffcmh.org

Tuesday, April 15, 2008

MENTOR

I know I am a day late with this blog. I would not make a very good newspaper publisher or editor because you wouldn’t get your paper on time and if it was a daily you probably wouldn’t even get it every day. I spent yesterday with two great friends driving up from Glen Alpine, NC to Stone Mountain State Park, NC. Yes there is a SMSP here in NC as well as the more famous one in GA and I am sure there are more I don’t know about. We stopped in North Wilkesboro on the way up because we saw an antique store that looked interesting. Once inside we discovered it had four floors and decided we would need to come back because this store alone was a half-day adventure. It was full of the dreams of folks from the past and held dreams for new folks from the future.
We finally made it to the park were we saw deer, turkey and beautiful trout streams. I saw the biggest tom (a male turkey) I had ever seen in my life. There were three men there with packs on their backs and poles with round circles on the end. We tried to guess what they were geared up to do. We could not. Finally I walked over and asked them. They were student researches from North Carolina State University and the devices were to shock the fish in a portion of a stream so they could get a count of the fish. I wanted to go with them for a spell, but they didn’t invite me.
I don’t know much about being outdoors, but what I know I have learned from other people being kind enough to share their knowledge. The person who has been most patient with me and taught me the most about the outdoors and fishing is a guy named Russ. It isn’t the fact he has a graduate degree in the subject or worked and wrote in the field his entire working career that makes him a good mentor. It is first, that he is willing. Secondly, that he has the patience to deal with even me. Thirdly, he knows when to teach and when to let you try on your own. He makes a good mentor.
I found this in yesterday’s New York Times “On Saturdays during the school year and all week in the summer, PinChang Huang, 16, leaves her home in Queens just after dawn and boards a crowded van bound for a nail salon on Long Island.
Through a long workday, she gives manicures, pedicures and massages, and observes her clients at the Aroma Spa with a careful eye. Older women are most prone to yell if you make a mistake. Customers who read books tend to tip the best.
PinChang has not seen her mother since she came to New York with her father and brother four years ago from a small village in China. She spoke no English and had no friends, and all the buildings looked the same to her, so she often walked into the wrong apartment complex on her way home from school. To ward off frustration and loneliness, she started keeping a journal. “I wrote down everything I saw, everything that made me happy or upset,” she said. “I wrote the things I wished I could say out loud.” In front of a packed auditorium at the New School in Manhattan one night recently, she got her chance. PinChang and her mentor, Deborah Kolben, a former managing editor at The Village Voice, read an essay they wrote together about PinChang’s getting her first manicure. PinChang spoke about the peculiar sensation of being on the receiving end of an exchange that often makes her feel “like a slave.” The reading was hosted by a nonprofit group that pairs high school girls from disadvantaged backgrounds who want to be writers with women who are authors, journalists, playwrights, poets and editors. The group produces an anthology of student writing each spring, and puts on several public readings.”
My point is simply that whether you are suffering from a mental illness, sexual abuse or spiritual pain everyone needs a mentor if they are ever to learn to DREAM AGAIN.
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org
www.ffcmh.org

Thursday, April 10, 2008

BIPOLAR IN KIDS

Another resource has been added to the resource list at the bottom of this blog. It is the web site for the Federation of Families for Children’s Mental Health. Their site www.ffcmh.org reminds us that “May is Mental Health Month. The National Federation of Families for Children’s Mental Health again declares the first full week in May, May 4 - 10 as National Children’s Mental Health Awareness Week. Chapters and State Organizations across the nation are meeting weekly to share ideas and resources for how to make Children’s Mental Health Awareness Week 2008 the most successful week ever!”
Children’s mental health is on my mind because the other night I watched PBS’ Frontline program “THE MEDICATED CHILD”. You can go to their site and watch the entire show and there are other resources.
Their site is www.pbs.org
Most of the program is a discussion about childhood bipolar disease. Does it exist? If so how do you treat it? Are kids over medicated? What are doctors to do? What are parents to do? The only question really not asked that should have been is what are kids to do?
Christmas 1963 my parents and I returned from the mission field in Zimbabwe (then Rhodesia) and I was enrolled in Berea Foundation School, Berea, Kentucky which was a boarding high school run by Berea College. One of my sisters was attending Berea College and the other was married to a minister of a church about 65 miles away. One day I stole a car (I was not old enough to have a driver’s license but had learned to drive in Africa) and ended up at my sister’s home who was married to the minister. Needless to say she was surprised. I spent a year going to the University of Kentucky Medical Center for both group and individual therapy before going back to the mission field with my parents in 1965. I did not know at the time what was wrong, but now I know I was in mania when I stole the car.
I tell this very personal story simply to say I may not be smart enough to tell you what medications (at that time I was not given any) children should be given or what age, but I believe from my own experiences that bipolar disorder can begin at a very early age. The episode at Berea was not my first and of course it was not my last.
My prayer is that someday we will care enough about children that we will take seriously the task of protecting them from abuse which I wrote about in my last blog and care enough about their mental health that we will invest the dollars needed to discover the truth and stop guessing and using them as guinea pigs.
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org
www.ffcmh.org

Monday, April 07, 2008

NATIONAL CHILD ABUSE PREVENTION MONTH

Recognizing the alarming rate at which children continued to be abused and neglected and the need for innovative programs to prevent child abuse and assist parents and families affected by maltreatment, the U.S. Senate and House of Representatives resolved that the week of June 6-12, 1982, should be designated as the first National Child Abuse Prevention Week. They asked the President to issue a proclamation calling upon Government agencies and the public to observe the week with appropriate programs, ceremonies, and activities.
The following year, April was proclaimed the first National Child Abuse Prevention Month. Since then, child abuse and neglect awareness activities have been promoted across the country during April of each year.
The federal law does not give definitions for all types of abuse such as physical, neglect or emotional abuse, but it does give a definition child sexual abuse.
TITLE 42 - THE PUBLIC HEALTH AND WELFARE/CHAPTER 67 - CHILD ABUSE PREVENTION AND TREATMENT AND ADOPTION REFORM/SUBCHAPTER I - GENERAL PROGRAM: 5106g
(4) the term “sexual abuse” includes—
(A) the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or
(B) the rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children;
As you can see it is not a very full definition. I am aware that each state also have their laws, but I still have to ask the question are our children any better protected in 2008 than they were in the 50’s and 60’s when I was being sexually abused?
I also feel the need to raise a question most people feel uncomfortable with. When I was training as a medic in the military during the Vietnam War, I did my training in Texas. Part of my training was on the burn unit. I was unable to complete my entire rotation there. Working with burn patients was the only thing I found I simply could not do, but I was there long enough to learn the difference between first, second, and third degree burns. Why do I bring this up? Because I think there should be a language for talking about childhood sexual abuse that takes into account the different factors of the experience.
There is a way of talking about the severity of burns or pain. Has your doctor ever asked you to rate your pain on a scale of 1-10? I am not trying to say that a child touched in a sexual way has not suffered abuse. Most of the folks that have been sexually abused from an early age by a family member or someone close to the family and over a long period of time are either locked up on the backward of a state hospital or commits suicide at an early age.
Our ways of coping are different and believe it or not we recognize each other with very few words being exchanged. I had that experience with a lady in Florida and everyone wondered how I knew and why she was drawn to me when she turned away from most people.
I am saying we need a language that addresses the severity, physical pain associated with it and longevity of the sexual abuse along with what coping strategy the person used to endure the ordeal. If one created people to survive then the help needed is certainly different from a person who used another mechanism.
The language may be out there and I have just not been exposed to it. If that is true then will you please tell me where to find it? If it is not then help me develop it. We need a language that reflects the truth not some theory from an ivory tower. I was not abused in an ivory tower. It began in an Appalachian barn.
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org

Thursday, April 03, 2008

STATE HOSPITALS

The first public meeting I attended in Florida in the early nineties I got in trouble with a segment of the consumer advocates in Broward County. When it was time for public comment I stood and spoke forcefully for the need for a state hospital. I spoke against closing it and using the money for community programs. The phrase “in the community” was the popular and trendy idea to support, but I saw it a little differently. In the community for most of us meant living in isolation and poverty. Alone without much of a support system and besides I thought the person should be asked where they wanted to be.
My point was that if the state said it had a right to lock me up then it had an obligation not just to put me back into the community when it was convenient or cheaper for the state. I should have a say. I was not a very popular person at that meeting and I have found myself in a similar position at other meetings. I am not always on the side of the majority to say the least.
South Florida State Hospital changed from a state run hospital to a private run hospital. Yes they got a new building, but they also got other things. Like more restrictive movement on the grounds for example. A much more authoritarian environment. In my humble opinion a place much less conducive to healing. What a price is being paid by those of us with mental illness for the state to get a new building and spend a few less dollars.
Here in North Carolina Broughton Hospital, the state hospital here in Burke County, is going through some rough spots. They lost more than $1 million in Medicaid and Medicare money a month and are working hard to get it back. It is state run with the culture that comes with a state institution. It is making progress and may have a bright future. Is it needed? Yes.
They removed in from the division that was directly responsible for mental health to the North Carolina Department of Health and Human Services. The other division was in the same department, but now the state hospitals are directly under the Secretary of HHS. Is this a good idea?
In my opinion no. Here again I am running against the current. In this state we have what are called Local Management Entities that control the state money for certain geographic areas. The state hospitals should be under local control. The LME that make up the area served by the hospital should form a governing body to run the state hospital in their area. Funds saved by wisely using the state hospital could be used in the community. Local control always makes more sense than top down control.
Who knows best? The people on the frontlines. Give them the power to make the decisions and you will see better decisions being made. Make sure they include primary consumers and their families on these governing boards and you will see better state hospitals.
How do I know? I saw it work before South Florida State Hospital was turned over to a for profit company to run. In fact one who’s only experience had been running prisons. Let the people closest to the problems solve them. Believe in ordinary people. They will surprise you. They really do know something.
You can reach me directly at edcooper@projectdreamagain.com
{Being on this resource list does not imply their endorsement of this BLOG.}
www.mentalhealthministries.net
www.pathways2promise.org
www.mentalhealthchaplain.org
www.annafoundation.org
www.ncmentalhope.org
www.faithnet.nami.org