1. Programs in Ontario (including consumer/survivor initiatives and CAMH)
#1.1
You talked about “Diabetes Peer Support Project”. I think some persons can’t walk well (limping etc.) because of side effects of drug or stresses. I have seen some persons who have to use a wheelchair. Are researches about dystonia or dyskinesia done? Do you have a service for such a person? (A person with such a side effect can rent a wheelchair for example.)
Some earlier generation
medications do cause those side-effects that you mention. Generally, when an individual is on social
assistance due to a permanent disability (in this case a mental health
diagnosis), they are eligible for what we call “assistive devices program” or
ADP in Ontario. Depending on the person
or family income, the government may contribute part or all of the cost,
provided there is a healthcare professional such as a physician who will sign
an application stating that this is necessary equipment.
#1.2
In Ontario, the Ministry is funding to so many mental health programs. What idea does the Ministry have in order to realize such a situation?
First of all, the primary
intent is to place the client/consumer in an appropriate level of care and in
the community wherever possible.
Hospitals and institutions mean that the person being treated may have
to be away from home and far away (Ontario, especially outside of big cities,
is a very large province, and hospitals can be one or more hours’ drive away).
There is a phrase we use
called “the continuum of care”. It means
that there is a range of services that is suitable for consumers. As they get better, they should be able to
change service providers to fit their needs.
So, for example, someone who is in hospital transfers out of emergency
care, to case management to monitor their progress, and when they stabilize,
can start using outpatient daycare programs and later on, peer support services
also. Employment-based services and
going to school with counseling help are also available later on. However, not all services are available in
all areas and waiting lists are possible.
#1.3
What programs do psychiatric social workers provide in Ontario for example?
Social workers are
employed in both community and institutional settings alike. Social workers can
be case managers, supervisors, senior management, or work one-on-one with
clients. One thing social workers are
not able to do unless they are self-disclosed consumers themselves ? provide
peer support. Because they do not have
“lived experience” of what it is like to have a mental health diagnosis.
#1.4
You told that professionals intervene unnecessarily. But I think that such a discourse is right only if all the clients have ample support. What kind of approach do professionals in Ontario use as they are involved in outreach services?
It varies. My personal opinion is that when
clients/consumers are consulted and listened to respectfully by professionals,
or better still, when a peer support worker is part of the treatment team, they
get the best treatment. When peer
supports are encouraged (for example, peer supporters from a consumer/survivor
initiative regularly visit the emergency ward or inpatient unit to meet
first-time patients), it is a win-win situation for professionals (better
understanding), for the client (being able to share what they are going
through), and for the peer worker (recruiting a potential new member for their
organization who will learn more about recovery after leaving the hospital).
#1.5
How is the money from the Ministry to consumer/survivor initiatives spent by them?
The situation is not much
different from any other community agency.
They have to pay staff salaries, find office space (rent), and cover
other operating expenses (office supplies, transportation costs, administrative
support, and so on). However, because
CSIs were set up to be an “anti-recession project” in the 1990’s, they were
never properly funded as permanent mental health agencies (and also because
they did not use professional staff).
CSIs therefore have less money; staff earns less or are likely to work
only part-time. It is attractive for
consumer staff to jump to mainstream agencies that will pay more for people who
did not learn through book knowledge but have had practical experience.
#1.6
Does the Ministry impose some restriction or obligation on consumer/survivor run organizations funded by the Ministry?
In my slide presentation,
I mentioned that the Ministry is no longer directly responsible for funding
each organization. The 14 LHINs that
make up the province are responsible for the CSIs within their territory. The only rules are to follow the business
plan (“be effective and efficient; work with other agencies to provide the best
person-centred care” is my short version”.
Oh, and do not run a deficit by losing money.)
#1.7
In Ontario, is it difficult for organizations to get the funding from the government if they are run without professionals?
In these economic times,
it has rarely been possible for new community agencies to start up (of any
kind). Again, I speak from personal
opinion ? it is not whether professionals or consumers or family members get
funding ? the important key is whether they can provide a business case for a
new way of providing healthcare.
Realistically these days, a partnership of professionals, consumers, and
family members is “politically correct” to have a reasonable chance of being
listened to. The expression is “breaking
down the silos”, meaning people have to learn to work together instead of
keeping to their own kind. Teamwork in
healthcare is most responsive to a recovery-based approach to mental
healthcare.
#1.8
In Ontario, is peer counseling funded by the government?
CSIs, peer support
organizations, and patient councils in hospital settings receive funding. Family self-help organizations also get money
from the government. It is possible self-help groups started up by volunteers
receive one-time grant funding from foundations, other Ministry monies, or are
self-funded by the volunteers themselves who may have access to free/low-cost
community space to meet.
#1.9
Do you know the concept of “basic income”? If you know it, please tell us something about “basic income” and consumer/survivor initiatives.
I suggest you look up
“ODSP” on the Internet using Google. This
is the Ontario Disability Support Program (the basic income for consumers who
are considered disabled and therefore unable to work).
I also suggest you check
out the “Income Security Advocacy Clinic” (the full name on Google). It is called ISAC for short. As the grassroots activist organization, it
has a clearer picture of how inadequate the money available to mental health
consumers and other non-working disabled people really is.
#1.10
I heard that Cheng-san is one of the board members at CAMH. I would like to know about CAMH. How large is it? What character does it have? They have a locked ward? How long do patients stay there? What services can patients have there? Does CAMH has peer support? If they have it, is it effective?
* “San” of “Chen-san” is a Japanese honorary term of address.
I suggest you Google
“CAMH” or “Centre for Addiction and Mental Health” to answer these
questions. The only answer that I know that
may not be on the website involves peer support. Yes, CAMH is introducing peer support workers
into some of its units (the short-stay wards for people who have diagnoses of
mood disorders and schizophrenia and who take a step back by going into crisis
and need a hospital bed until they get better).
They also have peer
workers in some wards for people who have longer-term stays.
#1.11
What is “court support services”?
When someone has been
charged by the police with a crime, sometimes, there is a question of whether
that person is “of sound mind”. When
there is a question, a judge can make a motion to send that person to a
psychiatric hospital for a period of time for a mental health assessment. The psychiatrist who supervises this
assessment is then asked to testify of his opinion. If the client is found to be mentally competent,
he or she will leave the psychiatric hospital and go to the criminal justice
system. If the client is found not
mentally competent, the judge can authorize that a person be sent to receive
treatment.
As the client has legal
representation (a lawyer), he or she can decide if they want to appeal the
decision. There can be many steps taken before someone is either on trial or in
the forensic hospital.
What is “regional forensic services”?
Forensic psychiatry is a
special kind of care because it involves elements of custody (confinement) and
care. A general hospital is not generally
a secure environment to keep people in detention. Regional forensic hospitals have better
security and specialist teams (from doctors to social workers and so
forth). CAMH happens to be the Toronto
regional forensic services hospital.
For long-term and very
difficult cases, some people spend a long time in Penetanguishene Mental Health
Centre (the provincial centre).
Who funds consumer/survivor initiatives? The national government? Or voluntary organizations?
In Ontario and all other
Canadian provinces, healthcare services are funded in lump sums by Ottawa (the
national government). Each province
decides how it wants to spend its money on healthcare. In Ontario, funding for peer support
organizations can come from the LHINs (the money managers of healthcare),
sponsoring agencies who get money from LHINs and give to groups that are not
independent organizations, and given from hospital budgets to patient councils.
Consumer/survivor
businesses get the majority of their funding from government (it is considered
a healthcare program that keeps consumers out of the hospital by having them
work), but also earn income (A-Way Express by charging for courier services,
Fresh Start for doing maintenance office cleaning).
Sometimes organizations
have private or public sponsors (the city), do fundraising, and win grants from
foundations by writing successful proposals to set up programs or projects
(usually one-time or temporary).
2. The relationship between consumer/survivors and professionals
#2.1
When you became a board member of a hospital, what did you have to insist for professionals?
I don’t really understand
this question, but I hope the next answer is sufficient for your understanding
on the topic of consumers and professionals.
#2.2
What factor do you think is important to build the partnership between consumer/survivors and professionals?
‘Put yourself in the
other person’s shoes” is a good attitude to take. Listening and practicing mutual respect is of
utmost importance. At the same time, you
have to be truthful and consistent in what you say and what you believe
in. Because the truth can be hurtful and
unpleasant at times, developing a sense of humour to sweeten the message is
very helpful.
#2.3
About the slide #15 (Ontario Context - Programs). Do professionals in Ontario have equal relationships in a real sense with their “clients”? (e.g. Social security, or working wage.)
No! The professionals go home after their 9 - 5
jobs to a comfortable life. The
consumers go home (if they have one) and they are still poor, likely not having
anything good to eat, somewhat lonely, and wishing for a job. The basic income for consumers on a
disability pension (ODSP) is far below the “poverty line”.
#2.4
I am studying social work at a university. Please let us know what do you think is the role of social workers.
A social worker
facilitates the process of recovery by listening to the wishes of the consumer
or client. Ideally, this means having a
good knowledge of the system, and what particular services and supports is
appropriate. This may change with the
assessment of the consumer over time, and therefore changes in the type of
treatment or program should be a joint decision. A good social worker is empathetic (has
feelings too) and is more motivated by having a consumer become independent
than to want to keep the person on as a client.
I have mentioned in my presentation the idea of “risk management” in
recovery. Together as a team, the
consumer and social worker (and perhaps with permission the family members too)
must strategically think about goals, and to consider what are the positives
and negatives of taking the next step. A
comparison is a financial consultant in a bank that works with a person to
determine if he should buy a house and how much money to borrow. Together they would consider the current
salary, if there are any raises in salary in the future, whether the job is
safe, if other family members can help out, and so forth. Taking the same analysis to plan recovery in
mental health is like that.
#2.5
Please explain more about “CURA”.
CURA is a form of
university research funding offered by the federal government in Canada. It means “Community University Research
Alliance” and is a means to encourage community organizations (who do not
ordinarily do research as part of their operations) to build partnerships with
academic researchers who don’t spend a lot of time providing care to people.
A research partnership
that explored culture in community mental health was an important project to
me. We have many cultures in Ontario
(not just immigrant, but the First Nations People (natives or aboriginals)),
and using an English-speaking medical-model system of care is not appropriate
for everyone. So the research aimed to
find out if there could be new ways of looking at mental health, new ways of
helping people navigate the system (use the services), and creating awareness
of all the participants that there were weaknesses in being able to communicate,
deliver, and plan appropriate services for these special populations.
Japan has a more
homogenous identity (with one common culture and language), so it may seem
strange to you. However, as a Canadian
who is fully adapted, but who looks “different”, I can tell you that even I
have had less than perfect experiences with some services because I am supposed
to be “different”. Or people don’t take
the time to listen. This is also true
because of my physical disability.
3. Toolkit
#3.1
Do you think family members also need a toolkit like the OPDI Peer Support Toolkit?
I think they do indeed,
and that is a very good point. As I
mentioned in my presentation, “talk is cheap”.
You have to write down your knowledge to be able to effectively share it
and teach it to other family members.
#3.2
To become a peer specialist requires any certification? How much are paid for a peer specialist? How does a person become peer specialist?
Doesn’t hierarchical order between trainers of the Toolkit generate inequality?
* I’m not sure whether you talked about “peer specialist” or not. This person may be writing about consultants or super trainers of the Toolkit project.
In Ontario, before we
began the Peer Support Toolkit Project, people did what you did in Japan. You used the resources in the United
States. WRAP is something we have in
Canada too, for example. However, if
someone graduates from training in the States, I am not sure if that
certificate is formally recognized like having a diploma or a professional
degree.
Right now, CSIs train
their own people differently. They may
use their own resources, or use resources adapted from the United States.
With our OPDI Peer
Support Toolkit, we are putting together “the greatest hits of all the CSIs
doing Peer Support in Ontario”. So it is
a rich resource and specific to the needs of people who use mental health
services in Ontario. Over time we hope
to create special topics that will take peer support to an integrated way of
keeping people healthy in emotional, physical, and possibly spiritual ways.
Peer Support Workers in
CSIs are paid okay but not good money.
CSIs may not be able to hire them for full-time work (not enough
funding). Hospitals pay well but don’t
hire for enough hours. In some respects,
peer support is still not recognized by the wages that are paid.
When you ask about the
training hierarchy in our Peer Support Toolkit Project, I think the short
answer is that we want the very best peer support people who are able to teach
to be the “super trainers”. As I mentioned before, every person in recovery has
different strengths and weaknesses. Some
are great communicators who inspire others.
Those are the ones we want to help be the trainers.
#3.3
I am a consumer/survivor and studying at a university to become a certified psychiatric social worker. I will become “prosumer” from “consumer”. I understand well about the quality of services because I have been a user of them.
I think that people who become “prosumer” from “consumer” will share the orientation to recovery. In Japan, the effectiveness of a tool for recovery has not been explored and a tool for recovery itself has not been developed yet.
Please talk more about a tool for recovery.
Congratulations on your
success! This is exciting to see you be
able to come back and want to help other people.
The answer to the
question is that YOU are the tool for recovery.
You just don’t know it, but by being who you are and doing what needs to
be done (instead of just talking about it), you too have the ability to become
an inspiration. I just want to remind
you that your health is very important, so take care of it during this
stressful period of your life.
You are not alone ? as
you continue your studies and then enter the workforce you will meet your
peers. What you yourself and as a group
can do is unlimited ? but it is important to take little steps and to be
yourself at all times.
4. The Minister’s Advisory Group
#4.1
How did the executive director of OPDI get to participate in the Minister’s Advisory Group?
She has been a
well-respected participant in government meeting before, and has gained even
greater recognition in the last two years as she has become more skilled at
doing this kind of work. People are not
necessarily picked for their “job title”, but whether they are good at being
able to think and work together even if they come from many different
backgrounds.
#4.2
You told that the executive director is on the Minister’s Advisory Group as the representative. Can all the staff members at OPDI make one unified opinion?
No. She is officially a private citizen offering
a consumer perspective. However, since her personal views are closely aligned
with OPDI (since she does have a job with the provincial umbrella of
consumer/survivor organizations), if OPDI’s policy positions are what she
brings to the table, that’s OK with everyone (wink, wink).
5. Mental health in Japan
#5.1
In this society of Japan, which does not accept people with mental illness, what do you think is needed to make peer support formal and universal?
From what little I know
about Japan, differences are sometimes social unacceptable. Also, in Japan, the family unit is more
important than the individual. Therefore
if an individual has a mental illness diagnosis, the family has two
choices: hide it (putting great stress
on everyone), or ask the consumer to live alone (which is not healthy in the
long run). Because of these cultural
differences, I am sorry to say that recovery is especially difficult to
achieve.
If you want to have peer
support be formal and universal, I think you need more people to share the word
that recovery is possible from mental illness/a mental health diagnosis. Each person is different in the way that they
get better, but better functioning is indeed achievable. If you have a culture that has low
expectations and discriminates, this is hard.
I think personally that
successful consumer/survivors know this in their heart ? those that think and
act like North Americans are most likely to succeed.
#5.2
I think that people in Japan have little voluntary ethos. Do you have any good idea about what we should do?
I am not sure about this,
but this is my opinion:
I think that if something
is free in Japan, people are suspicious of it.
If free help is offered, it can’t be good, right?
So, my suggestion is,
think of peer support like a business. Charge a membership fee to join (a
member), be an associate (family member), or an agency that wants to help
(sponsor). Use the money to do “happy
things”. Parties, group outings, common
meals (potluck), guest talks… and so forth. This brings more people out to
participate, and more paying members… and soon you have a group. That means you can then be more like a business. And when it is like a formal organization,
people who are good at business get excited and want to join. And then that is when you are big and
successful. This will take some time and
planning. But it is possible.
6. Miscellaneous
#6.1
You told that “peer support is a light house of caring friends”. Could you explain more about what this phrase means please?
A lighthouse sends out a
light. It is usually to warn a ship of
danger. But it can also guide the ship
to its destination.
Peer support works the
same way. If a consumer is close to
crisis, peers will tell the individual and guide that person so that they can
avoid hospitalization. A consumer can
also rely on peers on directions to guide their way to recovery (because those
peers have also “been there”).
#6.2
Are the four steps for the evolution common to all the people?
No, the road to recovery
is different for each person because we all have different goals. My recovery was job-related because I found
out by volunteering and being myself that I had skills that were desirable.
Other people may find
recovery in finding a soul mate, in going back to school, in getting physically
in shape, or in many other different ways.
It is a common theme, however, that each person has to find out who they
are, what they want to be, and THEY HAVE TO LIKE THEMSELVES.
#6.3
You told about "Evolution in 4 Steps". What stage do you think consumer/survivors in Japan are standing at now?
The very question is
interesting. The individual wants to know how consumer/survivors are doing
right now. My answer, of course, is that
every individual can and should be uniquely looking at the path of recovery.
Every person is different, so I cannot generalize. What is important is that people who have a
mental health diagnosis or are receiving treatment be exposed to the language,
ideas, and hope that comes with a focus on recovery, and are able to access
peer support.
There is a certain
anxiety about being different (because of your mental health status) and then
even more different (trying to stay well) and then challenging society's
expectations (getting to as high-functioning as possible). When you consider that failure to thrive is
acceptable in mental health, I think we know that is not right. If we
therefore have to be
different to be successful, there is nothing wrong with that.
#6.4
What approach do you think is important in order to help a person who can not accept her or his mental illness?
This is a very
interesting question, because I must have had the same feeling when it was very
early in my mental health diagnosis. My
personal opinion is that it is usually because you are not mature enough to see
yourself through your own eyes. You are
denying who you are by listening and trying to behave to others’ expectations
(family, friends, co-workers). When in
denial, you are not listening to your heart.
That kind of false awareness is misleading because you will be building
a fake personal identity who is not really yourself. It just creates more stress, and the very
real likelihood of chronic episodes. So
in the end you become exactly the person who you don’t want to be… someone who
gets so sick so often that recovery will become very challenging. Recovery is most likely to be taken by people
who have learned to limit the time spent in intensive treatment (hospital
stays, strong medication, ECT, and so on).
#6.5
If you had a bad peer staff like me as a colleague, what would you do with me?
Hello! Just because we are peers doesn’t mean you
get a job evaluation every year. If it
is unsatisfactory, you can be laid off just like anyone else.
Up to a point, a
consumer/survivor organization will acknowledge that sometimes staff is not
able to work well all of the time and need time off. But they should be honest about their health
over the long term. If they can’t do a
good job because of health challenges, they should not be working. They are not helping themselves, and more importantly,
not helping the peers who trust them to do a good job.
#6.6
You talked about learning what is good about peer support and what is wrong about peer support. I would like to know about it concretely.
* I am not sure which part of your talk this person is mentioning to. It is possible that this person would like to ask about “Sharing Ideas around Recovery is to Acknowledge that there is no Right Answer or Wrong Answer ? only Choices that ought to be Explored.”
Peer support is ideally
for people who have stabilized their health, have a good support system of
friends and family, and are prepared to move ahead with life and the
future. This means that there are many
possibilities and voices of people sharing their opinions of what peer support
can do for you. It is important as the
consumer to listen carefully and think of what might work best.
Here is a comparison with
a financial consultant again. Imagine this person has 100,000 yen. The consultant would say: here are stocks, bonds, gold, savings
accounts, lottery tickets, and other choices.
What mix do you want?
Peer support is part of a
mix of mental health services and supports that are available. Some people may want case management more;
others prefer doctors; others just want to keep to themselves and live a quiet
life.
What I mean is that there
is no right way and no wrong way. You
can choose peer support as an important part or ignore it. What is important to me is that you are
thinking about recovery and getting to the point where you are a satisfied
functioning citizen in society.
#6.7
What is “community”?
By “community” in
Ontario, I think a general definition is care that does not take place within
the hospital inpatient unit. It means
that agencies outside the hospitals provide day treatment and regular
appointments with clients. Some types of
crisis programs do provide short-term stays in beds, but they are in a
home-like setting. Hospitals, too, can
run outpatient programs that are considered community-based.
Institutional programs
mean that in general that clients have a hospital bed and care revolves around
access to being in the hospital 24 hours a day until they are discharged.
When someone is in a
community program, there are many more of them than there are hospitals where
psychiatric care is available. There is
greater variety, and more importantly, they are likely to be closer to
home. This is the preferred option for
both consumer (personal preference) and government (use of less intensive care
costs less money).
#6.8
What is “recovery”?
Recovery is different for
everyone. I suggest that you Google
“mental health recovery” and read up the definitions. There will be some material in Japanese.
For me, recovery when it
comes to mental health was like learning about myself and knowing who I was and
what my goal in life was.
You see, when we are
young, all things seem possible. When
there is a mental health diagnosis that drops into the middle of life, it is
true that it takes time to understand that we can’t do everything we dreamed
of. But it is a blessing for me; it
focused me on developing my strengths (speaking, writing, being funny and
getting along with people) and let go some of my dreams (work as a computer
programmer, earn lots of money, show off at high school reunions). As it turns out, I found my path to recovery
to be a better quality of life than I could imagine. I love my job; I get to travel; the money is
more than okay; and in my work I used to meet former computer programmers who
got sick from their work (true).
What is “empowerment”?
Again, I urge you to go
to the computer and look for Japanese as well as English references. “Consumer empowerment” and “self help
empowerment” are also good terms to look up.
Personally, I think
empowerment is having the passion and honesty that comes with building up
self-confidence to be who you are. This
means that the things that you say and believe privately should be communicated
openly in public. It doesn’t mean
disclosing to people in the first five minutes about your mental health
diagnosis. But you can certainly make a point
of saying something like “based on my personal experience…”
What is “strength”?
A personal strength is
something you are good at. Everyone has
some personal strengths ? the key is to be able to listen to your heart well
enough to recognize what they might be.
Sometimes people close to you will praise you for what you are
doing. Take the time to write it down,
or better still, ask politely what they meant.
Eventually patterns will emerge.
Then go and put together a plan to make your strengths the basis for
improving your mental health. This awareness is always an ongoing process.
Not a question but a comment or information. If you have some comment, please write.
#1
In Japan, consumer/survivors are involved in provision of home help service. But they provide same services (e.g. daily living support or physical support) as those provided by non-consumer/survivor helpers. The uniqueness of their work is ambiguous. I hope strongly that you will develop the toolkit for peer support and it helps us to clarify the uniqueness of peer support in service provision in Japan.
Thank you. As I understand it, Japanese people respect a
successful business model. I have
mentioned this before in an earlier question.
I think that if consumer/survivors (especially in partnership with
successful entrepreneurs or businesspeople with marketing and management
skills) can come up with ways of starting their own service agencies, this is a
good way to provide a “made-in-Japan” approach to peer support. If consumers can get sympathetic supporters
and volunteers (family members and like-minded people), it is possible.
I caution you strongly to
make sure you have legal and copyright protection. Also even if you are from different parts of
the country, consumer/survivors should be working together in partnership
(using the Internet and telephones) to develop such models.
Here’s my reasoning why
it might work: the Japanese healthcare
system is too expensive and will not be affordable. A consumer/survivor service agency would do
three things: keep consumers healthy,
have them working (good taxpayers), and be cost-competitive with
hospitals. Moreover, I think the
outcomes for clients will be just as good or even better (for example, clients
leaving the hospital programs for peer support programs). I think you could make the case at the
federal government or prefecture level for new funding to try this. And if you need a consultant from abroad to
help you, you know where you can find me.
#2
I am a consumer/survivor. I think that it may be difficult for consumer/survivors to have daily life smoothly. Addition to it, because of long period of illness, we do not have opportunity or motivation to learn how to communicate with others and are not good at having the good relationships. Sometimes I don’t know what to do when I experience a conflict with others.
Hi there. I understand your situation. What I can suggest is looking at a recovery
approach to mental health in this way:
#3
It was difficult for me to understand the lecture. (I am a consumer/survivor.) But I felt your passion to communicate something to us.
Thank you. My speaking style is passionate because I want
to share my own story and give people inspiration. I hope the notes will be calmer and allow you
to understand better. Also, there were
audio recordings made of the presentation that can be played back on the
computer.
#4
In Japan, people with disabilities are insisting that the Services and Support for Persons with Disabilities Law is against the Constitution. The district court has reached the decision that the Ministry of Health and Labor and the group of people with disabilities should have a settlement. (March 2010) I think that this happened because of the change of the national government from Liberal Democratic Party to Democratic Party. A newspaper told that a person from the Ministry made a comment that they will listen to voices from people with disabilities. But the name of the person was not described.
* See
http://mdn.mainichi.jp/mdnnews/national/archive/news/2010/03/24/20100324p2a00m0na016000c.html)
# 5 (This comment may be written by the same person as above.)
In Japan, five or six years ago, the Ministry of Health and Labor suddenly established the Services and Support for Persons with Disabilities Law, which orders people with disabilities (physical disability, intellectual disability, or mental illness) to pay charge when they use services. As I am living in Osaka Prefecture, first I paid about 10,000 yen for about three months but, after that, paid just 1,500 yen per a month. Last year, the general election was held and the party of national government changed from Liberal Democratic Party to Democratic Party which is trying to abrogate this law. Also the Ministry is trying to listen to voices by people with disabilities.
Thanks for this recent
piece of news. I think that by charging
a fee for services, disabled people are being told they are a burden to
society. This is old-style thinking.
Ideally, the government should be considering that the disabled community is
uniquely qualified in understanding how to make the healthcare system operate
more effectively, efficiently, and be more flexible. This is because they are the users. Who would you trust more to tell the truth ?
the service providers asking for money or the people receiving services? Listening to the voices of the disabled is a
good start; involving them in planning, implementing, delivering and evaluating
the services themselves are aspects that consumers of all kinds (mental and
physical) should be able to do.
#6
Recently, I think that the concept of “peer support tool” or “recovery” is becoming professional.
I agree with you to a
certain point. But when peer support
tools and recovery is promoted by consumer/survivors themselves and not
professionals who are trying to market their services to sound more “pleasant”,
you know you are getting the “real deal”.
Like any good shopper,
you need to study the products in the marketplace carefully. Who makes it?
Where does it come from? What are
the qualities of the product? Are there
good references? What do the customers
say about it?
The same applies to
looking at organizations or people who are speaking these words ? you need to
examine carefully what they really mean. Sometimes it is the genuine product,
and sometimes it is just false advertising.
#7
I have a depression and so hard time now. A person whom I can rely on is just a doctor. I have no support. All the things I do will be ineffective if my illness is not cured.
Hello there. I know you are going through a difficult time. From the way you wrote out your question, you
are probably not happy about the approach you are taking to your mental health
diagnosis.
First of all, you do not
have a mental illness as much as you have had someone give you a label ? a
person with depression. How much you tie
your self-identity to the mental diagnosis is in my personal opinion directly
connected to how you feel.
If you make an effort to
say to yourself “I am a good person who according to my doctor is going through
a hard time”, you are beginning the process of acknowledging that the
depression is happening to you right now, but can improve and change over time.
As much as a doctor can
help you with medication and talk, he or she is not an expert on recovery. The mindset of a doctor around mental health
is generally “once a patient, always a patient, therefore always a source of
income”. The mindset of getting better
and achieving one’s road to recovery is to use other services and supports that
move you from the medical model.
You say you have no
support. What I say is ? you should try
to be less socially isolated and go out and get them. It is hard at times during this period to be
motivated, but this is really the best time to do so. You have lots of time, have the ability to
think about what you would like to do, who you want to be with, and most
importantly ? because you are alone, it is the best time to talk with your
heart. Understanding yourself in this
quiet time is really a blessing because you can concentrate on taking care of
yourself.
By doing these things,
you are creating a recovery plan: what
to do, who to meet, when to go. It is
helpful to write this down and even keep a journal so you are aware.
My final advice is
this: it may be useful to treat the idea
of recovery as a job. Give yourself some
hours during the week for this. Plan out
approximately (remember, you do have good days and bad days) what you would
like to do.
Hopefully, at some point
you will have the services of a social worker, or meet other peers. Then take it from there ? YOU ARE NOT ALONE.