Category Archives: Mental health recovery

December 20, 2013 · 10:28 pm

Friday Soup Dump

SAMHSA sez:

43.7 Million Americans Experienced Mental Illness in 2012

$31 Million Announced To Improve Mental Health Services for Young People

Nearly one in five American adults, or 43.7 million people, experienced a diagnosable mental illness in 2012 according to SAMHSA. These results are consistent with 2011 findings.

[Does anyone else besides me suspect that the reason so many are diagnosed is because of marketing of psycho-pharmacological drugs?]

Top Three Reasons Adults Did Not Get Mental Health Treatment in 2012

They worried about affording the cost.
They thought they could handle the problem without treatment.
They did not know where to receive services.

“The President and Vice President have made clear that mental illness should no longer be treated by our society—or covered by insurance companies—differently from other illnesses,” said HHS Secretary Kathleen Sebelius. “The Affordable Care Act and new parity protections are expanding mental and substance use disorder benefits for 62 million Americans. This historic expansion will help make treatment more affordable and accessible.”

Related note (click to read whole article):

The British drug maker GlaxoSmithKline will no longer pay doctors to promote its products and will stop tying compensation of sales representatives to the number of prescriptions doctors write, its chief executive said Monday, effectively ending two common industry practices that critics have long assailed as troublesome conflicts of interest.

Another news item:

On December 12, 2013, Congressman Tim Murphy (R-PA) introduced the “Helping Families in Mental Health Crisis Act of 2013”. While the National Federation of Families for Children’s Mental Health applauds Congressman Murphy’s inclusion of provisions that would reauthorize the Mental Health First Aid Act (S.153/H.R.274), the Garrett Lee Smith Memorial Act (S.116/H.R.2734), the Children’s Recovery from Trauma Act (S.380), the Excellence in Mental Health Act (S.264/H.R.1263), the Justice and Mental Health Collaboration Act of 2013 (MIOTCRA;S. 162/H.R.401) and the Behavioral Health IT Act (S.1517, S.1685/H.R.2057), we decry provisions that would effectively reverse the progress made in mental health treatment and support over the past 30 years.

For decades, organizations such as the National Federation of Families for Children’s Mental Health have been working to add a more balanced approach to mental health services and treatment. The National Federation advocates for the rights of children, youth and young adults who experience mental health challenges. As family members, we feel it is important that our loved ones are able to receive the support they need while remaining at home and in the community. We realize that mental illness does not affect just one person, it is something that the entire family experiences; therefore, it is crucial that initiatives are in place to support the entire family unit.

Rep. Murphy’s bill magnifies the stigma of mental illness by creating an extremely biased link between mental illness and violence. Countless studies have determined that the relationship between mental illness and violence is minimal and that individuals experiencing mental health challenges are 11 times more likely to be the victims of violence than the general public.

The National Federation rejects the expanded use of involuntary outpatient commitment (IOC) and urges Congress to champion practices proven to be effective in facilitating a holistic approach to treatments and supports for children and youth who are experiencing mental health challenges and their families.

Finally, the National Federation strongly opposes legislation that threatens to essentially dismantle key efforts and programs of the Substance Abuse and Mental Health Services Administration (SAMHSA) which functions as the lead public health agency dedicated to mental health and addiction treatment, services, and supports. Transferring authority away from SAMHSA and decimating significant activities within the Department of Health and Human Services are not in the best interest of our most vulnerable citizens who are striving to be participating members of their communities.

The details in this bill reflect the continued, urgent need for a national conversation with individuals who experience mental illness, their families, and their communities to facilitate the creation of systems and networks that support maximal health, safety, and welfare for all community members. We urge Congressional leaders to take this opportunity to create legislation on behalf of their constituents that solidifies a bond among all stakeholders that highlights the dignity, respect, and self-determination of all individuals.

–The National Federation of Families for Children’s Mental Health issued this statement in response to the bill.

More old Cuckoo’s Nest poetry by JN:

01-30-2009AD

5:20pm

Spoken Cold-Mountain

[I had given him a copy of Cold Mountain Poems and this was his reply]

Breeze is cold, wet and fresh

Unknown writer I read his writing

Chilled the soul to touch his spirit

Vast as the array of description

Oneness not disconnected was He

Truth in the sporadic words- adrift the snow

Cliffs for bed softened his head

Reading the stone carved wit

Closer to the mountain I get

As I thought those rolling weeds in the wind

Climate is cold to touch, but normal for the universe

Who is wittier?

Mother Nature or the man who wrote?

Void isn’t the mountain with minerals galore

Treasures of the mind I must find

Breaking illusions is for me

This is my trail to this mountain

Entering meditation is salvation

A bird and animal not to sight!

Vast self to roam

Free indeed is the writer in me

Wrote a letter to karma

Issued a food through the threshold

Moonlight glistening snow winds I see

Cold-Mountain: we’re all alone, so it spoke these words

You are home sparkled the stream of life

Years ago I would not have stayed

Fleshy thing in the way

Ghosts are the host that talks wisdom to thee

By JN

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December 6, 2013 · 8:21 pm

News from the Cuckoo’s Nest

We got a look at a new report today. The hospital is all about hiring consultants and then systemically ignoring what they tell us. Our latest visit was from Dr. Ragins of MHA-LA.

I suspected we would never see a non-redacted version of his recommendations but I’ve been proven wrong.

Here it is, along with a older report he did as a pdf link. I’ve also included the introductory letter from our CMO, Dr. Rupert Goetz.

December 6, 2013

To: All affected staff

From: Rupert Goetz, MD

Subject: Attached Consultative Report

As we move into this biennium, one of the changes we are pursuing is to strengthen our understanding of “Recovery” at OSH. Hope, Safety and Recovery are after all the three core concepts in our Vision Statement.

In strengthening our understanding, we want to build on our past (remember the collaboration between Dean Brooks and Maxwell Jones around the Therapeutic Community concept; remember more recently the visit by Sandra Bloom around the Sanctuary Model). But primarily, we want to look forward. We want to look at the many ways we can grow together. For example, we also want to better understand how peer-delivered services can help us build our desired culture.

To that end, I asked Mark Ragins, M.D., who has for years helped implement the recovery model at The Village in California, to visit with us and share his thoughts. Attached is his report.

The purpose of the visit and of sharing the report is to provide us with an outside perspective. While we want to honor our past, as well as our many current internal champions, we want to creatively plan our path forward together. This additional perspective is intended to help us do so.

There are minor details such as the “not guilty” reference (it is in Oregon “guilty except for insanity”) that we might want to quibble with. There may also be the assumption that this is the blueprint for our work in the coming year – it is not. I hope rather that you find it a thought-provoking place to begin our conversation about how we strengthen recovery at OSH.

Oregon State Hospital Recovery Transformation Consultation Report

Mark Ragins, MD

Acknowledgements:

I want to thank the Oregon State Hospital for welcoming me to share your work and your lives with me. A friend of mine defines welcoming as “opening a space in your life for a guest to feel comfortable and opening yourself up to them, knowing full well your guest may change you in unexpected ways.” I have felt truly welcomed by you. I hope I have been a good guest.

This report is not meant to be an expert, authoritative evaluation and orders for you. Recovery transformation is a complex problem and complex problems are not solved by outsiders or by definitive answers. Successful transformation is an evolving, collaborative process that never ends. At best my influence can by to support, nurture, inspire, instruct, guide, and share your organic process of growth. The explorations, observations, thoughts, and suggestions I’m writing here are just the current iteration of my evolving reactions.

I have attached a large volume of reference material from our work at MHALA and the Village. These are not meant to be blueprints for you to replicate the Village or even an instruction book for you to build your own program. They are concrete, real world, useful tools we have evolved in our own process that may inspire your imagination of what possibilities you might pursue. Remember that they have evolved over decades of work at MHALA and the Village…and we’re not slow learners; we’re aggressive innovators.

A note on language in this report: The words I most commonly heard you use to describe the people you serve were patient and client. There was widespread distaste for the word inmate. In other places I’ve seen people also called residents, guests, members, students, consumers, people in recovery, etc. It’s likely that each of those words would be an accurate description of roles people have experienced along the way. There is a considerable power in the words we choose and how they reflect our mission and values. Your choice has evolved and may evolve further. I will use patient and client interchangeably in this report to “meet you where you are”.

Recovery and the Oregon State Hospital:

For me the initial overriding question for this consultation was “Is it possible to use recovery as an overarching philosophy and approach at a place like OSH?” Recovery emphasizes concepts like empowerment, self determination, self responsibility, and community integration. The patients at OSH have been specifically selected for people who are unsafe, untrustworthy, incompetent to be held self

responsible, and who have been forcibly excluded from community life. Even for a true believer in recovery and strong advocate like me that seems a difficult challenge.

Can people at OSH actually recover? Over my few days at OSH I saw several things that impressed me that the answer is yes. Firstly, the enormous majority of people at OSH will be living free from restriction in our community at some point in the future. Their day-to-day reality at OSH emphasizes risk assessment, confinement and restriction. But if we take the long view, the vast majority of people realistically should be preparing for freedom, not ongoing confinement. Second, the long term staff I met were all hopeful for the clients they’re working with. They believe things will get better for them. Third, and probably most importantly, there were widespread examples of patients at all points in their journey who are making progress and recovering. These ranged from someone who was soothing himself with a guitar to reduce his assaultiveness and seclusion from every day to a few times a week to a young man doing Calculus homework for his online college class who has been approved for discharge to a group home hoping to continue his studies on campus. Whether you describe yourselves in recovery terms or not, recovery is happening at OSH now.

For recovery to be a pervasive culture, the wide range of hopes, dreams, and personal journeys of each patient’s recovery need to be unified into a shared collaborative vision and destination. My proposal is: People living at OSH are engaged in a hopeful, healing journey towards freedom, safety, and self responsibility. I believe that those three characteristics of the destination – freedom, safety, and self responsibility – are all mutually interdependent. None can be sustained independently without the other two. Whichever of the three are not addressed and achieved will ultimately drag down the other two. I believe that vision of recovery can be applied throughout OSH.

My next concern about implementing recovery was “Is it possible for the staff to have relationships with the clients that regularly support and facilitate their recovery?”

The clients at OSH are in a strange, awkward moral place where society has rejected them without convicting them of any crime. The staff must be “abnormal in a certain special way” in order to reach out supportively to people who have been cut off and exiled by our society. To create a “counterculture of acceptance” at OSH staff must be consistently accepting of them. It seems as though the majority of your staff is already there.

It would be helpful to have a unifying “moral stance” regarding the clients that everyone accepts. I would propose: These people have been determined not to be guilty, bad people who should be punished, but rather incapable people who should be supported to become capable again. This stance is consistent with the recovery vision above. Staff who become punitive instead would need to be sanctioned. It would also be helpful to include the ability to accept your clients on that basis as part of your recruitment, hiring, orientation, training, and retention.

The other serious obstacle to forming recovery relationships is the danger staff are in because of the patients’ violence and the fear the staff feel as a result. It is extremely difficult to collaborate with and empower someone we’re frightened of. A good deal of the staff seem to have embraced trauma

informed care as a tool for reducing fear, conflict, power struggles, and actual danger. This should become universal.

Beyond that, the most impressive thing I saw at OSH was the innovative and exemplary practice on a very dangerous unit: They have come together as an amazingly unified team, using a detailed, highly individualized “engagement” tool that assesses each person’s dangerous behaviors including their triggers, warning signs, helpful relationships, self soothing and care combined with a DBT approach. The staff never give up and continue to seek out creative approaches for each person gaining administrative approval when exceptions to policy need to be made. They appear to have drastically reduced the dangerousness on the ward. Beyond that, even though there continue to be assaults and seclusion and restraints, the staff feel safe and are allied with the clients. This is a remarkable accomplishment that should be analyzed, replicated, rewarded, and treasured. I believe that if it can be done widely alongside trauma informed care, it can get you through the fear barrier to recovery relationships.

I think more work could be done proactively and on an ongoing basis to keep staff from becoming too fearful and traumatized. Your staff have to have the resilience to feel safe even though they’ve been assaulted and likely will again. They may need to be selected for that trait (from a variety of experiences). They need support when they’re weakened and need recharging. They need each other most of all. Toughing it out alone or feeling trapped with a certain patient or unit are both likely to lead to burnout. Ongoing attention to staff nurturance to avoid fearfulness is essential.

My conclusion is that – with ongoing support and emphasis – enough hope, acceptance, alongside enough avoidance of fearfulness and punitiveness could be maintained to have recovery relationships throughout OSH.

What advantages would recovery likely have at OSH that would make it worth the effort?

Integration of services: There is a dazzling array of services at OSH ranging from psychiatric medications, to external controls, to sex offender therapy, to art and music therapy, to supported employment, to peer advocacy and bridging, to access to a legal library, to discharge resource development, to an Empowerment center, to yoga and mindfulness, to anger management and substance abuse groups, to Basketball and a woodwork workshop, etc. Although there are some team meetings and a coordination plan much of what is done is not integrated together. A recovery focus brings the utility of each activity into focus: Does this activity move the person closer to freedom, safety, and self-responsibility from where they are now? There is far less need for power struggles and hierarchies to determine whose work gets priority if you’re all in alliance working on the same goals in the same direction. It would also be clearer to the patient how everything fits together to benefit them.
Decreasing “staff vs. patient” conflicts: Recovery emphasizes collaboration, shared decision making, and empowerment rather than compliance, informed consent, and professional authority. Those differences radically reduce conflict. Safety would likely be improved for both staff and patients as a result.
- Decreased staff burnout and increased satisfaction: One of the most powerful factors behind the spread of recovery is how much staff prefer it once they are doing it openly and together and confidently compared to their previous work. At bottom, recovery feeds our hearts more than standard treatment does.
- Alliance between administration and staff: if administration embraces and adopts recovery practices for themselves in addition to prescribing it for their line staff the entire program works more synergistically.
- Improved community advocacy: When community advocacy is based on fear and “demonizing” our patients we can get extra money, but we badly decrease community welcoming and reintegration for our patients. When community advocacy is based upon recovery, we can ally with our patients, and we have a foundation for promoting community welcoming and reintegration. Telling stories of patients achieving safety, freedom, and self responsibility are far more likely to help them be accepted than billboards of staff injuries at the hands of dangerous, frightening patients.
- Protection against slipping into dehumanized, punitive, coercive relationships: Any program that is involuntary, locked, and largely hidden from society is prone to slip into increasingly dehumanized, punitive, relationships and from there into overt abuse. Power is corrupting. A recovery culture can provide a counterinfluence to these destructive trends.

Recovery implementation:

Recovery is primarily a treatment culture. It emphasizes less what is done and more how and why it is done. Therefore, implementing recovery is a prolonged, organically evolving, complex process. It needs to be tended and nurtured like a farmer does, not blueprinted and built like an engineer does. Take your time. Be gentle to the land and be a good farmer: Till the soil to prepare it, help pick out seeds and pay for them, plant alongside the staff and clients, fertilize and nurture seedlings, pull out weeds (but not with widespread poisons), rotate crops to avoid exhaustion, and celebrate the harvests together.

There are many recovery principles and practices – like “client-driven” or managing relationships during times of transition to promote growth and self responsibility or strengths based community advocacy – that require years to explore and master. Be patient. Here’s a link to something I wrote to comfort and guide transformational leaders: http://mhavillage.squarespace.com/storage/69KeepingPerspectiveandStayingSane.pdf.

The land can be plowed by mapping recovery. There are a number of “maps” of recovery to adopt from, but you should create your own and it should be very specific to your clients’ journeys. Years ago I created a four stage “map” for the Village based on the work of Elizabeth Kubler-Ross that includes four stages– hope, empowerment, self-responsibility, and achieving meaningful roles. http://mhavillage.squarespace.com/storage/08ARoadtoRecovery.pdf is a link to my short book “A Road to Recovery” that describes this map using lots of stories and learning from our direct experiences at the Village.

Your map could include stages like:

Being involved in a tragic, socially forbidden action,
being determined to be incapable of self responsibility and punishment and referred to OSH to rebuild capability,
being faced with unwanted external control and coercion,
being stuck in resentment and rebellion,
resisting change and trying to “fake it to evade it”,
feeling ongoing pressure for internal change,
demoralization and giving up,
maladaptation to living in the institution,
having seeds of trust and collaboration with staff to try to rebuild,
prolonged internal self-evaluation and skill building in a variety of ways,
- repeated cycles of failing to do enough to be released,
achieving release status but no community opportunities or resources,
being released and facing ongoing coercion and control and community rejection,
- returning to unsafe behaviors and environments,
- achieving full freedom, safety, and self responsibility.

It is essential that this map be from the clients’ point of view to be a recovery map. (If it’s from the staff’s point of view it’s a treatment map, not a recovery map.) The “gold standard” is that the clients can recognize themselves and their journeys on the map. Make every effort to amplify the clients’ voice and experience. Embellish the map with client stories, artwork, music, video, poetry, etc. Here’s a link to a touching example of a video created by a group of consumers in Porterville, California: http://www.youtube.com/watch?v=uH9gV_7jmiQs.

You can gain some cultural depth by connecting the map to other human journeys (like achieving death with dignity, Joseph Campbell’s hero’s journey, 12 step journeys, or other recovery narratives, etc.)

You can also gain some spread of this map from just applying to clients to applying to everyone by creating a narrative of the recovery process OSH has experienced going through the same stages as the clients. It almost seems uncanny to me how closely these stages describe the last few years at OSH. MHALA applied the same four stages our members go through to what staff go through when we structured our Recovery Oriented Supervision trainings to emphasize that we need to treat our staff the way we want them to treat our clients.

Your recovery map can then be a direct guide for determining how staff relationships facilitate or hinder recovery at each stage, how services should be organized and integrated “meeting clients where they are at”. A standard for valuing staff and services becomes “How does this promote your client’s recovery?” rather than which staff has more power or influence within the system or hierarchy. This also makes the resolution more often “and” rather than “or” valuing each staff and service for their strengths and figuring out how they can work together instead of competing against each other. (For example, a team with a united front demonstrating a “show of force” standing behind an individual staff with a soothing relationship trying to help an aggressive client problem solve and re-establish self

control can work together without either one being “wrong”.) It should be possible to promote efforts that strengthen people without weakening someone else.

The Village found that our treatment principles mapped directly onto our four stages map too (see attachment 1). Notice how precisely stated and focused our principles are. You may have staff that are good at developing clear treatment principles that apply across OSH defining the “beliefs” that underlie your evolving recovery culture.

Administratively, you want to develop parameters to guide staff as they develop individualized recovery relationships rather than highly prescriptive policies, especially avoiding pervasive “thou shalt not” policies that “straightjacket” them. This link has a set of parameters that the LA County Department of Mental Health developed and adopted with our assistance: http://mhavillage.squarespace.com/storage/82NewRulesforStafftoWorkBy.pdf.

OSH staff expressed a lot of change fatigue and burnout. My overall impression is that there are more people who think there have been too many changes, especially administratively engineered changes, than people who think that OSH is stagnant at present. Top down engineered changes engender more change fatigue and resistance than bottom up, organically emerging changes. Except for three pointed exceptions I’ll describe below, I would recommend cultivating currently emerging changes instead of directing new mandates. (For example, after I visited a state hospital in Provo, Utah each staff member made a large cutout of a helping hand with one thing they would do differently to support hope, empowerment, self responsibility, or meaningful roles and then the patients responded by each of them making a large cutout of a foot with one thing they would do to walk a path with more hope, empowerment, self responsibility, and meaningful roles. A lot of excitement and empowerment was generated there by this approach.)

Promising examples of emerging changes I heard about at OSH included:

Trauma informed approaches to reducing seclusion and restraint and increasing self control
Team based integrated engagement and DBT approaches to reducing aggression and assault
Creating more “nimble teams” that could rapidly solidify trust even with staff movement and turnover
Enhancing peer support services
Specialized ethnic and sexual orientation specific peer support
Using music recording to explore personal growth and create positive roles
Using yoga to address trauma wounds and healing in non-verbal ways
Create a robust family and community volunteer presence in the treatment malls to increase community connections and acceptance
Create a client key card system so that increase privileges and self responsibility are directly connected with increased freedom of movement around OSH. (BTW I saw this done successfully in that same state hospital in Provo Utah)
Openly discuss and develop parameters for including positive, permissible sexual activities including dating, hugging, dancing together, and conjugal visits.
Increase peer bridging to peer run organizations n the community to increase community supports and connections upon initial release from OSH
Creating a newsletter with stories of hope and recovery

I’m sure there are many more seeds and saplings of ideas around that need nurturance.

Hope requires a lot of consistent nurturance built into your program or we end up focusing on the crises of the day and the things that go wrong. ( Examples of hopeful rituals include beginning team meetings with stories of hope, regular celebrations, special staff acknowledgments and rewards, etc.) Too many policies are made to make sure one serious incident “never happens again” instead of strengthening us so when something tragic happens, and it inevitably will, we’re able to continue on.

The three area in which I would recommend you do serious course corrections (or to use our sailing metaphor, three places where I think you should tack – including communicating the need for a course change, micromanagement of the course change, and bringing people together to handle the change as a team) are: 1) personal dedicated recovery relationships, 2) peer support services, and 3) board hearings.

1) Personal dedicated recovery relationships:

Your present system tries to ensure that everything is in place to facilitate someone’s recovery. They have written goals and a recovery treatment plan. They have the availability of a wide variety of supports and services which they are scheduled into. And they have clear objective assessments to prepare them for hearings and release. What they don’t always have is a trusting, collaborative relationship with a single dedicated staff to guide them through the process. This staff also needs to guide them through the internal process of recovery – engagement, motivational enhancement, commitment, dealing with grief and loss, internalizing skill building and role changes, moral development, building self responsibility and self reliance, preparing for discharge and community belonging.

I strongly prefer a “therapist case manager” model to a “broker case management” model for this primary relationship so that the internal and external processes of recovery can be integrated. At the Village we call this person a “Personal Service Coordinator” and have adopted Kansas University’s “strengths based case management” model.

I fear that implementing a PSC model at OSH will require substantial top-down structural reorganization, precisely of the kind resented by your staff and causing change fatigue and burnout. Nonetheless, I think it’s a crucial course correction.

This is an opportunity to emphasize some of the more personal aspects of recovery relationships instead of making administrative assignments: Which staff is the best personal fit for this patient? Who has the most hope? Who has the least fear? Who has personal life experiences that enable them to connect to this person and inspire them? Who is strongest at the particular phase of recovery this person is in?

Client empowerment can also be overtly included: Who do you want to work with? Who do you trust

the most? The Village even has “open enrollment” periods every six months when our members can switch PSCs or teams within the same level of care without needing to give a justification.

2) Peer support services:

There comes a point in the development of peer services when they need to move from being “angry outsider advocates” to “collaborative, insider reformers” to move forwards. As the walls keeping the patients’ voice silenced are lowered, other voices besides aggressive, antagonistic, self righteous voices can be heard. This is a disorienting time for peer advocates. The traits that have been absolutely essential to lowering those walls and bringing about change, that have been nothing less than heroic, are now being criticized and blamed for not being able to progress further. Newer peer staff may not respect their contribution and what they’ve been through so they could have a voice. These experienced peer advocates may not even agree that there has been substantial progress or that the walls have been lowered. They may fear a “trick” to weaken them or co-opt them. And sometimes they will be right.

But at other times, when the swords are put down, there is a flourishing of other voices and relationships. Sometimes a Nelson Mandela emerges from the fight instead of dying on the battle field like Che Guevara did. Sometimes unions that were regularly striking and being repressed engage in collective bargaining or even shared ownership.

In my opinion, OSH has made enough progress to try to put the swords down. I would recommend substantially increasing the number of peer staff, while substantially decreasing their adversarial “peer advocacy” in favor of collaborative “peer support” services.

Making that course correction will likely be quite difficult. In my experience in other places what usually happens is that some of the most valued and successful long term peer advocates end up removed or reassigned out of the mainstream to move forwards. That seems a shame to me and I don’t know that it’s the only possible strategy. It does however, open the door for a wider acceptance of, and integration of the other peer supporters with the treatment teams improving the patients’ recovery services directly.

At OSH there is a legal restrictiveness that exists side by side with the clinical services that is very important. This brings up the possibility that some of the most valued, but most dedicated to advocacy, peer staff could be moved into a new robust “peer advocacy” department and separated from the “peer support” department that would become co-supervised by the teams and by peers. I don’t know if that’s been done in other forensic settings. If the peer advocacy service was robust and respected enough it could be a valuable “check and balance” against the corruption of power and coercion that is an ever present risk in involuntary, locked settings.

I would advise having a small team of clients, staff, peers, and administration charged with developing a plan to move to a larger peer staff that is no longer emphasizing advocacy. They should seek out guidance from other exemplary peer services. I’ve been exposed to successful programs at Recovery Innovations, Riverside County and Tulare County in California, and King’s County Hospital in Brooklyn.

NAPS (National Association of Peer Specialists) can probably point you towards further resources. The team would be expected to inform and guide the process of changing course, but the course itself wouldn’t be negotiable.

In my view, the main emphasis at this point in your development is not to accentuate the differences between clients and staff but instead to blur those differences. Justice and righteousness are less crucial than trust and reconciliation. Desegregation, power sharing, collaboration, mutual respect, inclusion, and interdependence would be my points of focus. Towards that end I would hire more “blurred people” – both peer staff who have professional skills and degrees and probably more importantly, professional and para-professional staff that have lived experience of mental illnesses. In addition we need to remember that there are a substantial number of staff who are currently hiding their lived experience out of fear. That is a terrible burden on them and deprives the patients of a considerable source of support and hope. Those staff shouldn’t have to take sides. They should be proud of both their personal and professional gifts and be able to use them without fear.

3) Board hearings:

Although there have been changes in these hearings recently, they are still clearly the cause of major distress, antagonism, hopelessness, and divisiveness. A patient complained that they are arbitrary and unpredictable, often not following the clinical input of the staff, leading him to withdraw and give up in helplessness. A psychiatrist said that he pisses off the public defenders, the district attorneys, and the hearing officers about equally so he must be doing something right. Frankly, that doesn’t’ sound like a collaborative relationship either.

Over the last decade there have been substantial innovations within mental health legal hearings. There are mental health courts and drug courts scattered around where the hearing officer has a personal relationship with the client and actively participates in their recovery: They engage and motivate clients. They grieve and celebrate with clients. They mediate between staff and clients working to improve their collaboration. They actively secure community resources and services for clients. They even hug clients. I am aware of an exemplary court and judge in Nevada County, California who handles the involuntary outpatient commitments (Laura’s Law AOT). The Elyn Saks institute at USC is connected with a large number of resources who could inspire and guide you.

I realize that this recommendation is beyond the scope of my consultation and expertise, but I think these hearings could become a major force promoting recovery – especially as defined by freedom, safety, and self responsibility.

Recovery Accountability:

Recovery sometimes seems so nebulous that it can’t be measured or promoted in an accountable manner. This argument maintains that it’s too non-specific, too subjective, too individualized to quantify or track. Either you have it or you don’t. I don’t agree.

Broadly speaking there are three areas to try to create accountability: 1) Recovery service provision, 2) recovery outcomes, and 3) recovery culture. There will always be a tension between the accuracy and detail of the measurements in the accountability tool and the burden it places on clients and staff. (The Mental Health Center of Denver is very sophisticated in their use of data driven management and accountability.)

1) Recovery Service Provision

This is the most common way mental health services are held accountable: Are we providing the services we’re supposed to in sufficient amounts. In many parts of the system our payments are directly tied to service provision. It is also the weakest way to assess accountability. There’s no way of knowing if a service is being provided well or not, effectively or not, compassionately or not, etc. All we know is that, at least on paper, someone did something.

Recovery services can be described and counted as well as traditional psychiatric or rehabilitation services. I attached a list of recovery service areas that MHALA uses (attachment 2). These are included in our EHR alongside the medical service codes.

2) Recovery outcomes

It would be nice to know if we’re actually helping people recovery. We can track outcomes that are desirable whether they resulted from recovery or not, and we can track correlates of the recovery process.

California’s statewide AB2034 program that enrolled people who “deinstitutionalization failed” had four targeted outcomes: Psychiatric hospital days, incarceration days, homeless days, and employment days. The 70% reduction in hospitals, jails, and homelessness alongside a 400% increase in employment days were powerful outcomes for California’s legislature and Governor Schwartzneger. These four outcomes were specifically chosen to monitor the outcomes society had assigned to us and are relatively easy to track reliably. You could make a small set of similarly targeted outcomes, for example, reduced incidents of assault or other violence, increased incidence of competency restoration at hearings, employment earnings within the hospital, increase in board approved discharges to lower levels of community care, etc.

MHALA didn’t feel that the variables on our four stage map of recovery (hope, empowerment, self- responsibility, and meaningful roles) would be reasonably measurable to track recovery although they successfully captured subjective experiences of recovery. We created a tool that is uses staff ratings to track individual’s progress through recovery using three correlates of recovery – risk, engagement with mental health services, and skills and supports. This link has the eight point Milestones of Recovery Scale (MORS) and describes its development, validation, and use: http://mhavillage.squarespace.com/storage/84AGuidetotheMORS.pdf.

You could create a similar tool using the three most crucial outcome dimensions for your program – safety, freedom, and self-responsibility to define stages you could track people through; for example

stages like extreme danger, high external restriction, low internal control and self responsibility. Remember that the map shouldn’t be linear and should include forward and backward movements to realistically map recovery.

3) Recovery culture

On the face of it, culture is the most difficult thing to measure. MHALA has developed a tool for adult community based mental health programs that begins with seven core valued dimensions of a recovery culture and then describes concrete indicators of whether the program is doing nothing, exploring, emerging, maturing, or excelling in each area. This link http://mhavillage.squarespace.com/storage/87ARecoveryCultureProgressReport.pdf has the Recovery Culture Progress Report and a discussion of its rationale, development and usage. Note how each domain flows from a value statement. You could develop a tool like this for your own program.

Conclusion:

The same friend of mine I began with said that for hope to be useful it has to include three elements: 1) A vision of where you’re aspiring to get to that is clear and specific enough to become believable (not that you ever get to exactly where you imagined or hoped for), 2) A commitment to take a few concrete steps that lead towards your vision (and see what happens), and 3) Enough passion and understanding of why this vision is important enough to you that you’re resilient enough to make it through the inevitable blockades and setbacks.

I think you have enough useful hope to achieve recovery transformation at OSH. Thank you for including me in your journey.

WE BELIEVE…

MHAVillageGuidingPrinciples and the Stages of Recovery

Hope makes recovery possible; it facilitates healing of the mind, body and spirit.

Welcoming people includes creating a culture of acceptance with easily accessible integrated supports and services.

Focusing on the whole person includes their strengths and weakness, abilities and barriers, wounds and gifts.

Each person creates their path and determines the pace of their recovery.

The recovery process is a collaborative journey in support of individuals pursuing their life goals.

Relationships are developed through mutual respect and reciprocity, including openness to genuine emotional connections.

A solid foundation for recovery is built by helping people to honestly and responsibly deal with their mental illness, substance abuse and emotional difficulties.

People thrive, grow and gain the courage to seek change in respectful environments that promote self responsibility.

The practical work of recovery takes place in the community.

Each person has the right to fair and just treatment in their community ensured through advocacy and social responsibility.

Everyone deserves the opportunity to have a place to call home.

Promoting natural supports, having fun and a sense of belonging enhances quality of life.

Employment and education are powerful means to help people build lives beyond their illness.

Program success is based on achieving quality of life and recovery outcomes.

Recovery Based Service Categories and Vignettes

1) Welcoming / engagement – connecting the member with staff, program and peers, relationship building, demonstrating our “usefulness” to the member, engaging in collaborative goal setting, shared decision making, connecting with the member through self-disclosure

I asked Ann to bring in the drawings she’d made with the art supplies her mother had sent to the Board and Care, admired them, and made a couple copies to put on the wall. I also showed them to other members and staff who were sitting around the team area, introducing Ann as a “real artist”.

2) Crisis interventions / Responding to basic safety needs and community expulsion threats – accessing, collaborating with and/or diverting from hospitals and jails, advocating with the legal system to prevent incarceration, locating, placing in and/or paying for emergency shelter to prevent homelessness, , safety interventions – medical, substance abuse harm reduction and prevention, responding to threats of dangerousness, suicidality, and impending harm (e.g., domestic violence)

Donna wandered into the team area looking quite confused. She didn’t respond to anything I said, just staring at me. Yesterday she had been coherently calling checking her status on the waiting list for a rehab program, so it seemed likely she was high or coming down. We tried to get her to take some medication, but she wouldn’t. We watched over her and gave her a ride home where they know she gets like this a lot and can take care of her.

3) Assessments – assessing goals and needs, understanding their view of themselves, mental health status assessment, Quality of Life assessment, co-occurring conditions (e.g., medical, substance abuse, developmental disability), “eligibility” determinations (voc rehab, disabled students, SSI, bus passes), fitness determinations (legal competence, child custody and driver’s license)

Mike says he wants to get a job, but he seems far too disorganized and our employment staff is hesitant to work with him. We decide to give him a “we pay” job using client support funds to put together new charts and shred paper for us for one hour a day to see if he can show up and if he does, how he’s able to function at those tasks, and if he follows directions. The information gathered can also be used as part of his SSI disability report.

4) Building and maintaining the safety net / “protective factors” – assisting in obtaining benefits and entitlements, connecting to poverty services (e.g., COA food bank, multi-service center), charity (e.g., bus tokens, food, clothes, toiletries), safe and secure housing, family connections, assisting in obtaining basic documentation (e.g., ID, birth certificate), connecting to basic social

services (DPSS, SSA), connecting to cultural connections, (Native American services, UCC), connecting to spiritual strength and security (faith community)

Anna has been staying with a variety of men she finds, but they all end up taking her money and short lived. She seems always surprised when they pressure her for sex. We make a deal with Ann that if she contributes $150 per month out of her GR check, we’ll give her a hotel voucher worth $650 to have a safe place to stay for the month, but she can’t have any one stay in her room with her.

5) Motivating / Engaging in growth oriented activities – engaging in motivational interviewing, outreaching to isolated members, exposure to opportunities e.g., plays, sports, dances, hobbies, job fairs, schools), exploration of possibilities for the future, career exploration, core gift activities, goal visualizing, peer bridging

Carl hangs out at the sober living all day long, using pot and not following up with anything. He says he doesn’t have any money to do anything. I offer to take him out to lunch with a small group of members and on the way intentionally take him by one of the other member’s apartment starting a conversation about what it would take for him to get an apartment of his own too.

6) Treating mental illnesses and substance abuse disorders to reduce barriers – helping members to gain control over their mental illness, helping members to identify and control their symptoms (e.g., WRAP), 12-step step work, medication services, providing psychotherapy, building emotional coping skills (e.g., CBT, coping with past traumas, anger management, relationship skills), building wellness skills (e.g., meditation, eating and sleeping routines, yoga), treatment of acute symptoms and relapses

Renee is struggling with panic attacks and flashbacks of being raped and is overtaking the Klonipin she’s been prescribed combining it with alcohol. I teach her several anxiety reducing techniques including a “butterfly hug” to use during flashbacks, relaxation imagery for when she’s not quite as anxious, and to carry around a small tin of coffee grounds in her pocket that immediately calm her by reminding her of her mother when she was a child.

7) Treating physical illnesses – providing basic wound care, monitoring and treating chronic physical illnesses (e.g., diabetes, hypertension, chronic pain), medication management for physical illness medications, seizure response, physical illness education (e.g., diabetes, hepatitis), smoking cessation, promoting physical wellness (e.g., exercise and nutrition)

Dennis fell in the bathroom at the Village and said he was “knocked out” for a second. I called a nurse to check his vital signs and make sure he didn’t have any neurological signs that would indicate we should take him to an Emergency Room.

8) Providing and building support – connecting to Village resources (e.g., job development, educational) and community resources ( Jewish Community Center, Gay and Lesbian Center, primary care provider, 12-step support groups, warm lines), connecting to social services (e.g., In Home Supportive Services, Family Preservation), participating together in community

activities and opportunities (“giving moral support”), helping families to support members (e.g., family education, consultation, problem solving), providing help directly (e.g., “doing it for them,” adding structure to their lives, making decisions for them, ”caretaking”)

Martin needed to get help to move his stuff from his hotel room into a permanent apartment. He couldn’t get any friends or family to help him and he didn’t have $15 to pay day labor to do it with him. Since there wasn’t that much stuff, I drove my own car over and helped him put his stuff in my trunk and then helped him unload it into the apartment.

9) Rehabilitation / Skill building – teaching, job coaching, supported models (employment, education, housing), in-vivo teaching, providing work experience, teaching self-help skills (e.g., budgeting, shopping, laundry, hygiene, medication management), helping the member to build and practice meaningful roles

Kenny’s shower head broke off in his apartment. His girlfriend who lives with him demanded that he do something about it and threw it at him. He brought it in and put it on my desk demanding that I do something about it. First I coached him through the process of calling his manger with him on the phone talking but that got nowhere. Then we got in my car and I coached him through the process of actually getting a replacement part at the hardware store. Once again, he did the talking while I stood by his side giving him hints. He screwed the shower head back on himself. He wrote a letter to the manager, enclosing a copy of the bill, to get the money back sitting at my desk going over it step by step.

10) Building personal growth and responsibility – Helping members understand and move through normal stages of life (e.g., prolonged adolescence, first parenting, mid-life crisis, empty nest syndrome), building self- responsibility (learning cause and effect, not blaming others), building self- efficacy (building the ability to positively impact one’s life), empowering members

Andy was offered a catering job with the Village Deli on a Saturday for four hours, but that was also the day his case worker was taking some members on an outing to Universal Studios. Andy was torn between fun and responsibilities. While another immature member urged him to go to Universal Studios with them and just have fun, I helped them both see how cancelling out on his boss at the last minute would make him a less responsible employee and that fun has to scheduled around work.

11) Community integration – developing and facilitating members’ connections beyond mental health and social services (Taking a member to a Mommy and Me group, helping a member to join a bowling league, creating a calendar of low-cost community events), helping member to discover niches, roles, and opportunities in the community, promoting being a good neighbor and citizen, helping member to invest in and give to community in positive ways, helping the member to learn to give to others

Francis had been raised Catholic, but hadn’t been back to Church in many years while she’d been on the streets and using drugs and prostituting. Now she was clean, but felt too ashamed to return to

Church. I connected her up with another staff member who goes to Catholic Church regularly and he agreed to go with her and just sit in the back together during services to see how it felt.

12) Community development – making the community a better place for people with mental illnesses, increasing tolerance and acceptance of mental illness, reducing segregation, reducing stigma, developing welcoming hearts in the community, building connections with other community social causes

The East Village Association arranged for a community clean-up day. A group of members and staff came in together as a Village team to help this neighborhood effort.

13) Promoting self reliance, separation from services, and graduation – building financial independence (getting off SSI and Section 8), obtaining private insurance, preparing for graduation, facilitating relationship changes with staff, finding and providing opportunities to give back to others still struggling, developing self-advocacy skills, developing friendship skills

When Kathy called asking for my advice in her problem with her boyfriend, instead of giving her advice, I helped her explore who else she had in her life whose advice she could rely on, so she wouldn’t need me anymore.

87ARecoveryCultureProgressReport

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Filed under Mental health recovery, Mental Hell Treatment, wellness and systems change

Tagged as Mental health recovery

February 12, 2011 · 6:19 pm

Letter from Actual Sanity

from actualsanity.com

An Unusual Love Letter To The World, Or Whoever May Happen To Read It

Anonymous Author, USA, 2010.

PLEASE NOTE: This letter has been written in a special way. It contains difficult but necessary truths. Some people may feel uncomfortable or upset while reading the first half of the letter, but it is important to keep reading until you reach the second half.

When you get there, you will understand why the first part needs to exist. Please do not be upset or afraid. That is just your ego reacting the way all egos do. Merely observe the negative feelings and let them pass. This letter has been written to help you.

Dear YOU,

Straight away, before anything else, I want you to understand that what you are about to read is a love letter, written because I love you. In fact, it’s very possible that I love you even more than you love yourself, which is why I’m writing to you today.

It’s also why I’m going to tell you some things that might be hard to hear. In fact, they WILL be hard to hear. The first thing I’m going to tell you might hurt worst of all.

YOU, my dear beloved creature, are INSANE. Not just a little insane, in the way you think of the people you may know who are diagnosed with “depression” or ‘bipolar disorder” or what have you. Your insanity isn’t something so easily treated with a pill or a visit to a therapist. I wish it were.

Your insanity is systemic, very nearly universal, and absolutely incurable from within the system that sustains it. Every “professional” you might go to for help is as crazy as you are. Get that straight right here and right now. Your insanity is not recognized, acknowledged, or understood by the “mental health system.” In fact, all that system can do is help you become a happier crazy person.

Yes, my dear beloved human being, you are as crazy as a shithouse rat, and there’s absolutely nothing anybody you might be have trusted to help you can do about it, because they are as insane as you are.

It’s an awful situation you are in, and because you are thoroughly insane, you don’t know how to do anything but make it worse.

Don’t get me wrong, help for your deadly condition does exist. There have been qualified doctors who have tried to help you many times, but because of your insanity, most of you have either ignored them, jailed them, and/or or tried to kill them. And those of you who did want the help they offered still weren’t able to accept it, because you’re just too crazy, thanks to the crazy world around you.

In your madness, you projected your own twisted and warped ideas onto these doctors and tried to make them into gods, villians, lords, martyrs, and damn near anything else your diseased minds could think of to transform them into something other than what they were – your brothers and sisters in humanity who recognized and shared your suffering. All they ever wanted to do was help you, because they loved you that much. They loved you more than you love yourselves, and they paid the price for it.

And how did these doctors want to help you? Without exception, they had only one prescription – to lead you back to you who you really are. In fact, you probably don’t know it, but that’s all “religion” really is and all it was ever meant to be, at least before it was hijacked by hordes of self-serving crazy people. “Religion” means “reconnection” – reconnecting with your real nature – who and what you really are. If you’re a stickler for details, like most of you crazy folks are, go ahead and look it up. That’s the root of the word “religion.”

But before your knee-jerk aversions and pre-programmed ideas kick in and cause you to flee from this page in fear of being assailed by typical proselytizing, let me assure you that I’m not here to preach religion to you – at least not in the crazy, insane sense that you understand religion. I’m not here to convert you to Jesus, Buddha, Flying Spaghetti Monster, or the fencepost. Don’t be scared. I care about your freedom of conscience as a sentient being and I wouldn’t do that to you. Only crazy people are into the whole concept of conversion, because it’s totally insane.

Instead, what I’m here to do is guide you toward the very same medicine those “doctors” I mentioned tried to prescribe for you (with the possible humorous exception of the Flying Spaghetti Monster). But please pay attention – I’m not here to tell you about what you might already THINK those guys taught. It’s a very safe bet that you really don’t have a clue what they actually taught, because the only source of information you have about them is the insane distortions and misunderstandings projected onto them by your fellow crazy people.

So, who the hell am I, anyway? Because I know you much better than you know yourself (just like all sane people understand crazy people better than crazy people understand themselves), I know that’s what you’re probably wondering right about now. What’s my whole deal and what right do I have to talk to you like this? In addition, you’re probably starting to strongly suspect that I’m the crazy one, not you. All the signs are there – or at least all the signs your fellow crazy people have taught you to help you detect people who are actually sane and label them nuts. You see, that’s the whole game – that’s how your insanity maintains itself. You label the people who are actually sane as crazy. It’s so simple that you couldn’t call it rocket science, and yet it’s also diabolically brilliant. And, just in case you care, it’s also progressively killing your whole so-called “civilization” deader than a doornail.

But enough about that right now. By the end of this letter, you’ll either see it or you won’t. As for me, my “personal identity” is not important. Don’t bother trying to discover it, as I’ll deny it even if you happen to guess right. The only purpose of knowing “who I am” in terms of my mundane life in this crazy world would be to check me out and get my “bonafides” in order to figure out if I’m qualified to be talking to you like this. Well, let me tell you straight off, I have no “bonafides” whatsoever in your crazy society. I have no degrees attesting to my ability to pass crazy tests designed by crazy people. I have no insane titles – academic, religious, psychological, or otherwise – to indicate my exceptional achievement in jumping through misguided hoops devised by an insane world. Why on Earth would I choose to spend a single minute pursuing any such thing? Can you tell me? Think about it for a moment or two, and then let’s move on.

Now that that’s out of the way, let me tell you my *actual* bonafides – the actual things that qualify me to write you this rather unusual love letter. Firstly, and most importantly, I care about you. I’ve said it several times already, but it bears repeating. Because you are insane, you don’t understand actual love in the slightest and have to be continually reminded that it isn’t the sentimental nonsense you’re trained to expect from romantic comedies and Hallmark cards, nor is it the self-serving lies you are told by politicians, world leaders, or celebrities of any kind. I’m writing to you today because you are in a life-threatening state of emergency. Your mind is occupied by a deadly, world-killing insanity and I want to help you cure yourself of it. It’s just that simple. I’m no god, guru, lord, master, or martyr. I’m simply an unusual kind of doctor, if you will – one who is not licensed to practice in any state or municipailty in the world other than the hearts and minds of those who sense that something is dreadfully wrong. And those are the only places I need to practice.

Secondly, I’m qualified to talk to you this way because I’ve spent far more time and energy figuring out how to be sane than most of you have spent doing anything in your entire lives. While you were wasting time at your insane, world-killing jobs, schools, and churches (sorry, but it’s true), I was working hard every day, all day, 7 days a week trying to figure out how not to be as crazy as you are. I did this for 15 years. That’s 15 long, hard years, trudging through 10 miles of psychological snow every day, uphill both ways. I have given blood, sweat, and tears for a scrap of actual sanity – just a scrap. And in comparison to your crazy society, a scrap of actual sanity is like a ten-ton hammer.

And why did I do such a thankless thing? Because I care for you. I see your suffering. I see your world dying – being murdered. I see the never-ending tide of your pain and tears. I see your self-inflicted tragedy reflected in six billion hauntingly brilliant shades and colors, and because I am not insane like you are, I cannot simply stand by and watch it happen without doing anything in my power to help. I’m not a hero, a martyr, or a grandiose person by any means. I’m just a flawed, ordinary human being like yourself who, through a fortunate series of misfortunes, had the dumb luck to become distanced enough from your crazy world to get a glimpse of actual sanity. That’s the only real, significant difference between you and I. It doesn’t matter that my IQ is higher than yours (which it perhaps isn’t) or that I read better books or comb my hair backwards or smoke Camels instead of Marlboros or anything else. It only matters that I, though no fault, merit, or intention of my own, just so happened to end up living a rather different sort of life than most of you have, and therefore I have gained access to a rather different sort of perspective.

However, on the other hand, don’t take me for one of your beer buddies, because that would be just as wrong as the opposite error. Don’t doubt that after 15 years of practice, I understand every bolt and screw in your diseased minds better than most of you will ever understand yourselves, even in 100 crazy lifetimes. Believe me when I tell you that should you find yourself in my presence, it would take no more than smallest flick of my metaphorical wrist to psychologically destroy you in any way I should so choose. I’m not exceptional or special in this regard – all sane people have the very same ability. Like Jeff Goldblum’s cable TV repairman character in the movie Independence Day says to his father when asked how he managed to triangulate someone’s location electronically, “all cable guys can do it, Dad.” It’s not hard to manipulate the crazy fears and insecurities of the insane. Your “authorities” and “rulers” also know just enough about how the madness of your world works to be capable of turning your screws to destroy you for their benefit, – and guess what? That’s exactly what they do. But I don’t, because I have no interest in enslaving or exploiting you.

On the contrary – I want to free you, which is a much taller order.

Because destruction is not what I want for you, I will never stop caring about you no matter how many times you laugh in my face, belittle me, spit on me, or attempt to mistreat me in any of the ten thousand ways your insane society has taught you to marginalize and neutralize the threat of people who dare to be sane. Your attempts to turn me against you lost their power years ago. Rest assured, I’ve got training in this, because you started early with me. You tried to destroy me in your insane school system long before a hair had even thought to sprout on my chin – but I survived, recovered, and grew beyond anything you could have imagined.

Pay attention – the fact that you think this is a self-pitying “sob story” indicates just how insane and clueless you are. It is precisely the opposite. Do you want to know what fear is? Then read and understand now – you cannot stop me from caring for you. I will do everything in my power to drag you, quite possibly kicking and screaming for all you’re worth, into the light. I will do everything I can to save you from yourselves no matter how hard you fight to defend your twisted attachment to self-destruction. Through the priceless gift of over thirty years of your ceaseless opposition, you have given me that power, and I thank you for it on behalf of all those who have benefited and will benefit until the day they shove me into a pine box and I am forced by Nature herself to stop doing my own small part to free a suffering world.

Incidentally, just in case you care, Jesus and Socrates had the same love for you, and you killed them for it – exactly as they had planned and willingly allowed. In permitting you to fool yourselves into thinking you had destroyed them, they became more powerful than entire civilizations and empires. You read their words today because they did as I have done, and as all sane people must do in the face of your insanity – they allowed you to give them the gift of your ignorance and hatred. As you hated them more fiercely, so did their light shine ever-brighter, until in at last killing them, you ignited them as eternal stars in the heavens, never to die.

Don’t get me wrong, though. I’m nowhere near the level of of a Jesus or a Socrates. You can put away that “he’s a lunatic who thinks he’s Jesus” label you’re trying to stick on me as one of your predictable little pre-programmed defense mechanisms. Only in my dreams am I at such a level – but I don’t needto be at that level to tell you what you need to be told. A lesser degree of development will suffice just fine, because to be frank, it doesn’t take Einstein to figure out that our world, under your insane psuedo-democratic “leadership,” is in serious trouble. Heap big trouble, kemosabe.

But this letter is not about me, Jesus, Socrates, or anybody other than YOU. And that, of course, is where the tricky part comes in. You see, while I have the power to destroy what is good and beautiful, just as you do (and which you have a habit of psychotically utilizing at every opportunity), I lack the power to do the opposite. I cannot give you the gifts of sanity, love, and freedom. If I could, I would do it instantly. I would do it with such force as to imprint compassion and truth on your soul irrevocably. But I can’t. You have to freely accept the gift of sanity of your own volition, and that’s incredibly hard for you to do, because you’re so thoroughly insane.

Oh yes, you are disastrously insane. I know I’m in danger of the broken record effect, but have I reallymade that clear enough yet? Have I repeated it frequently enough for it to begin to penetrate the massive concrete bunker of crazy that is your mind, even just a little? No, probably not. But perhaps, just maybe, the utter “weirdness” of what I am saying has interested you enough to keep reading. Maybe you want to see where this whole bizarre trainwreck leads, because that’s still what it is to you, isn’t it? A bizarre trainwreck obviously written by a crazy person. Something on the order of the Unabomber or David Koresh, no doubt. You’re programmed to associate any sudden appearance of actual sanity with those caricatured, media-pimped bogeymen to make it go away. That’s okay, I don’t mind. Please go right ahead reading under the assumption that I’m a nut. I don’t blame you at all, because you have absoutely no other way to see it – at least for the time being.

Nonetheless, please understand that your world IS crazy, regardless of whether or not I am. Sorry to be the bearer of bad news, but you are some seriously whacked-out people. You do crazy, crazy, batshit crazy and insane things and label them “normal,” “necessary,” or “justified.” Don’t you see that when you do that, you are declaring to all the world that you are crazier than a shithouse rat? You go to war and justify it as “a fact of life.” Thousands are slaughtered for the sake of absolute lies and evil motives, and you don’t bat an eyelash. That’s not “just the way life is,” it’s batshit crazy – I mean drooling, straightjacket batshit crazy. Can you imagine YOURSELF doing it? Would you REALLY fire a deadly weapon at another human being just because “your leaders” told you to? If you would, then my God, you are really crying out for the tender mercies of Nurse Ratchet.

But that’s not even the worst of it. Like a group of sugar-buzzed, frenetic children playing a massive game of “Hungry, Hungry Hippos,” you view life as a contest, a race, or a competition to control as large a share of the world’s resources as you can get your hands on in the 80 trifling years you have on Earth – and you don’t see a damn thing wrong with that, even as your brothers and sisters in humankind starve and die because of it. In fact, you celebrate this madness, preach about its “necessity” and “morality,” and assure the world that “there is no alternative.” That is murderously, shockingly, abysmally crazy. It is among the craziest things that any intelligence could concieve of. Even God Himself would have considerable difficulty devising a more insane world than yours – the very same one you are trained to think of as “normal.”

You are killing yourselves. And in reality, it is worse than that – you are murdering yourselves, and murdering as much of this beautiful, irreplaceable planet as you can manage to take down with you. But, being blindingly insane, you certainly don’t stop at homicide and terracide (the murder of planet Earth). That wouldn’t be nearly enough to satisfy your psychotic thirst for destruction. It isn’t just that you kill, rape, enslave, and destroy in the name of “war,” “politics,” economics,” “religion,” “truth,” or a thousand other distorted self-serving fictions and fantasies. Merely doing that would mean that there would be some period of your lives in which you were not behaving insanely, and that simply won’t do. Your virulent madness will settle for nothing less than complete domination of the entire human experience, lock, stock, and barrel, 24/7/365.

And so, you enslave yourselves. You sell yourselves to the highest bidder. Without so much as a twinge of conscience, you shamelessly piss away your ONLY two God-given (or Nature-given, if you prefer) resources in this life – your precious time, and your precious energy. And let me assure you, my dear insane friends, these are not resources which you have in great supply. You’ve been told over and over that your lives are short and your energies are limited, but you don’t really believe it, because you are completely in denial. You behave with unbelievable recklessness, acting as if you had unlimited amounts of time and energy to waste on utter trivialities, traps, distractions, mental prisons, and every other kind of insane, diabolical pitfall your fellow crazy people expect you to spend your whole life falling into. And before you can say “Orville Redenbacher,” whammo, right out of the clear blue sky and much to your total surprise, you are going to be out of time and wake up dead – but not before realizing at the last minute the enormous true value of what you wasted and threw away.

But hey, I could go on and on (and trust me, I really could), but you get the idea by now – even if you refuse to accept it because of the insane brainwashing you’ve been callously and cynically subjected to every day of your life right up to this moment. So let’s cut to the chase, right? Well, here it is on a silver platter:

Pitiably, regrettably, and disastrously, your insanity almost always prevents you from realizing that all you have to do in life is love each other. That’s it. Nothing less, nothing more. That is the ONLY thing that determines whether or not you are “successful” as a human being. Do you understand? All you have to do is really give a damn about your neighbor and act like it. I mean really care, in the same way you care about yourselves. You’ve been told this before, but your insanity ensures that it is the LAST thing you really want to do. You’ll go to any lengths to avoid taking it seriously. You’ll move Heaven and Earth – literally – to run away from it.

Because of this, you’re destroying yourselves and taking everybody on Spaceship Earth down with you. Sorry to beat a dead horse, but you’re crazy – homicidally crazy – and you’re killing yourselves along with your brothers and sisters. Worst of all, barely one man or woman in ten thousand even has the small scrap of actual sanity needed to suggest that maybe you ought to cut it out. You are well and truly screwed, and had better start considering the possibility of paying attention to what I’m saying here very quickly. Like yesterday, or last week. You have no time to waste, because even if you don’t value your own time and energy, rest assured that I do. What this means is that I am an extremely limited resource. There aren’t very many like me in the world (especially since you’ve worked so hard to erase us all from existence) and your chances of even encountering this message to begin with are extremely slim – but somehow you did anyway. And do you know what that means?

It means that congratulations are in order, because you have just won the lottery. Not the money lottery, of course, which would only entrench you in your insanity even further. If you’ll kindly allow me a slight (but relevant) tangent, it bears noting that your love of money is perhaps the clearest sign of your tremendous sickness. If you had any actual sanity at all, you would hate and despise money beyond belief. I know that statement just pegged the needle on the handy-dandy “crazy meter” you’ve been programmed to use to defend yourself from the dangerous influence of people like me, but just for kicks, why not consider it anyway? You think of yourself as a freethinking person, right? It won’t kill you to entertain an idea, will it? Just turn it over in your head, if you have the cajones. As a thought experiment and nothing more, take a minute or two to play with the idea of actually hating and despising money. It feels completely bizarre, foreign, and crazy to you, doesn’t it? Guess what. That’s because you are thoroughly insane.

There, that was good practice, and if you’re still reading, I’ll assume it didn’t kill you. Give yourself a round of applause, but don’t get too carried away. That’s just the tip of the iceberg. Money, war, and selfishness are only three of the countless sick, twisted, insane, and evil ideas you believe are “necessary facts of life,” but they are perhaps the three finest examples of how deep your craziness runs. Why did I mention selfishness, you may be wondering? Isn’t the acceptance of selfishness so well-ingrained in modern thinking as to stand beyond question? Haven’t you, for thousands of years collectively and decades individually, heard and been comforted and justified by continual rationalizations of selfishness, its basis as the foundation of human nature, its necessity, and even its virtue? Of course you have, because you are part of a ravaging horde of crazy people trying to convince each other how real and wonderful your twisted and destructive delusions are. That’s the gist of it in a nutshell. A nutty nutshell.

Enough beating around the bush. If I spend any more time trying to convince you of how insane your world is, I think we’ll both get a migraine. Besides, that’s not even the worst of it, at least from your perspective. Here is the reality, which I promise that you will NOT be able to accept without extreme difficulty. Get your blindfolds ready, because this is going to hit far harder than what I’ve written so far, and cut far deeper. It’s far more frightening and offensive to your diseased minds than an eternity of calling you “crazy” and “insane” would be. That, you can handle (because you’re used to abuse, given that your whole society is based on it) – but what I’m about to tell you, you can’t handle. You’ve proven it over and over for thousands of years. In fact, I’ve only been calling you crazy and insane to prepare you for the REAL awful truth – and here it is:

YOU are a beautiful, inherently powerful, irreplaceable, unique and wonderful being of infinite worth and value.

Yeah, YOU. The frustrated, depressed middle manager who has already sold away well over half your precious time and energy to the highest bidder only to have life hand you one shit sandwich after another for your trouble. As you lift a drink to your mouth to wash away the pain of your empty existence, know this and at last have hope:

YOU are a beautiful, inherently powerful, irreplaceable, unique and wonderful being of infinite worth and value.

Yeah, YOU. The kid in school who is picked on continuously, to the point that you’ve given up on life. As you contemplate suicide and consider the unspeakable act of depriving the world of your irreplaceable presence and all the good you will someday do thanks to the gift of your painful origins, know this and understand:

YOU are a beautiful, inherently powerful, irreplaceable, unique and wonderful being of infinite worth and value.

Yeah, YOU. Whoever you are, whatever you’ve done with your life up to this very moment (even if all you’ve ever done is piss it away), and whichever one of the 6 billion unique and irreplaceable facets of human life on this Earth you might happen to be, know this for a fact and feel its truth in your heart – perhaps for the very first time:

YOU are a beautiful, inherently powerful, irreplaceable, unique and wonderful being of infinite worth and value.

And that’s the truth you’ll never, ever be told by the insane world that wants to use fear and self-loathing to control you, just as they have done all your life so far. Understand me clearly – this isn’t about “self-esteem” or some slick self-help nonsense peddled on Oprah’s book club. This is about the fact that your incredibly unlikely, miraculous existence is the cold, hard, factual result of a universal process that extends all the way back to Big Bang, the divine moment of creation, the Garden of Eden, or whatever story of creation you happen to prefer. Whether you were created by God, Nature, random quantum fluctuations, or the Noodly Appendage of the Flying Spaghetti Monster, the simple fact that YOU are here is a miracle. That’s not New Age nonsense, it’s the very reality of your whole being. I don’t care who you are, what you look like, how much money you make, or what anybody else thinks of you – if anything in this endless Universe is a miracle, then you are a miracle. Learn it, love it, and start acting like it.

People of the world, or at least the few who will ever have the opportunity to read this letter, please – listen. Listen for any reason you like, even if only to ridicule me, use me as an example of whatever insanity you want to project onto me, to try to smear my words or my personality, or whatever you like, but simply listen, just for a few more brief moments. I have some special words to share with you, from a special source. I don’t care one iota if you want to call that source God, Buddha, Nature, my subconscious mind, the collective unconscious, bipolar disorder, sniffing glue, Captain Jean-Luc Picard, Allah, or whatever the hell you like. Simply trust, if only for five minutes, that there is a source beyond the ordinary experience you think of as “reality” – a source not subject to the insanity of your crazy world – and whatever it might be, it has begged and pleaded with you for all of human history simply to hear and take heed of a few simple words.

So, with no further ado…

You MUST stop all of this hatred and division. Not for me, and not only for yourselves, but for ALL LIFE. Do you understand that ALL LIFE is what you really are? No, of course you don’t, because your crazy world has denied you this knowledge – but it remains true nonetheless. Can you understand that there is NO SUCH THING as an isolated, truly “independent” being on this world or on any other in this infinite Universe? Every living thing is your brother or sister. KNOW NOW, right now, that this is not some recycled hippie New Age John Lennon “kumbaya” bullshit I’m trying to sell you. That’s how you are denied this truth in your crazy world – it is lumped into those tired old dismissive categories and swept out of your sight, never to trouble you again. But nonetheless, it remains true that not even GOD HIMSELF can alter the fact that unity and interconnection is the ACTUAL TRUTH of all existence. It’s a fact, a complete, stone cold concrete FACT, and the only fact that matters.

Phew, that was a lot of capitalized words. Please don’t get the wrong idea and imagine that I’m trying to preach to you like the self-serving spiritual salesmen do, convince you to believe anything through bullshit sophistry, or bully you into accepting anything that isn’t already present in your own heart. I cannot do that, even if I wanted to! Not even God, Nature, or David Hasselhoff has that power, much less a mere mortal such as myself.

Instead, what I am trying to do is LOVE you. Do you understand that? Have you ever actually been loved – really loved – in your whole crazy, manipulated, pre-packaged life? Perhaps you’ve been exposed to so much blithering insanity disguised as “love” that I am the first person to ever really show you what the real thing looks like. Think of what that would mean. If you don’t now understand in your heart of hearts how crazy your whole world is – when perhaps the one of the only examples of real love you’ve ever known is coming into your life through a random internet web page – then perhaps I cannot help you – but I will keep trying anyway.

Look, I’m not above begging, if that’s what it takes. Please, please stop hurting yourselves and everyone else. Stop all of this killing, exploiting, enslaving, and self-serving blindness. It’s not “necessary,” it’s not “just the way life is,” and there ARE alternatives – an infinite number of alternatives, or at least as many as six billion free and sane human minds can come up with. Your insistence on imagining that utter self-destruction and planet-wide injustice is “just the way things have to be” is so painful. Just in case you’re interested in history, please understand that it has torn the heart and soul out of every indigenous culture you have crushed under its heel. There is a reason so many Native Americans sit around on the reservation and drink their lives away – and it ain’t what you might think it is. It’s not their “laziness,” “lack of education,” “unemployment,” or anything else of that nature. It is the pain of having a sane world stolen from them and replaced with an insane one.

This world has been called a “vale of tears,” and it certainly is – but only because you refuse to stop hurting yourselves and everyone else. Doctor after doctor has tried to cure you of your madness without success, and they have done so *fully knowing* that most people would offer them nothing but a piping hot shit sandwich for their trouble. My efforts will be (and have been) received no differently for the most part, but at least perhaps I can plant a seed in a few rare open hearts.

Take this fragile little seed of compassion as my gift to you. Do with it what you will. Throw it out the window into the trash heap ten minutes from now if you must – but just for now, right at this moment and with no thought of the future, take the seed, just because you can. Don’t be afraid. It has taken a few of us “doctors” thousands of years to produce it at the cost of sacrificing everything. We have bled for it, died for it, submitted ourselves to every kind of degradation, rejection, and humiliation for it, worn rags for it, starved for it, and willingly accepted every kind of abuse for it – for no other purpose than to pass it on to YOU. But don’t pity us, because we knew what we were doing and we did it willingly. Take the little seed we’ve made for you, just for a single moment, as our free gift. You don’t have to say a prayer, bow to anyone, go to any church, join any movement, or do anything besides open your heart just a tiny bit and allow the little seed to take root. That’s it. No strings attached, no shipping and handling, no gimmicks. In the words of Huey Louis and the News, “you don’t need money, don’t need fame. Don’t need no credit card to ride this train.”

The rest is just a matter of staying out of the way of your own heart. The seed will grow as grass grows – without effort and without struggle – as long as you simply let it be.

Let the seed grow, and as begins to flower into a mighty oak, begin to understand that you must no longer sell your precious time and energy to the highest bidder. You must no longer waste your resources on things as meaningless as the insane world’s ideas of “status” and “success.” Chasing after those things is a virulent form of insanity that is killing the world, and you have chosen to become sane instead.

Let the seed grow, and as it sinks its strong roots into the fertile soil that is the interconnection and brotherhood of all beings, understand that you must no longer submit to those insane ideas and forces which seek to replace your infinite value and beauty with a false sense of lack. You lack nothing. Whatever belongs to the Universe belongs to you, as your absolute inalienable birthright. If you are being denied any portion of that birthright, it is through no deficiency or failing of your own, but through the machinations of a destructive madness which you have chosen to no longer support. For the first time in your life, you will experience what it is like to be without constant guilt and shame, because for the first time in your life, your heart of hearts knows that you are no longer helping the insane world to kill itself.

Let the seed grow, and as its healthy green leaves turn toward the infinite sun of true Being, understand that the senseless killing, exploiting, and enslaving must end. In the sanctum of your own mind, ask the insane world around you “what part of Thou Shalt Not Kill didn’t you understand?” What part of “exploitation and slavery are wrong” don’t “normal” people get? Don’t hope for a sane answer, though. The crazy world around you is incapable of providing one, but that’s okay, because you have chosen to no longer share their delusions.

When you must kill, even a fly, make a practice of apologizing out loud with true regret – and when you do, reflect on how crazy the world would think you are if they caught you doing that. Understand that it’s not your insanity for doing so, it’s theirs for not. And then know that everything you need to do to live with compassion and actual sanity is just like apologizing to the fly. It is simply a matter of being sane enough to let the whole crazy world think you are nuts for the sake of love. Do you see how this works? Doctor Jiddu Krishnamurti (a “doctor” in the true sense) said it best – “it is no measure of sanity to be well-adjusted to an insane world.” Live with true compassion and you’ll be called a nut. Understand this, accept it, and do it anyway.

Let the seed grow in a thousand other wonderful and surprising ways, as compassion begins to flower in your heart. Never beat yourself up for anything – let the crazy world take care of beating itself up, as it always has. Don’t be afraid to get angry from time to time – no one whose heart knows genuine compassion has ever gone without knowing the burn of anger. You are angry because you care. You are angry because you love.

Most importantly, you are angry because you live in a world that is killing, enslaving, and destroying itself in a state of total self-satisfied, smug arrogance, and by God (or Darwin), you’ve had it up to here. You aren’t just a little miffed or vaguely disappointed at the sorry shape the human race is in. That’s for people who don’t care much, and don’t intend to let such small stirrings of conscience disrupt their TV time. No, that route is not open to you anymore. You already know too much, and try as you might, you can never unsee what you’ve seen in the few minutes we’ve spent together. Sorry, Charlie, but I wasn’t being completely truthful with you when I said I wouldn’t turn your psychological screws. It was a little white lie that was necessary to uproot a big black one.

If you have allowed love and compassion to take firm root in your heart, do not be surprised or dismayed that you are quite capable of becoming enraged, livid, and furious at the insanity of it all. This does not mean you are a “spiritual failure” as the phony, self-seeking “gurus” of the world would have you believe. It means precisely the opposite. You have the capacity for great anger because you have the capacity for great compassion. They are co-identical, like the Taoist concepts of yin and yang, and neither occurs without implying the co-existence of the other. Thousands of children are starving to death every day, and there is absolutely nothing wrong with the fact that you may begin to feel absolutely outraged over it. On the contrary – what’s so horribly wrong with the world is that everyone else doesn’t.

Do not reject anger or try to stifle it with feel-good platitudes, as selfish people who care only for their own happiness do. Instead, use your anger. Allow it to forge your love and compassion for a suffering world into razor-sharp weapons of unbreakable steel. Remember, as it is said, “I come not to bring peace, but a sword.” Peace cannot be won without sacrifice. The sword of compassion forged within your heart is not for striking out at others, but for mercilessly slashing away every false and destructive self-deception and every self-justifying excuse in your own mind, until all that remains is an unquenchable desire to do your small but infinitely meaningful part to ease the world’s suffering – a desire as keenly felt as a drowning man’s desire for air. Become the Bodhisattva, and find your salvation in that of the world.

When anger and frustration come, as they surely will, allow the intensity of these natural feelings to forge your true heart into a fortress that is untouchable and indestructible. Allow them to temper your determination to the point that you will NEVER, EVER stop being willing to reach out to your fellow man in a spirit of true compassion even if they nail you to a cross for it. Allow them to strengthen your resolve so that you know in your heart that not even your own worst fears, or even God Himself, can stop you from reaching out to ease the pain of a suffering world, even if it has to be dragged to the medicine kicking and screaming every step of the way. As Enigma puts it, don’t care what people say / just follow your own way. Don’t give up and lose the chance / to return to innocence. “Innocence” is simply the nature of who you really are. Know that you will do what it takes to be true to your true self. No, that isn’t a redundant or meaningless sentence. If you think it is, read it again until you understand. Read it a thousand times if you must. Whatever it takes.

Let the seed grow, and become strong and powerful, in a way the weak (who are called “strong” in the insane world) will never be able to touch. Never flatter your ego by engaging in self-serving fantasies of yourself as a martyr, but nonetheless prepare yourself to suffer every kind of degradation and abuse for the sake of passing the seed on to just one more open heart. Prepare to be considered “weak” by the “strong” of this world – those who have learned to embrace the insanity, become the craziest inmates of the crazy house, and keep the whole insane system going for their own short-sighted benefit. In the insane world, they call those people “winners,” “leaders,” “the successful,” and “role models.” Accept their rejection, condemnation, and abuse without blame. They know no better.

Let the seed grow, and even in the defining moments when you face your personal demons, learn to summon the world-changing strength to love and bless your enemies, for you know something they do not. Even in all their worldly might, they have no power against the seed you carry. Even their shriveled and petrified hearts might someday, somehow be opened to it, much to their shock and horror. No one is beyond redemption, because we all share in the same infinite source. In your “weakness,” as seen through the eyes of the insane world, lies your greatest power. By staying true to your true self and the seed (for ultimately they are one and the same), you shall overcome.

If you dare, decide right this moment to turn your life around. I’m sorry if this sounds like an “altar call,” but I honestly can’t help that. At some point, everyone has to decide which team they are going to bat for. Please understand that I don’t mean “turn your life around” in the sense of shouting “praise the lord” or doing some kind of “self-help” program or getting a better job or joining the military or attending the University of Phoenix or deciding to spend 20 minutes a day chanting “AUM.” I mean turn your life around in terms of a 180 degree about-face turning away from the whole crazy insanity of this world and toward the REAL truth of who and what you are.

If you dare, decide right now to be “in the world but not of it.” Yeah, I know Jesus and some other scary religious people said this, but I can’t help that. They said it because they had to. There’s no other way to give you any chance of becoming sane. “I am the way, the truth, and the life” doesn’t mean that I personally (as in the author of this webpage) am some special awesome being you have to obey and listen to just because I’m The Lord of Lords, Captain America, or even Rick James. Hell no, and please get that crazy rubbish out of your head. Instead, it simply means that this message (the message of compassion) is the only way to actual sanity and a better world – and it meant exactly the same thing when Jesus said it, too. “I, the message of compassion, am the way, the truth, and the life.” Sorry about your bad luck, but no man comes to the Father (your true nature) but through me (the message of compassion). Got it now? Okay, good – and don’t blame me, meaning “me” as in the imperfect human being who is being used as a vehicle for these truths. I didn’t make the rules, and neither did Jesus, Buddha, the Dalai Lama, or anybody else who has tried to carry the message to you.

So, with that in mind, here are some practical steps you can take as soon as you feel ready – but be warned, some of them might be an ouchie at least until you have accumulated some practical experience in not being nuts:

Rather than getting a better job, if you’re single and child-free, see if you can figure out how to get rid of your job completely. GASP! The shock! The horror! Well, get over it. I said what I said and I meant it 100%. If you can do something as monumentally “crazy” (in the insane world’s eyes) as this, holy mackerel, are you ever on the right track in a big way. Although you’ll probably be poor, your spiritual future’s so bright you gotta wear shades. You are on the spiritual short list, as opposed to the spiritual short bus. That’s the ride everybody else who is still chasing after money is taking.

Rather than joining the military, learn what a “conscientious objector” is and see if you can’t become one. Want a hint? It’s the totally ridiculous and nutty belief that “war is always wrong.” Wow, what a concept, eh? If you can get your crazy little head around that, even if takes you 20 years of arguing with yourself over whether Hitler had to be stopped, then oh boy, are you ever moving in the right direction in a Porsche 944. It might come as a surprise to you, but “thou shalt not kill” is an extremely sane idea. The more you get acquainted with it, the quicker you’ll make progress in every area.

Rather than attending the University of Phoenix, why not tear up every degree you might already have and become the dean of your own personal Sanity University? Stop giving credence to the crazy belief that any degree or award the insane world can confer upon you can do one iota to help you move toward actual sanity, happiness, fulfillment, or whatever else you’ve been falsely promised. If you can manage to never have a thought of chasing another one of their gold stars or seals of approval again, then good lord, are you ever taking off into actual sanity at warp speed. Lao-Tsu said it best – “give up learning, and put and end to your troubles.” What you really need to learn, this world doesn’t teach.

Rather than chanting “AUM” for 20 minutes a day, start right now to stand up for compassion in every area of your life, beginning from the tip of your nose and extending outward to encompass the whole universe. Aim high and never take “no” for an answer. Don’t let anyone tell you you’re setting your sights too high. Man’s reach must always exceed his grasp or we’re all wasting our time doing absolutely nothing. Don’t be fooled by those who tell you to “be practical.” They only want to kill their consciences by excusing and rationalizing away their own unwillingness to act. Dream big. Resolve to save the whole suffering world and get busy doing it. By doing that, you’ll already have succeeded. As Gandhi put it, BE the change. That’s all – nothing less, nothing more.

Remember, YOU are a beautiful, inherently powerful, irreplaceable, unique and wonderful being of infinite worth and value. If you’re an American, Mister Rogers (one of our truly great spiritual leaders and a thoroughly sane man) told you this as a kid, but the insane world beat it out of you. So now, listen again. It’s a beautiful day in the neighborhood, if you choose to make it one. You have strength beyond measure waiting to be unlocked somewhere deep in your heart. All the “doctors” of history have done their damndest to tell you exactly where to find it, if you’ll just shut off the crazy voices of the world in your head for five minutes and really, sincerely LOOK and LISTEN. Turn off the TV and unplug the phone if you have to, just to find a place to start. Never believe that you cannot change the world, for it is really you and ONLY you who can. That’s a fact, Jack. Learn it, love it, live it.

But please, for the love of Buddha, don’t simply believe anything I’m telling you. I don’t care if you “believe” in me, God, Nature, Santa Claus, science, compassion, a spherical Earth, or anything else. In fact, I’d prefer if you didn’t “believe” in anything at all. Beliefs are dangerous and you don’t exactly have a good history of using them wisely. Instead of believing, go within. Go into the depths of your heart and see if what I’ve told you rings true. Go to the place where there is no logic, no “truth” that can be formulated in words and used to beat your fellow man over the head, no belief, and no chattering mind. Go to the quiet place where faith lives – and I don’t mean Crazytown’s phony self-serving sales-pitch version of “faith” that asks you to send $100 to Benny Hinn, believe that dinosaurs and man walked the Earth together 5000 years ago, or blow yourself up for the glory of Allah. I meanreal faith – the universal message of the heart. Put aside everything the crazy world has ever told you, go to that small, still place, and see if what I’ve said to you rings true. If it doesn’t, then I’m sorry I’ve wasted your time and you can bill me for your two cents worth.

As your brother in humankind, I am at your service forever, even if you choose to hate me, as many of you have already chosen to do throughout our shared lives together here on Planet Crazytown. It’s okay – I forgive you and always will, for you truly know not what you do. However, you CAN learn. This is your opportunity. You won’t have many more, so take it lightly at your own risk. No conversion, no “sinner’s prayer,” no church, no collection plate, no robes, no rituals, and nothing other than one totally free being in the universe choosing to open himself or herself to the possibility of a better course for the one and only short little human life any of us have.

As it is has been written in every true medicine book in the world by better doctors than me:

“Treat others as you would be treated, that is the only law.”

Or, as one unusually sane man in particular put it:

“Love your neighbor as yourself.”

It is up to you now. Will you at least take the seed into your heart, for just a moment? Will you step outside your self-imposed ego prison for just a brief instant and see that the insane ideas, beliefs and attitudes you have been trained to accept as “normal” are killing you and the whole bloody world spiritually, psychologically, and even materially? Will you, like Nero, choose only to fiddle while Rome burns? Can you, just for a moment, set aside this deadly blindness and arrogance? Will you turn away from the madness, at long last, and face the shining Sun of your true infinite being? Will you reach into the depths of your heart and summon the courage to become who you really are?

I know I promised you no religious nonsense, but if you will allow me one small metaphor in closing, it is this: When you accept the seed of compassion into your heart, it is at that very moment that all sentient beings are saved and the universe and its infinite angels rejoice for all eternity – because eternity is within you.

Yours Truly,
Actual Sanity

P.S. You’ll find no links to my church, my movement, my seminars, my retreats, or anything else. I don’t have any. I don’t need any. I told you I had nothing of that sort to sell, push, or preach, and I was telling the truth. You know what to do if you want any of that. It’s all out there in a thousand forms and a million places. If you want Jesus, he’s not hard to find (although I’d recommend staying away from most churches). Ditto the Buddha, Lao-Tsu, the Dalai Lama, Swami Anybodyananda, Pantheism, Humanism, or whatever appeals to you. As long as you understand that all of these doctors prescribe the same medicine you’ve just been prescribed here, knock yourself out. Compassion is the only medicine in the world on which you can never overdose.

That is all. This is my whole and complete message to you. Take it for what it is – not some “sermon” from on high, not a lecture from some “guru” or “master,” but a heart-to-heart personal letter from a brother in humankind who shares in your pain and heartache. Just for today, and just in the form of these few words, I am merely offering to play the role of your “doctor,” not your “master.” Your true master is and has always been your own heart and nothing else – and if I have been at all successful in opening your mind to its small, still voice, then that is the true medicine.

Good luck to you, and may we each do whatever is in our power to cure our shared suffering together, as brothers and sisters on this little blue ball of mud. I will see a few of you on the streets, at the markets, and on the wires, where you will neither know me nor care to know me – but understand that I do know you, and no matter how crazy you are, you will always be my friend.

And that, very simply, is why I will never lie to you about what really matters. You may now be very, very insane – but you don’t have to be. The choice is yours.

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Filed under Mental health recovery, Spirituality

Tagged as links to information on mental health and recovery, spirit, The Great Love

October 27, 2010 · 7:40 pm

OCSC/ No Radio

The Oregon Consumer/ Survivor Coalition had it’s Strategic Planning Retreat last week. In attendance were approximately 40 individuals representing a number of consumer operated organizations and individual members. I’ll do a more involved post soon enough but I wanted to get my pictures from the retreat up while I’m thinking of it.

Also, there will be no MLBM radio show this month. We have been preempted by a Halloween Special on KBOO. Next time, then.

The meeting room before the meeting- notice that it's dark outside.

Deb and Diane prepare to facilitate a PATH plan...

This is what it looked like about halfway through the morning.

Deb worked hard to keep up with the thoughts and ideas generated by the group.

Animated discussion about chickens and the delusion of normal-

Amy and Deb- and this is my best shot of the completed plan. The others were even worse.

Now there sits a man with an open mind. You can feel the draft from here.
Groucho Marx

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Filed under CS/X movement, Mad Radio, Mental health recovery, pictures, wellness and systems change

Tagged as C/S X Movement, links to information on mental health and recovery, Mad Radio, pictures, Recovery

April 26, 2010 · 5:28 am

Small post

It’s Sunday night, I’m tired and still want to share a couple things.

First, Update on Blizzard, our cat that had her eyes removed (surgically) because she was suffering from glaucoma. She’s doing exceptionally well. Wayy better than when she was going bind from the glaucoma. She gets around the house without any difficulty, hardly ever uses the walls to roam the place. One of these shows her eating with her sister Annie.

A great little short story:

09-02 You’re Ugly Too – Lorrie Moore

Anxiety a problem? Step into my office for your hypnosis session:

Attacking Anxiety Relaxation Session – Female Hypnotist Guided

Before:

After:

Never Give up. I mean it.

Never give up

Miscellaneous-

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Filed under animated gif, animation, cats, comedy relief, Mental health recovery, mp3, sound bite

Tagged as animated gifs, mental health, Mental Health treatment, mp3, sound bites

April 13, 2010 · 12:00 am

Absolutely Beautiful, plus news clips

Cherry trees in bloom at Oregon State Hospital (click for full size, as usual)

Other news from OSH:

State Furloughs = Lack of Logic!

Controversial Ruling by PSRB!

Dying in Plain Sight!

Let the Feds Clean it Up!

Increased Federal Oversight Needed!

Maybe there are really serious problems!

Why Dr. Robinson didn’t come to work!

Duh!!! (Thanks, Gary)

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Filed under Mental health recovery, Nature, pictures

Tagged as human/ inhuman behavior, mental health news, Mental Health treatment, pictures

April 2, 2010 · 5:50 pm

You Missed It

So here are some pictures from the KBOO studio in the middle of the night.

The recorded show should be in archives by end of the week.

Mad Liberation by Moonlight-

Mental Health consumer-talk-radio,

tonight, Friday night, 1 a.m. to 2 a.m.-

April 2nd, 2010.

On KBOO 90.7 FM (in Portland, OR)

or streamed on the web: kboo.fm.

Call in at 503-231-8187 to be on the radio

(or show up at the studio).

We need your voice.

Older shows are archived above under the “MLBM” tab.

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Filed under Mad Radio, Mental health recovery

Tagged as Mad Liberation by Moonlight, Mad Radio

December 29, 2009 · 10:20 pm

Radio night again

Friday, 1/1/10 (New Year’s night), at 1 a.m. will be the monthly installment of Mad Liberation by Moonlight on KBOO 90.7 FM (or kboo.fm streaming on the web).

Department of Redundancy Department:

Mad Liberation by Moonlight- Mental Health consumer-talk-radio, 1/1/10, Friday night, 1 a.m. to 2 a.m. On KBOO 90.7 FM or streamed on the web: kboo.fm. Call in at 503-231-8187 to be on the radio (or show up at the studio). We need your voice. There are people listening (all over the world, by internet). Call in at 503-231-8187 between 1 and 2 am, late Friday night. Archived shows are available at the tab above that says MLBM or at https://rickpdx.wordpress.com/mad-liberation-by-moonlight-archives/

Be well,

Rick

Remember: Call 503-231-8187 between 1 and 2 am Friday night

Mad Liberation by Moonlight- Mental Health consumer-talk-radio, Friday night, 1 a.m. to 2 a.m.-December 4th, 2009. On KBOO 90.7 FM or streamed on the web: kboo.fm. Call in at 503-231-8187 to be on the radio (or show up at

the studio). We need your voice. There are people listening (all over the

world, by internet). Call in at 503-231-8187 between 1 and 2 am, late Friday night. Archived shows are available at https://rickpdx.wordpress.com/mad-

liberation-by-moonlight-archives/Be well,RickRemember: Call 503-231-8187

between 1 and 2 am Friday night

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Filed under CS/X movement, Mad Radio, Mental health recovery, Mental Hell Treatment

Tagged as C/S X Movement, Consumer/ Survivor Movement, Mad Liberation by Moonlight, Mad Radio, MLBM Radio

July 24, 2009 · 6:04 pm

My Boss Retired, etc.

First off, June 30th was the last work day for my supervisor at the Oregon State Hospital. He has been a supportive and wise boss, not something you find everyday. My new boss can’t fill his shoes. My co-worker and I (there is essentially just one other person here doing the same job as myself) feel like we’ve been hung out to dry.

This is something that he wrote before retiring, click for download (word doc)

The Lighter Side of 45 Years Working in St

Other news at work- Next week the Department of Justice comes to visit. Oregon State Hospital is under fire, in trouble, up sh*t creek (pick your metaphor) due to problems in patient care, staffing, use of seclusion & restraints, etc. Staff have been told they shouldn’t try to talk to the DOJ Team. Especially we should not mention the horrible understaffing, mandated overtime and burnout which has not improved since their last visit. Patients have to sign up with their ward/ unit staff to be put on a lsit to talk to the Team. Some wards, notorious for poor conditions, treatment, have tried to spruce up; treating patients better for the past week in hopes that everyone will forget how things really are.

Some links to articles about the visit:

http://www.disabilityrightsoregon.org/usdoj-coming-back-to-oregon-state-hospital

http://www.mentalhealthportland.org/wp-content/uploads/2009/06/oregons-letter-to-the-federal-department-of-justice.pdf

http://www.oregon.gov/DHS/mentalhealth/osh/news/0709.pdf

http://www.statesmanjournal.com/article/20090712/NEWS/907120329/1001/news

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Filed under Mental health recovery, Mental Hell Treatment, wellness and systems change

Tagged as C/S X Movement, Mental health recovery, Mental Health treatment, news

April 16, 2009 · 10:29 pm

MLBM Announcement

Re: Looney Radio 4/17/09

Mental Health consumer-talk-radio
This Friday night, 1 a.m. to 2 a.m.-
April 17th, 2009
KBOO 90.7 FM or streamed on the web: kboo.fm
Call in at 503-231-8187 to be on the radio (or show up at the studio).

Please set your alarm if you aren’t up at that time- we need your voice.
There are people listening
(all over the world, by internet)
Call in at 503-231-8187

Archived shows are now available at
https://rickpdx.wordpress.com/mad-liberation-by-moonlight-archives/
We’re running a week late again this month due to my son’s birthday (this time)

last weekend.

KBOO 90.7 FM or on the web at kboo.fm (note the repetition)

With any luck at all next month’s show will be May 8th- not following the full moon, but within 24 hours of it (the moon is actually full on the 9th, which is technically when the show happens- don’t worry about it).

Be well,
Rick

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Filed under CS/X movement, Mad Radio, Mental health recovery

Tagged as CS/X movement, Mad Liberation by Moonlight, Mad Radio, mental health

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Category Archives: Mental health recovery

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