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June 23, 2017 by Bob Nikkel, MSW

You Say You Want a Revolution, Part 2

Two years ago, I wrote a blog entitled “So You Say You Want a Revolution?” in which I laid out in general terms what I saw at that time as the key ingredients in making revolutionary changes in public mental health systems–they were 5 C’s:  Commitment, Courage, Creativity, Capability, and Care.

I’ve had 2 more years to think about these things and have a few more thoughts on the topic.  If working from the 5 Cs seemed daunting before, my ideas for system revolution are now more specific and even more challenging.

A formative experience for me was beginning to work several years ago with a large state agency that served many young people with mental health problems.  A colleague from my days as the state mental health and addictions commissioner began to talk with me about my new perspectives on the treatment of people with mental health challenges.

He told me that he was interested in looking at how psychiatric medications were being used in his agency.  His words were encouraging:  “Whatever we’re doing, I want to make sure it is in the best interests of the youth in our care.”  I jumped at the chance.  I toured facilities, discussed the issues and the risks in overusing medications with another former colleague who was in charge of treatment services.

The bottom line ended up being a financial equation:  “If it costs a dollar to keep a young person out of trouble using medications and it costs a lot more to keep the young person under control with staffing, what do you think we’re going to do?”

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June 21, 2017 by Lauren Spiro

When the war in our mind ends, peace emerges

When we co-founded Emotional CPR (eCPR), I put my very best thinking into the project as a way of embodying how I envisioned relationships and how every person could learn how to support another person through an emotional crisis. eCPR has evolved over the years and so have I. I have a new insight and an invitation I would like to share.

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June 9, 2017 by Tamara Staples

Starting conversations that save lives

Artist Tamara Staples on the discussion panel “The Making of an Epidemic: Polypharmacy in the Treatment of Mental Health ” at the San Jose Institute of Contemporary Art. The panel discussion was the culmination of her installation exhibit “Side Effects May Include”.

Before my sister’s untimely death from an overdose of pharmaceuticals, I didn’t think much about pharmaceuticals  in any meaningful way. I’ve never dealt with serious illness. My sister was eccentric from an early age and no one thought much of it.  Of course, the labeling of mental illness had not yet come into play at that time.

We were adopted from separate families and when she met her birth family, she discovered that her father was bi-polar. He was taking Lexipro at the time, so she found a doctor who would prescribe the same. 

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June 2, 2017 by Laysha Ostrow, PhD

Wealth of resources on peer respite at

Self-Evaluation Guidebook Just Released is a comprehensive online resource dedicated to dissemination and implementation efforts to help communities create effective, sustainable crisis alternatives through independent peer-run programs. Live & Learn, Inc created to provide a comprehensive online resource dedicated to dissemination and implementation efforts about peer respites, providing public access to information about research, technical assistance, resources, and a program directory.

In May 2017, we launched the Guidebook for Peer Respite Self-Evaluation: Practical Steps and Tools to assist in building the evidence for peer respites.

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June 1, 2017 by Bob Nikkel, MSW

Trauma in Common?

Recently, I had a chance to look at a review of DJ Jaffey’s new book, Insane Consequences:  How the Mental Health Industry Fails the Mentally Ill.   As can be expected, the book will meet with considerable blowback–a starting example:  The title of the book using the long outdated term “insane” will set some bells and whistles going.

But I found myself asking whether that is such a good thing considering, among many other dynamics, the deep polarization that is spreading almost like an illness through all of America these days and even contaminating views of us abroad as well.

The dispute that will be ignited further is the one between the proponents of DJ Jaffey’s world and that of the “other side”–those who are equally dissatisfied with how the mental health system works because it does not respect the individuality of persons with major mental health challenges and does not support the idea that people can recover–even those with the most damaging diagnoses of “schizophrenia.”  The latter group is one that is actually quite diverse and includes everyone from progressive members of the American Psychiatric Association (admittedly still a minority though growing group) to the antipsychiatry advocates.  There are numerous other advocates in between including some long-time NAMI leaders who are speaking to the harm of conventional mental health treatment and pushing for many kinds of alternatives.

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May 11, 2017 by Eliza Galaher, QMHA & Eli Addison, QMHA

Hearing into Healing

#4 in the series An Affirming Flame: Veterans’ Journeys from Trauma to Healing

In the book, Walking the Medicine Wheel: Healing Trauma and PTSD, co-author David R. Kopacz adapts Joseph Campbell’s cycle of the mythological heroic journey to that of the experiences of war veterans. Campbell breaks the heroic journey into four stages—beginning/ending, separation, initiation, and return.

Kopacz writes of this cycle, “Separation is the call to adventure that takes one away from the everyday world. Initiation is the challenge, the trial, and it is the acculturation to a new world, an unknown world. Return,” he writes, “is the journey home, with new knowledge, a new sense of self, and a gift or boon to give to society.” Kopacz remarks about this return, “Society needs the returning hero, but is initially distrustful because the hero has gone where ordinary humans should not go and has been exposed to the mysteries of life and death.”

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April 12, 2017 by Bob Nikkel, MSW

Mad in America to Host Webinar On Oregon’s Innovative Early Psychosis Programs

On Friday, April 28th, from 1-2:30 pm Eastern time (10-11:30 am Pacific), Mad in America Continuing Education will be host a webinar on the Early Assessment and Support Alliance, a one-of-a-kind early intervention project in Oregon for youth experiencing psychosis. The EASA projects are unique in that they build on nearly 2 decades of outcome research and represent a pragmatic blend of models from Australia, Open Dialogue, and others.

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April 10, 2017 by Gina Nikkel, PhD

Hearing Voices Network USA training in Atlanta

Gina Nikkel, PhD and Gail Hornstein, PhD in Atlanta at the April 5 panel discussion “What can we learn from people who hear voices?”

As President and CEO for The Foundation for Excellence in Mental Health Care (FEMHC) I have to admit that I get to participate in some life changing meetings and meet extraordinary people. This past week was no exception.

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April 5, 2017 by Bob Nikkel, MSW

Opening a Dialogue about Early Psychosis Programming in the United States

As a state mental health commissioner and after, I’ve had a long interest in the development of early psychosis intervention services. During my tenure in the state executive position, I worked with a number of community partners to secure $4.3 million from the Oregon Legislature in 2007 to expand the regional Early Assessment and Support Alliance program to about 75% of the state and today, Oregon has 29 programs – more than the most populous states of California and New York.

So when the Schizophrenia Research Foundation announced a webinar to “discuss the paths and barriers to widespread effective care” for young adults and their families experiencing an early psychosis, I jumped at the opportunity to sign up.

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March 30, 2017 by Eliza Galaher, QMHA

Heaven But as a Highway for a Shell

#2 in the series An Affirming Flame: Veterans’ Journeys from Trauma to Healing

Wilfred Owen was a British soldier who fought on the frontlines of France in World War I, and who was eventually diagnosed with shell shock, or in more contemporary terms, post-traumatic stress disorder. Influenced by the poet and fellow British soldier Siegfried Sassoon, Owen wrote extensively, through poetry, of his experiences fighting on the front lines in France. Owen’s writing was revolutionary at the time in that it refused to glorify war, but instead captured vividly the grotesqueness of on-the-ground fighting. For instance, in his poem “Dulce et Decorum Est,” Owen described in gripping detail the horrific effect of mustard gas exposure:

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