Inside Outside The Power of Stories in Battling Stigma

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Inside Outside The Power of Stories in Battling
Stigma

• Strengthening Our Future Developing Healthy
  Children and Youth, Strong Families, and Safe
  Communities
• Kansas City
• April 28, 2004
• Carol Bianco, Mandy Frankel, George Badillo
• Advocates for Human Potential, Inc.
• 518-475-9146
• cbianco_at_ahpnet.com

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SAMHSA / NFI OLMSTEAD INITIATIVE

• To support state-level coalitions aimed at
  eliminating the unnecessary institutionalization
  of children with serious emotional disturbance,
  and adults with serious mental illnesses.
• To assist state mental health systems to promote
  recovery

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SAMHSA NFI INITIATIVE Components

• Annual stipends of 20,000 to States for
  coalition-building and community integration
  planning
• Technical Assistance to States and stakeholders
• Specialized materials development
• Analysis of State-level activities and approaches
• Dissemination of lessons learned

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Achieving the Promise Transforming Mental
Health Care in America

• Americans understand that Mental Health is
  Essential to Overall Health
• Mental Health Care is Consumer and Family Driven
• Disparities in Mental Health Services are
  eliminated
• Early Mental Health Screening, Assessment, and
  Referral to Services are common practice
• Excellent Mental Health Care is Delivered and
  Research is Accelerated
• Technology is used to access mental Health Care
  and Information

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Background Olmstead Decision ADA TITLE II

• Applies to State and public entities
• No qualified individuals with a disability
  shall, by reason of such disability, be excluded
  from participation in or be denied the benefits
  of the services, programs, or activities of a
  public entity or be subjected to discrimination
  by any such entity 42 U.S.C. Section 12132

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Background Olmstead Decision THE INTEGRATION
MANDATE
A Public Entity Shall Administer services,
programs, and activities in the MOST INTEGRATED
SETTING appropriate to the needs of qualified
individuals with disabilities 28 CFR 35.130(d)
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Background Olmstead Decision THE QUESTION
PRESENTED IN OLMSTEAD
Does Title II of the ADA compel a State to
provide treatment for people with mental
disabilities in a community placement, when
treatment can also be provided to them in a state
hospital?
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Background Olmstead Decision OLMSTEAD VS. L.C.
E.W.

• A lawsuit was brought on behalf of two women
  (Lois Elaine) with psychiatric and
  developmental disabilities confined to a Georgia
  State Hospital
• Their doctors said they were ready to leave the
  hospital
• The State of Georgia said there were long waiting
  lists for community services, and they could
  continue to receive adequate services in the
  hospital until community services became
  available
• Years of litigation ended up at the Supreme Court

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Background Olmstead Decision OLMSTEAD VS. L.C.
E.W.

• What did the Supreme Court Say?
• Under ADA, there is a legal right to be served in
  the most integrated setting. Not open to states
  discretion.
• Unnecessary isolation and institutionalization is
  discrimination and requires community placement,
  if

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Background Olmstead Decision OLMSTEAD VS. L.C.
E.W.

• What judgments did supreme court say show that
  unjustified institutional isolation is a form
  of discrimination?
• Institutional placement of persons who can
  handle and benefit from community settings
  perpetuates unwarranted assumptions that persons
  so isolated are incapable or unworthy of
  participation in community life.
• Confinement in an institution severely
  diminishes the everyday life activities of
  individuals, including family relations, social
  contacts, social options, economic independence,
  education advancement, and cultural enrichment.

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Inside/OutsideBuilding a Meaningful Life in the
Community After the Hospital

• A Film by Patricia E. Deegan and Terry Strecker

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Outside
Inside
Inside
Outside
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Inside-Inside

• We physically enter the institution and at first
  it seems strange and alien
• However, slowly the institution creeps inside of
  us - its routines, emphasis on conformity,
  letting others make decisions for us
• The voice of self is submerged and the voice of
  the professional other becomes our reference
  point

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Inside-Outside

• At some point we catch a glimpse of a new
  possibility for ourselves outside of the
  institution
• We are still physically inside the institution,
  but our soul soars for a moment outside of the
  institution.
• For some people this comes in a sudden moment of
  insight. For others it comes more gradually

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Outside-Inside

• As people approach discharge they sometimes grow
  afraid of the very thing they long for. They have
  become dependent on the very thing they wanted to
  escape.
• People leave the hospital physically, but inside
  they are still acting and thinking as if they are
  in a hospital. They look to others to make them
  well.

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Outside-Outside

• We eventually live outside of the hospital and we
  also eject the internalized hospital
• We discover our voice and our choice. We begin to
  trust ourselves. We begin to look to ourselves
  for direction. We learn who we can depend on. We
  develop relationships with peers and friends. We
  have the supports we need.