NEWS, COMMENTARY, AND ARTS BY PSYCHIATRIC SURVIVORS, MENTAL HEALTH PEERS, AND OUR FAMILIES
VOL. XXXV NO. 3
•
FROM THE HILLS OF VERMONT
! P O P •
SINCE 1985
•
WINTER 2020
Project Initiatives Empower Peers By ANNE DONAHUE
POP grants. The acronym has been around for years, but the unique focus of the grants on initiatives that are led by and intended to help support individuals with a lived experience of mental diagnoses may be less well known. “POP” stands for peer-operated projects, and up to $3,000 is awarded to each of the successful applicants. They must be independent and peer-run. Proposals can range from peer mentoring, support or crisis diversion to recovery- and wellness-oriented initiatives or creative projects such as art or music to benefit peers and promote community awareness. The funds come from federal mental health block grants issued to states and designated for community-based services for adults with serious psychiatric diagnoses and emotional disturbances. The Department of Mental Health allocates $30,000 from that larger grant to Vermont Psychiatric Survivors to support peer-run projects. Nine projects received grants from VPS last year, and six of them are profiled in this article.
Painting Breaks Down Walls CASTLETON – “There’s no mental illness when you’re painting; everybody’s got their own voice,” which is a key to the “healing property of painting.” That’s what Tom Merwin said led him to begin to share his lifelong love for art expression with others who were struggling. Art “breaks down the wall that [says] somebody’s mental illness makes them different” and “links us straight to a reality Cartoonist Cara Bean teamed up with the Center for Cartoon Studies in White River Junction to cre- where there’s no judgment,” Merwin said. “Art’s always been a link for me to get through the world as ate a comic book for teens on mental health. See article on page 12. it is,” he said. A mental diagnosis “is not a disability if you use it creatively.” For him, the project has “given a bigger purpose to art itself.” “It becomes more what art is meant to be,” he said. By ANNE DONAHUE Merwin said the POP grant has enabled him to provide WATERBURY – First-ever disclosure of the use of force on patients who greater access to materials for those who come to his studio and voluntarily went to the Brattleboro Retreat indicate that restraint and seclusion the places he travels to expand art opportunities. may be as large a concern to advocates as the force used on patients who are being “I’ve been painting all my life,” he said. So, when he retired held involuntarily. The new data’s highest levels were on units where the previously to Vermont and began to work at 47 Main Street, the name of a public data for involuntary patients only showed no, or very low, use of emergency group home for men, he brought art to it. He opened his studio involuntary procedures. It adds to data that shows an ongoing increase in the overall some 20 years ago. rate of force across all Vermont psychiatric units, and the Retreat as consistently Now, he travels from central through southern Vermont and (Continued on page 10) (Continued on page 4)
Use of Force Increases
11 The Arts12
Seclusion Plan For Residence Raises Concerns
22
The Isles of Mental Illness
2 Peer Leadership and Advocacy
Fall 2018
Meeting Dates and Membership Information for Boards, Committees and Conferences Peer Organizations VERMONT PSYCHIATRIC SURVIVORS BOARD
A membership organization providing peer support, outreach, advocacy and education. Must be able to attend meetings monthly. Experience with boards preferred, but not necessary. For information call 802-775-6834 or email info@vermontpsychiatricsurvivors.org.
COUNTERPOINT EDITORIAL BOARD
The advisory board for the Vermont Psychiatric Survivors newspaper. Assists with policy and editing. Contact counterpoint@vermontpsychiatricsurvivors.org.
ALYSSUM Peer crisis respite. To serve on board, contact Gloria at 802-767-6000 or info@alyssum.org. DISABILITY RIGHTS VERMONT PAIMI COUNCIL
Protection and advocacy for individuals with mental illness. Call 1-800-834-7890 x 101.
State Committees ADULT PROGRAM STANDING COMMITTEE
Advises the Commissioner of Mental Health on the adult mental health system. The committee is the official body for review of and recommendations for redesignation of community mental health programs (designated agencies) and monitors other aspects of the system. Members are persons with lived mental health experience, family members, and professionals. Meets monthly on 2nd Monday, noon-3 p.m. Check DMH website mentalhealth.vermont. govor call-in number. For further information, contact member Daniel Towle (dantowle@comcast.net) or the DMH quality team at Eva.Dayon@vermont.gov.
LOCAL PROGRAM STANDING COMMITTEES
Advisory groups required for every community mental health center. Contact your local agency for information about meetings and membership.
Advocacy Organizations DISABILITY RIGHTS VERMONT
Advocacy in dealing with abuse, neglect or other rights violations by a hospital, care home, or community mental health agency. 141 Main St, Suite 7, Montpelier VT 05602; 800-834-7890.
MENTAL HEALTH LAW PROJECT
Representation for rights when facing commitment to a psychiatric hospital. 802-241-3222.
ADULT PROTECTIVE SERVICES
Reporting of abuse, neglect or exploitation of vulnerable adults, 800-564-1612; also to report violations at hospitals/nursing homes.
VERMONT CENTER FOR INDEPENDENT LIVING
Peer services and advocacy for persons with disabilities. 800-639-1522.
VERMONT FAMILY NETWORK
Support for families with child or youth with mental health challenges. 800-800-4005; 802-876-5315.
VERMONT CLIENT ASSISTANCE PROGRAM
Rights when dealing with service organizations such as Vocational Rehabilitation. Box 1367, Burlington VT 05402; 800-747-5022.
HEALTH CARE ADVOCATE To report problems with any health insurance or Medicaid/Medicare issues in Vermont 800-917-7787 or 802-241-1102.
VERMONT FEDERATION OF FAMILIES FOR CHILDREN’S MENTAL HEALTH
Statewide support for families of children, youth or young adults in transition who are experiencing or at risk of experiencing emotional, behavioral or mental health challenges. 800-639-6071, 802-876-7021.
PEER WORKFORCE DEVELOPMENT INITIATIVE
Webpage for updates, including statewide training and registration information. www.pathwaysvermont.org/ what-we-do/statewide-peer-workforce-resources/
Hospital Advisory VERMONT PSYCHIATRIC CARE HOSPITAL
Advisory Steering Committee, Berlin, check DMH website for dates at mentalhealth.vermont.com.
BRATTLEBORO RETREAT
Consumer Advisory Council, fourth Tuesdays, 12-1:30 p.m., contact Director of Patient Advocacy and Consumer Affairs at 802-258-6118 for meeting information.
RUTLAND REGIONAL MEDICAL CENTER
Community Advisory Committee, fourth Mondays, noon, call 802-747-6295 or email lcathcart@rrmc.org.
UNIVERSITY OF VERMONT MEDICAL CENTER
Program Quality Committee, third Tuesdays, 9-10 a.m., for information call 802-847-4560.
New Research and Studies Messaging in Biological Psychiatry: Misrepresentations, Their Causes, and Potential Consequences In a study recently published in the Harvard Review of Psychiatry, the researchers “summarize the academic studies describing how biomedical observations are often misrepresented in the scientific literature…These misrepresentations affect the care of patients. Indeed, studies show that a neuro-essentialist conceptualization of mental disorders negatively affects several aspects of stigmatization, reduces the chances of patients’ healing, and overshadows psychotherapeutic and social approaches that have been found effective in alleviating mental suffering. Public information about mental health should avoid these reporting biases and give equal consideration to the biological, psychological, and social aspects of
mental health.” For the study, published on November 12, go to journals.lww.com/hrpjournal/fulltext/2020/11000/ messaging_in_biological_psychiatry_.4.aspx
Survey on Antipsychotic Medication Withdrawal
People who have taken antipsychotic medication (such as Zyprexa, Seroquel, Abilify, Risperdal, Haldol, Geodon, Stelazine, and others) and stopped taking them, can take this survey, which aims to improve mental health services by better understanding medication withdrawal. Lead researcher is Will Hall, a therapist and Ph.D. student who has himself taken antipsychotics. Service users/survivors/ consumers from around the world also gave input. For more information or to take the survey, go to www. antipsychoticwithdrawalsurvey.com
The Service Building, 128 Merchants Row Suite 606, Rutland, VT 05701 Phone: (802) 775-6834 email: counterpoint@ vermontpsychiatricsurvivors.org MISSION STATEMENT:
Counterpoint is a voice for news and the arts by psychiatric survivors, ex-patients, and consumers of mental health services, and our families and friends. Copyright 2020, All Rights Reserved FOUNDING EDITOR Robert Crosby Loomis (1943-1994) EDITORIAL BOARD Joanne Desany, Emma Harrigan, Calvin Moen, Sara Neller, Eleanor Newton, Sarah Simoneau The Editorial Board reviews editorial policy and all materials in each issue of Counterpoint. Review does not necessarily imply support or agreement with any positions or opinions. PUBLISHER Vermont Psychiatric Survivors, Inc. The publisher has supervisory authority over all aspects of Counterpoint editing and publishing. EDITOR Anne B. Donahue News articles without a byline written by the editor. Opinions expressed by columnists and writers reflect the opinion of their authors and should not be taken as the position of Counterpoint.
Counterpoint is funded by the freedom-loving people of Vermont through their Department of Mental Health. Financial support does not imply support, agreement or endorsement of any of the positions or opinions in this newspaper; DMH does not interfere with editorial content.
Counterpoint is published by Vermont Psychiatric Survivors three times a year, distributed free of charge throughout Vermont, and also available by mail subscription. Vermont Psychiatric Survivors is an independent, statewide mutual support and civil rights advocacy organization run by and for psychiatric survivors. The mission of Vermont Psychiatric Survivors is to provide advocacy and mutual support that seeks to end psychiatric coercion, oppression and discrimination. Counterpoint does not use pseudonyms in its reporting without stating that a pseudonym is being used and without an explanation for why the person’s identity is not being disclosed. Counterpoint does not use anonymous sources under any circumstances.
Department of Mental Health 802-241-0090 mentalhealth.vermont.gov For DMH meetings go to web site and choose “more” at the bottom of the “Upcoming Events” column. ADDRESS: 280 State Drive NOB 2 North Waterbury, VT 05671-2010
Don’t Miss Out on a Counterpoint! Mail delivery straight to your home — be the first to get it, never miss an issue. c Enclosed is $10 for 3 issues (1 year). c I can’t afford it right now, but please sign me up (VT only). c Please use this extra donation to help in your work. (Our thanks!) Checks or money orders should be made payable to “Vermont Psychiatric Survivors.” Send to: Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701
Access Counterpoint online at www.vermontpsychiatricsurvivors.org
-
_______________________________________________ NAME: _______________________________________________ ADDRESS: _______________________________________________ CITY • STATE • ZIP
NEWS .
Winter 2020 Fall 2018
3
ROUND UP In the News
In the Arts
POP Projects Empower Peers ‘Let’s Talk’ Comic Book
Peer-operated project grants provide funding A cartoonist and the Center for Cartoon for initiatives to support others (see Page 1). Studies have teamed up to produce a comic book for youth, “Let’s Talk About It: A Graphic Guide Voluntary Patient Restraints to Mental Health” (see Pages 1, 12). New data required to be disclosed shows that a sizeable amount of restraint and seclusion at Psychopoly: a Critique An art piece brings a graphic portrayal of the Brattleboro Retreat is used with voluntary “Psychiatry Versus the People” in a mixed media patients (see Page 1). work (see Page 13).
Certification Issue Reviewed
A new peer group is working to make recommendations to the Department of Mental Health on whether and how certification should be instituted (see Page 6).
Lawmaker Ran Support Line
The winter Louise Wahl Writing Contest winners are presented, including the first place (Wounds of the Third Eye, Zachary Nuzman), second (Last Rain in Montana, Vesna Dye) and tied-for-third poems (Echo of a Teardrop, Alance Raquel; Falcon, Nathaniel Greene) and first place prose, (Face in the Moon, Vesna Dye). Second place prose, (Grateful, Belle Cashman, will be published in the next issue (see Pages 14-15).
In Commentary Editorial
The author of a children’s book that uses biased languages apologizes (see Page 16).
A newly elected legislator is the peer who Publisher’s Commentary Karim Chapman discusses the need to update developed and was the first director of the Vermont Support Line at Pathways Vermont the state’s Olmstead plan (see Page 16). (see Page 7).
Mental Health Is Not Criminal
The validity of using mental health crisis specialists by police is discussed (see Page 17). As a draft is developed to expand a program that places mental health crisis workers in staff Force Versus Autonomy police barracks, some advocates have praised Choosing one’s treatment options is crucial to key elements; others oppose the plan itself (see self-direction (see Page 18). Page 8).
Police Crisis Model Praised
Louise Wahl Winners
Entering Into Peer Support
A new patient representative explores her experiences as a staff member at Vermont Psychiatric Survivors (see Page 19).
Isles of Mental Illness
The dominant culture has supported a forever-sick model of mental illness, but there is a way to escape it (see Page 22).
Delivering Peace, or Violence?
The promises of peace but the realities of violence by police have analogies to the promises of the medical model of mental illness. (see Page 23).
New VPS Staff Introduced
Three new patient representatives have begun work at Vermont Psychiatric Survivors (see Page 9).
Stay Tuned!
Annual Meeting Alert
Survivor Named To Council
The executive director of Vermont Psychiatric Survivors has been appointed to the Criminal Justice Council, which will set out requirements for police hiring and training and for sanctioning unprofessional conduct (see Page 9).
be o
f
New Residence Will Use Force
The new locked residence that is in development will allow use of restraint and seclusion, the Department of Mental Health says, over the opposition of advocates (see Page 11).
The annual meeting of Vermont Psychiatric Survivors will deferred this year, to be replaced by a virtual meeting in early 2021, according to Zachary Hughes, President of VPS’ Board Directors. Hughes said that safety restrictions relating to the COVID-19 pandemic prevented an in-person meeting from taking place. “We are working hard to organize a statewide virtual meeting in the early part of 2021,” Hughes said. “The plan is to locate facilities around the state where fewer than 10 people can safely meet, and outfit those locations with teleconferencing equipment that will connect all members to a virtual annual meeting,” he said.
Counterpoint Telephone Poll QUESTION:
Should emergency involuntary procedures (restraint and seclusion) ever be used with voluntary patients? (See article on page 1) VOTE “yes” or “no” by calling:
888-507-0721 (Toll-free call)
Results of the poll will be published in the next issue of Counterpoint.
4 NEWS
FallWinter 2018 2020
POP ROJECTS EMPOWER ACTION BY PEERS • Continued from page 1 hopes to expand further. The work is displayed at regional art shows, including about 200 paintings at the most recent show. “It was a great show” this year, he said; there have been at least five art shows in recent years, and they have been growing. He began receiving POP grants to support the work two years ago and hopes to continue. Merwin said his approach is to give participants a large canvas, and “we just start working.” Instead of having people start with a “set route” for an art piece, he watches them at work, “and when I see how they push the paint, it opens up a communion” with artists from the past who used similar styles, he said. That leads him to link the artistic expressions with forms of art that speak best to the individual, Merwin said. “The dialogues open” for the direction of the person’s styles of art. The art show “More Than Meets the Eye” ran from January 2020 and extended past March and into the summer due to Covid-19, Merwin said. Also participating in that show was The Yellow Tulip Project, “I am More: Facing Stigma” in which young people addressed mental illness and suicide as well as several other artists exploring such subjects as grief, transatlantic slavery and Peru’s indigenous peoples, he said. Merwin had a statement posted at the show that described how the artists saw their work. “Mental illness is a world condition,” it said. “Those of us diagnosed and on the front line are resources too often overlooked. We hope to mirror your reflection with ours on the surface of poetry and painting... “While defying marginalization and the pressures of isolation, we look forward to seeing you at the show, receiving gifts where eyes meet... “I have painted with my friends for the past four years. Using the visual arts is a valid and proven access to our whole and healed being.” Free painting workshops for challenged students and their families that were disrupted by COVID-19 were tentatively rescheduled for the fall, and “we are also hoping to reschedule with Stone Valley arts for an open workshop and show next year,” Merwin said. There is information available for “More Than Meets the Eye” on Merwin’s website, www. merwinstudios.com.
Family Support Without Labels BRATTLEBORO – Katie Wilson and Elibee Valentine’s POP project was unique in bringing people together regardless of whether they identified as having a psychiatric label. That was both a core purpose and its greatest success, they told Counterpoint. The Dinner Together project was a community meal to bring families together for “sharing food, sharing camaraderie, sharing support ... while the kids were playing” thanks to the presence of child care, Wilson explained. She and Valentine facilitated the conversations. Both are single moms. “It really felt amazing to help connect people who wouldn’t [usually] connect” because of having different backgrounds because of their jobs, housing situations or other factors – “all strata of our community,” Wilson said. It was the “greatest example of how we can offer peer support. Anyone could be here,” she said. Valentine shared several experiences that she said had a particular impact on her. There was a physician who participated, someone who might be perceived by others
as “the one who has it all together,” Valentine said, “but she got to be vulnerable.” Another time, she said, someone arrived late, and Wilson sat with her to talk. “It was such a beautiful, beautiful moment to witness,” Valentine said. “It was so important for [the person] to be there. It meant so much to that person.” When a person with grant oversight duties came to one dinner, they too “were vulnerable and shared” despite “being in a power position,” she said. Valentine said she was “in the midst of healing my own trauma” from a “life experience that was really, really challenging” that was happening at the time” and the project allowed her to see and experience her “stronger self,” able to use her skills towards her own Elibee Valentine designed the flyers for the Dinner Together project. life goals. with that had helped with such community “This is what I want to create in the world,” connections in the past. the opportunity “to be more human together,” The grant budget was “pretty lean” at $50 per and heading up the POP grant gave her that meal, Wilson said, so she focused on cooking ability, she said. “simple stuff” while also trying to model healthy Wilson said that the state investment of the food. federal grant dollars into projects that build Valentine was more effusive. Wilson did stronger communities is “one of the best, most an “incredible job” as the cook, she said, therapeutic things we can do.” making “food that was really comfortable” and When people feel they fit in the community, also “being mindful” of inclusive menus for and instead of negative labels their “label is, participants with diet limitations. community members who are valued,” they There were five of the monthly dinner events are “much more likely to seek the services they in all, Wilson said, before COVID-19 interrupted. need,” she said. Different people came in and out of the group, By being non-judgmental and open to anyone, she said – some for one time, and others more it also allowed those who do not identify with regularly. mental health needs to be vulnerable and to be more aware of the experiences of others, Wilson Rebuilding Skills With Pottery said. RUTLAND – As a small non-profit, the One time, a conversation evolved about the Turning Point Center doesn’t have the flexibility fear some had of family services intervention – with funds to create new activity options, so of having the state come in and judge them – and “I was grateful for that opportunity” to do “some people are insulated” from understanding something different, Tracie Hauck said about that perspective, she said. “It moved the needle” the POP grants. for understanding the experiences of others, She proposed a pottery program, buying a Wilson said. pottery wheel and hiring an instructor, and The idea for the project came about when estimates that some 50 people were able to Wilson and Valentine, who were friends, met participate before the program had to stop short in the Brattleboro Food Co-Op and began in March due to COVID-19. brainstorming about the grant opportunity and Hauck, who has been executive director at “what would be a real value to our community,” the peer-run recovery center for the past five Wilson said. years, said that having activities helps make it Both had skills as facilitators – Wilson more comfortable for people who are early in through her job at the peer-run Copeland Center their recovery. At that stage, people often don’t and Valentine as a community organizer. They yet trust others or don’t want to spend time just recognized that “there’s never enough support talking about substance abuse, she said, and for families,” Wilson said, and they decided need to rebuild social skills, she said. to rekindle an event Valentine was familiar “It changes the focus,” she said, and helps people to feel, “I can do that.” “It felt good to be able to provide them,” she added, referencing the lessons and opportunities the pottery wheel offered. H a u c k The art show “More Than Meets the Eye” was a part of this year’s POP grant to Tom Merwin said the of Castleton. Also participating in that show was The Yellow Tulip Project, “I am More: Facing center offered Stigma” in which young people addressed mental illness and suicide. pottery prior
NEWS . NEWS
Fall 2018 Winter 2020
5
POP ROJECTS EMPOWER ACTION BY PEERS • Continued from page 4 to getting the POP grant, but people were just “given a clump of clay” to mold. With the grant and the purchase of the pottery wheel, people learn the skill and have their work fired, so that it is a permanent creation, she said. The appeal of the project brought different people in who hadn’t come to the center before, Hauck said.
Receiving While Giving BENNINGTON – Annette Denio exudes so much excitement about the members of her Sunshine Social Club that she almost sparkled through the phone as she talked with Counterpoint. “They pick me up,” she said of 20 or so people who come for snacks, games, conversation and support. “I love doing it. They’re giving it back. We need it, too.” She’s quick to start describing club members and how they open up after becoming involved, naming one after another. One man who started just by coming for the meal was described by the staff at United Counselling Service as practically non-verbal. He began coming earlier for the games and other activities and now shares his active sense of humor with everyone. “It’s how you see them,” Denio said. “They won’t talk to staff. They talk to us because we’re peers. They respect us because we respect them.” She said she didn’t mean to criticize the staff; it’s just that “they don’t see what we see, because they’re not peers.” Denio said she can tell members, “I’ve been there. I did it.” Denio started receiving the POP grant to subsidize supplies and her gas several years ago, and in the time before COVID-19, it was a day’s work. She had a prep team of eight for the homecooked meal that was served. As people arrived, they’d start with snacks, and a group game would follow. A “table draw” would be held for chances to come to a gift table with food, knick-knacks and clothing to choose from, many of them donations from friends she’s met. Door prizes came next and then the meal. One favorite game was Jeopardy. “The idea that people with mental disabilities are not educated is foolish,” she said. Denio should know. She was a charge nurse doing geriatric care before becoming ill, and creating and running the club has helped her own recovery, she said. One of the things she expressed great pride about was keeping the club going after the restrictions created by the coronavirus. When the UCS CRT program had to close
Annette Denio moved outside after COVID-19 hit so that residents could still gather for the Sunshine Club.
down, Denio and Greg Burda, who runs the Hot Topix group, approached Washington Elms, a community care home where many of the CRT clients live, and received permission to continue. Although they started by phone, it didn’t work as a replacement for the social club. So Denio “ended up moving to the lawn” in front of the residence, sitting in a lawn chair while residents gathered on the expansive front porch. While the meal couldn’t continue, the snacks, games and prizes could and did. “We’ve come to them,” she said. The members talk about “everything and anything they want to,” and Denio creates a shopping list of small items that are requested, crafts and the like – especially appreciated because of being cooped up by COVID-19 restrictions. “We love it because we’ve been able to continue when CRT [at UCS] can’t,” she said. With the cold weather moving in, Denio is hoping to move the group inside, and is negotiating about dividing into two groups so that they are small enough to maintain social At the Recovery Center in Rutland, a POP grant enabled distancing. Tracie Hauck to purchase a pottery wheel. “It sounds really, really possible” that it will have put some other crimps in, such as no longer happen, she said. being able to use overhead power points or to Denio started the club before applying for POP use the YouTube humor clips that he used to end grants, but they make it easier to be independent the presentations with, so that there could be a of UCS. The staff there wanted her to track client few “laughs and smiles” at the finish, he said. progress, for example, and she refused. But Burda said he has developed alternatives “It’s for them, not you,” Denio said she told to have a fun note for the 20-to-25 weekly the staff. “It’s not my job.” participants by creating a little competition, When she talks about the club, Denio such as a word search, with small prizes. constantly turns back to the individuals who Most of those who take part are clients of the participate. One woman was “a shivering leaf area community mental health center who live [who] stood in the corner” and was someone too at the same assisted living facility, but Burda afraid to go to the CRT program at UCS, Denio makes copies and hand delivers the materials to said. the “four regulars” who live elsewhere. “Now she’s on the porch” ahead of time “It means a lot to me” to be able to run the waiting, and when she sees her, calls out, program, he said. “It’s actually opened my eyes “Annette’s here, Annette’s here.” to what I’m supposed to be doing with my life.” She encouraged a new resident of the home Burda said he suffered a brain injury on the that, “these people love you and you’ll do okay” job, and “I got slapped in the face by God, to and over a short amount of time participating in advocate for people who cannot advocate for the club, “he’s really opened up.” themselves.” One man who started out being reluctant to do His college degree in medical technology more than come for the meals at the UCS facility gives him the skill set to “take difficult medical eventually became a valued helper, coming early terms around mental health and use language to unload supplies, she said. that someone without a medical background The most important thing about receiving can understand,” he said. the POP grant is that “emotionally we felt The expansion to the local television station appreciated,” she said of the work she and Burda creates a new purpose for the information, are doing. Burda said, because it not only provides They feel the love that they are sharing with important information – he’s also “trying to members of the groups back. “It feeds us.” take the stigma off” mental health and addiction issues.
Topix Expands to Local TV
BENNINGTON – In the five years since Greg Burda started his “Hot Topix” presentations with a POP grant, he has seen them expand into a community access television production and also converted them to telephone groups to continue through the coronaviris crisis. He said that what hasn’t changed is the basic purpose of supporting people with their recovery through information that will help them address issues that pertain to their own challenges. “The group members are the ones who decide what the topics are,” Burda said, and then he researches the facts to create his presentation. A recent sampling of topics included diets for anxiety and depression, cabin fever, COVID-19 tips, and motivation. The grant funds have enabled him to get the supplies he needs, make copies and – until COVID-19 hit – bring snacks for when the groups meet. Suspension of in-person meetings
Greg Burda extended the reach of his Hot Topix POP grant project on Bennington’s local cable television.
NEWS 6 NEWS
FallWinter 2018 2020
Peer Group Looks at Certification
By TRACY BRANNSTROM
The Peer Workforce Development Initiative steering committee, composed of leadership from peer support organizations, has begun meeting to assess whether to recommend Vermont adopt a formal certification process for those who use their lived experience with mental health recovery to help their peers. It isn’t a new discussion, but this time, the recommendation may have weight in the Department of Mental Health’s decision on whether to move forward. After last year’s listening tour of the public’s priorities for mental health, the Department of Mental Health identified expanded peer support services as one of its eight key action areas for the future in its “Vision 2030” report, with the goal that, “Peer services are accessible at all levels of care.” The Vision 2030 report called for a “peerled workgroup to make recommendations about whether and how credentialing and Medicaid reimbursement should be considered or implemented,” and the task was given to Pathways Vermont as part of this year’s DMH annual peer workforce development grant. What would a certification model for peer work look like? And what kinds of changes should it bring, financially and otherwise, to potentially help expand peer services?
‘A Healthy Debate from Both Sides’ Historically, some have argued that the tradeoffs are not worthwhile because some of the autonomy that is essential to a peer relationship may be lost. (See Counterpoint, fall 2018, “Is Peer Support at Risk as It Grows?”) According to Pathways, the PWDI committee has nine members who work across peerrun organizations and as peer support staff in community mental health agencies. One new member of the steering committee is Karim Chapman, executive director at Vermont Psychiatric Survivors, who said he believed in credentialing, but “there’s supporting arguments on both sides – a healthy debate from both sides.” He said it could increase recognition for the status of peer support staff and allow hours to be billable under Medicaid. Another member of the steering group, Dan Towle, said that a move to certification could disempower the peer movement in that it would be “capitulating to the pharmaceutical and medical models, and detracting from the whole idea of mutuality, peer connection and understanding each others’ worldviews.” Towle is a peer operator for the Pathways Vermont Support Line and is the NAMI-VT peer support outreach coordinator. Malaika Puffer agreed, saying that the point of peer support is “to pose an alternative layer of resources to the current system.” She is a PWDI committee member and manager of peer support services at Health Care and Rehabilitation Services, which is the community mental health agency for southeastern Vermont. Towle said that the issue “comes down to philosophies of affecting change in society.” “While an evolutionary approach would work to change existing systems from within, in a revolutionary approach, peer communities control their own destiny in a way that’s analogous to women’s and civil rights movements, and to the Black Lives Matter movement,” he said. Towle added, “we need both.” Puffer said that if certification means coming
to a consensus on what counts as peer support and making sure that peers have adequate training, it would be great. “But the devil’s in the details,” she said. “What strings are attached, and what aspects of professionalization aren’t compatible with peer values?” Puffer said she thinks that concerns about certification outweigh the benefits and hopes that a certification model is not carried out.
Only 4 States Don’t Certify Peers The steering committee began its work this year by hiring the founder and director of the Poultney-based advocacy organization MadFreedom, Wilda White, to prepare a report that summarizes mental health peer specialist certification programs across 13 US states and Canada. All but four states – California, South Dakota, New Hampshire and Vermont – have certification programs for peer specialists. The report also reviews eligibility for receiving federal Medicaid funds for peer staffing, which it says would become possible under a certification model. “It would open up additional funding streams for increasing much needed peer-run community resources,” White said. Chapman said in his prior experience as a peer support worker with Rutland Mental Health, his hours were not billable under Medicaid, which meant the agency had to cover them. He said that points to the underlying question of how peer organizations can ensure that peer support can be implemented in the right places to reach those who need it, when funding is so narrowly applied. According to White’s report, peer specialists must be trained and credentialed with continuing education requirements to receive Medicaid reimbursement for services. States have flexibility in creating their certification programs, including what the curriculum looks like. White’s report shows that many of the 13 states require at least 250 hours of relevant volunteer or paid work experience for certification. On the high end, New York requires 2,000 hours. Many states also require a certification test, letters of recommendation, and an application with written responses about their recovery and views of the mental health system.
How Would Certification Look? Many mental health agencies and peer-run organizations in Vermont use Intentional Peer Support as core training, usually combining this with programs such as harm reduction, hearing voices, trauma, suicide and poverty, White’s report said. Certification would entail a more uniform series of training programs, according to the report.
Gloria van den Berg, a PWDI member and the executive director of Alyssum, a peer-run respite program in Rochester, said that it may be up to individual organizations to decide whether to require certification for all staff, but that ideally certification would be voluntary in that some peer staff could chose not to. She also said the program should be designed and run by peers, but that will require reaching consensus – which does not exist yet – on what this would look like. Dawn Lowery, a committee member and peer support specialist and program coordinator at the Another Way peer-run drop-in center in Montpelier, said she would like to see a certification model move forward, but that requiring a combination of mandatory trainings for peer positions could pose problems for small organizations like hers, with a limited budget. The organization currently pays for training costs, including costs for travel and lodging for peers to attend trainings in Massachusetts, and these costs could increase with certification, she said. Other fees would likely come with a certification model, White’s report shows – for filing applications, taking exams and recertifying. Rhode Island charges $175 to file an application; certification fees, once approved, are $750 in Canada. According to Puffer, peer specialists are currently hired at her agency, HCRS, if they have relevant lived experience, with no minimum education or work experience requirements. As with all hiring at the agency, Puffer interviews candidates, checks references and does background checks – but certification could add new requirements. Certification could bring community organizations into alignment through standardized trainings and competencies, said Keith Grier, the director of community support services at Washington County Mental Health. But, he said challenges could be in getting agreement on the definition of “peer,” and the standardization could exclude some individuals from the peer workforce. Grier said a consideration was that certification might further legitimize peer work, prompting other community organizations to add peer support services. White said that her organization, MadFreedom, “supports a peer-driven, voluntary certification process for peer support workers.” “However, MadFreedom would not support or endorse a mandatory peer certification program,” she said. “Folks should be allowed to deliver peer support services without obtaining a certification. A certification should only be required for Medicaid reimbursement.”
Potential Effects of Medicaid White’s report said that the Wellness Workforce Coalition, which coordinated peer workforce development under the DMH grant prior to the PWDI, had also discussed certification. It included in its list of peer competencies that peer specialists receiving federal reimbursement should abide by Medicaid requirements related to treatment planning and providing notes on a person’s progress. The link between program requirements and the ability to bill Medicaid is one of the concerns for some committee members. Puffer said that at HCRS, which funds peer services with bundled DMH payments, they are (Continued on page 7)
NEWS . NEWS
Winter 2020 Fall 2018
7
New Legislator Ran Support Line
ESSEX – When the legislature is sworn in this January, one new representative will bring a lived experience of the mental health system to her responsibilities. Tanya Vyhovsky told Counterpoint that “as someone who has experienced trauma,” she wants to work to change “the very systems I’ve tried to navigate” in her own times of struggle. Vyhovsky worked with the Department of Mental Health to develop and launch the Vermont Support Line in 2013 and then ran it for Pathways for its first year. The support line is a peer-run warmline that was funded as a part of the state’s response to the closing of the Vermont State Hospital in Waterbury in 2011 after it was flooded by tropical storm Irene. Vyhovsky said that what she learned from working with the state on the support line was that there can be “huge impact with innovation.” At the time, new options were being develop to transform the system to reduce hospitalizations. That was “so foundational to why I ran and how I want to serve,” she said, because she believes expanding options for people is critical and saw what the role of state government in making it happen can be. “Working in human services as long as I have,” she said, “I’ve seen so many of our systems failing people.” “Experiences color how we see the world,” Vyhovsky said, and that includes her own experiences with trauma but also her current profession as a social worker and school counselor. It led her to feel that it was irresponsible to work only on “individual solutions to system problems,” she said. Expanded options include more peer support, she said, if done in a way that “honors the experiences and the work that’s being done” rather than looking for a less expensive service. “Real human connections” are what heal, Vyhovsky said, not telling people what they have
to do. She said, “what it means to provide peer services” needs to be considered. Most people “encounter events that challenge our mental health” somewhere on a spectrum of intensity, she said. If anyone were to “just flip through the DSM [Diagnostic and Statistical Manual]” would find that they “probably meet the criteria” of a disorder at some point in their life. As a result, “we are all each others’ peers.” Vyhovsky said she grounds her social work practice “in careful and thoughtful disclosure” to clients, telling them, “I might be on this side [of the table] now,” but ”I’ve been on that side, too.” One of her priorities, she said, is affordable housing – another aspect of the work done by Pathways. Without prevention such as safe housing, outcomes are “most costly and more traumatizing,” she said. Another is “making sure that we fully fund human services,” based on the knowledge that “there isn’t enough money to meet the need,” Vyhovsky said. Vyhovsky said she hopes to “see us take bold, economically just action on climate change” that centers “the people who are most affected,” rather than “on the backs of people who are just getting by as it is.” She’d also like to work on criminal justice reforms that focus on treatment for substance abuse and mental illness, rather than punitive approaches, she said. Vyhovsky said after seeing the election process at work with mail-in ballots this year, she plans to introduce a bill to allow voters to correct errors when a ballot is rejected for a technical reason. Vyhovsky “believes that this state will only work for all when all voices are adequately represented and fully participating,” she said on her campaign website. Vyhovsky, who ran as a Democrat and
Representative Tanya Vyhovsky Progressive, said it was “a little surreal” to have won her legislative seat. She had run unsuccessfully in 2018, losing by 394 votes against the second-place finisher, an incumbent, in the two-seat district. This year she faced opponents in both the primary and general election in a race with an open seat after one incumbent did not seek re-election. She won by beating the third-place finisher, a Republican, by 433 votes. After her work at Pathways, Vvhovsky pursued her Masters in social work at the University of Vermont and went into private practice in social work counseling in Essex, and became a school social worker at the Charlotte Central School. She is a vice-president and board member of the National Association of Social Work and is on its social justice steering committee and its legislative committee chair, her website says.
PEER GROUP LOOKS AT CERTIFICATION • Continued from page 6 not required to document peer services. She said that is crucial since individuals receiving peer services often do not want notes being logged about them. Direct billing of Medicaid, she said, would require entering a diagnosis and notes from a supervising clinician along with a billing code. Puffer said that this is contradictory to the work of peer support, which is offered as an alternative to the medical model. If certification was put in place, she added, HCRS would continue to support staff to work in a way that does not require such documentation.
Current Medicaid Billing Exists According to van den Berg, peer organizations like Alyssum, and others such as Another Way and Vermont Psychiatric Survivors, must rely on funding from DMH and other external grants. Although community mental health agencies may have the ability to directly bill Medicaid for some services, those in Washington County and southeastern Vermont said they fund their peer positions through bundled payments received from DMH that incorporate Medicaid funding. George Karabakakis, HCRS’ chief executive, said that the southeastern Vermont agency funds four full-time peer positions through those DMH payments and does not do direct Medicaid billing. Grier, at WCMHS, said that since there is flexibility in how this money can be spent, the
agency allocates some of it for 16 peer support positions. Peer work is coded as “community supports” for Medicaid reporting, he said. Grier said that it is unclear whether a certification model would bring additional federal funding to designated agencies, or whether certification was specifically intended for the financial benefit of peer-run organizations that don’t have federal funding to begin with. He said that an additional source of revenue would be helpful, but the agency plans to continue expanding peer services regardless. “That’s a programmatic priority for us,” he said. The steering committee will need more information from Medicaid about the specificities of reimbursement, van den Berg said. She noted that billing Medicaid is complicated for other reasons and that organizations may not have the right interface set up and would need to draw on additional time and funding to set up their billing structure. Grier agreed, saying that for those administering peer support programs, a certification model will require additional tasks and costs. Puffer said that she would like to see more trainings offered to those working in peer-run organizations about how to apply for external grants that they could supplement with DMH grants for funding peer work. There may be other ways to expand than billing Medicaid, “which will box us in for a long time,” she
said. “Certainly, it’s possible for the state and local governments to decide to fund more peer support.” Karabakakis said that expansion of peer services through Medicaid reimbursement is one way of doing it, but “it would be absolutely worth exploring to look at alternatives to expand peer support in Vermont.” “The state can be pretty creative,” he said. “Perhaps there are other ways.”
History and Track Record According to White’s report, mental healthfocused peer support arose in the US out of the civil rights movements of the 1960s and 70s in response to involuntary hospitalizations, forced drugging and incarceration of people with mental health conditions. Peers draw on their lived experiences of recovery to support others in crisis. They work across clinical settings, community mental health agencies, peer-run organizations, hospitals and other locations, the report says, distinguishing peer specialists from clinicians and other mental health professionals, she said. The Visions 2030 report states that strategies to expand peer support across systems of care have shown impressive potential and client experience outcomes in other states. Models include peers in prevention and at all levels of community and healthcare provider planning and delivery, it said.
NEWS 8 NEWS
FallWinter 2018 2020
Draft for Police Specialists Praised
By ANNE DONAHUE
WATERBURY – Some psychiatric survivors are praising the initial response to their input on the expansion of a program placing mental health crisis specialists at state police barracks, while other advocates remain opposed. The legislature rejected testimony in September to require that the Department of Mental Health develop the program rather than the Department of Public Safety. It did require DPS to collaborate with DMH and to include “ongoing engagement” with stakeholders, “including individuals with lived experience of a mental health condition or psychiatric disability.” DMH Commissioner Sarah Squirrell said the two departments are “working side-by-side” in developing the memorandum of understanding that will establish how the workers, hired by community mental health centers, will operate under contracts with the state police. Malaika Puffer, a member of the state program standing committee, told DMH leadership that she was “so grateful” that the concerns from psychiatric survivors were “really being heard” on the crucial issue of not having the workers involved in a forced hospitalization process. Her comments came after deputy commissioner Mourning Fox told the committee that DMH understands that “having a mental health professional who has the ability to take away civil liberties can be a barrier” for a person to have a helpful conversation with that professional. DMH “would like to steer away from that instead of towards that,” he said, and follow the practice that has been in place with an existing program in St. Albans. There, if an involuntary emergency examination at a hospital is believed to be necessary, a separate crisis screener is called for the assessment, he said. The committee is an advisory group to the commissioner made up of individuals with lived experience of mental health labels. The expansion of the state police program from two barracks to nine was authorized and funded by the legislature this year. A draft document of “major points” to include in the memorandum of understanding uses the term “crisis specialist” for positions that were called “clinicians” in the legislation.
Some Oppose Plan Itself Not all advocates were supportive of engagement in the discussion. “I am opposed to the concept (embedding social workers into police departments) in general, so I will not participate in feedback about MOUs,” Hilary Melton, Executive Director of Pathways Vermont, wrote in an email to other advocates. In September, many organizations and individuals testified in opposition to the proposal, suggesting alternatives for crisis responses, or at a minimum, that DMH be placed in charge since it came from a health perspective rather than a criminal perspective. The House adopted the position that DMH should have the oversight, but the Senate opposed it, and its position prevailed in the end. Wilda White, executive director of MadFreedom, said that in recent investments by the state, “all the significant money is invested in interventions that really conflate mental illness with criminality.” MadFreedom, formed in September and based in Poultney, describes itself as a “human and civil rights membership organization whose mission is to secure political
These alternatives are “not in conflict” with the current initiative, but an issue of “where we go” in moving forward, Puffer said. The committee expressed consensus support for her comments and agreed to draft a position paper to articulate it in writing.
Outreach to Advocates power to end discrimination and oppression of people based on perceived mental state.” White said the plan for social workers in state police barracks was one example of “an explicit ideological shift from mental illness as a health issue to mental illness as a public safety issue.”
Question of Peer Staffing Members of the standing committee asked whether mental health peers able to provide peer support would be considered as a hiring priority. The legislature had rejected including that as a requirement. Squirrell told Counterpoint that the department recognized that there would be “incredible value in being a peer” to provide a crisis response role and that it is “really critical that we have the right person in that role.” However, Squirell said, they would not want to exclude someone who might be the ideal for the job but, as one example, was not ready to disclose a background of having a mental health diagnosis. The next phase of working on a job description will be another “key opportunity” for input on criteria for the positions, she said.
Puffer said that she did not believe in a longterm vision for “as much integration as possible” but rather for “as many options as possible.” The draft “major points” document proposes a hiring panel that includes a person with lived experience. Other suggestions from the committee included incorporating Intentional Peer Support training for crisis specialists to gain the skills offered in it, even if they were not peers as understood for purposes of the training. Fox said it was “a fantastic idea” that would be added to the planning list. Dan Towle asked whether the same concepts under discussion could be applied to “parallel activities” that are being developed between community mental health agencies and local town police departments. Fox said he supported more expansion — “the more, in general, integrated the better” in many contexts — and that the work DMH and DPS are doing “can be a model that can be used in other places.” He said he saw the current expansion of the program as a “first large step” beyond the two barracks where it has been in place and that he hoped for further expansion in the future. Later, Puffer emphasized that she did not believe in a long-term vision for “as much integration as possible” but rather for “as many options as possible.” That means mobile peer support as an alternative to police intervention, drop-in peer centers as an alternative to emergency rooms, and peer respite as an alternative to hospitalization, she said.
Squirrell said that DMH had been taking the lead on involving stakeholders and had reached out to Vermont Psychiatric Survivors, the local program standing committees, NAMI-VT, the Federation for Families and the state’s director of racial equity, along with others. DMH will “take that feedback” to its work with DPS on the next draft for the memorandum, she said. Karim Chapman, the executive director of Vermont Psychiatric Survivors, said his input included the issue of ensuring there was peer involvement in the program. “We play a unique role,” he said. A person in crisis “may not want to deal with a clinician” based on previous experiences with the mental health system. He said he would also be sharing a concern about “the responsibility of the troopers regarding supervision of the mental health specialist” at the scene of a crisis. Under the draft document, “the final say is really going to VSP... [there] should be a middle ground” that would be more collaborative, he said. Chapman also said he wants to see more focus on preventative work, such as “how they are managing call logs” in order to be sure there is an “accurate understanding of a person” and what they are experiencing. If a person is hearing voices, “you screaming at them is only going to [further] trigger them,” he said. The draft document on major points says that the troopers’ role is to “provide initial response; scene safety and continued safety during emergency situations” while crisis specialists are available for on-site assistance for crisis support, assessment and referrals. “Once the scene is considered safe, it will be collaboratively determined by the trooper and/ or supervisor of the scene and the mental health crisis specialist [regarding] who will remain on scene,” but if there is a disagreement about safety, “the trooper and/or supervisor at the scene will have the final decision.” The draft also states that patient confidentiality laws apply and therefore limit the information that can be shared without patient consent. Goals of the program are described as including more efficient and effective access to supports and services for those in a mental health crisis, shortening of the time for a person in crisis to meet a mental health crisis specialist for assessment, and having a direct initial contact and follow up supports that “may reduce potential future crisis circumstances and/or reduce future law enforcement contact.” Disability Rights Vermont reported that it submitted comments to DMH by sharing a draft agreement that it helped Northeast Kingdom Human Services develop for a similar initiative with the state police at the St. Johnsbury barracks. The memorandum of understanding states that, “Through this collaboration NKHS and VSP strive to serve these individuals in a way that encourages safety, self-determination and healing, prevents unnecessary trauma and uses of force, and reasonably accommodates an individual’s known disability and avoids causing the individual to suffer greater injury or indignity than nondisabled individuals.”
NEWS .
Fall Winter 20182020
9
COVID-19 Impacts May Be Yet Unseen By ANNE DONAHUE
WATERBURY – A feared increase in deaths by suicide resulting from the stress and isolation caused by the coronavirus pandemic did not occur between this spring and the end of September, either nationally or in Vermont. However, experts warn that there are still highrisk factors for an increase, and some said the impact could show up in the months after the first phase of the pandemic. The Centers for Disease Control said in an August bulletin that, “Addressing mental health disparities and preparing support systems to mitigate mental health consequences as the pandemic evolves will continue to be needed urgently.” Department of Mental Health data and anecdotal evidence from local hospitals indicate increases this fall in people waiting in emergency rooms for psychiatric admission.
VPS Receives Support Grant Vermont Psychiatric Survivors was awarded a $15,000 grant in coronavirus relief funds “to offer peer support to folks in more remote areas of the state, to purchase and distribute pre-paid cell phones to service users to combat isolation, and to assist with mental and psychiatric health referrals and support options,” according to Sara Chesbrough, the state’s health operations center equity technical advisor. The grant came from $1.25 million appropriated by the state legislature specifically to assist people in health disparity populations, defined as those at “high risk of adverse outcomes from the COVID-19 pandemic” based on certain factors, which included disability. The funds were to address “safely meeting essential needs, including food, shelter, health care, and emotional support” during the emergency. The VPS grant was “the only one targeted specifically for psychiatric survivors,” Chesbrough said. VPS had requested $72,000 for its proposal, but it was reduced to $15,000, VPS staff said.
Emergency Waits Increase Inpatient psychiatric hospitalization rates – as with hospital use in general early in the pandemic – dropped significantly in the spring when the coronavirus pandemic began. However, because of the number of closed beds, actual available capacity did not increase measurably and the number of patients who
needed to wait in the emergency room for an available bed continued to increase. For much of the spring and summer, nine beds at the Vermont Psychiatric Care Hospital were closed because of the need to use them temporarily for residents of the Middlesex locked facility. Two units have been closed indefinitely at the Retreat for financial reasons – the “emerging adult” and the co-occurring substance abuse unit – for a loss of 36 beds. As a result, occupancy of available beds only dropped from 87% to 83% in the spring; it would have been 61% if all hospital beds were available. By summer, occupancy was back to 87% and the number of instances that an involuntary patient was held in the emergency department for lack of an inpatient bed continued a steady rise from 82 last winter to 107 at the start of the fall, when the last data was reported. Those waits only include patients being held involuntarily, not waits by the 80 to 90% who are voluntarily seeking care. The Vermont Association of Health Care and Hospital Systems did not have data immediately on hand to confirm numbers, but a representative told Counterpoint in November that, “We have been hearing about regional spikes in people coming to emergency rooms for mental health needs throughout the fall.” The combination with a late fall surge in coronavirus patients in Vermont has the association anxious. “An increase in both COVID-19 patients and patients seeking mental health treatment will be extremely difficult for emergency departments to manage,” said Emma Harrigan of VAHHS.
Risks Factors Exacerbated In September, the Pan American Health Organization warned that “the COVID-19 pandemic may exacerbate suicide risk factors,” urging people “to speak about the issue in an open and responsible manner, remain connected even during physical distancing, and learn to identify warning signs to prevent it.” Evidence from previous epidemics suggests a short term decrease in suicide can occur initially — possibly linked to a “honeymoon period” or “pulling together” phenomenon, according to an article in the British Medical Journal in November. According to the Vermont Department of Health, as of the end of September there have been 73 suicide deaths among residents, slightly
fewer than previous years, “however this may change because the data is preliminary.” It also reported that as of November 10, emergent care visits for suicidal ideation and/or self-directed violence continue to follow trends similar to previous years.
Quarantine Site Opens DMH has developed a separate hospitalization site for quarantine of patients who both test positive for the coronavirus and need inpatient mental health care. Sarah Squirrell, the Department of Mental Health commissioner, told the legislature that federal emergency funds were used to rehabilitate the Windham Center in Bellows Falls to make it appropriate for all levels of care. It had no longer been designated by the state for involuntary care because it was not designed appropriately for acute care levels, the legislature was told. The first psychiatric inpatient to test positive for a COVID-19 diagnosis was transferred from the Brattleboro Retreat to the Windham Center in November, Squirrell verified. Under a contract with the state, Springfield Hospital staff is on standby to care for any COVID-19-positive patients, Squirrell told the legislature. The facility remained vacant until the November admission.
Police Council Adds Psych Survivor
MONTPELIER – Karim Chapman, Executive Director of Vermont Psychiatric Survivors, has been appointed by the governor as one of seven new public members of the new Criminal Justice Council, a former training oversight group that was given significantly expanded authority by the legislature this fall. Act 166 says that the council was renamed “in order to fully reflect all of its powers and duties, which relate to training, certifying, and professionally regulating law enforcement officers” in the state. The new authority includes making determinations of unprofessional conduct and imposing sanctions. Chapman said he was “pretty honored” by the appointment, which will enable him to bring perspectives from “my experience not only as a survivor but a person... my interactions with police in the past.” The council was expanded from eight state officials to 24, with 11 of them
representing members of the public. At least one member is required to be “an individual with a lived experience of a mental health condition or psychiatric disability.” The Commissioner of Public Safety, Michael Schirling, recommended Chapman for that slot, telling the governor’s staff, “He comes highly recommended as a great thinker in a variety of areas including the mental health system and the intersection with public safety.” Chapman shared in an interview with Counterpoint in the fall that his passion for helping those “who are oppressed or don’t see a way out” were directly related to his experiences with mental health issues and criminal justice encounters after police killed his father in a case of mistaken identity. He became involved with drugs and gangs and served time in federal prison, he said. He wants to focus his efforts on the council on
training issues, saying that police often aren’t aware of what is happening to a person with a mental illness. “Why does it take five or seven people taking out their weapons?” to engage with someone, he said. Its new role adds the responsibility to “maintain statewide standards of law enforcement officer professional conduct by accepting and tracking complaints alleging officer unprofessional conduct, adjudicating charges of unprofessional conduct, and imposing sanctions on the certification of an officer who the council finds has committed unprofessional conduct.” The council is also in charge of establishing a model policy on the use of body cameras, which will be binding on officers who use them. It has also been directed to review and make recommendations to the legislature on a range of issues that have been raised regarding police conduct and oversight.
FallWinter 2018 2020
5
Brattleboro Retreat Tyler 4 Rutland Regional South Vt Psychiatric Care Hospital Combined Level 1 Units
4 3 2 1
- Ju ne Apr
-M ar 20 20
Jan
De c Oct -
- Se pt July
ne Apr
- Ju
-M ar 20 19 Jan
De c Oct -
pt - Se July
- Ju ne Apr
-M a 20 r 18
0 Jan
Rate per 1,000 patient hours of care
NEWS 10 NEWS
Rate of Restraint and Seclusion on Level 1 Units Line graph is a reproduction of graphs in Department of Mental Health quarterly reports, with one segment revised to reflect corrected DMH data.
USE OF FORCE INCREASES • Continued from page 1
higher in the rate of force it uses against patients in intensive, Level 1 units. The one data indicator that includes force used against all psychiatric inpatients in Vermont shows a continuous upward trend line, greater by 1 1/2 over the past five years, in the number of hours of restraint or seclusion for every 1,000 patient hours of care, going from .45 to .70. That data is not reported on a per hospital basis. The Retreat’s data on restraint and seclusion used on Level 1 patients spiked so high in the March to June quarter that a number of psychiatric survivors came to the quarterly review committee meeting in October to raise questions. Although the Retreat and the Department of Mental Health pointed to a lower number of patients with more serious symptoms as impacts of COVID-19, data from both before and after the March-June quarter also showed high levels of use of force. The rate of use, which compares the number of hours of emergency involuntary procedures to the number of hours of patient care, has been consistently higher for the Retreat’s intensive, Level 1 unit than the other two hospital Level 1 units for at least the past three years. The Retreat’s rate pushed the most recent combined rate for the three hospitals to an all-time high among posted reports. Rates were not available for the most recent July-September quarter because DMH said it had not completed its data review yet. Those rates do not include restraint or seclusion used with voluntary patients or with less seriously symptomatic involuntary patients, so actual rates for overall use of force are not available for any individual hospital. Trends beyond five years are not included in any of the reports. In an additional information gap, in response to an inquiry from Counterpoint, DMH said that there has been no written definition that explains the difference between the sub-categories of physical restraint, which are listed in data reports as either “manual” or “mechanical.” Although several stakeholders said they have assumed that manual restraints – which constitute the majority of reported use of force – involved brief interventions, newly requested data showed numerous times that manual restraint lasted more than 15 minutes and occasionally much longer. The new data on use of force on voluntary patients at the Retreat demonstrates that “it’s crucial” that the Department of Mental Health has information from all hospitals that “shows the whole picture” if there is to be progress on reducing the use of restraint and seclusion, said AJ Ruben, senior staff attorney at Disability Rights Vermont. Minimizing the use of emergency involuntary procedures is required of all hospitals. It “really is unacceptable that DMH and [other oversight entities] ... do not receive all
information about a hospital’s use of force,” he said. “They’re only seeing half the story.” Ruben, who has seen the actual records from October as part of DRVT’s legal oversight role as the state’s mental health ombudsman, said it appeared that uses of force were “less intense” with self-admitted patients – the use of a seclusion room might be for a shorter length of time, for example – but voluntary patients still represented a significant number of all of the types of emergency procedures. DRVT’s role includes review of all incidents reported to DMH and dialogue with DMH about them.
It “really is unacceptable that DMH and [other oversight entities] ... do not receive all information about a hospital’s use of force,” Ruben said. “They’re only seeing half the story.” According to raw data provided to Counterpoint, the highest number of those reports came from the unit that serves young children, which had no reports of uses on involuntary patients. Among other instances, the raw data reported that mechanical restraints were used on voluntary patients on the adolescent unit on 12 different occasions in October, several times for more than an hour and a half. DMH said that mechanical restraint “includes the use of a device that restrict a person’s movement” in contrast to manual restraint, which is “a type of intervention that uses physical force in order to hold a person to prevent or limit movement. This intervention does not include a mechanical device.” The legislature instituted a new requirement this year for the Retreat to provide de-identified information about restraint and seclusion for voluntary patients as part of a set of quality of care oversight measures being required as a condition of the millions of dollars it was receiving from the state to sustain it in the face of financial losses. DMH Commissioner Sarah Squirrell initially told Counterpoint that because she had not yet seen the first reports on voluntary patients that started coming in October, nor the ongoing data on involuntary patients for the July to September quarter, she would need to check on it before giving a reaction to the data. She said, however, that for DMH, “Patient safety and care is our north star,” and that accountability was critical. In terms of the data
report for the spring, however, she said it was important to understand “what the data is telling us,” because during that time there was a “significant increase in acuity” at the Retreat, in part because the Vermont Psychiatric Care Hospital was operating at 48% capacity. She also noted that numbers “can swing significantly from quarter to quarter” because a small number of acute patients can impact the rate. Regarding reaction to any data since June, Squirrell responded later, “The research and stats team is currently working to compile all of this information and ensure data integrity,” so data on involuntary restraint and seclusion from this past summer would not be available until December. She said the Retreat data on voluntary patients would be part of the October-December 2020 report that would be public next March. Regarding the data that was provided directly to Counterpoint, DMH said, “Please note that because this was a request for raw data, it has not undergone any cleaning or preparatory analyses.” At the October quarterly meeting of the Emergency Involuntary Procedures Review Committee, the Retreat explained the spring data in similar terms as Squirrell. According to minutes from the meeting, the Retreat’s director of patient safety, Karen Crowley, said that there had been a “greater push with getting senior leadership involved” as well as significant training. “We have CMS [the Centers for Medicare and Medicaid Services] here quite frequently looking at our numbers, and they don’t have any concerns,” she was paraphrased as saying. The Retreat “has significant concerns for patients who are slamming their heads on doors or putting hands on staff. We are doing [restraint and seclusion] mindfully and only when things like this happen,” the minutes quoted Crowley as saying. The committee’s annual report noted the “many public voices in advocacy roles” present at October’s meeting in response to the latest Retreat data. One participant, Malaika Puffer, said it took an incredible emotional toll to participate and to listen to the defensiveness from the Retreat, adding, “I feel a little nauseous, and my heart is racing.” She said that hearing the Retreat say it did not come to the meeting prepared to talk about it and being told: “don’t attack the Retreat” failed to acknowledge the violence that was occurring when restraint or seclusion is used. Puffer called it a “gut-wrenching, traumatizing, sickening experience,” and said there needed to be “an attitude of eagerness of what needs to change.” The committee’s annual report said that “tension increased significantly” at meetings in the past year, with “concerns expressed repeatedly by peers and advocates” that “it often does not seem there is any response evident” when “concerning trends continue.”
NEWS .
Winter 2020
11
An early architectural draft presented this concept as an option for the 16-bed locked residence that the Department of Mental Health is developing to replace the current 7-bed program in Middlesex. Commissioner Sarah Squirrell said DMH has met with some of the current program residents and further stakeholder meetings on design will resume soon. The facility is planned for the grounds of the former Woodside youth detention and mental health facility in Colchester, Squirrell said. The current building would be torn down. She said its gymnasium would remain for use by residents of the new facility.
Restraint To Be Permitted in Residence By ANNE DONAHUE
WATERBURY – Leading mental health advocacy organizations say they used a recent meeting to push back on the plans to include a seclusion room and other restraints in the new locked residential program under development. The Department of Mental Health said later that it is not reversing its position. Sarah Squirrell, the commissioner, told Counterpoint that DMH believes “that [when] safely used and clinically indicated,” availability of involuntary emergency procedures “is a key tool” to ensure patient ability to transition at the earliest time from a hospital to the residence. She said brief restraint or seclusion could “avoid unnecessary trauma” from calling the police and being re-hospitalized based on a brief crisis. DMH has to consider how staff can intervene and “quickly and safely de-escalate” a situation, she said. Squirrell said she recognizes the “culture and values of the program are critical” in minimizing use. The DMH policy statement was not what the meeting participants were pressing for. “All the stakeholders were on the same page that we don’t want restraint and seclusion,” Laurie Emerson, executive director of NAMIVT, said after a meeting with leadership from the Department of Mental Health. “We want less trauma, or no trauma” and the use of force is trauma, she said. “We’re totally against that portion” of the planning, agreed Karim Chapman, executive director of Vermont Psychiatric Survivors. Chapman said advocates stressed that “preventative efforts should take place as part of handling individuals that are at risk of hurting themselves or others” rather than relying on reacting to an emergency. Emerson agreed, saying staff “need to intervene ahead of that,” and if prevention is not possible, what was needed was to consider about a person, “are they ready to be in a therapeutic setting” like a residence, rather than a hospital. The new facility would replace the existing secure residence in Middlesex and expand its size from seven to 16 beds. The Middlesex building is made up of converted trailers installed after Tropical Storm Irene destroyed the old state hospital in Waterbury. The trailers were supposed to be temporary; the dilapidated structure is now seven years old.
The program was initiated in 2013 and DMH said it was intended to serve patients who had been at VSH and no longer needed hospital care, but were still deemed to require a locked facility. Part of the stated intent at the time was to reduce the number of more expensive hospital beds that needed to be constructed to replace VSH. DMH did not apply for a change in regulations to allow involuntary emergency procedures like restraint and seclusion when the Middlesex program was developed. Squirrell said they believe that change is now necessary to ensure access to a step-down residence that is a lower level of care. The department submitted a report to the legislature last January that identified the lack of emergency procedures at the Middlesex residence as a barrier for discharging patients, contributing to a shortage of hospital beds for new patients. Ed Paquin, executive director of Disability Rights Vermont said, “We don’t like the idea of creating another institution where use of force is an option, but I understand the reasoning.” “What they described was reasonably thought out,” he said, of the DMH desire to avoid creating a hospital step-down residence where if someone happened to have a crisis that created an “immediate but short-term danger,” they would have to be removed and returned to the hospital. Emerson said the advocates “gave them many different options to think about” to address emergencies without needing restraint or seclusion. She said NAMI was “looking for DMH to take the lead” in eliminating restraint and seclusion, especially in a residential setting, and that “we need them to set the tone,” including for hospitals in the state. Emerson noted the emphasis on the role of leadership and prevention in the SAMHSA core strategies. SAMHSA stresses the need for “consistent and continuous involvement of senior facility leadership” and identifies another of the evidence-based strategies as “anticipating the needs of individuals and actively engaging them in prevention efforts.” Jack McCullough from Vermont Legal Aid, the other participating advocate, said he questions the underlying need to more than double the number of locked beds rather than increasing the amount of housing in the community.
That point was emphasized by another advocate, Wilda White, who was not a participant at the meeting. She told Counterpoint her organization, MadFreedom, opposed investment of money into locked institutions. Chapman and Emerson both said they stressed the need to have staff peer specialists as part of the program. “Connect individuals who have the potential to be violent or disruptive with a peer to form a rapport before issues arise,” Chapman said. Chapman also suggested that DMH considered creating a space available to residents where they “have the ability to calm down and vent in their own way safely” – perhaps something like a room with padding on the walls where a resident could go to release energy or frustration. Emerson said she also raised the need to keep a focus on discharge options, specifically access to supported housing. Paquin said he told DMH that if it planned to go the route of allowing restraint and seclusion, its use needed to be clearly identified as a treatment failure, and embed strategies that have been proven to prevent the use of emergency involuntary procedures. He said the focus needed to be on the “necessity for minimizing the use,” and that there is “every possibility there could be no use” based on the experience in other states that have used the “Six Core Strategies,” as cited by the federal Substance Abuse and Mental Health Services Administration. Squirrell said DMH did intend to use the “Six Core Strategies” approach endorsed by SAMHSA. White, whose new organization identifies itself as focused on human and civil rights for people who experience discrimination and oppression based on perceived mental state, said that the issue of emergency involuntary procedures was a narrow one contrasted with the expansion of locked institutional capacity itself. “MadFreedom opposes the investment of funds into carceral, institutional settings for people in mental or emotional distress, particularly given the paucity of community resources in Vermont for prevention, maintenance and early intervention,” she said, adding that the "capacity for seclusion and restraint is part of an explicit ideological shift from mental illness as a health issue to mental illness as a public safety issue.”
Have News To Share? Send it to Counterpoint! The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701 or by email to: counterpoint@vermontpsychiatricsurvivors.org
Deadlines:
FALL (September delivery; submission deadline July 29) WINTER (December delivery; submission deadline October 30) SUMMER (June delivery; submission deadline April 7)
The Arts
12
Winter 2020
Let’s Talk About It
Cara Bean was a Massachusetts art teacher who wanted her high school classroom to be a safe space for students. She got a lot more than she bargained for. The issues teens were coping with “just overwhelmed me,” she said, and her training was in art, not psychology. It was her art that led her to a response for students in the form of her newly released comic book, Let’s Talk About It: A Graphic Guide To Mental Health, which focuses on destigmatizing the conversation around mental health, addressing everything from stress to anxiety to addiction. The project was a collaboration between the Center for Cartoon Studies in White River Junction and an Ohio mental health agency. The 24-page comic book is available by free download at cartoonstudies.org/mentalhealth. Bean, who has her Masters in Fine Arts in drawing and painting, was teaching at Lexington High School in Massachusetts when she began to encounter students in mental health crises. Sometimes, it came out in their artwork, she said, or in expressing concern about friends. Sometimes, it was much more direct: a student who would say, “I want to kill myself.” Bean began taking advantage of any workshop she could find that helped her learn more about mental health. As a cartoonist, she said she saw the opportunity to use cartooning as a tool to communicate and help young people in crisis. The first result, the product of a workshop on depression and suicide, was Snakepit. It was a comic designed to help adults who were concerned about a teen in their life. It was very popular, she said, and was her “first clue” about the level of need for publications like
A page from ‘Snakepit,’ Cara Bean’s comic about depression.
Cara Bean it, and she decided to take a year off from teaching to work on a longer graphic novel on the issue of mental health and kids. “This is not going away [and] no one else is working on it,” she said she felt. During that year, she completed a monthlong residency at the Center for Cartoon Studies. That connection led to the request that she take on the comic book project when an Ohio agency approached the center about a comic that would help to reach kids. The agency – Stark County Mental Health and Addiction Recovery – provided the research support to help ensure the messages were “helpful and not hurtful,” and the center provided the creative base, she said. “I know how to talk to children,” Bean said, so it felt like the right combination to direct her talent as a cartoonist directly to a teen audience. She also turned to the real experts for help. Bean brought an early draft to a school in Chicago and presented her ideas to the kids there, and received “really beautiful feedback,” she said. She also shared it with children within her own extended family. “The comic is really meant to be a communication tool,” Bean said – not something to hand to a young person and say, “read this.” Adults need to be prepared for that conversation, she said. Bean has found that discussions about being worried about a friend are the most comfortable approach to the topic in public spaces. But when “anyone opens up” because a teacher has created “a safe space in their classroom,” teachers “need to take responsibility” for addressing the situation, she said. “These projects seem to happen when the right opportunity meets the right cartoonist at the right time,” said James Sturm, director and co-founder of the Center for Cartoon Studies in a blog post. Sturm said that when Stark County Mental Health and Addiction Recovery contacted the center, he immediately thought of Bean, because she is “an exceptional cartoonist” who was working on the same topic during her residency there. “The need for creative ways to interact with young people about their mental health felt urgent,” he wrote, “Now, even more so” as a result of the coronavirus pandemic. “I’m hoping this comic creates and holds a space for anyone who is struggling with their mental health or is looking to help someone in their life who is struggling,” Sturm said. The Department of Mental Health is reviewing the comic book to consider making it widely availably for young people in Vermont, according to Commissioner Sarah Squirrell.
The Arts . 13
Fall 2018 Winter 2020
Psychopoly: Psychiatry Versus the People
Mixed media, Phoebe Sparrow Wagner, Brattleboro The artist writes that beyond the clear objects – such as the person in a restraint chair, the hammer of Haldol smashing the bottle of hopes and dreams on the anvil of Compliance, and the chess pieces on a scale, the pawns collectively weighing less than the queen MD – others may call for explanation. “The luna moth is actually fixed on a pin, and the woman in a lavender dress represents a life other than the one led by the woman in the restraint chair. Some of the other internal drawings also illustrate Robert Frost’s poem, ‘Design,’ a poem I have always loved. Red/green glasses in my art always represent seeing the truth, seeing what is real, while sunglasses represent occluded vision or seeing what is surface only.”
Design
by ROBERT FROST
I found a dimpled spider, fat and white, On a white heal-all, holding up a moth Like a white piece of rigid satin cloth Assorted characters of death and blight Mixed ready to begin the morning right, Like the ingredients of a witches’ broth A snow-drop spider, a flower like a froth, And dead wings carried like a paper kite.
What had that flower to do with being white, The wayside blue and innocent heal-all? What brought the kindred spider to that height, Then steered the white moth thither in the night? What but design of darkness to appall? If design govern in a thing so small.
Another Way There frequently is a growing need for quieter space, somewhere nonjudgmental, welcoming and safe, away from either harsh glares or blank stares too often imposed by much of the human race; a sanctuary for souls seeking potential refuge as well as mutual healing and peer support, a place of equals; one absent diagnostic criteria, labels and also vastly lowered expectations; exploring and finding another way, where hope, passion and love can grow and thrive; a peaceful haven for one to simply be themselves as well as to also possibly move on however and wherever life might take them next.
by Morgan W. Brown, Montpelier
Got Art?
Share It! Send it to us at:
counterpoint @ vermontpsychiatricsurvivors.org or mail to Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701 Please include name and town
by LINDA A. WALSH
St. Johnsbury
14
The Arts
1
FallWinter 2018 2020
Face in the Moon For Agnes
“I’m afraid we won’t decorate the Christmas tree this year,” my friend Maggie said, reaching for her sister’s hand. “We could lose Mother before Christmas day arrives ... “I looked at the old lady’s wrinkled face. “Come angels,” she kept whispering. I realized she wasn’t talking to us but to the angels coming to take her up with them. Closing my eyes, I retreated into my memories of Agnes ... A few months ago I received a phone call on the ad I put in the local paper. The job sounded challenging, but I liked the soft woman’s voice. She was looking for a home-health aid for her Mother. The job was located in a low-income housing high-rise in downtown Burlington. We scheduled the appointment. A tall, plain looking woman with big, deer-like eyes in a simple black dress opened the door. “Nice to meet you. I am Jennifer; my sister Maggie will show you how to keep our Mother comfortable as soon as she’s done cleaning the bathroom. Make yourself at home. I must run down to the pharmacy to get Mother some medicine.” The old woman was sitting in a recliner, her hands shaking, eyes swelling with tears. “She has Parkinson’s,” Maggie explained when she was done with the bathroom. “Alzheimer’s too - advanced stage.” The old woman swung forward, accidentally knocking down her coffee cup. Maggie quickly took a rag. “We know it’s not an easy job,” she apologized. “We’d understand if you say no. The agency doesn’t pay well either, we have trouble keeping caregivers. It makes Agnes nervous to constantly see new faces. But we do need another person; our Mother needs a 24-hour care.” The old woman started shaking uncontrollably - she was so frail that I got afraid she’d break apart if I touched her. In her white dress and white ribbon in her hair, she looked like a porcelain doll. For a moment, I hesitated. I got another job offer which sounded easier and the wages were better. But when I looked into Agnes’s eyes, I saw a special glow, like a star on a snowy sky. My heart told me I must choose Agnes. My decision proved right - I enjoyed my time with Agnes. After the lunch, I usually wheeled Agnes to the park next to the lake. She always seemed in good spirits, humming a song. But whenever she’d see a sailing boat, she grew restless and I had to wheel her back. I couldn’t understand what was wrong. Later, Maggie explained how their father, Agnes’s husband, lost his life in a tragic boat accident. “Our lives were so messed up,” Maggie said once when we had a coffee break together. “My parents had a farm in Northeast Kingdom. My Mother rode horses and knew how to hunt. She shot raccoons; when our resources ran low, she would make us a raccoon stew.” I was surprised. “I thought they shoot deer, not raccoons.” Maggie shook her red curls. “No, she never wanted to shoot deer. She believed bad luck would come to someone who shoots those graceful animals.” “What happened after your dad died?” I was getting more curious about their lives. “Mother sold the farm and moved us to Burlington. That was a bad idea; our lives would have been much better if we’d stayed on the land. Our ancestors came from Scotland to continue the tradition of fanning. Now look what’s happening - so many farms sold, land being used for development.” “What a shame,” I agreed. “The same happened to my
homeland, Croatia – though I don’t know anything about fanning, I was born and raised in a city.” The sisters and I became close friends; their stories fascinated me. When the first snow fell after Thanksgiving Day, it was the time to start planning for Christmas. “I’ll put some red gingerbread hearts from Croatia on the Christmas tree,” I suggested. “And my daughter will cut paper angel ornaments,” Jennifer said. “And I will knit a large silver star to put on top of the tree,” Maggie said. “We always had one when we lived on the farm.” Only Agnes didn’t seem happy about Christmas. She kept staring at the picture of a young man in uniform on the wall and refused to eat her meals. “I know what’s bothering her,” Maggie said. “It’s Peter, our brother. He was good with guns; he went deer hunting every fall since he turned fifteen. He went to Vietnam War where he lost his right leg and his nerves. He never married. Mother longed to have Peter’s grandchildren, but her wish was never fulfilled.” “But where is Peter?” I interrupted her impatiently. Maggie’s face went pale. “About ten years ago, right on Christmas Eve, he shot himself. Mother found him dead on the floor - no explanation, no farewell letters. Peter was severely depressed. I suspected he was planning to kill himself for quite a while. He just never had the time to do it. When they laid him off his job, that’s when he finally found the time.” “That’s so ... tragic,” I mumbled, unable to find comforting words. “That’s when Mother started to get sick - first Alzheimer’s, then Parkinson’s ...” A loud noise of a broken glass brought me back to the present. Agnes was staring at the spilt milk and shattered glass on the floor. “A sign of death in my homeland,” I mumbled to myself. Agnes died on Christmas Eve. A day after Christmas, in a bleak, windy day with a few snowdrops flying around, we followed Agnes’s body to her last resting place. The sisters, Jennifer’s daughter, a few neighbors and me, gathered around the coffin each with a white rose in our hands. A neighbor dressed in Scottish kilt played “Amazing Grace” on his bagpipes. With the last notes of “Amazing Grace” pounding in my ears, I could suddenly see it all: the farm standing on a hill, Agnes riding a black horse, sunflower fields behind her swaying in the wind, her daughters dancing near the river; the Sun spinning like a windmill above the green hill tops .... Out of this town, there was a Vermont I wasn’t familiar with - Vermont of farmers and laborers whose ancestors came from Scotland, where one had to struggle hard to survive the harsh winters, and where music was the only outlet for the centuries of grief ... And in that moment, I was one with them - no more a foreigner, I had a family, I finally belonged ... That evening after the funeral, I woke up in the middle of the night – something was calling me to go out and look at the Moon. I couldn’t believe my eyes as I gazed at the cold sky - for there, in the full, bright Moon was Agnes’s face, pale and solemn, the way it looked like when she lay in the glass coffin ... When I called Maggie on the phone the next day and told her I must had been sleepwalking, she said: “No, you didn’t. At the same time you saw my Mother’s face in the Moon, I saw a shooting star ...”
by VESNA DYE
Burlington
The second place winner in prose, Grateful by Belle Cashman, will be published in the summer issue of Counterpoint.
The Arts . 15
Winter 2020
Wounds of the Third Eye
1
I am a God Child. Can’t you see? Apathy will never rise above Divinity. People pirate life then flake out. Concerned not to miss the Breakout. Do not heed false hopes and secrets meant to keep. Be a star. Avoid flocking as sheep. I’m an anomaly. Philosophically, a monstrosity; Hyperbole rarity. Phenomenally, an oddity. Act accordingly and handle business properly. It has come to me, plain to see, this world filled with disparity. Vulnerably I try to live with purity. What’s lost is found, Every justice earned. Diligently, we leave no stone unturned. A Shepherd’s Rhyme with nowhere to run, I have always been an Army of One. Patiently, I wait for my turn. Live fully and find out, there is much to learn. Everything is at face but there are webs of hidden layers. A life filled with restless nights; Unanswered prayers. Blessings to Love and Glory every day. Believe it will be, with Unity heard and felt, it just may.
For Haley
No one knows Why it happened Maybe it was your longing To drift into the Eternal Light. Then he finds you there Spread on the floor, Your blonde locks scattered Over an empty gin bottle. Outside, horses rear, Ravens pounce upon A run-down rabbit;
2
This is when the time stops In those early hours of dawn In mid-November When rain destroys the last leaves Left on the branches.
by ZACHARY NUZMAN, Brattleboro
After three days of constant rain They take you to your final destination; Hiding under umbrellas They don’t know what to sayWords cannot fill up Empty spaces in the heart.
Echo of a Teardrop A profound inescapable sadness Unrelenting. Unerringly the ache seeps into every pore of my heart and soul. Hijacking my natural joy. Like a flower struggling bravely not to wilt in a torrential rain. Longing for safety in a shelter away from the heaviness of the emotional storm The wind hears the flower’s sign of defeat ...Unimaginable Regret... An impossible wish to turn back the hands of time. A lightening bolt strikes. Cuts through the sky like broken glass eroding warm memories and leaving them tattered on the edge of despair. Thunder rages, trees bend until the storm finally passes on. A ray of sunshine peeks through the dark clouds and the flower’s petals shift towards the light reaching for a glimmer of hope.
Last Rain in Montana
The priest reads from the Bible: Ashes to ashes, Dust to dust ... No matter what is said Departures are always the hardest
3
Especially in this downpour When it is impossible To preserve the flowers ... by VESNA DYE, Burlington
Falcon
The falcon that flies so high I ponder were she goes. Flying Through the trees, Into the Sky, Through the dust and the wind. She is very fast and a pretty little thing, birds like her love to soar and glide. She soars to the ground to catch some mice, catching them twice. She hears some cries, baby bird cries. She flies with the mice in tow, She lands in the nest, a big little nest and feeds her little young. She gives them some love and little baby bird hugs. Then again she flies through the trees and into the sky, through the dust and the wind. Soaring so high into the sky, I ponder were she goes.
by ALANCE RAQUEL, Burlington
by NATHANIEL GREENE, Bellows Falls
Louise Wahl Memorial Writing Contest First Place - Poetry - $50 Wounds of the Third Eye - Zachary Nuzman, Brattleboro Second Place - Poetry - $30 Last Rain in Montana - Vesna Dye, Burlington Third Place, Tie - Poetry - $10 Echo of a Teardrop - Alance Raquel - Burlington Falcon - Nathaniel Greene- Bellows Falls
First Place
Prose
$100
Face in the Moon - Vesna Dye - Burlington
Second Place
Prose
$50
Gratitude - Belle Cashman
Enter the 2021 Contest: Deadline July 10 $250 in Total Prizes! Named for a former Vermont activist to encourage creative writing by psychiatric survivors, mental health consumers and peers. One entry per category (prose or poetry); 3,000 word preferred maximum. Repeat entrants limited to two First Place awards. Entries are judged by an independent panel. Winners will be published in the fall, 2021 Counterpoint.
Send submissions to: Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701 or by email to: counterpoint@vermontpsychiatricsurvivors.org Include name and address.
16E
The Arts
Editorial
FallWinter 2018 2020
Opinions
Blind Spots This fall, a new children’s book was published as part of the “Manimal Tales” series, an engaging collection of stories which combine anthropomorphic personanimals with a leading character that is the childreader themself. An adult ordering the book provides the child’s name and chooses the child's skin and hair color, who appears as hero or heroine. The new story was a cautionary and educational tale that made no bones about being a critique of President Donald Trump. The manimals are taken in by the Organgey-Tan’s promises and they elect him, then soon discover he is full of lies and is hurting and marginalizing both the animals and other manimals in the jungle — even building a wall to keep undesirables out. We won’t spoil the end about how the child-reader saves the day. But we will tell “the rest of the story” through a simple reprint of the email that Counterpoint staff sent the author, and the response received. From Counterpoint: “Please, please, please – make a critical revision to this book (The Orangey-Tan) before it spreads prejudice and discrimination, just the opposite of what it clearly (and wonderfully) is attempting to do. “I had filled in my grand-nephew’s name and was reading it with absolute delight until I got to the first reference to Orangey-Tan as being ‘insane,’ and then reference to being crazy, and finally, worst yet, ‘nutto.’ “It seems that those of us with psychiatric disabilities are the last disenfranchised minority group for whom it is still socially acceptable to make derogatory comments and to mock. “You are mimicking our bigoted President and the way he uses language against those of us with mental illness; yes, he does it with many different groups and individuals — but you, here, in exposing how wrong his words and actions are as a whole, perpetuate the discrimination and stigma against us by retaining the slurs against those with mental illness. “Being evil and exploiting others is not being mentally ill, it is being morally corrupt; this story equates them, and then uses the derogatory language of ‘insane’ and ‘nutto.’ Please re-edit before further damage is done.” Author Sue Donhym replied: “Thank you so much for your email. I have to admit, it made me feel very sad, as you are absolutely correct. “It does make derogatory references where they aren’t necessary and don’t accurately reflect the story. And I used them thoughtlessly, which clearly exposed a blind spot in my thinking. I think you said it best in your last line: ‘Being evil and exploiting others is not being mentally ill, it is being morally corrupt.’ “I am going to re-edit the book to take out the language. I ask you give me a week or so, because I actually just had a kid and also because it takes a while to do so given the programming that goes into personalizing these books. “Thanks so much for the feedback, I truly do appreciate it, and I’ll send you an email when it’s been updated.” Hey, folks, we all make mistakes in our lives. We all have blind spots. It hurts when we are the victim of someone else’s blind spot. But we think one of the greatest attributes someone can have is the ability to recognize a mistake, apologize, learn from it and make amends. There was not a hint of defensiveness in this author’s response. She understood what she had done. She apologized. She fixed it. One can’t ask for more than that. Kudos, and thank you.
Publisher’s Commentary
Rebuilding Olmstead By KARIM CHAPMAN
The Vermont S t a t e w i d e Independent Living Council has been holding remote meetings with networking partners and stakeholders to examine the Vermont Olmstead plan, commissioned by the legislature and presented to Gov. Jim Douglas in 2006. Such state plans were developed in response to the United States Supreme Court Olmstead decision of 1999, based upon the 1990 Americans with Disabilities Act integration mandate. The plan, which lists 11 challenges, is mostly forgotten at present. The SILC, along with its partners, including VPS, is attempting to update the plan and describe
action steps that should be taken to address the challenges listed in the plan. SILC is considering what has been done to this point to address those challenges and what needs to be addressed going forward. SILC has purview over independent living programs and services in the state as it is responsible, by federal law, for writing the 3-year state plan for independent living. It is thought that integrated, communitybased living with the highest degree of selfsufficiency and self-determination possible is essential to VPS and its members. SILC will continue to hold periodic Webinars with the ultimate goal of suggesting revisions to the state Olmstead plan. It looks forward to working with VPS and its other partners in this regard and to a successful outcome. Karim Chapman is the Executive Director of Vermont Psychiatric Survivors.
Letters to the Editor
Sharing Survivor Status
To the Editor: I finally got around to reading [the fall] Counterpoint. I was stunned to see and read about your and other “attempt” survivors share about preferring peers above paid professionals and certainly not police, to respond to a crisis. I am an “attempt” survivor as well, but usually, I don’t share that. However, my new personal care aide told me of trauma in her early life and an “attempt.” She had had a good counselor and a friend she met at the Howard Center,
but had never heard of Vermont Psychiatric Survivors or Counterpoint. I still had an extra copy and gave it to her. She was especially interested in the 24/7 warm line. COVID-19 has been and is hard on everyone. She’s working on getting out and not being too isolated. That makes her a “first responder” and a hero of our times. Everyone seems to be more worried as cold weather comes and winter blues start. We live one day at a time. No wonder the warmline is needed! NAME WITHHELD, Burlington
PUBLIC COMMENT OPPORTUNITIES ON LAW ENFORCEMENT POLICY WORK: Members of the public who want to provide comments on the state’s work to modernize policing may do so through dps.vermont. gov/modernization. They may also email comments to policing.feedback@vermont. gov. Copies of model policies, guiding
documents or other materials regarding development of a statewide model policy for law enforcement use of force, can be sent to Jennifer Morrison, special assistant to the commissioner of Public Safety, at jennifer. morrison@vermont.gov
The Arts 17
Fall 2018 Winter 2020
Mental Health Is Not Law Enforcement By HEIDI HENKEL
“Mental health is not a law enforcement issue.” think about this a lot. It’s complicated. People make calls to police because of “mental health” for a wide variety of reasons. Sometimes it’s because the person has expressed suicidal feelings and the person they’ve spoken to is very poorly informed about what to do about that. In order for those calls not to go to the police, there needs to be some entity to field people’s concerns when their friends or family members say suicidal-sounding things, and that needs to be well-publicized. When people are in that situation, they need someone to talk to about it. “Don't call the police” only works if there’s an “instead, call (some trustworthy entity that people believe will be able to help).” People don’t know how to deal with that on their own, and it’s an awfully huge emotional load and a huge responsibility for most people to bear. And some people will make very poor choices about how to handle it if left on their own to handle it. There needs to be some kind of public entity whose job is to field those concerns when they happen. Sometimes it’s because of profiling. A person is acting strangely or saying strange things, and people who have heard a bunch of misinformation and stereotypes think the person is dangerous or “needs help” just because the person is acting strangely. This is prejudice. This is not much different from calling the police just because of the color of someone’s skin. This should not happen. I am not sure how to stop it from happening, just as it’s very hard to get white people to stop calling the police on black people just for existing while being black. I think there will always be some calls to police
I
like that, just like there will probably always be existing-while-black calls to police. How should the police handle that? Especially if the caller makes it sound different from what’s really happening, as they often do to black people (which I think is how this type of call usually goes)? One common version of this is mental-health calls to police as a form of controlling or other abuse. The abuser calls the police and makes their victim seem to the police to be crazy and dangerous. This often results in a terrible “mental health care” ordeal for the victim. It’s especially easy for abusers to do this and get away with it if the victim has a mental health history. The police tend to believe this stuff. They tend to easily believe that someone with a history is having another episode, and they tend to believe the more together-sounding person, even if that person is actually an abuser and lying. In that instance, sending a social worker would not be an improvement unless the social worker is wise to this type of abuse and is skeptical rather than buying into it (not an improvement other than that the social worker would be less likely to murder the victim.) How would that be handled better? What structures or training or personnel would be needed, for that to be handled better when it happens? Another situation is where a person is actually doing something dangerous, or threatening harm, or committing a crime, or something like that. It becomes apparent that the reason they’re doing it has to do with their mental or emotional state or developmental status or something like that. They’re not really malicious and/or they don't really understand what they’re doing. The police get called because what the person in distress is doing actually has to be stopped for other people's safety. But this should be handled differently from a crime. And there are situations where the person in distress calls the police. The police sometimes pick up on it pretty quickly that the person is having a mental health
crisis. OK, then what are they supposed to do next? Refer the person somewhere? What if the person refuses that referral and just keeps calling their station again and again? And there are actively dangerous situations. I think of Woody Woodward in Brattleboro holding a knife in the All Souls Church, saying he was going to kill himself and saying some paranoid-sounding things. The police ended up murdering him. Almost any other outcome would have been better. What would be a better way for that type of situation to be handled, and what preparation would make it possible for that type of situation to be handled better? Just giving police Tasers hasn’t helped much. They still often murder people in mental health situations, and they abuse the tasers by shooting them at peaceful, non-threatening citizens, such as peaceful protesters. Maybe having more peer support would allow things to never escalate to that point, but what if, once in 20 years, something like that does happen? While I would like to see a much greater investment in Intentional Peer Support completely separate from law enforcement and the medical system, I also think it’s unavoidable that the police will continue to receive mental health calls. There needs to be some kind of plan as to how to get it to go better when police get those calls. I think the ideas about training police about mental health and/or having social workers as part of police department staff are for that purpose. I don’t think the goal is to try to deliberately overly-involve police departments in mental health. I think the goal is to make it go better when it does happen. It would be nice if it were never to happen, but we’re probably 50 years of hard work away from that.
Heidi Henkel is a Counterpoint contributor from Brattleboro.
Letters to the Editor
Suicide and the Impact of Isolation
To the Editor: Please consider the impact of suicide on society. Many live with daily thoughts to leave this world but remain here feeling a desire to live. Out in public, I notice a deepening depression. More people are voicing their despair but stay alive, hoping for a better life. Unhappiness seems to be spreading. I sense the cause to be in a formation of an alien-human race as the virtual reality, separating humanity by hypocrisy. The way to live with dignity by earning a fair wage has a disturbing desperation today. The workday is impacting health to defend their protective security bubble in cyberspace. A sense of community used to exist, but it has
slowly deteriorated, creating homelessness in Brattleboro, where I live and elsewhere in the world. The current options to earn a living seem rather desperate. Sell out to slave labor for a corrupted economy, promoting alcoholism or psychiatric care or narcissist self-promotion online. I believe the state of Vermont needs to hear more to stop hiding from the truth. A partial truth leaves room to justify deception by defending the economy that’s killing us off. I use a mobile iPhone to access the Internet. I live offline with no access. I chose to take on an experimental lifestyle for the review of human connection. I have never felt so alienated and cut off from
the flow of perceived love. Love becomes an illusion. Human-ness is lost. I do not support this change of heart, to turn against one another to protect individual time and personal convenience. When I reached out to three neighbors in 2018 as a new resident of Sunset Lake Road, I learned the hard truth about community. People seem threatened by their online life and afraid to face the offline reality of what their digital presence has done to create a deeper human suffering. If we are going to win as human beings, we have to give life back to each other in real living. TAHNEE RIFITY Brattleboro
Send your comments or reactions to editorials or commentaries to: Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701, or to counterpoint@vermontpsychiatricsurvivors.org Please include name, address and email.
EDITORIAL PAGE 18 COMMENTARY
FallWinter 2018 2020
Essays on Force Versus Autonomy By ROY BUZZEL
PART 2 of an essay series. n December of 2019 I stopped nightly doses of psychiatric medicines. December 26 was my last dose. I didn’t let the team at Counseling Services of Addison County know. Several years earlier, I came to believe that my attempts to withdraw from psych meds had been adversely affected by negative bias from others. It is more than seven months later, and I am not finding any significant ill effects from my choice. However, I am about to reveal the preliminary results of my experiment and have significant trepidation with regard to others’ reactions. You see, I have been protected from excess scrutiny and others’ doubts. Neither of which is helpful. In “conventional” drug trials, the placebo effect is often used. Occasionally double-blind studies as well. These are attempts to mitigate the effect of biases on the outcomes of the study. I made a conscious decision to keep my experiment to myself. Fear of humanmade consequences nearly had me abandoning the project. I resorted to subterfuge and ordered refills for several months to conceal my actions. I have not been problem-free for seven months. Have you? I was asked by a relative recently on a phone conversation, during which I expressed dissatisfaction with where my life was going, whether I was taking my medicine. See, the general public has been led to believe that being “under a doctor’s care” and “on medicine” is the only way for a diagnosed person to be safe — for themselves and the community. This belief has led to human rights violations on a grand scale — forced medication. Drastically compromised patient autonomy. Several weeks ago, I began to be less cautious with news of my experiment. I asked a close friend whether she thought I was in need of a change in
I
medication. The answer was “no.” She believed that my life difficulties and disillusionment were understandable, given life circumstances. She was unaware of my near 7-month period without meds. So, her opinion wasn’t influenced by that knowledge. She is somewhat “pro-med” and certainly entitled to her opinions in that regard. I let a few trusted individuals know of my results, still keeping my CSAC team out of the loop.
This belief has led to human rights violations on a grand scale. Forced medication. Drastically compromised patient autonomy. Today is the big reveal. August 3, 2020. I have had one 2-mg dose since December 27, 2019. Before any backlash, I wish to remind you all that psychiatry and psychology are imprecise arts, highly subjective. And that I have an inside scoop on what is going on in my head. You don’t. I have been judged repeatedly on past behavior. I am looking for evidence of change in your behavior that my autonomy will no longer be limited by your fears. In order for me to ever trust again, I must have real, measurable changes.
Why medical records from mental health facilities shouldn’t be saved and viewed as valid data Electronic medical records are increasingly becoming portable, and the industry claims that better treatments will result from the sharing of this data. It starts with an individual patient being compelled to share their personal files with various medical providers. I anticipate that the subjective views and prejudices of mental health professionals will only be more amplified and ultimately ever more flawed. Computers parsing words written by highly biased individuals can only multiply errors. An example is the use of the DSM (Diagnostic and Statistical Manual of Mental Disorders, used by health care professionals as the authoritative guide to the diagnosis of mental disorders.) Internationally, these categories of diagnoses are seen as clumsy and in need of revision. Insurance processing protocols result in resistance to change and improvement because in order to bill for services, providers are herded into using unhelpful language and approaches with a built-in reward for chasing funding. As a consequence, the peoples’ well-being is compromised. So please don’t continue to zealously preserve accounts of some of my worst version of who I was according to others from an outside point of view, with perhaps a bent to pathologize behavior and attach nasty labels with horrible results of an enduring nature. Let us start fresh. Destroy these awful repositories of my worst versions of my worst self on my worst days. Are you who you were 20, 30, 40 years ago? We are often encouraged to let go of the past, but those terrible monuments are meticulously preserved. Let me grow. Discard this unfavorable record of days gone by. Roy Buzzel died in October, 2020. (See obituary below.) He sent these essays in the summer of 2020 as part of a series. The first three segments appeared in the fall issue of Counterpoint. “He was very much looking forward to seeing his essay published,” his partner told Counterpoint. Roy Buzzel was from Middlebury and a leader in peer support.
Obituary Roy D. Buzzell, Peer Support Leader MIDDLEBURY -- Roy D. Buzzell, 57, a leader in peer support, passed away on October 1, 2020, surrounded by his family. Buzzell worked for the Counseling Service of Adison County from 2013 to 2018. In 2013 he was one of the first in Vermont to take Intentional Peer Support training. He then began work at CSAC’s Evergreen Day Program offering peerto-peer support and co-facilitating a men’s group.
He made this work within the context of a designated agency, his family said, collaborating with peers and mental health providers and offering a peer perspective in staff meetings. He later began work with CRT employment services as a benefits advisor for CSAC clients. He was described as being known for his compassionate connections, quick wit and forward-thinking philosophy. Buzzell was born on June 27, 1963, the son of the late George and Doris
Buzzell of Derby, Vermont. He is survived by his longtime companion, Mary Price, also of Middlebury; his daughter Felicia, her husband Chazz Canney, and their daughters Phaedra and Blythe; his son Justin and Megan Hughes; his daughter Sarah and Ben Curran; as well as Elizabeth, his beloved cat. Memorial donations may be sent to: HOPE, www.hope-vt.org, or Alyssum, www.alyssum.org
Roy D. Buzzell
COMMENTARY COMMENTARY. .
Fall 2018 Winter 2020
19
Entering the World of Peer Support By LAURA SHANKS
I
n October, I joined the V e r m o n t Psychiatric Survivors team as a patient representative for southern Vermont. To be completely honest, I wasn’t sure what to expect. I hadn’t even heard of VPS until I saw the job listing. What I have discovered and what I am learning is that there is a whole field of work and a community of like-minded individuals out there I never knew existed. As a peer myself, I am well aware of the mess that is the American psychiatric system. My entire life, I was told I was different: too sensitive and emotional, as is if that was a bad thing. These differences, coupled with a lack of understanding of my empathic nature, led to further distress, disorder and disease in my life. It wasn’t until my late 20’s when I discovered traditional yoga, meditation and Ayurveda, that I came to learn that my differences, when nourished properly, were actually profound gifts. This lack of understanding and proper knowledge of care at the time led to labels of psychiatric disorders, years on the merry-goround of pharmaceutical prescriptions and immense feelings of fear and shame. Now, several years into my own personal recovery, I have been blessed with the opportunity to help those who are going through similar experiences. The ability to support peers and create change has first and foremost been the most gratifying experience for me at VPS. I am joining the team in the middle of a global pandemic, so initial progress has been slow and challenging with the current restrictions in place, but the little I have been able to do so far has been greatly rewarding. These experiences have been both liberating and scary. On the one hand, it has been beautiful to find that there are others who went through
similar experiences as me with the psychiatric system. From the complete backfire and failure of years of psychiatric medications and treatments to similar personal self-healing journeys, it is cathartic to learn I am not alone in my experiences. On the other hand, this job is also forcing me to revisit and reopen old wounds. To face old traumas with a newfound sense of strength and stability has been challenging, to say the least.
From the complete backfire and failure of years of psychiatric medications and treatments, to similar personal self-healing journeys, it is cathartic to learn I am not alone in my experiences. Working with a supportive staff that shares similar beliefs and quirks and their special differences, has eased the process and been extremely heartwarming. The staff at VPS are truly amazing. They care about what they do and those they work with like no one else, but they also know how to take care of themselves and honor this. This is how I personally choose to live as well, so it is refreshing to work in an environment that promotes and respects this. One of the most fascinating parts about this job has been to see the connections that organizations such as MAD in America and WRAP [Wellness Recovery Action Plan] have with yoga philosophy and India’s holistic school of medicine, Ayurveda. Yoga and Ayurveda have thousands of years of experiential proof that they work. When modern scientific research and studies have shown that the current accepted standards for psychiatric
care often don’t work, yet alternative approaches and peer support do, the biggest question I have is, why are we still in this mess? On the other end of the spectrum, the slow pace at which government processes move has, of course, been frustrating. At the moment, patient representatives and peer support specialists aren’t considered “essential workers.” The statistics don’t lie; mental health challenges and mortality have risen due to the pandemic. We need to be considered essential by the state and allowed back into facilities now. As we wait for approval of “essential worker” status, though, we have our work cut out for us. When I started, my first thought was, “how did I not know about these movements or organizations like VPS before?” As a former publicist, I see publicity and exposure as the biggest priority. The VPS team was well aware of this before I started, and one of the first tasks I have a part of is a marketing campaign so that peers know we’re here for them. We are actively reaching out to facilities and local communities across Vermont, placing cards and brochures with information and ways to contact us. Now, more than ever, people need our support. I have also observed a need to build stronger, better relationships with facilities and their staff members. It’s clear we both want the same things. We want people to be happy and healthy, and we do what we can to help promote this. If we can understand that our individual ears only respond to a small spectrum of sound that exists and each of our eyes only responds to a very narrow spectrum of light and color, we can begin to see that our individual experiences are quite limited. When we can accept and embrace that each of us observes the universe from different perspectives and points on the spectrum, we can learn to utilize and unite our viewpoints rather than fight against them. In doing so, we become empowered with limitless potential for true change.
Laura Shanks is a new patient representative for Vermont Psychiatric Survivors in southern Vermont.
VPS Appoints 3 New Patient Reps RUTLAND – Vermont Psychiatric Survivors has announced the appointment of three new patient representatives. Laura Shanks has a background in public relations, communications, activism and holistic health, the agency web site biography states. A former publicist from New York, Shanks has a strong interest in philosophy, self-inquiry, and self-healing which stem from a lifelong search for truth and have become her life’s passion, her biography states. Shanks said that after spending several years traveling, teaching, and studying abroad, she found herself drawn to Vermont where she now dedicates her time to peer support, yoga, teaching, and nature. She holds a bachelor’s degree in journalism from SUNY Purchase College, is a certified yoga and meditation instructor and an Carter Kinoy accredited TESOL
teacher. She also teaches yoga, mindfulness, Eastern philosophy, Ayurveda, and anatomy on yoga teacher trainings around the world. Carter Kinoy, describes himself as a survivor of mental health services who brings lived experience of, and passion for, best practices in the treatment and empowerment of peers. Kinoy has deep roots in Vermont, the agency biography states. He is a graduate of Bellows Falls Union High School in Westminster and said he has a deep interest in sociology and a strong commitment to both social and racial justice that stems from his own life experiences and from his family’s involvement with the civil rights movement. Nicole Julian comes to VPS with a bachelor’s degree in psychology and biology. A former employee of the state and the Howard Center, Julian said in her website biography that she has a strong interest in helping people and working to empower individuals. She said that having personal experience with mental health, she believes in the power of peer support and working within the community to provide tools to assist individuals to find their
independence and confidence. According to the agency biography, Julian was born and raised in Vermont, loves the outdoors and nature, is learning yoga and meditation but also learning new dessert recipes. Patient representative positions are established under Vermont law to “advocate for persons receiving services and... foster communication between persons receiving services and health care providers,” when they are under the custody of the Department of Mental Health and being served in designated hospitals, intensive residential recovery facilities or a secure residential recovery facility. Under the statute, the Department of Mental Health is required to contract with an independent, peer-run organization to provide patient Nicole Julian representation.
20
Winter 2020
DISABILITY RIGHTS VERMONT ANNOUNCES FY 2021 PRIORITIES Disability Rights Vermont (DRVT) is a private nonprofit agency dedicated to defending and advancing the rights of people with mental health and disability issues. We are empowered (and funded!) by the federal government to investigate abuse, neglect and serious rights violations. Our fifteen-member staff teams with the six member staff of the Disability Law Project of Vermont Legal Aid (DLP) to create the cross-disability legal protection and advocacy system for Vermont. Despite the pandemic, DRVT and the DLP were busy defending the rights of people with disabilities both in individual case work and in systemic change. We can’t list everything here that we have done this year but following are a few of our important activities. DRVT has continued our work to create a more robust community-based system that will both provide needed supports for people experiencing mental health crises and avoid involuntary treatment, incarceration or other major life disruptions that occur now because of a lack of adequate community capacity and coordinated discharge planning. DRVT has published a major report, “Wrongly Confined,” highlighting the harm that people suffer when held in inappropriately segregated and institutional settings such as inpatient units beyond the time when they could safely return to the community. In www.disabilityrightsvt.org/pdfs/Publications/ DRVT-Olmstead-Report-2020.pdf DRVT identifies the scope of the problem and suggests solutions so that people receiving services can do so in the most appropriate integrated settings as required by the ADA. Recently, DRVT settled a case brought in federal court initially requiring the Woodside Rehabilitation Facility to modify their policies relating to the use-of-force, seclusion and isolation, and overall treatment policies – and ultimately leading the Department of Children & Families to close the facility. We continue to monitor DCF planning for services to insure children with disabilities get the support they need. DRVT staff has continued to promote self-advocacy by offering training in preparing Advance Directives for health care, by assisting individuals to understand institutions’ grievance processes and by offering assistance to peer-run services. We have also trained staff at several psychiatric units and designated agencies in recognizing and respecting patients’ rights. DRVT maintains a focus on detecting, remedying and preventing the inadequate provision of mental health care and the unnecessary use of force and isolation against people with disabilities in hospitals and correctional facilities throughout Vermont. The COVID-19 pandemic has unfortunately forced us to cut back on in-person monitoring of facilities and we have attempted to keep close contact through phone and other remote means. DRVT staff has been flexible in adapting to delivering meaningful services to people in a variety of treatment environments, meeting remotely with patients and prisoners. DRVT staff continued to support the right of people with disabilities to vote by conducting extensive voter registration efforts and providing polling place accessibility surveys to town officials.
We continue to assist beneficiaries of Social Security who face barriers to employment throughout Vermont. DRVT has helped to resolve employment discrimination claims, access to vocational services concerns, and inappropriate overpayment demands for many Vermonters. We also review representative payees of people with disabilities at the direction of the Social Security Administration. Over time, DRVT has greatly expanded our work to assist victims of crimes who have disabilities throughout Vermont, including having provided training to law enforcement officers on how best to interact with victims of sexual assault who have disabilities, providing representation for victims as they navigate the criminal justice system, and by helping victims with access to safety and to social services they might need. DLP and DRVT staff has made real and positive differences in the lives of the many individuals who have contacted us and for whom we have provided information, referrals, short-term assistance, investigations, and litigation. DRVT is publishing our formal Fiscal Year 2021 (10/1/20 - 9/30/21) priorities for the Protection & Advocacy for Individuals with Mental Illness (PAIMI) program on the adjoining pages. These priorities serve to focus the work of the agency and are developed by our Board and our Advisory Council, who get input from the community and staff. Your input is appreciated! We strive to do as much as we can with the resources we have and we can do that best when folks in the community let us know their greatest advocacy needs! We need volunteers, too! Disability Rights Vermont (DRVT) is looking for volunteers to serve on our PAIMI (Protection & Advocacy for Individuals with a Mental Illness) Advisory Council (PAC). We are looking for members with connections to the broader community who will assist DRVT in developing annual priorities and assess our performance. Each applicant must identify with one of the following categories: • You are a psychiatric survivor • You are or have been a recipient of mental health services • You are a mental health professional • You are a mental health service provider • You are the parent of a minor child who has received or is receiving mental health services. • You are a family member of an individual who is or has been a recipient of mental health services • You are a lawyer If any of the above categories apply to you and you are interested in having an impact on our community we want to hear from you! Please call 1-800-834-7890 x 101 for an application to join our PAIMI council.
Send us your comments to help us stay connected to the community we serve!
COMMENTARY.
Winter 2020
DISABILITY RIGHTS VERMONT
21
FY’21 PAIMI PRIORITIES
(PAIMI is Protection & Advocacy for Individuals with Mental Illness)
Priority 1: Investigate individual cases of abuse, neglect, and serious rights violations in inpatient facilities (hospitals, any state-run facilities, emergency departments, facilities for minors), prisons/jails, and community settings, including peer services and designated agencies. Measure of Success: A. Work on a minimum of 75 cases of abuse, neglect, or serious rights violations of people with mental health issues. Among closed cases, at least 75% of those not withdrawn by client or found to be without merit by DRVT staff should be resolved favorably. B. In at least 10 opened cases, DRVT will advocate for timely discharge of patients identified by their medical providers as being unnecessarily institutionalized, or release of prisoners who have served their “minimums” in the spirit of the community integration mandate of the Americans with Disabilities Act. C. DRVT will assist at least five clients to assure they receive appropriate medication, with informed consent and without coercion, and/or alternative treatment if that is their preference. D. DRVT will assist at least two clients to overcome employment discrimination. Priority 2: Reduce the use of seclusion, restraint, coercion, involuntary procedures, and inpatient confinement when not warranted by patient treatment needs through systemic efforts. Continue systemic work to create culturally competent, trauma-informed, violence free and coercion free mental health treatment environments. Measures of Success: A. Work with at least two institutions to create respectful, trauma-informed, violence free and coercion free mental health treatment environments. B. Conduct systemic advocacy in the legislature, and with the administration, to preserve or enhance the right of Vermonters to be free from coercion in their mental health treatment, and to receive timely, individualized, efficacious, community-based services in the most integrated setting. C. Conduct systemic advocacy in the legislature, and with the administration, to preserve or enhance community-based services for people with mental health needs. D. Monitor the: quarterly statistics of the use of Tasers (Act 180 of 2014); periodic statistics on segregation in state prisons; and Certificates of Need (CONs) for Emergency Involuntary Procedures (EIPs) in inpatient settings. E. Continue to participate in the Adult Protective Services (APS) Subcommittee of the Department of Disabilities, Aging and Independent Living (DAIL) Advisory Board and actively participate on the Vulnerable Adult Fatality Review Team (VAFRT) and the Mental Health Crisis Response Commission (MHCRC).
Priority 3: Reach out to community settings, designated facilities and hospitals, emergency rooms, prisons/jails, residential and therapeutic care homes. Monitor conditions and educate residents, patients and providers about rights, selfadvocacy, and DRVT services, with emphasis on the integration mandate of the ADA. Measure of Success: A. Outreach is conducted at a minimum of 5 community care homes (CCH), including but not limited to residential care homes, therapeutic community residences or licensed residential childcare facilities. These visits include distribution of DRVT literature & self-advocacy materials. B. Outreach is conducted, at a minimum, to the four state prisons housing the most PAIMI eligible prisoners. C. Outreach is conducted at all designated hospitals, including any state-run facility. D. DRVT literature is distributed to all of the community mental health agencies, prisons, to intensive rehabilitation residences, and to specific homeless shelters, “club houses” and peer-run services. E. Outreach is conducted at least once at each hospital Emergency Department or other inpatient unit where patients who have been admitted based on a psychiatric diagnosis are held. F. Outreach will be conducted to individuals labeled with a disability who are victims of crime or domestic abuse. G. DRVT PAIMI Staff will maintain and improve their cultural and linguistic competence and their trauma-informed skills and sensitivity.
Priority 4: Advocate for self-determination, access to alternative treatment options and community integration. DRVT will advocate for designated agencies to establish relationships with individuals in inpatient settings during discharge planning in order to support people to seek their full potential in the community. Measure of Success: A. Conduct self-advocacy and/or advance directive trainings for 40 individuals. B. Assist at least 5 individuals across the State of Vermont with their preparation of Advanced Directives. C. Respond to opportunities to encourage the development and expansion of peer run and alternative services in Vermont’s mental health system reform and educate peers on access to these services. D. DRVT will participate in systemic efforts to improve state services for inpatient or incarcerated individuals to speed successful reintegration. E. Participate in coalition efforts to address transportation infrastructure needs of low-income people with mental health issues. F. Support the Vermont Communications Support Project In addition, DRVT does not ignore evolving (VCSP) in order to ensure that people with communications situations and other cases, or treatment facilities, disorders related to their mental health can participate in the which require attention. judicial and administrative systems. G. DRVT Staff will receive training in awareness of alternative treatment modalities available for individuals with psychiatric disabilities. Case acceptance is based on these PAIMI priorities; whether a client meets the federal definition of an individual with a mental illness; whether the case can be shown to have merit; whether the client does not have other representation; and whether there are sufficient staff resources to take on the case.
How can you make your voice heard?
Contact DRVT at: 141 Main Street, Suite 7, Montpelier, VT 05602 Or by phone: 1-800-834-7890 or, locally, at (802) 229-1355
By email at: info@disabilityrightsvt.org Please visit our website at www.disabilityrightsvt.org
COMMENTARY 22E NEWS COMMENTARY.
FallWinter 2018 2020
Sailing the Isles of Mental Illness By STEVEN MORGAN
I
n a nutshell, the message I got from mental health and society was that my brain is broken. I have to say I liked this story. When you don’t know what’s going on and are in desperate pain, any story with a beginning, middle and end is attractive. And this story had that. In the beginning, I was born with bad genes, the story said: the cloud of mental illness hovered above. In the middle, the genes erupted and made my brain chemicals go crazy: the cloud struck me with lightning. In the end, I may have lived a productive life managing my mental illness, but the cloud will still be there, so stay in treatment and stay alert. So my past, present and future got modified by the idea of mental illness. And it was then that I took on a new identity. I learned that far away from the mainland are these islands of mental illness, and that on these islands live a people called “the mentally ill” who I would now join. The island I had property on was Bipolar Island. Not the furthest from the mainland, not the closest. Smack dead in the middle. I was told that no one ever leaves Bipolar Island, that there are no ships to the mainland. So on this island, I lived for years. I applied for disability. I got used to the hospital being the place of help. I started to talk and think about myself like a nurse’s note: as a collection of symptoms. As something gone wrong. And over time, I got trapped. I became imprisoned in ideas that I was forever sick. I truly thought I was broken and that everyone else has their acts together. I became a psychiatric hypochondriac, always fearful. I lost what little hope I had left. Then one day, while living on Bipolar Island, I ran into someone new. I asked her how she ended up on the island, and she said, “Oh, I used to live here, but now I’m just visiting to say hello to newcomers.” “Wait, you used to live on Bipolar island and you’re off of it?!?” “Oh yeah, a group of us are,” she replied. “Impossible!” I said. The field guides say you can’t escape. “How did you get off this island?” She said, “Well, when I lived on the isles of mental illness, they were being used as a bombing test site. And a lot of us got really hurt. So, one day, we formed our own group to talk about the pain and heal our wounds.” “We found we had a lot in common. Though all of us had ended up on the islands because of
hard times, staying here actually made our lives harder. But we believed we could never leave.” “But as we kept talking and creatively helping each other, we started to see that while none of us alone knew how to build a canoe, we had the skills spread amongst us to do it. Birdie loved trees so knew which woods were strong. Dax had been a baseball player, so figured he could swing an ax. Shannon liked to see things clean
and was up for sanding the lumber. Kaia could tell true north from the stars.” “When we all came together like that, we discovered that between us, we could build a canoe and navigate the high seas. So that’s what we did. We sailed off the island.” And that, I discovered, is peer support. People trapped on an island coming together and figuring out how to build boats. But wait, I was confused. I thought mental illness was a permanent thing that hovers above you always. But wait, I asked for the first time, who decided that? It turns out that a group of doctors comes together every so often and writes a book called the DSM that teaches the world what mental illness is. If the authors disagree about what should be included as mental illness, do you know how they decide? They take a vote.
In dominant culture, information about mental illness is supposed to be made, first and foremost, by scientific studies that sit atop a hierarchy of knowledge production. But there’s a problem with the entire top-to-bottom chain: Big Pharma influences all of it. For their most recent edition, they asked the public for help writing. In fact, anyone could submit suggestions for new disorders, for deleting other disorders, for adding subtypes, and so on. If these authors were looking to us for suggestions about what is and what is not mental illness, I began to wonder whether they knew what they were talking about. I investigated deeper. I learned that the first DSM, released in the early 1900s, talked about “reactions”; you are having a psychotic reaction, a manic depressive reaction. Mental illness was a person reacting to the world. But by 1980, when the 3rd edition came out, the authors decided to switch to “disorders.” Mental illness was not a person reacting to the world anymore; it was a problem with your biology. It was inside you, not between you — a chemical imbalance. They didn’t have good evidence for this, but they promised it was coming soon.That didn’t pan out. It hasn’t still, 35 years later. When the American Psychiatric Association released the last DSM, in 2013, they said, “We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.” So a chemical imbalance or brain disease has never been found. But no one seems to know this. The assumption that mental illness is a medical condition like diabetes is widespread.
Why, I wondered? In dominant culture, information about mental illness is supposed to be made, first and foremost, by scientific studies that sit atop a hierarchy of knowledge production. But there’s a problem with the entire top-to-bottom chain: Big Pharma influences all of it. The pharmaceutical industry funds most of the research on their drugs; they throw out negative studies; they hire marketers called ghost writers to write study results; they give lavish gifts to doctors; they build academic and research centers; they make full-page magazine ads and TV commercials; they donate to advocacy groups; they lobby all levels of government. And, they love the broken brain model. It guarantees them markets. They’re not shy about promoting it. So, how is all this working out? Not very well. By all accounts, outcomes for people with psychiatric diagnoses are worsening. And studies show that promoting the idea of mental illness as a brain disease is increasing fear and prejudice, both by others and towards oneself. What has been forgotten as the medical model of mental health has come to dominate is that psychiatry is only one window through which we might understand human distress. We might also understand distress through a lens of the arts, spirituality, psychology, sociology, mythology, race, sexuality, gender, culture, nutrition, history, trauma... And that trauma lens is particularly important. Because the more trauma you’ve experienced, the more likely you are to have the kinds of distress that are called mental illness. And indeed, many studies reveal that the great majority of people who end up diagnosed with major mental illness have significant trauma and abuse in their lives: 60, 70, 80, 90 percent of people interviewed. And yet the number of times the National Institute of Mental Health uses the word “trauma” in any of its informational materials on bipolar and schizophrenia: zero. So, we have a big problem here. We’re not finding the causes of so-called mental illness in biology — in what’s wrong with you, but, if we listen, we can often find the reasons for distress in biography — in what’s happened to you. So, in my own evolution, after I discovered all this information after I met peers who were living well despite having been written off, I needed to do some soul-searching. I needed to see if I could find a way off the island. And that begs the question, “What empowers?” Let’s start at the smallest level. A carbon molecule, the most basic unit of life, is laid out like a honeycomb, and in its hexagon chambers are carbon atoms, some of the tiniest things in the universe. In order to make this molecule, carbon atoms have to bond and share their particles with each other. Their connection powers the universe. What’s interesting is that when atoms connect, they transform into something entirely new. Sodium atoms and chlorine atoms are deadly on their own, but mix them together and you get table salt. So it’s not just in our DNA to connect. Connection is our DNA. It’s what life does. And if we ask trees, “What empowers?” they might say, the forest I’m a part of… the community. Trees can hitch onto each other, literally (Continued on page 23)
COMMENTARY 23 NEWS
FallWinter 2018 2020
Promising Peace, Delivering Violence some of us have ancestors who were so wrong in so many ways and now here we are less and less days left in which we can turn the tide - adrienne maree brown “we are no longer surprised”
By CALVIN MOEN
A
s my friends and I read, share, and talk about the news that Walter Wallace, Jr., a young Black man, was murdered by Philadelphia police — executed with 14 bullets in his chest and shoulders — we are not surprised. It’s a story we know well by now: Family members called 911 for an ambulance to respond to Wallace’s distressed state, and officers shot him dead while his mother pleaded for his life. Over the past six years or so, the movement for Black lives has shone a light on the frequency and impunity with which law enforcement takes Black lives. The increasing availability of video footage of these killings has made irrefutable the claims of racist violence. Maybe some of us were shocked at first, white folks who have not had to live constantly beneath the shadow of state violence. But no one can claim to be shocked anymore. When we are shocked, we are susceptible to manipulation. When “shock treatment,” or electroconvulsive therapy, was developed, doctors thought of it as making the mind a “clean slate” on which they could write. In her book The Shock Doctrine, Naomi Klein uses this analogy to explain how the capitalist state can make bold moves following a disaster.
It takes advantage of such an event’s shocking effect to shape reality and consolidate even more power and wealth. Earlier in October, along with a friend and colleague, I delivered training for the Vermont Peer Workforce Development Initiative on Mad movement histories. As a framework for our discussions, we showed a video series by Patricia Deegan called The Politics of Memory. In these videos, Deegan offers examples of what she refers to as the “master narrative,” the story as people and systems shape it with the power to control the narrative to their advantage. The master narrative asserts that atrocities against people thought to be Mad were few and all in the past. It insists that “medical” interventions like bleeding, drowning, sterilization and restraint that went on for days were perhaps misguided but done with the best of intentions. It warns us that patients who complain of their treatment do so only because they are not yet cured. A careful study of history teaches us to identify the master narrative by what it leaves out, to hear through promises of reform, and repairing a broken system, as though it had gotten off track and could be realigned somehow. Systems that promise peace and deliver violence, that promise care and deliver harm, run on the tracks that were laid for them, and the only way to stop them from running us over is to derail them. Following Walter Wallace, Jr.’s killing, I saw a petition calling for mental health professionals to respond to mental health crises rather than police. This makes logical sense to those who are not familiar with state violence at the hands of the psychiatric system. And maybe if social workers had arrived without armed backup, Wallace would still be with us today. However, as several of us testified in the Vermont legislature this fall, the psychiatric system is so enmeshed with the criminal punishment system as to be indistinguishable
SAILING THE ISLES OF MENTAL ILLNESS • Continued from page 22
sharing roots. Underneath the forest floor, there is a giant, living web of fungus called mycelium that connects nearly all of the trees and plants and soil creatures to each other. This web of tiny threads moves chemical and electrical messages across the forest, even between species. Everything — rather, everyone — talks to one another. Mycelium also moves nutrients around. Old trees nurse the young by sending them sugar they make from the sun. Rich soil provides nitrogen to poor soil. There are trees who have been cut down to a stump, who cannot make food anymore but are kept alive because their neighbors give them sugar. We humans have a word for that: love. In a mature forest, every tree — strong or weak, lopsided or straight, even dead or alive — belongs, each contributing to the health of the whole. Indeed, when we chop down parts of a forest, something disturbing happens: instead of collaborating, the trees left standing start to compete. Inequality soars. And yet, in the end, studies show that all trees, big or small, fare worse in a logged forest because they’ve lost the gifts of their connections. There’s a lesson here about empowerment: dependency is good and natural. Co-dependen-
cy, far from being a weakness, or worse, a symptom of a disorder, is a strength — a sign of maturity. But here’s the catch: only if we share power. If the tree in rich soil refuses to share their sugar, everyone suffers; if the tree in depraved soil refuses to share their sugar, everyone suffers. So what needs to happen for co-dependency to bear fruit is that the sugar, the “help” we give one another, has to flow both ways. Mutual support like that is deep in our species’ roots. We evolved in small tribes. At that scale, we couldn’t easily ship off one of the pack who acted strangely. Instead, we had to expand what’s permissible to include this person’s experiences. Today, we can ship one another off. But this is why studies have found that people with psychiatric diagnoses often have better lives in economically-developing countries than here. Communities are stronger. The forest isn’t clear-cut, so trees are healthier. So, the question, I think, for all of us, is, how do we become like a pack again, like a forest where straight trees and curvy trees belong, and neither has to become the other? Because in every ecosystem on Earth, diversity creates health. That’s why you never find just one species — just one way — in a wild land-
to many who have been caught up in it. It’s a matter of swapping out the hand that delivers the blow, justifying violence as medical care instead of justifying it as justice. But don’t take my word for it. Listen to the Black and Indigenous movement leaders who have been telling us this. Look at how BIPOC are overrepresented in the numbers of people in institutions, the numbers of people labeled mentally ill and dangerous, the numbers of people forced by the legal system to take heavy neuroleptic drugs for years, the numbers of psych patients whose lives are shortened by 25 years on average. It is the day before Halloween as I write this, a day on which we bridge the worlds of the living and the dead. I am thinking about my ancestors and the roles they may have played in forming the world I live in. They were European settlers and immigrants who benefited from this country’s legacy of white supremacy. I am thinking of my Mad ancestors, whose ghosts I seek to commune with by learning and teaching their history, in the hopes that they will journey with me as I seek liberation and justice. And I am thinking about generations that will come after me, presuming there will be any, and the role I play in shaping their world. In my short lifetime, I’ve never felt this level of danger in the national political landscape or this level of possibility. Patterns of state violence are nothing new. But we survivors are part of a legacy of resistance. Let us not be shocked into inaction.
Calvin Moen is a psychiatric survivor, advocate, educator, writer, editor and performer. He is the Greenfield coordinator for the Western Mass Recovery Learning Community and a co-founder and organizer of the Brattleboro-based Hive Mutual Support Network. He is also a facilitator with the Peer Workforce Development Initiative at Pathways Vermont.
scape. The more diverse, the more resilient… and beautiful. And yet, diversity in itself isn’t productive. Throw a pine tree and fungus and squirrel together, nothing happens. Only in maturity do they work out the mutual exchanges that value their diverse contributions. In maturity, the pine — who makes sugar from the sun, feeds those sweets to the underground fungus, and the fungus gives thanks by extending the reach of that pine’s roots to tap distant treasures in the soil, and the squirrel digs up that delicious fungus for food, hanging it to dry on another pine’s limbs, which ends up spreading that fungus to new trees, who then feed it sugar in exchange for extended roots, and so on and so on, until the unique contributions of the tree, the fungus, and the squirrel together become a superpower. So we need a forest not just where straight trees grow in their patch, and curvies grow in their patch, but where we intertwine and make use of the other’s gifts. Steven Morgan is a peer support activist and educator and on full moons — an artist. He resides in Vermont. This text is adapted from a longer keynote address entitled, “What Empowers?”
24 Resources Directory SURVIVOR PEER SERVICES Vermont Psychiatric Survivors Peer Support Groups VPS Peer Support Groups are temporarily suspended during the COVID-19 crisis. VPS is a membership organization providing peer support, outreach, advocacy and education 128 Merchants Row, Suite 606, Rutland, VT 05701 802-775-6834
www.vermontpsychiatricsurvivors.org Peer Support WARM LINES VERMONT SUPPORT LINE (STATEWIDE): 833-888-2557; 24 hours, 365 days [833-VT-TALKS] By call or text
PEER PLUS (STATEWIDE):
802-595-0588; 7 days/wk, 6-9 p.m.
MUTUAL SUPPORT NETWORK THE HIVE: info@hivemutualsupport.org www.hivemutualsupport.org 802-43-BUZZ-3 (802-432-8993)
CRISIS RESPITE
Alyssum, 802-767-6000; www.alyssum.org; information@alyssum.org
VERMONT PSYCHIATRIC SURVIVORS OUTREACH AND PATIENT REPRESENTATIVES (800) 475-4907 info@vermontpsychiatricsurvivors.org
HOSPITALIZATION ALTERNATIVE
Soteria House, information and online application at www.pathwaysvermont.org/what-we-do/ our-programs/soteria/ or call Pathways Vermont Intake Line, 888-492-8212, ext. 140
Peer Centers and Recovery Centers are temporarily suspended during the COVID-19 crisis. Call to check on reopening schedules.
Peer Centers & Employment Support ANOTHER WAY, 125 Barre St, Montpelier, 802-229-
0920; info@anotherwayvt.org; www.anotherwayvt. org; see website for events calendar.
PATHWAYS VERMONT COMMUNITY CENTER, 279 North
Winooski Avenue, Burlington, 888-492-8218 ext 300; www.facebook.com/PathwaysVTCommunityCenter; www.pathwaysvermont.org/what-we-do/ our-programs/pvcc
Vermont Recovery Centers WWW.VTRECOVERYNETWORK.ORG BARRE, Turning Point Center of Central Vermont, 489 N. Main St.; 479-7373; tpccvbarre@gmail.com BENNINGTON, Turning Point Center, 465 Main St; 802442-9700; turningpointbennington@comcast.net
Winter 2020
NATIONAL SUICIDE PREVENTION LIFELINE 800-273-TALK (8255) 24/7 confidential support
Samaritans Hotline
877-870-HOPE (4673)
Vermont Federation of Families for Children’s Mental Health
Counterpoint publishes this resource directory to allow readers to seek out choices for support. Counterpoint has not reviewed or evaluated the quality or biases of these resources, and makes no representation about their value for any individual. Public Community Mental Health COUNSELING SERVICE OF ADDISON COUNTY, 89 Main St.,
Middlebury, 05753; 802-388-6751
UNITED COUNSELING SERVICE OF BENNINGTON COUNTY,
Statewide support for families of children, youth or young adults in transition who are experiencing or at risk to experience emotional, behavioral or mental health challenges. 800-639-6071, 802-876-7021
PO Box 588, Ledge Hill Dr., Bennington, 05201; 802-4425491
Pride Center of Vermont
FRANKLIN & GRAND ISLE: NORTHWESTERN COUNSELING AND SUPPORT SERVICES, 107 Fisher Pond Road, St. Albans,
LGBTQ Individuals with Disabilities Social and Support: Connections and support around coming out, socializing, employment challenges, safe sex, self-advocacy. During COVID restrictions, call (802) 860-7812
Brain Injury Association
Support Group locations on web: www.biavt.org; or email: support1@biavt.org; Toll Free Line: 877-856-1772
DBT Peer Group
Peer-run skills group. Sundays, 4 p.m.; 1 Mineral St, Springfield (The Whitcomb Building). tinyurl.com/PeerDBTVT
Trans Crisis Hotline
The Trans Lifeline (dedicated to the trans population) can be reached at 877-565-8860.
CHITTENDEN COUNTY: HOWARD CENTER, 300 Flynn Ave., Burlington, 05401; 802-488-6200
05478; 802-524-6554
LAMOILLE COUNTY MENTAL HEALTH SERVICES, 72 Harrel
Street, Morrisville, 05661; 802-888-5026
NORTHEAST KINGDOM HUMAN SERVICES, 181 Crawford
Road, Derby; 802-334-6744; 800-696-4979, 2225 Portland St., St. Johnsbury; 802-748-3181; 800-649-0118
ORANGE COUNTY: CLARA MARTIN CENTER, 11 Main St.,
Randolph, 05060-0167; 802-728-4466
RUTLAND MENTAL HEALTH SERVICES, 78 So. Main St., Rutland, 05701; 802-775-2381
WASHINGTON COUNTY MENTAL HEALTH SERVICES, 9 Heaton
St., Montpelier, 05601; 802-229-6328
WINDHAM AND WINDSOR COUNTIES: HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT,
Crisis Text Line
390 River Street, Springfield, 05156; 886-4500; 51 Fairview St., Brattleboro, 05301, 802-254-6028; 49 School St., Hartford, 05047, 802-295-3031
LGBTQ Youth Crisis Hotline:
24-Hour Crisis Lines: Involuntary Custody Screening
Around-the-clock help via text: 741741 for a reply explaining the ground rules; message routed to a trained counselor.
The Trevor Lifeline now at 866-488-7386. TrevorText Available on Fridays (4-8 p.m.). Text the word “Trevor” to 1-202-304-1200. Standard text messaging rates.
ADDISON COUNTY: Counseling Services of Addison County 802-388-7641
BENNINGTON COUNTY: United Counseling Service, 802-
Connections Peer Support Groups
NAMI is providing its support groups by various alternative means during the pandemic. All meetings are facilitated by trained NAMI peers — individuals with mental health conditions who are at a good place in their recovery journey and want to help other peers get to a good place in their recovery. For more specific information, go to namivt.org/ support/peer-support-groups/ NATIONAL ALLIANCE ON MENTAL ILLNESS-VT (NAMI-VT)
802-876-7949 x101, or 800-639-6480; 600 Blair Park Road, Suite 301, Williston, 05495; www.namivt.org; info@namivt.org
442-5491; (Manchester) 802-362-3950
CHITTENDEN COUNTY: Howard Center 802-488-7777 FRANKLIN AND GRAND ISLE COUNTIES: Northwestern Counseling and Support Services, 802-524-6554; 800-834-7793
LAMOILLE COUNTY: Lamoille County Mental Health, Week-
days 8 a.m.-4 p.m. 802-888-4914; Nights and weekends 802-888-4231
ESSEX, CALEDONIA AND ORLEANS: Northeast Kingdom
Human Services 800-696-4979
ORANGE COUNTY: Clara Martin, 800-639-6360 RUTLAND: Mental Health Services, 802-775-1000 WASHINGTON COUNTY: Mental Health Services, 802-229-0591 WINDHAM,WINDSOR COUNTIES: Health Care and Rehabili-
tation Services, 800-622-4235
Please contact us if your organization’s information changes: counterpoint@vermontpsychiatricsurvivors.org
BRATTLEBORO, Turning Point Center of Windham County, 39 Elm St.; 802-257-5600; tpwc.1@hotmail.com BURLINGTON, Turning Point Center of Chittenden County, 191 Bank St, 2nd floor; 802-861-3150; www.turning pointcentervt.org or GaryD@turningpointcentervt.org
MIDDLEBURY, Turning Point Center of Addison County, 228 Maple St, Space 31B; 802-388-4249; tcacvt@ yahoo.com MORRISVILLE, North Central Vermont Recovery Center, 275 Brooklyn St., 802-851-8120; recovery@ncvrc. com RUTLAND, Turning Point Center, 141 State St; 802-7736010; turningpointcenterrutland@yahoo.com
SPRINGFIELD, Turning Point Recovery Center of Springfield, 7 Morgan St., 802-885-4668; spfldturningpoint@ gmail.com
ST. ALBANS, Turning Point of Franklin County, 182 Lake St; 802-782-8454; tpfcdirection@gmail.com
ST. JOHNSBURY, Kingdom Recovery Center, 297 Winter St; 802-751-8520; c.boyd@stjkrc.org; j.keough@ stjkrc.org; www.kingdomrecoverycenter.com WHITE RIVER JUNCTION, Upper Valley Turning Point, 200 Olcott Dr; 802-295-5206; secondwindfound.org; mhelijas@secondwindfound.org
Veterans’ Services
Vermont Veterans Outreach
WWW.VERMONTVETERANSSERVICES.ORG
BENNINGTON AREA: 802-442-2980; cell: 802-310-5391 BERLIN AREA: 802-224-7108; cell: 802-399-6135 BRADFORD AREA: 802-222-4824; cell: 802-734-2282 COLCHESTER AREA: 802-338-3078; cell: 802-310-5743 ENOSBURG AREA: 802-933-2166; cell: 802-399-6068 JERICHO AREA: 802-899-5291; cell: 802-310-0631 NEWPORT AREA: 802-338-4162; cell: 802-399-6250 RUTLAND AREA: 802-775-0195; cell: 802-310-5334 VERGENNES AREA: 802-877-2356; cell: 802-881-6680 WHITE RIVER AREA: 802-295-7921; cell: 802-881-6232 WILLISTON AREA: 802-879-1385; cell: 802-734-2123 OUTREACH TEAM LEADER: 802-338-3022; cell: 802-881-5057 TOLL-FREE HOTLINE (24/7) 1-888-607-8773
HOMELESS PROGRAM COORDINATOR: 802-742-3291 BRATTLEBORO: Morningside 802-257-0066 RUTLAND: Open Door Mission 802-775-5661; Transitional Residence: Dodge House, 802-775-6772
BURLINGTON: Waystation/Wilson 802-864-7402 FREE TRANSPORTATION: Disabled American Veterans:
Toll Free: 1-866-687-8387 X5394
Homeless?
Vermont Veterans Services (VVS) program for homeless veterans with very low income, call 802-656-3232.
www.MakeTheConnection.net Web site sponsored by The Department of Veterans Affairs with testimonials by veterans to help connect with the experiences of other veterans, and with information and resources to help transition from service, face health issues, or navigate daily life as a civilian.
VA Mental Health Services
VA HOSPITAL: Toll Free 1-866-687-8387 MENTAL HEALTH CLINIC: Toll Free 1-866-687-8387 Ext 6132 OUTPATIENT CLINICS: Bennington: 802-447-6913; Brattleboro: 802-251-2200; Burlington Lakeside Clinic: 802-6577000; Newport: 802-334-9777; Rutland: 802-772-2300 VET CENTERS: (Burlington) 802-862-1806; (White River Jnct) 802-295-2908