MENTAL HEALTH CRISIS

✌️✌️I’m fired up about the “mental health crisis”.

I know I’m a C.E.O. of a substance use disorder recovery organization and I’m supposed to stay in my lane.

But… I think we all know that is a silly proposition. REGARDING MENTAL HEALTH AND SUD.

Probably the most accurate thing I ever said.

ALL IS NOT EQUAL

There is great help available. But it’s not always easy to find. It’s not available equally.

And our understanding of mental health syndromes / disorders is not complete.

We know that certain medication is essential in certain situations. Especially for acute stabilization to mitigate potentially dangerous behaviors etc …

We know that certain medications are necessary from a “maintenance” perspective.

It’s especially important to stay on medication to avoid “kindling” (ie…stacking episodes one on top of the other with no period of stability).

The longer you go between episodes the better the prognosis.

INCOMPLETE SOLUTIONS

We know that medicine is an incomplete solution. Lifestyle and self-management is just as important as “medicine”.

However, there is a catch 22… when we go off medication we may experience symptoms that make self-management difficult.

That’s another reason why prescribing “maintenance” medication is such a common practice.

We know that MOST PEOPLE struggle mightily with taking maintenance medication.

It’s too simplistic to say “take your medication daily” and then admonish people when they don’t.

When I broke into the behavioral health field, I did so as a mental health Casemanager at the University of Pittsburgh Medical Center-Western Psychiatric Institute and Clinic.

ASSERTIVE COMMUNITY TREATMENT

This was 2001. I quickly progressed to program director of an Assertive Community Treatment (ACT) Team.

ACT is one of the most intense and challenging models across the entire behavioral health continuum.

We were responsible for individuals with “serious and persistent mental illness”.

People coming out of state hospitals. The era of de-institutionalization manifest in western Pennsylvania.

I learned motivational interviewing in 2001. And we were saturated with continuing education.

The main job was not “getting people clean and sober” OR making people “comply” with treatment plans.

CONNECTION & SUPPORT

Our job was connection. It was support.

Our job was the provision of unconditional positive regard regardless of the “patient’s behavior”.

UPMC was a teaching hospital. So we received fantastic training. DBT intensive and certifications. CISM Intervention’s and certifications. On and on.

We were rotated through on-call weeks. The team provided crisis support 24 hour/365 days per year.

We were not allowed to say the patient “just did not show up for his appointment”. We had to go find them.

On a regular basis I had a psychiatrist in the car with me as we searched the streets of Pittsburgh looking for one of my participants.

INTENSE MENTAL HEALTH FOR 5 YEARS

5 years. The most important 5 years of my career. The most fulfilling 5 years of my career. And the most stressful and difficult 5 years.

We just wanted to help. No other agenda.

I burned out. But it was still wonderful experience.

At the end of the day …. we marked progress in terms of incremental steps.

MODEL MENTALITY

I know this model can’t be replicated everywhere. It’s very expensive. We could only serve 150 people at any one time.

It’s not necessarily the model that I want to promote. It’s the mentality.

Even so, I don’t anticipate this type of thinking becoming commonplace. Where does that leave us?

Families are going to have to fill in the gap? Become case managers?

Become subject matter experts? Train families and participants so they can serve as their own case manager?

Is that ludicrous?

Is it any more ludicrous than the current model?

The post MY FIRST OFFICIAL MENTAL HEALTH RANT! appeared first on The Recovery Cartel.

Consequential Times They Are A Changing

✌️We are living through very Consequential Times !

The following is Inspired by the futurist Lawrence Douglas.

I think I want to be a “Professional Futurist”. How does one become a futurist?

FUTURIST. AKA a scenario planner, AKA foresight thinker…OR DOOMSAYER. Not the Utopian fantastical futurist.

What academic degree do I need to do that job?

Our World Your World

We “do the world” via our “World View” and solve problems via Heuristics.

MEANING; “Worldview is how you look at the world, how you think it operates, why things happen the way they do, what your purpose is. …

For example: A worldview of atheism, which is a belief that God does not exist, explains the creation of the universe and of life as randomness acting over a very long time.

Good-Enough Solutions ???

Heuristics are a problem-solving method that uses shortcuts to produce good-enough solutions given a limited time frame or deadline.

Heuristics are a flexibility technique for quick decisions, particularly when working with complex data.

Decisions made using an heuristic approach may not necessarily be optimal”.

However, in today’s world heuristics “get us through”.

Systems & Sub-Systems

We have agreed upon heuristics at the community, societal level AND at the level of subsystems.

Subsystems such as healthcare; education and BEHAVIORAL HEALTH .

We have institutions that exist within these systems and sub-systems.

They operate via mutually agreed upon heuristics as well. Within the same domain; “they all do the same thing”. Use the same model.

Modus Operandi For These Consequential Times

Our systems operate with an underlying unspoken agreement that; “This is the best way to do things”.

Most people are not even aware what the heuristics are and they just “do life day to day”.

BUT THEN… BOOM….BOOM and then more boom….

A global pandemic, and the co-occurring mental health / SUD crisis, comes along and the system is laid bare.

The severe limitations are revealed and the fragile nature of things is obvious.

The system and our institutions are brittle. And everything falls apart. 🙏🙏

CARTEL BONUS: CHECK OUT BOB’S SONG FROM LONG AGO

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The Ripple Effect by Rich Jones

Things are starting to slowly turn in a positive direction. In terms of understanding the virus, advancing medicine/vaccines, increasing testing and related issues. Trending in a better direction.

You can’t shut-down such a large slice of economic activity without it leaving some pretty bad scars.

Projections of 20 plus % unemployment, 30% GDP contraction and the near elimination of small business in several sectors. Permanent change to airlines, hotel, restaurant industries etc….

The economic impact will be incomprehensible and beyond any frame of reference. There is nothing to compare this to in terms of modeling an economic recovery.

The Ripple Effect

The “ripple effect” will be profound.

Consumer behavior will be forever altered. If you own a business Adapt and transition and do all you can to survive. Pivot like Shaq back in his Orlando Magic days….

But I believe things are starting to turn in a better direction (relatively speaking). We will be seeing movement toward a “re-opening” sooner than later.

SIDE NOTE: The media is starting to prepare for a full out politicalization of the COVID-19 issue ahead of the presidential election.

They will get even more sensationalistic. Each side digging in for trench warfare. The erosion of journalistic integrity is somewhat comical. If it weren’t so sad and scary.

All Hands On Deck

The co-occurring mental health and substance misuse epidemic concerns me. Suicides climbing. SUD escalating. Overdoses are happening all day, everyday.

Public health interventions for behavioral health issues need to be aggressively rolled out. Community health workers out in the neighborhoods.

And the workers do not have to be “recovery coaches only”.

We need to get over this idea that only recovering people can help. All hands on deck.

Be Compassionate

I never liked the whole “only an addict can help an addict” vibe.

I think recovering people bring vital knowledge and unique skills to the fight. However, I know many recovering people who are mean and punishing and do more harm than good.

I reject the “recovery” only vibe. How about this: “only nice people are allowed to help. Only compassionate people….”.

Everyone will need to contribute to containing the behavioral health pandemic. Just as everyone needs to contribute to containing the COVID-19 pandemic.

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