The Recovering Life

My Recovery Blog has moved

2010-06-17T10:06:00.000-04:00

I have moved my blog to posterous because it is just easier to use.

Go to http://recoverymi.posterous.com to subscribe

Book Review: Mental Health, Naturally

2010-04-09T10:29:00.000-04:00

Mental Health, Naturally is a book written by an M.D., and is part of what I would call "soft" mental health treatment. It deals with the issues that families run into with their kids, and it is medically oriented.

On the other hand, the author is familiar with a lot of nutritional and life style approaches to mental illness and what we would call "recovery". If you can get past the warm and fuzzy language and the medical view of mental health, there is a wealth of information, tips, and techniques that could be useful for anyone working on their recovery.

Reading through this book reminded me of my experiences with Orthomolecular Psychiatry in the 70's and the way OP affected the substance abuse community and people with severe mental illness. When I get the time, I'll post some of those stories.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

Firewalkers

2010-04-03T08:41:00.000-04:00

"Firewalkers: madness, beauty & mystery" is a book of recovery journeys developed by VOCAL, a recovery community non-profit. The power of the book lies in the inclusion of solid descriptions of "emotional turbulence and altered states; visionary melt-downs and spiritual breakthroughs; ecstatic visions and crazy blessings", as the back cover describes them.

Each of the seven stories is as different and unique as you would expect. They reflect the real experiences and journeys of their authors, the good, the bad, the ugly, and the lessons. They also reveal the great risks they underwent.

The book is rounded out with questions about the authors experiences and their views on stigma and the truth they have learned from their mental experiences.

The openness about mental experiences and the lessons they contain reminds me of the 60's and early 70's when there was a greater acceptance of unusual experiences. Unfortunately, at that time, recovery was only an individually discovered, and locally supported, notion without the exploding social network and community movement we have now.

Well worth purchasing, and well worth a read. And you'll be helping VOCAL in its recovery community work.

Paperback, $14.95

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

Comments on Health Reform Goodies

2010-03-31T07:14:00.000-04:00

Now that health reform has passed, what can we expect?

In the Near Term:

In 90 days, a temporary high risk pool for people with pre-existing conditions. High risk pools only work for people with chronic conditions if the premiums are controlled. Otherwise, the premiums tend to drift up and make the pool not affordable.
Parents can cover their kids up to age 26. I think, but am not sure, this adds a year and broadens already existing practice for some carriers.
No more life time limits on dollars of coverage.
Better coverage of preventive services
Better monitoring of carrier use of funds, and better investigation of big rate increases
Medicare Donut hole rebate for the near term, and elimination of the donut hole by 2020
Expanded Medicare coverage for people exposed to an environmental emergencies
Improved care coordination for people who receive both Medicare and Medicaid
A 10% tax on tanning services(!)

A couple of other interesting things:

Section 2402 and what follows seem to allow home and community based services in a waiver to easily use 300% of SSI as the income limit. This would broaden eligibility for waiver services in many waivers.
An interesting project on shared medical decision making

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/

Recovery Council Six

2010-03-22T17:37:00.001-04:00

Rich Casteels gave a report on the Michigan Recovery Center of Excellence. Many, many activities and information tools at http://www.mirecovery.org/

Rich reviewed web use data, as well. They have done a variety of online trainings. He also pointed out that their technology could be used by MRC and MDCH for any recovery related events.

Rich asked the Recovery Council to form a Steering Committee to guide the work of the Recovery Center.

Volunteers made their willingness known, and Marlene voluntold a couple of others.

Comments covered a wide variety of things. Northern Lakes channel on YouTube has a recent video work from NLCMH. Also, how do deal with cuts in services.

Meeting Adjourned.

Recovery Council Part Five

2010-03-22T13:45:00.001-04:00

The 4th Work group has set up a wiki at http://www.copower.org/milawswg/ to allow comments on laws and rules over the next few months.

The fifth work group focused on stigma, trauma, and health/wellness. Sara went over the ladder of meaningful involvement from consumers are manipulated to Consumer directs the Recovery Meeting.

The WG wants to gain an understanding of existing efforts, generate positive messages of recovery, and increase frequency of training.

Ideas include awareness campaign, prevention and early intervention, and how education credits work.

They have reviewed what is being done now. They have established some goals and next steps for each area. They are linking with other groups that focus on these same issues.

They will be requesting training proposals for trainings and trainers.

Recovery Council Part Four

2010-03-22T11:57:00.001-04:00

The work groups are updating the Council on their progress and next steps. The first group found many, many policies on Recovery and will borrow freely from them. Pat Baker reviewed some longitudinal research that has shown how much more important the person's view of recovery is in reaching good outcomes. Planning must be driven by the person, and the role of other people in the mental health system is supporting that person driven framework internalized.

How well do we do recovery management planning in this light? Pat believes that we need a state initiative to improve system approach to this planning area.

The second group explored the possibility of a survey to agency staff about their recovery experience and its impact on recovery policy in their organization.

The third group is focusing on the ARR and how it is being implemented. They reviewed the meaning of Renewal and Re-commitment. They also went through the 11 sections of the ARR, and reviewed the principles embedded in them.

LUNCH TIME!!

Recovery Council Part Three

2010-03-22T10:36:00.001-04:00

Community Block Grant RFA process will be reviewed.All CMHs are eligible to apply, and Irene is hoping to get a proposal from every one. $70,000 per year for up to 2 years. Applications due in May.

Available to support recovery for people with severe mental illness and co-occurring disorders. They will require partnership with consumers in the application. Another focus will be barriers to Recovery. They expect concrete changes that include PCP and Recovery concepts, such as incorporating PSS in new places, expanding self determination opportunities, improving PCP processes, expanding opportunities for integrated employment, ARR goals attainment, and expanding community partnerships. bot GF and MA funds can be the target of self-determination control proposals. There are a lot of other suggestions and examples, as well as a format for the proposal narrative.

May 11 is the probable deadline. Will not require match or the usual sustainability (money) criteria for the proposals because of the problems with GF. However, they will look for policy change that is permanent and capability improvement that is permanent. Irene wants everyone to use this opportunity to improve their recovery agenda.

Irene asked for volunteers to review proposals. There is enough money that each CMH can have a grant.

Recovery Council Two

2010-03-22T10:09:00.001-04:00

Several great recovery stories. Mike head talked about the passage of the Health Care Reform bills. Expansion of Medicaid availability is one. Bad news is that the Senate cut 20% of General Fund dollars from the proposed budget. There is a hearing today in Detroit on the cut. There seems to be energy for finishing the budget early, but there has been no real effort to solve revenue issues. Caretaker relatives and 18-19 year olds have been removed from the Medicaid options. Small Board administration will likely go as well as CMH's are integrated into PIHPs. The physician tax will likely not go through. Stimulus will be extended into 2011, so that will help. PIHPs will be held accountable for assuring that each Medicaid beneficiary has the same expectation for services regardless of location. Mike has become at least a temporary Spartan fan.

Recovery Council One

2010-03-22T09:46:00.001-04:00

We are at LCC West for the March Recovery Council Meeting. It appears there will be a large turnout. The work groups on Council Strategy will report on their progress, and we will review policy issues.

More later.

Jeff Guthrie: How Self-Determination has made a difference in my life

2010-02-09T11:43:00.001-05:00

Jeff is presenting a slide show:

Jeff's interests include computers, video games, etc. Jeff has been received treatment for depression and chizo-effective disorder. He was the first person with MI to use self-determination under a pilot program using his PCP.

He talked to people he trusted, and found them to be very supportive of SD. He pulled his circle and an independent facilitator. It was a powerful experience. A core was the understanding of how much money was being spent, and the possibilities if those funds were re-directed.

Jeff's goals: move out on his own and get a job. He has done both of them. He hired a staff person to support his goals, especially menu planning, food shopping and cooking. He is very proud of himself.

Jeff has learned that networking is a useful tool, and spoke about his desire for a job during a presentation. He got two job offers on the same day and accepted both! He has met lots of people through his work.

His shyness has dropped away, opening up other doors. He believes that taking risk is necessary to truly experience life.

Jeff believes that SD means focusing on what you like to do and what you want to do.

Jeff is a leader in Michigan Partners for Freedom.

Possibilities

2010-02-09T11:31:00.001-05:00

More community options; academic and vocational training; assistance with accessible transportation and vehicle purchase; how we talk about purpose and SD; Co-payment systems; eliminate spend down; flexible and coordinated crisis support; a real crisis plan; financial crisis planning; Use b3's for people with MI; eliminate non-useful regulation and documentation requirements; more measures on outcomes, and less on docs; one stop for supports; cross system supports management; communication between DHS and CMH; social security needs to be a strength based system; eliminate redundancy in applications for supports; making communications from systems easy to understand; alignedservice systems;

Barriers to SD

2010-02-09T11:17:00.001-05:00

Funding, # of people supported; substance abuse, caseloads; learned helplessness, people don't think in SD terms, resistance to change, no consensus on medical necessity definition, how b3 services are interpreted,

President's New Freedom Report

2010-02-09T10:25:00.001-05:00

The 10 Fundamental Components of Recovery:

1. Empowerment
2. Holistic
3. Non-Linear
4. Strengths Based
5. Respect
6. Responsibility
7. Individualized and Person Centered
8. Self-Direction
9. Peer Support
10. Hope

Amount, Scope, and Duration

2010-02-09T10:22:00.001-05:00

Medicaid don't pay if you don't record this information accurately, in order to generate a documented encounter code.

Is there a more transparent, shorter, easier way to generate this necessary documentation?

Good plans are about your life, about the person, a map of outcomes, based on strengths, changing and evolving, and developed in more than one hour.

PCPC is a process, not a document, not a meeting, etc.

The more empowered the peer is in creating the PCP, the better the outcomes will be.

For our community, Self-determination is a journey of healing and transformation based on a foundation of recovery.

Self Determination for Peers

2010-02-09T10:14:00.001-05:00

I'm at a workshop to discuss self-determination for peers in Michigan's mental health system. We have discussed barriers and ways to promote SD, and Pam Werner is now reviewing the history of attempts to get SD to work in our community.

She has mentioned paperwork, and failure to implement as the two biggest problems. She is focusing on the Person centered plan as being subordinate to the ultimate goal of "getting a life"

The ultimate question is "What is my dream"?

Look at Community Inclusion, Participation, Independence and Productivity.

RCSD Final: Next Steps

2010-02-09T06:26:00.001-05:00

Because we broke into work groups for the final effort around priorities, I'll wait to post on the outcomes of the strategy planning for the minutes and other documents. But the results were pretty good. More later on this, and I'll be reporting from a Self-Determination Workshop focused on peers today!

RCSD7: Aftermath

2010-02-08T12:50:00.001-05:00

We have settled on 6 priorities, and have finished coming up with some initial steps for one of the priorities. We just finished a good lunch and are regrouping for the rest of our planning. The objective we have finished is the "Statewide" Recovery Policy".

RCSD6: Top Priorities

2010-02-08T10:29:00.001-05:00

We are rating the priorities from last meeting and coming up with an initiating activity for each. More later

RCSD5: More Vision

2010-02-08T10:21:00.001-05:00

Respect is the way you tell whether the system is transforming; Every part of the system needs to be flooded with recovery; it needs to be seen everywhere.
We need an operational model of recovery to impact the system as an infrastructure; Boards need to be immersed in recovery;

RCSD 4: National Pillars of Support and More Vision

2010-02-08T10:15:00.001-05:00

Supervisory support is a key Pillar of Support in the system; PSS ID; Issues of Support for burnout, building an outside life; not taking on too much; sharing ways to balance; support for peers working full time with benefits and a career path; eduation around nutritional approaches to recovery; positive media re recovery; resolve paradox of recipient rights and employee rights; all DCH documents related to recovery should be reviewed; we need a much fuller vision of a complete community system of supports based on recovery;

RCSD 3: More Vision

2010-02-08T10:06:00.001-05:00

Concrete signs of respect for PSS; Stories by peers about how they are getting a life; professional incentives for understanding the recovery movement; actual effort by CMH to respect peers; held a conference focused on providers and recovery, and we will hold another this year; The RC has bonded, and will show collaboration in reaching the outcomes we plan today; More attention to rural areas, enough to publicly show their understanding of the importance of recover; empowerment of peers through modeling of RC activities, and modeling by peers;

RCSD 2: Accomplishments and Vision

2010-02-08T09:57:00.001-05:00

# of peer support specialists; REE implementation and the data it produces; The system would understand and show that each person's chosen life is possible; relationships outside the system; PSS embedded in day to day workings of the system; Recovery in education and training and public education; PSS on university faculty in Georgia!!; More stories of recovery in the public arena and self-identified peers in positions of power;

Recovery Council Strategy Development, Part 1

2010-02-08T09:48:00.001-05:00

Ike is leading our effort today, to build a Council strategy for 2010 at LCC West. We will be reviewing our vision and our priorities, and modeling our future relationship with DCH and the CMH system.

Problems at the Core

2010-01-22T06:21:00.001-05:00

Image via Wikipedia

Both our political parties have

BuzzNet Tags: political parties,problems

significant structural and functional problems. They each contain a group that believes the purpose of politics to be ideological warfare, and they each contain a group that believes politics is a tool to serve their interests. Since the groups within each party are not compatible with one another, there is a struggle within each party that mirrors the struggle between parties in oddly complementary and paradoxical ways.

We might call the two groups Selfish Toadies (ST) and Cultural Fanatics (CF).

There is a cycle of dynamic dominance between the two groups in each party. Currently, the Republican party has seen the rise of more and more ideological cadre, with the STs trying to co-opt the message of the CF's for their own purposes. In the Democratic party, liberals are gradually taking the role of spoilers, again with the STs trying to co-opt the CW message for their own purposes. The Obama administration is largely STs at this point.

Across parties, the struggle is between CFs in the Republican party and STs in the Democratic party. The current political instability is not just between the parties, but also between the components within each party. Any stability that occurs either within or across parties will be immediately undermined by the other inside "enemy" or the other party. This general instability will not change any time soon, especially with the economy crashing and the growing deterioration of the health care system, local infrastructure, and the fragmentation of allegiances in every part of the political fabric. In a phrase, everyone, in multitudinous and shifting groups, is struggling for the "soul" of “their” party.

The national political system is no longer capable of solving any major problem. The two parties view vetoing effective action by the other as the only predictably useful political strategy, and within the parties, the components view vetoing the other component in the same way. Joe Lieberman is kind of the poster child for this approach to a political career.

As the whip cream on the sundae, the Supreme Court has now allowed a far greater use of corporate funds to promote political agendas than at any time in modern history. Spin and insults are standard competitive tactics used by corporations to undermine competitors. Therefore, we will be spending far more money to create an incompetent political class than we have in the past.

Needless to say, the extra money will not produce better political results.

What to do?