advocacy

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Trauma-Informed Care in Action

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My hope is to create a series on Trauma Informed Care (TIC) in Action. Rather than wasting everyone’s time with a multitude of awareness campaigns that only serve to cater to those already aware of the issues. When I was in graduate school, TIC became a hot button issue/training opportunity. Hopefully this was sparked by the new wave of combat veterans and research on adverse childhood experiences. The hope of this series is to highlight people and projects contributing to real changes in trauma-informed care not necessarily where federal, state, and local money flow.

I didn’t fully confront my own medical trauma until graduate school, when out from the end of first semester I wrote a dark and honest performance piece called, “Gods and Monsters.” A piece that opens with, “As a child my teddy bear wasn’t allowed to have eyes.” Memorized, engraved somewhere in the lizard part of my brain. 

My talents in social services are my abilities to write, my high attention to detail/excellent memory, and my desire to advocate for others. As a writer, I write professionally/clinically as well as creatively. I write performance pieces or poems meant to be performed and I have been fortunate to be published by other change agents. Cathy Plourde formed Add Verb Productions (The Thin Line, Major Medical Breakthrough, You the Man, Out & Allied Project Volume I & II) and later Animal Mineral Press (Making Out Like a Virgin). Both ventures have focused on sharing the experiences of others in subjects meant to educate and respond to social justice issues most professionals will not or do not know how to approach. I prime example of taking action rather than wasting time and money on another awareness campaign. A feel-good project accessorized with brightly colored bracelets. Never mind the stigmas that victims and survivors carry with them and others are walking around with look-at-me bracelets.

Mistakenly, I thought social workers were a profession of trauma survivors, a field of flowers that was once a minefield, showing others how to plant the seeds of change. We aren’t even fully aware of the trauma we continue to inflict on others. I went to a TIC training hosted by Brown County by Disability Rights Wisconsin. It changed how I interacted with clients, especially those who are not able to verbalize their needs. Environmental psychology taught me that children who have experienced trauma have a larger personal space bubble. My bubble requires much more space than others I interact with on a daily basis. I am not a hugger, not even with family. “To hug me is to hold a collection of bones mummified for self-preservation.” Give people their space. Take some action and start planting the seeds of change rather than advertising the seed package.

Links associated with this post:

Addverbproductions.org
Animalmineralpress.com
Disabilityrightswi.org

“Rage More Victoria”

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I was looking up the institutional levels of care for Long Term Support services. When I looked at the nursing home level of care, I saw that as a kid I qualified because of my G-tube and speech/physical therapies. So that was a trigger. And then that quote from the movie, ‘Lost and Delirious’ popped into my head.

I just find it kind of hilarious that doing G-tube feedings is a skilled nursing service. When I remember going to the school nurse’s office and doing them myself. I even changed them by myself, like Tony Stark in Iron-man replacing his chest doodad.

Triggers are a strange thing and they don’t have to make sense and they aren’t always something that puts you in a negative state of being. Today’s little situation just helped remind me where I am in life, who supported me, who though less of me, and why I do social work advocacy.

SW Policy and Politics

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As I was watching the Democratic Debate tonight, I was thinking about the very few social workers I know that are involved in policy work and political change. I think people too often want to box in the field of social work in advocacy of youth.

I am very much into working on policy changes within social work. I wouldn’t have fought so hard and succeeded against my graduate program when they openly discriminated against students with disabilities. My favorite professor in graduate school was my advanced policy instructor. She was very politically involved. She encouraged me to be brave in my advocacy and continue to raise my voice for positive social change.

In the past I’ve been involved in political and social policy change campaigns. I’ve done door to door canvassing, phone bank calling on election day, community interfaith events, and initialized local action groups for larger statewide campaigns.

The majority of the news I pay attention to is political news. So I am unfazed when political candidates make grand campaign promises. I know that the most successful political and social changes occur in grassroots efforts. Which means at the local community levels.

I used to be inclined to burn bridges when it came to my style of advocacy. However I promised myself that I would stop doing that when I began this blog and this personal brand. It’s funny, Abraham Lincoln used to write very angry letters to people that he got mad at until he was challenged to a duel. After that his tune changed and he was more civilized in his ways of dealing with confrontations.

VA Will Not Pay For Service Dogs

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I am a very big supporter of service dogs, in fact I carry the ADA regulations for service dogs in my bag in case I’m at an establishment that gives people any grief.

Recently on NPR, there was a story about the VA acknowledging that service dogs help in dealing with PTSD but they refuse to pay for the cost of the highly trained dogs. It appears that there have not been any substantial studies conducted to back up the cost/benefit ratio. A service dog costs about $30,000. Interestingly enough, I believe a police K9 is also around the same price. So I estimate a $2500 per year cost to the VA for each dog. Dogs would help with physical disabilities as well as hypervigilance. I would say hypervigilance and trauma triggers would be the most common and most under-served symptoms of PTSD.

I am not sure what the VA or the federal government defines as assisting veterans when all they seem to do is over-medicate their clients or leave their files in a sort of limbo until the individual dies from the effects of service or homelessness or mental illness. I used to want to work for the VA but then I would just be contributing to the wasteful spending of professionals versus the funding of services. Supplying people in debt from college to serve people who are in our debts.

http://www.npr.org/sections/health-shots/2016/01/04/461529833/veterans-say-trained-dogs-help-with-ptsd-but-the-va-wont-pay

Transinstitutionalization

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While looking at treatment models in other states, I ran across this unfamiliar word. But it represents a sentiment and belief that I have had for a while. First of all, transinstitutionalization is the movement of people from traditional institutional hospitals to other institutional settings. So nursing homes and prisons have become the new institutional settings and thereby allowing people to continue to push an agenda that says that society has moved away from institutionalizing the mentally ill.

In fact, I saw Disability Rights Wisconsin tweet out a story about a Milwaukee institutional hospital shutting down their long-term care departments. In one way, it is good to be able to celebrate that people are able to move into the fold of society. In another way I think it’s tragic to see a disability rights organization flash this at their followers and clients. What happens when you leave an institution? Is a nursing home or group home not just a community-based institution?

Yes, there has been much progress in keeping people in the community; however I continue to run across people who get trapped in nursing homes because of the level of care they require. The general public continues to believe that we are progressing in not only our attitudes of mental illness but also in our treatment. Institutionalization is a trigger for me because I was almost sent to Central Wisconsin Center when I was little. A nurse tried to force my mom to sign papers to have me committed because of my complex medical needs. I now have a Masters in Social Work and an APSW license. My parents also had to fight relentlessly to prevent the school system from putting me into special education.

I have experience working with youth with autism and behavioral issues that would get them released from other programs or even temporarily institutionalized in a hospital. But then, here is my issue with crisis intervention and people not understanding how less severe or invasive it is to use a physical hold on someone rather than putting them in straps inside a hospital. Which one seems less traumatic for the client or the family? Which one could the state or county use in trying to push their agenda that says that they don’t institutionalize people anymore? Are hospital wards, nursing homes, and prisons not institutions in their eyes?
We must do more, we must hire more qualified staff, and we must remain client-focused.
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To Be Underestimated

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“It’s actually wonderful to be underestimated.”~Jack Canfield.

I’ve been thinking a lot about an interview I had with Outagamie County Shelter Care back in October. The supervisor was a fellow classmate from the same MSW program. I was told that someone with more social service experience was ultimately hired. The biggest thing was that the job I was interviewing for required a less advanced degree. Also, at the time I was doing a job that required more responsibility than what I was potentially going to be required to perform.

Currently I am working on social service policy implementation in a clinical/behavioral health environment. I’m in  charge of enrolling an agency and staff into an unfamiliar billing and rendering service.

This blog was the catalyst for being considered for the current project. Among having previous experience working within the agency. It feels good to be trusted to perform in a leadership role. Leaders don’t need to be constantly supervised to work. It’s refreshing to be able to prove the misconceptions of others wrong.

Putting Action into Practice

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One of the 3 topics I researched heavily for my Masters research project was using theatre games to teach social skills to youth with autism.

I bumped into this TEDxColumbia video last night and it brought me back to my graduate school days.  I invested a lot in trying to make that research project work. It was ultimately scrapped because there were issues with getting informed consent from youth with autism and having them fully understand that the project would be voluntary.

When I ran across this video last night which uses Theatre of the Oppressed and Forum Theater, my immediate thought was “I need to ask a high school theater teacher/club to assist me in testing this out and creating a pilot production for issues like bullying, cutting, and suicide prevention.”

Then I thought, how great would this be as a training tool for professionals? Or students in college working to become professionals? To be able to learn that the simplest action can bring about change.

I thought about Cathy Plourde who created a theater group in Maine, AddVerb Productions: Adding the Verb, Adding Action. She used some of my spoken-word poetry in collaboration with other youth in the country to create powerful theatre productions and published anthologies to create change. She invited local service providers to talk about the services they provide to an audience that had taken a step forward from being a spectator to being an agent of change.

I love this idea! It needs to come to fruition! 

Restrictive Measures Part 2

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I’d like to solidify my interest in addressing this topic. I am trying to find out why agencies that address community crisis do not employ the professionals or the training needed to address crisis events in a more broad client population.

My first contact was with DHS about some of my questions regarding community crisis and using police as an intervention tool. I had phone and email contact with Brett Loescher, a policy manager for the state of WI.

What I garnered from that contact was that people needing restrictive measures have a history of aggressive behaviors, so community crisis programs don’t serve them. It was suggested that hospitals and institutions were available for clients with more aggressive histories. But there was an attempt made to point out that de-institutionalization is valued over long term institutional residency. It was an unfamiliar topic when I questioned whether police were being contacted as a crisis tool in community crisis programs. I don’t think I came away with any new insights or answers to my questions.

Through education and research, I know that de-institutionalization began in the 70’s. However I don’t buy in to the suggestion that we are de-emphasizing institutional care as much as people like to talk about it.

It’s becomes a paradox when community crisis agencies don’t use behavioral supports in serving clients. Specifically those whose history may prove problematic for agency-specific services or the skills of unlicenced professionals. Medication is chemical restraint and it is part of the intervention or management of mental illness. But when an agency seeks to hire professionals that only receive internal agency training, how knowledgeable are professionals on the complex effects of medications and keeping updated on the daily mental/physical/environmental changes of clients?

Currently I am following the Post Crescent on their series about addressing children’s mental health. They covered a story about police departments not having crisis intervention training. So that presents another question; when you know that you don’t have the authority or training to handle a situation and you call the police, what are you really expecting?

My next contact will be with police departments.

Sustainability of Non Profits?

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The Fox Valley has easily over 500 non-profit agencies. Many of them are smaller and run by individuals who saw a need not met in the community. Rarely do smaller non-profits collaborate or join together to become one larger agency. The biggest issues that smaller agencies deal with are funding resources and building a client population to implement the goals of the agency’s initial creation. Many people create a non-profit organization because of some event in their life or they saw a need and wanted it addressed in the community.

When I worked for the Boys and Girls Club Fox Valley, most of their programs were and still are funded by community grants, program-specific funds, and state/national grants. The Boys and Girls Club Fox Valley was created in 1998 out of a deadly gang fight that rocked the community back in 1995.
(http://articles.chicagotribune.com/1995-07-06/news/9507060158_1_gang-nicknames-joker-members)

That event sparked a conversation about safe places for teenagers to socialize and spend their free time. When I worked with youth on gang prevention, I did a lot of research through the Office of Justice Programs(OJP) and the Office of Juvenile Justice and Delinquency Prevention (OJJDP). Most negative behaviors in teenagers occur in the after-school hours. So there is correlated evidence that after school programs help prevent juvenile justice related behaviors. Although, during school behaviors are very much a part of a juvenile justice social worker’s job.

The Fox Valley Community Foundation (cffoxvalley.org) is one place to begin obtaining grants for an agency or a particular initiative that brings value into the community.  It also offers beneficial information on financial sustainability of an agency or service. According to their website, 986 non-profits including schools and hospitals received funds from various community grants and personal donor funding sources in the 2014-2015 fiscal year.

Martin Luther King Day and Volunteerism

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Today I want to focus on MLK Day and volunteering. Monday is Martin Luther King Jr. Day and I’ve already received plenty of emails about volunteering in the community on that day.

I’ll probably spend my day volunteering at Riverview Gardens. Being a gardener, the winter is hard to get through and they have a beautiful indoor hydroponic garden. But what I really want people to know is that becoming a regular volunteer in your community is very beneficial to you and others. Sure you could use volunteering as a networking ploy. However I have found that my volunteer work with men on supervision has really opened my eyes on the needs of the community, especially a population that seems to be forgotten.

I am much more knowledgeable about community resources, in fact I was provided a giant binder full of resources and contacts when I first started volunteering. Now I go out and research or interview service providers to be able to find out more and share that information.

You then get a sense of where your advocacy or social service work can have the most effect. You have to realize that the majority group is always going to ask you to wait, wait for a better time to act in the way you need to seek your rights or the rights of others. You don’t wait, you act and understand that you don’t need to worry about other people’s comfort zones. Progress is not made by conforming. Civil disobedience is not about civil convenience. You can quote me on that! So go out and get engaged with your community every day not just a national holiday.

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