Rethinking Mental Health: Peer Support and Peer Services

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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.

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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?

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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.

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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.

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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.

 

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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

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