Wednesday, April 22, 2009


We are experiencing a time in this country unlike any in my lifetime. I have been on this earth for over sixty years and more people in this country and around the world have their backs up against the wall than ever. Solutions are being sought, but are they really the ones that help people over the long haul. Do you give folks a fish or a fishing pole? The following piece comes off the website of Heifer International, which can be found at

“A Midwestern farmer named Dan West was ladling out rations of milk to hungry children during the Spanish Civil War when it hit him.
“These children don’t need a cup, they need a cow.”
West, who was serving as a Church of the Brethren relief worker, was forced to decide who would receive the limited rations and who wouldn’t – literally, who would live and who would die. This kind of aid, he knew, would never be enough.
So West returned home to form Heifers for Relief, dedicated to ending hunger permanently by providing families with livestock and training so that they “could be spared the indignity of depending on others to feed their children.”
In 1944, the first shipment of 17 heifers left York, Pennsylvania, for Puerto Rico, going to families whose malnourished children had never even tasted milk. Learn about the cowboys who brought cows and kids together.
Why heifers? These are young cows that haven’t yet given birth – making them perfect not only for supplying a continued source of milk, but also for supplying a continued source of support. That’s because each family receiving a heifer agrees to “pass on the gift” and donate the female offspring to another family, so that the gift of food is never-ending.
This simple idea of giving families a source of food rather than short-term relief caught on and has continued for over 60 years. Since 1944, Heifer has helped 8.5 million people in more than 125 countries.” From the Heifer International website
This is more than a story about one man’s dream, but it is also the story of many people being able to dream again. The AARP Magazine in its May/June issue has an article by Barbara Kingslover about her trip to Nepal and the work of Heifer. It can be found at

Why am I going into such detail about all this? Because if you want to help folks you have to reach out in ways that empower them to help themselves so they can regain and maintain the dignity of their humanness. That is what the Messiah did for us on the cross. He made it possible for us to be restored. To be completely whole again. To become a new person. Persons with brain disorders and their families need to know and to be able to dream again about becoming whole.

Wednesday, April 15, 2009


I have never liked to be referred to as a case so I am not particularly fond of the term case manager, but trying to change common terminology only leads to more confusion and we already have enough of that in the mental health field. There are many ways to deliver case management services and they go by an assortment of names. Some of the names are intensive case management, supportive case management, assertive community treatment teams, broker/advocacy case management, wraparound case management, and clinical case management. Clinical case management is a model where the case manager is also the person’s primary therapist. Trying to define all the others would be futile because they mean slightly different things depending on where they are being put into practice and the resources available to the system implementing the model. They are also put together in varying ways in different systems across this country. The point is I cannot say supportive case management and everyone understand the word in the same way. The simple truth is we have an array of case management concepts implemented across this country working to varying degrees.
I want to suggest a team approach for those of us with a severe and persistent mental illness based on the idea that we are bio-psycho-social-spiritual beings.
Bio: The team needs a primary care physician, a nurse, and a psychiatrist.
Psycho: The team needs a psychologist preferably with a doctoral degree.
Social: The team needs social workers, rehab specialists, peers, and an advocate/broker case manager.
Spiritual: The team needs a pastor, minister, chaplain or some way to get to the spiritual care of their choosing.
This may sound grandiose, but preventive care and ongoing excellent care is less costly in the long run than poor care and hospitalizations.
We can do better and the truth is we have the moral obligation to do so.

Thursday, April 09, 2009


I have known mental health advocates who seem to think they are not doing their job if they are not finding something wrong the staff are doing or have done at a state mental hospital. It is a good thing to make the care received by folks who are locked away as first rate as we can. Most of them are not there voluntarily. Since we are forcing them to be there claiming it is our right as a state to do so, we certainly owe them our very best psychiatric care under the safest conditions we can possibly provide.
The key some folks seem to be missing is that the people working in state hospitals are humans with all the same emotions and baggage the rest of us carry around. Which means in very plain and basic terms if I want to be treated like a human when I am a patient in a state mental hospital then I had better hope the staff there are being treated fairly by their superiors, critics, the media, and the public. The better they are treated the more likely I am to be treated well. If you care about the patients, you will care just as much about the staff.
Recently, the staff at Broughton (the state hospital in Morganton, NC) was vindicated by a judge who said a previous investigation had not been accurate or fair. Will the public remember that or all the bad press?
We must at some point learn to respect each other enough to see one another as fully human. Staff, patient, family members, the public, media, and government all have a role to play in this endeavor. As long as we can look pass, each other without seeing the humanity of the other we will remain in the darkness. The light only shines when we open our eyes and see the person next to us as they really are. Fully human no matter how flawed.