The Day the Programs Stopped
Monday, February 23, 2015
by Robert E. Davidson
Some people want mental health and social service programs out of New London or wherever they live. Here’s what might happen if they got their wish.
The thirty to fifty people who go to First Step every day gathered on the corner of Green and Golden Streets wondering why the door was locked. They went down the block to Community Mental Health Services of Southeastern Connecticut on State Street, only to find that the door to the second floor had disappeared.
Someone called the Southeastern Mental Health Authority at the old Uncas on Thames Hospital, and heard that the number had been disconnected. Someone reported that the SCADD detox program on Coit Street had disappeared and someone else said that the Care Plus dual diagnosis day treatment program on Vauxhall Street had been replaced by an old-fashioned temporary labor company that supplied alcoholic laborers to construction sites.
As the day wore on, people from other programs found them. Stonington Institute had become a retreat for former town officials and wealthy refugees from the casinos. Reliance House in Norwich had been renewed out of existence and the building converted to antique shops and architects’ offices.
Someone learned that Social Security had stopped serving people with disabilities so there would be more money for retiring baby boomers. Another found that the state had redirected all Medicaid money to pay for tuition reimbursement for UCONN students so their parents could afford tickets to the new stadium.
Tension mounted as they learned that the entire network of services was gone. The client-government committees broke under the strain and people were really on their own. Someone went into crisis at all the uncertainty and was taken to Lawrence and Memorial Hospital. An ER nurse told her that the psychiatry unit had been converted back into a nurses’ residence and gave her directions to the bus to New Haven. But she got the same story there. All community mental health services were gone.
Someone asked a police officer what had happened. The officer told her to move on. She asked again. The officer asked to see proof that she was born in New London. She did not carry her birth certificate with her, so she was arrested for trespassing and driven to the Waterford town line.
In the next few weeks, people got hungry. They ate as little as possible because their disability checks were eliminated with their Social Security. Some went to their jobs, but were so unsettled that they couldn’t concentrate. One store manager yelled at a worker, who ran and hid in the stockroom. The manager called the job coach, but that program was gone too. While the boss debated whether to fire the employee now or wait for police back-up, the employee quit. Because another clerk was sick and the third was visiting her mother, the store manager had to close for the day.
That scene was repeated all over town, as clerks, stock people, baggers and burger flippers, traffic flaggers and florist’s assistants, actors and brass workers and library assistants all left or lost their jobs. The bottom rung fell off the economic ladder and the other rungs showed signs of wear.
Soon other people began to notice the changes. Pharmacies lost major business and two neighborhood drug stores went out of business. Coffee shop patronage dropped off because clients did not stop in to counter the effects of sedating medications. Pfizer stock dropped fifty points as its antipsychotic and antidepressant medication sales evaporated. They planned layoffs in that division and worried about the new buildings on the waterfront. Hughie’s patrons took heart.
Months went by. Clients stayed home, rationing their food and pills to make them last as along as possible. Some wandered the streets redeeming soda cans and doing whatever else they could to get money. They got dirtier because they could not afford to do laundry. Many became homeless when they could not pay their rent.
People looked on them suspiciously. Patients who had monitored their symptoms successfully for years suddenly did not know whether their paranoia was returning or whether people really were conspiring against them.
Without medication, some people who had passed for normal began to have symptoms again. Executives, managers, business owners, and secretaries took unexplained leaves of absence. Their secrets came out and they were thrown back into the poverty and stigma of a life they thought they had left behind.
Groups of people with untreated mental illnesses began to hang out on street corners. Some begged for money or food. Some argued with the voices they heard in their heads. Others tried to explain the loss of programs to passersby, who hurried away and hoped to see a police officer. Those who broke a law or aggravated a policeman went to jail, prompting new bond issues for prison construction. The state surplus became a deficit again.
People with drug and alcohol histories relapsed without support for their sobriety. Those who relapsed on hard drugs began to steal again to pay for them. Some tried to organize AA meetings, but found it hard to sit still without their medication. Some people started to drink to quiet the voices and anxiety, despite warnings from those who knew from experience that the relief had the side effect of addiction. Regular bar patrons began to ridicule the people who came in begging for drinks. A few regulars stopped drinking because they didn’t like the new sport.
Police departments met to stop the futile practice of deporting each other’s natives with mental illness. They started to call family members to pick up long estranged relatives and lobbied for laws to force families to care for any child, niece or nephew of whatever age. Some families cashed in retirement accounts to support their relatives.
The loss of pension fund money caused the stock market to fall, ending the long run of prosperity, increasing unemployment, depressing housing prices, and crippling the local economy. Pfizer pulled out of Fort Trumbull with the buildings half finished the week after Hughie’s was torn down.
Families finally ended the crisis. They lobbied the state to reopen community programs. Wall Street covertly supported them. Governments used deficit spending to stimulate the economy and train new mental health workers. Entrepreneurs saw opportunities.
Universities did studies that showed that community programs reduced disruption, arrest, and hospital use by up to 70% compared to no treatment. Old techniques were rediscovered and given new names. Someone found that mineral springs calmed mood swings and others found new compounds that filled brain receptors related to symptoms of mental illnesses. Psychiatry was reborn as Clinical Neurobiology and a new Board Certification Exam was created.
Eventually we saw that medications did not do the whole job. People needed help with the stresses of everyday life. They needed places to live and productive activity. They needed coaxing to come out of their apartments and face the lingering hostility in the community. They needed help to deal with the new bureaucracies set up to regulate services and distribute funds.
When they got that help, most mental illnesses slowly became invisible again. Homelessness and public intoxication declined. People went back to work.
Residential, vocational, educational, and case management programs were reborn, staffed by eager young graduates determined to improve society. The leaders were a mix of elder statesmen left over from the old days and the fastest rising of the new group. There was an excitement in the new programs as people saw dramatic improvement from simple interventions.
Ideas abounded, organization lagged. Money was spent on good things, but faster than it could be accounted for. Eventually a TV reporter did an expose.
State auditors arrived. Disillusioned staff moved on to other careers; leaders just moved on. Administrators came in from banks and the motor vehicles department. Rules proliferated. More staff left, if they could. The Dedicated Few remained, getting quietly desperate. Newcomers who liked people and didn’t expect to earn much anyway joined them.
Time went on. Programs stultified. Clients stagnated. Complaints grew as people forgot how it was without the programs. Developers wanted the property where programs had moved and stirred up neighbors about zoning issues. And a new call to get mental health programs out of town arose.
The thirty to fifty people who go to First Step every day gathered on the corner of Green and Golden Streets wondering why the door was locked. They went down the block to Community Mental Health Services of Southeastern Connecticut on State Street, only to find that the door to the second floor had disappeared.
Someone called the Southeastern Mental Health Authority at the old Uncas on Thames Hospital, and heard that the number had been disconnected. Someone reported that the SCADD detox program on Coit Street had disappeared and someone else said that the Care Plus dual diagnosis day treatment program on Vauxhall Street had been replaced by an old-fashioned temporary labor company that supplied alcoholic laborers to construction sites.
As the day wore on, people from other programs found them. Stonington Institute had become a retreat for former town officials and wealthy refugees from the casinos. Reliance House in Norwich had been renewed out of existence and the building converted to antique shops and architects’ offices.
Someone learned that Social Security had stopped serving people with disabilities so there would be more money for retiring baby boomers. Another found that the state had redirected all Medicaid money to pay for tuition reimbursement for UCONN students so their parents could afford tickets to the new stadium.
Tension mounted as they learned that the entire network of services was gone. The client-government committees broke under the strain and people were really on their own. Someone went into crisis at all the uncertainty and was taken to Lawrence and Memorial Hospital. An ER nurse told her that the psychiatry unit had been converted back into a nurses’ residence and gave her directions to the bus to New Haven. But she got the same story there. All community mental health services were gone.
Someone asked a police officer what had happened. The officer told her to move on. She asked again. The officer asked to see proof that she was born in New London. She did not carry her birth certificate with her, so she was arrested for trespassing and driven to the Waterford town line.
In the next few weeks, people got hungry. They ate as little as possible because their disability checks were eliminated with their Social Security. Some went to their jobs, but were so unsettled that they couldn’t concentrate. One store manager yelled at a worker, who ran and hid in the stockroom. The manager called the job coach, but that program was gone too. While the boss debated whether to fire the employee now or wait for police back-up, the employee quit. Because another clerk was sick and the third was visiting her mother, the store manager had to close for the day.
That scene was repeated all over town, as clerks, stock people, baggers and burger flippers, traffic flaggers and florist’s assistants, actors and brass workers and library assistants all left or lost their jobs. The bottom rung fell off the economic ladder and the other rungs showed signs of wear.
Soon other people began to notice the changes. Pharmacies lost major business and two neighborhood drug stores went out of business. Coffee shop patronage dropped off because clients did not stop in to counter the effects of sedating medications. Pfizer stock dropped fifty points as its antipsychotic and antidepressant medication sales evaporated. They planned layoffs in that division and worried about the new buildings on the waterfront. Hughie’s patrons took heart.
Months went by. Clients stayed home, rationing their food and pills to make them last as along as possible. Some wandered the streets redeeming soda cans and doing whatever else they could to get money. They got dirtier because they could not afford to do laundry. Many became homeless when they could not pay their rent.
People looked on them suspiciously. Patients who had monitored their symptoms successfully for years suddenly did not know whether their paranoia was returning or whether people really were conspiring against them.
Without medication, some people who had passed for normal began to have symptoms again. Executives, managers, business owners, and secretaries took unexplained leaves of absence. Their secrets came out and they were thrown back into the poverty and stigma of a life they thought they had left behind.
Groups of people with untreated mental illnesses began to hang out on street corners. Some begged for money or food. Some argued with the voices they heard in their heads. Others tried to explain the loss of programs to passersby, who hurried away and hoped to see a police officer. Those who broke a law or aggravated a policeman went to jail, prompting new bond issues for prison construction. The state surplus became a deficit again.
People with drug and alcohol histories relapsed without support for their sobriety. Those who relapsed on hard drugs began to steal again to pay for them. Some tried to organize AA meetings, but found it hard to sit still without their medication. Some people started to drink to quiet the voices and anxiety, despite warnings from those who knew from experience that the relief had the side effect of addiction. Regular bar patrons began to ridicule the people who came in begging for drinks. A few regulars stopped drinking because they didn’t like the new sport.
Police departments met to stop the futile practice of deporting each other’s natives with mental illness. They started to call family members to pick up long estranged relatives and lobbied for laws to force families to care for any child, niece or nephew of whatever age. Some families cashed in retirement accounts to support their relatives.
The loss of pension fund money caused the stock market to fall, ending the long run of prosperity, increasing unemployment, depressing housing prices, and crippling the local economy. Pfizer pulled out of Fort Trumbull with the buildings half finished the week after Hughie’s was torn down.
Families finally ended the crisis. They lobbied the state to reopen community programs. Wall Street covertly supported them. Governments used deficit spending to stimulate the economy and train new mental health workers. Entrepreneurs saw opportunities.
Universities did studies that showed that community programs reduced disruption, arrest, and hospital use by up to 70% compared to no treatment. Old techniques were rediscovered and given new names. Someone found that mineral springs calmed mood swings and others found new compounds that filled brain receptors related to symptoms of mental illnesses. Psychiatry was reborn as Clinical Neurobiology and a new Board Certification Exam was created.
Eventually we saw that medications did not do the whole job. People needed help with the stresses of everyday life. They needed places to live and productive activity. They needed coaxing to come out of their apartments and face the lingering hostility in the community. They needed help to deal with the new bureaucracies set up to regulate services and distribute funds.
When they got that help, most mental illnesses slowly became invisible again. Homelessness and public intoxication declined. People went back to work.
Residential, vocational, educational, and case management programs were reborn, staffed by eager young graduates determined to improve society. The leaders were a mix of elder statesmen left over from the old days and the fastest rising of the new group. There was an excitement in the new programs as people saw dramatic improvement from simple interventions.
Ideas abounded, organization lagged. Money was spent on good things, but faster than it could be accounted for. Eventually a TV reporter did an expose.
State auditors arrived. Disillusioned staff moved on to other careers; leaders just moved on. Administrators came in from banks and the motor vehicles department. Rules proliferated. More staff left, if they could. The Dedicated Few remained, getting quietly desperate. Newcomers who liked people and didn’t expect to earn much anyway joined them.
Time went on. Programs stultified. Clients stagnated. Complaints grew as people forgot how it was without the programs. Developers wanted the property where programs had moved and stirred up neighbors about zoning issues. And a new call to get mental health programs out of town arose.
A Journey
Thursday, July 10, 2014
by Sharon DeBrady
In the middle of life and living, I made it to the other side.
I'm in recovery and will be there for the rest of my life.
It's a hard place to be and it's scary for me, sometimes life was better when I was all closed off...Now I have to deal with things.
That's why this job is so important to me! I know I can do the job.
Realize that I have a lot of anxiety and nervousness which gets in
the way of doing the job.
I believe I will be successful...but
it has to happen now. Now in the middle of life and living, it's the best thing
that's ever happened to me.
I am just running out of words; I guess I ran out of words but
Looking back they are all there. I put in so much energy; who would
ever know? I want it to get better, and I wasn't sure I'd ever make it.
At least now I enjoy life, and I feel very fortunate to have found recovery.
I'm in recovery and will be there for the rest of my life.
It's a hard place to be and it's scary for me, sometimes life was better when I was all closed off...Now I have to deal with things.
That's why this job is so important to me! I know I can do the job.
Realize that I have a lot of anxiety and nervousness which gets in
the way of doing the job.
I believe I will be successful...but
it has to happen now. Now in the middle of life and living, it's the best thing
that's ever happened to me.
I am just running out of words; I guess I ran out of words but
Looking back they are all there. I put in so much energy; who would
ever know? I want it to get better, and I wasn't sure I'd ever make it.
At least now I enjoy life, and I feel very fortunate to have found recovery.
A Story of Recovery
Wednesday, Novermber 7, 2012
by M.
May 5th is indeed an important day for me. May 5th marks one year that I have continuously been out of the hospital. A year might not sound like a long time, but believe me, for me, this is a big deal.
Before this date last year, I was averaging being in the hospital about every three months. As a person with Bipolar Disorder, previously known as manic depressive disorder, I had extreme ups and downs. However, did this mean I needed to be in the hospital every two or three months? No, but I THOUGHT it did, and that was the thought pattern I had to break.
When I went to the hospital, I was taken care of, my atmosphere was less stressful, I could go to classes, but then rest. Weren't these things I could do at home? I didn't think so because there was one thing standing in my way. When things got really difficult, when I became overwhelmed, my thoughts immediately turned to suicide.
After all, I had thought of suicide beginning at the age of eleven. My mother had attempted suicide twice, and had been in the hospital most of my life. Being in the hospital, being taken out of a stressful situation was modeled for me my whole life.
Of course, in the early years, there were not sufficient medications to make a person truly stable enough to live in recovery, only to exist. Therefore, if I had a suicidal thought, I immediately thought I had to be hospitalized. That wasn't the case, but I THOUGHT it was the case, and that's what kept me stuck. Something in my thinking had to change and I did not know how to go about it.
DBT, Dialectical Behavioral Therapy, was new on the horizon when I came to Connecticut. It was THE go-to behavior modification tool that is still used widely in outpatient programs across the state and country.
When I was first approached about going to this type of class, I went berserk. I thought I was being blamed for my thinking. I wasn't being blamed. People were trying to show me a new way of thinking, which would thereby affect my actions and ultimately, my mood.
I started learning about how to do the opposite of what I felt like doing if what I felt like doing was staying in bed, or being self-abusive. I learned how to be in the moment rather than stewing in the past or projecting into the future. I learned how to distract myself and soothe myself by taking long bubble baths, slathering my skin with creamy lotion, or letting chocolate melt in my mouth until I experienced all the layers of the taste of the chocolate.
Do I do at least one of these on a daily basis? Most of the time. I will not go so far as to believe that DBT is THE cure-all, but it certainly helped.
There was one other brick to take out of the wall though.
I needed to believe that I could take care of myself. Because my mother had been in the hospital off and on since I was eight months old (I'm 46 now), I PERCEIVED that I would always need someone to care of me. I needed someone to offer me a blanket; I needed someone to assure me that I was going to be okay. I needed someone to check in with me.
I found those things in the most unlikely of places, or so I thought. The source? Alcoholics Anonymous. Being in the fellowship of Alcoholics Anonymous has not only helped me to apply their principles to abstaining from alcohol or other mind-altering substances, but it has helped me to admit, that left to my own devices, I am powerless over my mental illness.
I said powerless, not helpless. I cannot predict how I might feel on a certain day, but I do have the skills to know how to make it better. Part of making it better is believing that a Power greater than myself, whom I choose to call God, could restore me to SANITY, yes, that is verbatim from the Big Book of Alcoholics Anonymous!
In this fellowship, I have found women who care, women I can bond with, women I go on campouts with, and women who help me stay ACCOUNTABLE! As I go further in my journey, I can pass along the experience, strength, and hope that I have found in recovery.
That's really what recovery is about, isn't it? Staying accountable to taking care of myself! If I am accountable to myself, well then, recovery is really in MY hands isn't it?
Now, of course, chemicals in my brain may change, life circumstances may change that warrant an extra doctor's visit or an extra therapy session, but I can do that! I can call my doctor, the same one I've had for twelve years and say, "Hey, Doc, I think I'm starting to get depressed." "Hey, Therapist, things are starting to pile up on me, can I schedule an extra session?"
Acting on these things as quickly and effectively is really the key. And how will I celebrate my anniversary/birthday? Like any other with cake and ice cream and friends in recovery, one day at a time, one moment at a time, one second at a time.
Life is good; in this moment life is good, and that's all I have to be concerned with: this moment. I think I'll stick around!
Before this date last year, I was averaging being in the hospital about every three months. As a person with Bipolar Disorder, previously known as manic depressive disorder, I had extreme ups and downs. However, did this mean I needed to be in the hospital every two or three months? No, but I THOUGHT it did, and that was the thought pattern I had to break.
When I went to the hospital, I was taken care of, my atmosphere was less stressful, I could go to classes, but then rest. Weren't these things I could do at home? I didn't think so because there was one thing standing in my way. When things got really difficult, when I became overwhelmed, my thoughts immediately turned to suicide.
After all, I had thought of suicide beginning at the age of eleven. My mother had attempted suicide twice, and had been in the hospital most of my life. Being in the hospital, being taken out of a stressful situation was modeled for me my whole life.
Of course, in the early years, there were not sufficient medications to make a person truly stable enough to live in recovery, only to exist. Therefore, if I had a suicidal thought, I immediately thought I had to be hospitalized. That wasn't the case, but I THOUGHT it was the case, and that's what kept me stuck. Something in my thinking had to change and I did not know how to go about it.
DBT, Dialectical Behavioral Therapy, was new on the horizon when I came to Connecticut. It was THE go-to behavior modification tool that is still used widely in outpatient programs across the state and country.
When I was first approached about going to this type of class, I went berserk. I thought I was being blamed for my thinking. I wasn't being blamed. People were trying to show me a new way of thinking, which would thereby affect my actions and ultimately, my mood.
I started learning about how to do the opposite of what I felt like doing if what I felt like doing was staying in bed, or being self-abusive. I learned how to be in the moment rather than stewing in the past or projecting into the future. I learned how to distract myself and soothe myself by taking long bubble baths, slathering my skin with creamy lotion, or letting chocolate melt in my mouth until I experienced all the layers of the taste of the chocolate.
Do I do at least one of these on a daily basis? Most of the time. I will not go so far as to believe that DBT is THE cure-all, but it certainly helped.
There was one other brick to take out of the wall though.
I needed to believe that I could take care of myself. Because my mother had been in the hospital off and on since I was eight months old (I'm 46 now), I PERCEIVED that I would always need someone to care of me. I needed someone to offer me a blanket; I needed someone to assure me that I was going to be okay. I needed someone to check in with me.
I found those things in the most unlikely of places, or so I thought. The source? Alcoholics Anonymous. Being in the fellowship of Alcoholics Anonymous has not only helped me to apply their principles to abstaining from alcohol or other mind-altering substances, but it has helped me to admit, that left to my own devices, I am powerless over my mental illness.
I said powerless, not helpless. I cannot predict how I might feel on a certain day, but I do have the skills to know how to make it better. Part of making it better is believing that a Power greater than myself, whom I choose to call God, could restore me to SANITY, yes, that is verbatim from the Big Book of Alcoholics Anonymous!
In this fellowship, I have found women who care, women I can bond with, women I go on campouts with, and women who help me stay ACCOUNTABLE! As I go further in my journey, I can pass along the experience, strength, and hope that I have found in recovery.
That's really what recovery is about, isn't it? Staying accountable to taking care of myself! If I am accountable to myself, well then, recovery is really in MY hands isn't it?
Now, of course, chemicals in my brain may change, life circumstances may change that warrant an extra doctor's visit or an extra therapy session, but I can do that! I can call my doctor, the same one I've had for twelve years and say, "Hey, Doc, I think I'm starting to get depressed." "Hey, Therapist, things are starting to pile up on me, can I schedule an extra session?"
Acting on these things as quickly and effectively is really the key. And how will I celebrate my anniversary/birthday? Like any other with cake and ice cream and friends in recovery, one day at a time, one moment at a time, one second at a time.
Life is good; in this moment life is good, and that's all I have to be concerned with: this moment. I think I'll stick around!