Mental Health Association of Portland

By Jenny Westberg, Portland Mental Health Examiner, Jan. 14, 2013

Kristi Jamison

“My life and the lives of others depend on it.”

That’s how Amy Anderson describes peer-delivered wellness services. So it’s not surprising that peer services — a key part of the CCO (coordinated care organization) model used in health care reform — were on the program for last week’s CCO Oregon conference. What’s surprising is that these services were not originally on the agenda.

Although getting a place on the program “does demonstrate a progressive, flexible, collaborative approach, ‘we’ had to ask to be a part of the conference. We hope to be asked in the future,” said Kristi Jamison, executive director of Empowerment Initiatives in Portland, who led the breakout session.

In fact, Jamison added, “This is the first time any consumer panel at a statewide provider conference occurred.”

Sellout crowd

The two-day conference, Transforming Care 2013, was held Jan. 8-9 at the Oregon Convention Center.

Jamison led a panel discussion the second day of the conference, called “Effective Community Engagement.” Every seat in the house was filled.

Panelists were:

• Amy Anderson, CAC and Executive Board member for Multnomah County
• Chris Bouneff, executive director of NAMI Oregon
• Jawanza Hadley, Wellness & Organizational Development Consultant
• Angel Prater, Director, Intentional Peer Support, Community Counseling Solutions
• Beth Quinn, board director of Cascade Peer & Self Help Center

Backed by evidence

In 2011, landmark legislation wrote Peer Wellness Specialists, Personal Health Navigators and Community Health Workers into Oregon law (see ORS 414.665).

There is ample evidence for Peer Wellness Specialists. “A research base has been established that demonstrates that peer-delivered services are an effective component of mental health care” with a range of positive results, according to draft committee recommendations by members of the Oregon Health Policy Board.

Amy Anderson (L) and Jawanza Hadley

A sign of hope

“The importance of peer-delivered services, in my experience, is that when we receive a service from someone who has had similar lived experience and seeking or in recovery of some sort, there is a natural connection,” said Hadley.

Hadley also said he was encouraged by the language being used by providers during the conference when discussing self-direction, wellness and recovery. “To me,” he said, “this is a sign that there is hope that we are moving away from the traditional medical model and towards the idea that everyone and anyone can recover from whatever challenges we may be experiencing in our life.”

Love, time, commitment

Anderson said peer-delivered services have been vital in helping her meet the challenges of two life-threatening health conditions, diabetes and cirrhosis of the liver.

“Without peers, mentors and community health workers in my life I would probably not be alive today,” said Anderson, whose health is now stable. “Just knowing there is another person out there I can talk with when I have my fear moments brings happiness and comfort.”

“Peers help teach and guide others by giving back, of their love, their time and finally their commitment to seeing the person improve no matter how long it takes,” Anderson said. “No one could begin to understand what facing death feels like, except those who also live on the edge.”

“Someone to walk with”

According to Jamison, “Having someone with similar life experience to go to appointments, facilitate provider contact, assist with provider appointments — someone to walk with — can not only reduce missed appointments (which providers care about) but it enables the person to learn to be a better self manager. Ideally, as they gain skills and tools, they share with others in their previous situation.”

Peer-delivered services are “based on the concept of mutuality,” Jamison said. “Everyone needs an advocate and a friend. I think providers finally understand that improved health outcomes include a truly person-based holistic approach, and Peer Wellness Specialists bridge that gap.”

Focus on quality

The conference, which was attended by over 500 people, included a video address by Kathleen Sebelius of the U.S. Department of Health & Human Services.

“We’re emerging from a system of skyrocketing costs and mediocre results, and we’re moving toward a new system that emphasizes care coordination, prevention, and quality care rather than quantity,” Sebelius said. “This transformation will mean better health, better care, and lower costs for all Americans. But it can’t happen without leaders like [those at the conference] showing the way.”

Insult to injury

Jamison said the panel she moderated was well received and the topic resonated with the audience.

However, after having to ask to be on the program, insult was added to injury — the session was cut short, leaving no time for questions and answers.

“It was very offensive and frustrating,” said Jamison.

CCO Oregon, when planning next year’s conference, should take note.

From the Clackamas Review, May 30, 2012 – not online

Centerstone opens in Clackamas mall area to access population

Clackamas County opened a new clinic this spring to target mental health in ways that are at least unique to the county, if not also the state as a whole.

The clinic provides walking distance access for a large low income population near the Clackamas Town Center. Many other parts of the county can access the Centerstone Urgent Mental Health Walk-In Center by TriMet bus and light rail. Leaders credit county health director Cindy Becker coming on board with a behavioral health redesign in deciding to move mental health more out in the community. A subcommittee recommended a model like Centerstone, where patients can choose one or both peer support and medicinal therapy.

“We have professional support and peers together and that’s what makes it so special and effective,” said Centerstone Manager Martha Spiers.

“They’ll talk to people who have had bad experiences with traditional mental health services
and provide a different route. They can come here and get peer support without the pressure to see a psychiatrist or take medications.”

Peer Services Coordinator Jim Whipple is running a “standard mental health support group” called Common Ground for people with psychological issues. An Empowerment Initiative peer-support group meets on Saturdays from 1 to 2 p.m.

“We’re going to emphasize people taking leadership in their own choices,” Whipple said. “There will be no pressure to talk, and we’re just giving people a chance to tell their stories.”

The mental health center will hold a grand opening on Thursday, May 31 from 5 to 7 p.m. It’s 7,000 square feet with four interview rooms, a training room, a peer support lounge office and a nursing exam room.

Health by design

Mental health court, nurses and peer support are located in the same place for the first time in Clackamas County at Centerstone. Many of the other unique features of the clinic involve design and architectural strategies.

“We didn’t reinvent the wheel, but a lot of the design features are based on new research,” Spiers said.

All of the chairs in the clinic’s waiting areas have their own wall or nook, so they aren’t backed up against each other, which can make some patients nervous. Some of the chairs can rock back and forth to help patients ease their tension. Interview rooms all have two doors so that patients don’t feel trapped.

“The crisis team was hidden behind the behavior health clinic, but now it’s much more visible,” Spiers said.

Through CCSO, two new mental health specialists are available to deputies to engage with a caller to 911 who, for example, says that something is coming through his ceiling to attack him. Centerstone gets all the police reports that mention mental health issues for possible outreach.

More than 20 full-time employees perform crisis support, investigate cases and operate a Warm Line for people who may be feeling unstable. The clinic’s annual budget is nearly $2.2 million, 56.5 percent of which comes from federal and state coffers.

Early intervention is more cost-effective, and it works better on an individual basis, points out Aaron Abrams, a community relations specialist for Clackamas County.

“We’re not a replacement for an emergency room, but many people use that much more expensive service unnecessarily,” Abrams said.

People who have committed non-violent crimes as a result of their mental illness can be convicted but avoid jail time by volunteering in a treatment program.

“We’re not a money-making operation, we’re a cost-avoidance organization to keep people out of the emergency room and keep them away from the sheriff’s office,” Spiers said.

Here’s the March 2012 edition of Eyes & Ears, a mental health consumer run newsletter for consumers, their friends & family and mental health professionals.

Download and read the March 2012 issue at:

Online Reading  Version  of Eyes & Ears – with links
Full article version of Eyes & Ears – for printing
Contact the editor at eyes.ears_newsletter@yahoo.com

Included in this issue:

* Thank You Donors To Eyes and Ears!!
* Empowerment Initiatives Provides Peer Specialists for Innovative New Centerstone Clinic
* Federal Authorities Hear Concerns About Portland Police’s Use of Force
* Budget Rebalance Largely Spares Oregon Health Authority
* State Hospital Nears Finish of New Facility
* Major health reform bill passes with bipartisan vote in Oregon House
* Generative Narratives and the Counterculture Psychiatrists
* Extra on the online version with links:Criminalizing the Homeless Costs Us All; Oregon Health Care Picks Up Where Obama Left Off; ; more State Hospital news; Portland Housing Bureau Awards $9 Million to 3 Low-Income Housing Developments; MHAP’s Media Guide gets more play; and more
* Coming Events: Rethinking Psychiatry’s 2nd Annual Symposium Call for Proposals; Alternatives Conference 2012; and more

Besides other news there are a variety of listings of meetings, services, support groups, job opportunities and more.

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The Centerstone Clinic is the first of its kind in Oregon, blending traditional mental health services with Peer Delivered Services. The Centerstone Clinic is for residents of Clackamas County to access help 7 days per week. It opens later this month near the Clackamas Town Center.

In addition to offering traditional crisis supports, persons can access Peer Delivered Services, which include: problem solving and crisis support, in home or community based person directed planning, WRAP® plans, in home respite support, Hearing Voices groups, transportation planning, RentWell© education, medication empowerment education, resource support, facilitating community integration and work activities.

This valuable resource will be available for people who just walk in off the street, and also will be an option that other parts of the mental health system can offer for people in need. The Clackamas County Crisis Line, Crisis Services, and Commitment Investigators will all be able to make referrals.

The Centerstone Clinic is based on the Sanctuary Model. Their website states “The Sanctuary Model® represents a theory-based, trauma-informed, evidence-supported, whole culture approach that has a clear and structured methodology for creating or changing an organizational culture”, and “The concept of ‘sanctuary’ refers to the important emphasis we place on the active and conscious development of a sense of safety within the context of a therapeutic milieu”.

Those of us who have been in a mental health crisis know how vitally important that feeling of safety is to helping us come out of our crisis. When we are in a safe and welcoming place, we are able to take those first steps on the road to our recovery.

The idea of ‘changing an organizational culture’ is also timely in these days of healthcare transformation in Oregon. Empowerment Initiatives is uniquely qualified to be in partnership with Clackamas County in the development and delivery of these new services. Empowerment Initiatives has been delivering cutting-edge services to Peers in Oregon since April 2004. They are run by people with a lived experience of mental health issues.

Empowerment Initiatives is a nationally recognized expert in Peer Brokerage Services. They currently provide Peer Supports at several of Clackamas County’s supported housing, clinics, and also work with Crisis Services.

Together, Empowerment Initiatives and Clackamas County are blending their strengths to provide new opportunities for people with a lived experience of mental health issues to find safety and recovery in their lives.

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Here’s the February 2012 edition of Eyes & Ears, a mental health consumer run newsletter for consumers, their friends & family and mental health professionals.

Download and read the February 2012 issue at:

Online Reading Version of Eyes & Ears – with links
Full article version of Eyes & Ears – for printing

Contact the editor at eyes.ears_newsletter@yahoo.com

Included in this issue:
* MHAP’s Kickstarter Fundraising Campaign for Eyes&Ears
* Portland Hearing Voices Expands to Weekly Meetings & also starts new Women Survivors of Sexual Trauma support group
* Part 2 of Interview with Gina of Empowerment Initiatives
* Oregon Health Transformation news
* Aaron Campbell’s $1.2 Million Settlement
* U.S. Justice Dept. to hold town hall forum Feb. 28th on Portland police use of force
* Extra on the online version with links: Discrimination, Serious Mental Illness and Health Care Professionals; Foundation for Excellence in Mental Healthcare Begins funding First Projects; Release System at State Hospital Debuts; Portland Candidates 2012; and more
* Coming Events: Rethinking Psychiatry 2012 Winter Film Festival; Introduction to Open Dialogue workshop;  Rethinking Psychiatry meeting; Money Basics; and more

Besides other news there are a variety of listings of meetings, services, support groups, job opportunities and more.

Please take a few moments to:
read about our Kickstarter Fundraising Campaign for Eyes & Ears,
and then:
Donate to Eyes & Ears on Kickstarter!

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Portland Hearing Voices facilitators. Standing, left to right: Bruce, Chaya, Jake, Nicole. Seated: Kate, Casadi, Jenny. (Photo: Will Hall)

On January 22, 2012, Will Hall, founder of Portland Hearing Voices, trained 7 new facilitators to lead Portland Hearing Voices groups. Portland Hearing Voices support group has had more than 250 people involved since its founding, with visitors and regular participants learning about new ways to understand and support each other around extreme states such as voices, mania, paranoia, and unusual beliefs. It is the only group of its kind in the area and one of just a few on the west coast. Groups have been held twice a month for over a year and will now move to every week, at the same time and place:

Every Tuesday, 6:00-7:30pm, at Empowerment Initiatives, 3941 SE Hawthorne

The new format for the group has 2 facilitators, with Will Hall sometimes present for backup. All of the new facilitators have attended the support group and identify with having experienced voices, visions, and/or extreme states of consciousness. Some have facilitated the group before. Hall’s next step is to expand the regional Hearing Voices network to other locations in and around Portland. Eventually he hopes to expand this network regionally to the rest of Oregon, Washington and California.

Will Hall

Hall trained the new facilitators in basics such as the goals of the groups and essential structures. The training also covered how to handle challenging and triggering situations. After teaching the basics, Hall encouraged new facilitators to find what works for them as group leaders and to experiment with new forms while keeping the essentials. Each new facilitator has a unique story and background, so there is a diversity of style, knowledge and experience that is now coloring the Portland Hearing Voices community. The new skills and energies are sure to keep PHV inspiring, strong and ever evolving.

“Participating in the facilitator training reinforced for me the importance of witnessing experience in building community. I value the effects of being seen and heard. I left the training feeling like a completely different person,” said one participant in the training.

Check their website portlandhearingvoices.net for news and updates on future groups. Portland Hearing Voices is open to all experiencers. Family members and friends are invited to the Mental Diversity Meetup (see the PHV website for details).

From Spotlight on Recovery Issue 28 – 12/13/11

I have been fortunate to get an interview with Kristi Jamison, the executive director of Empowerment Initiatives (EI). Her answers to my simple questions are profound.

Kristi Jamison, Executive Director of Empowerment Initiatives

1. If you had a free hand and unlimited resources to promote mental health recovery, what would you do?

I would dream big! The first thing is to employ consumers. I would promote the value of employing consumers. People feel empowered by self-sufficiency, structure of work or volunteer activities and participating in something meaningful.

The other approaches all have to do with connecting individuals to meaningful recovery, establishing community roots, reclaiming lives, art, wellness education; I would help create independent mental health brokerage options for people, in addition to offering WRAP or Person Directed Planning and start a dragonboat team! And, so much more……

2. Does the traditional mode of mental health treatment (clinics, clinicians, psychiatrists and chemicals) promote mental health recovery?

Not currently. In fact the system does not seem to have a way for recipients to “leave” or “graduate” services. I recently was in Brattleboro, Vermont. I was able to visit the Brattleboro Retreat. It is the defacto State Hospital, since there was a severe flood permanently closing the Vermont State Hospital this fall. As you walk in. there is a sign that reads: “how can we help you get home”.  I am struck by this notion… a system that implicitly states their goal is to get you the hell outta there. That is the right message. Helping people reclaim their lives, return to meaningful community ties and normalize their circumstances to be able to know their life is valuable, and this does not define them.

3. Is there a place for psychiatric chemicals in mental health recovery?

Yes. Informed use. This includes an individual creating a holistic wellness plan to address temporary challenges with an equal plan to reduce or eliminate the need for the prescriptions in the future. Whatever a person chooses, the most important element is to be armed with a wellness action plan, good information and support. Oh- And a prescriber on the same page. An individual is always the best advisor to their own recovery process. This has to become the value of the entire “treatment” team.

4. Are there people with mental challenges so extreme they may never recover?

Not only is this deeply false idea but it’s a harmful one. As a consumer/survivor community we “hold-the-hope” for one another.

.. the day I claim this is true, I’ve lost my own hope, hope for others and it’s time for me to step down.

5. If someone is a danger to themselves is it acceptable to use force as a last resort to stop them?

Never. Ever. Amen.

Balancing a person’s rights with the community or staff safety has presented untold challenges to “the system”.  Trust me, I’ve been in the meetings where there is hand ringing and not a lot of understanding on permanent trauma these policies have inflicted on the community.

For example, seclusion & restraints was always a horrible idea. There are many alternatives, from sensory rooms, music to talk/resolution teams. The most important element for the person in “crisis” to know is that they are safe and are capable of self soothing. It’s so important for a person to have their dignity. It never made sense that we address aggression with even more aggression. It’s so demoralizing- for the person and the system. Empowerment Initiatives, Inc. agrees with SAMHSA: “experts have long understood that seclusion and restraint practices do not reduce trauma but exacerbate it”.  Oh, and efforts are being made at the top: http://www.samhsa.gov/samhsaNewsLetter/Volume_18_Number_6/EndSeclusionRestraint.aspx

But more is needed. That’s where we come in. The power of our stories, fighting for our rights, being unified in our hope.

Here’s the November 2011 edition of Eyes & Ears, a mental health consumer run newsletter for consumers, their friends & family and mental health professionals.

Download and read the November 2011 issue at:
Online Reading Version of Eyes & Ears – with links
Full article version of Eyes & Ears – for printing

Contact the editor at eyes.ears@cascadiabhc.org

Included in this issue:
* Billboards with hotline number are up; now, so are calls to Crisis Line
* Mental health advocate Ron Coleman speaks at Empowerment Initiatives
* A new life for Oregon’s recovering addicts
* GUEST VIEWPOINT: Junction City hospital
* Officials worried by thought of having no psychiatric ward
* Low Income Energy Assistance Program (LIEAP) contacts, Housing wait list opens Nov. 16th-18th
* Extra on the online version with links: Finally, a small step down the road to justice for Lukus Glenn; Troubling Trends in Mental Health Funding; Calling City Hall, Occupy Portland on housing; Penn team finds success with talk therapy for schizophrenia; and more
* Coming Events: Book Club at Empowerment Initiatives, Mental Health Advocates Meet!, Guilty Except for Insanity, International Survivors of Suicide Day conferences (Nov.19th), and more

Besides other news there are a variety of listings of meetings, services, support groups, job opportunities and more.

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