Category: Community (Page 2 of 4)

An observation of APD CIT training: “Because we didn’t know how to reach out to you without making it worse.”

Far too often lately (over the last year and a half), with the multitude of hardships I’ve faced, I’ve not garnered the sorts of sympathies one would expect from friends or even colleagues.

The leading excuse for saying nothing at all has been . . .


We didn’t know how to approach you and thought we’d make things “worse.”


I must assume this is because I’ve been a peer in crisis. I extrapolate this from “thought we’d make it worse.”

Er . . . So because I’m a peer in crisis, naturally I should be treated differently. Almost as if stereotyping and stigmatization are the best choices for handling a colleague on an advisement board like MHRAC.


What the heck have I been training you guys to do when it comes to deescalation of peers in crisis?


This is a topic I’ll be exploring, considering I won’t be resigning from any of these committees I’ve worked so hard to develop.

Think of it in these terms:


How can I feel confident officers in the field are usung the skills I’ve trained them for if they can’t employ these skills with a peer they know and work with intimately? And how can I tell peers who trust me that APD CIT training is working without being hypocritical?


It’s a crisis of faith, with a parting nod that I did not include persona non grata in the CIT training.

Think it over. This is a topic worth exploring.

In Loving Memory of Clarissa “Clare” Nina Castellano, Dearest Friend and Provider Advisor to DBSA Albuquerque

On October 29, 2017, the behavioral health world said its saddened goodbyes to Clarissa Nina Castellano.

Clarissa Nina Castellano

Clare (as she preferred to be called) graduated from the University of New Mexico and New Mexico State University with degrees in Psychology and Social Work, the first member of her very large family to achieve a Masters degree. Her naturally strong work ethic was noticed and commended by all, first at CYFD working with the children under her care and also at Molina New Mexico as Care Coordinator 3 and mentor to two care coordinator teams. It was at Molina that Clare shone brightest, working in the field with higher needs peers, many of whom attended our DBSA Albuquerque weekly peer support groups. The kind care she provided these peers (who she called her “little members”) was always a highlight of what they shared with our group. The amount of love and care these peers received from Clare is a rarity in the New Mexico behavioral health community. She didn’t merely go through the motions. Clare became a trusted person in their often confusing and chaotic  lives.

Clare was licensed as an LMSW in New Mexico, and with her vast knowledge and on the “front line” experience, when she accepted our request to bring her personal and professional acumen to the management of our peer support groups and education programs, our chapter and our community were instantly all the richer.

Clarissa Nina Castellano

The best way for DBSA Albuquerque to remember and honor Clare is to share a few anecdotes of why she is such an amazing person, and how her passion for helping others empower themselves was not a career, it was her calling.

Clarissa Nina CastellanoEarly in Clare’s collaboration with DBSA Albuquerque, she brought to our attention the need for transportation for many peers who would attend our groups if they could only get there. Working with Clare, we were able to be considered a “provider”  (we are not, we are a volunteer peer-run organization), and with this status many of her “little members” began attending DBSA groups using their MCO (managed care organization) medical transportation benefits. For the first time, these peers were able to come from all parts of our community to our three weekly venues that for them were always too far to travel by foot. Many of these peers continue to attend our support groups.

Clare also took part in helping to develop the SUTS (Stand Up To Stigma, in collaboration with our chapter) Laugh It Off program by attending our weekly presentation at Turquoise Lodge Hospital in Albuquerque. If you are unfamiliar with Turquoise Lodge Hospital, they are a facility dedicated to helping peers with substance issues, many of whom have an underlying and often undiagnosed behavioral health component to their daily challenges.

Clarissa Nina CastellanoLaugh It Off is a program where our SUTS peer presenters (we recruit those peers with co-occurring life experiences) stand up before an audience and do . . . stand up comedy, centered on essentially making fun of ourselves based on the horrible things that have happened in our lives as a result of our diagnoses and symptoms. As Clare put it, “If you can laugh at the horrible things that have happened to you, it takes away the horror and gives you back your power.”

At Turquoise Lodge Hospital, because we are at an inpatient facility with peers who are struggling, rather than doing a question and answer session after the comedy routines, we spin the program into a DBSA peer support group. Clare’s admiration for the successful implementation of this model got her thinking of what else we could do to make the experience as positive as possible for the patients. Because many of her “little members” contend with  co-occurring challenges, she had several recommendations for Laugh It Off.

Clarissa Nina CastellanoThe most important recommendation that was hard-fought to garner was not limiting the choice of words for the patients during the support group; at Turquoise Lodge Hospital, cursing is not allowed from the patients. Taking this recommendation/request to Jackie West of Turquoise Lodge Hospital, and combining Clare’s advice with Jackie’s insistence that providers not be in the room during Laugh It Off (including Jackie), the support group portion of the program became an open, welcome, and safe environment where many of these inpatient peers talked about very personal topics they had never shared anywhere before. They connected and realized (for many) that they were not alone in their struggles. Clare’s recommendation gave a one hour reprieve from word choice restrictions because, as Clare put it, “How can you express what is in your heart if you are constantly worried you’ll get in trouble for saying how you really feel using the words most natural?”

Clare’s calling and passion for helping others wasn’t limited to places like Molina and Turquoise Lodge Hospital. There was no “off switch” to her heart. One such illustration of this happened at Tiguex Park in Old Town Albuquerque. Having lunch with DBSA Albuquerque president Steve Bringe, Clare and he met a young couple who had just arrived in Albuquerque from Santa Fe. They were experiencing homelessness, and the young lady was in her third trimester of pregnancy. They came to Albuquerque because they knew there were better services in Bernalillo County than Santa Fe. They just didn’t know where to obtain these services.Clarissa Nina Castellano

Clare and Steve spent Clare’s lunch hour writing down notes, numbers, services, contacts, facilities . . . any and all of their combined knowledge they knew would be helpful to this young couple, this forthcoming young family. Later, Clare said, “I totally forgot to tell them out an MCO postpartum benefit! We need to go back to Tiguex Park and find them!” And that’s exactly what happened, although it wasn’t only information Clare and Steve returned with. Blankets, a backpack, and a picnic dinner accompanied them, and what was intended as a moderate amount of time spent getting to know the young couple and ensure they had as much helpful information as possible turned into an all-night camp out playing games and sharing stories.

A pet project of Clare’s we never had the opportunity to develop is literally a pet project. Clare’s dog, a Chihuahua named Hamlet, brought her such joy and comfort that she felt peers living alone would also benefit from having a canine companion. Clare’s wish was to partner with the City of Albuquerque to match shelter dogs with peers. This is still a project for our chapter to pursue, although under her guidance the project would have come to fruition much sooner and would have been successful right from the start.

Clarissa Nina CastellanoClare’s tenure as DBSA Albuquerque’s Provider Advisor was far too short in terms of the amount of time she served. In terms of the manner and magnitude of her contributions to our chapter, our peer members, and our community, Clare has changed DBSA Albuquerque deeply and eternally. It is not an exaggeration stating Clare Castellano is the finest provider advisor DBSA Albuquerque has had the honor of collaborating with in the three decades we have been a DBSA chapter.

Our community is left with a void that will never be filled. When Clare passed last October, our chapter did not lose a colleague, we lost our cherished friend and the kindest soul. Clare Castellano, among all her wonderful qualities, is irreplaceable.

May angels lead you in, Clare. Thank you for being you from your friends at DBSA Albuquerque.

 

 

More wonderful words for Clare Clarissa Nina Castellano at Steve’s Thoughtcrimes

And more wonderful words for Clare Clarissa Nina Castellno at Steve’s Thoughtcrimes

Steve’s Thoughtcrimes

So Many Apologies: Certified Peer Support Worker Training with OPRE

DBSA Albuquerque readers and members,

This is Steve Bringe offering you a HUGE mea culpa and HUGER apology.

The article for the Certified Peer Support Worker training that was supposed to be posted here on our chapter website, with a great amount of information on the training and OPRE, was not posted … quite obviously.

This article was not endorsed by our chapter.

What was posted was an article I had drafted for my personal website StevesThoughtcrimes.com. If you briefly cruise by the site, you’ll see that the content once posted here to the DBSA Albuquerque website is much more fitting to the Thoughtcrimes website. In fact, it was written for the Thoughtcrimes website entirely.

To any members, OPRE folks, or just anyone who might have been offended by the lack of professionalism and by my personal error, please accept my sincere apologies. In no way was it endorsed by our chapter, the fault is entirely mine.

Best of mental health to you,
Steve Bringe

Spring is coming, and so are DBSA Albuquerque get-togethers!

The temperatures are warming, the sunlight is hanging around a little longer every day, and if it weren’t for the winds today and the impending spring winds of New Mexico to come, we could do pretty much every event outside. But we won’t, because their are cool things inside, too.

Here’s a small sampling of the things we’ll be offering our community, with the single idea of:


Let’s allow the friends we make while at group to meet each other, learn more about each other, and enjoy each others’ company with folks who won’t judge or expect you to be symptom-free to enjoy going out.


DBSA Albuquerque events:

  • Weekly Bosque Walks
  • Sunday visits to any of the Albuquerque and New Mexico museums and parks.
  • “Laugh It Off” performed weekly so our community will under what it is like to live with mental health challenges… and we’re always looking for new comics!
  • Monthly education nights around the city that focus on practical information peers, friends, and families can use.
  • A tour of the 911/242-COPS Call Center (this is a way cool one!)
  • Periodic out-of-city geology and history tours led by Steve Bringe – This requires coordinated transportation.
  • Visits to our state’s National Parks, including our own local Petroglyph National Monument. – We are organizing a talk from NPS employees on the Access Card and how to obtain one.
  • Bowling Nights.
  • City Park barbecues.
  • Peers performing our education programs, “Laugh It Off”, “Milestones In My Recovery Journey”, and “You Cant’ Always See It” to live audiences, with questions and answers afterwards.
  • Our established weekly Game Night, of course.
  • Health Fairs where YOU can come help represent our chapter and our peer community.
  • A Peer Wellness Conference in September. This is going to take a lot of work and we’ll need your help to make it a success.
  • And so so so so so much more!
  • This is just to give you an idea of what we’ll be up to as a chapter this year and into coming years.

    The other main reason for all these events, beyond education, beyond companionship, beyond having fun… For those with mental health challenges, it’s so easy to stay home in bed and isolate. We really want to offer folks a reason to get out of bed into the world. Come to any group. There’s not a one of us who hasn’t isolated because of our symptoms.

    Whew! That’s a lot, although when you think in terms of I’ve been putting this stuff together and planning everything for four years now, it’s not as overwhelming of a task as it might seem.

    Let’s get out when the sun is high, have some fun, and get to know each other better outside of group.

    Let’s get out because it’s great for our wellness and recovery.

    Let’s just get out!

February 15, 2017 – Happy Behavioral Health Day, New Mexico!!!

Of this past week, Wednesday, February 15, 2017, can be considered the day that the State Legislature of New Mexico truly stood up and declared that the stigmas surrounding and permeating mental health issues will be a thing of the past. It was on February 15, this week, that Senate Memorial 83 (SM0083) passed through the Senate of our New Mexico legislature, and this day will henceforth be known as…


BEHAVIORAL HEALTH DAY!!!


Introduced by Senator Mary Kay Papen, the memorial strives towards understanding, education, hope, and innovation in our state’s behavioral health community. Senator Papen has long been one of our strongest voices in the state legislature, and this was a much-earned personal victory for her endless efforts towards making the lives of peers and their loved ones as joyful and successful as they can be.

DBSA Albuquerque’s Steve Bringe (awardee of the 2017 Lifetime Achievement Award from the New Mexico Behavioral Health Planning Council) and his father Stanley Bringe, along with other BHPC awardees and personnel, had the distinct pleasure of being on the Senate floor during Senator Papen’s speech on SB0083, and as it subsequently passed unopposed.

Later that afternoon, the House Memorial for Behavioral Health Day also passed unopposed.

February 15, 2017 – New Mexico Behavioral Health Day. Superb.


NOW, THEREFORE, BE IT RESOLVED BY THE SENATE OF THE STATE OF NEW MEXICO that February 15, 2017 be declared “Behavioral Health Day” in the senate and that the senate recognize the many people who devote themselves to public policymaking on behalf of the thousands of New Mexicans who live with behavioral health disorders; and

BE IT FURTHER RESOLVED that the theme for “Behavioral Health Day” be behavioral health in New Mexico — innovation in action;


DBSA Albuquerque continues to celebrate Recovery Month through Education!!!

On Tuesday, September 20, DBSA Albuquerque presenters Marion Crouse, Rasma Cox, and Steve Bringe will be presenting “Milestones in My Recovery Journey” to a class of students at New Mexico Highlands University.

The focus of the presentation is law enforcement response to peers in crisis, something our presenters all have firsthand experience with. Rasma and Steve present “Perspectives in Psychotic and Manic Symptoms” and “Deescalation” at APD’s Crisis Intervention Team training and these presentations cover very similar topics when instructing APD officers.

Wish our presenters the best of luck! We’ll have photos and reviews from the presenters later this week.

Notice: Requests to Observe DBSA Albuquerque Support Groups

Our chapter has received requests from UNM graduate program students inquiring if they may observe our peer support groups as part of their course requirements.

Unfortunately, we cannot accept these requests. DBSA Albuquerque support groups are peer-led for peers, and part of the strength of our peer support groups requires implicit confidentiality. Because of the very personal and private life experiences we share with each other, members are not comfortable with academic observers attending our support groups.

We do offer several community education programs that we have presented at both CNM and NM Highlands University. If you would like to know more about these education programs, please contact:

Steve Bringe
505-514-6750
steve.bringe@dbsaalbuquerque.org

Thank you for reaching out to DBSA Albuquerque and thank you for your understanding.

“CCS Discharge Medications – A firsthand review of helping patients fill their prescription” by Michele Franowsky

DBSA Albuquerque sits on the board of the Bernalillo County Forensic Intervention Consortium (BC FIC) chaired by Barri Roberts. The purpose of FIC is jail diversion. This means getting peers to mental health services rather than criminal incarceration. It is with pride and honor that we assist with peer advisement for FIC.

On August 30, Dr. Bryan Lance Hurt, Mental Health Director of the Bernalillo County Metropolitan Detention Center (BC MDC) shared with FIC members that CCS (Correct Care Solutions):

“Effectively immediately, CCS will now be providing a prescription for a free 14 day supply of medication to released inmates instead of the 3 day supply that was provided previously. CCS continues to provide a 30 day prescription which at the patient’s expense.”

This is incredible news and a huge step in the right direction. There have been many replies to Dr. Hurt’s email notification from FIC members, and DBSA Albuquerque is republishing a contribution to the email thread from Michele Franowsky, retired mental health social worker for the Mental Health Division of the Public Defender Department. This email is republished, in full, with permission of the author.


Hello All,

I am writing this e-mail based on my experience of being the mental health social worker for the Mental Health Division of the Public Defender Department for 14 years. As I retired one year ago, the information provided below may have changed.

During my employment with the Public Defender, I have picked up clients from MDC upon their release and transported them to obtain their specific social service needs. Sometimes, when I did not have access to a state car, I took the bus with a client.

One of the problems is that it is very difficult to navigate the system. It was difficult for me to navigate the system and I know the system very, very well. One must keep in mind that the individual has a severe mental disorder and has just been released from jail. Most often the client is dropped off downtown and has no money.

It is the client’s responsibility to check in with his/her Pre-Trial Services Officer or Probation Officer upon his/her release. To go to Probation and Parole, this meant getting from downtown to the Monte Vista/University Area where the Community Corrections Unit Probation Officer was located. (The Community Corrections Unit is the unit that is trained to deal with individuals who have mental health issues). That interview, itself, can take 3 or 4 hours. (Or at least that is what I was told when I took a client to Probation and Parole in 2013).

When it becomes somewhat of a challenge to pick up medication, clients’ motivation decreases significantly. The individual must be able to get to the closest pharmacy, usually by walking. Frequently, they don’t have the money for a bus ticket. If they do have the money for a bus ticket, they need to be well versed in taking the bus or have access to a phone or a computer to obtain the bus route.

If clients are able to obtain their two-week supply of medication (previously 3 days), the next hurdle is to get the month’s prescription filled. This means they must have Medicaid. If they do not, then the individual has to go to UNM or Healthcare for the Homeless at the prescribed times. At UNM, they may not be seen for the first three times. They are guaranteed to be seen on the fourth visit, however. Transportation to UNM is an issue just like getting to the pharmacy, except that it is a really long walk from downtown.

Another problem I frequently experienced (I dealt with the Walgreen’s on Sequoia and Coors) had to do with the medication being called in. Both PSU and most Walgreen pharmacies are always very busy. After going to Walgreen’s with no successful outcome, I learned to call them first to ascertain whether the prescription was called in. If not, then I contacted PSU and asked them to call it in. Then I would call Walgreen’s to verify that it had been called in. I was told by a pharmacist at Walgreen’s that they often had to check their voice mail to see if the prescription had been called in. Not only that, but I was told that the Walgreen’s (on Sequoia) had a second voice mail that needed to be checked as well. So when I called Walgreen’s, I had to ask the staff if they had checked both voice mails.

On one occasion, I went directly to Walgreen’s from MDC with the client at 11:00. After multiple phone calls to PSU and Walgreens, I was able to pick up the medication at 6:30 p.m. and take it to my client by 7:00 p.m. On that particular day, PSU/MDC had a crisis and my calls regarding meds for my client were simply not a priority (and nor should they have been).

I want to be clear that I am not being critical of either PSU or Walgreen’s. As I previously noted, both are extremely busy. Both endeavor to make things work. And I do not think that the solution lies in working with either entity to solve this particular problem. What is really needed is an individual to help the client navigate the system: Someone to follow up to ensure the medication has been filled; someone to pick up the medication; someone to ensure that the one-month prescription gets filled and picked up; and someone who ensures that the client gets into the system for medication management, i.e. a case manager. However, Medicaid doesn’t pay for transportation nor does it pay for case managers.

In my opinion, the real solution is expanded mental health services. Why not try to obtain funding to expand St. Martin’s, Healthcare for the Homeless, NM Solutions, or UNM to provide a one stop shop, so to speak. It would be a place where the individual could be seen by a prescribing provider and have easy access to a pharmacy. Ideally, the location would be downtown since that is where individuals are released when not picked up by family, friends, etc. upon their release from MDC.

One might expand this facility to include staff who could do psychiatric assessments for crisis situations and provide appropriate referrals. It could also include staff who consist of social workers and counselors who could provide case management services and counseling. The facility could develop a volunteer program to include peers to provide case management services.

Perhaps we could look at ways of developing such a treatment center as an alternative to AOT. One of the problems I have with AOT is that it involves the courts. Once the courts are involved, the unintended consequences would probably be increased incarceration for non-compliance. That is the only leverage the courts have. We already use the jails for non-compliance with medication management.

The other problem I have with AOT is that for it to be effective, there will be a need for expanded mental health services. Why not avoid the courts and the legislative process and deal with the solution to the problem directly?

In addition to the difficulty of navigating the system, many clients don’t want to be on medication for various and legitimate reasons. If there were a one stop shop where clients could be assessed in a crisis situation and/or receive counseling without having to be on medication (at UNM Psychiatric Center, it is not possible to be seen for counseling unless one is on medication), providers could develop long term relationships with clients. Over time and with supportive psychotherapy, clients could be engaged in treatment.

These are just a few of my thoughts. If anyone has any questions regarding the above, please let me know. Thank you.

Michele

“I Have Post Traumatic Stress Disorder (PTSD)” Card from New Mexico Solutions

New Mexico Solutions
“I Have Post Traumatic Stress Disorder (PTSD)” Card

Dr. David Ley, Executive Director at New Mexico Solutions, has provided to DBSA Albuquerque a PDF version of NM Solutions’ brilliant “I Have Post Traumatic Stress Disorder (PTSD)” card that is now available to download and print from the DBSA Albuquerque website.

New Mexico Solutions “I Have PTSD” Printable Card


What is the New Mexico Solutions
Post Traumatic Stress Disorder (PTSD) Card?
How Can the NM Solutions PTSD Card Help Me?

The NM Solutions PTSD Card is developed to be carried by peers in their purse, their wallet, or even in their pocket, and is something that a peer experiencing symptoms of PTSD can provide to law enforcement, medical providers, first responders, and anyone who could benefit knowing that, when in crisis, sometimes we peers just need a few moments to collect ourselves, to employ our coping skills, to tap into our mindfulness exercises, to think through our WRAP (Wellness and Recovery Action Plan), and with these few moments we can often subdue these PTSD symptoms on our own.

Sometimes, PTSD symptoms can appear to be confrontational, or these symptoms can make us momentarily unresponsive. It isn’t a matter of defiance or an inability to cooperate. The symptoms of PTSD can manifest unexpectedly and can be overwhelming. Anxiety, fear, panic, confusion, disassociation, difficult breathing… these are all symptoms common to PTSD.

For some peers, encounters with law enforcement and first responders is a potentially significant trigger for PTSD symptoms, and in these situations it’s often difficult or nearly impossible to communicate this simple message that is on the NM Solutions PTSD Card:

“I sometimes have panic attacks in response to challenging situations. If I seem anxious, upset, or am having trouble breathing, please just give me a few minutes and allow me to calm down. Please do not think I am defying your instructions or refusing to cooperate. I appreciate your understanding of my condition.”

In these instances, the New Mexico Solutions PTSD Card is a perfect solution for a very real need for many, many peers.

At DBSA Albuquerque, we have made the NM Solutions PTSD Card available at our weekly support groups. Now, we can offer visitors to our site the opportunity to download and print this card for yourself, your loved one, and your community.


What is Post Traumatic Stress Disorder?

Source: http://www.samhsa.gov/disorders/mental

Post-Traumatic Stress Disorder

PTSD is characterized as the development of debilitating symptoms following exposure to a traumatic or dangerous event. These can include re-experiencing symptoms from an event, such as flashbacks or nightmares, avoidance symptoms, changing a personal routine to escape having to be reminded of an event, or being hyper-aroused (easily startled or tense) that makes daily tasks nearly impossible to complete. PTSD was first identified as a result of symptoms experienced by soldiers and those in war; however, other traumatic events, such as rape, child abuse, car accidents, and natural disasters have also been shown to give rise to PTSD.

It is estimated that more than 7.7 million people in the United States could be diagnosed as having a PTSD with women being more likely to have the disorder when compared to men.

Risk for PTSD is separated into three categories, including pre-traumatic, peri-traumatic, and posttraumatic factors.

  • Pre-traumatic factors include childhood emotional problems by age 6, lower socioeconomic status, lower education, prior exposure to trauma, childhood adversity, lower intelligence, minority racial/ethnic status, and a family psychiatric history. Female gender and younger age at exposure may also contribute to pre-traumatic risk.
  • Peri-traumatic factors include the severity of the trauma, perceived life threat, personal injury, interpersonal violence, and dissociation during the trauma that persists afterwards.
  • Post-traumatic risk factors include negative appraisals, ineffective coping strategies, subsequent exposure to distressing reminders, subsequent adverse life events, and other trauma-related losses.

Diagnosis of PTSD must be preceded by exposure to actual or threatened death, serious injury, or violence. This may entail directly experiencing or witnessing the traumatic event, learning that the traumatic event occurred to a close family member or friend, or repeated exposure to distressing details of the traumatic event. Individuals diagnosed with PTSD experience intrusive symptoms (for example, recurrent upsetting dreams, flashbacks, distressing memories, intense psychological distress), avoidance of stimuli associated with the traumatic event, and negative changes in cognition and mood corresponding with the traumatic event (for example, dissociative amnesia, negative beliefs about oneself, persistent negative affect, feelings of detachment or estrangement). They also experience significant changes in arousal and reactivity associated with the traumatic events, such as hypervigilance, distractibility, exaggerated startle response, and irritable or self-destructive behavior.

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