Innovations in Peer Supports

I first met Larry Fricks, Founder, Appalachia Consulting Group, the first day that I showed up for the DBSA Texas Certified Peer Specialist training in 2007 in Austin, Texas. My father paid for that certification training because I couldn’t afford the $900/training that year. I was promised a job and I needed a job. I ultimately wasn’t hired in MH in Texas anywhere but my higher purpose was in giving back and it led me to where I am today.

The backstory to my procuring and earning my Texas CPS is a basic one. Texas at th time (2007) did not have CPS certification training or program but there were quite a few stunning people who had befriended me and I them. The list is long.

Being resourceful came easy. I had somehow gotten Fricks’ mobile number and telephoned him when I was at Dallas HIV/AIDS training while working with AIDS Services of Austin after 2007. I must have sounded desperate. I asked him how Texas could “get” a CPS training. My reasoning was honest. I wanted to see it in place and my CPS ’07 training had changed my life. He explained how CMS and a Texas Medicaid Director with supports from the MH Recovery Community could strategize and leverage a State of Texas CPS.

In ’08 NAMI Texas and Mental Health America Texas, along with DBSA Texas and the Texas Consumer group collaborated to apply for a SAMHSA Transformation grant. I, of course, excitedly, helped. Texas was awarded a grant in ’09 and the rest is well, history. I was thrilled. I saw the rise of many of my Texan Peers and formation and branding, brilliantly, of via HOPE Texas Mental Health Resource directed by Dennis Bach.

I saw Larry again when via HOPE brought him to Texas to dialogue on Peer supports and CPS Core Competencies with colleagues and co-horts in Central Texas. Appalachia Consulting eventually won the RFA to spearhead the initial CPS certification training.

I liked Larry all at once and respected the work that he and others at the Georgia Mental Health Consumer Network along with the State of Georgia DBHDD Medicaid language guru had developed and changed for those like myself. Larry coined the CPS Medicaid language perhaps near 23-24 years ago now.

Today the CPS exists in nearly 44 states in the United States and luckily in all states where I have worked as a person with shared life experience. What continues to stand in our development is clinical direction resistance to offering Medicaid waivers that could financially sustain a CPS in most states.

In Maryland where I currently reside and work, Adult CMS with support via Medicaid waiver(s) is resisted and I simply wonder at this. Brandee Izquierdo, Director of the State of Maryland Office of Consumer Affairs shines and advocates for thousands in the state. Linda Oney, Director of Training at the University of Maryland, supports and provides oversight for the Maryland Certified Peer Recovery Specialist (CPRS) certification. There are others who work selflessly like On Our Own of Maryland with shining stars Denise Camp, Daphne Klein and for instance, multiple On Our Of Maryland sites (Prince Georges, Montgomery County, Frederick) who subsist in keeping doors open for others like Jen Padron when I was first starting out.

Years later, I eventually made my way from Texas to North Carolina, Georgia, Maryland and Washington, DC to offer my work in MH/SUD as an advocate, activist, program designer and project manager. It’s been quite a ride but I won’t lie and say it isn’t difficult. It is.

Working as a CPS is financially unsustainable for the individual working as a CPS. The pay is miserably low. Unless a person has a sugar daddy or a sugar mama, is married within a 2 income household combined with personal wealth on top of perhaps receiving SSDI means that not many more can afford to do this good work. It worries me. I see poverty. I see hunger not only of the body but for Spirit and of Community.

When a Peer’s  walk and journey finds the CPS it is a marker. It’s a benchmark. It is Spirit led.

Many advanced trainings like WRAP (Copeland 2016), or WHAM (Appalachia Consulting Group and National Council 2016), or Emotional CPR (Fisher 2016) or Intentional Peer Support (Hansen & Mead 2016), and now Mental Health First Aid (National Council 2016) is hungrily devoured by the base CPS community nationally and globally (iNAOPS 2016).

I see the Recovery Coach and Intentional Forensic Peer Support CPS endorsments and certifications seeding and growing nationally. It’s exciting stuff and stuff of legend in my constituency that I walk and work with.

I’m told to be patient. I’m encouraged to be supportive of the growth and in sum, while I am, I urge faster growth. The CPS is brilliantly a tool of Recovery and it is the Peer who literally controls it. The threat of co-optation may undermine mutuality with clinical control over the CPS embedding into Integration. Several years ago, Padron & Associates worked with Cenpatico to develop a peer workforce demonstration pilot project which ultimately was blocked by clinical oppression. It was a stunning end to arduous labor on my part and attempts to see innovation come to fruition. Today, Klein, Padron & Associates continues the struggle.

I see this time and time again in my work. Without full clinical supports, executive and individual US State Director leadership for the CPS to receive CMS Medicaid waiver(s) the CPS is dead in the water, basically. I see it now in Maryland. There must be positive partnership and collaboration. Peers can talk and yell and scream until we’re blue in the face to procure “approval” for state CMS Medicaid waivers and without it, the CPS is not sustainable.

I kindly urge Maryland leadership but not only Maryland’s Director to support an Adult CMS Medicaid waiver for the CPRS because quite simply, it’s the right thing to do. It does not open Pandora’s Box. It supports. It sustains. It offers substantial financial sustainability to an idea that works. I volunteer to show you how.

It remains that people like myself are still dying on average <25 years earlier than those individuals who are not receiving US Public Community Mental Health services and supports (NASHMPD 2006, SAMHSA/CMHS 2016).  Still, the average age of morbidity and mortality rests uncomfortably at 52 years of age.  The work of many others nationally on psychiatric torture, survivorship to trauma induced by psychiatry (e.g., Stop Shock), Recovery as touchy feely as it is, is respected by me and I stand in support as I’ve walked it and continue to.

This Friday, June 24, 2016 the National Council for Behavioral Health and SAMHSA/HRSA led by Larry Fricks is hosting a national webinar at 1-2 PM EST. I have invited colleagues Brandee Izquierdo and Dr. Jessica Wolf to co-present on Peer/CPS disruptive innovations and emergent initiatives regionally, nationally.

I hope you will register for it and sit with us to dialogue. Wolf’s work recently surveying the United States along with others will present on CPS educational attainment strategy and professional growth. Her Toolkit 1.0 encapsulates how the Certified Peer Specialist certification supports such personal occupational growth, establishing strategies instilling not just Hope but basic common sense knowledge. Izquierdo’s recent work developing the State of Maryland CPRS iFPRS (Intentional Forensic Peer Recovery Support) presents on ideas, philosophy and basic tenets to Peer to Peer (CPS) supports and services.

My presentation is meant to show benefits and a roadmap on the how’s, why’s and where the CPS benefits millions of Peers. I came from this. I am a part of it. This is my family and this is my tribe.

Larry Fricks’ work with SAMHSA/HRSA and NatCon presents Innovation Community is designed to engage organizations in acquiring knowledge and skills and applying their learning to implement measureable improvements in a high priority area related to healthcare integration. Lessons learned over the course of the innovation community are compiled and shared with the health care field so other organizations can benefit.

The innovation community is designed to address three key components associated with innovation implementation, including:

Topic-specific foundational information, knowledge, and best practices

Innovation implementation planning

Adoption and sustainability of the innovation

Check out registration information and I hope to dialogue with you this Friday.

Advertisements

Rethinking Mental Health: Peer Support and Peer Services

The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.

**

Psychology Today Interview with Jennifer Maria Padron, CPS, M.Ed, PhDc

EM: Your special interest is in the area of developing peer support and peer services to help individuals in emotional and mental distress. Can you tell us a little bit about your philosophy and initiatives?

JMP: Philosophically I am a Realist who fights pessimism juxtaposed with magical thinking that service is still service and helping other individuals who have been where I’ve been is my belief. This has formed my value system and my beliefs. I am a person with shared lived experience of living with mental diversity. I’m also a psychiatric survivor, a multiple SI attempt survivor, and received 2 years of invasive “medically, clinically necessary” electroconvulsive therapy which has muted my cognitive functioning abilities, dulling comprehension.

I vision that in the US, creating jobs for Peers is a step-up to self-autonomy and freedom. The US Peer Workforce is a model for mental health systemic transformation using innovative and emergent models of co-locating Behavioral and Primary Care Integrated community public health care. A Peer workforce comprised of other survivors who achieve training and Certified Peer Specialist, Forensic Peer Specialist, Recovery Coach and Community Health Worker Promotora certification inevitably will be embedded within behavioral care environments meeting a drastic shortage of mental health or substance use disorder workforce nationally.

Locally, I helped write the State of Maryland Peer Supports and Services Plan conceptual basis and proposal supporting the State of Maryland’s Certified Peer Recovery Specialist (CPRS). I am a Member to the Team THAT developed the integrated Forensic Peer Recovery Specialist (iFPRS) endorsement to the State of Maryland CPRS. I’m actively involved with several regional and national initiatives offering a step-up and technical training assistance to CPRS-led and various Peer driven Consumer Operated Service Provider (COSP) groups and individuals in and out of Maryland.

EM: You’re an advocate for “mental diversity in community public health care.” Can you tell us a little bit about what you mean by that and about your advocacy efforts in that area?

Advertisement

JMP: I reject the disease model. I am not my diagnosis. Diversifying the experience of mental diversity is a powerful thing. It makes room for Spirit led personal growth and opens the door to Magic. We can honor the other. We will make space. Mental Diversity comprises a richness in human Spirit during times of (ill)health, (dis)ease, and traversing the depths of despair. Mental diversity in US Community Public Mental Health Care must be culturally attuned to seed and grow understanding of Recovery and Wellness to wholeness.

I have realized and learned, over the course of 10 years, that my philosophy of mental diversity, social justice, wellness solutions and social inclusion sits 180◦ from the American psychiatric medical model. And I am dissuaded from believing or having good general faith in psychiatrists or current mental health Social Work model of care of psychotherapy and where lackluster advanced study of medicine precludes being culturally attuned. The staid training in psychiatric social rehabilitation and cognitive behavioral talk therapy steeped in Dialectical Behavioral Therapy stands very short of dialogic contact.

Service recipients of the US Community Public Mental Health system are inherently sociocultural and political throwaways. We wear a dollar sign by Providers. We are not able to subsist in today’s medically, clinically necessary model of treatment, meds management and for continuum of care. We are square pegs meant for round holes. Mental Diversity leverages a nonlinear spectrum of human behavior and holds more meaning than the terms “Mental Health” or “Disease.”

EM: Can you tell us a little bit about your thoughts on how mental health services are “delivered” in urban, frontier and rural settings?

JMP: I spent 2 years working 24/7/365 mental health and substance use disorder(s) mobile crisis intervention in North East Georgia that spanned 14 rural Appalachia Mountainous counties. I saw gaps firsthand in the rural Georgia NE Region 1, State of Georgia Department of Behavioral Health & Developmental Disabilities (DBHDD) public community mental health system.

Advertisement

I watched as a State of Georgia Certified Peer Specialist see how Peers in ill health will cuff and drive individuals in crisis to inpatient psychiatric facilities by State of Georgia Troopers, Police, Sheriff’s or sit in a jail. The jailed individuals are ignored for weeks waiting for supports. Monthly involuntary Haldol shots are utilized for those individuals in frontier/rural locations who requested wrap-around social services, but with a focus hell-bent on psychiatrically dosing them to stupidity.

The geographically non-urban tend to be more isolated, are economically disenfranchised or impoverished, marginalized. Being displaced so far from available health care and attention, these are physically isolated impoverished men, women, children and youth who may be experiencing first-onset psychosis during a particularly intensive, clinically documented SI based ideation. Many in non-urban locales often run out of prescribed psychotropic medications and are unable to maintain or manage self-care, practice self-health activation because of geographic territory and an inaccessibility to adequate health care services. Transportation is a major barrier to continuum of care. Naturally, then, I saw a lot of falling through the cracks in frontier and rural geographic territories such as the Appalachia in Georgia or Texas looming size

I feel disappointed and surprised by non-culturally attuned disease-centric training in frontier, rural and urban schools of thoughts for the Clinical Staff (LCSW, LMFT, LPC, PhD, MD, RN, PA) to experienced “psychosis” triggered by fear during any moment of crisis. Instead of treating psychosis as a magical moment or spiritual emergency, the immediacy of obtaining quick medical clearance at ER and medical designation for involuntary commitment has the eventual occurrence of involuntary monthly shots of Haldol which are de rigeur.

We live in dire times. Those classified with a mental illness receiving community public mental health care die on average at 52 years of age (NASHMPD, SAMHSA/CMHS, 2016). The political trend to return to a Modern Asylum system of “care” is tantamount to the frailty of human condition.

The US community and Recovery movement constituencies are largely, a vulnerable, disenfranchised, already marginalized population systematically prosecuted, persecuted, tortured and are dying 25 years earlier than one who does not receive community public mental health care. On the books, the numbers of dying resemble a genocide.

At AltCon14 while co-presenting on Mobile Crisis Intervention and the US Rural Peer Satellite Network, a CPS from Alaska noted how many completions they must sustain due to the arduous geographic territory where, literally, a helicopter is needed to save lives.

EM: If you had a loved one in emotional or mental distress, what would you suggest that he or she do or try?

JMP: Over the course of the past year, I have grown to see and know death, dying, suicide, ideation with plan, attempts and completions in a new way. I acknowledge that Suicide is dire and it is a health crisis with numbers surmounting the frequency of 12.3 minutes/per completion; however, I believe in the right to die with dignity, to die a good death and resolutely now.

Pain that wracks body, mind, spirit and community from overwhelming despair, of death, of dying or transformative change is rooted deeply in trauma. It remains that death and dying is intrinsically an autonomous private and personal right, choice and decision. In order to live fearlessly and fully, we must accept death, dying and redress physically.

When a loved one is in emotional or distress, I encourage action to the despair, Hope seeking behavior or practice (WRAP, WHAM, eCPR) self-love, self-care, and I ask directly, how I can help as a friend. I no longer recommend the current failed US medical or psychiatric system of medication stabilization through or the medically irresponsible act of prescription of psychotropic medication, medication compliance, outpatient forced treatment and/or electroconvulsive (ECT) treatment. Nonclinical Peer Respite and community supports are co-designed to organically support dialogic contact that in itself proves to be more effective than any public/private mental health services throughout the US.

I espouse: Learn to count on yourself. Trust yourself. Trust your gut. Speak up for yourself and use your Voice. Angrily demand and locate your self-love and do it madly, unequivocally while concurrently making all good faith efforts not to isolate or self-alienate from the support and love from trusted friends, family, community. You must learn to take care of your own needs. I work to practice emotional regulation, mindfulness and do what feeds me internally… that might be something so simple as sitting in quiet, discerning my needs, bathing, cooking, driving, working out, making art and filling myself up with all that is filmic, playing with my favorite music making mix. And my work. Look, listen and find your peace first and foremost. Give yourself whatever you need and receive it. Recovery is a selfish thing.

I urge others to see different worlds and to experience them. Allowing yourself to vision for exactly what you are at your core heart place and walk forth unapologetically. Remember there are no bells and whistles and most of the promises that your mother taught you will never ever come to be during your lifetime. Make peace with what torments you, what scares you, misgivings, forgiveness, and dispel ghosts of trauma. Being gentle, kind and practicing authenticity and transparency are rules to live by. Spiritual peace, being direct with others and easy living in relationship and community is a plus.

Above all else, harm no one and rest well.

**

Jen is Founder and Principal of k | p + associates. She resides in Baltimore, Maryland and enjoys traveling, painting, photography, and all that which is filmic.

 

**

Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at ericmaisel@hotmail.com (link sends e-mail), visit him at http://www.ericmaisel.com, and learn more about the future of mental health movement at http://www.thefutureofmentalhealth.com

The Right to Die With Dignity

The Right to Die With Dignity

Jennifer Maria Padron, M.Ed, CPS, PhDc Public Health & Amanda Barnabe

We are US Peers and we are Peers in everything that Peerness implies from State (Georgia, Maryland, Texas) certification. Acting in a healer saint wrap around service advocate activist give back to the community type of social supportive role, Peer supports and professional adherence accounting for personal-responsibility rings true. As well, we hold fast (in sum) to all federal Certified Peer Specialist SAMSHA related principles and codes.

We work pro bono or on average for >$12/hr as a Certified Peer Specialist in both public and private behavioral health systems of care for US Mental Health (MH), Substance Use (SUD) and now are in support of any individual experiencing criminal justice intersected challenges and where behind locked doors robbed of hope, we have insured that the Forensic Peer Recovery Specialist Endorsement and Certification is your brand new best friend in the State of Maryland.

We are unapologetic queers, submersed in this revolution of peer developed and implemented advancements battling a dark history of psychiatric practices.

We are practiced as a Certified Peer Specialist in the frontier, in rural and urban environments of the US.

We are trained, practiced and tried first responders and we are respected in 24/7/364 mobile crisis intervention (MH/SUD) and/or emergency response in rural and metropolitan environments where the demographics are broadly suicide or homicide or sometimes both.

We are the other and we know it.

We’re the damned.

We are the nonconforming square pegs, metropolitan, gender queer, gender fluid, gender non-conforming non-Judeo Christian, women of color with a disabling previous diagnosis of serious persistent mental illness.

We live lives in recovery as tortured psychiatric survivors who have survived to now.

We are more than our diagnosis.

We are more than our sexual identity.

We don’t buy-in to mental health or mental illness or the disease model or the medical model.

We get it and expect more.

If you can, then do. If you can’t, step aside for us to get ‘er done.

In the Winter of 2012 I (Padron, 2012) was impressed with five completions.

The State of Texas Department of State Health Services and Mental Health America of Texas Suicide Prevention point of contacts dealing with suicide education and prevention contacted me to ask me if I knew the details on the 5 completions from suicide of peers. I was aghast. Yes, I knew them. I know them. Their thinking was that they had a cluster on their hands. I hung up. I deleted their emails. I did not return their calls. I did not accept their calls.

Death and dying from our own hands is not a new feature to this (dis)ease. There is one death by suicide in the US every 12.3 minutes and every 30 seconds globally.

We are of the opinion today that should a person desire to die, then that is their right. At the moment there is anything sembling a Plan, there is nothing you or I can say to another person truly to “save” that life. It is one’s right inasmuch and as stigmatizing that suicide and mental illness is punitive, deadly even, it is in our experience that quite simply what works is to simply sit and listen with the individual in distress, in turmoil and emotional, physical, spiritual pain.

Inasmuch as the impulse derides or appears to lack any commonsensical logical thinking at the moment or eclipse of completing – saying simply, I love you or I would miss you terribly helps both people at the crux of a suicidal intervention back to center. Mixed episodes for those diagnosed with Bipolar 1 disorders tend to be at greatest risk.

Now, we ask you why then when, why, how and where does our dying and planning one’s death, and/or even by talking about it between ourselves, with others (e.g., lover, friend, family, providers) is this act formally considered a new feature and the not so (un)symptomatic of the clinically depressed, the bipolar disorders, the schizophrenia spectrum disorders, or anxiety/panic and/or the personality disorders?

The 25 year, on average, mortality rates of individuals living with a serious persistent mental illness number in the hundreds of thousands today (NASMHPD, 2007). It is my community’s genocide.

Why shouldn’t we count pharmaceutical and population’s genocide to psychiatric diagnosis and assuming my logic is correct then, why is Suicidal Completion numbers so shocking to you?

Many friends and colleagues are lost to dying from physically based illnesses such as cancer, heart attacks, congestive heart failure, stroke, car accidents, drownings and the like and more from suicidal completion. What is the difference between my dying from 30 years of consuming psychotropic prescriptions killing me slowly, like rat poison, with its’ long term effects causing pre-diabetic ailments, exhaustion, mind numbing grips of lack of passionate living, obesity, high blood pressure, cognitive impairment, or taking my life as juxtaposed with dying from a socially acceptable debilitating disease?

For selfish reasons alone, as a Certified Peer Specialist (Georgia, Maryland, Texas) we are rather directed by SAMHSA and national Core Competencies to provide Hope via all fashionable ventures in the name of Recovery. My story will not save anyone. My Hope and Story certainly cannot and will not save another person from completing. We’ve tried. We’ve lost too many. That we’re still walking, breathing, bitching and pissed off says it all. We are invincible. With at least ten (10) combined failed attempts, we conclude that we are unkillable. We are immortal.

We are Spiritually led to the opinion that the right to die a good death in dignity is an inherent privilege and may very well be perhaps the only thing which we retain control over, truly. There is one death by suicide in the US every 12.3 minutes and every 30 seconds globally. Individuals are killing ourselves off, completing, because living a life with a diagnosed serious persistent mental illness equates to being held in shackles by the current US antiquated, creaking, leaking mental health system built from a history of asylum, of involuntary commitment, of psychoactive medication dosing, chemical restraints and the dichotomy of failed medical healthcare professionals and vulnerable mental health consumers.

We are privy to terrible drownings and more divergent choices of suicidal completion (e.g., hanging, guns, auto, motorcycle, biking, cliff/bridge jumping, belts, poison, od’s, auto erotic asphyxiation). The US Community Public Mental Health system is in the business of Death and we are Agents of it, then.

We see no difference between dying from a terminal Stage IV invasive physical disease or the fact that 45 combined years of consuming psychotropic prescriptions is killing our bodies like mercury poisoning, with presumptive and eventual long term effects causing diabetic related ailments, exhaustion, mind numbing grips of lack of passionate living, obesity, disjointed involuntary movements, high blood pressure, cognitive impairment.

The right to die a good death in dignity is an inherent privilege and may very well be perhaps the only thing which we retain control over, truly.

Rate of Queer suicide attempts (%) (Trevor Foundation and Williams Institute 2016)

  • According to surveys, 4.6 percent of the overall U.S. population has self-reported a suicide attempt, with that number climbing to between 10 and 20 percent for lesbian, gay or bisexual respondents. By comparison, 41 percent of trans or gender non-conforming people surveyed have attempted suicide.
  • The most recent, comprehensive data on suicide attempts was gathered by The Williams Institute, in collaboration with the American Foundation for Suicide Prevention. Its report, Suicide Attempts Among Transgender and Gender Non-Conforming Adults, analyzed responses from 6,456 self-identified transgender and gender non-conforming adults (18+) who took part in the U.S. National Transgender Discrimination Survey.
  • Beyond the overall number of suicide attempts, the rates are consistently high from respondents ages 18 to 65, when they begin to recede. Trans men are the most impacted, with 46 percent reporting an attempt in their lifetime. Trans women are close behind at 42 percent, and female-assigned cross-dressers report rates of 44 percent.
  • Rates of transgender and gender non-confirming suicide attempts by age (%) (Source 2016).
  • Rates of transgender and gender non-confirming suicide attempts by gender identity (%) (Source 2016).
  • Race and ethnicity also play a role. More than half of all American Indian, Alaska Natives and mixed-race/ethnicity respondents have attempted to take their own lives, and the figures aren’t much better for the black (45 percent) and Latino (44 percent) trans communities. Even those with the lowest rates—Asian or Pacific Islander and white respondents—are still almost nine times higher than the national average.

Queer adolescents are more likely to be involuntarily committed to a long term mental health facility where they are subjected to being forcibly medicated with powerful psychotropic drugs, and archaic treatments such as aversion therapy, sensory deprivation, rotational therapy, ECT, restraint isolation and other inhumane practices. Homosexuality was removed from the DSM in 1973 but we are still persecuted, tortured and psychically damaged in our community’s youth.

SAMHSA’s efforts and initiative to increase the numbers of “saved” lives from suicide is telling. People are killing themselves out of presumably apparent poverty, experienced trauma, loss, grief, hate crimes, living shelterlessly, living disenfranchised and marginalized, from battling in combat and seeing it full front and center or from being out and out and exhaustively beaten to a pulp by our mental health system.

In SAMHSA’s and the Alliance for Suicide Prevention (2012) paper and study, “National Strategy for Suicide Prevention: How You Can Play a Role in Preventing Suicide,” they comprehensively detail the following facts:

  • Suicide is the 10th leading cause of death in the United States, claiming more than twice as many lives each year as homicides. i
  • On average, more than 33,000 Americans died each year between 2001 and 2009 as a result of suicide—more than 1 person every 12.5 minutes. ii
  • More than 8 million adults reported having serious suicidal thoughts in the past year, 2.5 million people reported making a suicide plan in the past year, and 1.1 million reported a suicide attempt in the past year. iii
  • Nearly 16 percent of students in grades 9 to 12 report having seriously considered suicide, and
  • 8 percent report having attempted suicide once or more in the past 12 months. iv

Although suicide can affect anyone, the following populations are known to have an increased risk for “suicidal” behaviors:

  • Individuals with mental and/or substance use disorders;
  • Individuals bereaved by suicide;
  • Individuals in justice and child welfare settings;
  • Individuals who engage in non-suicidal self-injury;
  • Individuals who have attempted suicide;
  • Individuals with medical conditions;
  • Individuals who are lesbian, gay, bisexual, or transgender (LGBT);
  • American Indians/Alaska Natives;
  • Members of the Armed Forces and veterans;
  • Males in midlife; and
  • Older

Further, in SAMSHA’s Leading Change 2.0: Advancing the Behavioral Health of the Nation 2015-2018. (HHS Publication No. (PEP) 14-LEADCHANGE2. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.) they speak to creating, “… a framework and process for identifying, developing, and implementing strategies to yield specific outcomes and ultimately influence system change” (p. 6). SAMHSA’s Strategic Initiative (SI #3, pp. 19-22) describes Disparities fall-out:

“Trauma, violence, and involvement with the criminal justice system disproportionately affect individuals, families, and communities of color, including indigenous and native populations. Racial, ethnic, sexual, and gender minority individuals experience trauma not just as individuals, but often also in the context of historical, intergenerational, or community trauma, which further compounds the effects of specific traumatic events. Mass trauma, such as natural disasters, often leave these communities underserved, unserved, or cut off from recovery resources. These communities are overrepresented in the justice system, are provided less opportunities for diversion from the system, and often move deeper into a system that itself is traumatizing and not geared toward recovery for people with mental or substance use disorders. For some people in these communities, the justice system becomes the de facto behavioral health system.”

For hundreds upon thousands of individuals living within the spiritual and emotional day to day anguish compounds and builds traumatizing distress. For individuals living with dual diagnosis and/or co-occurring physical health issues, how does recovery and hope really save us from the very “medicinal” prescriptive medications which are killing us slowly, bit by bit, day after day? They will not and they won’t help. We have accepted that we are dying a fast death biochemically due to extraneous debilitating side effects from 45 years of combined clinically invasive medication with concurrent treatment adherence at the hands of psychiatric staff nationwide. Our vital body organs are damaged, disease inflicted. We show premature damaged sugared blood coursing our veins blurring vision. Increasing terrible physical pain, aching and tenderness with effected cognition and comprehensibility is affected. We are already dying and we welcome relief.

Our argument rests in the very simple understanding that there is no difference between physical or psychiatric illness. That the body inherently breaks down and dies is tantamount to one’s humanity towards longevity of eternal life of one’s mind, heart and spirit. The daily poisoning of one’s body daily with antipsychotics, antidepressants, mood stabilizers from big pharma (e.g., Eli Lilly, Astrazeneca, Bristol Myers Squibb) weighs heavily on increasing opportunity for physical structural breaking down due to consistent poisonous or negligible medication dosing.

Symptoms to many of these very prescriptive psychiatric solutions is increased suicidal ideation which may or may not lead to death of the body. Given the presumptive mutual agreement between provider and acknowledging non-revocability to remaining truly self-informed, then contractually, we retain a right to die a physical death. We choose not to accept that which is de facto from a failed behavioral health and public community mental health system within the United States, or being jailed physically, and to be scapegoated publically and personally.

To die in dignity means that you must acknowledge and accept a daily walk with Death.  “Die Wise: A Manifesto for Soul and Spirit” Author Stephen Jenkinson, a Death Doula, a man busy in the death industry speaks to one’s right to die wisely. No judgment. There is just honoring the individual’s right to choose how to, when to and where.

  • Centers for Disease Control and Prevention. Fatal Injury Data, 2009. Web-based Injury Statistics Query and Reporting System. Available at http://www.cdc.gov/injury/wisqars/fatal.html. Accessed January 12,
  • Centers for Disease Control and Prevention. Fatal Injury Data, 2009. Web-based Injury Statistics Query and Reporting System. Available at http://www.cdc.gov/injury/wisqars/fatal.html. Accessed January 12,
  • Substance Abuse and Mental Health Services Administration. Utilization of mental health services by adults with suicidal thoughts and behavior. (National Survey on Drug Use and The NSDUH Report.) Rockville, MD: Author; 2011.
  • Centers for Disease Control and Youth risk behavior surveillance—United States, 2011. MMWR. 2012;61(4) 1-162