. . . and get action
In today's world of service cut-backs and uphill fights, consumer activists in Georgia have been scoring victories. For a state that's been under Department of Justice investigation for abuses in its seven hospitals, this might seem surprising. But when you get the commissioner of Behavioral Health and Developmental Disabilities reporting to the annual meeting of consumers in Georgia about his agency's progress in meeting their priorities, that's noteworthy.
Last year, Dr. Frank Shelp attended the annual conference of the Georgia Mental Health Consumers Network (GMHCN) on St. Simon's Island. He was the first commissioner to do so, a fact that executive director Sherry Jenkins Tucker noted with appreciation.
As they do every year, before their meeting ends, consumers vote a list of priorities. It's an agenda for taking action consistent with promoting recovery. This year when Dr. Shelp returned, he enumerated steps his office took to meet requests for improved housing, more jobs, and accessible, dignified transportation.
Setting priorities is a priority
Consumers devised the practice of identifying priorities at their first conference in 1991 at Mercer University in Macon, Ga. The state provided transportation, bringing more than 600 people from each of the state's 83 day-treatment programs. Larry Fricks, Georgia's first director of consumer affairs, organized that conference. State officials, he said, were not expecting the turn-out to be so well organized or for participants to be so articulate in their demands. "We took the moral high ground by setting out those priorities, and the state had to listen." They've been doing so ever since.
Dr. Shelp explained that last year's request for better housing led to consultation with Pathways to Housing originators of the Housing First model. This model is credited with reducing homelessness, hospitalizations, and providing services while reducing costs associated with spending time in an emergency room, hospital or jail. He announced progress in providing civilian transportation rather than relying on local law enforcement to take someone to an emergency room. And he initiated the highly regarded seminars, RESPECT, developed by Joel Slack to train the department's 8,100 employees.
Respect is not just the acronym for a training seminar. "Respect is at the core of countering stigma," he said. An already sympathetic audience broke into applause at the otherwise sedate conference center, Epworth by the Sea, when he added, "If everybody has respect, stigma goes away."
Dr. Shelp reminded the group of the the recent appointment of one of their own, Mark Baker, to the position of Director of Advocacy. Baker brings the experience of a certified peer specialist in addition to an earlier career as ordained Episcopal priest. He will work directly with the commissioner. Baker was trained in the certification program that is among the signature accomplishments of the GMHCN. Training peer counselors for certification now continues under Fricks's leadership with the Appalachian Consulting Group, which he founded.
As did Fricks before him, Baker intends to use his office to place consumers' voices at the heart of initiatives, to guarantee that their recommendations and complaints are addressed without bureaucratic gymnastics. As an example of how he intends to operate, Baker emailed the commissioner after hearing someone describe, at an open mic session, the outrage of being stripped searched while being admitted to a hospital. The next day, Dr. Shelp announced an investigation of admissions policies would commence. He appointed Baker to head the initiative and said consumers will be involved throughout. Work began on the first Monday following the conference.
"He will look at this with an eye to respect for people's dignity and human rights," Baker said.
In profound ways, the model of certified peer specialists, articulating self-directed priorities, departs from the traditional medical model which dwells on the eradication of symptoms within an ordered hierarchy. Peer specialists work with individuals to help them gain control over their lives, using resources that empower based on strengths that are unique to each. That they also have a diagnosis of schizophrenia or bipolar disorder, and perhaps an addiction disorder, means that they have a wealth of experience from which to offer hope in support of individual accomplishments while someone builds a self-defined life.
In Georgia today, peer services can be found in every elbow of the system, from helping someone find community housing in preparation of leaving a hospital to providing respite beds and wellness activities and help someone avoid one. Certified peer specialists do outreach and counseling in prisons and homeless shelters, they are employed as case managers, on ACT teams, as job coaches, and they participate on the Georgia Mental Health Planning and Advisory Council, to which Danton Sealy, a certified peer specialist, was recently named. In Georgia alone, more than 550 people have received training to become certified as peer specialists.
Building on the model of success in consumer-operated programs that the Report of the Surgeon General's Report on Mental Health discussed, Georgia led the movement to reimburse peer services with Medicaid. In the past decade, two dozen states have adopted similar measures.
In significant ways, Georgia's consumer's movement has provided leadership that is succeeding not only in delivering services but solidifying its leadership role. What better evidence is there than the dialogue leading to change, commenced by consumers, embraced by the commissioner?