It’s amazing the contortions we go through to prove our worth when under threat of budget cuts.
The Western Mass Recovery Learning Community (along with the five other RLCs across the state of Massachusetts) remains in jeopardy of a 50% slash to our budget that would go into effect July 1, 2015 should it come to pass. As noted in my previous post (Peer Supports Under Siege), the proposed reduction was introduced by Governor Charlie Baker in early March. However, there are many hoops to jump through and so we’ll remain in budget limbo for some time to come while the House and Senate draw up their own recommendations and then everyone comes together to make a final call.
Of course, we wouldn’t be the Western Mass RLC if we just stood idly by and waited. Instead, we’ve been talking to Representatives and Senators every chance we get. Representative Paul Mark had a powerful visit with people at our Greenfield Center a couple of weeks back. Representative Aaron Vega will visit our Holyoke Center on Monday, April 13 at approximately the same time that Representative Tricia Farley-Bouvier and Senator Ben Downing (and hopefully others!) will be headed to visit with our Pittsfield-based community. Meanwhile, we’re in process of scheduling a visit to our Springfield Center with Representative Carlos Gonzalez. We took part in a rally at the State House on April 1. We’ve distributed two press releases, spoken to several reporters and have been successful in getting multiple articles published (Recovery Learning Communities Head to State House; Advocates for Western Mass Mental Health Program Protest Proposed Budget Cuts; Greenfield Mental Health Outreach Program Threatened by Statewide Cut) .
People want to know what supports we offer, where we’re based, and all the usual stuff. Some – most, even – are satisfied with that. But, others also want to know the answer to questions that just aren’t so easy to answer in any real way. They’re asking questions like:
Are the supports we offer ‘evidence based?’
How much money are we saving?
Where’s the evidence we’re effective?
Evidence Based?: So, yes, ‘peer-to-peer supports’ are considered to be evidence based, and given that RLCs are, at their roots, all about peer-to-peer supports, I guess that makes us ‘evidence based,’ too… at least by association. Really, there are tons of studies out there (see http://psresources.info/the-evidence) suggesting the positive impact of this type of work, but if I’m honest, I question the integrity of some of the peer supports being studied.
And what is ‘evidence based,’ really? I’m not sure it amounts to much more than a group of people who have enough money to pay researchers to interpret data (generally in their favor). That’s not to say that there is no value in research, but there is tons of privilege in being able to fund the process. So, as one might imagine, it’s the big, mainstream efforts that most commonly tend to achieve the grandest ‘evidenced based’ glory.
There’s another issue with ‘evidence based,’ and that’s the process by which much research is done. People who have been psychiatrically labeled have historically been taken advantage of by researchers in a myriad of ways. They’ve been ill informed of risks, and sometimes not given any real choice at all. At times, their desperation for help has been preyed upon.
Even more commonly, research methodology has been invasive which can break trust and accessibility of supports in a heartbeat. As such, the RLC has typically steered clear. We’ve prioritized the work and the people over the cost and status of evidence-based proof. So, all we can really do is extrapolate from research results performed in other peer-to-peer environments and the voluntary, survey-based feedback we have sought only after someone has received support and never in the heat of a ‘crisis’ situation. (Though, in fairness, I should say that some of those voluntary, survey-based feedback processes have garnered some pretty impressive results.)
Cost Savings?: “How much money are we saving?” is, of course, the eternal (and infernal) question around every corner. However, I recall one particularly wise man at a conference in New Orleans last November pointing out that it may not be the best idea to set cost savings as the most important goal of all. He was concerned it set a bad precedent of forever equating the best care with the lowest cost. One has to wonder where that ends, since costs can only be reduced so low, and perhaps it may just be okay to get good with investing real money in our humanity and well being?
The truth is the RLC does save money. All signs (and a voluntary, survey-based study conducted by UMASS Medical) point to our supporting people to stay out of the hospital and get more invested in community and there’s just no way that doesn’t bring all sorts of savings (both monetary and otherwise) to bear. But can we prove it with in depth, double blind, statistically relevant, replicated studies? And, more importantly, can we prove the costs we’ve saved by contributing to people never landing in system—based services in the first place? (Something I wholeheartedly believe that we accomplish on a regular basis.) Not so much.
Show Me the Evidence: That brings me to the last question: Where is the evidence that the RLC is effective? (That’s kind of like ‘Where’s the beef’ for those of you who can remember back that far.) Well, it’s with the people, silly!
In 2012, during the process of finishing up our first RLC film, ‘Beyond the Medical Model,’ I got some invaluable advice from Gail Hornstein (Professor of Psychology at Mount Holyoke College) that I hope I never forget. We’d used the term (since removed) ‘anecdotal evidence’ in the film in reference to people’s stories, and she essentially advised us to give up that term for good. She pointed out that people’s stories ARE evidence. They’re different, but not lesser (and often better) than quantitative analysis. She suggested we stop downgrading the proof in people’s stories by referring to them as ‘anecdotal.’ She was right, and so we did.
The truth is that when you’re not obsessing over numbers, documentation and accumulating ‘evidence,’ you have the time to build real relationships and trust. And, when you build real relationships and trust, then people will tend to give of their stories pretty freely when the opportunity arises. No complex scientific process required.
It’s amazing the contortions we find ourselves going through to prove our worth when threatened with budget cuts… even though the evidence has been right there in front of us all along. We can argue numbers and scientific interpretations all day and night, but it’s hard to argue with evidence like someone straight up saying, ‘The RLC saved my life.” It’s even harder when there’s many someones all saying the same thing.
Please take a few minutes (okay, 8, to be exact) to check out (and share!) this short RLC video produced by our very own Evan Goodchild (with contributions from many in our community).
The RLC saves lives. How do we know? Just watch. (And after you’ve watched, please don’t forget to contact Massachusetts legislators to advocate for our survival!)