Editor’s Note: Sera Davidow is executive director of Wildflower Alliance, which opened a peer-run respite center, Afiya House, in 2012. The Wildflower Alliance wrote a letter of support for Stabbin Wagon’s application for a grant from the Oregon Health Authority to create a peer-run center in Southern Oregon. Stabbin Wagon’s proposed budget included $7500 for a 24-hour training of peer workers by the Wildflower Alliance. She writes about Stabbin Wagon in this blog.
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Peer respite has gained a fair amount of ground since its start. With now over three dozen peer respites across the country, the numbers still fall far short of where they should be, but are nonetheless headed in a promising direction… if the integrity of the model has and can be maintained. But, that’s a big ‘if,’ and recent bumps in Connecticut and other states serve to reveal just how challenging keeping an alternative approach actually alternative can be. Oregon is one prominent example of how things can go awry, even when they seem to start off on the right foot.
Who Are Our Lions?
The mission of a peer respite is to provide a non-clinical, alternative to landing on an inpatient psychiatric unit or other more invasive and harmful environment when someone is in emotional distress or otherwise perceived to be at risk due to extreme mental states and similar. These spaces provide a homelike place to stay (typically somewhere between five nights and two weeks depending on the particular respite) where everyone there (both working and staying) has faced life-interrupting challenges of a similar nature. The opportunities to rest, be heard, build community, make meaning, and turn “crisis” into a learning opportunity are all consistently available.
In 1978, Jennie Fulgham dreamed into existence a place called the Zuni Federation for
Mental Health in Virginia. As a former “mental patient” who had been negatively impacted by her experience in the psychiatric system, she wanted to offer something different. So, she took some property she had, and built a sort of retreat for other folks with psychiatric histories. It was an alternative to landing on an inpatient unit, and an early start of sorts to the peer respite model. Jennie not only had a psychiatric history herself, but she was also a Black woman in a nation where Black people had gained the right to vote barely a decade earlier, and women had been afforded the right to have a loan in their own names only four years before. Her accomplishment was impressive, yet her story is barely known, lifted up primarily by Vanessa Jackson’s “In Our Own Voice,” and more recently, the Black Movement Leaders project. There are likely lots of lost stories of marginalized people creating their own supports much like Jennie, but as Chinua Achebe wrote, “Until the lions have their own historians, the history of the hunt will always glorify the hunter.”
If we look at the more official history of peer respite, the model didn’t really get rolling until the late 1990s with Stepping Stone as developed by Shery Mead and company, and informed by the research of Jeanne Dumont and the not-quite-peer-respite Crisis Hostel in Ithaca, New York. Further steam was gained as supporting research from movement leaders such as Laysha Ostrow began to accumulate. Governmental systems (for better or worse) like the Substance Abuse and Mental Health Services Administration (SAMHSA) began to take notice in the 2000s (even lending some research-motivated funding). And, in 2021, the World Health Organization (WHO) recognized Afiya Peer Respite (Massachusetts) as one of about two dozen international exemplary rights-based alternative crisis response models.
Not long before that point, it was also folks working with Afiya and the organization to which it is connected (the Wildflower Alliance [formerly known as the Western Mass Recovery Learning Community]) who produced one of the first short films that sought to define what peer respite is, along with the first comprehensive Peer Respite Handbook (in collaboration with Intentional Peer Support Central) that centered the values and integrity of the model. And it was that same handbook that the Oregon Health Authority (OHA) wrote into their Request for Proposals (RFP) as an essential guide to implementation when they geared up to fund four peer respites in their state.
Off to an Impressive Start
Only about a dozen states have peer respite at all, and most that do started small. But, community advocates in Oregon got off to an impressive start, and state officials more or less followed suit at various advocates’ persistent urging. In both parallel and intersecting processes, they each consulted with other regions, collected sample documents, and made big plans for how to move forward. Ultimately, the intent would be to fund four peer respites across the state, including the first culturally specific peer respite in the nation.
Perhaps what is most unusual and most admirable about how this all played out is that OHA not only wrote their RFP with apparent intention to support the integrity of the peer respite model, but also appeared to ‘walk the walk’ of all their talk, and actually awarded the grants to smaller, more radical, grassroots, peer-led initiatives.
Most notably, they successfully awarded three of four intended contracts, with one going to Black Mental Health Oregon (also to fill the “culturally specific” slot) and another to Stabbin’ Wagon, a harm-reduction group based in the Southern part of the state. (Project ABLE—a more established, well-funded, and conventional peer-to-peer training and support organization—was the third grant recipient, and a fourth grant recipient has also just recently been added.) Black Mental Health offers the following statement about their mission:
Black Mental Health Oregon is a non-profit organization whose mission is to be a mental health resource for our African American or of African descent communities. We aim to be a liaison between the consumer and the provider and to provide ethnocultural effective services, such as educational training and community classes. Our mission is to give our community and our families the much needed mental health support they deserve in order to create wellness. We are devoted to building morale in communities of color and to no longer just survive, but thrive.
Meanwhile, Stabbin’ Wagon is described as follows:
Stabbin’ Wagon operates under ethical best practices for harm reduction, and uses evidence-based solutions to reduce the transmission of disease, prevent overdose deaths, and improve the health & well-being of the community we serve. Our values are rooted in abolition, autonomy and self-determination. We are committed to fighting stigma, and ending the racist and classist war on drugs.
Both appear to be exactly the sort of organization who should have their hands deep in the creation of community-based crisis alternatives. It’s also worth noting that they each have further demonstrated their commitment to doing this right by reaching out to the National Empowerment Center’s (NEC) peer-led technical assistance support and/or to Wildflower Alliance to establish relationships for future guidance. Meanwhile, Stabbin’ Wagon employs a former employee of Afiya Peer Respite and received the highest ratings of all peer respite proposals received by the state. Who could be more ready to go, at least from a philosophical standpoint?
Oregon’s willingness to take risks on smaller organizations who were able to submit highly rated proposals demonstrating deep understanding of and commitment to the model was exactly what they should have done. In fact, they were off to a better start than almost every other state that has ventured down this road so far.
But, things began to backslide from there…
Ready, Set… HOLD UP!
Supporting small and historically under-resourced organizations run by people from marginalized communities is the right thing to do. In fact, doing so is a critical anti-oppressive step that challenges systems otherwise set up to privilege the already privileged. When it comes to peer respite work that so clearly centers seeking to heal the harmful impacts of oppressive systems on the people it supports, the importance of a move like this is even greater.
However, simply offering such groups a contract without also considering how to properly support them to grow can be a setup for failure that has the converse effect of making the already more established spots seem like the only viable option. Robust technical support should have been a part of the design in Oregon, but it was not. Patience for organizations to move a bit more slowly (if needed) to get things on track should have been a given, especially when lifting up a respite plan for people who’ve faced compounded oppressions (both psychiatric and race-related).
In a society where rushing is a well-known maintainer of white supremacist systems (for all the marginalized voices that the rush leaves out or incapacitates), Oregon’s peer respite rollout has seemed destined for problems. This was only reinforced by the fact that the state itself was given the luxury of delays its well-established systems shouldn’t have needed, sometimes forcing invested parties on the grant recipient end to need to move on to other pursuits for their own financial survival.
Indeed, as time has passed, paperwork inconsistencies, struggles with overall administrative organization, and even radical groups continuing to be radical (as if they’re supposed to suddenly take it down a few notches and change who they are in the name of retaining a state contract) have been allowed to rise to the surface as reasons to put the whole thing on pause. Meanwhile, the focus of questions to the OHA has been on who they decided to fund rather than how they have supported them to get up and running.
What has transpired in Oregon is not necessarily because the people or groups involved are in any way less capable, creative, intelligent, or able to pull the vision off. With marginalization comes less resources, less prior access to leadership and other development opportunities, less ability to shuffle funds around and retain good people while waiting out contract delays, and a much higher degree of scrutiny and onlookers waiting for signs of failure upon which they can pounce. In the absence of support, many grassroots start-ups just won’t be able to survive all that is stacked against them. And, funders headed down the path of supporting the “little guy” with integrity will themselves need some bolstering in order to tolerate community pushback and some of the messiness that will inevitably ensue. As much as this sort of change is needed, it doesn’t come easy or without real discomfort along the way.
Unfortunately, it would seem that OHA either didn’t consider these points, or romanticized what the process might be like and the tenacity that would be needed to navigate challenges and still push through to a fully realized vision. Maybe they thought they’d be congratulated for their progressive decisions (as they do actually deserve to be) without having fully thought out all that would be involved in making it actually work. Whatever the case may be, at least one contract (Black Mental Health) is now on hold with hints that it might be at risk for being pulled altogether, and another (Stabbin’ Wagon) appears at risk, too.
The Lund Report: So Much for the Underdog
Media coverage can sometimes make or break a group like Black Mental Health or Stabbin’ Wagon that doesn’t yet have a widespread, well-established, and balanced identity in the public eye. They can be responsible for building a place up or tearing it down, motivated by any number of interests. Even the outlets that claim to have the most admirable values and steadfast integrity can behave in oppressive ways and do damage they might not even understand. Enter the Lund Report.
The Lund Report was founded in 2008 by Diane Lund-Muzikant. As a small, non-profit, Oregon-based media source, they make claims such as not being “intimidated by powerful special interest groups” and producing stories that reveal “profit-driven practices among nonprofit health care entities, corporate fraud, the checkered pasts of bureaucrats, and bloated bonuses and salaries.” They’re a very small outfit professing only a little over $100,000 in assets according to Guidestar, and a relatively small audience with only about 1400 followers on Facebook, and around 2700 on (what at least used to be) Twitter. Yet, they nonetheless seem to be a powerful influence in Oregon healthcare, claiming such victories as prompting the state to rescind its policy to deny medical coverage for certain procedures for children, among other successes.
Over the last few years, they’ve turned their attention to peer respite. And particularly in the last two months, they’ve written stories contributing heavily to negative views of both Black Mental Health and Stabbin’ Wagon, particularly in relationship to the contracts that they were awarded (including one piece specifically on the contract that now seems to be on hold). So much for pointing the public gaze toward corrupt systems rooted in capitalistic interests.
In 2002, the Boston Globe’s Spotlight team worked to expose corruption and sexual abuse in the Catholic church. They were responsible for challenging the very powerful church system in the name of protecting vulnerable kids, all leading to the issue of sexual abuse of children by members of the Catholic clergy landing squarely in the public eye. Yet, in 2016, the very same team failed dramatically at putting even a modicum of effort into uncovering the truths of the mental health system in their oppressive “Spotlight on Mental Health Series,” instead zeroing in on another vulnerable community—those with psychiatric histories—as the ones to be exposed. The Lund Report has apparently followed suit by focusing on these organizations as “the problem” and further questioning their role as grant recipients, rather than centering scrutiny on the lack of support offered by historically oppressive systems and why that sort of support is necessary to achieve equity. These actions are in direct contradiction to their stated mission and aims.
Another compelling twist in this story and Lund’s coverage of it is that the media group has spent a much more in-line-with-their-mission bunch of time exposing problems at OHA itself. They’ve published articles quoting former OHA Director James Schroeder (who resigned his post not long after taking it on earlier this year) referring to OHA as a “toxic place,” as well as another piece on the resignation of an OHA Program Manager, Angela Carter, who referred to OHA as “maliciously negligent” on their way out the door.
Yet, the underlying read-between-the-lines message of the two separate-but-connected-narratives at least appears to be that OHA needs to make some serious changes to how they do business, while Black Mental Health and Stabbin’ Wagon should simply be disappeared. This disparity in assumptions about how each situation should be handled (the well-established, well-funded one should make changes while the grassroots “new kid on the block” should be excluded) is precisely what keeps us locked into corrupt systems with leaders too often driven by motives other than the actual mission of the work.
The problem doesn’t stop with the slant of Lund’s coverage. Lund is one of those organizations that stakes their reputation on their integrity. They also make various claims about transparency related to conflicts of interest on their About Us page, and much of that seems historically valid. However, some of the most damning quotes in their peer respite articles come from one particular source that is especially problematic for a few different reasons.
These comments are particularly damning because that source is a relatively prominent member of the peer support community who was instrumental in advocating for peer respites in Oregon in the first place. Yet here he is in Lund, questioning the competency of the aforementioned organizations to carry out their contracts. This sort of infighting and accusations within the confines of a marginalized community is not exactly unusual, but most know it is especially bad practice to do this in a way that contributes to continued marginalization in public view (that is, essentially making the oppressor’s argument for them). Responsibility for this piece of the problem is on that individual more than Lund, but what does fall on Lund’s head is that they fail to mention that this particular source is also a member of their four-person Editorial Advisory Board. In fact, a quick search reveals that same individual has been quoted in over 30 Lund Report articles.
When it comes to common components of systemic oppression, it would seem that Lund is guilty of perpetuating at least two:
- Blaming marginalized groups for the problems created by oppressive systems; and
- Behaving as if one member of a marginalized group (especially one that has interests in the publication that’s quoiting them) is able to appropriately represent that entire community’s voice
Trying and Backing Down Is Worse Than Not Having Tried in the First Place
Fair or not, every time a disruption of this nature happens with an alternative model that is inherently fragile for the fact that it runs counter to the status quo, the implications of how things play out bear relevance to far more than just the local or statewide community in which the controversy is taking place.
Increasingly, people from around the country are already taking notice. When asked for comment about the situation in Oregon, Oryx Cohen, Chief Executive Officer of the NEC, had this to say:
“As an organization that has supported the development of Peer Respites for years, we at the NEC are watching from a national level at what is happening in Oregon with keen interest and honestly disappointment. Given the opportunity we would love to do more than watch, we would love be able to be an organization that joins others in supporting these grassroots, underserved community organizations to be successful and to provide these much needed supports in the community. Instead of attacking these already oppressed organizations and communities, we should be lending a hand.”
Oryx speaks not only from an organizational perspective, but also his own. Approximately 10 years ago during a particularly difficult time, he himself stayed at Afiya Peer Respite (an experience he shared in the award-winning documentary, Healing Voices).
If Oregon backs down from supporting either Black Mental Health or Stabbin’ Wagon to carry these contracts forward (and especially if they back down from both), it could do serious damage to the future of peer respite contracting both within Oregon’s borders and beyond. Most public systems are well known for their reactivity, and creating new policies or practices based on “what went wrong that one time way back when.” Worse, states looking to newly dip their toes into the peer respite waters are also quite likely to survey how things have played out in other regions, and look to Oregon for insight. For some, that might just be one story to consider among several. However, in instances where those others are inclined to take steps to appear progressive without truly understanding or being invested in what that means (which is more often the case than not), a story like this might be just the back-up they need to justify starting at conservative and failing to hold fidelity to the model at all.
That said, this shouldn’t be heard as a message to just not bother trying. Rather, it’s a plea to those in power to more fully consider the gravity and far-reaching nature of their decisions. If they’re so shortsighted or invested in other interests as to not care about that, then nothing that can be said will change them, but some just don’t seem to realize the far reach of the choices they make.
The Bottom Line
Peer respites aren’t the “end-all be-all.” Dropping a peer respite into an area with otherwise mostly conventional clinical options won’t solve any of the vast problems that currently exist within the mental health system. They are but only one thread in a tapestry of alternatives that are needed.
However, they are an important thread that has made real difference in the lives of many people. Peer respites are a precious resource that deserve protection, and implementation that prioritizes the full vision of the model and prevents co-optation (taking something real and mimicking it in name and languaging without carrying forward its core parts). That means taking risks on groups that make people uncomfortable with their “radical” ideas, or tolerating the very real fact that being underfunded and stretched too thin (as is the norm among small organizations trying to gain traction) leads to administrative weaknesses that might not be present in places that have whole departments to manage (or cover up) what’s going on.
It also means having tolerance for when things don’t work out without scrapping the whole plan or writing off the places that need extra support to navigate real growing pains in order to be ready. It even means that should it come to the point of it truly not working out for one organization, that no assumptions are made about a whole category of people, and that we don’t automatically revert to preferencing the big box shops.
Undoubtedly, it is foolish to expect conventional organizations and the systems that keep their cogs turning to care about anti-oppression principles. But foolish dreaming sometimes forms the underpinnings of real change, and so it’s further worth naming or reiterating the following points, too:
Change doesn’t happen without real risk. Change doesn’t happen smoothly or without tolerance for mess. Blaming groups with the least power for the problems created by those with the most power only further entrenches the problems at hand. Choosing grassroots organizations made up of people with under- and unrepresented voices who really “get it” is the right move to make. And most importantly, communities who’ve experienced compounded oppressions may need compounded supports to have an equitable opportunity for success.
Oregon, the national peer respite scene is watching. Please hold steady on the path upon which you first set foot, adjust what truly needs adjusting, and do right by us all.
Well researched and written. Thank you for the better understanding of peer respite and what is happening in my home state.
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Thanks for taking the time to read and comment, Sharee! 🙂
-Sera
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Thank you so much for this nuanced and thoughtfully researched piece. I wholeheartedly agree that grassroots, community led orgs are ideal for peer run respite programs, and deserve the resources, time, and technical assistance to develop peer respite programs. In Wisconsin it’s often taken years for programs to build a solid foundation of the finding the right house, program development, and staff training (this was the case even for long-established peer run organizations). I hope a way forward can be found so that the original grant recipients can have the time, flexibility, and resources to create successful peer respite programs.
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Thanks, Vic! Yes, I so wish people had a much better understanding of what it takes to really support groups to develop and create more equity in a system that has so often been about save dollars and rush, rush, rush particularly where there’s historical marginalizations at play!
Thanks for your comment!
Sera
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This article documents a complex set of issues no one person can tease apart perfectly. I am a supporter of Oregon’s efforts since first learning about Kevin Fitts’ hard labor to get a bill passed in the legislature to establish peer respites in OR. I followed nearly every step of that process, and even provided helpful language when I was invited to. This important part of the history was not mentioned in the article but it was an example to peer groups, especially in Washington state. WA’s peer respites were included in systemic legislation and while the map in this article doesn’t indicate it, WA has three peer respites of various types. Serving on the Lund Report’s editorial advisory board should be considered a benefit for peer voices who are often excluded from positions like this. I would have gently suggested the Report indicate the relationship in articles but beyond that there can’t be anything considered sinister. In this case, I know that Kevin has worked long and hard to have a seat at the table and he has been publicly recognized. We have done each other a massive disservice in our movement by chipping away at successes or targeting failures for the masses to point fingers. I get the sense that OR peers would welcome technical assistance from Afiya founders and others. I visited Jeanne Dumont’s program decades ago and was filled with hope. I appreciate that Sera mentioned Jeanne’s work – not everyone has when sharing the history of these services. We have come a really long way and I can see way beyond where we are now. The peer/survivor movement is so much stronger for it.
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Laura,
I know we’ve talked about this on social media already, but I’ll repeat a bit of what I said there here:
I agree that getting seats on advisory boards can be a win in many instances, including Kevin’s with Lund Report potentially. However, if that power is used only to be the one who is used to check the box of ‘got a quote from this group’ (as seems like might be an issue given the prevalance of articles with quotes from him and the lack of quotes from others), then is one not becoming complicit in tokenization at times? And if one isn’t striving to use this power to bring in other voices from that same group, is one not maybe missing the point of having that power in the first place?
I don’t know why things have played out the way they have with Kevin and Lund. I reached out to ask him if he’d share more about why he made the choices he made here before I wrote this piece, and he didn’t respond.
I do, however, believe it will NEVER be okay for someone from a marginalized group who gains this sort of power to use that power to then contribute to the tearing down of folks in that marginalized group in a public media forum EVEN IF there are legitimate concerns. Those legitimate concerns should be dealt with in a different way that doesn’t contribute to the media’s relentless tearing down of our work and credibility that already exists. THAT is the huge historical issue and one that acts as an enormous barrier to our progress… Filing paperwork and such is a far smaller issue and one that could be dealt with by giving support, not public criticism.
I will offer that I have been in contact both with Stabbin Wagon and Black Mental Health, and we will/would happily offer technical support. But an uncompensated organization from across the country surely isn’t the answer I’m calling for when I say robust technical support. These organizations would need to be given funding to receive such technical support in a robust way, and that includes local hands on support, too, in order to meet what I’m talking about.
Regardless thanks for your comment. I appreciate your presence in this movement and that you hold knowledge of our history including Jeanne’s work and so on.
Thanks,
Sera
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Hi Laura,
Your historical and continuing work has been sterling and a model for many like myself to follow. Thank you.
A few years back I did a conference presentation entitled “Nothing About Us Without……..which ones of us?” It focused on the normal but unhelpful human group dynamic by which over time, an egalitarian advocacy group can subtly and unintentionally experience a few in the group become the “experts” who can lapse into shortcut decision-making patterns and speak “for everyone.” This reality needs to be anticipated and constantly monitored in a group environment where everyone can voice early signs of folks veering off the “Without Us” rails in safe and non-defensive ways. I asked several folks during work on the Peer Respite bill here in Oregon, some who are writing here and others not, what was happening on the bill, who was involved in writing it, when/where were they meeting, when would they report to the community and ask for feedback, and how to help. Like many others similarly curious in our community experienced, there were only general reassurances that the few working on it were moving along and accounting for everything. I believe our future efforts might be better served when we, as a group, self-monitor, raise alerts, speak non-defensively, and assure inclusive “Nothing About Us……..” I also have encouraged spreading the news reporters around to interview the many, wonderful, gifted, active Oregon Peers/LE folks who can in a collective way represent our diverse views, but also our unifying and steadfast principles.
You are one of my heroes, Laura. Thank you so much.
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Before you stand up for the Stabbin Wagon did a little deeper …you obviously don’t know the whole story..
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Linda,
I do actually feel like I know a lot about Stabbin Wagon, though yes, I didn’t go too deeply into that here. That said, everything I do know – whether included here or not – continues to lead me to support them. Of course, I’m not sure what you’re referring to so I’ll have to leave it at that!
Thanks,
Sera
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I have been helping to run a mutual aid project in southern Oregon, alongside the Stabbin Wagon. I have been out doing outreach with them since way back when they only had a little cart to bring their supplies out to people on the street. They have been doing more to save the lives of our most vulnerable population than anyone, I know.
As someone who has been through rehab without decent peer support, I can only dream of seeing this respite center open. Stabbin wagon and their friends have helped me feel at home here in sourhern Oregon in a place where people are otherwise, often, quick to judge and attack the houseless and drug using population.
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Thanks so much for chiming in here, Michael! This affirms my impression of the work they do!
-Sera
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As an ironic add-on, OHA used to have a Mental Health Director who, until the beginning of this year, had for three years operated by three solid principles, one being that mental health services needed to be measured by outcomes mostly based on the reports of those receiving services. He also for the first time ever, expanded the Peer/Recovery-based (now-)Office of Recovery and Resilience from two persons to over ten; provided them a couple of million dollars to use in a basically self-determined way (which the Director of ORR immediately used to train the entire new staff in Intentional Peer Support); and required MH decision-making groups to have a quantity of Peer/service-user members of equal standing and authority as all other group members. (And OHA was itself re-configuring some of its committees and work groups similarly.)
Being a former administrator experienced with the struggles of true system transformation into humane and person-centered programs, I saw the MH Director inevitably laboring to slowly implement these changes while strategically blocking the demands of outside power players to remove service users from the MH committees and work groups, and relocate them again into “advisory groups” of old.
In fact, much to my surprise and pleasure, the MH Director had the state program licensing Director meet with our ORR Director and others of us to discuss how they could create a new license by which Peer Respites could operate outside medical model requirements, and prevent Peer Respite values and effectiveness from being eroded. He even supported Jim Gottstein and Susan Musante (using their Soteria-Alaska experiences) meeting with us to examine ways of building safety into the operations without resorting to restrictive medical model constraints on “client” privileges.
The outcome of these truly heroic efforts? When the process was taking a long time, as new service user members were being hired and learning the ropes in their MH decision-making roles and their efforts were being challenged overtly and behind the scenes, some traditional big money players, and smaller players wanting more of the pie, began “educating” the likely-to-be new Governor about the “ineptness” of the MH Director (and his OHA Director boss). When the new Governor came into power, her plan to make good on her campaign rhetoric to remove these Directors was clear to everyone, so the Directors voluntarily left.
Now OHA has returned to the top down leanings of the past voicing no principles guiding system operations. There are some within the system who are trying to retain some scraps of prior progressive successes, but the atmosphere of service-users centering program design and evaluation decisions is a faded image barely recognizable. Those who advocated for the removal of Directors supporting service-user inclusion now have more than what they bargained for.
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The “former Director” Steve Allen, removed the respite recommendation from the prior Governor’s budget, stating that the project was doomed to fail if it was unable to bill Medicaid. This meant that the bill that established the respites brought by Kevin Fitts was done emphatically without the support of the Division as well as was accomplished by serious efforts to establish a base of support within the legislature to intentionally override this targeting by the Division. That this was successful, is a first in Oregon peer and legislative history respecting laws concerning the implementation of peer services, as well as the guarantees that were written into the bill that the recipients of the grants would be wholly peer run.
The Director that was fired by the new governor, as his last effort to rig the table, took 135 million the legislature designated for equitable programs for the homeless that included supports for diversity elements in the populations that were unhoused, and gave it to mainline providers as an emergency measure to accommodate the backed up “unfit to proceed” clientele — which meant filling in supports around the state psychiatric hospital and the acute care agencies feeding into that system.
One hundred four 50k planning grants for implementing the funds above were simply shelved and disregarded — while at the same time the former Director Allen extended contracts with other established providers that would last two years past his tenure as a last effort to insure that the incoming administration could not make significant changes to the array of recipients of state monies.
This fact was not hidden and there were no regrets expressed by the Oregon Health Authority or Behavioral Health Services Division for the disenfranchised efforts to innovate, expand, and support diversity. I sat in a meeting where Allen proudly announced that not a dime of the 135 million designated for equity and homeless services would be spent on any of the planning work done by agencies promoting equity, and it was arrogantly suggested that these projects be “showcased” to the legislature to demonstrate the potential of such innovation.
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Our lived experience community were never informed or mobilized to make input into the OHA decisions about where to take the monies from to meet the now court-ordered Oregon requirement to provide aid and assist services. The OHA Director moved ahead to make those difficult administrative decisions without our input because only one or two individuals have been involved from our community, in relative isolation and without informing or mobilizing our LE community. Had there been an effort to communicate these concerns and mobilize our community to make pre-decision input or object to the decisions after being made, we may have been able to influence these events. We still have no such LE community coordinated activity. We only have one or two isolated individuals making decisions independent of the rest of us, and remaining satisfied to not direct news outlets to other of our excellent LE advocates to gather diverse views.
I was fortunate to regularly attend one OHA mental health committee where a few LE individuals had been appointed members and were influential since they were given equal authority to speak due to Steve Allen making good on his openly professed principle to ensure that our services were being shaped based on the reports of service-users. The proceedings of this group were regularly shared on our listservs with invitations made to others to join. When numbers of LE folks coordinate and strategize, we have a better chance addressing these issues than when we sit alone in meetings, or lobby the Governor to get rid of the first and only Oregon MH Director to voice our principles, appropriate money to expand the office which represents our values and needs, and paved the way for our inclusion on decision-making bodies. We now have allowed that opportunity to pass and have no one voicing any principles for leading mental health policy, let alone including our principles and values as being central.
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To stay on point here, the Office of Recovery and Resilience and its funding was an amalgam of sources that included using block grant resources. It was also an anomalie in the actions generally taken for most of Steve Allen’s tenure. Way to go Steve, or more like way to go Brandy or Kailee at the state who stood in there as money expanded.
That is not necessarily relevant to the fact that Steve deliberately removed the funding auth from the prior governor’s budget for peer respite and did the same with all (not just a large portion) of the homeless and diversity money… after giving the balance to “under funded” (sic) mainline providers NOT producing results… either in mental health or homelessness. The remaining amounts were for the unfit to proceed problem which still is not fixed by doing the same thing over and over again. I know because I wrote one of the innovation grants that tried to produce useable results oriented answers to people living in the camps or marginalized in housing due to class, race, and cultural exclusions.
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It might be mentioned that some of the controversy might have been avoided had the state of Oregon itself accepted the applications of two other peer organizations that should have scored higher though mysteriously didn’t in the selection process. There is no shortage of solid places that don’t have resort to “fragility” as an aspect of this, that could have easily been chosen without risking the whole model due to organizational challenges that need to be solved for them to function in their own environments.
FolkTime, the Miracles Club, Bay Area First Step, and others have provided numerous and successful alternative supports and have been established for a while and yet were passed over. Or not encouraged to apply for any culturally specific opportunity. Having someone point out this risk involved as a last resort, rather than as an attack, because of the likeliness of some serious crashes looming… Is not irrational. It was just that — it was a last resort because things were not working in ways that *could not* be blamed on the system’s or society’s forces of darkness.
Especially after almost 2 years of trying to implement these funds and hitting screwed up situation after screwed up situation, from numerous sides.
The supports from the state are essential, though somebody has to otherwise be on the other end to receive them. And until there isn’t a high risk that all the peer respite pilot programs would be unfunded for their failure, it is hard to make sense of the state (not the Lund Report) not choosing arguably uncompromised other programs that don’t need as much support to implement this.
Instead they put good people in the breach based on other reasons, some geographic, some unknown as of now, and jeopardized the entire envisioned new alternative agenda of the dream here of fully funded respites.
And this is not to say that there are not situations where mainline agencies are given passes when providing substandard applications and services, those, even more equally, deserve to be rooted out and categorically eliminated.
However, some kind of fidelity and promise was made to the legislature here as to the viability and relative strength of the peer movement and abilities in Oregon, (Oregon) and some of that is not very evident… and some of the issues that were pointed out, by far more sources than the Lund Report, are a last gasp to get the state peer agency to look at folks that can do this and who are being marginalized themselves by the state selection process. I would look there first for the primary cause of this most recent conflagration.
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Robert,
There are certainly things you’ll know far more about than I. However, in looking at the websites of the places you mentioned, only one (Miracle Club) appears to be led largely by non-white folks. Perhaps they would have been a great choice, I don’t know anything about them, although their website looks entirely substance focused and that isn’t always a great mix because the 12-step world is a very different sort of peer support than what the peer respite world offers! (This isn’t a universally impossible melding, but even ‘Recovery Coaching’ training tends to be awful and oppressive on issues related to suicide, etc so it would certainly be a question for me.) The issues that show up in conflict between the world of recovery from problems with substances to the peer support world related to suicide, voices, etc actually tends to not be of issue when it comes to orgs focused deeply on harm reduction around substances because harm reduction (when done right) is inherently rooted in liberation, self-determination, etc. must like good peer support at a peer respite is…
Additionally, I think Bay Area First Step would have been *hugely* problematic. I realize they’re saying they’re ‘peer-led’ but it is a version of ‘peer-led’ that is not consistent with peer respite as their identity appears to be largely clinical and they explicitly state that they provide clinical services, refer to people as ‘clients,’ etc. That doesn’t make them inherently bad, but you can’t both be a ‘peer-run’ organization and so definitively clinical, at least not by the definition of ‘peer-run’ that applies here. There’s a *huge* difference between serving as a clinician who is informed by, open about, and using their own personal experience in their work and peer support… Both have value, but in order to not become problematic we need to be clear about which is happening.
All that is to say there may very well have been some other good candidates, but it’s not so simple because for sure at least one and possibly two of your suggestions wouldn’t have lined up as being good candidates.
All I can say about the rest of what you offer here is:
1. It’s a very tricky balance. We can argue against taking risks with rewards forever, but if risks are never taken and proper support given to navigate those risks, then nothing ever substantively changes and the underfunded/multiply marginalized folks are forever relegated to the fringes. But you’re also right that if funders take risks, don’t properly support them, and then let them fail that can ALSO serve to lead to a “See, we told you there wasn’t value in this approach” response that also leaves us forever on the fringes, too. I still maintain that the right decision is to take some risks and then truly support them. Oregon certainly took some risks. And I think even better, they gave one award to a much more established org *AND* chose two less established more marginalized groups which allows for some additional balance to test the approach itself… But the support has been totally lacking, and that is what I’m largely speaking to here.
2. Going to the media – the majority of which already paints people with psych histories as incompetent, dangerous, needing supervision, etc – and giving them more ammo against us will never be the right choice. That was such a problematic thing to do… One needn’t go to the media to call out concerns. Talk with the orgs, talk with local advocacy groups about how to support, whatever it needs to be… But being quoted in multiple articles criticizing and questioning the competence of a marginalized group? I can’t ever see that as acceptable, and it certainly feels very hard to justify it as anything that would ever ‘help’ the problems you are describing either.
The situation in Oregon is complicated, and I’ve never claimed – including in this piece – that there are no legitimate issues to be concerned about. The question is what do we DO about those concerns to move things forward toward liberation, anti-oppression, and the creation of valuable, true alternatives.
Regardless, thank you for weighing in here and providing additional context.
-Sera
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Bay area is fully integrated into all of the rural system where they are, and are not dependent on grants or general funds as a result. And while you may want to draw conclusions from their website about them being medical model, I am pretty sure that the reality on the ground is using the money that they generate in furtherance of things that people need or ask for – and do so flexibly and liberally, as contrasted with what Medicaid will allow.
Note that the state tried to kill Kevin’s respite bill in the Governor’s budget here because it did not include billing for Medicaid funds which is the vast source of public mental health resources here. Bay Area has managed that hurdle and still remains an alternative program.
The state consumer council took up the issue of the agencies not being ready and it fell on deaf ears. And despite months of inquiries and advisories to the principles at the state who were peers doing the contracting, everything is -still- at a standstill for everyone…
Try to understand that the same people who selected these folks, despite our concerns did not build in themselves a support or any technical support functions, and in partial response, Kevin wrote and carried a separate bill and obtained sponsors and massive support for just such a technical support purpose – a bill that was lost here when the Republicans staged a walkout and all hearings stopped due to no quorum in May.
[Many] others brought up the issue at the time of the surprising state scoring and selection process, and while Black Mental Health and Stabbin Waggin might be more mental health oriented, some of the basic elements for their integration into a pretty stodgy crisis system in southern Oregon, are simply missing or in conflict with the environments that they must navigate to not almost immediately fail … and in terms of Black Mental Health, it is not a small set of problems that exist, which is why the Charitable Activities Section of the Oregon DOJ is now involved. (and believe me I am not a big “by the rules” person). There are issues that are facially almost doomed for a number of *not because we wish them ill* reasons if these programs are looked at closely. With that, we cannot keep any promises to the legislators that went out on a limb to buck the mental health division’s opposition, and as you should be aware, detractors are already poised to drive trucks through even the slightest hint of misappropriation or mismanagement, and as people are well aware, even one death in a program like this can be used to shut it down.
So, for the rest of us that are scratching our heads, why, if there are others that were possible, or even by now the state could have formed support for vendors that could include exactly the configuration that they wanted without having to find a way to explain away things that are going to put our efforts in conflict with the public interest in this?
And yes, it does come down to success, or supporting something that might or is at serious risk not to succeed, though why is this a question when in fact there were places that could manage this successfully and had capacity to do so, with the idea that networks of technical support could expand even, why were these others repeatedly passed by to the outcry of many folks in the peer community? (the folks that ultimately like Oryx, or me, or Kevin, etc would be users of the services, btw)
Bay Area, is completely run by peers, and was excluded by the state selection committee as not peer run, (huh?) when in fact it is ONLY peer run, and amazingly does have a certificate of approval to provide any service that anyone might need, including large expansions into already existing motels they have bought, integrated support work, to other housing that provides immediate respite and crisis refuge for folks. These elements are robust and successful, and their “client” moniker aside, they simply respond to real world needs of a large population that is engaged and served better than the County’s own agencies such that people go to them first…
It is odd that the state, knowing what it did at the time of evaluating the programs, made the choices that it did. And we are all wondering what is the breakdown involved in the peer culture that chose this particular controversy and course? After long and specific conversations by the community with the contracting folks, nothing was done about the technical support OR the selection process errors. It is like a confrontation that did not need to happen… finally, after a year of this, public opinion was drawn to the matter and that concern can no longer be disregarded as the error was not in how this was conceived, legislated, or funded…
And rather than building out a now fully statutorily peer run (as in the legal requirement that it be owned and controlled only by persons with lived experience) set of respites that the legislature had enthusiastically signed on to support with almost 6 million dollars… all on the basis of Kevin’s work and the popular idea of keeping people out of the acute care system and its traumatic processes, … we are mired in the administrative and capacity issues.
PS.
Your statement:
“2. Going to the media – the majority of which already paints people with psych histories as incompetent, dangerous, needing supervision, etc – and giving them more ammo against us will never be the right choice. That was such a problematic thing to do… One needn’t go to the media to call out concerns. Talk with the orgs, talk with local advocacy groups about how to support, whatever it needs to be… ”
The assumption here is that these conversations and actions did not take place or that sufficient effort was not made to solve what should not actually have been an issue…
Nothing, was done to try to remedy this or work through it and the concerns involved and the looming problems about to happen that now are happening, were predictable and as damaging as anything to the peer cause if things were allowed to go forward and crash into this AFTER things were funded and set up.
This effort was not for want of alternative approaches to address this, including the bill that I mentioned above. And yes there were concerns that the media might cause the peer movement to be scrutinized in a negative light – though you will have to decide for yourself in this regard who broke ranks and stood up for what we were doing and its purpose. The public option as it were, was weighed against the failures and the lack of *any* action to address any of the concerns by literally everyone in positions of responsibility… even with advocacy FOR these organizations involved.
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Robert,
I don’t think we’re going to get very far here. I would agree with the State that Bay Area is not peer-run. We seem to be operating on very different definitions of ‘peer.’
I understand (I think?) that you are saying they are ‘peer run’ because the org is run by people who have struggled with related issues themself. I believe that to be an extremely problematic definition of ‘peer’ that turns it into an ‘identity’ that is synonymous with consumer, client, patient/ex-patient and so on.
On the contrary, I understand ‘peer’ to be about a way of working and being with one another that is rooted in common experiences, yes, but *ALSO* in minimizing power imbalances, not ‘fixing’, and so on.
‘Peer’ as an identity is a part of what is co-opting our work. It’s allowing people in peer roles to be pushed into doing whatever the systems want them to do because it’s simply about that role and not the way the work is done. No ‘peer’ can stand alone so there can’t ever be ‘a peer’ because ‘peer’ only exists in relationship with someone else.
What it sounds to me from what I’ve seen on their website is that Bay Area is deeply rooted in employing only people in *clinical roles* that have relevant personal histories and are willing to disclose them and use the wisdom they’ve gained in their *clinical work*. By their own report, they’re doing assessments, using cognitive behavioral approaches. They use ‘client’ language, etc. etc. etc.
That’s not peer-run, and I think we’re pretty doomed if we allow that to become the definition. (Honestly, I think we’re pretty doomed anyway for a number of reasons, but I’m not going to stop fighting to maintain as much integrity as I can…)
I *DO* think there is great value in clinical services as provided by folks with their own histories and willingness to disclose. It’s not about them being bad.
But it doesn’t make them peer run because they’re doing *clinical* work. I would have ruled them out, too.
I hear you that there are legitimate concerns in some instances. I don’t agree with how Kevin handled it at all, and I don’t agree with knocking these orgs down in any public way especially until effort has been made to really build them up and give them a fighting chance.
-Sera
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“I don’t agree with knocking these orgs down in any public way especially until effort has been made to really build them up and give them a fighting chance.”
One is that they should not necessarily been there to fight in the first place, and
Two, there was a concerted effort to lobby the very folks that chose these programs to make sure that what is happening now would not happen.
The question then becomes, since the cavalry is not coming, and since this is going to be a problem that is existential for the entire effort, as in not renewing or designating the entire thing a failure, and embarrassing those that spoke up for it and provided the opportunity, such that it may not get a chance in the future at all… whether folks want to have this discussion now or have it later, after programs must work and don’t – or failure for reasons that could have been reasonably predicted before the selection was made?
Briefly, too. I agree with you about context and language. Apologies, I was using a haphazardly common term as peer anything, I’d be happy to have that discussion along the lines of Darby Penney’s discussions of “peer support” and its origins. As well as whatever invalidating or co-opting terms that might make the term relatively meaningless.
I have a lot of respect for Afiya and have directed folks to your talks about suicide and the desire to live as contrasted with preventing people from killing themselves. In terms of peers (small p) attacking each other in the media I have been watching in horror as hearing voices in America has disintegrated its ability to solve its problems in some ordered way. In the same regard, you could call Layisha out the way that you are referencing Steve Sanden’s work, a person who I know and trust, and his relatively successful efforts, as well as Project Able’s folks. They have roles that by definition of the actual supports they provide, do not fit into a clinical model, they simply don’t despite whatever apprehensions the language might cause. Though hell, I don’t need to argue that, I invite people to talk to the folks they help or to Steve or to their staff or go there. I see some kind of bias against their survival as only possible if they are co-opted rather than the remarkable fact that they are unmaking the systemic challenges where they are – and actually there when people need them, in what is not an urban, ideologically advanced, or east coast environment.
What do they give up on an average day to keep people from getting ground up in a system that is indifferent and stigmatizing at best and lethal and damaging far more of the time?
Contrast this with someone that essentially insisted that they could apply for a 750k grant as a 501 c 3 without any structure by simply writing in their name with the state and declaring themselves – a single individual – to be a non profit.
And when we, a number of folks, that were worried that this course was going to crash due to the folks making the selections not using some sense of viability as a qualifier, approached the state “peers” (capital p) who contracted this, to see if this might remedied before it became something that jeopardized the entire effort, we were told that yes, they needed technical support and should be given a chance. To which we asked “How?” Or… “Where is the program or money or personnel or time for this?” And heard crickets as the thing continued to go over the cliff, for almost 18 months now…
Faced with an existential problem, there continued to not be a “we will provide support and help these people” option offered, nor was there anyone who set these folks up and made the choices of these agencies willing or able to provide that. That was not a result of anything that Kevin did at all. Quite the contrary.
I don’t like the options involved, though it is arguably better to have this public discussion -now- before it becomes a full pejorative cancellation of everyone’s work, including the programs that do not need technical assistance. The problem with going after Kevin in this, is that he essentially did not create the risk here, and did not attack these people – he went after the process that got us here and challenged people to justify putting these folk in this position where they had to show that they were viable.
And he simply did just about everything except stand on his head to get the state to do just the sort of thing that you describe, prior to making it an issue warranting public discussion. I myself, had several lengthy as in hours long conversations with the contracting folks last fall, trying desperately to instill in them what they would need to provide to get this to work, and the amount of attention that would be needed to get all of the respites over the finish line, and all the external and auxiliary supports that were missing and would be needed, and spent a lot of time asking where the additional supports and resources would come from. Mostly around the the question, “Do you know what you are getting yourself into if you are going to make sure that these programs succeed?”
Does this sound familiar here?
And it did not slow down or inform the state’s actions at all… and there were others knowledgeable who did the same thing before and after me, repeatedly. Other than inviting you or other advocates from afar to talk with them, or perhaps praying for divine intervention, its not like someone did not put in the effort or recognize the potential challenges. Nor did they do it in a way that was attacking any of the programs that applied, other than asking why more obvious candidates were categorically excluded – programs that were excluded that would need to fight less or not at all to survive in the role.
Given this, it would be nice to know what other way there was to stop the impending train wreck without the public, at some point, finding out there was a lot of problems involved… and ironically, the fact that this discussion is now taking place may just be the catalyst that gets these processes to work right and include the necessary supports to succeed… as well as make the selection criteria more transparent.
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I think the interesting question that never gets asked is, why do the “standard mental health” programs continue to get funded despite mountains of evidence that they not only don’t work in the long run, but in many cases cause damage? Kind of a double standard, isn’t there?
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Robert,
I’m not sure how you are comparing Laysha’s work to others. Laysha doesn’t claim to be doing peer support. She’s a researcher. If she suddenly claimed to be doing peer support, that would in fact be a problem. She still gets to claim her psychiatric history and the value of people with psych histories being in charge of the research, but it’s worlds apart from claiming she’s doing peer support.
I don’t know anything about the org or person you’re defending, but what I do know is this: Even if one group can somehow magically overcome the fact that they’re really not a peer support org and do something fabulous with peer respite, it opens up the door for allllllllll the other orgs around the country that aren’t looking to do the work as carefully and are just looking for an excuse to basically justify being a clinical org that is co-opting peer support… Given that, I’m just not sure its worth debating whether or not a single org can overcome the fact that it’s a clinical org (albeit one by folks who have psychiatric and other relevant histories) to offer peer support with true fidelity to the model. There’s a bigger picture issue here…
As to Kevin et al, Honestly, I’ve heard far, far more feedback suggesting I’m right to question why this path was chosen – including other examples of concerns etc – then I’ve heard your perspective. I think it’s a complicated situation, but I continue to think it was unacceptable to air ‘dirty laundry’ in a media forum of that nature!
I know I’m not answering all that you raised… I’m a bit out of time at the moment! Thanks again for all the context you are offering!
-Sera
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As long as the peer respite concept is dependent on the larger “mental health system” for approval and monitoring, we will see power being used by those uncomfortable with the idea of peer empowerment to undermine this kind of effort or kill it off. I wish I knew the answer.
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Steve,
We talk about this point in our Alternatives to Suicide trainings. To illustrate the ‘why,’ I like to quote Joseph Franklin:
Joseph Franklin, a psychologist working and teaching at Harvard University was quoted as follows:
Quote#1:
“Our analyses showed that science could only predict future suicidal thoughts and behaviors about as well as random guessing. In other words, a suicide expert who conducted an in-depth assessment of risk factors would predict a patient’s future suicidal thoughts and behaviors with the same degree of accuracy as someone with no knowledge of the patient who predicted based on a coin flip…This was extremely humbling — after decades of research, science had produced no meaningful advances in suicide prediction.” (American Psychological Association, 2016)
Quote #2, Same article, next paragraph:
“As most of these guidelines were produced by expert consensus, there is reason to believe that they may be useful and effective.” (American Psychological Association, 2016)
In other words, Joseph contradicted himself, and basically said ‘we know these things don’t work, but do them anyway because important people said they were good.’
It’s a similar phenomenon to what you’re referencing… Because it’s easier, because people in power said so, because people are overwhelmed with what it would take to truly do things differently… Just do it the same and pretend its right.
-S
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Exactly. You see it all the time – an article proves that antidepressants are completely useless for kids and meanwhile increase the suicide rates, but the conclusion is, “We should be careful to make sure that antidepressants are only prescribed when indicated in children.” And they get away with it, because they’re saying what those in power want to hear!
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Thanks so much for this Sera.
In terms of the history of peer work and housing is there a source to use? How does the history of Soteria fit in on all of this? And there were some places that were both parient and professional staff living and working together I think the man who invented the Rorasch test was somehow involved. And what if we saw everyone as a peer?
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Hi Mary,
Can you clarify what you mean in terms of a source to use? To you mean one that talks about some of the history of peer respite?
Soteria – developed by Loren Mosher with the original based in California – was on a separate track and did/does include more of a collaboration between people including folks in clinical roles. Their values, ways of being with folks in the house, etc. are quite relatable to the peer respite model… But it’s definitely different both in intentional inclusion of clinical roles and for the fact that folks who stay there typically stay at least 6 months and its focus is on people having their first experience of distress related to things like hearing voices, seeing visions, unusual beliefs etc (note: not all people who hear voices or see visions experience distress, and even people who do experience distress from some of those experiences also often have positive experiences too, and some of the distress is rooted in how society responds to those experiences and teaches people to fear them).
There is a book on Soteria, though unfortunately right now there’s only one single Soteria program that I’m aware of that is active in the US (in Vermont). There is also a book on peer respite (that I wrote in collaboration with Intentional Peer Support and a few others from Wildflower Alliance), and a short film on peer respite that we create that speaks to the history as we knew it at the time which omits things like Jennie Fulgham’s story. Jennie is written about in Vanessa Jackson’s ‘In Our own Voice,’ and appears in the blackhistorymovement.info leaders project as well (which was founded by myself, Chacku Mathai, and Dana Smith).
In terms of seeing everyone as a ‘peer’ I get what you mean, but I think it’s dangerous. There’s layers here.
First, I don’t think it’s helpful to see ‘peer’ as an identity. It’s a relationship and a way of being with one another that is rooted both in some common experiences with one another and minimizing power imbalances, etc. I don’t see how we minimize power imbalances when one person, say, has the power to take another’s liberty and put them in a psych ward.
I also think we really need to play high value on the experience of loss of power and how hard it is to understand what losing your liberty is like and how much value there is in being supported people who get that (and often overlooked element of ‘peerness’ b y those who focus only, say, on having been diagnosed and having particular experiences of related distress).
HOWEVER, I absolutely do wish our systems and our culture placed way more value on human experiences and the sharing of them across all people regardless of their roles, as well as an emphasis on being able to learn from one another through that sharing… Perhaps that’s some of what you are getting at!
Thanks so much for your comment,
Sera
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Oh Sera I was just thinking that there needs to be some definitive history of the systems in human history that have helped or hurt or harmed those who are in crisis or who are out of the mainstream flow.
I just discovered the art work of Matthew Wong and brilliant and he choise not to go in as Vincent did. But what he left amazing and bullying was an aspect of his life as it was with Vincent and ultimately in these hard times of multiple big issues there seems to be well the Surgeon General’s use of lonilness and I as a kid who was teased – no one is more lonely in some ways and if one has a medical concern or different ways of thinking that usually falls into not an easy life. And in not easy life crisis can happen.
So how can we all work together in a various wesknesses and strengths. Power seems to be a big problem and control and money. And the concept of everything has to go perfectly or look better than it actually is. And the power calls snd ultimatums coming from on high and that just makes so much so much worse because the infighting squablling is a plus for those who hold the keys snd the purse.
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Thanks, Mary. Power and money are certainly both big issue, you’re right about that! Unfortunately, one of the massive downsides of peer support is that when so many psychiatric survivors started taking system-funded jobs, they stopped approaching things with so much fight because their livelihoods became dependent on the systems they were trying to change because those systems employ them. It also encourages some folks to get deep into self-promotion over collective and community goals and voices, and is very related to at least some of the ‘in-fighting’ you reference. I wish it were easier to unpack all that and make it be different!
-Sera
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Thanks for this, Sera. It is really thorough, and a solid analysis of what’s happening here in Oregon. I hope everyone who cares about peer respites in our state and beyond will read this!
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Thanks so much, Derek! I appreciate your comment.
-Sera
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Hi – As someone who lives in Oregon, I think this is a helpful and important take on what’s happening in mental health resources in our communities. I hope we can have grassroots-led peer respites here soon.
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Hi Al,
Thanks, I hope that for Oregon and for all other states and territories, too! 🙂
-Sera
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Thank you so much for this article. I live in southern Oregon, and for a bit of transparency I want to say that I a) know and love Stabbin Wagons peer respite team b) have volunteered along long side them c) work in a clinical mental health role as my day job and d) I’m mad (in both forms of the word)
Theres no part of me that can relate to people in my community or state who would stand in the way of a genuine, hard fought effort to create peer respites. Those of us on the clinical side of things are extremely aware of how lacking mainstream services are. People are struggling to survive, find a sense of belonging, find an open ear or a different way to cope. Folks here wait months to get into clinical mental health counseling, which they are often told is the only way they can get better or be heard. I know one new program doesn’t fix the systemic issues, but I felt a bit of hope when OHA selected some actually grassroots, peer led groups to pave the way, because even as I work for the mainstream and have some great coworkers, I have no hope that such a project could be done right by the calcified nonprofits that are already running everything here.
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Thanks so much, Beavers. Like a previous poster, your comment affirms my overall impression of Stabbin Wagon. I wish all clinical mental health folks recognized the problems with that system in the way that you do, but I’m glad that you’re there to help shed light on it!
Thanks,
Sera
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Thank you for this!
It breaks down the bits that are able to be, and holds to the clear understanding of the complexities that go throughout this situation in a really understandable way.
I am also very thankful for your comment responses and the clarifying explanations of the different parts that make up peer respites and engaging in peer support.
I agree with the comment above, I hope everyone who cares about peer respites in our state and beyond will read this!
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Thanks so much, Moss! 🙂 I appreciate your taking the time to read through all of it and share your feedback!
-Sera
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If people are looking for (and competing for, from the sound of it) state funds, it’s not surprising that they would turn to the media. Where does one draw the line? Every searchable page on the internet could be considered media.
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Kate,
Not sure what you mean. There’s nothing wrong with turning to the media to advocate for funds, etc. There is, however, something deeply wrong with turning to the media as a member of a marginalized group to become complicit in further marginalizing other members of that group.
I just don’t think there’s any excuse for it. It doesn’t actually solve the problem, and certainly contributes to those in power gaining more ammo while members of our community lose credibility. It’s harmful.
-Sera
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Can someone explain what the difference is between a clubhouse and a peer respite?
Minnesota, for example, has no peer respite according to the map above, yet it does have a clubhouse, Vail Place.
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The differences are pretty vast. Clubhouses can look substantially different from one another, but overall, they are about the “work ordered day,” do not have an overnight component, and are not centered around peer support. Most people who visit most clubhouses will find that there are different ‘units’ they can volunteer and work in, assistance finding jobs, as well as social components. They are not the same as day programs, but are much closer to day programs than they are to peer respites. Although some Clubhouses have a real ‘peer support’ component, most employees of Clubhouses are not required to have psychiatric histories or similar.
Peer respites, on the other hand, operate largely as alternatives to staying on an inpatient psychiatric unit or other more restrictive environment. Stays at peer respites range from a few nights to up to a couple of weeks depending on the respite and its particular way of operating. In order to qualify as a peer respite, all employees working at the respite must identify as having a psychiatric history or similar life-disrupting challenge that they’ve navigated. Although this can vary a bit, most peer respites focus on creating options for how to spend one’s day but are very much not highly structured or organized around work, etc.
Hope that helps,
Sera
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As editor of The Lund Report, I’d like to add a few points for the record. First, we’ve rectified our earlier article’s inadvertent omission that a peer advocate we quoted sits on our new advisory board. The board met for the first time last week. We’ve added an editor’s note to the article.
Since we’re on the subject, I would note that the editor of Mad in America eventually added a note atop your column. It rectified your omission that you work for an organization that would receive funds from one of the Oregon grant awards we wrote about.
I encourage your readers to read our actual reporting. The Lund Report has been monitoring and covering the peer respite legislation for some time, noting that published research supports the respite model. We have been the only reporters covering the state’s failure to roll out the program in a timely way (indeed, you linked to one of those articles).
In keeping with our mission and the Society of Professional Journalists’ Code of Ethics, we went to great lengths to connect with the organizations involved in this situation and provide the public with the best information possible. In fact, in pursuit of context and the two organizations’ perspective, we significantly delayed our initial article about the concerns raised by the Oregon Department of Justice and others in order to make further and extraordinary efforts to make contact. Unfortunately, though both had applied to be part of a public-facing, publicly funded government program, they refused.
I appreciated your candor in one comment response, acknowledging the article’s topic is a ‘complicated situation,’ but maintaining that in your own opinion, ‘dirty laundry’ should not be aired publicly. Personally, I believe that just as our society relies on quality information from journalists and others to pursue positive change, the people who obtain needed services from systems of care benefit from scrutiny of those systems to ensure quality of care and access to care. When concerns are not aired, they more often go unaddressed.
That said, I do agree that the situation is multi-faceted and complicated. My colleague at The Lund Report recently was able to finally talk with one of the grantees, driving four hours and staying overnight to do so. In short, we keep pursuing our mission of ethical, public-service journalism.
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Nick,
There’s a key difference here re: the ‘conflict of interest’ you’re referencing. Lund has repeatedly quoted Kevin across several articles without citing his relationship that was clearly known to Lund. It’s also an issue that’s more that goes to more than just naming the relationship. To sit on the advisory board and be such a sole source (at least from what I saw) itself is a problem, too. It begins to look tokenizing when one person is repeatedly used to represent the voice of a marginalized group. I’m concerned that Lund doesn’t appear to better understand that point given their mission and values.
Re: my so-called ‘conflict of interest’: I have no issue with it being named here. HOWEVER, it’s important to note that I was not aware of that ‘relationship’ until folks at Mad in America were notified about it. The letter was signed by our Director of Training, and amounts to promise of a 24 hour training for which they would pay $7400, most of which would be eaten up by doing the training itself.
While perhaps some would think I “would or should” know about that, we have an entire training arm that is facilitating trainings everywhere from Australia to California to Maryland and so on. Additionally, about 75% of people who ask us to say we’ll offer a training if they can get funding for it don’t end up getting the funding, and the training isn’t offered. So, I guess we can call that a ‘conflict of interest,’ but given I wasn’t aware of it at the time I wrote this piece, I think it’s not an accurate comparison at all.
I think you are still missing the point of what I’m saying regarding both Lund and Kevin, and both are somewhat different points. My point re: not speaking publicly about concerns is specifically for Kevin, not Lund. From an anti-oppression perspective, to have someone internal to a movement speaking to the *media* about their concerns is a HUGE problem. It’s not about keeping secrets. It’s about not giving a whole media system that has scapegoated, stigmatized, discriminated against, and painted our entire community as dangerous villains, incompetent, and so on unnecessary ammo. There are other ways to address those concerns than giving a public that already has such a skewed view of who we are unnecessary fodder to further stereotypes.
I am aware of your more recent coverage of Stabbin Wagon which is good. I continue to feel that your organization lacks some of the fundamental understanding of dynamics related to systemic oppression that would better inform how you approach some of these issues. I continue to maintain that – much like the Boston Globe – you’ve spent too much time villainizing folks who are multiply marginalized without putting it in the proper context of systemic oppression.
In that way, I continue to maintain that you failed. That doesn’t mean you have to keep failing.
Thanks for your response.
Sera
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(Just to clarify, when I say “we” above… I’m talking about Wildflower Alliance where I serve as Director. I actually write independently and not as an employee of anyone, but my writing is deeply informed by my work so it would be disingenuous to say they are entirely separate. I do also sometimes try to help with some of the training stuff when its piling up… I’ve been helping with Australia, Maryland, and Pennsylvania contracts recently. But I have to intentionally steer clear of most of it and leave it to our direct or of training and admin manager or I’d drown so I do so happily! Just wanted to clarify the “we” part!)
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Dear Sera,
Some may call me a dreamer but I would like to believe your weighty pebble toss in the metaphorical pool might lead to beneficial permanent change. I admire your courage to speak up with your observation.
“Who Are Our Lions?” Indeed, another telling metaphor. There truly are so many diverse styles of leadership in our communities. The lion is widely known as the king of the jungle, however I see most of our community leaders resemble more closely starving dogs groveling and scraping for the scraps from masters’ tables (from non-peer authority figures.) Yeah sure, it would be swell if more among us fit that regal, powerfully whole-hearted, and fulfilled picture of leadership.
I think for that to happen though we need to ween ourselves from clinging to the coat-tails of influences that don’t share our communities values. I know we are of the same heart and mind in the notion that we can muster more emphasis together for independence in support streams.
Strength in numbers, intersecting alliances of mutual benefit. If everyone contributes a dollar, maybe in short time we will have a million? What then, what can we do with more…
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Have you seen the recent National Empowerment Center webinar, “A Taste of Wonderland,” Sera? I just watched it last weekend finally, it came to my attention highly recommended in the continuum we’ve been developing over the years (thanks Oryx!). Within it I noticed a big emphasis on incubation of innovations for social enterprise to empower our communities with real substantial solutions for “the best life” possible.
Of course this could include peer-run respite projects possibilities that haven’t been considered yet, and so much more potential to expand upon what currently exists “here and there” around the country. You hint at this path of discovery in the statement:
“They are but only one thread in a tapestry of alternatives that are needed.
“However, they are an important thread that has made real difference in the lives of many people.”
I would like to see an effort to promote more awareness of the primary areas of these alternatives that could build an alternative crisis response and stabilization system to compliment what is missing from that nationwide 988. Promote and support, like the technical assistance that was needed to incubate-to-maturity the peer run respites in Oregon example.
Prevention –> crisis response –> stabilization –> remedial care –> crisis recovery
There are successful examples of alternative (peer-run) supportive services all over the nation. I’d like the best of them to be showcased and see and effort at “propagation” come about. “…call me a dreamer but I would like to believe your weighty pebble toss in the metaphorical pool might lead to beneficial permanent change.” My feeling and experience with the ripple effect suggests to me your courageous efforts contribute to a larger phenomenon soon to be reality.
“Something awesome, this way comes…”
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Hey Luke,
Sorry I’m just seeing your comments now! Thank you, and no I haven’t seen the webinar, but will check it out! 🙂
-Sera
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My goodness, Sera. Don’t you have enough problems on the East coast?
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I can totally see why your comment is spot on, lisbeth, in so many regards.
I also want to point out, as in my analogy presented when the drop of a pebble in the pool, that changes were set in motion by the courageous act to tactfully speak out. I live in Oregon, so I noticed the beneficial turn around that this ripple effect resulted in.
Much respect and gratitude, Sera!
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