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December 9-12, 1998 F2F Steering Committee Meeting December 9, 1998 Meeting Notes Consumer-Operated Services Bernie Arons, Director, Center for Mental Health
Services Dr. Arons suggested that the Steering Committee look for opportunities to present what it is learning through the consumer-operated services program and that the information be made available to legislators. He explained that the Center for Mental Health Services (CMHS) is 6 years old and that it was created out of the National Institute of Mental Health (NIMH). CMHS received a budget increase this year; however, its operating funds were decreased so the CHMS staff may not be traveling to sites as often. He announced that Sally Rogers from Massachusetts and Ruth Ralph from Maine were selected as co-chairs of the Steering Committee. Paulo DelVecchio, Senior Policy Analyst, Office of Policy, Planning and Administration Mr. DelVecchio stated that the meeting of the Steering Committee represented an exciting day for the consumer movement. This project represents the largest federal investment of dollars to consumer-operated services to date. He stressed that as the work of evaluating the services is conducted that values of the movements should be maintained. These values included: (1) individual respect, (2) dignity, (3) the concept of social justice, (4) the concept of mutual support, helping one another on peer basis, rights/protections and the consumer bill or rights, voluntary treatment, (5) hope, and (6) diversity. He pointed out that a lot of work needs to be done in the area of diversity and that it must be valued as well as the aspects of recovery. In addition, he said that hope is what keeps us going and it is most important that hope be maintained. Mr. DelVecchio said we have a responsibility to peers to inform them about services. He indicated that as the movement grows and becomes more bureaucratic that it not take on the characteristics of the entities that oppressed us in the past and that it take caution not to re-created oppression. He ended his comments with this quotation from Helen Keller: "Nothing is possible without faith and optimism." Stephen Hudak, Division of Grants Management Mr. Hudak explained that he handles the business/finance and non-programmatic aspects of the grant, and he opened the floor to questions about finances from the Steering Committee. The following information was shared:
Overview Presentations By Grantees The Connecticut Site Department of Psychiatry, Mount Sinai School of Medicine, Advocacy Unlimited Advocacy Unlimited focuses on abilities, not disabilities. It is a grassroots movement under the guise of education. Individuals are accepted wherever they are on the continuum of recovery. If they are angry, their complaint is taken and they are worked with on what they can do about the complaint. The goal is to educate people to be vocal, united, and visible role models. The organization believes that if people try, they can gain anything they want in life and that change occurs from the inside out. Self-advocacy is the beginning base. One of the community barriers is stigma—the way people look. People look for people with mental illness to look like they are mad. If a person can not be heard because people avoid him/her because of appearance, then the person may need to change his/her appearance to become an advocate. By the person being different, he/she can remove barriers. The statewide program consists of a 14-week training course that is limited to 10 participants. The course covers the history of the consumer movement, stress and time management, public speaking, etc. There are three levels that include: (1) self-advocacy, (2) system advocacy, and (3) legislative advocacy. Participants are also taught about the American Disabilities Act. There are tests and assignments and participants are videotaped every week as they conduct presentations and are critiqued by classmates. Participants are required to do community service. Continuous support is provided for participants throughout a six-month period. There are four-day retreats where additional training occurs, and participants attend national conferences to exchange information between states. The program attempts to facilitate wellness and stability. The program works collaboratively with clubhouses and drop-in centers. Its participants come from these two sources. Individuals are instructed to build a support system that consists of a minimum of five people. Funding for the program comes from the Department of Mental Health and grants. Clients are paid $25 a week to participate in the classes so that they have money to buy clothing or whatever else they need. They get $50 a month when they enter the internship. Many clients are hired when agencies see their abilities. Some clients go back to their college education or work on their GEDs. The program stresses spirituality and the light force that everyone has, and it seeks to change the quality of life. The Florida Site The Florida State Peer Center, Inc. The $2 million grant was award to the Peer (Personal Empowerment Education and Recreation) Center, a consumer-run program. The director of the center is also project director, and oversees all grant activities, including consultant researchers from Florida International University and the Florida Mental Health Institute. Before applying for the grant, the applicants held focus groups at the drop-in center, and some consumers said they didn't want to do it for fear that researchers would control the program and change it. Ultimately, the board of the Peer Center gave the go-ahead to pursue the grant, the staff supported the decision, and the members enthusiastically supported it. Florida believes that the future of the consumer movement is at stake if it doesn't do well with this grant. The Peer Center was created as a result of a class-action lawsuit that generated $90,000 for the establishment of a consumer-run program. A drop-in center was started in 1992, and there are now 1,500 in the center's database, with 145 consumers coming to the center on a daily basis. The center provides activities, washers/dryers, showers, food, and a pool hall, and a housing program whereby people can receive a decent apartment. The center has a moving van to help people get moved into their apartments as well as used furniture. There is a shelter employment program that runs a printing operation, peer counseling, a crisis program, a warm line, and a computer lab with Internet access. The address for the web site is peercenter.org. The Peer Center also sponsors a program for elders 55 and older who are mentally ill called Silver Center. Henderson Mental Health Center was approached by Peer Center and was receptive to collaborating on the grant. It was founded in 1953 and is the largest mental health services provider in the county. It has a mobile crisis team, day treatment, site rehabilitation, community support services (assertive community treatment team). The grant will allow for the random assignment of clients who receive services only at Henderson. Another group will be randomly assigned to receive Henderson services plus Peer Center services. Clients will have a choice about where they want to go and will be tracked for 24 months. The grantees did not want to violate consumer freedom of choice. The advisory board for the grant consists of two staff from Henderson, two consumers from Henderson, three staff from the Peer Center, and three consumers from the Peer Center. The pilot study will be starting soon to test instruments on members of the Peer Center. One hundred members will be tested and the instruments refined. Then another group of 25 will be tested and additional refining will occur. Indicators to be measured include empowerment, housing, employment, socialization and satisfaction. Because 95 percent of the Peer Center’s clients live in poverty, the poverty burden and effects of poverty will also be studied. The California Site Center for Self-Help Research, San Francisco Office of Self-Help, MHCAN, Consumer’s Self-Help North In preparing to apply for the grant, a couple of drop-in centers were looked at. Researchers and consumers were brought together to find out what the concerns were. The group met on a regular basis and this led to the founding of the Center for Self-Help Research. The center set an agenda to develop the measure of concepts and types of outcomes the consumers wanted to look at such as empowerment, self-esteem, and other things they thought were being left out of the evaluation of self-help programs. The group proposed a randomized trial of self-help, mental health, and self-help alone. The trial was conducted on people entering the mental health system. There are now 477 people in three groups in trial. One group consists of people who come to services on their own, one is randomly assigned, and the other is of mental health services. Three county mental health centers and three drop-in centers are represented. The group serves an ethnically diverse and needy clientele. Mental Health Client Action Network in Santa Cruz, California Santa Cruz is a tourist town to which many homeless are attracted. The network was initially funded in the county in 1991. Staff went to a conference and came back radicalized. The program had been operating out of a Methodist Church basement and people weren’t aware it was there. All staff worked 20 hours—the staff has been consistent. The program has a budget of $110,000. The peer counselors receive stipends. There is a high percentage of men who come to the program. The emphasis is on expressive communication and not on advocacy. There are classes in creative writing, art, poetry, guitar playing, group folk singing, crocheting and knitting. The network tries to get people out of systems that ghettoize them. Participants are sent to corporate computer classes and they are not treated differently. Referrals come from homeless centers, case managers, and the courts. There is a career services co-op and people are hired from there. People who are about to be released from the hospital are brought to the network for socialization. People get to make choices—they are accustomed to being told what to do. There is one mental health center and one hospital in the community. Tenderloin Outpatient Clinic in San Francisco The clinic receives a high number of referrals from the ACCESS point – about 25 a month. Referrals are 75 percent male, 40 percent substance abusers; many have no families and limited resources such as SSI, SSDI, or general assistance. The clients are disenfranchised. The clinic offers outpatient care, medication, urgent care, case management, dual diagnosis treatment, and therapy. Clients can not stay at the clinic all day. It is located in the central city area. The clinic emphasizes that mental illness is not a career—it is not what you are and not what you want to be doing with your life. The mental health and self-help are the two groups in the current study. December 10, 1998 Meeting Notes |
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