Monday, October 14, 2019

Comments by Bob Nikkel

Showing 22 of 22 comments.

  • Dr. Russerford,

    I appreciate your comment and also appreciate your understanding of some of the regrets that some of us have. It’s good to know I’m not alone!

    We’re talking about a number of new marketing ideas at our next board meeting and I will add the suggestion/question about whether we have posters or flyers. The quick answer right now is that we don’t but it’s exactly the kind of thing we will be talking about.

    Thank you!

  • Thank you very much for all these great suggestions. These are exactly the kind of ideas I was hoping would come along and you obviously have a lot of experience with implementing these. We have a board meeting coming up and I’m doing an immediate “cut and paste” of your comments so that we can consider them carefully and begin to implement some or all. Again, thank you very much, I appreciate your taking the time and sharing these.

  • Molly, thanks for reading and commenting. My goal here was simply to open a window into how things at state and local organizational levels tend to work. I’m not terribly optimistic but there are some who want to work from within the system and maybe this will be of some help in thinking through the issues and dynamics.

  • madmom, thank you, I think you’re pointing to many of the significant obstacles to the kind of system change I was trying to describe from a former “insiders” perspective in state and local government. I really like the way you frame the experience of family members who haven’t gotten real help for their loved ones, and instead have been treated to a mythology that reinforces the disease model.

  • Yes, Frank, a benevolent dictatorship isn’t any kind of an answer. And in a sense, revolutions don’t ever come from the top. The best we can hope for is some support and collaboration from enlightened leaders. And there aren’t many.

  • Chris, thank you very much for your thoughtful comment. I like the way you put it–real change will come from grassroots and can at least be supported by those at the top with, as you say, collaboration, negotiations and adaptations. I don’t pretend to know all the answers about how to do this. My blog was an attempt to stimulate this kind of conversation and appreciate your point of view very much.

  • I wish I had been more enlightened and aggressive during my commissioner days (2003-2008). I like the idea of customer service windows at the state hospital; but really, we need to find a way to get the entire hospital system to be customer service oriented. A huge huge challenge to change cultures.

  • Amari, thank you for your comments and observations about what’s going on in South Africa. I’m afraid it’s not entirely different here in the US either. One of the first things I learned when I was doing alcohol/drug counseling was that alcohol and street drugs could mimic any mental health symptom or disorder. Maybe it’s better than a few years ago but very few mental health workers get much training in alcohol/drug work. One of the standards in mental health should be the ability to conduct a careful interview to collect accurate information about alcohol/drug use–and that would include the use of psych drugs too. We’ve known for a long time now that at least half of the people who have mental health challenges also have had or are having problems with alcohol/drug use too. Of the guys who end up in jails and prisons, it’s probably closer to 90% according to studies conducted by Linda Teplin. For women it may be even higher–and that doesn’t count the PTSD that’s almost always there. And you’re right–drugs don’t seem to be going away in this world.

  • Stephen, first, thank you for your courage in refusing to chart! Now, that can get to be a real problem in the world of policies on documentation and I’m sure you’re finding out enough about that without me saying anything more than I respect your commitment to doing the right thing–relating to people as they are and not as they’re charted to be. I’ve said several times, I would be fired very quickly now if I tried to go back into paid public mental health and addictions work. The issue of whether alcohol/drug problems should be considered diagnoses and problems and mental illnesses is clouded by the traditional AA position that alcoholism is a disease. Much of the 12 step literature is based on this and since I’m not in recovery for alcohol/drug problems, I’m going to stay out of the discussion about whether this makes sense to me or not. The fact is that many peers in the addictions field have defined themselves in this way. If It works for them, it’s not my issue. But your point about addictions being interpreted as “mental illnesses” is a good one in my opinion and we need to be talking about all this a lot more than we have. Thank you for your thoughtfulness.

  • Ute, I appreciate the concerns and issues you’re raising. We do have several persons with lived experience on our board and our input has been and will be a critical factor in deciding which courses the project will develop. We’ve used the term “unbiased” to guide our review of studies and courses away from those sponsored or ghostwritten or influenced by commercial interests, mainly but not entirely limited to the pharmaceutical corporations. I believe an honest reading of the research literature leads in the direction that Bob Whitaker’s review of the field describes. Whether this is a bias or not, I’ll leave for others to judge.

  • Ted, thank you for your comments and your questions and even skepticism about whether this will be a useful project. I agree that it’s not something that will correct the many many problems in the field. My sense (and I understand I could be off base) is that more people working in the mental health field are uncomfortable and looking for better information. There’s actually a lot of doubt, whether it’s expressed openly or not. I hope the continuing education courses will help. And I agree completely that we need the vigorous human rights movement that you and others have championed for many years.