Hi Sera
I appreciate your taking the time to provide a very thoughtful reply to my Op-Ed. I think that by and large there are so many fundamental differences in our beliefs and philosophies that it makes it impossible to arrive at anything other than clarifications of our points. But that is fine with me. I did not write about your blog with the hope that I would change your point of view but rather to distinguish more clearly mine from yours.
I personally enjoy and benefit from much of MIAâs content. A lot of it is very much in keeping with my own opinions. I too, like so many others, have experienced involuntary confinement and treatment along with restraints and seclusion. I rebel against the pretense that medication and clinical treatment is the answer to all of our problems. I think that the system is very quick to take away someoneâs rights and excruciatingly slow to restore them.
I do know that my ideas about peer support are quite different than yours and many of the people who have commented on our blogs. Iâm not against you having your point of view, but I would say that while many people are in agreement with the ideas you have set forth there are many more who believe that peer support only gets better with increased knowledge and experience and that setting standards elevates the field. I think that the people who choose to work in this area are entitled to be paid a living wage with opportunities for career advancement. For a number of years I provided peer support as a volunteer and felt strongly that the support and strength that I got from helping to provide support to others was of great value. I also saw that many of the people who were really great at providing support eventually moved on because as their personal recovery increased they wanted to have full or part time jobs that allowed them to climb out of poverty.
I believe that the way to keep many of our best supporters from leaving is to create increasing employment opportunities with the potential for growth in positions and income. Expanding the peer workforce moves many people from disability to ability. Growing the peer workforce is the only way we will ever achieve the goal I believe in, which is that peer support should be available to anyone who wants it. As it is, even with over 25,000 certified peer specialists and thousands more who have been through training without certification, peer support is difficult to access.
The belief that peer support should be, as some would say, voluntary without compensation or the benefits of employment is fine for people who choose that route but it, in my opinion, would create a serious shortage of peer supporters and would be an unintended message to providers that peer support is less valuable than traditional treatment. Many believe that it should only be available through peer-run organizations. I happen to believe that it is the most powerful model but I also believe that the thousands of peers working to provide true peer support from within the system have a powerful influence in creating a better, more effective, more humanistic and recovery oriented system of care for those who choose it.
As to the meaning of the bell, I still believe that itsâ strongest message is an end to the brutality of restraints. The very fact that it is cast from them is powerful to me. That is the part that speaks to a system that has abused and discarded countless souls. Yes the rest of the message says an end to mental illness. That it is not a message of increased treatment, rather it is one that allows for any kind of approach that ends peoples pain.
About the idea of questioning âpeernessâ I, as before, quote you: âThese organizations sometimes shroud themselves in so-called âpeersâ, but often only those who donât flinch at having their identities boiled down in such a way. That is not to say that they arenât still good people with voices as potentially valid as the next, but all too often theyâre also the ones who have a job they canât afford to lose and so feel constrained within their organizationâs âparty linesâ. Sometimes theyâre the people wrapped up in so much internalized oppression they canât see through their own medicated haze. Or, theyâre the tokenized one committed to âcreating change from withinâ that started out with such a clear vision, but have fallen so far in that they canât quite see theyâve lost their center. To me âso called peersâ definitely questions an individualâs right to call themselves a peer, and âcanât see through their own medicated hazeâ is actually very insulting and demeaning to people who choose to use meds. You may say you didnât refer to us directly, but putting this in a blog aimed at MHA seems to make your intentions very clear.
You question whether or not individuals have had or currently have the support to not be swallowed up whole, co-opted and used by the system. You also question the nature of a system that would prefer to hire people in this position than those who have gone through a fuller process of self and system realization. So do I, and I believe it is essential that individuals working within the system have a strong support system of their peers and a strong sense of self and awareness. I also believe that those same individuals and the ones who have gone before them are the ones to set the standards that can change systems to prevent co-optation and to provide peer support based on equality and mutuality, respect, and shared learning. The people working within the system and creating change are the pioneers who are making it possible for the true power of âsupportâ to be available throughout healthcare.
Since you state in your reply that you donât believe that MHA has taken a completely healthy peer support industry and knocked it off the perch, and you further state that it was already suffering and that âMental Health America ainât helping the situationâ it seems that perhaps the headline doesnât match the intent. Those statements are a far cry from the title of your blog which is The Downfall of Peer Support: MHA & National Certification. To me it sounds like you are now saying that MHA is just not helping the situation while your title sounds a lot like you are saying that the MHA certification is causing the downfall of peer support.
As to the word peer, I believe that saying that I am a peer means that I share some set of circumstances and/or experiences with another person, and that this person accepts me as a peer in that context. Is it silly to use a word that can apply to people in all walks of life, yes, just like the word consumer was. I think it is so popular because there are a very large number of people who want to be part of a community of people with similar experiences. So, while it is not a very accurate phrase it does not inherently demean anyone. The word itself is neutral. I did not say that doctors and licensors are necessarily peers, although they certainly can be. An excellent example of that is Dan Fisher M.D., Ph.D. To be clear we had 9 self-disclosed peer subject matter experts including a primary care physician who has worked in peer support and understands and has worked hard to overcome the innate power differential of a title. We also had 3 other, non-peer experts who were there for the specific reasons I wrote about in my Op-Ed. Anyway why are we discussing this, it is not a claim I made.
As to DBT, I am not saying that peer supporters should treat people they serve like children. What I am saying is that it takes some knowledge to ask the right questions of the person they are supporting. I realize that there are many examples of people being forced into DBT, but it is supposed to be voluntary, so when it isnât it is being done incorrectly. I ascribe to the belief that âIf it isnât voluntary, it isnât treatmentâ.
We could of course rehash every line in each blog but I donât think it will make much difference. The bottom line is that I believe that organized peer support with certification is not inherently wrong, rather it is a positive development. I believe that peer support and the knowledge that backs it up is expanding and it is moving towards a time when it will be available to all of us. The purpose of our certification is so that the individual who has earned it can demonstrate to employers (peer or not) that they are highly skilled and experienced in their chosen field and can continue to grow in their skills and provide the best possible support.
Hi Sera
I’m not avoiding answering you and the other comments. I live in South Florida right where the hurricane came through and we had to evacuate. This is the first access I’ve had to my computer since last week. I’ll catch up on all the comments and reply in the next few days.
Hi Sera
I appreciate your taking the time to provide a very thoughtful reply to my Op-Ed. I think that by and large there are so many fundamental differences in our beliefs and philosophies that it makes it impossible to arrive at anything other than clarifications of our points. But that is fine with me. I did not write about your blog with the hope that I would change your point of view but rather to distinguish more clearly mine from yours.
I personally enjoy and benefit from much of MIAâs content. A lot of it is very much in keeping with my own opinions. I too, like so many others, have experienced involuntary confinement and treatment along with restraints and seclusion. I rebel against the pretense that medication and clinical treatment is the answer to all of our problems. I think that the system is very quick to take away someoneâs rights and excruciatingly slow to restore them.
I do know that my ideas about peer support are quite different than yours and many of the people who have commented on our blogs. Iâm not against you having your point of view, but I would say that while many people are in agreement with the ideas you have set forth there are many more who believe that peer support only gets better with increased knowledge and experience and that setting standards elevates the field. I think that the people who choose to work in this area are entitled to be paid a living wage with opportunities for career advancement. For a number of years I provided peer support as a volunteer and felt strongly that the support and strength that I got from helping to provide support to others was of great value. I also saw that many of the people who were really great at providing support eventually moved on because as their personal recovery increased they wanted to have full or part time jobs that allowed them to climb out of poverty.
I believe that the way to keep many of our best supporters from leaving is to create increasing employment opportunities with the potential for growth in positions and income. Expanding the peer workforce moves many people from disability to ability. Growing the peer workforce is the only way we will ever achieve the goal I believe in, which is that peer support should be available to anyone who wants it. As it is, even with over 25,000 certified peer specialists and thousands more who have been through training without certification, peer support is difficult to access.
The belief that peer support should be, as some would say, voluntary without compensation or the benefits of employment is fine for people who choose that route but it, in my opinion, would create a serious shortage of peer supporters and would be an unintended message to providers that peer support is less valuable than traditional treatment. Many believe that it should only be available through peer-run organizations. I happen to believe that it is the most powerful model but I also believe that the thousands of peers working to provide true peer support from within the system have a powerful influence in creating a better, more effective, more humanistic and recovery oriented system of care for those who choose it.
As to the meaning of the bell, I still believe that itsâ strongest message is an end to the brutality of restraints. The very fact that it is cast from them is powerful to me. That is the part that speaks to a system that has abused and discarded countless souls. Yes the rest of the message says an end to mental illness. That it is not a message of increased treatment, rather it is one that allows for any kind of approach that ends peoples pain.
About the idea of questioning âpeernessâ I, as before, quote you: âThese organizations sometimes shroud themselves in so-called âpeersâ, but often only those who donât flinch at having their identities boiled down in such a way. That is not to say that they arenât still good people with voices as potentially valid as the next, but all too often theyâre also the ones who have a job they canât afford to lose and so feel constrained within their organizationâs âparty linesâ. Sometimes theyâre the people wrapped up in so much internalized oppression they canât see through their own medicated haze. Or, theyâre the tokenized one committed to âcreating change from withinâ that started out with such a clear vision, but have fallen so far in that they canât quite see theyâve lost their center. To me âso called peersâ definitely questions an individualâs right to call themselves a peer, and âcanât see through their own medicated hazeâ is actually very insulting and demeaning to people who choose to use meds. You may say you didnât refer to us directly, but putting this in a blog aimed at MHA seems to make your intentions very clear.
You question whether or not individuals have had or currently have the support to not be swallowed up whole, co-opted and used by the system. You also question the nature of a system that would prefer to hire people in this position than those who have gone through a fuller process of self and system realization. So do I, and I believe it is essential that individuals working within the system have a strong support system of their peers and a strong sense of self and awareness. I also believe that those same individuals and the ones who have gone before them are the ones to set the standards that can change systems to prevent co-optation and to provide peer support based on equality and mutuality, respect, and shared learning. The people working within the system and creating change are the pioneers who are making it possible for the true power of âsupportâ to be available throughout healthcare.
Since you state in your reply that you donât believe that MHA has taken a completely healthy peer support industry and knocked it off the perch, and you further state that it was already suffering and that âMental Health America ainât helping the situationâ it seems that perhaps the headline doesnât match the intent. Those statements are a far cry from the title of your blog which is The Downfall of Peer Support: MHA & National Certification. To me it sounds like you are now saying that MHA is just not helping the situation while your title sounds a lot like you are saying that the MHA certification is causing the downfall of peer support.
As to the word peer, I believe that saying that I am a peer means that I share some set of circumstances and/or experiences with another person, and that this person accepts me as a peer in that context. Is it silly to use a word that can apply to people in all walks of life, yes, just like the word consumer was. I think it is so popular because there are a very large number of people who want to be part of a community of people with similar experiences. So, while it is not a very accurate phrase it does not inherently demean anyone. The word itself is neutral. I did not say that doctors and licensors are necessarily peers, although they certainly can be. An excellent example of that is Dan Fisher M.D., Ph.D. To be clear we had 9 self-disclosed peer subject matter experts including a primary care physician who has worked in peer support and understands and has worked hard to overcome the innate power differential of a title. We also had 3 other, non-peer experts who were there for the specific reasons I wrote about in my Op-Ed. Anyway why are we discussing this, it is not a claim I made.
As to DBT, I am not saying that peer supporters should treat people they serve like children. What I am saying is that it takes some knowledge to ask the right questions of the person they are supporting. I realize that there are many examples of people being forced into DBT, but it is supposed to be voluntary, so when it isnât it is being done incorrectly. I ascribe to the belief that âIf it isnât voluntary, it isnât treatmentâ.
We could of course rehash every line in each blog but I donât think it will make much difference. The bottom line is that I believe that organized peer support with certification is not inherently wrong, rather it is a positive development. I believe that peer support and the knowledge that backs it up is expanding and it is moving towards a time when it will be available to all of us. The purpose of our certification is so that the individual who has earned it can demonstrate to employers (peer or not) that they are highly skilled and experienced in their chosen field and can continue to grow in their skills and provide the best possible support.
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Hi Sera
See my comment on your first comment. I will get back to you soon.
Report comment
Hi Sera
I’m not avoiding answering you and the other comments. I live in South Florida right where the hurricane came through and we had to evacuate. This is the first access I’ve had to my computer since last week. I’ll catch up on all the comments and reply in the next few days.
Report comment