How to Work with Issues of Mental Health Warehousing as a Professional

Early in my career as a social worker, I couldn’t even see the phenomenon of mental health warehousing let alone know how address the issue in a relationship. My college texts had promoted the mainstream eugenic presumptions associated with mental illness. I didn’t know what was needed to recover from things like psychosis, personality disorders, or addictions and live a fulfilling life other than to tell the client to take their medication.

 

Now, in my twenty-three years of experience working in the system, I have seen many other workers not really learn about the effects of mental health warehousing. It’s as if those of us who work in the field slept during social psychology lessons of Stanley Milligram and the Stanford Prison Experiments. And many of us who do understand the dehumanization process associated with warehousing may abandon the work for private practice. It’d nice it they left a little space in their practice for warehoused individuals. Perhaps some do.

 

Believe me, I never imagined that mental health warehousing would happen to a conscientious person who excelled in the mental health professional like myself. I used to think I was empathetic towards clients because that’s what always impressed others about me. Now I think I was just sympathetic and encapsulated! Indeed, though it could happen to most us, we rarely think that way. When I did land in warehousing, it was a real education.

 

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Are you Prepared to Address Psychosis in Your Practice? (Feature-Length Version)

In Madness and Civilization, philosopher Michel Foucault has predicted a proliferation of madness as disparities increase and modern society advances. Indeed, with psychopharmacology industry booming, rates of addiction, fueled by the opioid epidemic, skyrocketing, terrorism wars raging abroad, ongoing drug wars afflicting low income neighborhoods, escalation in homeless encampments in major cities, and a rise in bullying in schools, and even cyberbullying, it really does seem like higher percentage of people have been forced to explore their mental health struggles. While mass shootings have kept danger stigma in the media high and the media response continues to reinforce silence about mental struggles, the field of psychotherapy does have a lot more trends to address.

When I look through my state’s psychotherapy association’s annual conference, I see many of these trends getting addressed in workshops. But ever invisible is the issue of psychosis. Is it possible that the issue of psychosis functions as a significant part of the madness narrative? Is it possible that psychosis too is affecting more and more Americans as Foucault inferred?

 

 

What the Statistic Say: Continue reading “Are you Prepared to Address Psychosis in Your Practice? (Feature-Length Version)”

A Need for Providers who Specialize in “Psychosis.”

A Need for Providers who Specialize in “Psychosis.”

 

I was hired straight out of college into work in the counseling field. I started to work with an adult mental health population at my second professional job at the age of twenty-three. Since that time I have been increasingly focused on how to make therapeutic engagement meaningful when working with people in “psychosis.” In the field there are many who will say or imply this is not possible. They may argue that the mental health system is the best we can do. This story is for the providers who think more can be done to help individuals who have anomalous experiences.

 

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Working my way through graduate school, I can still remember struggling to get my dumb-ass footings as a professional counselor. I remember thinking about how ironic it is that they start you out with the most sophisticated of problems.

“Oh, you’re good,” said this vagabond homeless man who sticks out in my memory.

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How to Keep “Psychosis” Focus Groups Inclusive:

I fervently believe that having survivor-led group therapy that redefines “psychosis” is missing in the system.

Over the last nine years, I’ve been leading what I call special message groups in multicultural settings. I have found that such groups can be run safely and have the power to transform lives. However, I do admit that when it comes to kicking people out of group to maintain group equilibrium and safety that I believe there are a few things to consider first.

Firstly, I believe that a group leader needs to be prepared for the fact that mad people show up in very different ways. Group facilitators need to be familiar with and recognize a wide variety of presentations or manifestations. Perhaps group members may feel like they are being mocked by others in the group via illusionary ideas of reference or even controlled by them. They may code up their language for protection. They may treat the facilitator as if the facilitator can hear the same voices they hear. They may not believe, in spite of stories shared, that the facilitator has experienced what they have.

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Letting the Public Know I Suffer from Schizophrenia

When people seek mental health services from me, I routinely break what was once a cardinal sin to me early on in my recovery; I review my diagnostic history. I do this with love in my heart to help inspire recovery, however, in the process, the “s” word, “schizophrenia,” will bubble up.

I do this habitually in the outpatient program I work in. I have done this by redefining the medical model definition of the word so that it more accurately reflects the shared internal process that we with “schizophrenia,” or “schizoaffective,” or “bipolar,” or “depression,” or hosts of other diagnoses experience.

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Affects of Psychiatric Incarceration

Through a sea of tissues and a hacking cough, I scan Netflix pressing that stubborn button on my Roku remote multiple times. I read the summations of shows for several minutes until I come across a documentary called, the 13th. Finally, I settle in. Resting is not an easy thing to do with that constant sense of urgency I live with.

I don’t know what’s worse these days: dragging through a pre-holiday week on the outpatient psychiatric unit on Dayquil; or listening to the radio talk about impending loss as the new cabinet of Trump supporters get selected.

A cross town slog into East Oakland after work on the unit one night last week revealed once again that the streets are ever-burgeoning with homeless, some of whom I know intimately. In each car encampment, I saw a distinctive cultural story that needs to be heard.

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Advocating to Avoid Warehousing

Perhaps, early in my career as a mental health counselor, I couldn’t consider the effect of mental health warehousing.  Landing my second professional job gave me the financial power to leave a ghetto apartment in the most murderous city on the East Coast. Since I was only just entering a Master’s Program, I felt extremely privileged. As a result, I aligned myself with my supervisor and other more experienced workers. Without credentials, I was focused on working with people who would get my back.

One day, I received a client and was ready to get to work on housing issues, when I found out that she came attached with a more experienced case manager. Though not very talkative, she did tell me very clearly that she did not want to go to a particular boarding home, the largest such facility in the county. When I talked to the case manager who would later be my supervisor when I got promoted, he was clear about the woman’s future. She had to go to the unwanted boarding home.

“Wow, that girl is really sick!” I heard the coworker who worked the graveyard shift at the crisis house say.

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Multi-Culturism in the Hacienda of Mental Health

Back when I was just a yuppie, I learned a few points of wisdom about working through stigma. I needed mentors to help teach me how wrong stigma is. Now,  I want to pay forward some of  what I learned outside the class room  to some mental health academics and administrators who may not have gotten the same lesson.

I was learning to chop cheese steaks at a Korean owned deli and instantly enamored with this mentor on the grill, Mister Ray Gee. The deli was located just across the river from downtown Philadelphia, in the North Camden ghetto.  This Mister Ray and I were just meeting. We were both the same skin-and-bones size, our last names went together in rhyme, and any middle aged man who didn’t have a gut was an inspiration to me.

Mister Ray took one look at me and exclaimed in one breath, “Wow you are an Asshole! But don’t worry, it’s not your fault!  You were just raised that way!”

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Towards More Honest Ways to Teach Counseling Theories

I’d like to think that if therapists like me who have been farting around with psychotherapy for twenty years or so, might be able to improve the way counseling theory is taught in graduate school. Ideally, I would like to support the development of theory that address social ills. I have found myself feeling this way when I think of all the different misconceptions that I have endeavored in over the years. Now that I have established my niche and am advocating for new movements and theories that make most sense to me, I am finding myself wanting to help budding therapists learn how to conduct the art of psychotherapy in ways that help solve pressing issues, not just apply a scientifically proven technique or pass a test.

I think psychotherapy has made a break through to some extent that doesn’t get talked about. More and more theory is being constructed that help therapists solve problems rather than exhibiting panacea proclamations. I consider panacea theory to be what I was taught in graduate school: in its most postmodern form it includes narrative and solution focused therapies. Panacea theory was often remiss to really address social ills as they exists in agencies and on the ground. I think the onset of what I would call problem-centered approaches began with movements like DBT and Motivational Interviewing.

 

Problem-Focused Therapy instead of Panacea Therapy:

And I think if we look at what works about the problem-focused therapies that already exist, we can learn a lot about not only about how to solve real social problems, but also how to create theoretical elements that actually help teach other therapists in ways that enhance their art of psychotherapy.

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Radically Different Techniques

Eight years ago when I read about the Hearing Voices Network in Europe, I thought it was a dream. There seemed to be no better way to challenge the mainstream myths that psychiatry promotes. I wanted to make it come true but I didn’t know anybody.  Bearing a very contained two and a half year history of madness, I did what I could: I started a professional group in the outpatient program I worked in in St Louis Missouri called Special Messages. Now that the Hearing Voices Network is becoming a local reality, I am excited. However, there are a few things I have learned from my work with Special Messages in St. Louis over the last eight years that I hope might contribute to the vision of making self-help widely available those who have experienced “psychosis.”

 

My Journey Creating the Special Messages Group Therapy Curriculum:

When I started the Special Messages group, I had just become blessed with a forty hour a week schedule for the first time since I got dropped off at a Greyhound Bus Station from out of the State Hospital seven years prior.  With four thousand dollars in the inseam of my jean, and the tendency to look back over my shoulder, I had to work a lot more than forty hours a week to stay housed, off social security, and out of dilapidated barracks.

Finally, I attained my license in 2008. With a sudden new allotment of time, I searched the internet. I discovered the work of National Empowerment Center and Patricia Deegan. Additionally a site called Successful Schizophrenia, administered by Al Siebret, really helped motivate me. I also started the process of getting trained as a WRAP Facilitator. In my free time, I started the writing of my story in memoir form.  I didn’t know anybody in the movement and the one book I sent away for that was about the Hearing Voices Network, never arrived.

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