{"title":"通过同伴健康服务创造深度民主","authors":"M. Caughey","doi":"10.7728/0501201413","DOIUrl":null,"url":null,"abstract":"As healthcare reform transforms systems of care, there is a compelling necessity for systems to value the contributions of persons with lived experience of psychiatric diagnosis. The concept of deep democracy, of non-violence in action, is consistent with persons who have lived experience leading healthcare reform and helping transform coercion and oppression into health and wellbeing. Consistent with deep democracy and the creation of a “culture of wellness” for persons with mental challenges, a Portland, Oregon community behavioral healthcare program utilizes Peer Wellness Specialists and initiates a new model of integrated care that values whole health. The Cascadia Peer Wellness Program utilizes the unique and powerful resource of persons with lived experience of psychiatric diagnosis by training and employing Peer Wellness Specialists to partner with clinicians and other healthcare team members in order to help those they serve find their way to recovery. Keywords: Peer wellness, peer support, deep democracy, recovery, mindfulness practice I clearly remember how deeply shaken I was when the 2006 report from the National Association of State Mental Health Program Directors came out saying that people with serious mental illness who are treated in the public system die an average of 25 years earlier than the general population (Parks, Svendsen, Singer, & Foti, 2006). I was diagnosed with schizophrenia when I was nineteen. When this report came out I had finally reached a place in my personal recovery that allowed me to work as a peer mentor in a community mental health program. I realized that during the four months I had been working at the program, four of my peers who had received services there had died prematurely. This felt very personal—like a body blow—and my response was to vow I would dedicate my work to ending premature mortality and improving the quality of life for those who have psychiatric disabilities. It is not enough for those of us with disabilities to do the hard work of creating our recovery and then to die; it is our equal right to live well and enjoy longevity. This basic right is accomplished within the context of an environment, which is imbued by “deep democracy”. Deep democracy is founded upon a social agreement for community members to adhere to non-violence in language and behavior. I became convinced of the necessity of this as a way to escape my dismal pattern of violence and hospitalization. During this time, I acted out self-harm and found myself hospitalized against my will. My behavior was repeatedly controlled by mechanical and chemical restraints. I did not know that I had any power or responsibility to address my difficult emotions except by physically struggling. Likewise, the hospital staff reinforced my beliefs that I had no control over my actions. This disturbing scene was to be repeated many times over many hospitalizations. Finally, I reached a point where I saw that I would either have to do something different or live without my freedom. I had started meditating years before and finally became convinced that acting out violently was not consistent with my meditative experience. I was not sure if change was truly possible, but the alternative was no longer workable. I was no longer willing to live my life within the walls of an institution. My intention became to create a different life for myself, and I soon started seeing opportunities that became expressions of a nascent sense of empowerment and self-determination. A new locus of control started growing within me. This change was built upon a new choice to find non-violent ways to express myself; to express the seemingly bottomless sense of pain that had been with me for much of my life by making art rather than acting out. This then became the beginning of my recovery. I sought reinforcement for my changes within a Buddhist community that supported my meditation practice. Here, non-violence was the norm, and I eventually grew to regard it as my own. As my recovery strengthened, I started to look for opportunities to express myself through peer work where I could serve other persons who had lived experience of their own mental health struggles. Through my work as a “peer mentor”ein a community mental health program, I sought to spread the idea that individuals have the ability to choose non-violence, even in the middle of our hardest struggles. I relied upon a number of tools, including the practice of mindfulness and the expression of feelings through my paintings and drawings. Persons who have serious Global Journal of Community Psychology Practice Volume 5, Issue 1 June 2014 Global Journal of Community Psychology Practice, http://www.gjcpp.org/ Page 2 mental health challenges need the example of others who may still struggle in their lives with their own mental health, but who are successful in creating their own fulfilling and gratifying lives. I created the Peer Wellness Program so that my own journey of expressing my inherent wholeness might serve as a source of hope for my peers.","PeriodicalId":87260,"journal":{"name":"Global journal of community psychology practice","volume":"5 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2014-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Creating Deep Democracy through Peer Wellness Services\",\"authors\":\"M. Caughey\",\"doi\":\"10.7728/0501201413\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"As healthcare reform transforms systems of care, there is a compelling necessity for systems to value the contributions of persons with lived experience of psychiatric diagnosis. The concept of deep democracy, of non-violence in action, is consistent with persons who have lived experience leading healthcare reform and helping transform coercion and oppression into health and wellbeing. Consistent with deep democracy and the creation of a “culture of wellness” for persons with mental challenges, a Portland, Oregon community behavioral healthcare program utilizes Peer Wellness Specialists and initiates a new model of integrated care that values whole health. The Cascadia Peer Wellness Program utilizes the unique and powerful resource of persons with lived experience of psychiatric diagnosis by training and employing Peer Wellness Specialists to partner with clinicians and other healthcare team members in order to help those they serve find their way to recovery. Keywords: Peer wellness, peer support, deep democracy, recovery, mindfulness practice I clearly remember how deeply shaken I was when the 2006 report from the National Association of State Mental Health Program Directors came out saying that people with serious mental illness who are treated in the public system die an average of 25 years earlier than the general population (Parks, Svendsen, Singer, & Foti, 2006). I was diagnosed with schizophrenia when I was nineteen. When this report came out I had finally reached a place in my personal recovery that allowed me to work as a peer mentor in a community mental health program. I realized that during the four months I had been working at the program, four of my peers who had received services there had died prematurely. This felt very personal—like a body blow—and my response was to vow I would dedicate my work to ending premature mortality and improving the quality of life for those who have psychiatric disabilities. It is not enough for those of us with disabilities to do the hard work of creating our recovery and then to die; it is our equal right to live well and enjoy longevity. This basic right is accomplished within the context of an environment, which is imbued by “deep democracy”. Deep democracy is founded upon a social agreement for community members to adhere to non-violence in language and behavior. I became convinced of the necessity of this as a way to escape my dismal pattern of violence and hospitalization. During this time, I acted out self-harm and found myself hospitalized against my will. My behavior was repeatedly controlled by mechanical and chemical restraints. I did not know that I had any power or responsibility to address my difficult emotions except by physically struggling. Likewise, the hospital staff reinforced my beliefs that I had no control over my actions. This disturbing scene was to be repeated many times over many hospitalizations. Finally, I reached a point where I saw that I would either have to do something different or live without my freedom. I had started meditating years before and finally became convinced that acting out violently was not consistent with my meditative experience. I was not sure if change was truly possible, but the alternative was no longer workable. I was no longer willing to live my life within the walls of an institution. My intention became to create a different life for myself, and I soon started seeing opportunities that became expressions of a nascent sense of empowerment and self-determination. A new locus of control started growing within me. This change was built upon a new choice to find non-violent ways to express myself; to express the seemingly bottomless sense of pain that had been with me for much of my life by making art rather than acting out. This then became the beginning of my recovery. I sought reinforcement for my changes within a Buddhist community that supported my meditation practice. Here, non-violence was the norm, and I eventually grew to regard it as my own. As my recovery strengthened, I started to look for opportunities to express myself through peer work where I could serve other persons who had lived experience of their own mental health struggles. Through my work as a “peer mentor”ein a community mental health program, I sought to spread the idea that individuals have the ability to choose non-violence, even in the middle of our hardest struggles. I relied upon a number of tools, including the practice of mindfulness and the expression of feelings through my paintings and drawings. Persons who have serious Global Journal of Community Psychology Practice Volume 5, Issue 1 June 2014 Global Journal of Community Psychology Practice, http://www.gjcpp.org/ Page 2 mental health challenges need the example of others who may still struggle in their lives with their own mental health, but who are successful in creating their own fulfilling and gratifying lives. I created the Peer Wellness Program so that my own journey of expressing my inherent wholeness might serve as a source of hope for my peers.\",\"PeriodicalId\":87260,\"journal\":{\"name\":\"Global journal of community psychology practice\",\"volume\":\"5 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2014-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global journal of community psychology practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7728/0501201413\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global journal of community psychology practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7728/0501201413","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Creating Deep Democracy through Peer Wellness Services
As healthcare reform transforms systems of care, there is a compelling necessity for systems to value the contributions of persons with lived experience of psychiatric diagnosis. The concept of deep democracy, of non-violence in action, is consistent with persons who have lived experience leading healthcare reform and helping transform coercion and oppression into health and wellbeing. Consistent with deep democracy and the creation of a “culture of wellness” for persons with mental challenges, a Portland, Oregon community behavioral healthcare program utilizes Peer Wellness Specialists and initiates a new model of integrated care that values whole health. The Cascadia Peer Wellness Program utilizes the unique and powerful resource of persons with lived experience of psychiatric diagnosis by training and employing Peer Wellness Specialists to partner with clinicians and other healthcare team members in order to help those they serve find their way to recovery. Keywords: Peer wellness, peer support, deep democracy, recovery, mindfulness practice I clearly remember how deeply shaken I was when the 2006 report from the National Association of State Mental Health Program Directors came out saying that people with serious mental illness who are treated in the public system die an average of 25 years earlier than the general population (Parks, Svendsen, Singer, & Foti, 2006). I was diagnosed with schizophrenia when I was nineteen. When this report came out I had finally reached a place in my personal recovery that allowed me to work as a peer mentor in a community mental health program. I realized that during the four months I had been working at the program, four of my peers who had received services there had died prematurely. This felt very personal—like a body blow—and my response was to vow I would dedicate my work to ending premature mortality and improving the quality of life for those who have psychiatric disabilities. It is not enough for those of us with disabilities to do the hard work of creating our recovery and then to die; it is our equal right to live well and enjoy longevity. This basic right is accomplished within the context of an environment, which is imbued by “deep democracy”. Deep democracy is founded upon a social agreement for community members to adhere to non-violence in language and behavior. I became convinced of the necessity of this as a way to escape my dismal pattern of violence and hospitalization. During this time, I acted out self-harm and found myself hospitalized against my will. My behavior was repeatedly controlled by mechanical and chemical restraints. I did not know that I had any power or responsibility to address my difficult emotions except by physically struggling. Likewise, the hospital staff reinforced my beliefs that I had no control over my actions. This disturbing scene was to be repeated many times over many hospitalizations. Finally, I reached a point where I saw that I would either have to do something different or live without my freedom. I had started meditating years before and finally became convinced that acting out violently was not consistent with my meditative experience. I was not sure if change was truly possible, but the alternative was no longer workable. I was no longer willing to live my life within the walls of an institution. My intention became to create a different life for myself, and I soon started seeing opportunities that became expressions of a nascent sense of empowerment and self-determination. A new locus of control started growing within me. This change was built upon a new choice to find non-violent ways to express myself; to express the seemingly bottomless sense of pain that had been with me for much of my life by making art rather than acting out. This then became the beginning of my recovery. I sought reinforcement for my changes within a Buddhist community that supported my meditation practice. Here, non-violence was the norm, and I eventually grew to regard it as my own. As my recovery strengthened, I started to look for opportunities to express myself through peer work where I could serve other persons who had lived experience of their own mental health struggles. Through my work as a “peer mentor”ein a community mental health program, I sought to spread the idea that individuals have the ability to choose non-violence, even in the middle of our hardest struggles. I relied upon a number of tools, including the practice of mindfulness and the expression of feelings through my paintings and drawings. Persons who have serious Global Journal of Community Psychology Practice Volume 5, Issue 1 June 2014 Global Journal of Community Psychology Practice, http://www.gjcpp.org/ Page 2 mental health challenges need the example of others who may still struggle in their lives with their own mental health, but who are successful in creating their own fulfilling and gratifying lives. I created the Peer Wellness Program so that my own journey of expressing my inherent wholeness might serve as a source of hope for my peers.