While the following is about an event in Oregon, it applies to Medicaid funding throughout the USA… and really to government-funded mental health system internationally. How can the public influence government-funded mental health services for deep change, so that people helped are empowered, so that there is real choice, so that people are helped more than hurt?
MindFreedom Oregon News – urgent
About Oregon, Changing the Mental Health System, Buzz Phrases and Medicaid
How You Can Speak Out About More Creative Funding of Mental Health In Oregon
by David W. Oaks, Director, MindFreedom Inernational
AT BOTTOM is a forwarded notice about Oregon’s next Medicaid Advisory Committee Meeting (MAC) – THIS Wed. morning, 22 April 2009 in Salem.
Please try to attend, speak out during public comment, and whether or not you attend submit written testimony, which you can do by e-mail.
On their agenda this Wednesday will be the subject of mental health.
And this time mental health consumer/psychiatric survivors will also speak out. We wish them well!
MindFreedom has been asking for this opportunity for two years.
I know people’s eyes can tend to glaze over when they think about the subject of Medicaid, unless those eyes belong to, say, a full-time MBA specialist on Medicaid-funding who works for a huge corporate health care provider. Such big corporations can and do influence Medicaid rules every work day.
So how about the citizens who actually pay for the Medicaid?
BACKGROUND ON OREGON, MEDICAID AND MENTAL HEALTH
An enormous part of mental health services are, of course, funded by Medicaid.
According to one of the main Medicaid experts MindFreedom has worked with for years, each and every US State has a surprising amount of discretion about *how* that Medicaid money ought to be spent.
Some states are *far* more creative than Oregon in spending Medicaid money, for example, on mental health peer-support activities, public education, etc.
While local officials like to say that their hands are completely tied by federal rules, the fact is that a State is more empowered than that.
Where these issues are supposed to be discussed is the State of Oregon’s “Medicaid Advisory Committee” (MAC).
For two years, MindFreedom Oregon has requested that Oregon’s MAC directly address these topics. I’ve spoken during their public comment about their need to do this.
There’s bad news and good news.
The bad news is, MAC has refused to put our EXACT topic of empowerment and peer-support alternatives in mental health on the agenda.
The good news is, this next MAC meeting — in two days, this Wednesday, 22 April — the issues can be brought up.
That’s because this MAC meeting will be on mental health, but on a particular sub-topic of mental health. It’s the “buzz phrase” of the moment throughout the mental health system, from international systems to county systems.
And that buzz phrase is:
“Integration of mental health and physical health.”
I’ve been doing this work for 33 years, and where these buzz phrases originate from is a bit puzzling to me. For a while years ago the buzz phrase was “community mental health.”
And there were the years when the buzz phrase was “transformation.” Everywhere you went, the mental health system was talking about “transformation.”
Then there was a flurry of buzz phrases about “recovery,” and that was hopeful.
In any case, whoever is “Global Commissioner of Buzz Phrases in Mental Health” has chosen “integration” of physical and mental health as the flavor of the day.
Now, what this means exactly is open to interpretation. There is no technical definition of this “integration.”
But it can mean when the rubber hits the road, for example, making mental health services more available inside physical health clinics… and adding physical well being care such as check-ups into some mental health clinics.
This can be good.
It can be bad.
But as usual, like countless minor reforms for 200 years in mental health, it means MORE MONEY going to mental health care.
According to a World Health Organization recent report, when a small village in India that tried “integration,” what it meant was a massive increase in psychiatric drug prescriptions, without adequate advocacy, information and alternatives.
Here in Oregon, if a physical health clinic “integrates” mental health, then what about the voice of mental health consumers/ psychiatric survivors? Often they do such clinics even know that this voice is important, and why?
But to make a long story shorter, the MAC meetings lately are addressing mental health by focusing on this “integration” buzz phrase.
I wish they were addressing “Empowerment of Mental Health Clients,” or “More Peer Support Non-Drug Alternatives for Mental Health Consumers,” or “Rights of Psychiatric Survivors,” but that is not the flavor of the day.
WHY DOES THIS ALL MATTER?
Yes, too often the complicated rules can make it challenging (or boring) to get involved in Medicaid issue.
I call it Medicaid’s “Curtain of Complexity.” But look behind the curtain:
The reality is, these issues can impact lives.
This past Saturday, MindFreedom and several other groups united through the Opal Network in Lane County to have a TOWN HALL MEETING, with State Sen. Morrisette, Mayor Kitty Piercy and two other elected officials. More than 80 people packed the room, many of them psychiatric survivors and mental health consumers.
We heard passionate testimony about how the SAFE/WONDERLAND/VALIA center — a unique, entirely peer-run mental health community center and clinic — may be destroyed by Lane County by suddenly deciding they do *not* qualify for Medicaid funding they have received for two years. The cancellation letters have already gone out to more than 100 clients.
The fact is, Medicaid rules already allow activities like SAFE/ WONDERLAND/VALIA.
But changing Oregon’s rules to make this even more clear would help.
So the MAC meeting can, in the long run, make a huge difference. A Columbia River sized amount of federal mental health dollars flow through Oregon… let’s do what we can to have it fund good programs.
MindFreedom has been asking for consumer/survivor input for a year so we hope this Wednesday goes well! We hear Beckie Child is one of the consumer/survivors to speak, so we expect Beckie to tell it like it is.
There is always a public comment period at these meetings, too, if people want to go (usually toward end of event, hard to say exactly when that is).
If people want there might be an opportunity to listen in and comment via teleconference, but better ask soon.
Note that below forwarded notcie also encourages written testimony, which can be submitted by e-mail, to the e-mail address provided.
By the way, someone interested in this at the end of his life was the long-time activist Dave Romprey. So one way to help fill Dave’s huge shoes would be to take a little action on this, so here we go:
ACTION ACTION ACTION
* WHETHER OR NOT YOU ATTEND: Consider written testimony. Identiy yourself with name and postal address, etc., and submit testimony about the need for Oregon to be more creative in funding peer-based services and other alternatives in the mental health system! Even a brief message will help, but you can make your message as long as you would like, and it will be part of the public record.
FORWARDED MESSAGE FROM STATE OF OREGON:
MEETING PLACE: Oregon State Library
250 Winter St. NE
MEETING DATE: Wednesday, April 22, 2009
MEETING TIME: 9:00am – 12:00pm
Dr. David Pollack from Oregon Health & Science University will give a presentation on best practices, considerations, and recommendations for physical and behavioral health integration. The Committee will also hear testimony from a panel of behavioral health consumer advocates on the accessibility of physical health care. The meeting will conclude with a legislative update. Please submit written testimony electronically to Nicole Merrithew at Nicole.Merrithew@state.or.us.
Please visit the Committee’s website atfor minutes, reports and updates.
– end of forwarded message –
Forwarded by MindFreedom Oregon
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