red in everything everywhere i love it.
k | p + associates is preparing a national report which will help to sustain the US CPS Workforce.
red in everything everywhere i love it.
k | p + associates is preparing a national report which will help to sustain the US CPS Workforce.
I have a dream
that my four little children
will one day live in a nation
where they will not be judged
by the color of their skin,
but by the content of their character.
Martin Luther King, Jr.
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.
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)
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:
Although suicide can affect anyone, the following populations are known to have an increased risk for “suicidal” behaviors:
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.