OPINION: “High Functioning” is such a crock of nonsensical categorization by those who don’t understand what it’s like to have mental health issues (aka crock of shite)

Reprinted from Steve’s Thoughtcrimes by permission of the author Steve Bringe.

Today, I negotiated with the City of Albuquerque for DBSA support groups venues and a venue for our SUTS (Stand Up To Stigma) May Mental Health Education Fair.

I also wrote a letter declining a sizable donation after much consideration and board discussion. I wrote a letter thanking a prior support group venue for their hospitality and that we unfortunately are moving venues because of severe safety concerns, also after much consideration and board discussion. Neither of these letters were easy or a pleasure to compose.

I paid my bills, marveling at how much water can cost per unit and vowing this is the year I build a cistern for gardening. I contested a recent billing from my insurance company. I questioned an unknown fee on my phone account.

Recently, I endured a nine hour deposition in the Walgreens suit that did not include a lunch break. I then had to review the deposition transcript for any errors, another four hours of my life in a nearly 300 page transcript. This is difficult stuff, having to relive the trauma of being nailed in the back of the head by a huge sign at Walgreens (not my error, t’was theirs).

I’ve been grieving the loss of Clare, the idiocy of her family and friends, and recovering.

I’ve been vocal about my treatment concerning MHRAC and have learned people I once respected are documented liars. So there’s something else that self-empowerment dictates I care for.

Seems like a lot to juggle, yes? Seems odd that a peer can take on so much, yes? Why, I must be “high functioning”. That’s the term used for me, both in conversation and in medical records.

You should have seen me last year, in particular last August and September when I was paranoid out of my head that the police were going to break into my home and throw my arse in jail. For what? For nothing. I was paranoid because I had low potassium. Hypokalemia. I was hospitalized at Haven for that. And then I was hospitalized again at Pres because my hands and legs stopped working. Again, low potassium. Hypokalemia. Entirely unrelated to bipolar, by the by.

Was this “high functioning”? I have a solid command of the English and French languages. I get by pretty well with ASL. No false modesty, I’m really smart. I’m a very good public speaker. So I’ve been accused of being “high functioning.” How am I labeled when symptomatic? How am I when I cannot do any of the so impressive tasks that make me “high functioning”? Is there a medical category for “temporarily not high functioning”?

It’s an insulting turn of phrase, much like how I had to untrain Muggles at meetings from telling me “You’re so articulate FOR A PEER.” Yes? Well, you’re so ignorant for someone who works with peers daily.

There’s a commonality in saying to me “You are so articulate for a peer” and “You are so high functioning.”


There is an implication that having a mental health diagnosis holds a great potential for being intellectually deficient.

Phrased in inarticulate, low functioning terms, statistical “baseline” peers are stupid until proven otherwise.


I learned a lot from my Care Coordinator girlfriend, Clare Castellano (angel above), about the classification system used by Molina New Mexico for peers. It’s based on a tri-level system of NEEDS. When I’m at my best, I have no need for care coordination. When I got out of Pres and Haven, being on a walker, unable to drive, unable to cook, unable to get to my provider appointments and retrieve my medications from the pharmacy, having difficulty talking and concentrating, I was a HIGHER NEEDS peer, a Level 3 at that. Now, I have no needs for care coordination once more.

Did I change as a person when having Level 3 needs? Did I become “stupid”? Incompetent? Low functioning?

Nope. I was still Steve Bringe, and I was struggling, and I needed additional help. And I could still be in a place where I am struggling and needing additional help. Thankfully, I’m recovering and continue to noticeably recover both mentally and physically. I always ways and will forever be Steve Bringe. Other than for helping define treatment parameters and billing purposes, don’t box me in, baby baby.

Clare worked with Level 3 peers in the field (and was fucking excellent at her job from what her peers shared with me), and these were not stupid, incompetent people. They are people who need additional assistance to complete tasks. They just happen to have ailments like bipolar and schizophrenia. That’s on the behavioral health side of things.

On the physical health side of things, there is also Care Coordination. What’s the difference? None. Because Clare pointed out that Care Coordination is Care Coordination, and separating BH from PH is impossible in getting her “little members” all the assistance and services they need. Lacking a mental health diagnosis, the same attention to higher needs is offered and achieved.

I’m not blind to the fact some peers will most likely have higher needs for much longer than I did. However, these are not stupid people. These are people who need assistance with everyday living because of the way their mental illness affects them. Not because they are “low functioning.”

It’s the go to move to say “Would you say someone who needs help getting to dialysis or someone who needs physical therapy after a car accident or someone who is literally blind and can’t drive to the pharmacy is ‘low functioning’?” If you answer anything other than “no” then you are making excuses for playing into an embarrassing stigma. Embarrassing for you, not the peer.

While categorizing peers in terms of level of service needs is not ideal, it is also not euphemism, and it is very much practical and infinitely more honest than generalizing peers as “high functioning” and “low functioning”. Like EVERYONE on the planet, sometimes we need a little more help than other times. And just because I can out-lawyer the lawyers at behavioral health meetings doesn’t make me “a high functioning peer”. It makes me a person quicker and more logical than a lawyer I’m going toe to toe with.

Hey, maybe I am stupid. I just ended a sentence with a preposition. I’m sure there are some split infinitives in here, too. Sue me. I dare you.

– Dedicated to Clare Clarissa Nina Castellano who taught me much about Care Coordination and what it truly means to be a person who cares for PEOPLE.

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Email of interest to peers: Bills signed by governor — others await action – Ellen Pinnes

This message is from Ellen Pinnes and The Disability Coalition. Please do not reply to this email address. Ellen can be reached at EPinnes@msn.com.

Governor Martinez has signed into law two bills of particular interest to the disability community:

SB 11, Limitations on “Step Therapy”, sponsored by Senators Gay Kernan and Liz Stefanics and Representatives Liz Thomson and Monica Youngblood. The bill addresses use of health insurance practices, known as “step therapy” or “fail first”, that require an individual to try a lower-cost prescription drug and show it doesn’t work before use of a more expensive drug is allowed. The bill focuses on prompt appeal processes that patients and their doctors can use to bypass step therapy requirements and get the medications that work best for them.

SB 19, Uniform Guardianship and Conservatorship Code, sponsored by Senators Jim White and Daniel Ivey-Soto and Representative Gail Chasey. The final version of SB 19 was changed significantly from the introduced version, and does not enact the new national model law as originally intended. The bill opens up new guardianship hearings to the public in most cases, limits the authority of guardians to modify or ignore wills and powers of attorney or to restrict visitation, and sets new standards for future petitions seeking guardianship. It’s not clear whether the bill allows family members to readily access annual guardianship reports. Unfortunately, the new law does not include some of the improvements initially proposed, such as strengthening the role of the attorney representing the allegedly incapacitated person or encouraging creative alternatives to guardianship.

Only a few bills involving disability issues are still awaiting the governor’s decision to sign or veto:

HB 2, General Appropriations Act, the state’s budget bill for fiscal year 2019 that contains appropriations for all state government agencies. The bill includes $2 million for the DD waiver waitlist, $300,000 for Special Olympics, $100,000 for housing services to individuals with mental illness who are homeless or at risk of homelessness, and $100,000 to the Human Services Department for autism services.

HB 19, Criminal Justice Omnibus Bill, sponsored by Representative Nate Gentry and Senator Daniel Ivey-Soto, which includes requirements for jails and prisons to screen inmates or detainees for substance abuse or mental health issues and facilitate their enrollment in Medicaid, and for Medicaid managed care organization (MCO) staff to assess the needs of these individuals and link them to services upon release from the correctional facility.

SB 2, Due Process for Medicaid Providers, sponsored by Senator Mary Kay Papen, which provides procedural protections for providers who have been accused of fraud.

SB 220, Crisis Triage Centers, sponsored by Senator Papen, which changes the definition of these centers to include facilities connected to hospitals and authorizes them to provide residential as well as non-residential services.

Governor Martinez has until March 7 to sign or veto bills passed by the Legislature. If you wish to contact her about any bill that is still awaiting action, you can reach her:

By phone: Call her office at 505-476-2200 and leave a message.
By email: Go to her website, www.governor.state.nm.us. Click on “Contact and Constituent Services” at the top of the page, then on “Contact the governor”, and fill out the form that comes up on the screen.
By mail:

Gov. Susana Martinez
State Capitol – Room 400
490 Old Santa Fe Trail
Santa Fe, New Mexico 87501

The Disability Coalition is administered by Disability Rights New Mexico and is funded in part by
the New Mexico Developmental Disabilities Planning Council through Federal Program funding.
Additional funding is provided by The Arc of New Mexico,
the Independent Living Resource Center, New Vistas and DRNM.

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APD seeks missing man suffering from schizophrenia

http://www.kob.com/albuquerque-news/apd-seeks-missing-man-suffering-from-schizophrenia/4804695/

ALBUQUERQUE, N.M. – Albuquerque Police are asking for the public’s help in locating a man who they say needs to be constantly supervised.

Police say Hasewood Dennison went with members of his group home on a supervised group outing to Legacy Church on Sunday.

While at Legacy, officers say the 54-year-old walked away from the group and did not return to the group home later that day.

Police say Dennison suffers from schizophrenia and has constant visual and auditory hallucinations. Officials are worried for his health because he needs to take prescribed medications.

Anyone with information on Mr. Dennison’s whereabouts is asked to call Detective Lorenzo Apodaca of APD’s Missing Person’s Unit at 505-659-7258.

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Hypokalemia: Potassium and Mental Health

After one of our chapter members was hospitalized for extreme psychosis with symptoms resistant to psychotropic medications, it was realized by providers that low potassium level was the causal factor for these symptoms. This condition is called hypokalemia and produced psychotic symptoms completely separate from their bipolar diagnosis.

Dr. Ellen Hong has a definitive article concerning the link between hypokalemia and mental health.

https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp-rj.2016.111103

A 41-year-old African American woman with a past diagnosis of schizoaffective disorder and medical history of hypertension and chronic obstructive pulmonary disease (COPD) was brought to the emergency department for auditory hallucinations and paranoid delusions. Upon initial evaluation, she was irritable and agitated and reported active suicidal ideation associated with voices accusing her of being a murderer. She had recently moved into her brother’s apartment due to financial hardship and was unemployed. Family history was notable for a brother with schizophrenia. The patient denied a history of illicit substance use. Medications included hydrochlorothiazide for hypertension and albuterol as needed for COPD. The patient had been maintained on clonazapam and paroxetine for depression for the last several years without recent medication adjustment but had run out of medications a week prior to admission. Routine laboratory tests on admission revealed a potassium level of 2.3 mEq/L and negative urine toxicology.

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DBSA Albuquerque Board – Vice president position

In a conversation with our president Sarah Salway, I’ve agreed to remain on as DBSA Albuquerque vice president for the year of 2018. There’s much work to be done during transitioning our chapter, and much of this work will require I be on the executive board to complete for our chapter.

Best of mental health to you

Steve Bringe

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New Support Groups Coming Soon!

DBSA Albuquerque is working on doubling the amount of support groups we offer! Coming this March we will be adding a group in the Northeast Heights area of Albuquerque. We are also working on adding another group near central Albuquerque. Check back soon for info on when and where!

 

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DBSA Albuquerque Friday Support Group

As part of our mission to provide quality support groups for those living with a mental health diagnosis in the Albuquerque area, we host a group on Friday evenings at the Don Newton Taylor Ranch Community Center near Montaño and Golf Course. Doors open at 6:30 pm, group starts at 7 and ends at 8:30. Come enjoy our safe and welcoming peer-run group. We’ll see you there!

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DBSA Albuquerque Monday Support Group

It is DBSA Albuquerque’s mission to provide quality support groups for those living with a mental health diagnosis and their families. We are peer run and peer focused. Come enjoy a safe, welcoming group on Mondays from 2 to 4pm at the Kumba Coffee shop at Downtown @ 700 on the corner of Lomas and 2nd. We’ll see you there!

 

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Want to be on the DBSA Albuquerque board and help guide our chapter?

Dear DBSA Albuquerque members,

After many years guiding our chapter, I’ve made the decision to move on from our board and into a strictly advisory role for our chapter.

It’s simply time for new ideas.

I did agree to temporarily hold the position of Vice President the beginning of this year with the intent of helping with chapter reaffiliation. This interim period was planned until January 31. It’s time for our new Vice President to step up.

Because last year our board decided that my advocacy had gone well beyond the core purpose of the DBSA, which is to have SAFE, CONFIDENTIAL peer support groups, much of what I am involved with can jeopardize this safety for members. Not intentional, only potential.

So, being Vice President will entail ensuring support groups happen and that membership is increased and happy. Expanding into many areas of the city is important to this, and it is one aspect of the chapter I hope to continue to help develop.

If you are interested, please email info@dbsaalbuquerque.org for more details. It’s rewarding and lots of fun!

My tenure as President lasted three years longer than planned, and to reiterate, I have taken my advocacy passions well beyond the scope of our chapter core, peer support groups. /u

My true passion is education. It is education to expand knowledge and understanding, with the goal of breaking through stigmas that limit peer involvement and threaten peer safety. We are not our diagnosis, we are human beings who manage the symptoms of a malfunctioning organ, our brain.

For the past six months, a small group of peers have been transitioning a smooth division of my education programs and DBSA Albuquerque’s peer support groups. Over the last month, we have moved forward with gathering all processes and forms necessary to operate as a business within New Mexico and beyond (including England and Australia).

The name of our business is STAND UP TO STIGMA and our motto is “Stigma Is Temporary.” We’ve successfully completed a number of gigs with indefinite contracts like at the DOH’s Turquoise Lodge Hospital. We are training and will continue to train peer presenters across many organizations and communities. If you are interested in knowing more about our programs and becoming a peer presenter, please email info@standuptostigma.org.

I cherish my time as president of our chapter, and I am eternally grateful for the support and love I’ve received from our friends at DBSA Albuquerque. And really, peer groups are more family than only friends.

We need a new Vice President, and I am certain that taking on this position for our chapter will be just as rewarding and empowering as it was for me.

Best of mental health to you,
Steve Bringe

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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.

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