PROSUMER NEWS PROSUMER — A PERSON WHO IS PROA C T I V E I N T H E I R O W N L I F E AND GIVES BACK TO THE COMMUNITY ! A Prosumer is not who you are, it is what you do! www.ProsumersInternational.org, Facebook—Prosumers, Twitter—ProsumersInt Phone 1-800-577-3795 We are the ones We have been Prosumers- Waiting for!! A consumer led, consumer developed program having you focus on wellness and discovery. August 2021 Janet Paleo—Editor Volume 20: Issue 8

Peeranity Mentalism, Micro-aggression and the Peer By Janet Paleo and Anna H. Gray Practitioner By Pat Deegan

I know, peeranity does not seem like a real word but it is a word which I want to introduce. I was visiting with a group of peer practitioners who were working as According to the Urban Dictionary, “Anity is a way used advocates and mentors with people in a state psychiatric hospital. They were the to sort people into groups; by occupation, clan, place of first group of former consumer/survivors to work openly in that particular state origin patronage, parentage, adoption, even physical hospital. The group had asked me to come and meet with them because they felt characteristics (like red hair).” Humanity is the human race a growing tension themselves and "traditional staff" on the units. When they or human beings collectively. walked onto the psychiatric ward in the morning, the staff walked by them as if Humanity then is referring to the collection of human they were not even there. When there was a staff birthday or special event, the beings and all that it means to be human. The word human peer practitioners were not invited. Traditional staff did not socialize after work or can be an adjective or a noun. The Webster online during breaks with peer practitioners. Traditional staff frequently forgot to invite dictionary shows human as an adjective, meaning: peer practitioners to important meetings. What was going on? of, relating to, or characteristic of humans I wrote this short piece in order to begin to sketch out some ideas regarding consisting of or involving humans mentalism, micro­ having human form or attributes aggression and the peer practitioner who is working in traditional mental health representative of or susceptible to the sympathies and settings. Your frailties of human nature reflections on this topic are welcome! For example the last meaning includes: human kindness; Mentalism refers to the oppression of people who have been diagnosed with human weakness; and inconsistency are very human. psychiatric disorders. It As a noun human means bipedal, primate, mammal. has similarities with other "isms" such as racism (the oppression of racial So, humanity refers mainly to the adjective of human or the minorities), sexism (the characteristics of humans such as the list above. Our very oppression of women), heterosexism (the oppression of gay men and lesbians), inconsistency is part of what makes us human. Humans are class­based fallible and make mistakes. All people are human and have oppression (the oppression of people based on the socio­economic class they the full range of attributes of humanity. If we can remember were born into), and people’s humanity, then when humans are being human, able­ism (the oppression of people with disabilities). Like all forms of oppression, we are more tolerant of their humanity. mentalism occurs at In life, we get busy trying to make budgets work, cultural, systemic, interpersonal, and personal levels. thinking of vaccines, keeping up with household chores and At a cultural level mentalism in America is characterized by fear of a myriad of other life events which keep us from thinking emotionality and the primacy of rationality. An example of mentalism at the about humanity. When others make mistakes, we can jump cultural level is the creation and perpetuation of stereotypes through media and on them or be upset because we react and are blind to their films, about people diagnosed with psychiatric disorders as dangerous, humanity. Because we are human, mistakes will always unpredictable, criminal and predatory. happen. There is no getting around it. What happens when At the systemic level, mentalism refers to the ways that people with we or others lose sight of humanity’s humanity? We can psychiatric diagnoses are lose the compassion we have for ourselves and for others. discriminated against and are kept in a position of poverty, second class We don’t treat them with the respect due to every human. citizenship and are We are not tolerant of them being human. segregated from the community. Examples of mentalism at systemic levels So now I would like to talk about peeranity. What is include being forced to live below the poverty level on SSI; work disincentives that peeranity? To me, peeranity are the characteristics of prevent us from re­entering the workforce; marriage disincentives that lower our Continued on page 2 Continued on page 2 Our Mission: Our Vision: To empower all people to transcend adverse life experiences and to All people living their life fully, with all the respect due to inspire resiliency for all people to thrive while fulfilling their dreams. every human and all the passion to live the life they choose. Prosumer Meetings Currently Located in: * Denton * Houston * Plano * McKinney * San Antonio * Rio Grande Valley

Editor in Chief—Janet Paleo Prosumers International P.O. Box 120394 San Antonio, TX 78212 Phone: 1-800-577-3795 Email: [email protected] www.ProsumersInternational.org

Thanks to Hope Family Health Center for sponsoring Prosumers in Rio Grande Valley County. Page 1 The views expressed in this newsletter do not necessarily reflect the views of the editor or any of its sponsors. Mentalism, Micro­Aggression... continued from page 1 Peeranity Continued from page 1

SSI checks if we marry; being placed in segregated settings from which it is people who have the lived experience of mental health difficult to escape such as nursing homes, adult homes, board and care issues. Peers, therefore referring to characteristics of homes, and day treatment programs; inadequate healthcare (Medicaid, peers. Medicare) which lead to premature death for many; loss of custody of our When we then bring in mental health challenges children instead of supports to be effective parents; rules that say we can't use into the realm of humans, there are so many other the same bathrooms that staff use; the freedom the media feels in portraying things which must be dealt with. You have doctor us as murderers; etc. appointments, case worker appointments and a whole At an interpersonal level mentalism shows itself as prejudice and bigotry host of other things you need to take care of and our directed at those of us with psychiatric diagnoses. Examples include being humanity can get lost in the shuffle. We can get so denied a job if our psychiatric history is revealed; having a romantic partner busy with stuff and when the stuff doesn’t go right, we break off the relationship when they find out we have a psychiatric history; a disrespect ourselves. We can begin to get message neighborhood protesting the establishment of a group home in a town; a that we are broken, we should not risk living our supervisor at work leaving an advertisement for a new anti­depressant on your dreams, our brains cannot be trusted, and similar desk at work because you have been a bit down lately; being told that your messages. We might even call ourselves names. Do passionate objection to putting a client in restraints is simply you being the words, “stupid”, “idiot”, “dumbbell” or “crazy” sound unprofessional; etc. familiar? I know they do for me. These have been Finally, at the personal level, the oppression we experience can be names I identified with for a long time. internalized as a form of self­ hatred, internalized stigma, lowered self­esteem When we develop these blinders about and a tendency to talk about ourselves and our experience in the language of ourselves, we turn them on others as well. Some psychiatry. Examples of internalized oppression include the desire to people call this defensiveness, or even aggression. pass in public as normal; to hide, lie about or closet our psychiatric history; the They use our reactions as proof of our brokenness, desire to distance ourselves from other people with psychiatric diagnoses; which deepens the discouragement and “otherness”. referring to ourselves as diagnoses; distrusting our perceptions, emotions and We get in to this cycle and in the process we seem to experiences; and using clinical jargon to insult other people with psychiatric forget humanity and peeranity. It gets lost in the shuffle diagnoses i.e., "She is so low functioning. He is so borderliney." of life. We are not kind, compassionate, or ever Peer practitioners may encounter mentalism in all its forms when on the respectful to ourselves. Many times, we believe we lost job. In its most obvious form, mentalism is a macro­aggression. A macro­ our value when we got the diagnosis. So, what can we aggression is obvious and easily identified by all who witness it as unfair, do? biased and/or discriminatory. An example of a mentalist macro­aggression is The first thing we can do is remind ourselves of an emergency room automatically placing people with psychiatric diagnoses in being human and being a peer. We will not always get restraints while waiting to be seen by a physician or having only clients (not things right. However, in not getting things right we do staff) go through a metal detector at a local mental health center. have the opportunity to grow. We learn one way it Another form that mentalism can take is called micro­aggression. Micro­ didn’t work. As humans and peers, even though we aggressions are more subtle, not as obvious and therefore are harder to point can get things wrong, we can always learn from those out or confront. Mentalist micro­aggressions occur frequently and have a encounters. Therefore, one of humanity’s greatest gifts tendency to wear us down over time. Micro­aggressions tend to be "invisible" is to learn from all the mistakes we make. As peers, we and we often experience the cumulative effect of them as tension between get to learn from all the mistakes we make and realize ourselves. Here are some examples of mentalist micro­aggressions that our value did not change, nor could it change. Just experienced by peer practitioners on the job: because we may carry a label, it doesn’t mean we  I had been a patient in a mental hospital. Some time later I returned as a have lost our humanity or that we are subpar as worker to the same hospital. My paid, full time job was to work with humans. There is no such thing. I have heard people patients as a peer educator. I overheard staff grumbling that my very judge the quality of another person’s life and that does presence on the unit was a violation of professional boundaries. not work for humanity. No one can decide for another  I had been a patient in a mental hospital. Some time later I returned as a about the quality of their life. No one can strip anyone worker to the same hospital. My paid, full time job was to work with of being human. Nor can we strip ourselves from being patients doing advocacy and peer support. Some staff expressed concern human and being a peer. about which bathroom I could use. They questioned if I should use the The second thing we can do is acknowledge staff bathroom or the patient bathroom. humanity in ourselves and others. Showing ourselves  Once I went to escort a patient to a peer group meeting off the hospital the kindness, the compassion, and the tolerance that unit and a staff person said, "Only staff can do that." I felt like saying, "I am people would show if they can remember their staff!" humanity. Maybe our mantra everyday is “I am human  When I walk into the building the traditional staff don't even say hello to and so are all the people I will encounter”. Then with me. They look down and pass by like I'm not even there." humanity at the front of our mind, we would be more of  I couldn't believe it. They said that to apply for the job I had to have a letter what the world needs most, loving. from my psychiatrist saying that I had chronic and persistent mental illness The third thing we can do is to ask for the (SPMI). I felt like wearing a sign that said I was "SPAMI" as in SPAM. recognition of our humanity from those we meet, those who serve us and those who are family and friends. In  I was working at a clubhouse and they had a holiday party. There was a the asking for humanity, we can remind people that we keg of beer but they said only staff could have the beer. I figured that are human and so are they. We can also ask ourselves meant me so I went and served myself and they said I couldn't have any. to have more humanity or peeranity. Being present to  I spoke up passionately during a treatment team meeting because I felt the longer haul many peers must take to realize their that the client was being treated unfairly. My supervisor told me I was value is a huge part of peeranity. Recognizing that we being unprofessional for speaking up like that. He said I had to stop have worth and are worthy of love is a an attribute or "personalizing the issue." peeranity that many struggle with. Most peer practitioners will encounter micro­aggressions on the job. How The last thing we can do is gather in peer groups should staff handle these types of experiences and still remain within the role and support each other with our peeranity. Others who of the peer practitioner? The answer is that first peer practitioners must be able are not peers can empathize and be really great, to identify micro­aggression when it happens. This requires consciousness however, peers lifting each other up works in a different raising and a supportive group of peer practitioners who can help us name way. When you are with a peer who has gone through mentalism when it is happening. Secondly, peer practitioners must support and discouragement, disillusionment, and unworthiness; validate for each other, the reality of mentalist micro­aggression when it is and found their peerness and peeranity, then you have reported by a co­worker. Third, peer practitioners must learn to strategically hope for you to realize your peeranity and to realize respond to those people or policies that are oppressive, whether it was your humanity. Once those are realized and accepted, intentional or not. life is worth living. Page 2 Virtual Meetings — August 2021

SUN MON TUE WED THUR FRI SAT

AUG 1 AUG 2 AUG 3 AUG 4 AUG 5 AUG 6 AUG 7

Walking Grp 1:30 WOOP 1p Personal Medicine 2p Let’s Talk 10 am DBSA 7 pm Laughter Yoga 11 am Wellness in Motion10a Denman Park Mindfulness 1 pm Book Club 12 – 2 Social 7 pm DBSA 7 pm in person Focus 4 Life 4p Walking Grp 5 pm Men’s Group 7-8p

AUG 8 AUG 9 AUG 10 AUG 11 AUG 12 AUG 13 AUG 14 WOOP 1p North Let’s Talk 10 am DBSA 7 pm Rio Grande Valley Wellness in Motion10a

Walking Grp 1:30 Prosumer Mtg 12:30p Mindfulness 1 pm Prosumer Mtg 9:30a Houston Prosumer

Denman Park DBSA 7 pm in person Focus 4 Life 4p Walking Grp 5 pm Book Club 12 – 2 pm Mtg 12:30p-3p Men’s Group 7-8p Social Night 7 pm

AUG 15 AUG 16 AUG 17 AUG 18 AUG 19 AUG 20 AUG 17

Walking Grp 1:30 WOOP 1p Personal Medicine 2p Let’s Talk 10 am DBSA 7 pm Laughter Yoga 11 am Wellness in Motion10a Denman Park Mindfulness 1 pm SATX Prosumer Mtg Focus 4 Life 4p Social Night 7 pm DBSA 7 pm in person Walking Grp 5 pm 12:30 p

Men’s Group 7-8p

AUG 21 AUG 22 AUG 23 AUG 24 AUG 25 AUG 26 AUG 24

Walking Grp 1:30 WOOP 1p Personal Medicine 2p Let’s Talk 10 am DBSA 7 pm Laughter Yoga 11 am Wellness in Motion10a Denman Park Mindfulness 1 pm Book Club 12 – 2 Focus 4 Life 4p DBSA 7 pm in person Walking Grp 5 pm Men’s Group 7-8p Social 7 pm

AUG 27 AUG 28 AUG 29 AUG 30 AUG 31 SEPT 1 SEPT 2

Walking Grp 1:30 WOOP 1p Personal Medicine 2p Let’s Talk 10 am DBSA 7 pm Laughter Yoga 11 am Wellness in Motion10a

Denman Park Mindfulness 1 pm Book Club 12 – 2 Social 7 pm Focus 4 Life 4p DBSA 7 pm in person Walking Grp 5 pm Men’s Group 7-8p

Calendar Times are listed in Central Time To access the virtual meetings for Prosumers go to the Prosumer website at www.theProsumers.org. If you don’t have a way of getting to a computer or smart phone, call our office for help. Prosumer Meetings Call Numbers North TX (Collin County/Denton) Prosumer Meeting AUG 3 If in Crisis Call 9-1-1 or your LMHA Crisis Line RVG Prosumer Meeting AUG 13 • Texas Department of State Health Services Houston Prosumer Meeting AUG 14 Consumer Services and Rights Protection 1 -800-252-8154 San Antonio Meeting AUG 20 • Texas Department of Public Safety for Abuse and Neglect 1-800-252-5400 Groups—Subject to Change • Trans Lifeline 1-877-565-8860

Book Club Meeting - The Sum of Us: What Racism Costs Everyone and How If you are not in crisis but really need a peer to We Can Prosper Together by Heather McGhee—Current Book talk to, call the warm lines located on Page 8.

Depression Bipolar Support Alliance (DBSA) San Antonio - General Meeting

Focus 4 Life — We will be discussing the different parts of the Focus 4 Life training. Laughter Yoga— Utilizing yoga type move, learn the skill of laughing to bring healing to your body Let’s Talk— A General Support Group Men’s Group—A time for the guys get together and talk. Mindfulness Activity Group—This group practices the art of Mindfulness while making art Personal Medicine Coaching—Personal Medicine is what you do, not what you take. Come explore what things you can do to work with challenging feelings. Social Night Out—Join us for a night out of fun and games and ??? Come find out. Walking Group—Join us at Denman Park to walk. 7735 Mockingbird Ln, San Antonio, TX 78229 Wellness in Motion—Time to get moving with a Certified Trainer. From beginners to advanced

WOOP— A technique for getting what you want with lasting results. Stands for Wish/ Outcomes/Obstacles/Plan and is highly effective.

Page 3 Useful Websites and Links PROSUMER MEETINGS

Bexar County Elections Department www.bexar.org/1568/Elections-

Department Depression and Bipolar Support Alliance (DBSA) August Meetings www.dbsalliance.org Finding Joy in Simple Things Focus for Life www.myFocus4Life.com

Free Online Computer Classes www.gcfglobal.org This saying has been around for a very long time. In a Harris Center for MH&IDD www.theharriscenter.org world so complicated, how can one find any joy and/ Hearing Voices Network www.hearingvoicesUSA.org or find anything simple to enjoy? This is actually a mindfulness technique and we will explore and Information on national programs and services www.usa.gov/ practice how it works. It is going to be a really fun disability-services meeting!! Medications, Assistance, Discount programs www.needymeds.org Mental Health Self Help Clearinghouse mhselfhelp.org/ Tuesday AUG 3 — North Texas 12:30p—3p National Consumer/Survivor Coalition www.ncmhr.org Friday, AUG 13— Rio Grande Valley 9:30 National Empowerment Center: www.Power2u.org am—noon Patient Assistance with Medications www.phrma.org/ Prosumers website www.TheProsumers.org Saturday, AUG 14 — Houston 12:30p—3p Substance Abuse and Mental Health Services Administration www.SAMHSA.gov Friday, AUG 20 — San Antonio 12:30p—3p

Texas Administrative Code: www.sos.state.tx.us/tac/ Texas Empowerment Initiative www.texasnetwork.org To attend, please go to: Online www.capitol.state.tx.us www.theprosumers.org/ The Center for Health Care Services www.CHCSBC.org The Texas Election Division www.sos.state.tx.us/elections/ September Meetings TX Department of Housing and Community Affairs www.tdhca.state.tx.us TX government departments www.texas.gov Putting Fun Back Into Your Life

Via Hope, www.viahope.org Fun? The world is much too serious to be having fun! Which is exactly why this topic is so important. Kids Universal Important Numbers seem to have fun, at least most do. Then we hit adulthood and fun evaporates into work, responsibilities, and commitments. Come explore Prosumers International – 1-800-577-3795 extension 800 what fun is and how to balance your life by www.theprosumers.org, 6800 Park Ten Blvd, Suite 220-N, intentionally putting fun back in to your life San Antonio, TX 78213 Disability Rights TX 800-252-9108, DisabilityRightsTX.org Tuesday, SEP 7 — North Texas 12:00p—3p

Narcotics Anonymous – (888) 629-6757 Friday, SEP 10 — Rio Grande Valley 9:00 National Suicide Prevention Lifeline 1-800-273-8255 am—noon Texas Health and Human Svc - (877) 787-8999 Texas Youth Hotline 1-800-989-6884 Saturday, SEP 11 —Houston 12:00p—3p

TX Workforce Commission Assist with employment 1- Friday, SEP 17 —San Antonio 12:00p—3p 800-628-5115 www.twc.texas.gov/ Veterans Crisis Line 1-800-273-8255 To attend, please go to: www.theprosumers.org/

Texas Department of State Health Services Consumer Services and Rights Protection Special Thanks to: 1-800-252-8154

Texas Department of Public Safety for Abuse and Neglect 1-800-252-5400

Trans Lifeline 1-877-565-8860

Page 4 Collin County Elected Officials Houston Elected Officials

Senator Angela Paxton - Senate District 8, (972) 908-3424 SENATOR BRANDON CREIGHTON, SENATE DIST 4 Senator Pat Fallon - Senate District 30 (512) 463-0130 Representative Justin Holland - House District 33 409-838-9861 (972) 722-7521 SENATOR CAROL ALVARADO, SENATE DIST 6 713-453-5100 Representative - House District 70 (972) 548- SENATOR PAUL BETTENCOURT, SENATE DIST 7 713-464-0282 7500 SENATOR LARRY TAYLOR, SENATE DIST 11 Representative Matt Shaheen - House District 66 (469) 642-8708 SENATOR BORRIS MILES, SENATE DIST 13 281-261-2360 Representative - House District 67 (972) 908-3358 SENATOR JOHN WHITMIRE, SENATE DIST 15 713-864-8701 Representative - House District 89 (972)423-6542 SENATOR JOAN HUFFMAN, SENATE DIST 17 281-980-3500 SENATOR LOIS KOLKHORST. SENATE DIST 18 512-463-0118 Denton County Elected Officials REPRESENTATIVE , HOUSE DIST 126 281-251-0194 Senator Jane Nelson - Senate District 12 (512) 463-0112 Senator Pat Fallon - Senate District 30 (512) 463-0130 REPRESENTATIVE , HOUSE DIST 127 Representative Justin Holland - House District 33 512-463-0520 Representative Tara Parker - House District 63 (972) 724-8477 REPRESENTATIVE , HOUSE DIST 128 Representative - House District 64 (940) 243-0230 281-420-1588 Representative - House District 106 REPRESENTATIVE , HOUSE DIST 129 (512) 463-0694 281-488-8900 REPRESENTATIVE , HOUSE DIST 130 281-955-5152 San Antonio Elected Officials REPRESENTATIVE , HOUSE DISTRICT 131 713-776-0505 SENATOR Roland Gutierrez, SENATE DIST 19 REPRESENTATIVE Mike Schofield, HOUSE DIST 132 SENATOR JUDITH ZAFFIRINI, SENATE DIST 21 (956) 722-2293 SENATOR DONNA CAMPBELL, SENATE DIST 25 (512) 463-0125 REPRESENTATIVE JIM MURPHY, HOUSE DIST 133 512-463-0514 SENATOR JOSE MENENDEZ, SENATE DIST 26 (210) 733-6604 REPRESENTATIVE Anna Johnson HOUSE DIST 134 REPRESENTATIVE ANDREW S. MURR, HOUSE DIST 53 REPRESENTATIVE , HOUSE DIST 135 (830) 257-0432 281-807-3428 REPRESENTATIVE , HOUSE DIST 73 REPRESENTATIVE JOHN BUCY III, HOUSE DIST 136 (512) 463-0325 512-463-0696 REPRESENTATIVE TREY MARTINEZ-FISCHER HOUSE DIST 116 REPRESENTATIVE , HOUSE DIST 137 713-271-3900 (512) 463-0616, 210-733-8391 REPRESENTATIVE , House DIST 138 REPRESENTATIVE , HOUSE DIST 117 REPRESENTATIVE , HOUSE DIST 139 (210) 923-3638 713-699-3043 REPRESENTATIVE HOUSE DIST 118 (512) 463-0714 REPRESENTATIVE , HOUSE DIST 140 REPRESENTATIVE Elizabeth Campos, HOUSE DIST 119 713-694-8620 REPRESENTATIVE BARBARA GERVIN-HAWKINS, HOUSE DIST 120 (512) 463-0708, 210-822-2534 REPRESENTATIVE , HOUSE DIST 141 713-633-3390 REPRESENTATIVE HOUSE DIST 121 REPRESENTATIVE HAROLD DUTTON, HOUSE DIST 142 (512) 463-0686 REPRESENTATIVE , HOUSE DISTRICT 122 713-692-9193 (210) 402-5402 REPRESENTATIVE , HOUSE DIST 143 REPRESENTATIVE , HOUSE DIST123 (210) 308-9700 713-675-8596 REPRESENTATIVE HOUSE DIST 124 (512) 463-0634 REPRESENTATIVE MARY PEREZ, HOUSE DIST 144 REPRESENTATIVE HOUSE DIST 125 (512) 463-0669 713-740-8153 REPRESENTATIVE , HOUSE DIST 145 512-463-0732 Rio Grande Valley Elected Officials REPRESENTATIVE , HOUSE DIST 146

Senator Juan “Chuy” Hinojosa Senate District 20 713-667-4146 (512) 463-0120 REPRESENTATIVE , HOUSE DIST 147 Senator Eddie Lucio, Jr. Senate District 27 (956) 548-0227 713-520-5355 Representative House District 35 REPRESENTATIVE HOUSE DIST 149 281-988-0212 (956) 580-6944 REPRESENTATIVE , HOUSE DIST 150 Representative Sergio Munoz House District 36 (956) 584- 281-251-4222 8999 Representative House District 40 (956) 383- 0860 Representative “Bobby” Guerra House District 41 To find out who represents you go to: (956) 292-0407 www.fyi.legis.state.tx.us Page 5 Local Numbers

San Antonio Houston

CHCS Crisis Hotline 1-800-316-9241 18th Street Clinic 713-970-6090 2150 W.18th Street HOU 24/7 Crisis Clinic 601 N Frio 210-225-5481 Disability Rights Texas East region office: 1500 McGowen, Suite CHCS Center for Health Care Services 6800 Park Ten Blvd, 100 HOU. Learn more at www.disabilityrightstx.org 713-974-7691 Suite 200-S (Central Office) 210-261-1000 Harris Center ACT Team 713-970-8526 CHCS Adult Mental Health Intake 210-261-1250 Harris Center Helpline 713- 970-7000 24 hrs. (For Crisis Helpline CHCS Children’s Clinic —227 West Drexel 210-261-3500 press 1) 9401 SW Freeway, HOU CHCS Children’s Clinic for Eligibility/Enrollment 6812 Heights Public Library 832-393-1810 Bandera Road Suite 102 210-261-3350 NAMI Greater Houston– National Alliance on Mentally Illness of CHCS Northwest Clinic 5372 Fredericksburg Rd Bldg. F 210 greater Houston 713-970-4419 www.namigreaterhouston.org -261-1600 NAMI Family to Family Support Group Contact Phil or Lesley CHCS Palo Alto Clinic 711 Palo Alto Road 210-261-3200 Blackburn 832-367-4943 CHCS P. Elizondo Clinic 928 W. Commerce Neuropsychiatric Center (NPC) 713-970-7070 1502 Taub Loop DBSA-Depression and Bipolar Support Alliance, 6851 New Start 713-970-8625 6032 Airline, HOU 77076 Citizens Parkway 210-945-0689 Northeast Clinic 713-970-87007200 North Loop East, HOU Fair Housing Council of Greater San Antonio 4414 Northwest Clinic 713-970-8400 3737 Dacoma Rd, HOU Centerview Drive, Suite # 229; 210-733-3247 PE.E.R. House Crisis Peer Respite 713-970-6012 5518 Jackson Hearing Voices—(InsideOutGroup), 2nd/4th Sat 10am 6851 Street HOU Citizens Pkwy [email protected] re:MIND Houston Administration offices: Depressive Bipolar Support NAMI Office 210-734-3349 Alliance 713-600-1131 remindsupport.org Recovery Inc. recoveryinternational.org, Southeast Clinic 713-970-4300 5901 Long Drive, HOU Tues 10 am -12 pm, & Wed, 7:00 PM 210-317-7083 Southwest Clinic 713-970-3800 9401 Southwest Freeway, HOU SAILS – San Antonio Independent Living Services The Bristow Center – PATH 713-970-7413 2627 Caroline St, HOU 1028 S. Alamo Drive 210-281-1878 University of TX Harris County Psychiatric Center 713-714-6020 San Antonio Clubhouse 6851 Citizens Parkway, Suite 100 2800 South MacGregor Way, HOU 210-798-1619 San Antonio Gender Association at Metropolitan Community Church, 611 E Myrtle 210-472-3597 Rio Grande Valley www.sagender.net 1st & 3rd Thursdays 6:30p—9 pm VIA Metro Center 1021 San Pedro 210-362-2020 Abundant Grace Counseling Center: 956-381-0622 American Red Cross: 956-423-0523 Catholic Charities Rio Grande Valley: 956-702-4088 Collin County Cash Medical Clinic: 956-668-8813 Children’s Advocacy Center: 956-287-9754 Adapt Mobil Crisis Line LifePath McKinney Out- Crisis/Suicide Hotline: (877) 422-5939 866-260-8000 patient Clinic 972-562-9647 Crisis Text line Text hello to 741741 Al-Anon 214-363-0461 LifePath Plano Outpatient Alcoholics Anonymous Family Crisis Center: 1-866-423-9304 Clinic 972-422-5939 Hidalgo County District Attorney office: 956-292-7600 972-867-1115 LifePath complaints/ Allen Community Outreach concerns 972-372-0321 Hope Family Health Center (Medical and Counseling 972-727-9131 McKinney Housing Services: 956-994-3319 Assistance Center of Collin 972-542-5641 Hope Peer Support Warmline: 844-755-HOPE County 972-422-1850 Medicaid Transportation TX A&M Dentistry Mujeres Unidas: 956-630-4878 877-633-8747 Palmer Drug Abuse Program: 956-687-7714 214-828-8100 N. Central TX Workforce Children’s Advocacy Center Solutions 888-548-WORK Rio Grande Food Bank: 956-682-8101 972-633-6600 NEXUS 214-321-0156 Salvation Army: 956-682-1468 Collin County Indigent Health North Tx Behavioral Health South Texas Civil Rights Projects: 956-787-8171 Office 972-548-4702 Authority 214-366-9407 Texas Rio Grande Legal Aid: 956-393-6200 Collin County Veteran Services North TX Food Bank TX Tropical Behavioral Health Hotline: 1-877-289-7199 972-881-3060 214-269-0907 Dallas Housing 214-951-8300 Plano Housing 972-423-4928 DART 241-979-1111 Plano Workforce Center Food Stamps SNAP 211 469-229-0099 Green Oaks Hospital Salvation Army McKinney 972-770-0818 972-542-6694 Denton Homeward Bound 214-941-3500 Salvation Army Plano Hope’s Door Plano Crisis Line 972-423-8254 Denton Outpatient Clinic 940-381-5000 972-276-0057 Samaritan Inn 972-542-5302 Flower Mound Outpatient Center 214-488-0121 Jewish Family Services Social Security Office McKinney Outpatient Clinic 940-891-0970 972-437-9950 McKinney 866-931-2731 Morse Street Clinic 940-381-5000 Julia’s Center for Healthcare TAPS (Collin County) Psychiatric Triage Clinic 940-381-9965 972-535-5099 844-603-6048 The Center for Integrated Health 972-556-5836 Legal Aid of Northwest Texas Turtle Creek 214-871-2483 Denton County Crisis Residential Center 940-381-5000 800-906-3045 Watermark Urgent Care Lifepath Crisis/Suicide Hotline 972-972-8930 877-422-5939 Page 6 Global Psychiatry’s Crisis of Values: Dainius Pūras, MD Part 2 In this installment of Conversations in Critical Psychiatry, a former United Nations Special Rapporteur discusses the need for a change in the status quo of mental health care.

Editors Note: This will be a multi part series so you can get the full Aftab: Your 2017 report to the UN Human Rights Council1 provoked a conversation. This is continued from last month. rather spirited debate in academic journals such as the Australian & New Zealand Journal of Psychiatry, where you were accused of having Aftab: You have experience of living and working as a psychiatrist in an anti-psychiatry bias.2-4 Defending this characterization, one of the the Soviet Union. What are your observations regarding how the remarks by Dharmawardene and Menkes was as follows: “Scientific trajectories of psychiatry as a medical profession have been medicine progresses in the context of robust debate, and legitimate influenced by communism and capitalism in the East and the West criticism of psychiatry is welcome; science is about evidence and respectively? evolving utility… By contrast, anti-psychiatry discredits biomedicine’s Puras: To try to make a long story short, in the West, colonialism role in mental health as a matter of principle and in so doing privileges and capitalism led to burgeoning inequalities and poverty. This values-based policy over scientific evidence.”5 systemic violation of economic and social rights has had a negative, I do not think there is much value in debating the charges of anti- wide-spread impact on mental health and well-being, leading to psychiatry. I fear some of our colleagues are too trigger-happy when it medicalization and criminalization of social issues. On the other side comes to such accusations. However, what are your thoughts on the of the wall, Soviet-style socialism turned into a totalitarian system, relationship between values-based policy and scientific evidence? Do with attempts to make individuals equal by force, at the expense of you think one has a more privileged role than the other? political and civil rights, destroying any space for civil society and Pūras: The most worrying feature of psychiatry is that the leadership, private initiative. That kind of social experiment had a very under influence of hard-liners, tends to label those experts who blow the detrimental impact on individual and societal mental health, with long whistle and critically address the status quo as anti-psychiatrists. We -lasting effects. Even after peaceful revolutions and arrival of know from many painful chapters in the history of psychiatry and democracy in Central and Eastern Europe (CEE), this region with medicine what happens with discoveries in biomedicine when they are 400 million individuals still suffers. The region has very high rates of disconnected from values and undermine human rights. They can suicide and other forms of external forms of premature deaths, and become dangerous and harmful. And if influential psychiatrists continue they can be explained as reactions to prolonged societal stress, and to repeat that values are not a priority in mental healthcare, we should a consequence of the population’s lack of control over its own life not be surprised that global mental health and global psychiatry is and health under totalitarian rule. Soviet mental health care was facing a crisis, which to a large extent is a moral crisis, or a crisis of extremely reductionistic and brutally misused biological psychiatry, values. with almost no effective psychosocial interventions. Advances in medicine, including psychiatry, are based on 2 modern But what happened when the wall collapsed and borders finally concepts. These concepts, are, in my view, the best of what humankind were opened? While many of us in the East expected that the has achieved. The first is evidence-based medicine, and this is about development of public health and psychosocial interventions would relying on the scientific method. Just to clarify, that evidence comes now be supported by Western partners, things developed in a very from many sciences, including social sciences. Many of the social different way. Many consultants, including famous Western sciences are telling us that the status quo in global mental health is not psychiatrists, came and informed politicians and psychiatrists in this necessarily based on evidence. For example, the use of involuntary region, often with the support of the pharmaceutical industry, that the measures to address issues of dangerousness and medical necessity— only effective way to address epidemics of suicide and other mental evidence tells that this may do more harm than good. health related issues was to invest in psychotropic medications. This The second powerful concept is that of the human rights-based coincided with a paradigm shift in Western psychiatry, the move from approach. The human rights approach protects medicine, including psychoanalysis to the Prozac era. Sadly, this resulted in second psychiatry, from doing harm. We should not forget many sad episodes massive wave of medicalization of mental health care in the CEE in the history of psychiatry, and they often happened because values region. were undermined in the name of dubious or arbitrary evidence. The Even after 30 years, effects of this systemic mistake are in human rights and scientific approaches complement each other. But place. The mental health systems in this region continue to suffer evidence, as we know from history of psychiatry, may be fragile and from institutionalization, social exclusion, and overmedicalization. biased, or produced in dishonest way and questioned later. And this is Reforms are often effectively blocked by the prevailing idea that why human rights serve as a powerful guardrail. mental health care is about fixing mental illnesses with biomedical It is not a coincidence, I think, that psychiatry is more sensitive to interventions. This is what happens when we try to use brain human rights in some countries than in others. I will give the example of chemistry to manage societies undergoing difficult and complicated Germany. The most mature dialogue I had as a Special Rapporteur on transitions. mental health and human rights was with leaders of German psychiatry. Lithuania, the country in which I live and work, is not unique. In They initiated a meeting with me during the World Congress of the region of CEE, many countries have similar legacies and Psychiatry in Berlin, 2018, and then they organized a very important scenarios. Sadly, in many instances academic psychiatry has meeting in Berlin in 2019, inviting the president of European Psychiatric become too reliant on the status quo and is reluctant to transform Association (EPA), Silvana Galderisi, PhD, MD, and me as speakers. (It mental health services. Civil society organizations have been the real is relevant here to note that the EPA’s response to my 2017 report was leaders. very critical.) This meeting was attended by a large group of important Since 2018 I have been working as director of the Human Rights figures in German psychiatry. It was good to see a genuine desire to Monitoring Institute (HRMI), one of Lithuania’s human rights civil move towards a radical reduction of coercion, and a desire to society organizations, which holds authorities accountable for understand the seriousness of concerns that I was raising about human respecting, protecting, and fulfilling their civil, political, economic, rights violations in psychiatry around the globe. In many other countries, social, and cultural rights obligations. The regions of Central/Eastern leadership avoids hard discussions of mental health and human rights. I Europe and Central Asia have unique histories and realizing mental suspect that psychiatrists in Germany are more aware of their history health rights here is part of the broader transition to democracy. The and what may happen when supposedly scientific evidence is legacy of authoritarianism persists in our democratic institutions and disconnected from values. is perhaps most visible in our mental healthcare systems, which rely To conclude, I am convinced that psychiatry’s moral and scientific upon exclusion and institutionalization, with reductionist future depends on taking values as seriously as scientific evidence, and biomedicalization being a common, but ineffective, solution. In my this future may be quite bright if human rights are fully embraced. former role as the UN Special Rapporteur and in my current work Next month Part 3 with the HRMI, I am happy to strengthen the network of experts and organizations who are willing to abandon the legacy of discrimination *Note: The UN Report referred to in this article can be found as a and move towards fully embracing mental health care as a human resource on the Prosumer’s webpage—Resources. right.

Page 7 Vaccine Access for Everyone Hearing Voices Network Is Now Hosting Online Groups Announcing Disability Rights Texas New Vaccine Hotline

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Page 8 I live the life I love!!