UPDATE || INSTITUTIONAL CARE
The National Governor's Association had, among its illustrious
Task Force Panelists reviewing the problems with long term care, the following: [from the ten worsts states list below] Gov. Kenny Guinn # 2 Nevada; Gov. Phil Bredesen # 4 Tennessee; Gov. Sonny Perdue # 6 Georgia [home state to Olmstead vs. LC]; Gov. James McGreevey # 8 New Jersey | Four out of ten, I suppose that's not insurmountable |
HUMAN RIGHTS || INSTITUTIONAL LIVING
People with disabilities can have active lives when integrated with others
ADAPT the
Disability Rights Activist Group released the findings of a [USA] nationwide survey on the
10 worst states for community services | # 1 [or # 50, you decide] was Mississippi, indicating that "..
87% of its long term care funding being spent on nursing homes and other institutions, while only 13% goes for community services."
Citing a huge bias
in favor of institutional settings rather than community placment ADAPT members went to Seattle in July in an effort
to get some time with the
National Governor's Association | Not surprising, the activists were rebuffed | Not only did the NGA refuse to meet with anyone from the group but that "...
even before we arrived in Seattle, the NGA sent out a statement about us that not only bears little resemblance to the truth, but actually seeks to undermine our right to freedom of speech" [quote from Barbara Toomer, ADAPT Utah State Organizer]
The Disability Rights group was seeking support for a resolution that would
"...ask the NGA to sponsor and vote in support of the resolution. Along with Medicaid reform, the resolution calls for the NGA to work with the states to implement the U.S. Supreme Court decision in Olmstead vs. L.C. and E.W. which calls for states to move people out of, and divert people from admission to, nursing homes and other institutions so they can live in their own homes and communities with the support they need. It also calls on the NGA to support Medicaid reform that is not based on block grants and capitation of funding."
Olmstead vs. L.C was the June 1999 US Supreme Court decison that ruled "...
that the unnecessary segregation of individuals with disabilities in institutions may constitute discrimination based on disability..."
Five years later, in spite of
overwhelming number of people's opinions to the contrary, the states and our society still disregard this important human rights decision |
MEDICARE provides information on the quality of Nursing Home Care as well as that of Home Health Care agencies across the USA | If those links don't work, try the Medicare main page | The remaining Ten Worst states in ADAPT's included: # 2 Nevada; # 3 Louisiana; # 4 Tennessee; # 5 Illinois; # 6 Georgia [home state to Olmstead vs. LC]; # 7 Alabama; # 8 New Jersey; # 9 Florida; # 10 District of Columbia |
For a related, albeit somewhat tangetial read, check out George W. Bush's pdf.file report of the New Freedom Initative for People with Disabilities; It was penned in 2001, few [if any] of it's lofty goals enacted | We still got another half a year [or 4 and a half, G*D help us!] so maybe it'll happen |
MENTAL HEALTH ISSUES
"Recovery" is not a "treatment modality" | For at least three decades [
longer, if you go back to Clifford Beers] advocates, ex-patients and dispassionate observers have repeatedly argued that people can and often do, "recover" from long lasting disabling, debilitating conditions and experiences |
At the same time, the idea was scoffed and dismissed by high ranking clinicians and administrators, citing [still] the ghosts of
Kraepelin and Beuler as the rationale for why such an idea was untenable | "
People don't recover from 'mental illness' | Their lives are lost and so is any hope for them doing much better" the clinical careerists would steadfastly maintain |
Little or no thought was given to asking patients in mental hospitals what might be their wishs, hopes, dreams, or aspirations to acheive | Administrators spoke of "bed spaces," "treatment modalities" and "managed care." They asked drug companies when "the next miracle drug cure" would get people out of institutions and back on the streets |
The standard response to those who had different ideas, was to first ignore them, keep them from the decision making process and to demean and invalidate the critical voice that offered options |
Now, times have changed | Budget constraints sources called for innovation and "outcomes" | Major funding sources satrted telling them that "recovery is good"! | Gradually, those same
clinicians and bureaucrats who walk past patients without seeing them took up the call |
However, while the language has been embraced, other obstacles remain | "Clients" get wheedled and cajoled to large group meetings and say the process is "patient driven" | Abusive staff and practices continue unabated | Known wrongs that take place fail to get "substantiated" when only patients witness those wrongs |
How can this be? That bureaucrat driving his new custom SUV to the workplace while the patient gets penalized by Title 19 with "spend-downs" on maybe less than $500 a month | Patient driven huh! |
Folks, you don't have a clue |
Admittedly, the samples mentioned oversimplify the problems inherent in social injustice and lack regard for people with mental illnesses | Administrators, Nurse Educators and other who shape professinal opinion are still no different than the society at large | But my point would be the same no matter what quick capsule glimpse got noted |
Recovery is not a treatment modality | The reasons people can and do recover are many and multifarious | But they come as much [or more] from within | "Recovery" may or may not include taking meds | For
John Nash [the subject of the film
A Beautiful Mind] they by and large did NOT, no matter what the film said |
"Recovery" may or may not include assistance from mental health programs | In the case of survivors in the
Vermont Longitudinal Study in 1987, for a goodly number
it was in spite of what services the "system" provided |
Recovery is a process | It involves learning to live with complex and inexplicable phenomena [that many may call delusional], of freedom from unrealistic pressures to "get over" that phenomena within discrete time frame, and of being considered, cared for and loved as a fellow human being by others | Simple as that |
How much more difficult this is to achieve in a society and culture that does not value those souls who are not immediately responsive to time-motion-study lifestyles | So challenging to those who drive efficient bureaucrats to distraction with abstruse, and often unexplainable questions | In the long run, it may call for dramatic and complete changes in cultural attitudes and norms, not something so easy to implement when it isn't even discussed |
So...if you, the fashionably dressed mental health careerist can grasp this, then next time you wish to speak to someone -anyone, even one of your professional colleagues- about "Recovery" for people with living dramatic, even severe, cognitive / perceptual dissonance, then do so only after you actually drop your important paperwork and pre-occupation with meetings and give someone the time, energy and effort to sit with and actually get to know some of those persons who walk past you daily, but of whom you only know by diagnosis | Incidentially, it's a whole lot cheaper than funding the psycho-pharmeceutical companies, just takes longer to see results |
Now
that would be a step toward recovery |
Some resources: Clifford Beers' A Mind That Found Itself, National Empowerment Center, MindFreedom, Mary Ellen Copeland's Self-help Strategies
Pix Credits: 1- Jan Horn, Sulaco; 2- pines and palms; 3- www.ne.jp/asahi/ stellar/scenes/finepix/
