Category: Community Caring

Our Brain, Our Choice: “Med noncompliant” is inappropriate.

The term “med noncompliant” must never appear in a mental health peer’s medical records, and any psych provider who notes this in a peer’s medical record must be stripped of licensure and never be allowed to treat peers ever again.

Sure, that’s obviously hyperbolic, but it’s no less extreme than such front end loaded nonsense, that a peer must take psych meds or be branded as difficult, stubborn, and not serious about their treatment. Bite the big green weenie, you psych providers who use “med noncompliant” in a peer’s notes. You don’t make the choice for a peer and you have no authority over a peer’s treatment options and decisions.

It’s the peer’s decision on all treatment strategies. As a psych provider, you are like our mechanic. We tell you what’s wrong under the hood and you make recommendations based upon your professional training. You are a professional collaborative advisor and not a legal treatment guardian.

With few exceptions, notating “med noncompliant” is an inappropriate assessment that assumes an authority not given by the peer. It’s okay to notate something like “peer chose not to try meds at this time” because that is factual information useful to the peer in future treatment. It’s also the type of honest information useful to other providers, because when you write “med noncompliant” in a peer’s medical charts enough times that peer will fire you and find a new provider. This happens, providers being fired by the peer.

Recap: Never say a peer is “med noncompliant” for saying no to your medical advice. Medical advice is not one size fits all and it’s the absolute and ultimate choice of the peer whether to accept your medical advice.

Our brain, our choice. Simple.

© 2024 STEVE’S THOUGHTCRIMES 

I have bipolar. Is my life hard? Yes. Is my life harder than other people? Who cares?

I have bipolar. Keeping my symptoms in check so I can function in society following the same rules of the same social contract we all agree to is really hard for me. Perhaps it’s harder for me than others who don’t have bipolar. I can’t determine this. I don’t live their life and don’t know their challenges.

What I do know is I’m responsible for my life and how I live my life. I’ll never disempower myself by believing in “their privilege” and “it’s not fair” and “it’s so much harder for me.” All of these things may be true and to that I say “So what?”

If I have fewer opportunities and have more challenges, that’s my life to contend with. What we all share is the social contract implicitly signed by taking part in community, society, and civilization. So I work hard to live up to that, because in the final run through only I have authority over me. Anything less is disempowering and I work too hard to let that happen.

The University Interviews: Mental health peers to mental health providers.

In the months to come, STS is interviewing a number of peers pursuing university degrees in the mental health field. The unique challenges of college education for peers are illustrated in their experiences and stories shared, including how existing accommodations must improve to ensure peer success in their studies.

It’s a growing community of mental health peers returning to college to become mental health providers. There is a built-in benefit in this trend: Mental health peers taking primacy in the mental health provider market results in ongoing successful treatment for peers. Peers treating peers just makes sense.

Encouraging enough peers to enter degree programs is difficult, though, because these programs continue to lack properly enforced scholastic accommodation for the unpredictable nature of symptomatic episodes. The “wash out” rate is significant because the structure of degree programs value benchmarks and expected completion scheduling over the individual needs of candidates.

While university accommodation services are more available, the parameters are so ill-defined by administration and repercussions for non-compliance by educators is so inadequate, scholastic accommodations for mental health peers are easier to ignore than honor.

A prime concern is mental health peers aren’t involved in developing scholastic accommodations. Having peers develop mental health degree program scholastic accommodations for successful completion and graduation is critical, and not as an abstract talking point for consideration, this is required right now and going forward.

Given a choice, peers choose providers who implicitly understand with a unique-to-peers lived-experience empathy. And we peers deserve more providers who are peers. The time is right to change things up. Let’s create an ongoing education environment to support mental peer students. The upcoming interviews have lots of excellent insight on just how to do this.

Conspiracy theorists and mental health peers share a strong similarity.

Conspiracy theorists are upset that their views are dismissed and they thesmelves are marginalized. I say this is an excellent dynamic and I’ll tell you why, as a mental health peer advocate.

When I first started this peer advocacy thing – ten years ago – and began attending community behavioral health meetings in New Mexico, I was continuously “complimented” by others for “being so articulate… for a peer.” Yes, this is incredibly ignorant, biased, discriminatory, and just plain mean, and I could have gotten upset and demanded peers be treated with professional and basic human respect.

But I didn’t.

Why? Because as long as these minimizing well-wishers underestimate peers, we can get through all sorts of necessary change with little bureaucratic pushback. Being seen as intellectually deficient and less capable is a stigma worth capitalizing upon. So I did and I encourage fellow peer advocates to do the same.

The point is:

Now, my conspiracy theorist friends, a number of your ideas seem absolutely whack to me, but that’s a good thing. I take you seriously AND I think you’re nuts (at times). Folks like me are primed to accept your conclusions when we’re shown otherwise and logical proof. And to let you in on an observation, theorists friends. You’re more right that wrong, it just takes most of us longer to catch up.

So being tagged as a conspiracy theorist is a gift, not an insult. Let it ride. And, you can perpetuate their self-constructed myth even further with primely chosen words. For example:

Mental health community stakeholder: “Steve, you’re so articulate FOR A PEER.”

Me: “I’m sorry, I don’t know what half of those words mean.”

Just know going in, invariably the gift is rescinded when they figure you out. This gift to peers hasn’t been available to me for years. In fact, I’m seen as “too functional,” and because of this, mental health colleagues either didn’t recognize or simply ignored that I was falling into a seriously dangerous suicidal episode by volunteering to help the Albuquerque Police Department. But that’s a different tale for another time.

For now, always keep this chestnut cliche firm to the chest, ready at mind, and primed at the fore: Self-care, self-care, self-care! And this is a great number of articles for another time.

And again, let them underestimate you. It’s a great way to get things done with little resistance.

What was funny then is cringe-worthy now thanks to growth, evolution, and wisdom.

Do people change over the course of a decade or more? Let’s explore this with a joke I wrote about recently deceased musician Amy Winehouse in 2011.

When this joke was posted to Facebook in 2011 I laughed myself silly at how clever a comic I was. At the time that iteration of myself had limited experience with co-occuring peers, as in no experience with co-occuring peers at all. I read the post now in 2023 and I cringe reflexively and morally scold myself.

It’s never too soon for a joke and someone being offended by my joke isn’t a mitigating control. What makes this cringe-worthy now is I’ve had many co-occuring friends in my life since 2011, many peers at odds with addiction and mental illness. Five years of presenting Laugh It Off to peers inpatient at Turquoise Lodge Hospital gifted me insight into what it’s like living with addiction, and, yes, while it’s excellent to laugh at the horrible experiences of being a peer (the crux of Laugh It Off, that laughing at the horrible stuff takes back the power the horrible stuff holds over us), it’s simply never acceptable to take joy in a peer losing their life to their addiction.

So I’m morally scolding myself through the lens presentism. This isn’t the same as apologizing for the Amy Winehouse joke because the notion “I should’ve known better back in 2011” holds no weight or relevance. It’s like Disney firing James Gunn (writer and director of Guardians of the Galaxy) for a rape joke he made on Twitter over a decade before. Because he should’ve known better as a younger version of himself that joke would be cringe-inducing a decade later. And he should’ve known he’d be working for Disney. And maybe this isn’t the best example because Disney had to eat racist Dumbo crow and hire Gunn back to do Guardians 3 under threat of boycott by the principle cast. And now Gunn is the head of the DC Cinematic Universe. So he came out great with opportunities never presented had Disney not fired him over a flippant decade old post.

Okay, backtracking out of the rabbit hole, the point to laser in on is people’s attitudes and beliefs evolve over their lifetime, and this is borne of life experiences reshaping bits and pieces of their worldview. And often upon retrospection – in my case here because Facebook Memories remember forever and every year remind me of this – I’ll revisit a prior version of myself and think, “Dude, it’s sure a good thing I don’t think like that anymore, and thank every star above I’ve grown as a person.”

In 2011, a celebrity succumbing to substance addiction didn’t register in any real way. It was an abstract to riff upon as something jokey and fun. Twelve years later in 2023, I’ve witnessed too many friends and their lives impacted by addiction to ever find mirth in their pain. Growth and evolution of attitudes and beliefs is the core of the human experience. Poking fun at addiction isn’t acceptable joke fodder for me any longer, because my life experiences over twelve years are now wisdom unavailable when Amy Winehouse lost her life to her addiction.

Proof positive: The majority of Hunter Biden memes fall flat with me. Good on you, Steve. Here’s a self-earned self-administered pat on the back. Keep up the good work and I’ll see you in twelve years for the next round of “Dude, wh

The COVID-19 lockdown and our children

This post is from August 2021. American history and the fallout for our kids is now manifesting. Over the coming year we’ll have parents sharing their – often heartbreaking – stories of how the COVID-19 lockdown detrimentally affected their children’s mental health. For now, let’s just say it’s good fortune we have as many child therapy providers as we do.


To a five year old child, 1.5 years of forced lockdown is 30% of their life to that point. Extrapolating:

30% of a 10 year old child’s life is 3 years.

30% of a 15 year old teenager’s life is 4.5 years.

30% of a 20 year old adult’s life is 6 years.

30% of a 30 year old adult’s life is 9 years.

30% of a 40 year old adult’s life is 12 years.

30% of a 50 year old adult’s life is 15 years.

30% of a 60 year old adult’s life is 18 years.

30% of a 70 year old adult’s life is 21 years.

30% of an 80 year old adult’s life is 24 years.

Remember how summer vacation seemed to last forever when we were kids? It’s because as kids three months of our lives was a very large percentage of our living experience. Recognize this when in a few years we have the result of socially crippled kids needing tons of psych services for missing out on 30% of their social lives because of forced lockdowns.

And consider how we would turn out if we – as adults – were forced to stay at home for a decade or more. How socially crippled would we adults be after one decade of forced lockdown?

Why I didn’t and won’t watch Breaking Bad

It’s appreciated just how excellent a program Breaking Bad is. I didn’t watch it and I won’t watch it for this very simple and singular reason:

It’s a show that dramatizes drug culture.

The stuff I do in peer co-occuring advocacy gifts me with friends whose lives are severely and significantly damaged by illicit drugs like meth. Dramatizing drug culture isn’t necessarily condoning, glorifying, or celebrating drug culture. However, it’s impossible for me to watch a show like Breaking Bad without reflecting on the horrible life stories my friends shared with me. This negates anything pleasurable and enjoyable about watching the show. So I didn’t and I won’t.

And that Breaking Bad was filmed in Albuquerque makes it even more tangible, the literal recognizable physical setting of my friends’ life experiences.

I have an irritated good friend insisting I watch Breaking Bad, pointing out it’s about more than meth culture, that it’s about character development and character interaction. He insists if I give the show a chance I would understand this.

I asked him a single question: Does the show utilize meth production and sales as a central plot point throughout the series? The answer is of course “yes.” Returning to my first principle reason for not watching the show, because it is based upon dramatizing drug culture I won’t watch Breaking Bad. Flatly and immutably.

Call me stubborn if need be. I don’t feel my personally earned principles are open for debate. And I appreciate just how excellent a program Breaking Bad is.

Starting psych meds and remaining suicidal – or – Starting psych meds and only then becoming suicidal.

Last week’s thrifting found two DVDs from a medical-sounding production company directly funded by the Church of Scientology. These DVDs are candid interviews and group discussions with parents who lost a child to suicide. Viewing the material a few times, I recognized this logical pattern.

1.) Child is depressed and suicidal.

2.) Parent chooses to take child to medical provider.

3.) Medical provider prescribes antidepressant.

4.) Child begins med regimen.

5.) Soon after, the child suicides, by these accounts within days of starting the med regimen.

6.) The medical provider and their prescription is to blame for the suicide.

This logic troubles me greatly. As a peer who has cycled through many different antidepressants, I can attest to the dreaded “it’ll take two to four weeks to see if it even works.” And in this efficacy lag time, quite often I remained suicidal.

No antidepressant I’ve taken has ever worked within days.

Based on my experience and my understanding of psych meds, the query is plain:

Did the medication cause the child’s suicide, or did the child continue to be suicidal as before starting the medication?

The Church of Scientology is infamous for their outspoken denouncement of psych meds, and aggressively so. For DBSA and STS, Craigslist was a great way to reach peers in search of a peers support group. Well, the local Scientologists messed that up for everyone by overposting. Now, no peer support group posts are allowed.

You see, the church posted daily dozens of “support group notices” of the ilk:

“Do you have anxiety? Come to our support group.”

“Do you have depression? Come to our support group.”

“Do you have bipolar? Come to our support group.”

“Do you have PTSD? Come to our support group.”

“Do you have insomnia? Come to our support group.”

“Do you have an eating disorder? Come to our support group.”

And onwards.

There was no accompanying contact info, just an address … which was the local office for the church. I dropped in once in curiosity and upon arriving I was near immediately asked if I was prescribed psych meds and given literature similar to the DVDs I watched this week.

There were no support groups.

What’s so troublesome to me is how hazardous this tactic is, using manipulative illogic to dissuade peers from exploring every option available, in this case psych meds.

Don’t give your suicidal child psych meds because I did and it made my child kill themselves.

I asked the plain question earlier, was it the psych med that pushed the child to suicide or did the child remain suicidal and end their life in that dreaded two to four week lag time?

The answer is also plain. The child remained suicidal. Some will take this as me being insensitive and ignorant, which if you know me and my advocacy efforts you’ll know is not true.

What I find concerning is using correlative illogic to convince peers psych meds are universally deadly. How can that be? There are millions of peers making use of psych meds who are alive and healthy, their lives more successful and joyful in part from having the choice of psych meds available to them. This includes me.

We’ll never find a DVD of interviews with parents whose child has benefitted from psych meds. Like Yelp, reviewing activity is skewed greatly towards complaints and not praise. To take a (thankfully and blessedly) small population of family tragedies and claim this represents inherent danger is knowingly irresponsible.

How can I know this? Because if psych meds were as damaging as claimed, the pharmaceutical manufacturers would have been out of business decades ago.

This is plain logic that makes good sense.

My feelings on psych meds and treatments options for mental illness is consistent and transparent. Peers benefit the most from having as many choices as possible available. For my wellness, I am alive because of the choices I made in my treatment, and this includes choosing to have a psych med regimen.

It is responsible to encourage and promote support for all existing choices and the creation of new choices. Peers benefit from having choices.

And to be balanced, this includes choosing not to take psych meds.

STAND UP TO STIGMA: Mental Health Support Groups & Community Education