Remarks by
A. Kathryn Power, M.Ed.
Director
Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
Alabama Department of Mental Health/Mental Retardation 14th Annual Recovery Conference
"Whether you think that you can, or that you can’t, you are usually right."
May 3, 2006
Talladega
, AL
PowerPoint version
Attached is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
Slide 1/Cover
Good morning everyone. Thank you, John(Mike), for that kind introduction…and thank you for this opportunity to return to the great state of Alabama.
It’s always an honor and a humbling privilege for me to speak before an audience of consumers and their families…to share the podium with the courageous women and men who are traveling on the journey of recovery…and to learn from your voices of experience, hope, resilience, and healing. Your voices are inspiring. Your voices are empowering.
“Whether you think that you can, or whether you think that you can’t, you are usually right.”
These thought-provoking words first spoken by Henry Ford, serve as an inspiration and a reminder of the power that thought plays in everything we do. The power of thought is critically important when it comes to facilitating recovery. Bill Schneider, a consumer who is now with Ft. Lauderdale, Florida’s Office of Consumer Affairs, echoes this sentiment when he tells others, “No one can tell you how to do it—the important thing is to think that you can. You have the power and ability to make recovery a reality.”
As I look around this room, I see hundreds of you who have harnessed that power in your own recovery. I applaud your success. You have told yourself that you can be resilient…that you can achieve a better life…that you can take the incredible journey down the road of recovery. Your presence here today is confirmation that you are right. Consumers in recovery are the match that can light the fires of change…fires that will alter attitudes and beliefs throughout the system…and the nation…for years to come.
Slide 2/ATP
And that process has begun. Two years ago, President Bush charged the Substance Abuse and Mental Health Services Administration, or SAMHSA, to implement the goals and recommendations of Achieving the Promise: Transforming Mental Health Care in America, the final report of the New Freedom Commission on Mental Health.
What is the promise? The “promise” is a full life in the community for everyone. Mental health system transformation is the shortest possible description of what we, as a Nation, must do to keep that promise. We must create a system that is quality-driven…that is focused on the needs of consumers…and that holds the promise of recovery for every American who seeks it.
Creating a recovery focused system is a powerful concept with implications for policy, funding, and practice as well as for attitudes and beliefs. As a framework for this system transformation, SAMHSA has been working toward a consensus definition of recovery. Our understanding of recovery…what it means and what it entails…will affect changes in mental health service delivery significantly. Two months ago, SAMHSA unveiled a consensus statement outlining the principles necessary to achieve mental health recovery. The statement was developed through the deliberations of more than 110 expert panelists representing mental health consumers, families, providers, advocates, researchers, managed care organizations, State and local public officials, and others. The panel determined:
Slide 3/Recovery Statement
“Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.”
A few words based on a wealth of beliefs! The most unshakable premise is that every individual has an unlimited capacity for personal growth.
I have provided copies of the Consensus Statement and encourage you to use this to spread the word about recovery. You can order multiple copies to share with consumers and agency staff by calling SAMHSA’s National Mental Health Information Center at 1-800-789-2647.
Several fundamental principles underlie this definition. Recovery is a process that builds on the strengths of each individual. The process is nonlinear and self-directed. It is individualized and person-centered. It is holistic. It empowers consumers to make decisions that impact their lives. It recognizes the valued role of consumers in supporting others as they continue on their own journey toward recovery. It involves society’s respect for consumers and their rights. It involves a consumer’s responsibility, courage, and hope in moving toward recovery.
Recovery provides the essential and motivating message of a better future―that people can and do overcome the barriers and obstacles that confront them. States are beginning to embrace a broad definition of recovery and use it to create a recovery-focused system. They are taking critical steps to translate the recovery vision into a practical model program.
California provides a wonderful example. California recently passed a landmark piece of mental health and fiscal legislation with the concerted effort of consumer leaders and their families. The California Mental Health Services Act imposes a tax on California’s wealthiest citizens, which will finance additional mental health services and programs for children and adults. California counties will use a model of integrated, recovery-based services to plan their expanded services. The model includes outreach, medical care, short- and long-term housing, prescription drugs, vocational training, self-help, and social rehabilitation. California’s new mental health initiative is transformation in action!
In a recovery-focused system, consumers and their families will have full and equal access to the services and supports they need for recovery. What kinds of services and supports? All those services that each individual might need and want to live, work, learn, and participate fully in the community. These supports include housing, jobs, and meaningful relationships with others.
Slide 4/Federal Partner Workgroup
To create a recovery-focused system that can provide these comprehensive supports and services, it will require unprecedented leadership and collaboration. Leadership and collaboration is the foundation of mental health transformation. SAMHSA is leading collaboration at the Federal level. Nine U.S. Departments and the Social Security Administration are members of our Federal Partners Workgroup for mental health transformation.
What does this Federal collaboration mean in real terms? It means that these agencies—all of which serve individuals with mental disorders and their families—are working together to leverage their resources to provide the services and support you have told us you need to build resilience and facilitate recovery.
You know better than anyone that housing and employment are essential to achieve and sustain recovery. Stable housing substantially increases a person’s opportunities to access treatment and services. A job can be both a goal for recovery and a tool for achieving it. To this end, the Department of Labor and the Department of Housing and Urban Development will jointly fund five grant programs aimed at improving employment opportunities and access to housing for individuals experiencing chronic homelessness. These grants will be linked with SAMHSA’s initiatives to end homelessness among those who have mental disorders.
Of course, transportation is another absolute necessity in achieving and sustaining recovery. Transportation is essential to accessing treatment and a job. Transportation is fundamental to a consumer’s ability to establish and maintain social relationships. The Departments of Health and Human Services, Education, and Labor are working with the Federal Transportation Administration to address transportation barriers. These agencies will work with the States to ensure that consumers have access to transportation as a means to full community integration.
Recent studies confirm another necessary component in recovery…recovery after a disaster…is peer counseling. Peer counseling programs are proving invaluable in disaster response. We have recognized that people with mental health problems often rise above the immediate distress of a disaster to provide leadership and support to others. Peer support programs provide a wide range of social supports including “community families” for those whose natural families are unavailable.
Several states have been using innovative approaches to mental health disaster response through peer-run and peer-delivered services. One notable example is Project Liberty where consumers were hired as counselors to help other consumers after the World Trade Center Disaster.
To help promote recovery and build resilience among those affected by Hurricanes Katrina, Rita and Wilma, the Department of Homeland Security’s Federal Emergency Management Agency (FEMA) and SAMHSA are collaborating to provide over $97 million in federal crisis counseling aid to States to date. Last month, Alabama was awarded over $900,000 of grant money to for crisis counseling assistance through this same Federal partnership. The money will help Project Rebound provide mental health services to your ten counties directly impacted by the hurricanes.
Slide 5/Action Agenda
These are just some of our collaborative efforts we have undertaken on the Federal level to change the status quo of mental health. These steps, representing an unparalleled collaboration, are summarized in a document called Transforming Mental Health Care in America: The Federal Action Agenda. I have also brought copies of the Action Agenda for you.
In response to Achieving the Promise, the Action Agenda calls for consumers to take a more central role in a recovery focused system. SAMHSA has long supported consumer participation in all aspects of substance abuse and mental health services.
Slide 6/The Year of the Consumer
To expand consumer-driven approaches that foster recovery within our own agency and with States and communities across the country, I am pleased to declare 2006 as the “Year of the Consumer.” Through this initiative, we are taking action to spread the message of consumer-driven recovery and its importance in promoting healing and resiliency. I would like to share some of our progress with you.
At the heart of the “Year of the Consumer” initiative , is our National Anti-Stigma Campaign, a 3-year effort to educate Americans about mental illnesses and recovery and to encourage those who need help to seek it. The campaign will initially target young adults aged 18 to 25 and their support systems. The first public service announcements and other materials are scheduled for release in October.
In the last few years, the media has given more attention to the mental health problems of famous people like Jane Pauley, Brooke Shields, and even Abraham Lincoln which has certainly helped erode the stigma surrounding mental illness. But mental illness doesn’t just affect public figures. Mental illnesses are common illnesses.
Personal stories from everyday Americans and their families are an integral part of our anti-stigma campaign and will go a long way to eliminate the stigma of a mental health diagnosis and treatment. Public awareness of their experiences is vital to public acceptance of mental illnesses as common, treatable conditions…that people can recover…people do recover.
Slide 7/Voice Awards
Last year, as part of our Anti-Stigma Campaign, we created the Voice Awards program to recognize writers and producers of television, radio, and film whose words portray individuals with mental illnesses with dignity and respect. The first recognition ceremony was held in July. The Aviator, ER, Monk, and Scrubs were honored for their positive portrayals of people with mental health problems. Nominations for this year’s awards have just closed and winners will be announced this summer.
To create a sharper consumer focus at SAMHSA, we have surrounded ourselves with images of consumers of mental health. SAMHSA has been hosting a traveling exhibit by acclaimed photographer Michael Nye. The exhibit, called Fine Line: Mental Health/Mental Illness, is a documentary of voices, stories, and portraits of individuals living with mental illnesses. Speaking at our opening of this exhibit, Mr. Nye said, “I don’t know where mental health ends and mental illness begins. This exhibit is about the fine line that moves through all of our lives.” Mr. Nye’s exhibit is a dignified, respectful showcase of individuals with mental health problems and serves to help reduce the stigma associated with mental illness.
We recently brought together our National Advisory Council to develop an operational meaning of the term “consumer-driven ” so that everyone is working with the same definition. The result is a draft statement we have posted on the Internet and are seeking comments from the public.
Slide 8/Consumer Driven Definition & Web Site
“Consumer-driven” means consumers have the primary decision-making role regarding the mental health and related care that is offered and the care received. In addition, the consumer voice is paramount in determining all aspects of care for consumers in the community, State, and Nation. The consumer voice must be present and fully represented both collectively and individually with regard to all aspects of service delivery, from planning, to implementation, to evaluation, to research, to defining and determining outcomes. This includes, but is not limited to, the policies and procedures governing systems of care; choosing supports, services, and providers; setting goals; designing and implementing programs; monitoring outcomes; and determining the effectiveness of all efforts to promote mental health and wellness.”
You can review this definition in its entirety on the web site shown on this slide. I encourage you to take time to provide us with your feedback. This is your opportunity to ensure we are moving in the right direction.
We are developing an evidence -based toolkit on consumer-run services. Just like our other evidence-based practice resource kits for co-occurring disorders, illness management and recovery, family psychoeducation, assertive community treatment, and supportive employment─this toolkit will help raise the standards and facilitate wide spread adoption for consumer-run services.
You have many wonderful examples of consumer-run programs here in Alabama. “Wings Across Alabama”—an organization of mental health consumers facilitating the self-empowerment of others—exemplifies the importance of community to recovery…and the necessity of leadership by consumers. WINGS has been a recipient of one of the 19 State-wide Consumer Network Grants provided by CMHS. Those grants are in the third and final year and funding is anticipated with the new 2007 fiscal year budget. If new funding becomes available, I hope to see WINGS reapply to keep its tremendous momentum of helping other achieve recovery.
I’m impressed with WINGS’ work and your willingness to host the one and only consumer-driven drop-in center at today’s conference. Community drop-in centers are central to recovery and to a life in the community. They can offer an array of services such as assistance with transportation, cooking and sewing classes, meals and get-togethers, a nurse to discuss health issues, worship services, field trips, music, computer classes, and fellowship.
I want to acknowledge Alabama’s five centers across the State who are helping individuals through the recovery process: Our Place in Huntsville; Somi in Mobile; the 1920 Club in Birmingham; Friendship House in Tuscaloosa; and Cahaba {pronounced Ca-ha-ba} in Selma…who is to be congratulated for recently receiving a Self Development of People Grant from the Presbyterian Church USA. KIPs Center in Foley is scheduled to open soon.
SAMHSA is committed to helping States expand peer support. Through peer specialists, recovery has become part of what consumers do for themselves and for each other.
Peer support ―including the sharing of experiential knowledge and skills and social learning, and providing encouragement and a sense of belonging― is essential in a system driven by consumers and their families…and focused on recovery. We currently support 5 National Technical Assistance Centers on peer support and we hope to issue new grants for these next fiscal year. One of these Centers, CONTAC of West Virginia, is organizing this year’s national consumer conference, called Alternatives, in Portland, Oregon on October 25-29.
A few months ago, we announced the availability of $2.5 million for 7 Peer-to-Peer Recovery Support Grants to develop, design, deliver and document peer-driven recovery support services that help prevent relapse and promote long-term recovery from alcohol and drug use disorders.
We have been helping fund Georgia’s Peer Specialist Certification Project─a program that trains former or current mental health consumers to become Certified Peer Specialists (CPS) who provide peer support services that are reimbursable under the Medicaid Rehabilitation Option. As of December 2005, Georgia has 285 certified peer specialists who are filling key roles in Georgia’s public mental health system. We are using the project in Georgia as a model to develop a Peer Specialist Certification Resource Kit to be used by State mental health delivery systems across the country.
20 million, 5-year study, which began in 1998, funded seven sites to assess drop-in center programs, educational programs, and peer support programs. The initial findings show that consumer-operated services as an adjunct to traditional mental health services help to improve consumer well being. These findings demonstrate that peer provided services work!
We are completing the development of a training manual on alternatives to seclusion and restraint. This tool will help treatment center staff move away from the use of these methods and move to prevention and the use of alternatives that ensure the respect and protection of rights of consumers and their families. I commend the Taylor Hardin Secure Medical Facility who began to reduce and find alternatives to seclusion and restraint more than a decade ago—years before Medicaid and Medicare began to require such practices across the nation.
SAMHSA was the first Federal agency that called for an end to seclusion and restraint in mental health facilities and we are currently funding 8 States to reduce these practices. We hope to expand the number of States in this grant program this next fiscal year and Alabama may want to apply for the next round of funding. Alabama has long been on the cutting edge in the movement to eliminate this dehumanizing procedure.
To help consumers assume leadership roles, we are offering scholar ships to support consumer leadership development. We have already sponsored scholarships to 20 meetings the past year to give consumers the opportunity to be heard in front of mental health professionals, policy makers, and Sate officials. This year we will be holding regional consumer meetings in San Francisco and New York City.
I encourage each of you to become consumer leaders . Earlier, I applauded you for your courage and determination in tapping the power within and in making genuine progress toward your goal of recovery. Now, I call upon you to put that power to work for others. I call on you to help lead the transformation of Alabama’s mental health system into a system driven by consumers and their families…and focused on recovery.
Who better than you to take the lead in helping others transform their lives? As consumer leaders, you work continuously to achieve your full potential…and to help others to achieve their full potential. You hold valued roles in your families and in your communities. You contribute. Because of your hard work and courage on a daily basis, you inspire others to have hope in recovery. You live a life full of possibilities!
Only you, as a consumer, can help others understand the many possibilities of recovery. You are in a natural position to lead others on the journey of recovery. You are the evidence that counters myth with fact…hopelessness with hope.
One of Alabama’s very own is a shining example of consumer leadership. Joel Slack, your State’s former…and first, I might add…Director of Consumer Relations, travels the world promoting the message of respect and is actively working to improve the quality of life for persons with mental health challenges. Through his Respect Seminars, Joel has reached over 100,000 individuals in 40 different countries. Joel’s seminars demonstrate how providers of mental health services can positively impact recovery through respect and compassion. Joel, now Executive Director of Respect International, is leading the movement to make respect central to every psychiatric treatment program.
Slide 9/Quote
But you don’t need an official title or your own organization to be a leader. Most leaders are common people with uncommon determination. Former President John Quincy Adams defined leadership like this: “If you inspire others to dream more, do more, and become more, you are a leader.”
You can be a leader simply by talking openly about mental illness. There are thousands of men, women and, children of this great State who are living with mental illnesses. They need to hear your stories. They need you to share your message of hope and recovery: People can recover!People do recover!
For Roy Willingham, this was the key that opened the door to his recovery. Roy is here in the audience today. I’m sure many of you know Roy and may have heard his story. Roy has graciously permitted me to share it with the rest of you.
Roy grew up in rural Alabama and became addicted to alcohol before graduating from High School. He moved to Detroit and enlisted in the Army. During his enlistment, his addiction to alcohol continued and he became addicted to drugs. After his tour ended, he returned to Detroit and made several attempts to seek treatment but each failed. Eventually he was fired from his job of 23 years as a systems installer for AT&T. He lost his car. He lost his home. He lost his wife and children.
Roy was living on the streets and weighed only 112 pounds when his brother came to his rescue. He gave him food and put him on a Greyhound Bus back to Alabama. Roy admitted himself to the Bradford Addiction Treatment Center where he was diagnosed and treated for his addictions and a co-occurring mental disorder.
At “Bradford,” Roy met Bob, his counselor, who also happened to be a consumer. With Bob’s support, Roy was able to turn his life around. Roy said, “Bob took me aside after a counseling session and told me his story. He told me he had been in and out of the hospital for mental illness and substance use and had been in recovery and sober for 14 years. He inspired me so, that from that day on, I knew I could do it, too.”
And Roy did! Roy went through a half-way house and a vocational rehabilitation program. He became a job coach for Easter Seals. After spending his days helping people with mental retardation and addictions in hospitals, he spent his evenings spreading his story of recovery. He organized and held recovery meetings at night throughout his community. Roy said, “I began to tell my story to inspire others and give back what I received. I found the more I did, the better I felt about myself which helped my recovery.”
Roy eventually became a Community Support Specialist for the Mental Health Consumers of Alabama, a program funded by your State Department of Mental Health and Mental Retardation. Today, he is serving his second term as Mayor of Emelle, Alabama!
{ to Roy} Thank you, Mayor, for sharing your personal story with us, and let me congratulate you on your many outstanding achievements.
Roy ’s story illustrates the vital role that consumers play in helping each other through the process of recovery. Roy was fortunate to have returned to Alabama, one State that has long promoted the value of the consumer in recovery. Alabama was the first mental health department in the country to open an Office of Consumer Relations, a pioneering development that was followed by other States.
Roy was fortunate to have met his counselor, Bob, a “peer,” who had been through recovery. Counselors weren’t traditionally consumers back when Roy was going through recovery….and, if they were, they didn’t announce it for fear of stigma and discrimination. But Bob used the power of his lived experience to enhance his professional role and shared that spark of information that ignited Roy’s recovery. In turn, Roy followed Bob’s lead and began to light the way for others. This is the reality of recovery! This is how lives are transformed! This is consumer leadership!
A few minutes ago, I spoke about achieving the promise…the promise of a transformed mental health system. That won’t happen without you. As consumers, you have a responsibility to keep transformation moving forward.
Transformation is your opportunity to help drive the meaning and expectation of recovery…and to emphasize your predominant role in making recovery possible.
I urge you to seize this opportunity to lead transformation.
Go back and review the draft definition of consumer-driven. Respond and react to this definition.
Spread the message of recovery. Ensure that growing numbers of Americans embrace the reality that recovery is a real possibility. Educate others about the essential values of self-direction and hope in recovery.
Few families are untouched by mental illnesses. At some point in their lives, one in five adults will experience a diagnosable mental illness. They and their families need to hear you speak openly about your own experiences. Remember that “you are the evidence.” Make your stories known. Let each one help one.
You may be asking yourself, how can I, one person, make a difference? Let me tell you a story…
John Woolman was an American Quaker who lived in the 1700s. At that time, many Quakers were wealthy, conservative slave owners. Woolman hated the idea of slavery and dedicated his adult life to eliminating the practice of slavery among his brethren.
He spent more than 20 years visiting Quakers along the east coast. He did not criticize people, nor did he make them angry. Woolman pursued this effort by using the art of gentle persuasion. Driven by his vision, he persisted, visiting farms, one after another. By 1770, a century before the Civil War, not one Quaker owned a slave. The Quakers were the first religious group to renounce slavery.
Slide 10/ Power of One
This is the power of one.
Right now, as I look out into this audience, I see hundreds of potential John Woolmans. Each one of you has the power of transformation. Each one of you has the power to transform lives. Together, your power can transform mental health care in Alabama…and around the country.
Transformation of our mental health system is possible! Tell yourself that it is possible. Tell yourself that you can become a transformational leader. Tell yourself that you can, and you will be right.
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