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Recovery and re-entry

In many communities, nearly every child has a parent or close relative who has been incarcerated. How can we lessen the impact of this trauma? There’s no easy way forward. In some institutions it’s almost impossible for security reasons to send a child’s letters, pictures, and art to an incarcerated parent. And once a parent returns home, new obstacles to rebuilding family relationships emerge. Can childcare centers use parents with criminal records as staff or program volunteers? In your state, can parents help coach baseball if they have a felony conviction? Can you have a school picnic and invite known felons? What is the minimum level of screening and precaution we must support? What safety policies make sense when family reunification is the whole point? Meanwhile, the returning...

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Recovery is a process, not a thing

Let’s get recovery right. Recovery is a process, not a thing. A process (like learning), not a thing (like a diploma). Recovery is experienced, like jumping in a pool is experienced, like driving a car is experienced, like washing your face is experienced, like hanging out with friends or praying is experienced. Recovery is the experience of  making decisions, learning from successes and mistakes, asserting control, making progress. Living meaningfully. In the world of sobriety, recovery is doing what it takes to  avoid that next drink. In the world of mental health, recovery is coming to terms with the world, finding strengths,  figuring out what helps, confronting limitations, handling risks. If recovery were a thing, clinical systems could be optimized to deliver it....

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Stand your social distance or I’ll shoot

It’s the subjective element of Stand Your Ground laws that makes them come out racist. Any self-defense case involves a tragedy – but when convictions turn on the killer’s subjective impression of who is threatening, the people who get killed are more likely to belong to racial minorities and other out-groups, including people with disabilities. Human encounters are affected by social distance, a measure of relatedness, a bundle of concepts ranging from familiar, approved, trustworthy and safe, to strange, different, suspicious and unsafe. People are said to be closest to those they trust and know best, typically those who are most like them. Social distance can be seen today playing out in a benign fashion in restaurants, stadiums and other public spaces. More people gather in same-group...

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The 33 losses of modern psychiatry

What a portrait of modern psychiatry in today’s New York Times. Psychiatrists are abandoning 45-minute therapy practice for 40 brief encounters a day. Mechanized medicine. No therapy, because the system won’t pay. The featured doctor’s wife,  a licensed social worker, gave up her own therapy practice to become the full-time office manager and copay enforcer in her husband’s practice. Here’s a list of what modern psychiatry has given up, and what a sad thing it has become, as described in the course of the article. 1. No therapy. “Hold it. I’m not your therapist.” 2. No long appointments. 3. Less intimacy 4. Less familiarity 5. Can't know patients by name 6. Lowered goals of treatment. It used to be patients leaving “happy and fulfilled” 7....

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Is it Kendra’s Law, or better care, that helps people get better?

I recognize there is a place within our society for very limited, highly regulated use of mandated mental health treatment. On the other hand, I have difficulty supporting the rhetoric of involuntary treatment advocacy. Too often, what I hear or read combines a wishful longing for a quick fix with a desire to control “those people.” The emotional content around involuntary treatment is downright raw. Advocates speak eloquently about tragedies that occur when systems fail to act. But if humanity’s history of abuse of people with mental illness isn’t reason enough for caution, there is no shortage of counter-testimonials about how forced treatment can be horrific, whether it happens within or outside of a hospital. Fortunately, with sympathy...

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The Health Foundation of Greater Cincinnati considers its legacy

I have an engraved paperweight from the Health Foundation of Greater Cincinnati, a small token for connecting Catholic Social Services with this philanthropy. It commemorates a puny little grant of $6000, one of the first times our local bishop let the agency accept money with strings attached. My little prize is dated 1999, the first year of the Foundation’s Substance Use Disorder and Severe Mental Illness in the Criminal Justice Initiative.  From 1999 through 2008, this $12 million initiative funded ACT teams, jail diversion initiatives, mental health courts, crisis intervention teams and other efforts targeting the intersection of criminal justice and behavioral health disorders. The report that kicked off the project is still available...

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