image credit… ronald n. tan
i have been appointed to sit on a planning and advisory council for the newly formed office of behavioral health for colorado. this system shift is due mainly to the anticipated health care reform shift which is intended to create parity for mental health and substance abuse disorders in the larger health care system.
man- there seems such a distance to travel. the current status quo is sectioned into quadrants and the players du-jour are conditioned to fight for their selective scraps. my interest is twofold i think.
firstly i remember struggling to contain my behavior and my use when i was younger. because of lack of understanding mostly, i believed that something was intrinsically wrong with me which caused me to constantly fuck up. it was as if it was expected. had my small town, my family, and my educators understood bi-polar disorder better, perhaps an intervention early could have saved me from suicide attempts, running away from home, and the lifestyle of a gay runaway that came with heavy drug and alcohol use and addiction, ptsd, and hiv. lgbt youth and adults, persons with multiple occurring disorders, children of single parents, lgbtq families (of all colors) rarely sit at these policy shaping tables.
secondly, i wonder if the veil of aloofness that accompanies psychiatrists is truly helpful for the patients. i know it is to protect the providers and i can accept that. but i think that relationship is one of the main driving forces behind behavior change and the nature of psychiatrist-patient relationships leaves the one getting paid in the relationship with far more than the one behind the payments. and since my new task involves advocating for people with no money there are very few people minding after their interests. peer coaching and recovery oriented relationships may offer the lubricant that could enable some of our citizens to seek more spiritual ground.
i am curious about the direction the next year or so will take me. i breathe in hope that a more holistic people oriented system will replace the policy oriented system we currently have. my experience was that i had to jump through substance treatment hoops to be assessed for any other mental health issues. the catch-22 there is that i had become accustomed to self medicating my mental well being and it took several years for me hurt enough to be willing to change. this is a provider driven policy. jump through hoop 1 and then you earn a chair at the big table- where you will asked a plethora of questions and then given a prescription. but make sure you find someone else to talk with because the prescriber will remain aloof. this process took me awhile to swallow and accept as well. there was no one i remember offering me any guidance during this process. not like 12 step- where a sponsor becomes a cultural guide. i wish i had access to a guide like that for my medication journey as well as my ptsd journey and my shame journey (all of these continuing btw)
and i guess this is where prevention fits in. had there been education about mental health and lgbt issues, as well as thoughtful early interventions including healthy discussions about substance abuse and mental health medications, i might have had a different path. i wouldn’t choose it now, but i would like to make it a possibility for those that come after me.
what i hope is that this effort will help shine a greater light upon the idea that our people who get hiv, hep-c, many cancers put themselves in the vulnerable positions to contract these illnesses because earlier behavioral health issues went unaddressed. i am becoming an advocate for a behavioral health transformation- prevention, holistic treatment, and recovery. we might save lives, we certainly will save heartache, and undoubtedly save resources.
i dream that we can move towards a more inclusive system- and philosophy. the sheer numbers of people that are being shut out is increasing before our eyes. and all the while we are barraged with messages of how more and more people don’t deserve to be at the big table. and the rest of us writhe passively, numbed out by the sheer audacity of separatism and the cacophony of shrews.