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Compliance Officer II

An Equal Opportunity/Affirmative Action Employer. Women, minorities, veterans, and people with disabilities are strongly encouraged to apply.

JOB INFORMATION

Agency Name:	Department Of Mental Health
Official Title:	Compliance Officer II
Functional Title:	Patient Liaison

Occupational Group:

Investigation & Inspection

Position Type:	Non-Management Non-Civil Service
Full-time/Part-time:	Full-Time
Salary Range:	$38,530.96 to $55,671.72
Bargaining Unit:	06
Shift:	Day
Number of Vacancies:	1
Confidential:	No
City/Town Location:	Tewksbury
Facility Location:	Tewksbury Hospital
Region:	North East
Application Deadline:	07/19/2006
Posting ID:	10945

Duties:
SALARY INDICATED IS EFFECTIVE JULY 9, 2006

GENERAL STATEMENT OF DUTIES AND RESPONSIBILITIES:
Work with patients and staff to ensure a participatory process for patients as it relates to the reduction and/or elimination of restraint and seclusion. Conducts individual patient debriefings after incidents of restraint and/or seclusion in order to identify individual, unit and hospital-wide strategies to reduce/eliminate restraint and seclusion. Facilitates clinical debriefings with patients and staff to identify individual unit and hospital-wide strategies that reduce restraint/seclusion. Makes recommendations based on patient/clinical debriefings to supervisor and/or teams. Acts as an advocate for the patient in treatment planning as it relates to restraint reduction. Assists in the development of training and education regarding the patient/consumer perspective of restraint/seclusion. Identifies human rights issues as they arise during debriefings and collaborates with Human Rights Officer(s) as necessary.

DETAILED STATEMENT OF DUTIES AND RESPONSIBILITIES:
1. Interacts with clients on a regular basis to establish rapport and refers patients to unit staff and the human right officer when appropriate.
2. Assists in monitoring the facilitfacilities restraint and seclusion by reviewing each episode and related aggregate data regarding restraint and seclusion use.
3. Conducts individual debriefing of patients and facilitates staff debriefing after the use of restraint or seclusion.
4. Participates in the development of treatment planning which encourages alternate interventions to reduce the use of restraint and seclusion.
5. Participates in the training of staff related to the consumer perspective of treatment.
6. Participates as a member of the Executive Team and other restraint reduction related or risk management related committees, as applicable to role.
7. Works collaboratively with facilities Human Rights Officers.
8. Works collaboratively with outside advocates, as needed.
9. Compliance with all applicable state and federal laws including the Health Insurance Portability and Accountability Act (HIPAA) regulations which govern the privacy and confidentiality of information about patients.
10. Performs other duties as assigned.

Qualifications:
Minimum Entrance Requirements: Applicants must have at least (a) three years of full-time, or equivalent part-time, experience in investigatory or law enforcement work, or (b) any equivalent combination of the required experience and the substitutions below.

Substitutions:

I. A Bachelor's or higher degree may be substituted for a maximum of two years of the required experience.*

*Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

Special Requirements: Based on assignment, possession of a current and valid Massachusetts Class 3 Motor Vehicle Operator's License.

Preferred Qualifications:

QUALIFICATIONS REQUIRED AT HIRE:
1. Ability to understand, explain and apply the statutes, rules, regulations, policies, procedures, specifications, standards and guidelines governing assigned unit activities.
2. Ability to exercise sound judgment.
3. Ability to establish and maintain harmonious working relationships.
4. Ability to advocate for and/or with patients.
5. Ability to establish rapport with persons from different ethnic, cultural and/or economic backgrounds.
6. Agility to establish rapport with individuals with mental illness.
7. Ability to motivate others.
8. Ability to communicate effectively in oral expression.
9. Ability to write concisely, to express thoughts clearly, and develop ideas in logical sequence.
10. Ability to gather information through questioning or observing individuals.
11. Ability to gather information examining records and documents.
12. Ability to exercise discretion in handling confidential information.
13. Knowledge of the mental health system, inpatient facilities.
14. Knowledge gained from personally utilizing mental health services.
13. Knowledge of investigative techniques.

Comments:

Application Instructions:
PLEASE INDICATE POSTING #10945 ON COVER LETTER WHEN APPLYING FOR THIS POSITION

PLEASE PROVIDE TWO COPIES OF RESUME

How to apply:
Mail cover letter and resume to:
Health Office of Human Resources
Attn: Joyce Robito
365 East Street
Tewksbury, Ma 01876
Fax: 978-851-0133
Customer Service: 978-851-7321 X2155

Agency Web Address: http://www.mass.gov/dmh

Affirmative Action Officer: Ms. Georgette Tanner, (617) 348-5184 and Ms. Denise Jordan, (413) 284-5005

Human Resources Division

HRD Home

Privacy Policy

07/07/2006

A testing page

This is how to get involved: open your eyes and your eyes and use them to feel with all your heart. Testing

Ad lib center

Because of program growth, AdLib, Inc. - the Center for Independent Living for Berkshire County is looking for qualified individuals to fill the following positions:

Nursing Home Transition Specialist: Full-time (40 hour) professional position to identify and assist people with disabilities move from institutions to community based settings. Must be a self-starter who will work professionally with consumers, family members, other human service providers, and funding sources. Bachelor's degree and own transportation required. Must have a minimum of one year prior experience working with people with disabilities.

Peer Counselor/Advocate: Half-time (20 hour) position to work in Berkshire County with individuals with disabilities on specific independent living needs. Must be a self-starter who, through common personal experience, presentation, and actions will serve as a role model for individuals with disabilities. Must be able to deal effectively and professionally with consumers, family members, other human service workers and funding sources. Bachelor's degree preferred. Prior human service or counseling experience a plus.

recreational activities. This position is for five hour shifts on: both Saturday and Sunday. Bachelor's degree preferred. Experience: working with a cross disability and diverse population a must.: Requires basic computer skills.

Please send resumes for the above positions by October 27, 2006 to:: Program Manager, Ad Lib, Inc., 215 North Street, Pittsfield, Mass.: 01201. Persons with a disability are encouraged to apply. EOE/AA.

Bay Cove

Peer counselors are people who have personal experience living with a psychiatric disability, and who feel comfortable disclosing their disability to other service recipients, staff, administration, and others. Peer counselors provide assistance to and partner with service recipients to improve problem solving skills, explore potential options for roles beyond their current situation, and access available resources. Peer counselors also serve as mentors to residents and program participants at Center Club. Peer counselors may also assist service recipients in learning skills that are necessary to achieve independence, competence, self-confidence and self-esteem.

Peer counselors are not required to have a significant history of training in counseling and related topics, but will be required to attend trainings and supervision offered at Bay Cove to develop these competencies. A desire and willingness to participate in growth and development opportunities is an important component of the peer counselor position.

The goal of the peer counselor is to demonstrate the reality of "recovery," help foster a "culture of hope and recovery," and provide direct services that will benefit the resident/service recipient to begin to take small, success steps towards change.

Required Qualifications

Must be a person with a past and/or present diagnosis of a mental illness;
Must not currently use drugs or alcohol
Must be willing to disclose his/her disability
Must be able to speak about the impact both the illness and recovery has had in the person's life;
Must be able to listen, empathize and accept others;
Must work from the belief that recovery is possible for everyone, and that we are not the ones who can determine who will or will not move into a recovery process;
Attending trainings and supervision meetings;
A desire to expand his/her knowledge base; Participation in skills training to enhance peer counselor's listening and responding skills, problem solving skills, and other related skills.
Ability to tolerate constructive feedback.
Understanding of cultural influences on service provision.
Past experience as a peer counselor and the ability to speak additional languages desired, but not required.

Job Duties

Meeting regularly with service recipients;

Advocating on behalf of service recipients, and promoting self-advocacy.
Participating in activities meant to facilitate a hopeful environment.
Modeling and training service recipients in recovery roles;
Communicating with the Director of Peer and Recovery Services about problems, concerns, positive suggestions, regarding the practices in a residence or Center Club.
Participate in trainings;
Participate in an on-going network with other peer counselors.
Other duties may be assigned as the peer network develops.

Other Requirements:

Respecting the rights, values and beliefs of service recipients, Maintaining confidentiality;
Maintaining scheduled appointments.
Ability to work independently
Ability to initiate a conversation to supervisor when problems are encountered;
Ability to demonstrate a positive attitude and genuine concern forothers;
Able to complete all necessary paperwork in a timely manner.

If you are interested in this position, please e-mail or send your resume to Lyn Legere: BayCove Human Services: 66 Canal Street: Boston, Ma 02114: email at llegere@baycove.org

Director de Proyecto

Supervisar e implementar actividades del proyecto en todo el ámbito estatal
Supervisar actividades conducidas por el equipo de proyectos
Proporcionar apoyo al trabajo del Consejo Asesor de Consumidores Latinos (Latino Consumer Advisory Board)
Proporcionar apoyo al trabajo de subcomités de proyecto
Coordinar la labor de recolección de datos para SAMSHA GPRA y otras actividades de evaluación de programa
Preparar todos los informes y actualizaciones de progreso necesarios
Monitorear el presupuesto y supervisar contratos
Proveer actualizaciones de rutina al Director Ejecutivo, el Directorio y comités formados por partes interesadas
Asegurar la coordinación y la comunicación en toda la red de apoyo a pares
Coordinar el trabajo del Enlace de Asesoramiento de Pares (Peer Counseling Liaison)

ann@m-power.org

Employment specialist

kathy@resourcepartnership.org

jennifer@resourcepartnership.org

www.resourcepartnership.org

Events

Massachusetts Leadership Academy

The Massachusetts Leadership Academy is a 3 day retreat, funded by the Department of Mental Health and the Massachusetts Behavioral Health Partnership for mental health consumers/survivors.

The Leadership Academy is an empowerment to:

Learn Advocacy Skills
Build Self Confidence
Conduct Effective Meetings
Be Active on Policy Boards & Committees
Implement Action Plans
Develop Cultural Competency Skills
Work With The Media

The Leadership Academy is offered free of charge please contact M-POWER for an application:

M-POWER/Transformation Center
98 Magazine st.
Roxbury, MA 02119

Phone: (617) 442- 4111
Toll free: (877) 769 7693
Fax: (617) 442-4005

Email: sara@m-power.org or suzy@m-power.org

*in addition to the application we will call you for a brief telephone interview*

Dates:

Retreat Date Application Deadline Location

Mon Apr. 10 - March 3, 2006 Craigville Conf. Center
Wed. Apr. 12

First News Item

Jobs at the Edinburg Center

The following are jobs at the Edinburg Center.

Assistant Program Director, Supported Housing - Mental Health Residential Treatment Program

The Center's Supported Housing program comprises rehabilitation and support services delivered to clients in individual living arrangements scattered throughout our service area. The Assistant Program Director ensures correct clinical implementation of the Program Specific Treatment Planning process, provides crisis intervention as necessary, and offers direct services to clients. The Assistant Program Director also oversees the client intake/referral process, attends treatment planning meetings, and coordinates planning efforts in coordination with other members of the treatment team.

Qualifications: Master's degree and one year clinical supervisory experience with the adult mental health population or a Bachelor's degree and two year's clinical supervisory experience with adult mental health population required
Supported Housing or equivalent experience preferred. Valid driver's license required.

Supported Housing Counselors - Mental Health Residential Treatment Program

Full and Part-time, day or evening shifts available. Responsibilities include working in partnership with mental health clients to identify and provide services, skills training, and crisis intervention needed to support clients in the community. Located in Waltham.

Qualifications: BA/BS in human services related discipline and at least 1 year of direct experience required. Valid MA driver's license is required.

Lead Clinician - Program for Assertive Community Treatment (PACT)

Full-time (40 hour) position available to fill a dual role of fulfilling the responsibilities of a PACT clinician and assisting the team leader and psychiatrist in the organization and operation of the clinical program. Principle duties include: take a lead role in providing clinical treatment services; provide on-call crisis intervention; in coordination with the team leader, provide regular clinical and administrative supervision to staff, initiate and maintain relationships with collaterals, and adhere to agency expectations for quality assurance and maintenance of program policies and procedures; assume primary case management responsibilities for assigned clients; conduct comprehensive assessments when assigned.

Qualifications: Master’s level psychiatric clinician in mental health related field and three years experience with mental health experience required. Experience working as part of a multidisciplinary team in the provision of clinical, rehabilitative and recovery oriented services to consumers with major mental illness and co-occurring substance abuse disorders. Supervisory experience preferred. Valid driver’s license and reliable vehicle required.

Program Assistant - Program for Assertive Community Treatment (PACT)

Full-time position available as a support member to the PACT multidisciplinary team. The Program Assistant is responsible for: organizing, coordinating and monitoring all non-clinical operations of PACT under the direction of the team leader; providing receptionist activities including answering the phone, maintaining accounting and budgeting records for consumers and program expenditures; and operating and coordinating the management information system. Other job duties consistent with the nature of the position may be assigned.

Qualifications: Minimum of a high school diploma, at least two years related experience, excellent computer skills, and basic accounting/budgeting skills required.

Lead Nurse - Program for Assertive Community Treatment (PACT)

Full-time position available. Under the direction of the PACT Psychiatrist, the Lead Nurse will provide clinical supervision to the other PACT Nurses, develop medication policies and procedures, take responsibility for medication management, manage the medication administration system, provides case management for clients with complex health or medication issues and participates in on-call coverage for the program. The Lead Nurse also provides a range of nursing duties, including medication administration and monitoring; consultation to clients, families and staff about medication/medical issues; treatment planning; implementation and documentation; outreach; support; and case coordination as part of an interdisciplinary team.

Qualifications: BSN (MSN preferred); Registered Nurse in the State of Massachusetts; experience working with clients with major mental illness and co-occurring substance abuse disorders; experience working as part of a multidisciplinary team; experience working with individuals with serious and persistent mental illness in the community. Valid driver's license and reliable transportation required.

Nurse - Program for Assertive Community Treatment (PACT)

Full-time position available providing a range of nursing duties, including the development of medication policies and procedures, medication administration and monitoring, and consultation to clients, families and staff about medication/medical issues. Other responsibilities include treatment planning, implementation and documentation, outreach, support, and case coordination as part of an interdisciplinary team.

Qualifications: BSN and at least 1 year experience treating persons with serious mental illness; substance disorder, psychosocial rehabilitation and assertive community treatment experience preferred. Valid driver's license required.

Housing Resource Specialist - Program for Assertive Community Treatment (PACT)

Full-time (40 hour) position available assisting clients with finding and maintaining safe and affordable housing; acting as liaison to local housing authorities, realty agencies, and housing subsidy providers; providing ADL skill training and other rehabilitation and support functions utilizing and assertive outreach model as a member of a self-contained interdisciplinary team.

Qualifications: BA in mental health related field and at least 1-year experience working with persons with serious mental illness. PACT or assertive community treatment experience preferred. Valid driver’s license and reliable vehicle required.

Peer Specialist - Program for Assertive Community Treatment (PACT)

Full-time, 40 hour position available providing essential experience and consultation to a self-contained interdisciplinary team which utilizes an assertive outreach model to promote a culture in which each client's subjective experiences, points of view and preferences are recognized, respected and integrated into all treatment, rehabilitation and support services. The Peer Specialist participates in all program-planning processes and provides direct services that promote client self-determination and decision-making.

Qualifications: BA preferred. Experience with recovery from psychiatric disability required. Valid driver’s license preferred.

Nurse - Intensive Community Support Program (ICS)

Part-time position available providing a range of nursing duties, such as medication administration and monitoring, and consultation to clients, families and staff about medication/medical issues; other responsibilities include treatment planning, implementation and documentation, outreach, support, linkage and case coordination as part of an interdisciplinary team.

Qualifications: BSN and at least 1 year experience treating persons with serious mental illness. Substance abuse disorder, psychosocial rehabilitation and assertive community treatment experience preferred. Valid driver's license and reliable transportation required.

Assistant Director - Intensive Community Support Program (ICS)

40-hour position in an innovative community based diversion/step-down program to assist mentally ill clients in avoiding hospitalization or transitioning successfully from the hospital to community living. Primary responsibilities include assisting the program director in managing daily clinical and administrative operations of outreach team and directly managing the 24-hour respite component. Other responsibilities include clinical assessment, treatment planning, implementation and documentation, outreach, skills training, supportive counseling, crisis intervention, case coordination, linkage, and transportation. After hours on-call responsibility.

Qualifications: Masters degree in related field, MSW preferred. Previous supervisory experience preferred. Experience in assertive community treatment and psychosocial rehabilitation preferred. Valid driver’s license and reliable transportation required.

Respite Coordinator (Counselor III) - Intensive Community Support Program (ICS)

Full-time position available providing in-house supervision of respite clients, teaching clients appropriate use of community resources, providing crisis intervention, maintaining accurate and timely clinical records, coordinating with other staff and providers, and supervising assigned respite staff.

Qualifications: BA in human services related discipline plus two years experience in the field including at least one year with adult Mental Health population required. Valid driver’s license required. Ability to attain First Aid and CPR certification within the first 90 days of employment required.

Counselor I - Charles Webster Potter Place Clubhouse

1 Part-time (20 hour) position available in a community-based, clubhouse model program. Must have the ability to coordinate with a team of members and staff in all aspects of program functions. Responsibilities include instruction, guidance and support in prevocational and vocational needs of program participants.

Qualifications: High-School Diploma or equivalency required. Certificate in Human Services or related field preferred. Experience with Certified Clubhouse program preferred. Must be or have been a consumer of Mental Health Services. Valid driver's license required.

Residential Counselor II -

Mental Health Residential Treatment Program Provides support to individuals with various psychiatric disabilities in a residential setting. Responsibilities include supervising overnight staff, maintaining clinical records, writing and implementing treatment plans for clients, and case coordination. Additional responsibilities include assisting with daily living skills according to client needs, transporting clients to medical appointments, administering medications, and participating in maintaining a clean and healthful environment.

Qualifications: BA/BS and one year experience with adult mental health population required. Driver’s license and reliable transportation required. Must be able to obtain First Aid, CPR, and Medication Administration certifications within 90 days of hire.

Residential Counselors - Mental Health Residential Treatment Program

Full and Part-time positions available working with mental health adults living in community residences. Responsibilities include: participation in the development and implementation of treatment plans, client advocacy and direct care. Opportunities available in Waltham, Bedford, Lexington and Woburn, MA.

Qualifications: BA/BS preferred. Valid driver's license is required.

Direct Care Counselors - Mental Retardation Residential Treatment Program

Full and part-time positions available in respite and residential programs working with adults with mental retardation. Responsible for providing direct support to individuals, as well as client advocacy and implementation of individualized service plan strategies. Opportunities available in Bedford, Waltham, and Lexington, MA.

Qualifications: BA in related field and experience working with adults with mental retardation preferred. Valid driver's license is required.

Program Assistant - Mental Retardation Services

Full-time (40 hour) assisting the Director of Mental Retardation Services and Transitions Day Treatment Program. Responsibilities include staff scheduling; tracking and management of census data; coordinating staff development training, scheduling and coordination of guardianship evaluations; coordinating facility maintenance and upkeep; collecting and reporting various program related data and information; occasional local travel to programs

Qualifications: Excellent organizational skills and proficiency using personal computers including competency with Microsoft Word, Excel, Outlook and Access. Two years related administrative experience. Valid driver’s license and reliable vehicle required.

Community Specialist - Mental Retardation Clinical Services

Part-time (20 hour) position working as part of a Clinical Team providing support services to persons with mental retardation. Responsibilities include direct service caseload providing case management, behavior management and skills acquisition training to consumers in their homes and/or clinic settings.

Qualifications: Master’s degree in related field and experience with population required. Training/experience in applied behavior analysis preferred. Valid driver's license required. Individual Supports

Coordinator - Mental Retardation Clinical Services

Full-time position (40 hrs.) working as a part of a Mental Retardation Clinical Team that provides individual support services to persons with mental retardation. Responsibilities include coordination of support clients; oversight of individual support clinicians; provision of direct individual support; fulfilling the role of DMR liaison regarding support clients; ensuring that all regulatory requirements are met and related records are up to date and complete.

Qualifications: Master’s degree in related field and 2 years experience with population required. Training/experience in applied behavior analysis preferred or BA degree in related field and 4 years experience with population required Training/experience in applied behavior analysis preferred. Valid MA driver’s license required.

Clinician - Options Day Treatment Program

Part-time (20 hour) position available in adult psychiatric/dual diagnosis day treatment program working as part of an exciting multi-disciplinary team. Responsibilities include: facilitation and co-facilitation of insight-oriented group psychotherapy, individual therapy, treatment planning, implementation and coordination, and clinical documentation.

Qualifications: MSW , Psychiatric Nurse, Rehabilitation Counselor, O/T or Licensed Psychologist required; LCSW, LICSW or LMHC preferred; experience with adult mental health and substance abuse issues preferred and day treatment experience preferred.

Counselor I - Transitions Day Treatment Program

Full time position available working with adults with mental health issues in our Transitions day program. Responsibilities include: participation in the development and implementation of treatment plans, consumer advocacy, and direct care.

Qualifications: BS/BA and experience with population preferred. Writing and computer skills required. Valid driver’s license required.

Crisis Clinician - Mental Retardation Crisis Services

Part-time position (20 hours, Thursdays – Saturdays) available in a 24 hour community-based crisis program serving adults and children with mental retardation. Primary responsibilities include emergency on-call, mobile outreach, assessment, evaluation and behavior consultation. Program office is located in Lexington, MA.

Qualifications: Master's degree in related field and experience with population required. Valid driver's license required.

Per-Diem Crisis Clinicians - Mobile Emergency Services Program

Day and evening shifts available performing evaluations of clients in acute crisis (including suicide/homicide assessments, mental status exams, evaluation of support networks and resource availability). Evaluations can take place in clients' homes, schools, shelters, police stations, hospital emergency rooms and medical units, and other community settings. Clinicians screen clients for admissions to hospitals, diversionary programs, and Crisis Stabilization Program. Crisis Clinicians also present level of care assessments to managed care companies, hospitals, and other agencies that offer appropriate services for clients.

Qualifications: Clinical Master's degree (reimbursable by Mass Health), familiarity with DSM IV, excellent verbal and written communication skills, and ability to work independently required. Relevant experience performing mobile crisis evaluations preferred. Valid driver's license and use of car required.

On-Call Mobile Crisis Clinicians (beeper coverage) - Mobile Emergency Services Program

Relief hours on overnight shifts available performing level of care assessments for clients experiencing psychiatric crisis in homes, schools, emergency rooms, Police stations, and other community settings. Thorough, legible and prompt documentation of all client calls and interventions, entering evaluations on database, and related paperwork are included in position responsibilities.

Case Coordinator Full-time position available in the Outpatient/Community Support service at our Waltham clinic providing case coordination, advocacy, support, linkage, and outreach to mental health consumers living in the community.

Qualifications: BA in Mental Health related field and at least 2 years experience with adult mental health population required. Valid driver’s license required.

Workforce Development Coordinator Part-time position (20 hours) located in our main office in Lexington coordinating all aspects of workforce development. Primary responsibilities include: managing the agency’s internal job posting procedure; posting open positions to appropriate outside job boards; reviewing and forwarding resumes and applications to appropriate managers; conducting phone screens and interviews when needed: checking references and criminal history for potential employees; interfacing with hiring managers throughout the process

Qualifications: Recruitment experience, computer literacy and research skills required. Experience recruiting in a non-profit setting desirable.

Internships

Clinical and administrative internships available in many programs. Please use the icon below to inquire. for more information about the edinburg center Click Here

Just do It

Just Do It !

New Directions:

Consumer-Driven Mental

Health & Wellness

Interpretation for the Deaf and Spanish Speakers Provided

Thursday June 15, 2006

The Best Western Plaza Hotel

and Trade Center

* The word “consumer” is used to refer to those of us with mental health and/or addictions recovery needs

Please Register by 5pm Monday June 12^th

We will cut off registration earlier if we reach 400 people. Register as soon as possible!

Register by telephone or fax

Call 617-442-4111 or Toll-Free at 877-769-7963

Fax at 617-442-4005

TTY at 617-442-9042

The Best Western Royal Plaza Hotel

181 Boston Post Road West

Marlborough, MA 01752

(508) 460-0700

Take 495 to exit 24B; The Hotel is 1 mile on the right

(From the Mass Pike go North on 495 towards Lowell)

9:30 to 10:30am

Registration and Continental Breakfast

10:30 to 12:30

Opening Program

Keynote Address

“The Role of Peer Specialists: Giving Voice to Mental Health Recovery”

Larry Fricks, Appalachian Consulting Group

Larry Fricks was the Director of Consumer Relations in Georgia for 12 years. He has founded several organizations including the Georgia Mental Health Consumer Network and Georgia’s Peer Specialist Training and Certification Program. Larry is helping us to start a Peer Specialist Training and Certification program as well.

12:30 to 1:30pm

Box lunches provided; relaxation; indoor heated pool!

1:30 to 2:30pm

Convention breakout groups meet to discuss and vote on the top topics for our future direction: Topics include Integrating Peer Specialists in traditional treatment settings, Employment, Housing, Emergency & Crisis Support Services, Peer Support & Peer Education, Gaining Independence, Health & Wellness, Rights Protection, Dual Recovery, Alternative & Holistic Options, Bilingual/Bicultural Services, GLBT Community ...

3:00 – 4:00pm

Convention Debate, Voting and Celebration!

Votes on Board of Directors & Top Issues!

Please provide this information to register:

Name : _________________________________

Telephone Number: _______________________

Special Diet Concerns: ______________________

Other Accommodation(s) Needed: ______________

__________________________________________

Please do not wear fragrances at the conference to support people with fragrance allergies.

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Hi this is a child page

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The Greater Lawrence Peer Counseling Project

"Sharing as Equals"

Benefits...

For those who provide
Peer Counseling

Recieving high quality training
Learning new skills
Being challenged to grow
Meeting new friends
Making a significant contribution to the community

For those who recieve
Peer Couseling

Knowing someone who has had similar experiences
Having someone listen without making judgements
Recieving help with problem-solving
Becoming less isolated
Improving connections to the community
Finding their own answers
Being valued by another person
Experiencing more independence and autonomy

Project Description

    The Greater Lawrence Peer Counseling Project, funded by the Essex North Site Area of the Massachusetts Department of Mental Health, supports th development of one-to-one, caring relationships between mental health consumers. By teaching, Listening , and problem-solving sills to those with psychiatric disabilities the Project empowers them to provide sensitive, practical support to their peers. Peer counseling training and services are offered in both English and Spanish.
    All Peer couselors recieve 11 weeks of interactive training in listening and problem-solving techniques. Those who graduate aree paired with DMH-eligible consumers and meet weekly at locations that are mutually convinient. Everything shared by the two individuals is kept in confidence.
    Peer counselors recieve extensive, ongoing spuervision. They are expected to work four hous weekly and recieve a $50 monthly stipend.
    The Project Is sponsored by the Northeast Independent Living Program in Lawrence Massachusetts, a private, non-profit agency.
    To learn more about the Project contact Jo Bower at 978-687-4288 extension 30. Those interested in Spanish-language services should contact Oliva Tajeda At extention 13

Peer Counselors Recieve Training about:

Stigma
Disability awareness
Active listening skills
Burnout prevention
Supervision
Coping with suicide & other crises
Relationship dynamics
Confidentiality
Friendship
Resources and referrals

Who Can Participate?

Any mental health consumer in the Greater Lawrence or Greater Haverhill, including Newburyport, may become apeer counselor. To recieve peer counseling services, however, a consumer must be eligible to recieve Depatment of Mental Health Services from its Essex North Site Office, which cover Greater Lawrence and Greater Haverhill areas.

The Greater Lawrence Peer Counseling Project

is sponsored by and based at

The Northest Independent
Living Program Inc.
20 Ballard Road
Lawrence, MA 01843

(978) 687-4288 (voice) and (tty)
1-800-845-6457 (toll-free)
www.nilp.org (website)
jbower@nilp.org
otejeda@nilp.org (Spanish services)

and is staffed by

Project Coordinator
Jo Bower
Latino Outreach Coordinator
Oliva Tajeda
Staff Assistant
Sam Chivers

NILP is a scent-free workplace

Quotes from Peer Counseling Participants

Those who recieve peer counseling say:

"we're on an equal basis.
a peer couselor is someone
who's close to you like a brother."

"I tend to trust a peer
relationship rather than a
professional. Peer couseling
is very worthwhile."

"I like having the chance
to talk to someone who has
things in common [with me].
It feels good to talk, laugh,
and joke."

Those who provide peer counseling services say:

"I like helping people."

"both [people] gain from it."

"Peer counseling makes me a better person."

Medicaid Reimbursement

Mind Freedom Calendar 2006 - 2007

MindFreedom

links and calendar of upcoming events

2006-2007

MindFreedom News Briefs -- 25 September 2006
http://www.MindFreedom.org - please forward

News briefs on winning human rights in mental health system!

~~~~~~~~~~

* New York City Event on "Mad Movement" a Success!

At the New York University "Open Minds" conference this past
Saturday, 23 September 2006, keynoter David Oaks, director of
MindFreedom International, reflected on 30 years of human rights
activism and called for unity for a "nonviolent revolution in the
mental health system." You may download a PDF of prepared remarks here:

http://www.freedom-center.org/pdf/DavidOaksOpenForum2006ConfTalk.pdf

* Tuesday, 3 October 2006. Guest = Aby Adams. Show = "Mental health
screening in your school: What are the dangers? What are the
alternatives? What can you do?"

Aby is an activist with the Massachusetts group Freedom Center who
has developed a campaign to alert parents in local schools about the
dangers of and alternatives to traditional mental health screening of
kids.

How to Listen to MindFreedom News Hour: As well as guests interviewed
by host David Oaks, you'll hear the latest news and resources to win
human rights and alternatives in the mental health system.

Live: Every Tuesday, 1 pm eastern time, 10 am pacific time.

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http://tinyurl.com/hr4y6

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Nationwide Resources

Peer Specialist

WORK Inc.

FUNCTIONAL JOB DESCRIPTION

PEER SPECIALIST

Reports To: Vice President of Employment Services Department: Employment Services Division

Job Summary:

The Peer Specialist position is a part time (16 hours per week) position. Responsibilities include helping consumers of the WorkSource program in the following areas:

Staff Advisory Board
Implement Illness Management and Recovery modules for WorkSource participants
Assist in outreach efforts, including public information efforts (i.e. Kiosk activities)
Coordinate feedback efforts, (satisfaction surveys, etc.)
Co-Liaison to Discovery, Atlantic House and other area MH Service Providers
Outreach and Engagement

Essential Functions:

Responsible for:

Staff the consumer Advisory Board for WorkSource. Assist the Chair with preparing agenda, taking and distributing minutes, preparing for meetings, coordination with WorkSource Management and other related duties;
Assist WorkSource Management in developing and implementing a plan to incorporate the Illness Management and Recovery modules into the program. Coordinate with Career Development Specialists to identify program participants who might benefit form IMR. Coordinate with WORK Inc.’s Chief Clinical Consultant to implement IMR;
Assist in program outreach efforts;
Assist individuals with engaging in employment services;
Coordinate participant feedback. Seek out constructive criticism and serve as liaison between dissatisfied individuals and management
Assist all team members whenever possible.

(The essential functions listed in this section are not limited only to the tasks indicated and may include other duties as assigned)

Qualification/Education/Experience:

High School Diploma;
Experience advocating for people with psychiatric illnesses
.

Supervisory Responsibilities

None.

Mathematical Skills:

Ability to add, subtract, multiply, and divide.

Reasoning Ability:

Ability to define problems, collect data, establish facts and draw valid conclusions.

Communication Demands:

The ability to respond to common inquiries of complaints.

Environmental Demands:

The work is performed in a non-smoking environment. The work is normally performed in a temperature controlled zone, however, there are exceptions. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

*Definitions: continuous -- 66 to 100% of the time

frequent -- 31 to 65% of the time

occasional -- 10 to 30% of the time

rarely -- less than 10% of the time

RECEIPT AND REVIEW OF FUNCTIONAL JOB REQUIREMENTS

I, ______________________________, have read, understand and agree to the attached functional job description. I understand the essential functions of the position for which I was hired and acknowledge that I am capable of performing all of the essential functions of this position. I understand that the contents as presented are a matter of information and should in no way be construed as a contract between WORK Inc. and its employees. WORK Inc. reserves the right to change any part of this job description as circumstances require.

Signature Date

Witness Date

Peer Specialist Program Coordinator

Work closely with Peer Specialists, Peer Specialist Training Team, Recovery Learning Communities, mental health providers, mental health payors, researchers and evaluators to develop quality and effectiveness of the program.
Provide program information to interested persons/programs;
Coordinate application review, participant selection and lodging & logistics for eight day trainings
Supervise a training team of consultants and oversee curriculum and examination revisions
Oversee CPSP budget;
Maintain mailing list/contact information of interested persons/programs; and statistics on participant demographics and CPS employment of program graduates;
Maintain helpful contact with CPS graduates and CPSs to ensure quality of the program
Facilitate study sessions; train and provide support to tutoring consultants;
Train and provide support to exam staff in conducting oral exams and in scoring written exams; Act as proctor for and score written exams, and conduct oral exams;
Collaborate with evaluators and researchers of the project;
Other tasks as may be assigned by Director of Operations.

Strong administrative, communication, and interpersonal skills required;
Strong skills as a trainer
Strong organizational and logistics skills required;
Proficient computer skills with Internet and MS Office (Outlook, Word, Excel etc.);
Knowledge, skills, and ability to support and supervise;
Knowledge, skills and ability to create and adhere to time and task schedules;
Knowledge, skills, and ability to work standard office equipment;
Understanding of issues facing mental health consumers; and
Acceptance of a variety of lifestyles, behaviors, cultural, and spiritual practices.

Ability to frequently or occasionally lift between 10-50 lbs
Ability to sit for long periods of time
Ability to use office equipment

Valid MA Driver’s License and reliable vehicle

SALARY & BENEFITS

This is a full-time 40 hour per week position. Salary is $30 – 32K. Full-time employees are eligible for medical, dental, life insurance and vacation and sick leave after successful completion of the introductory period of ninety (90) days
EQUAL EMPLOYMENT OPPORTUNITY

The Transformation Center provides equal opportunity for all persons seeking employment without regard to race, age, color, religion, gender, marital status, sexual orientation, military status, national origin, disability, or any other characteristic as established by law.

RESPONSES

Send Resume and Cover Letter to:

Ann Stillman – Administrative Coordinator
M-POWER & The Transformation Center
98 Magazine Street Roxbury, MA 02119
617-442-4111; ann@m-power.org

updated 12/2007

PT Peer Education Specialist

PT Peer Education Specialist

Job Posting C844

Responsibilities:

Provide vocational preparation, tutoring, educational support and educational resource linking for program participants with psychiatric disabilities.

Qualifications:

BA/BS in Rehabilitation or related field OR minimum or two years experience in rehabilitation or related human services setting working with individuals with mental illness. In recovery from a psychiatric illness and able to utilize past experiences as a teaching tool to assist others in recovery focused work. Knowledge and understanding of the vocational and educational needs of adults with psychiatric disabilities. Ability to work independently and as part of a team in an outcomes based program.

Drivers License Required: No

Hours: 20

Schedule: Monday-Friday between the hours of 9-5pm

Salary: $14.25/hr

Recovery Learning Communities & Allied Orginizations

RECOVERY LEARNING COMMUNITIES ARE REGIONAL

Recovery Learning Communities (RLC’s) are being formed in six regions of the state. The goal is to develop local communities of support for mental health and/or addictions recovery. RLCs will link people who are active in this movement with people who want to learn and contribute more.

WHAT DOES A RECOVERY LEARNING COMMUNITY DO?

•   Support consumers to take charge of their own recovery process
•   Encourage people in recovery to develop a community around them that offers natural supports
•   Offer information and referral, access to a variety of peer support and self-help activities, advocacy, and training opportunities
•   Provide continuing education, and support to Peer Specialists located at provider agencies, train and support providers and their agencies to be effective employers of Peer Specialists
•   Stimulate and participate in culture change to establish a focus on promoting resilience, self-determination and wellness, rather than a narrow focus on symptom reduction.
•   Encourage increasing supportiveness and welcoming of people with mental health conditions in society

Although the RLC will have both office and meeting space, an RLC is not “program centered.” Support activities are made available where people receive services and in the community at large. RLC activities will be growing to appeal to the range of people in the community, including people of all racial and ethnic backgrounds, people of all co-occurring disabilities, and including those with high and low intensity needs.

WHO CAN USE THE RLC?

People with a serious mental illness, people in recovery and people who have experienced extreme states, regardless of insurance status. In addition, the RLC will work collaboratively with mental health providers, other human service agencies, and the community at large to forward the mission of supportive communities and respect for people with mental health conditions.

EVALUATING PROGRAM OUTCOMES

Recovery Learning Communities will evaluate the effectiveness of our projects and document what works and what doesn’t work. We want to learn from every experience. The RLC will study what others do as well, using this information for quality improvement and to make it available in Massachusetts.

WHEN WILL RECOVERY LEARNING COMMUNITIES BE OPEN AND HOW CAN I GET INVOLVED?

RLC’s are not open yet, however Guiding Councils of peers exist in six regions of the state. To learn more call:

•   The Transformation Center 617-442-4111, TTY 617-442-9042
•   Oryx Cohen – Central MA RLC 617-442-4111, x370
•   Michelle Carpentieri – Metro-Suburban RLC 617-442-4111, x372
•   Jess Zaller – Southeast RLC 617-442-4111, x371

Research assistant

Hello All: The Boston Community Academic Mental Health Partnership is
hiring part-time research assistants who are living with mental health
and addiction/recovery needs. The Partnership is funded through Boston
University. Information is below.

PART-TIME RESEARCH ASSISTANTS NEEDED
Contact: Melissa Hagan, Project Director

The Boston Community Academic Mental Health Partnership
Telephone: (617) 414-1378
Email: mjhagan@bu.edu

Overview
The Boston Community Academic Mental Health Partnership (BCAMHP) was
established to increase the
participation of people with mental health and addiction/recovery
needs in the design and conduct of
mental health services research. The BCAMHP is a partnership between
Boston University School of
Public Health, Consumer Quality Initiatives, Inc., Massachusetts
Department of Mental Health,
Massachusetts Chapter of the National Alliance for the Mentally Ill,
the Parent/Professional Advocacy
League, and The Transformation Center. The BCAMHP is seeking to hire
up to 6 part-time research
assistants (RAs) to help design and implement a research study to
examine the experiences of people
using psychiatric emergency services.

Job Summary
The RAs will be part-time positions based at the Boston University
School of Public Health and will
assist in designing and implementing a research study focused on the
use of psychiatric emergency
services. Responsibilities will include conducting face to face
interviews, collecting data, attending
project team meetings, and traveling to different emergency services
sites. Responsibilities may also
include assisting with the design of surveys, entering data into a
computer, and assessing and interpreting
the research results. Paid training will be provided.
Qualifications

• Must be living with or in recovery from major mental illness or be a
significant person (family
member, significant other, etc.) in the life of someone living with or
in recovery from major
mental illness and
• Must have experience with psychiatric emergency services use or know
people who have used
psychiatric emergency services
• Must live in the Boston area and be are able to travel within the
city (either by car or public
transportation)
• Must be 18 years of age and/or older
• Fluency in English is required
• High School degree or equivalent preferred
• Verbal and written communication skills preferred
• Ability and willingness to learn

Weekly hours will vary between 5 and 15 hours. The schedule (days,
evenings, weekends) is
negotiable. RAs will be paid $15 per hour. We will begin reviewing
resumes on February 1, 2007 and
continue until all positions are filled.
Please send a resume and cover letter to
Melissa Hagan, Project Director
Email: mjhagan@bu.edu, Fax: 617-638-4483, or Mail to:
Boston University School of Public Health
Attn - Melissa Hagan, Project Director
715 Albany Street, T2W, Boston, MA 02118

Site Map

Here is a map of all the material on the site. Please browse through each category to discover what we have to offer.

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Statement of Purpose: M-POWER is a member run organization of mental health consumers and current and former psychiatric patients. We advocate for political and social change within the mental health system, the community, city, and statewide. Organizing as a common voice, we claim and secure our human rights. We promote free access to information about those rights. We stand against stigma, bigotry,and discrimination that impede our ability to live as dignified people. We enlighten mental health professionals and the community with the truth about our lives, empowering ourselves in the process. We believe all people are entitled to lives free of prejudice and oppression.

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WHAT WE DO

Empowered at the statehouse picture gallery

Informed Consent

INFORMED CONSENT RIGHTS

You are an active partner in your treatment.

You have the right to know the benefits, risks and side effects of the proposed treatment, alternative treatments and what is likely to occur if you go untreated. This information should be discussed with you and given to you in the form of a consent form. Information sheets for each prescribed medication also will be given to you.

You are entitled to an explanation of your rights to freely consent to or refuse treatment without coercion, retaliation or punishment. Loss of privileges, threat/use of restraints, discharge, guardianship, Roger orders* or any form of retaliation and/or coercion shall never be used as punishment when you freely exercise your right to refuse/accept treatment. Such interventions may only be utilized in accordance with applicable legal and clinical standards. When you are competent and refuse a recommended treatment, alternative clinically appropriate treatment acceptable to you, including no treatment, shall be explored and offered where possible.

You have the right to freely consent to or refuse recommended treatment unless a court has ordered said treatment. (In emergency situations, medication may be given without your consent.)

If you have not received adequate information about your treatment rights, believe that your rights are being violated, or that you are being coerced into treatment, you may contact:

*the Human Rights Officer for your facility, or

*the Human Rights Coordinator for your DMH region:

    Western                                    Michael Nagy 413-587-6384
                                 Margo McMahon 413-587-6260
    Central                                        Liz Rollins 508-368-3380
    North Eastern                              Brad Richardson 978-863-5063
    South Eastern and the islands           Mary Vaeni 508-897-2058
    Metro Suburban                              Eileen Webster 508-616-3508
    Metro Boston                             Adrienne Plotkin 617-626-9270

* Mental Health Legal Advisors Committee at 1-800-342-9092 or 617-338-2345

* Center for Public Representation 1-888-967-6622 ext 6265

To Be Posted In All Patient Areas, per DMH Policy #95-5R Effective September 1, 1996

* Rogers Hearing

When a doctor believes you are incompetent, she may initiate a guardianship proceeding, popularly referred to as a Rogers hearing.
At this court proceeding, you have the right to be represented by an attorney, and if you cannot afford an attorney, the court will appoint one for you. the court shall authorize treatment with anti-psychotic medications only if:

it finds you not capable of making informed decisions regarding medication;
by applying a substituted judgment test, it finds that you would accept the treatment if competent; and
it approves and authorizes a written anti-psychotic treatment plan.

From: Mental Health Legal Advisors Committee "YOUR RIGHTS REGARDING MEDICATION"

Sections

About Us

Statement of Purpose: M-POWER is a member run organization of mental health consumers and current and former psychiatric patients. We advocate for political and social change within the mental health system, the community, city, and statewide. Organizing as a common voice, we claim and secure our human rights. We promote free access to information about those rights. We stand against stigma, bigotry,and discrimination that impede our ability to live as dignified people. We enlighten mental health professionals and the community with the truth about our lives, empowering ourselves in the process. We believe all people are entitled to lives free of prejudice and oppression.

Legislation

Coalition for Fresh Air Rights (CFAR)

CFAR

Coalition for Fresh Air Rights

H.1905

(Rep. Smizik)

and

S.1120

(Sen. Jehlen)

For psychiatric patients, access to the outdoors and to fresh air is essential for recovery from a psychiatric crisis.
Unfortunately for most patients this is denied or very limited
Most patients are in locked units in hospitals for 24 hours a day from admission until discharge without exposure to the outdoors.
Most patients feel that exposure to fresh air would aid in their recovery
Although some hospitals have begun to provide separate outdoor space, several private hospitals and some state facilities no longer permit psychiatric patients to experience the outdoors.
Limited access to fresh air and the outdoors affects almost 4,000 patients.
Access to fresh air could be enormously helpful in the successful implementation of the Restraint and Seclusion Reduction and Elimination regulations.
Fresh air access is in keeping with many state and federal laws, including: the Americans with Disabilities Act, The Rehabilitation Act of 1973, the Supreme Court's Olmstead Act of 1999, and the Massachusetts Constitution.

This legislation can help speed the recovery of psychiatric patients by providing access to the benefits of daily outdoor visits
In particular, the bill adds the right to daily fresh air to the Five Fundamental Rights already existing in the law.
Under this legislation, all patients receiving services from the Department of mental Health or any licensed facility by the Department will be afforded access to the outdoors.

This legislation is supported by the Coalition for Fresh Air Rights (CFAR), a joint project of M-POWER (Massachusetts People/patients Organized for Wellness, Empowerment and Rights, The Disability Law Center, The Protection and Advocacy System of Massachusetts who are funding and staffing the project. For more info contact Jon Dosick, at 617-442-4111 ext. 368

Dental Health Legislation - update

UPDATE:
In 2006, the legislature voted to restore Dental and Vision Benefits to MassHealth beneficiaries! Thank you to everyone who worked to make this happen, and to the legislators who recognized the importance of these services to overall health! Well done!

Dental Care is Essential for People Who Take Psychiatric Medications. Many Psychiatric Medications Cause Dry Mouth:

The bill (H-3101) to restore Dental Care for Mass. Health recipients and bill (H-2762) restoring both dental/vision and other services including prosthetics are being sponsored by Representative Teahan and are currently in the Health Finance Committee, chaired by Representative Patricia Walrath. She is in room 236. You could also contact your own legislator concerning these bills..

Is there a drought in your mouth ?*

Dry mouth is the condition of not having enough saliva to keep your mouth wet. It is known as Xerostomia.

Saliva is the “workhorse of the mouth” Saliva is necessary to help protect the teeth in these important ways:
Saliva is 98% water and includes antibodies, enzymes and mucoprotein and gives saliva that slimy feeling.
There are three sets of saliva glands, each producing different proportions of mucous and serous saliva.
Saliva constantly flushes the mouth to clear food debris that may act as a food supply for the bacteria in plaque.
It reduces the acidity in the mouth which helps to limit tooth decay by these acid attacks
Saliva contains fluorides and minerals needed to rebuild damaged tooth enamel.
It help digest food
It prevents infection by controlling bacteria and fungi in the mouth through its antimicrobial action.

Dry Mouth can:
Be caused by certain medication or medical treatments
Cause difficulties tasting, chewing, swallowing, and speaking
Increase your chance of developing tooth decay and other infections in the mouth
Be a sign of certain diseases and conditions
*This information was obtained from www.dentalgentlecare.com/dry_mouth.htm

Emergency Room Rights Fact Sheet

FACT SHEET: Emergency Room Rights bills
"Balser House Bill No 2042 & Koutoujian House Bill No 1891” (2007-2008)

M-POWER

Balser House Bill No 2042: “An Act to protect the mentally ill in emergency rooms”

Chief sponsor Rep. Ruth B. Balser, Mental Health & Substance Abuse Committee

H 2042 requires the department of public health (DPH) & the department of mental health (DMH) to write new regulations concerning psychiatric and behavioral health patients in ERs. H 2042 gives mental health advocates, such as M-POWER and NAMI-MASS a seat at the table in policy discussions. H 2042 lets us negotiate more humane and effective treatment.

Koutoujian House Bill No 1891: “An Act relative to the treatment of mentally ill patients in emergency room facilities”

Chief sponsor Rep. Peter J. Koutoujian, Public Health Committee

H 1891 gives DMH licensing authority over medical hospital emergency rooms, instead of DPH. ER staff unnecessarily fear mentally ill people because of the stigma of mental illness and a lack psychology training. This leads to discrimination and outrageous abuse. Abuses are not isolated incidents but rather result from mistaken system-wide policy. If H 1891 becomes law, DMH investigators will handle complaints about mistreatment. DMH better handles complaints by people labeled with “mental illness” than DPH.

Improving Conditions In Emergency Rooms

PLEASE CHECK BACK SOON FOR THE LATEST INFORMATION ON THIS IMPORTANT TOPIC, OR CONTACT CATHY LEVIN AT 617-442-4111 (TOLL FREE 877-769-7693) EXTENSION 360, OR VIA EMAIL AT:

cathy@m-power.org

News

Online Articles

Carroll: The stigma of mental illness

The MetroWest Daily News

By Iris Carroll, Guest columnist

GHS

Tue Jan 22, 2008, 12:19 AM EST

Have you ever wondered what lies buried beneath the stigma of mental illness?

Is it fear?

Maybe. But in spite of the media's tendency to sensationalize crimes committed by people who have been treated for mental illness, studies have shown that as a group, people living with mental illness are no more likely to be violent than the general population.

In fact, our country's own history includes people who have made major contributions to our society while at the same time struggling with mental health problems. Icons like Lincoln, Beethoven, Hemingway, Michelangelo, Churchill, and Dickens all experienced one of the major mental illnesses.

So why do we put so much distance between ourselves and other human beings who are obviously suffering and in need of comfort, instead of reaching out to them to help or offer support?

At Programs For People, clients recount stigmatizing events, painfully endured. They have lost friends after being hospitalized for psychiatric reasons. They have been ostracized by co-workers following a psychiatric hospitalization.

They say they have been stigmatized for being unemployed, been called "lazy" by family members, and pressured endlessly to get a job. They have even been asked inappropriate, probing questions by non-psychiatric, medical professionals.

It seems as though effects of stigmatization are almost as toxic as the illness, itself.

Why do kids pick on other kids who seem different? Why do adults denigrate others who appear to fall out of the norm?

Is it something deeply imbedded within the human psyche, some perverse Darwinian striving for survival of the fittest? Does it make us feel more sure of our own sanity to question the sanity of others?

In truth, relating to the strengths of anyone is much more personally rewarding than focusing on perceived weaknesses. In spite of our need for individuality and uniqueness, we all long to feel connected. We yearn to belong, to be understood, and to fit in somewhere.

Often when clients at Programs For People finally get up the courage to express the way they feel, they are absolutely amazed to find out that others have felt the very same way. When staff tell them that "lots of people, not just those with mental health issues, feel that way" they are incredulous.

Stigmatizing has lessened to some degree because, fortunately or unfortunately, these days almost everyone knows a relative, friend, or co-worker who has experienced mental illness.

In those instances, when we know and care about someone, it's easier to see them as a person who happens to have a mental illness. Too often, however, those whom we do not know are defined, in entirety, by the illness.

We need to look deep inside of ourselves about this, with greater compassion. What if it happened to us?

Once a client leaned forward and said to me, with incredible emphasis and feeling, "Do you know what it's like to hear someone whispering in your ear all the time?"

Even though I knew through my work that some people with mental illness hear voices, I was stunned. For the first time, I really imagined and felt what that would be like.

Put yourself there. Not easy to handle.

What helps people who have experienced mental illness feel better about themselves is knowing that there are people who care, understand, and stand by them - people who know that even with the illness, we are all still much more alike than different from each other.

Iris Carroll, MPH, is director of Programs For People, a Framingham-based agency that helps people to recover from mental illness and become employed.

F.D.A. Requiring Suicide Studies in Drug Trials - New York Times

Globe Editorial: First, Try To Help

GLOBE EDITORIAL

First, try to help

February 8, 2008

'HE FELL on bad times and turned to the bottle."

"She's meds-seeking."

"He's relapsed eight times. . . . The hospital gave him Percocet."

"He has no problem getting a job when he's sober."

The details of the troubled lives of homeless clients flew quickly in a conversation held last week by a team of counselors, shelter and housing directors, an outreach worker, and a domestic violence specialist all crowded around a conference table in Framingham at the Common Ground Resource Center. It's a weathered and sprawling white house that serves as the first stop for getting housing services from the South Middlesex Opportunity Council (SMOC), an antipoverty agency. The house has the feel of an old railroad station: It's a good place to disembark before one's life veers completely out of control.

The talk is a part of a vital national effort to provide "trauma-informed care," which recognizes how much people can be harmed by addictions and physical abuse.

Two years ago, there probably wouldn't have been much talk at SMOC about the men and women who were failing at saving their own lives, because the situation was stark: Clients who broke the rules were simply kicked out of SMOC's housing.

"It was a lot easier," SMOC's director of planning, Gerard Desilets, says of the old approach.

The only problem was that these people still lived with daily crises. They could end up ricocheting through the public system, going to detox, jails, and other shelters. Family members would cut them off. Some might sleep in cars. And they'd still drink or use drugs and struggle with mental illnesses.

So SMOC changed course, training 400 of its staff members to provide trauma-informed care. And the resource center team was created so that no one staff person would go it alone. The new marching orders were to stop focusing too closely on clients' rule-breaking and reckless behavior, and to be conscious instead of their underlying trauma.

A different approach

The National Center for Trauma-Informed Care (part of the US Department of Health and Human Services) puts it this way: Don't ask people, "What is wrong with you?" But rather, "What has happened to you?"

The devastating answers include domestic violence, child abuse, witnessing violence as a child, and physical and sexual assault. Or it might be that a person has aged out of foster care or left juvenile detention, and suddenly has to build a life out of thin air.

If trauma is severe enough, it can impair people's cognitive, emotional, and physical well-being. With this in mind, the SMOC team keeps talking - about clients and to them; discussing strengths such as who has found housing and a job. When it comes to struggling clients, the team brainstorms about what other staff members or programs might help.

Among the guiding principles: Keep people engaged even if they do break rules, because rule-breaking, relapsing into an addiction, and other self-destructive actions may in fact be clients' attempts to cope with trauma or the result of trauma-impaired functioning.

For those whose lives are fractured by trauma, rhetorical sticks such as "zero tolerance" or "three strikes and you're out" are less likely to work. The words may only seem like so much breath to an adult who is plagued by the demon of chronic childhood beatings.

"We still push sobriety," says James Cuddy, SMOC's executive director. But there's also an effort to help clients understand that some old harmful habits - which might have helped them cope with an assault or chronic childhood abuse - are no longer necessary. SMOC doesn't require clients to reveal traumatic experiences, only to learn the skills they need to heal and function more effectively.

Realism and compassion

Instead of giving up on clients who relapse into addictions, SMOC staffers say "relapsing is part of recovery," and they ask clients, "How can we help you relapse less?"

The work is emotionally draining. Staff members say they invest their hearts and souls. Some are recovering from addictions themselves, so they know, first hand, about this struggle.

Not everyone succeeds. But more of SMOC's clients are achieving stability and independence as SMOC uses trauma-informed care as part of a larger effort to place and keep people in permanent housing.

It can sound like coddling. But Cuddy says it's a matter of treating clients with more respect. He adds that the approach can save money by keeping people out of jail, shelters, and other public facilities.

Trauma-informed care is also championed by the state's Bureau of Substance Abuse Services, which said in a 2006 report that, "While important work has been done both nationally and in Massachusetts to develop trauma-informed integrated care, it is clear that for consumers . . . multiple obstacles remain." Clients need more coordinated care, and more public entities, from courts to state agencies, should be involved.

In the report, the bureau and the Institute for Health and Recovery, a Cambridge nonprofit, (both of which provided technical assistance to SMOC) also pushed Massachusetts to do more to address trauma - by involving law enforcement, helping traumatized parents meet their children's needs, and providing more skilled care across gender, class, ethnic, and other socioeconomic lines.

The bureau already requires the agencies it funds to provide trauma-informed care. And the Department of Public Health is extending the approach to AIDS programs. Federal efforts include a conference in July that's being sponsored by the National Center for Trauma-Informed Care.

It's an effort that should grow. People can be remarkably fragile. And many of the poorest and most harmed don't respond to attempts to flog them into better lives. That's no reason to abandon them.

Mental Health Wards Restrict Access to Email

SPECIAL MENTION 2- Incommunicado: Mental Health Wards Restrict Access to Email (Spare Change News, USA)

Paul Rice

Reprinted from Spare Change News

© Street News Service: www.street-papers.org

Mental patients find understanding in therapy led by peers

By Carey Goldberg, Globe Staff | June 8, 2007

TAUNTON -- Years ago, Jess Zaller came to the Pathways mental health program as a day patient. In and out of institutions, he had fought mental illness since childhood. His life felt like a nightmare of chaos and despair.

Zaller, 45, was back in a Pathways therapy group last week, but this time as a leader, listening carefully as members laid bare the pain of their fears and compulsions. When he delicately pointed the way, it was often in the first person, using his own hard lessons learned:

"Our lives are at stake," he told members. "It takes a lot of courage to walk a path of recovery, and each one of us develops our own path."

Massachusetts is beginning to develop a corps of people like Zaller who have been through the depths of schizophrenia, bipolar disorder, or depression, and recovered enough that they can help others with mental illness.

Such comradely aid has long been exchanged informally, or scattershot at mental health venues. But now the state has launched a new job category -- certified peer specialist -- meant to formalize these relationships and gradually, they hope, get peer counseling reimbursed routinely by insurers and Medicaid.

"There's something about receiving support from someone who's gone through exactly what you're going through now that people find invaluable," said Michael O'Neill, the state's assistant commissioner for mental health services.

A few handfuls of Massachusetts residents, including Zaller, have completed the eight -day training session and exams to be certified as peer specialists. On Monday, they are to be recognized at a State House ceremony.

The new field must work through many possible problems, from the potential for relapse among specialists to the potential for resistance from more traditional mental health staffers. But O'Neill expects the state's corps to grow to hundreds.

Massachusetts is redesigning its mental health system to be more user-friendly, he said, and "peer support is a fundamental element of that redesigned system." In the coming months, Massachusetts will be setting up six regional centers where peer specialists will work with clients and support each other in their fledgling vocation, O'Neill said .

The concept has taken off in 30 states. In half a dozen, Medicaid, the public insurance program for the poor and chronically ill, pays for the services, said Paolo del Vecchio, associate director for consumer affairs at the federal government's Center for Mental Health Services.

"Over the past five years, we've really seen the development of a new mental health profession emerging," he said.

The growth of the peer specialist profession comes against the backdrop of a sweeping national shift toward greater optimism that those in dire condition may improve or recover, and toward giving people with mental illness more control over the help they get. People with mental illness are not passive patients, the thinking goes; they can help themselves and as they get better, they can help others .

In their work, peer specialists are expected to share their stories of recovery when relevant to their clients. They may have learned skills worth sharing, or simply inspire hope by being much better than they once were.

The work goes beyond a typical speaker at a 12-step meeting.

It can include helping a patient in a psychiatric hospital make the shift back to living at home, or supporting an emergency room patient in crisis. A specialist might remind a team of clinicians that their patient is in a kind of hell, or take a lonely client out for pizza.

Early research, which is just beginning to accumulate, suggests that peer specialists may be particularly useful with patients who would normally resist help from the mental health system, said Larry Davidson, a Yale professor who conducts studies on peer specialists.

People with mental illness sometimes feel disliked by the professional staff who treat them, he said; it appears that with peers, "they feel less disliked and more understood."

Studies show that "people in recovery can provide services at least as well as people who don't have that experience," Davidson said. Hard data are being collected now on whether they offer "value added," he said.

Anecdotal reports of successful work by peer specialists abound. In Georgia, which has 340, they have proven particularly useful in helping discharged state hospital patients build new lives at home, said Gwen Skinner, the state's top mental health official.

Though the new field is growing, resistance remains, Davidson and others said.

They worry that staff and clinicians without mental illness could feel threatened by the influx of newcomers whose experience with illness is considered an asset. Traditional staff could also worry about being replaced by peer specialists. Certified peer specialists are supposed to earn a typical mental health staff salary of $12 an hour to $15 an hour on an entry level, said Deborah Delman executive director of M-Power, the Massachusetts mental health advocacy group that runs the peer training courses. But some peer workers who are not certified may earn less, she said.

After they are certified, Massachusetts peer specialists will continue to be overseen by The Transformation Center, a statewide training organization that is supposed to ensure they maintain ethical standards and continue their education.

The peer specialists also pose staffing issues. What if, for example, a peer specialist works with patients at a state hospital, then has a relapse and is rehospitalized there, then resumes the job? Boundaries and definitions may get fuzzy; confidentiality may become a concern.

Also, Davidson said, if supervisors view their patients as problems, then adding peer specialists to their staff is asking for more problems. The challenge, he said, is for them to shift to thinking about all people with mental illness as "having assets and strengths to help solve problems."

Judging by responses in Zaller's small therapy group in Taunton, some people with mental illness immediately see the benefits of being helped by a peer.

"He's not looking at us through a book," said one group member, Diane Silvia. "He can relate to us, and we can relate to him."

Psychiatric patients feel strain

State investigates complaints at ERs

By Liz Kowalczyk, Globe Staff | July 15, 2007

The state investigated at least 21 complaints over the last 18 months that emergency departments mistreated psychiatric patients, and officials cited hospitals in half those cases for problems that included wrongly forcing patients to undress, punching or hitting patients, and restraining others for hours without proper monitoring.

One patient died while in restraints, and a patient's arm was broken as a nurse forcibly removed his pants.

These cases are a sign of the growing strain on the state's overcrowded emergency rooms, doctors, nurses, patients and state officials said, and also reflect a shortage of services for the mentally ill, the challenge of caring for sometimes-aggressive psychiatric patients, and inconsistent training of harried ER staff.

Emergency rooms can be battlegrounds. They often are the last resort for psychiatric patients in crisis -- some patients are so out of control and aggressive that mental health facilities will not take them -- and ERs have responded by creating "safe rooms" to handle such patients and on occasion calling in police for help, according to inter views with 20 doctors, nurses, patients, and hospital administrators.

ER staff give psychiatric medications but are not trained to provide comprehensive psychiatric care, they said. And many of these patients stay in ERs for days without proper treatment because of backlogs in psychiatric facilities, creating potentially volatile situations for those patients, staff, and other patients. Hospital officials said nurses, too, have been injured in confrontations, and patients contend that they are humiliated by policies like the one requiring them to undress.

Patients "will be in the ER from hours to days and they get absolutely no care," said Linda Condon, an emergency room nurse who has worked at four hospitals in Southeastern Massachusetts. "You put a person with psychiatric problems in a room with four walls and nothing to do, and there are going to be problems."

Documents from the Department of Public Health -- which conducts investigations when patients or relatives complain or hospitals themselves report problems -- show that investigators cited 11 hospitals for a range of problems. Those cases include:

A blind, disabled patient who went to Lawrence General Hospital in April because he was suicidal. Hospital policy then required psychiatric patients to undress so that staff could look for hidden drugs or weapons, but the patient wanted to keep on his jeans. A male nurse "used excessive force" to remove them, the health department found, breaking the patient's arm. The patient required surgery and a three-week hospital stay.

In April 2006, a 49-year-old former nurse who arrived in the emergency room at Melrose-Wakefield Hospital at 10:30 p.m., intoxicated and uncooperative. Staff strapped down his arms and legs, gave him sedatives, and assigned a security guard to watch him. After a nurse called the security guard away to help with another violent patient, the first patient had a fatal cardiac arrest. The hospital's internal investigation determined that the patient was not properly monitored. Staff told state investigators that the ER was "very, very busy."

In June 2006, a male teen in the Merrimack Valley Hospital ER in Haverhill began pulling medical equipment out of a wall, kicking furniture, and biting staff. While he was biting a nurse, a staff member repeatedly punched him in the face. State investigators said the hospital did not properly train staff on how to restrain patients. Hospital staff said punching was a last resort because the patient was severely injuring the nurse.

State documents released to the Globe omitted the names of patients and staff for privacy reasons. When health officials find problems during investigations, hospitals must implement plans to correct them.

The state public health and mental health departments have been so concerned about the pattern of complaints that they sent a memo to hospital executives in September, detailing 21 steps they should take to improve care of psychiatric patients in ERs, including reducing waiting times, using trained mediators, and further training staff in techniques to calm patients.

But patients and advocates for people with mental illness say problems remain rampant. They are pushing legislators to increase the mental health department's role in regulating ER care and to require the public health department to develop "best practices" for treating psychiatric patients.

"When we get upset and don't want to take our clothes off, they think we're going to flip out," said Constance Surette, 57, of Plymouth, who has bipolar disorder and works with a group pushing for legislation. "But the way they treat us, of course they're going to get that reaction. The ERs should use peer mediators to talk to [psychiatric patients] because they are frightened of the authority figures."

Surette filed a complaint with the health department last month, alleging that city police officers at Quincy Medical Center sprayed one psychiatric patient with mace and handcuffed another to a bench while she was in the ER. Hospital spokeswoman Janice Sullivan said that she could not confirm Surette's account but that the actions taken were appropriate "for the safety of everyone involved."

Doctors and nurses say they have made improvements but are doing the best they can in an impossible situation. They said the number of complaints statewide is small considering the thousands of psychiatric patients who seek care in Massachusetts ERs each year.

In 2005, ERs reported 168,000 visits by psychiatric patients, 10 percent more than in 2003, according to the Massachusetts Health Data Consortium. And they usually have to wait longer for care. The average ER stay for patients who are eventually sent home or to another hospital is nearly three hours; it's nearly six hours for psychiatric patients. And many of these patients wait two to three days in the ER for an inpatient bed in a psychiatric facility to open.

"The emergency departments are overwhelmed," said Dr. Paul Bulat, medical director of the emergency room at St. Luke's Hospital in New Bedford. "We are seeing more violent patients and out-of-control patients. We're seeing mental health problems much worse than we should be."

ER directors are reluctant to acknowledge that overcrowding hurts patient care. But staff told the state health department that busyness was a factor in several of the cases investigated, especially those that involved inadequate monitoring of patients.

In the case of the former nurse who died at Melrose-Wakefield Hospital, not only did the security guard leave the patient alone for about 20 minutes, but the patient's condition was not checked every 15 minutes while he was restrained, as required by hospital policy. Monitoring is especially crucial for intoxicated patients who receive sedatives.

Hospital spokesman Richard Pozniak said he could not comment on the case because of regulations requiring patient information to be kept confidential. State investigators said in their report that 13 patients were in the ER when the man arrived, and 20 other patients arrived before he died 4 1/2 hours later.

Public health investigators also found that lack of training is an issue, including in cases where staff used excessive force. Better training in techniques to calm patients is especially important as frustrated psychiatric patients with no where else to go spend hours in the ER .

In the case of the patient whose arm was broken at Lawrence General Hospital, investigators found a range of problems, including that the hospital's internal investigation of the complaint did not include interviewing the patient. Investigators also found no evidence that staff and security had been trained in patient's rights. And they said the nurse should have explored the patient's reasons for wanting to keep on his jeans before resorting to force.

Hospital spokeswoman Ellen Murphy Meehan said the hospital "expressed deep regret to the patient" for what it considers an accident. She said Lawrence General has since changed its policy to allow some psychiatric patients to keep on their clothes and instead be frisked and scanned with a hand-held metal detector.

Paul Dreyer, director of the state Division of Health Care Quality, said "a culture change" is needed; he is organizing an educational summit for ER staff in the fall, hoping hospitals will improve on their own, making legislation unnecessary. Legislators expect to hold hearings this summer or in the fall.

We want "people to realize they don't have to call in security the first time someone looks at them cross-eyed," Dreyer said. "The ERs are in a production mode. Their aim is to process the patients as quickly as possible to get on to the next patient. These patients may not take well to being treated that way. They may act out."

A number of hospitals said they have improved care after serious encounters.

UMass Memorial Medical Center -- where campus police beat a psychiatric patient with a baton in 2004, injuring him, and, several months later, threw a patient against a wall and called her a "bitch," according to state reports -- said it has made significant changes. These include creating a secured, quiet area for psychiatric patients and training police to use calming techniques. Dr. Patrick Smallwood, medical director for emergency mental health services, also joined the hiring panel for campus police officers last year.

Dr. Bruce Auerbach, chief for emergency and ambulatory services at Sturdy Memorial Hospital in Attleboro, said hospitals need more resources, not more regulation. "When a patient who is having a behavioral health crisis is in my ER for four days not getting the intervention he needs -- it's a travesty in our healthcare system," he said.

Right to fresh air sought for patients

Right to fresh air sought for patients
By Felicia Mello, Globe Correspondent | July 8, 2007

It is not much -- just a 6-foot-by-12-foot space with a few chairs, a barbecue, and pots of basil and pink flowers. But to 47-year-old Gigi Alley, the garden she has built on the porch of her Medford home symbolizes everything she did not have during seven weeks of constant confinement in a psychiatric unit at Cambridge Hospital.

"Even in times of real distress, I can find moments of calm just by listening to the wind blow in the trees and seeing squirrels," said Alley, who suffers from depression and multiple personality disorder.

That is the idea behind a bill pending in the Legislature that would require psychiatric hospitals to provide patients like Alley with a right long enjoyed by prison inmates: daily access to the outdoors.

Dubbed the Fresh Air Bill and sponsored by Senator Patricia Jehlen , a Democrat from Somerville, and Representative Frank Smizik , a Democrat of Brookline, the legislation has met with opposition from medical centers and raised questions about the proper balance between patients' autonomy and doctors' clinical judgment.

"It's not that we're against fresh air, it's that we cannot guarantee safety," said David Matteodo, executive director of the Massachusetts Association of Behavioral Health Systems, which represents the majority of the state's private psychiatric institutions. "Many patients are in the hospital because they are dangerous to themselves and to others."

Massachusetts Department of Mental Health policy states that all public psychiatric hospitals should allow residents outdoors as long as it is safe.

But the guideline does not apply to the state's 64 private facilities, which range from high-rise, acute-care units in congested urban areas to a working farm in Western Massachusetts where people with severe psychiatric disabilities shovel hay and make cheese.

Consumers of mental health services and their advocates packed a hearing late last month before the Joint Committee on Mental Health and Substance Abuse, which is considering the bill, to make their case that sequestering patients indoors amounts to discrimination. It will be months before the bill reaches the floor of the Legislature -- if it ever does.

"I think in a way this is one of the last frontiers of the civil rights movement," Jonathan Dosick, founder of the Coalition for Fresh Air Rights, said in an interview afterward.

"Psychiatric patients in the larger picture are not being treated with decency and humanity. In our laws, prison inmates are guaranteed time outside per day, and then to have this population of people who are often labeled as violent and unstable and don't enjoy this right really angers a lot of people," he said.

Proponents and critics of the bill differ on how many hospitals would be affected. Matteodo says only two of the hospitals in his group completely ban fresh air breaks.

But many allow them infrequently, only when enough staff is available, or for patients who behave well, smoke, or stay for long periods. Advocates say such restrictions can make it all but impossible for residents to get outside.

"I have talked to parents who are getting calls from an adult child in a psychiatric unit who is told they cannot go outside because they don't smoke," said Dori Hutchinson , director of services for the Boston University Center for Psychiatric Rehabilitation. "Their child takes up smoking just to be able to go outside. To me that's outrageous."

Mary Milgrom, senior director of nursing at Cambridge Hospital, where Alley stayed, said the hospital works to provide patients with fresh air on a case-by-case basis and is currently reviewing its policies.

While few researchers have explored whether being outdoors speeds recovery, many mental health professionals see the idea as common sense -- especially practitioners of ecopsychology, a budding field that examines how the natural environment influences human behavior.

"People without psychiatric conditions seem to cope better and feel more hopeful when they have access to even a small amount of landscaping," Frances Kuo , an ecopsychologist at the University of Illinois at Urbana-Champaign, wrote in a letter to the committee. "Why, then, should people in a more vulnerable state be subjected to an often barren, institutional setting?"

A century ago, wealthy eccentrics flocked to sanatoriums in the countryside to recover from stress, while poor patients spent years on state farms where they got plenty of exercise even as the government exploited their labor.

In recent years, however, advances in medication and shrinking insurance payments have led to shorter hospital stays, usually indoors in urban environments.

With an average length of stay of nine days, some private hospitals argue, fresh air becomes less of an issue.

Administrators worry they will have to construct costly outdoor courtyards for patients, or else parade them through the hospital to reach the street, potentially endangering them and the public.

"We would never want in the name of fresh air to jeopardize a life," said Dr. John Herman , director of clinical services for the psychiatry department at Massachusetts General Hospital.

Those arguments do not convince patients like Alley, who called the unit where she stayed from February to April as insular as a space station.

Even the window blinds were kept closed at all times, she said.

Returning to the outside world was so jarring, she said, that every sound grated on her nerves.

"It's easy to feel freakish and different when you're locked inside," she said. "If I had been able to go out, it would have made me feel less disconnected."

(Correction: Because of a reporting error, a story in the July 8 City & Region section about psychiatric patients being given access to the outdoors incorrectly described state law. A Department of Mental Health policy mandates that state-run hospitals provide psychiatric patients with access to the outdoors if it is safe, but such access is not required by law. All but one of the department's five inpatient facilities have secure outdoor areas for patients.)

Who is My "Peer" in a "Recovery Learning Community"?

Cheryl Stevens MD, R.M.P. (Real Mental Patient – thanks to Jonathan Delman for this designation

As part of a developing recovery learning community in Western Massachusetts, I want to address the whole issue of who among us are our 'peers' and who is/are not our 'peers' but 'allies' or 'partners' instead - people who might have an interest in peer-run services but who do not have a personal recovery experience.

Mary Ellen Copeland MS, MA refers to people who have been labeled with psychiatric diagnoses as 'key stakeholders' and she designates all other interested people (family, friends, non-peer mental health staff, researchers, policy makers, citizens) as 'stakeholders'. I appreciate that distinction and I largely agree with it.

Except that there remains the not-too-small dilemma of those who work in traditional mental health service roles but for whom full-disclosure of our personal recovery histories would place us at risk for further victimization on the jobs (than what we already experience as underpaid and overworked staff).

Before we get too far afield on the theoretical questions of "who is a peer" in the "peer-run" and "peer services" frenzy, I believe in letting each individual decide in their heart of hearts if they have the kind of lived experience that would give them the moral authority to join in our discussions and then letting all interested individuals generate that discussion without too much fretting over who is one of 'us' ('real mental patients') and who is not (then by default, they would be one of 'them' - whomever "they" is/are - wanna be mental patients?!).

These kinds of artificially declared divisions - 'us/them' stuff - are often what happen when we use labels (like "peers") as a communication short-cut which creates categories of people instead of just dealing with people as individuals. Also, like it or not, the designation of "peer" in front of "worker" or "staff" still carries the oppressive yoke of one who has been labeled. Not everyone who has lived experience in recovery is going to be eager to embrace the mantle "peer"; nor should they have to just to have a seat at our table - which is of course, "their" table too.

I find discussions of these sorts of "boundary issues" about who is '"us" and who is not "us" to be difficult.

Our boundaries have been repeatedly violated by an overwhelmingly threatening cast of characters that have felt free to parade through our bodies, minds and psyche (souls) – our emotional, intellectual, spiritual, physical, sexual and social boundaries - without any fight from us or any social consequences or sanctions.

Then in some weird attempt to create a 'safe' place for 'us' to dialogue (as if there were such a thing as a 'safe place' when the source of one's terror has become internalized), we end up creating 'new and improved' labels ("peer") that continue to (inadvertently) exclude - and perhaps oppress - members of our own group! That is an interesting turn to the cycle of violence!

Can you see how the violence comes full circle when we internalize the label “peer” to mean a person who experiences psychiatric symptoms? This is just one more broken identity! Webster defines peer as “one that is of equal standing with another: EQUAL. 2. (archaic) COMPANION, FELLOW.”

Whether we suffered childhood traumatic stress/family dysfunction, adult re-enactments of violence ranging from distressing symptoms and addictions to the twisted relations of domestic violence, sexual assault, caregiver abuse and non-trauma-informed psychiatric treatment (psychiatric abuse) by continuing to use the word “peer” to mean someone with a psychiatric history we not only trump all our other past experiences, talents, roles and identities, but we are being (once again) insidiously silenced and co-opted.

First, we cramp our magnificent Essence into another little label/box that parrots the “master narrative” (to quote Pat Deegan, PhD) of traditional mental health services. We let our distressing experiences (symptoms) or our psychiatric histories define who we are, failing once again to speak the truth about the violence we experienced.

Second, although some of us have accepted these labels and then turned them around to make them work for us politically, others do not buy into the terminology at all even though they have had the same kinds of experiences as we have – and equally valuable contributions.

It is an ironic twist that we who have experienced the particular oppression of psychiatric labeling - and all of the doors that automatically close when someone accepts and internalizes these labels - not only corrupt the original meaning of the word “peer” with another broken identity, but then are quick to throw this corrupted label around to define yet another "in" group.

Now who is doing the excluding?

This is exactly what happens when we fail to speak the truth about violence – it gets re-enacted as the “victims” re-victimize themselves and/or go on to perpetrate the same kind of violence against others.

Our boundaries have been so thoughtlessly trampled upon again and again by the very people we trusted, do we dare trust ourselves and one another without the use of a “code word” – peer – to define (limit) us???

In this way, the "peer/non-peer" issue becomes yet another opportunity to either re-enact the cycle of violence or to transform our past trauma by "doing it differently" - set ourselves and one another free.

Such semantic conflicts have ended up hurting (disabling) the “consumer/survivor/ex-patient (c/s/x)” movement, by co-opting us into spearheading some kind of Psychiatric Reformation rather than keeping our original focus as a human and civil rights movement to end psychiatric violence (“treatment”).

I belong to the Staff Survivors Network (www.staffsurvivorsnetwork.com). We are c/s/x people who work in traditional mental health services - in either peer or non-peer designated roles – to speak our truth (“until we get sick and have to quit or until we make them sick and they have to fire us” to quote Jackie McKinney).

Having been oppressed by the effects psychiatric labeling, my “post- recovery” transformation requires me to help others who are still stuck in services (on either side of the paycheck) in addition to my social action (political transformation). I am then an “enlightened witness” raising awareness among people receiving services and speaking my truth to power – a natural role for me given my lack of social skills - I am as "reactive, confrontational, unapologetic and inconvenient" as the MPOWER T-shirt declares me to be - even inappropriate, too

My point is that there are those among us who still work in these oppressive roles in the system trying to do our part in easing the burdens of those who are still caught up in it. Some are (appropriately) not comfortable disclosing our personal experiences on the job, but might seek to have a role in a recovery learning community in off-hours....do we have room for such internal change agents without checking their R.M.P. (‘Real Mental Patient) credentials or asking them to blow their 'cover' in their day jobs?

If not, then why not?

Our movement should not exclude c/s/x’s who work in the system nor should we insist that they “out” themselves if I they have not widely disclosed their past on the job or to supervisors.

Although it might be a crude parallel - and I do not wish to offend anyone - I am reminded that many people worked for the resistance throughout Europe during Nazism, not just individuals of certain targeted groups. Schindler and other righteous people were not Jewish, gay, 'mentally defectives', intellectuals, artists, activists, etc. but were 'ordinary' German or French or Italian or English citizens (at least they didn't trigger the radar of the Nazi's) who could no longer remain silent and be another complicit cog in the oppressor's machinery. Their strategic influence depended on them NOT being on the radar!

I say that as a recovery LEARNING community, we make a decision to DO IT DIFFERENTLY. Let’s be a haven for ANYONE who feels like they are an individual - perhaps a round peg in a square hole - who can no longer participate in the cruel charade we call “treatment” (non-trauma-informed services/system) as perpetrated by a naked emperor (psychiatry).

Before we define who "we" are as a peer community of people interested in building peer-run recovery-oriented services, I suggest that we open up the tent and see/learn who comes in. Then we can be in a better position to meet one another and learn who we are - each one of us.

Then maybe we won't have to create another category or label that people have to fit into in order to join the discussion. We will be able to define who "we" are and exactly what we mean when we say something like "peer-run" because we will have forged respectful and mutually responsible (trauma-informed) working relationships with one another – something that people in traditional service systems fail to take the time to do, leading to continued traumatic repetition compulsions of the cycle of violence - further disabling (silencing) clients and staff alike.

We don’t have to be a parody of the mental health system by forcing members of our movement to adopt or to remain in oppressive little boxes (“peers, staff, clients, consumers, survivors, ex-patients, activists, service-recipients…”) which victimize one another and maintain the silence about the effects of childhood traumatic stress – growing up with neglect, physical, emotional and sexual abuse including incest; growing up in a home affected by alcoholism, “mental illness”, the loss of a parent;, someone who was incarcerated, or seeing your mother hit even just once (see www.acestudy.org for details on the effects of childhood trauma on various health indices of the U.S. adult population).

I didn't climb out of one box to be put in another one, especially one that is self-defined and self-directed.

Upcoming Events

Central MA Recovery Learning Community

February Events

Wellness Wednesdays

Wed. February 6, 2008 4:30-6 pm at RCC

Expressions of Hope and Joy!

After a wildly successful first run, this exciting and invigorating Wellness Wednesday returns to the Central MA Recovery Learning Community for a second round. What's it all about you ask? The answer is .....what are YOU all about? How do you express your joys, your hopes? What is your creative outlet? Singing? Music? Poetry? Dance? Art? Bring your favorite music, poetry, songs, stories, pieces of art, including originals of course and share with the group. Come and let your creative side flow and join us for a fun filled and restorative evening! No sign up required.

Wed. February 20, 2008 4:30-6pm at RCC

Piecing Together Poetry

Have you ever seen magnet poetry? You know ... when there are bunches of words on magnets and you piece them together in a way that is meaningful to you .. that's what piecing together poetry night is all about. No need to bring anything, just your openness to exploring the possibilities of your creative potential. Discover the poet in you ... so come and enjoy where the words lead you, you may be surprised by what they have to say! No sign up required.

Coffee Hour

Tuesday, February 12, 2008 10:30-11:35 pm at RCC

What is better than a hot cup of joe and some nice conversation? Come on down to the Resource Connection Center (91 Stafford St) and spend time with other folks who want to share thoughts and support each other. This is a great way to get to meet other people who are part of the RLC and find out what it is all about. And don't forget the best part, the coffee is FREE! No sign up required.

Maximize Your Income Introduction

Thursday, February 21, 2008 5-6pm at the RCC

This is a one hour introduction to a five week course on taking control of your fiances! The course will cover topics such as cleaning up your credit history and how to increase your income and still keep benefits intact. Information learned during this series can help you become an advocate for others. Come check it out and see what it is all about! Call the RCC (508) 751-9600 to sign up today!

Friday Nite Live!!!!

February 29, 2008 5:30-8pm at RCC

Are you bored? Lonely? Don't spend another Friday night alone!! Join your peers for a fun filled evening of conversation, games, blockbuster movies, poetry readings, etc. .... Call to find out what will happen this month (508) 751-9600. Refreshments will be provided! No sign up required.

WRAP (Wellness Recovery Action Plan)

Wednesdays - Worcester State Hospital 10-11:30am, RCC 1-2:30pm

WRAP works! It has been developed by a group of people who experience mental health difficulties. These people learned that they can identify what makes them well and then use their OWN wellness tools to relieve difficult feelings and maintain wellness. The result has been recovery and long-term stability. Your WRAP program is designed by you in practical, day-to-day terms and holds the key to getting and staying well. It does not necessarily replace traditional treatments and can be used as a complement to any other treatment options you have chosen. From Mary Ellen Copeland's web page mentalhealthrecovery.com. These classes are currently closed to new participants. Call today to find out when the next series will be offered! (508)751-9600

Recovery Story Project Workshop

Friday February 29, 2008 3-4:30

Do you want to inspire hope in others? Do you want to share your experiences and strengths? Then the Recovery Story Project is for you. Come find out how to become a recovery speaker and share your journey toward wellness with others. This workshop will offer guidelines for developing your story and how to get started as well as practical steps to being ready to share your story. There will also be an opportunity to hear other seasoned speakers share their stories and experiences. No sign up required.

Guiding Council Meetings

Thursday, February 14, & 28, 2008 5-7pm

The Guiding Council is a group of individuals from the recovery community in Central Mass that act as advisory board to the RLC. This group has provided the RLC wtih excellent direction and guidance in bringing this community together. Want to know more or learn how to join the Guiding Council? Give us a call (508) 751-9600. No sign up required.

Volunteer Orientation/Training

Monday, February 25, 2008 10-12pm at RCC

Find you have some time on your hands? Interested in helping out and using your skills to further the peer movement? We are looking for you! Why not help out and volunteer at the RLC. We are looking for people who want to share their strengths and talents and help this community grow. The volunteer orientation training is a two hour introduction to the RLC including an overview of hospitality, the history of the RLC, an introduction to trauma informed care and much more. Call today to sign up (508) 751-9600!

Central Mass Recovery Learning Community
91 Stafford Street
Worcester, Massachusetts 01603
508 751-9600

New Men's Trauma Group (ATRIUM)

Are you a man who has experienced
trauma in your life?

Join facilitator Mabella Mendez for an ATRIUM group for men, where participants will work on better understanding how their trauma histories are connected to their self-harming and/or self-destructive tendencies, and will also work on learning new approaches to coping.

Tentative Start Date:

^{Location: Holyoke RCC, 187 High St, Suite 303Applications required (due February 19). Space limited. Please call (866) 641-2853 ext. 200 with questions or for an application. Actual start date will depend, in part, on numbers signed up.
WHAT IS ATRIUM?: ATRIUM stands for Addiction and Trauma Recovery Integration Model and was created by Dusty Miller. The acronym is intended to suggest that these groups are a starting point for healing and recovery. The ATRIUM model is directed at bringing together peer support, psycho-education, interpersonal skills training, meditation, creative expression, spirituality, and community action to support survivors in addressing and healing form trauma The Western Mass RLC aspires to be fragrance free. Sign language interpreters available upon request. Please avoid scented products while at the RCC. The RCC is wheelchair accessible.}

Transformation Center Training Calendar

Please refer to the following for up coming events

http://www.transformation-center.org/calendar.html

For CPS dates please refer to the following

http://www.transformation-center.org/training/cps/index.html

Voices For CHANGE Newsletter

diversity and strength

consumer-operated

Please send submissions for consideration to

Cathy A. Levin, editor

98 Magazine Street

Roxbury, MA 02119

Fax: 617-442-4005

cathy@m-power.org

Authors receive $30 payment for each article. There is no budget for poetry and artwork, but you’ll get credit. Deadlines are six weeks before publication. Contact editor, Cathy A. Levin to find out the deadline for the next issue at 617-442-4111 x 360 or newsletter@m-power.org.

Our mailing list contains about 1,200 names. About 200 copies of VFC are mailed to clubhouses. An additional 100 copies are given away on information tables at events. About another 150 copies are provided to partner organizations, such at the MDDA and the Metro Boston Resource Center. VFC is also available at the M-POWER/Transformation Center office.

Voices for CHANGE is free for those for whom it is a hardship to make a donation. For those with greater means, a donation is gratefully accepted. To have your address added to our mailing list, please contact Ann Stillman at 617-442-4111 x 301, ann@m-power.org or send your check to Ann Stillman, 98 Magazine Street, Roxbury, MA 02119. To remove your address from the mailing list, also contact Ann Stillman.

Click here to veiw the article titled "What Helped in my Recovery"

Click the following link to view the archives

Articles

It is best if your writing is typed in Microsoft Word, Works or WordPerfect, and also in Times New Roman, 12 pt type, single-spaced, with standard margins, and only one space after periods. Please send your articles as email attachments to newsletter@m-power.org. As some people don’t have email, we also accept articles by mail and fax. Mailing address Editor, Voices for CHANGE, 98 Magazine Street, Roxbury, MA 02119 or fax 617-442-4005.

Artwork

The M-POWER/Transformation Center office has a scanner to convert drawings and photographs into digital images for use in the newsletter, in case you cannot email them.

Authors

The best length of articles is one page. That is about 500 words, a length that fits neatly into Microsoft Publisher as a two-column article. That length means we can include a photo of the author or a graphic design. We must limit articles to 1,300 words, so that more writers have a chance to be published. Our editors are skilled in trimming work in order to reduce the length for publication. They can also smooth out rough work and correct puzzling grammar or structure. Let us work with you to produce writing of polish and excellence.

Consumer Operated

Approximately five editors are working on the editorial committee of VFC. They are responsible for editing two-to-three article per issue, and also proofreading. Editors are also contributors. They are often asked to produce news articles about events and programs of M-POWER/Transformation Center or to turn newspaper reports into short articles or to write articles from notes. Editors work hard. They receive a stipend of $100 per issue for editing, in addition to $30 per article they write.

Diversity and Strength (Mission Statement)

Martin Koehler & Cathy A. Levin

The mission of Voices for CHANGE, the newsletter of M-POWER is to inform, educate and inspire.

To inform our readers with a forum for memoirs, opinions and ideas.
To publish stories about people’s own struggle to recover from psychiatric disability.
To empower people to build meaningful lives on the ashes of trauma.
To provide information on policy decisions, programs and opportunities within M-POWER and the Transformation Center.
To educate our readers about the thinking of national and local leaders in the recovery movement.
To educate consumer/survivors about our rightful place in the social system, and about civil rights and entitlements.
To inspire people by an awareness of our potential power by featuring the work of author’s who have made something of themselves.
To inspire persistence in the face of stigma, bigotry, discrimination, pessimism, helplessness and political defeatism.
To inspire self-esteem through role models among our peers in the movement.
To advocate politically, both individually and as members of an oppressed class of people.
And, most of all, to cheer on and applaud for non-traditional paths to achievement and success.

Editor Cathy A. Levin

What We Do

EMPOWERED! At the State House

UPDATE:

In 2006, the legislature voted to restore Dental and Vision Benefits to MassHealth beneficiaries! Thank you to everyone who worked to make this happen, and to the legislators who recognized the importance of these services to overall health! Well done!

June 23, 2005

Dear Empowered Event Members,

Every group of Massachusetts Leadership Academy Graduates have prioritized MassHealth Dental and Vision as the most important issues affecting them.

We would like to ask you to call or write your legislators and express your opinions about this issue.

We hope you will be able to contact your legislator, if you care about this one way or the other.

There will be a hearing on July 6^th for bills on Healthcare including Adult Dental Benefits (House Bill #3101) and House Bill (#3102)Hs #3101 restores. Adult Benefits to the level that they were in 2002. Hs. #3102

advocates for having Dental coverage for pregnant woman and woman with children under the age of 3 who are on Mass Health Benefits.

This hearing will take place in the Statehouse in room A2.

At the next EMPOWERED event we will be practicing meeting with and visiting our legislators offices.

We will be contacting you soon about the date for our next EMPOWERED Event.

Yours Very Truly,

Sara Sternberg, Jessel Smith, Deborah Delman and Linda Fountas

updated 11/27/07

Peer Networking/Support

Mission: To create a statewide support and advocacy network of people who have a variety of experiences with the mental health system. Honoring our past, we envision an integrated community, which promotes the greatest degree of self-determination. We come together to link resources and engage as equal partners in creating person-centered services.

CHANGE

Consumer/survivors Helping, Advocating and Networking for Growth and Empowerment

Mission:
CHANGE is a statewide support and advocacy network of people who have a variety of experiences with the mental health system. Honoring our past, we envision an integrated community, which promotes the greatest degree of self-determination. We come together to link resources and engage as equal partners in creating person-centered services.

We promote the following values:

RESPECT

We value RESPECT. It is the foundation for communication. Honoring the dignity and uniqueness of others strengthens our organization and fosters commitment as we take the high ground in accomplishing our mission. We recognize that we must give respect to receive it.

EMPOWERMENT

We value EMPOWERMENT. We grow and gain confidence as we stand up for ourselves and contribute to our organization by creating a collective, responsible power and commitment toward achieving common goals.

CHOICE

We value CHOICE. In the dignity of being able to take risks, there is a freedom and flexibility to consider our options, and learn through consequences of our decisions as we promote wellness and overcome obstacles.

DIVERSITY

We value DIVERSITY. Welcoming varied viewpoints, beliefs, backgrounds and experiences, we commit to attract and support a membership which is culturally and ethnically diverse.

COMMUNITY

We value COMMUNITY. Demonstrating the power of inclusiveness and support we come together in unity toward a common vision and mission and create a sense of belonging that inspires and nourishes our organizational spirit and energy.

HONESTY

We value HONESTY. Speaking and hearing truth matters as it establishes our integrity and creates an atmosphere of respect. Clarity and accountability are essential as we work together.

TRUST

We value TRUST. It is essential for working together and enhances our physical, emotional, and psychological safety as we rely on each other to create a comfortable environment that supports our progressive change.

CREATIVITY

We value CREATIVITY. Fresh approaches and new ideas can provide changes and solutions to seemingly insurmountable problems and ever-changing circumstances. Group expression releases potential for inspiration and resilience.

To learn more call M-Power at 617-442-4111 or toll free at 877-769-7693.

Policy Issues

OLMSTEAD 2007

OLMSTEAD UPDATE

Governor Patrick Reviews the State’s Olmstead Plan Progress

On November 9, 2007 the following message was sent by Laurie Burgess and Ellie Shea-Delaney, from EOHHS:

Dear Members of the Systems Transformation Grant Subcommittees:

We are writing to invite you to participate on an exciting, newly created, short-term subcommittee of the Systems Transformation Grant, the Olmstead Plan group. In recent weeks, Governor Patrick has expressed a desire to have an updated Olmstead Plan delivered to his office by March 2008. In response to this request, we are implementing this Olmstead Planning process as an appropriate activity to be addressed under the auspices of our Systems Transformation work. We anticipate that the Olmstead Plan Subcommittee will work intensively to:
• create a draft work plan in concert with the Administration that outlines what we have accomplished since the first Olmstead Planning phase in 2003-2003, what we have yet to focus on or complete, and steps for doing so, and,
• assist with designing and orchestrating a public process for vetting the new plan.
As part of this process, we will be providing the Governor an update on progress made and current planning and implementation activities, as they relate to recommendations that were presented in the People’s Plan and the Enhancing Community Based Services Plan (ECBS Plan), two reports produced in 2002 and 2003. The update will also include our proposed strategy for how we will use the Systems Transformation Grant subcommittee process, engage the public, and produce a plan. The Governor has requested that we provide the progress update by December 1, 2007, that we solicit public input over the winter and early spring, and that we submit a plan by March 2008.

In order to accomplish this ambitious work we anticipate that this new Systems Transformation Grant subcommittee will begin meeting the third week in November and will meet intensively, every two weeks or more often, until we have submitted the plan. We would expect that those of you interested in participating on the subcommittee will be able to make a firm commitment to participation on this very important new group. We will also create a process to keep everyone involved with the Grant, but who are not able to commit to subcommittee attendance, apprised of the group’s progress.

The group met on November 19, 2007 and plans to meet roughly every other week.

Questions or concerns, contact:

Dede Alley at 617-442-4111, or dede@m-power.org

updated November 2007

Olmstead Decision

The state's response to the Olmstead Decision: A status report.

Wendy Fox-Grage

Kevin Horahan

Donna Folkemer

March 2001

In June 1999, the Supreme Court ruled in L.C. & E.W. vs. Olmstead that it is a violation of the Americans with Disabilities Act for states to discriminate against people by providing services in institutions when the individual could be served more appropriately in a community-based setting. States are required to provide community-based services for people with disabilities if treatment professionals determine that it is appropriate, the affected individuals do not object to such placement, and the state has the available resources to provide community-based services. The court suggests that a state could establish compliance with the Americans with Disabilities Act if it has 1) a comprehensive and effective working plan for placing qualified people in less restrictive settings, and 2) a waiting list for community-based services that ensures people can come of the list at a reasonable pace and receive services.

Purpose of the study

In light of this ruling, the National Conference of State Legislatures (NCSL) conducted a 50-state survey to determine the initial state responses to the Olmstead decision. The purpose of this study is to enhance informed decision making by helping state policy makers understand the choices states are making and the options that are available to meet the needs of people with disabilities.

The study is appropriately called a status report because states are in the early stages of implementing the Olmstead decision. The long-term effects of the decision are still unknown. NCSL will continue to track activity involving the implementation of the Olmstead decision and update this report pending permanent funding which NCSL is currently seeking.

Conclusion

At this point in time, it is too early to determine the full effects of the Olmstead decision. Every state is moving toward more home and community-based services, although some are moving faster than others. However, this study shows that most states are responding to the Olmstead decision by developing a plan, or appropriating more money toward home and community-based services, or in many cases are doing both.

The court's decision has caused providers, consumers, and state officials to come together with the shared commitment to provide more community-based services and reduce the waiting list for such services. It also has caused the federal government to revise its policies in this area and to offer states flexibility and funding for them to develop innovative solutions. At the same time, Several lawsuits have been filed or are pending in the states as a result of a lack of home and community-based alternatives. Olmstead implementation will take many years, and it involves not only health care but transportation, housing, education, and other social supports to fully intergrate people with disabilities into the least restrictive settings.

This study is a work in progress. Contact Wendy Fox-Grage at (202) 624-3571 or email at wendy.fox-grage@ncsl.org if the authors have incorrectly reported or inadvertently omitted certain Olmstead activities.

Rights & Advocacy

5 Fundamental Rights

THE FIVE FUNDAMENTAL RIGHTS

Any consumer, client or patient in any program or facility which is licensed or funded by the Department of Mental Health is guaranteed by law the following:

Reasonable access to a telephone to make and receive confidential telephone calls and to assistance when desired and necessary to implement such right;

To send and receive sealed, unopened, uncensored mail;

To receive visitors of such person's own choosing daily and in private, at reasonable times. Hours during which visitors may be received may be limited only to protect the privacy of other persons and to avoid serious disruptions in the normal functioning of the facility or program and shall be sufficiently flexible as to accommodate individual needs and desires of such person and the visitors of such person;

To a humane psychological and physical environment. Each such person shall be provided living quarters and accommodations which afford privacy and security in resting, sleeping, dressing, bathing and personal hygiene, reading and writing and in toileting;

To receive at any reasonable time as defined in department regulations, or refuse to receive, visits and telephone calls from a client's attorney or legal advocate, physician, psychologist, clergy member or social worker, even if not during normal visiting hours and regardless of whether such person initiated or requested the visit or telephone call.

For the full text of the law, please visit

http://www.mass.gov/legis/laws/mgl/123-23.htm

Mental health law guide

We have authorization to notify you of and post these law documents in the following links from the Mental Health Legal Advisors Committee

Basic rights at inpatient mental health facilities

BASIC RIGHTS AT INPATIENT

MENTAL HEALTH FACILITIES

Many basic rights that people take for granted are not guaranteed for patients at inpatient mental health facilities. These rights should never be denied merely because you exercised a protected choice, such as refusing medication. Further, these rights should not be denied as punishment.

In addition to basic Constitutional rights, state law including The Five Fundamental Rights Act, (St. 1997 ch. 166 amending Mass. Gen. L ch. 123, § 23) protects the right to engage in some activities in programs and facilities operated by, licensed by or contracted with the Department of Mental Health (DMH). However, while some of those rights may be temporarily denied by the facility's superintendent, director, acting superintendent or acting director, other may never be denied.

I. YOU HAVE THE FOLLOWING RIGHTS:

Mail

The absolute right to stationery and postage in reasonable amounts.
The right to reasonable assistance in writing, addressing and posting letters and other documents.
The right to send and receive "sealed, unopened, uncensored mail." If you are present, staff may open and check mail for contraband, but may not read it. The superintendent, director, or designee of the superintendent or director must document with specific facts the reason for opening the mail.

Visitation*

The right to receive visitors of your "own choosing daily and in private, at reasonable times."

Telephone*

The right to "reasonable access" to a telephone to make and receive confidential calls unless making the call would be a criminal act or cause an unreasonable infringement of another's access to the telephone.

*Note: The rights to have visitors or use the phone may be suspended only if there is a substantial risk of serious harm to you or others and less restrictive alternatives would be futile. Any suspension must be documented in your record and may last no longer than the time necessary to prevent the harm.

You may not be denied the right to speak with your attorney.

Access to Advocates

The right to be visited (even outside normal visiting hours) by your attorney or legal advocate, as well as by your physician, psychologist, clergy person or social worker, regardless of who initiates the visit.

The right of an attorney (or legal advocate) to access, with your consent your record, clinical staff, and meetings regarding treatment or discharge planning which you are entitled to attend.

The right to "reasonable access by attorneys and legal advocates, including those of the Massachusetts Mental Health Protection and Advocacy Project, the Committee for Public Counsel Services, and the Mental Health Legal Advisors Committee," so that they may "provide free legal services." Upon admission and upon request, facilities must provide the name, address and telephone numbers of these legal agencies and must assist you in contacting them. These agencies may conduct unsolicited visits and distribute educational materials at times the facility designates as "reasonable."

Privacy & Security

The right to a humane environment including living space which ensures "privacy and security in resting, sleeping, dressing, bathing and personal hygiene, reading and writing and in toileting." This does not mean that you have the right to a private bedroom.

All programs must post a notice of these mail, visitation, telephone, access, and privacy rights "in appropriate and conspicuous places." The notice must be provided upon request and must be in a language "understandable" to the person.

Other Legal Rights

You also have the right to keep and spend a reasonable sum of money for canteen expenses and small purchases, to wear your own clothes, to keep and use your personal possessions including toilet articles, and to have access to individual storage space for your private use. These rights may be denied only by the facility's superintendent or designee for good cause. The superintendent or designee must make a note in your treatment record as to why the right was denied.

Although access to newspapers is not specifically protected by law, their denial may still be inhumane and something about which you should complain to the Human Rights Officer of the hospital.

You enjoy a Constitutional right to reasonable access to the outdoors.

II. WHAT TO DO IF THESE RIGHTS ARE DENIED

If you believe that you were unfairly denied a basic right while at a program or facility operated by DMH, contracted for by DMH, or licensed by DMH, ask to speak with the Human Rights Officer. You may also file a written complaint with the Person in Charge of the program or facility. You can give your complaint to any facility employee; he or she must forward it to the Person in Charge. If you are dissatisfied with the response of the Person in Charge and believe that additional fact-finding should occur, you have 10 days to request reconsideration. You also may file an appeal to a higher level up to 10 days after receiving a decision. The person to whom the appeal is made depends upon the type of complaint and the type of facility about which the complaint is made. In most cases, you have the right to a further appeal, which must be filed within 10 days of receiving the appeal decision. If you have questions about the complaint process, contact the Human Rights Officer or the Mental Health Legal Advisors Committee (1-800-342-9092).

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Hospitalization in connetion with a criminal case

HOSPITALIZATION IN CONNECTION WITH A CRIMINAL CASE

Under Massachusetts General Laws Chapter 123, a court may order you to enter a hospital during some stages of a criminal proceeding. Evaluations and commitments should take place at a mental health facility, unless the judge specifically finds that the strict security of Bridgewater State Hospital (Bridgewater) is required.

- Sec. 15(b)

The criminal court may require a period of examination and observation at a mental health facility to determine whether you are competent to stand trial* and/or criminally responsible* * for the crimes with which you are charged. To make this determination, the court may order you hospitalized for 20 days, and for an additional 20 days if needed. You are strongly advised to speak with your attorney before you meet with hospital staff. During this period of observation, the hospital may petition the court for your involuntary commitment. You have a right to a commitment hearing at which you are represented by an attorney. In order to commit you, the judge must find, beyond a reasonable doubt, that you pose a present danger to yourself or others by virtue of a mental illness and that no less restrictive alternative is appropriate or available. The court initially may commit you for up to six months. Subsequent commitments, heard in district court at the hospital where you are located, are valid for one year.

- Sec. 15(e)

If you are found guilty of criminal charges, the criminal court may require an evaluation at a mental health facility for up to 40 days as an aid in sentencing. During this period of observation, the hospital may petition the court for your involuntary commitment. You have a right to a commitment hearing at which you are represented by an attorney. In order to commit you, the judge must find, beyond a reasonable doubt, that you pose a present danger to yourself or others by virtue of a mental illness and that no less restrictive alternative is appropriate or available. The court initially may commit you for up to six months. Subsequent commitments, heard in district court at the hospital where you are located, are valid for one year. If the court decides against recommitment and you have time remaining on your sentence, the hospital will return you to a correctional facility.

- Sec. 16(a)

If the criminal court finds you incompetent to stand trial or not guilty by reason of mental illness, it may order you hospitalized for examination and observation at a mental health facility. This hospitalization may last up to 40 days; however, total hospitalization under secs. 15(b) & 16(a) may not exceed 50 days.

- Secs. 16(b) & 16(c)

If you are found incompetent to stand trial or not criminally responsible, the hospital or the district attorney may petition the criminal court for your involuntary commitment. The hospital or district attorney must act either during the period of observation described under sec. 16(a) or within 60 days after you are found incompetent or not criminally responsible. You have a right to a commitment hearing at which you are represented by an attorney. In order to commit you, the judge must find, beyond a reasonable doubt, that you pose a present danger to yourself or others by virtue of a mental illness and that no less restrictive alternative is appropriate or available. The court initially may commit you for up to six months. Subsequent commitments, heard in district court at the hospital where you are located, are valid for one year. If you are committed after having been found not competent to stand trial, the criminal charges against you will be dismissed on the date you would have been eligible for parole had you been convicted.

- Sec. 16(e)

If the court commits you to a mental health facility under sec. 16(b), it may restrict your movements to the buildings and grounds of the facility. If the superintendent of the facility believes you no longer need to be restricted, she must inform the court which ordered the commitment. If the court fails to respond within 14 days, the restrictions must be removed. If the superintendent intends to discharge you, she must notify the criminal court and the district attorney. The district attorney has 30 days within which she can petition for your commitment. During these 30 days, you will be held at the facility.

-Sec. 18

If the head of a correctional facility believes that you, as a prisoner, are in need of hospitalization by reason of mental illness, she may have you evaluated. A copy of the report will be sent to the court. The court may then order you to be evaluated at a mental health facility or Bridgewater for up to 30 days. The mental health facility, Bridgewater, or the correctional facility may petition for your commitment. You have a right to a commitment hearing at which you are represented by an attorney. An initial commitment is valid for six months. Subsequent commitments, held at the hospital where you are located, are valid for one year. If the court decides against recommitment and you have not yet stood trial or have time remaining on your sentence, the hospital will return you to the correctional facility. Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345 (800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Representative payees

JANUARY 31ST, 2005: THIS PAGE IS BEING REVISED, PLEASE CHECK BACK SOON.

VIII. FOR MORE INFORMATION ABOUT SOCIAL SECURITY AND REPRESENTATIVE PAYEES:

For information and legal advice regarding Social Security and representative payees, contact your local legal services office (the Legal Advocacy and Resource Center, at 617-742-9179, can give you the telephone number), the Disability Law Center (800-872-9992), the Center for Public Representation (413-584-1644 or 617-965-0776). For general information about disability issues, call the Mass. Network of Information Providers for People with Disabilities (800-642-0249) or the Mass. Office on Disability (800-322-2020).

Social Security has a toll-free number (800-772-1213) for information. It is good idea to write down the name of the person you speak to, the date and time you called, and what they said if you plan to rely on the information.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Rights regarding hospital privileges

RIGHTS REGARDING HOSPITAL PRIVILEGES

The Department of Mental Health (DMH) Patient Privileges Policy, #96-1, applies to adults and children at DMH operated inpatient facilities and at private inpatient units within state facilities. The policy also applies to any private inpatient facility which agrees by contract or other agreement with DMH to comply with it. This pamphlet describes the rights of patients in these facilities.

I. WHAT IS A PRIVILEGE?

A privilege is the level of freedom off the inpatient unit authorized for a patient. Privilege levels range from being restricted to the inpatient unit to being authorized to leave the buildings and grounds without escort for a specified period of time. Each inpatient facility must have a privilege policy, which is consistent with DMH Policy # 96-1 and provides a full range of privilege levels.

II. WHAT IS THE STANDARD FOR PRIVILEGES?

All patient privileges must be granted or withheld in a manner which provides the "most appropriate and least restrictive care and treatment consistent with safety, welfare, and legal rights of patients, staff and the public." Assignment of privilege level shall be based on the ability of the patient "to manage safely a given privilege level without unacceptable risk of serious harm to self or others."

Privileges may not be taken away as punishment. For example, privileges may not be withheld if a patient chooses to exercise his or her right to refuse treatment.

III. WHO DECIDES THE PRIVILEGE LEVEL?

The attending physician must assess the patient upon admission to determine the appropriate privilege level and must write an initial order regarding privileges. Within one business day following the initial order, not including Saturday, Sunday or holidays, the patient's attending physician, in consultation with the other members of the patient's treatment team, and input from the parent or guardian, will determine the privilege level. Privilege level must be determined with as much participation from the patient as possible. The attending physician must document in the patient's progress notes both the privilege level and the basis for its selection.

DMH Policy # 96-1 encourages the use of a point level system for child/adolescent patients to foster positive behaviors and support the patient in taking responsibility for his/her behaviors.

IV. HOW IS THE PRIVILEGE LEVEL DETERMINED?

The following factors must be considered in determining privilege levels:

Current risk of harm to self and/or others

Ability to care for self

History of significant harm to self or others

Legal status

Applicable legal issues

History and/or current pattern of substance abuse

Therapeutic goal(s) to be served by privilege level (e.g. autonomy, safety)
Manner in which privilege status is consistent with the multidisciplinary
treatment plan

The following factors must also be considered when determining privilege level for child or adolescent patients:

Safety of home setting and ability of parent/guardian to provide appropriate supervision
Ability to make sound judgments tied in with level of impulsivity
Child or adolescent's demonstrated behaviors and conformance with the treatment plan

V. HOW DOES THE PRIVILEGE LEVEL CHANGE?

A patient's privilege level may only be changed after a review by the attending physician, in consultation with the treatment team. A change in the patient's privilege level will be made when necessary to meet the patient's individual needs. Adjustments to the patient's privilege categories must be considered at each treatment plan review, and, if necessary, more often. All changes in the patient's privilege level must be documented in the progress notes.

VI. MAY STAFF MAKE CHANGES TO A PATIENT'S PRIVILEGE LEVEL?

Professional staff members other than the attending physician, who have been designated by the facility, may make changes in a patient's privilege level when necessary for safety reasons. The attending physician, in consultation with the treatment team, must review all such changes, no later than the next business day.

VII. WHY WOULD STAFF SEEK A SPECIAL CLINICAL REVIEW?

A special clinical review is a review by the facility to ensure that the privileges granted to a patient do not contradict or violate the terms of any applicable court order confining the patient to the facility.

Upon the request of the treatment team, each DMH operated facility will arrange for a special clinical review of the decision to grant privileges. The special clinical review process varies amongst DMH operated facilities. A facility's Human Rights Officer should be able to explain that facility's process. All special clinical reviews must be completed within one week of the request except when special circumstances arise.

VIII. WHAT IF THE PATIENT IS HOSPITALIZED AS A RESULT OF A CRIMINAL CHARGE?

A court may order that a patient enters a hospital during several stages of a criminal proceeding. At all DMH-operated and contracted adult inpatient facilities, units and beds, there is an additional process that a patient must go through before gaining unsupervised privileges.

Pursuant to DMH's Mandatory Forensic Review Policy, #00-1, hospital treatment teams who seek to authorize

Unsupervised privileges (either on or off-grounds),
Supervised off-grounds privileges, or
Discharge from the hospital

Must refer the patient to the DMH's Division of Forensic Mental Health for a mandatory forensic review of the team's decision if:

The patient's current admission originated with one of the violent or sexual criminal charges listed in the policy; or

The patient's current uninterrupted period of hospitalization includes a period of commitment for treatment (as opposed to evaluation) at Bridgewater State Hospital. [The Division will determine whether or not a mandatory forensic review will be conducted for a patient referred in this category.]

A final written report of the Forensic Consultant who conducted the review and the letter from the Senior Reviewer must be completed and sent to the treatment team within 25 business days of the referral completion date.

IX. HOW MAY A PATIENT REQUEST A CHANGE IN PRIVILEGE LEVEL?

A patient who wants to change his or her privilege level should first talk with the treatment team. The treatment team may consider a request for change during its regular treatment team meetings or during a periodic review. The patient should argue that he or she could safely manage a higher level of privileges without unacceptable risk of harm. If the patient is unable to negotiate a change with the treatment team, the following three options are available.

Special clinical review

A patient may request a special clinical review if he or she disagrees with a privilege decision. The patient may obtain help in this process from the Human Rights Officer or legal advocate.

Modifying or appealing the patient treatment plan

As the patient moves through various privilege levels, the attending physician documents in the treatment plan the criteria necessary for achieving the next privilege level. Thus, privilege level is influenced by language in the treatment plan. A patient has the right to reject part or all of the content of any treatment plan. A patient who is unhappy with his or her privilege level may seek to modify or appeal the treatment plan. Such an appeal must be filed within 30 days of the action or decision being appealed. For example, the patient should appeal within 30 days of being informed either orally or in writing of the privilege status. If the treatment plan is rejected, but an appeal is not filed in a timely manner, the treatment plan is considered to be accepted. To make the appeal, the patient must write a letter to the DMH Area Director describing the matter and the reason for appeal.

Complaint

The patient may make a formal written or oral complaint pursuant to DMH complaint process regulations. The complaint shall go to the Person in Charge of the facility in which the person is confined or to an employee of the facility, who shall forward the complaint to the Person in Charge. The complaint should explain how the current privilege level constitutes "a condition that he or she believes to be dangerous, illegal, or inhumane," the standard set out in the regulations.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

The DMH complaint process

THE DMH COMPLAINT PROCESS

The Department of Mental Health (DMH) has a complaint process which applies to all programs and facilities operated by DMH, contracted for by DMH, or licensed by DMH.

I. WHO MAY FILE A DMH COMPLAINT?

Any individual (regardless of age or competence) may make a complaint, either verbally or in writing, to the Person in Charge or to any employee of a program or facility operated by DMH, contracted for by DMH, or licensed by DMH. An employee who is made aware of a complaint must provide the individual with a complaint form and, if the person requests, assist the person in completing the form. The Human Rights Officer (HRO) is also available to assist individuals in completing and filing written complaints.

II. WHAT TYPES OF EVENTS MAY A PERSON COMPLAIN ABOUT?

A complaint may be filed about an incident, condition or circumstance which is dangerous, illegal or inhumane. An incident, condition or circumstance is considered inhumane when it occurs without regard for an individual's dignity.

III. WHAT HAPPENS AFTER SUBMITTING A DMH COMPLAINT?

After a complaint is made, the Person in Charge shall determine whether the complaint should be handled within the facility or not, depending on the seriousness of the incident or condition.

A "Below the Line" Complaint

An incident or condition which is determined not to be serious is considered "below the line" and is investigated within the program or facility.

An "Above the Line" Complaint

An incident or condition which alleges medicolegal death, sexual assault or abuse, physical assault or abuse, attempted suicide resulting in serious physical injury, a felony, restraint or seclusion practices not in accordance with Department regulations which result in serious physical injuries or which is sufficiently serious or complicated as to require an investigation by the Office of Investigation will be considered "above the line." The Person in Charge must forward it to DMH's Central Office where it will be addressed as follows:

DMH operated or contract program or facility

These complaints are forwarded to the DMH Office of Investigations. If another agency is already investigating the complaint, the Office of Investigations may let the other agency investigate, investigate on the other agency's behalf, or undertake a concurrent investigation. However, if the Office of Investigations does not agree that the complaint is sufficiently serious, it may refer the matter back to the Person in Charge to investigate as a "below the line" incident. The office will assign an investigator if it is undertaking the investigation.

DMH licensed program or facility

These complaints are forwarded to the DMH Director of Licensing who will coordinate the investigation with the DMH Office of Investigations.

IV. WHAT DOES THE INVESTIGATOR DO?

All investigations must begin with an interview of the complainant, followed by an interview with the individual wronged, if the individual is not the complainant, and interviews with each person complained of. The investigation should also include interviews with each witness and other people, including family members, who may have information related to the complaint. The investigator will have 30 days (which may be extended for good cause) to conduct the investigation and file written findings of fact and conclusions with the Area Director, Assistant Commissioner for Child and Adolescent or Forensic Services (hereinafter, "Assistant Commissioner") or Director of Licensing, as applicable.

V. WHO WILL ISSUE A DECISION LETTER?

A "Below the Line" Complaint

Upon receiving the complaint, the Person in Charge of the program or facility must undertake the necessary fact-finding and provide a written decision to the parties within ten days containing findings of fact and conclusions and any actions to be taken.

An "Above the Line" Complaint

DMH operated or contract program or facility

Upon receiving an investigation report, the Area Director or Assistant Commissioner has ten days to issue a decision letter.

DMH licensed program or facility

Upon receiving an investigation report, the Director of Licensing has ten days to issue a decision.

VI. IS THERE A RIGHT TO RECONSIDERATION?

Any party to the complaint has the right to request reconsideration of the decision from the person who issued the decision. The party must request reconsideration in writing within ten days of receipt of the decision. The request must indicate the failure of the investigator to interview an essential witness or consider an important fact or factor. A final decision shall issue within ten days of receipt of the request for reconsideration. Reconsideration is not a prerequisite to a DMH client filing an appeal.

VII. IS THERE A RIGHT TO AN APPEAL?

All appeals must be filed in writing within ten days of receiving a decision.

A "Below the Line" Complaint

DMH operated or contract program or facility

The DMH client may appeal the decision of the Person in Charge to the DMH Area Director or the DMH Assistant Commissioner.

DMH licensed program or facility

The DMH client may appeal the decision of the Person in Charge to the DMH Director of Licensing.

The appeal decision shall issue within 30 days, unless further fact-finding is required, in which case the decision shall issue within 40 days of receiving the appeal.

An "Above the Line" Complaint

DMH operated or contract program or facility

A DMH client may appeal the decision of the Area Director or Assistant Commissioner to the Deputy Commissioner for Program Operations (hereinafter, "Deputy Commissioner"). The Deputy Commissioner must issue a decision within 30 days of receiving the appeal.

DMH licensed program or facility

A DMH client may appeal the Director of Licensing's decision to the DMH Commissioner. The Commissioner shall issue a decision within 30 days of receiving the appeal and it will be final.

V111. IS THERE A FURTHER APPEAL?

A "Below the Line" Complaint

DMH operated or contract program or facility

A DMH client may appeal the decision of the Area Director or Assistant Commissioner to the Deputy Commissioner. The Deputy Commissioner shall issue a decision within 30 days of receiving the appeal and it will be final.

DMH licensed program or facility

A DMH client may appeal the decision of the DMH Director of Licensing to the DMH Commissioner. The Commissioner shall issue a decision within 30 days of receiving the appeal and it will be final.

An "Above the Line" Complaint

DMH operated or contract program or facility

A DMH client may appeal the Deputy Commissioner's decision to the DMH Commissioner. The Commissioner shall issue a decision within 30 days of receiving the appeal and it will be final.

DMH licensed program or facility

There is no further appeal.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

The rights of adults to move freely on a hospital ward

THE RIGHTS OF ADULTS

TO MOVE FREELY ON A HOSPITAL WARD

Staff have a number of methods to limit the movement of adult patients on a hospital ward. Some of these methods require patient consent, others do not if you are not sure if you have been properly restricted, ask to speak to the Human Rights Officer.

I. ROOM PLAN

A room plan is a form of treatment in which a schedule is created which dictates when a patient shall spend time in and out of a room on the ward, such as a bedroom. The schedule typically changes over the course of days if the patient abides by the plan, the time spent in the room gradually decreased and the time spent on the ward increased. The goal of a room plan is to cautiously bring a patient into life on the ward, while maintaining behavior that meets staff standards. Because a room plan is a form of treatment, it can only be used with the consent of the patient (if competent to consent) or a guardian (with the authority to consent to a room plan). Also, like other forms of treatment, it must be terminated if the patient withdraws consent.

II. QUIET ROOM

The quiet room is a room, usually empty, to which a patient goes to experience time away from staff and other patients. Use of the quiet room is voluntary and may not be ordered by staff. While staff may suggest or even encourage a patient to use the quiet room, the patient may refuse such a request. A patient has the right to leave the quiet room at any time.

III. SECLUSION

Seclusion is the placement of a patient alone in a room or enclosed space so that:

The patient cannot see or speak with patients or staff; and

The patient cannot leave or believes he or she cannot leave, or has been threatened with or experienced sanctions for leaving as a coercive means of maintaining the patient in the room.

While seclusion does not require patient consent, staff may only place a patient in seclusion in an emergency, such as the occurrence of or serious imminent threat of extreme violence or self-destructive behavior. Seclusion may be used only when less restrictive alternatives have failed or are not possible. When the patient no longer meets the standard for seclusion, he or she must be released.

IV. OTHER RESTRICTIONS OF MOVEMENT ON A WARD

At some facilities, staff limit the movement of patients on a ward through the use of other restrictions. A patient might be restricted to the day hall, male or female end of the ward, or other common areas. The hospital may have a policy which outlines when such restrictions may be used and who must approve their use. Furthermore, unless the areas to which the patient is restricted are available to and shared by other patients, such restrictions may constitute seclusion and require an emergency prior to imposition absent patient consent.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Your rights in hospitals regarding restraint and seclusion

RIGHTS IN HOSPITALS REGARDING

RESTRAINT AND SECLUSION

Hospitals may use restraint and seclusion only in cases of emergency and in compliance with strict standards. Additional requirements, not included here, apply when restraining children.

I. WHAT IS RESTRAINT?

"Restraint" is physical force, mechanical devices, chemicals, seclusion, or any other means which unreasonably limit freedom of movement. Hospital staff may use four types of restraint to restrict patients who are acting, or threatening to act, in a violent way towards themselves or others.

Physical restraint --

Holding a patient in a way that restricts his or her movement.

Mechanical restraint --

Using a device, such as four-point or full-sheet restraint, to restrict a patient's movement (excludes devices prescribed for medical purposes).

Chemical restraint --

Medicating a patient against the patient's will for the purpose of restraint rather than treatment.

Seclusion --

Placing a patient alone in a room so that the patient cannot see or speak with patients or staff and so that the patient cannot leave or believes he or she cannot leave. In facilities licensed, operated, or contracted for by the state Department of Mental Health (DMH), a mechanically restrained patient cannot be secluded.

II. WHEN MAY RESTRAINT BE USED?

Restraint may only be used to prevent violence in an emergency. An emergency is the occurrence of or serious imminent threat of extreme violence or self-destructive behavior, "where there is the present ability to effect such harm." Restraint may not be used for treatment, punishment, behavior modification, staff convenience or on an "as needed" basis (PRN orders). Restraint must be the most appropriate alternative available. Restraint may only be used when less restrictive interventions have been determined to be ineffective.

III. WHO MAY ORDER RESTRAINT?

Mechanical restraint, physical restraint and seclusion require written orders by an authorized physician or other licensed independent practitioner permitted by the state and hospital to order a restraint. If the physician or other qualified practitioner is unavailable, a designated staff person may authorize restraint for no more than one hour. A physician or other licensed independent practitioner must see and evaluate the need for restraint or seclusion within one hour after the initiation of the intervention. These orders may be renewed only to prevent a continued or renewed emergency. Only an authorized physician may order chemical restraint, but he or she may issue the order over the telephone by speaking to a registered nurse or certified physician's assistant who has personally examined the patient. A physician may only order chemical restraint if the medication has been previously authorized in the patient's treatment plan. Furthermore, chemical restraint may only be administered if it is the least restrictive, most appropriate alternative available. The treating physician must be consulted as soon as possible, if he or she does not order the restraint.

IV. HOW LONG MAY RESTRAINT CONTINUE?

When an emergency no longer exists, the patient must be released. Thus, staff should release a patient who, upon examination, appears calm. The total time which a patient

may be restrained is limited.

An initial restraint or seclusion order is valid for three hours.
After three hours, a superintendent, authorized physician, registered nurse, or certified physicians assistant may continue restraint or seclusion if the emergency still exists.
After six hours, an authorized physician must examine the patient and renew the order.
The maximum amount of restraint or seclusion allowed is eight hours in any 24 hour period unless the superintendent or his or her designee so authorizes.

V. WHAT FURTHER PROTECTIONS EXIST FOR RESTRAINED PATIENTS?

A patient in a facility operated by DMH, contracted for by DMH, or licensed by DMH has additional rights:

The patient must be fully clothed consistent with patient safety and dignity;
The patient must have access to the bathroom;
The patient should be continually assessed by staff to determine if the restraint or seclusion is still needed. These checks must be made at least once every 30 minutes;
Any space or device used must provide appropriate and safe ventilation, heating and lighting;
Once restrained or secluded, staff should help the patient calm down by using appropriate interventions; and
Staff must determine if the patient has a history of abuse by gathering information during intake from the patient, the patient's record, and, when necessary, from other treating clinicians. If the patient has an abuse history, staff will use strategies to help reduce the patient's agitation so as to avoid the need for restraint. If restraint or seclusion is necessary, staff must determine which type will be the least traumatic for the patient and which gender of staff would be most appropriate to administer or monitor it.

Furthermore, a patient in a DMH-operated facility has these additional rights:

To avoid restraint, staff should attempt to calm the patient through talking and other non-violent means;
The attendant accompanying the patient to the bathroom should be of the same sex as the patient;
A patient may not be held in restraint or seclusion for more than one-half hour

without a break unless he or she poses a violent threat to self or others (or is asleep);

A patient who is quiet must be released for a trial period; and

Staff should experience restraint as part of their training.

VI. WHAT ARE THE OBSERVATIONAL REQUIREMENTS FOR RESTRAINT?

When a patient is restrained or secluded, a specially trained person must be able to observe the patient. The condition of the patient in restraint must continually be assessed, monitored, and re-evaluated.

During seclusion, the observer may be immediately outside the patient's room--provided that the patient can fully see staff and staff can continuously observe the patient.

All staff who have direct patient contact must have ongoing education and training in the proper and safe use of restraint application and techniques and alternative methods for handling behavior, symptoms, and situations that traditionally have been treated through the use of restraints.

In facilities licensed, operated, or contracted for by DMH, staff must check a patient in mechanical restraint or seclusion every 15 minutes for comfort, body alignment and circulation.

VII. WHAT DOCUMENTATION IS NECESSARY FOR RESTRAINT?

Each time restraint is ordered or renewed, the authorizer must record the reason for its use on a form.
Within 24 hours of being restrained, the patient must receive a copy of the restraint form and be permitted to attach comments concerning the use of restraint.
The form and the patient's comments must be placed in the patient's chart and a copy sent to the Commissioner of DMH, who must review and sign them within 30 days.
The hospital must report to the federal Health Care Finance Agency any death that occurs while a patient is restrained or in seclusion, or where it is reasonable to assume that a patient's death is a result of restraint and seclusion.

VIII. WHAT SHOULD YOU DO IF YOU BELIEVE YOU HAVE BEEN ILLEGALLY RESTRAINED?

If you believe that you were illegally restrained while at a program or facility operated

by, contracted for, or licensed by DMH, ask to speak with the Human Rights Officer. You may also file a written complaint with the Person in Charge of the program or facility. You can give your complaint to any facility employee; he or she must forward it to the Person in Charge. If you are dissatisfied with the response of the Person in Charge and believe that additional fact-finding should occur, you have 10 days to request reconsideration. You also may file an appeal to a higher level up to 10 days after receiving a decision. The person to whom the appeal is made depends upon the type of complaint and the type of facility. In most cases, you have the right to a further appeal, which must be filed within 10 days of receiving the appeal decision. If you have questions about the complaint process, contact the Human Rights Officer or the Mental Health Legal Advisors Committee (1-800-342-9092).

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Your rights regarding access to mental health records

YOUR RIGHTS REGARDING ACCESS TO
MENTAL HEALTH RECORDS

An individual has a right to confidentiality with respect to his or her own mental health records. This right of confidentiality provides that, in most cases, only the individual, his or her guardian, and the individual's treatment providers may know the content of the record. However, whether or not an individual has the right to access his or her own records depends on what laws are applicable.

I. LAWS GOVERNING THE RELEASE OF RECORDS

Inpatient facilities operated, by the Department of Mental Health (DMH), contracted for by DMH, or licensed by DMH and Intensive Residential Treatment Programs (IRTPs)

At mental health inpatient facilities operated by DMH, contracted for by DMH, or licensed by DMH and at IRTPs for adolescents, patient access to and release of medical records are governed by a state law and corresponding DMH regulations. In certain cases, DMH policy and guidelines also apply.

An individual or guardian has a right to "inspect" the individual's mental health record, unless the DMH Commissioner or designee has determined that inspection will result in "serious harm" to the individual. An individual has a right to obtain a copy of the record when it is in the individual's "best interest." The DMH regulations list certain circumstances in which the best interest standard is automatically met. They include the following:

When the record will enable the individual, or someone acting on the individual's behalf, to pursue a claim, suit or other legal remedy, to enforce a right, or to defend him or herself against such action;
To ensure that the individual's civil rights are protected; or
To enable the individual or someone acting on the individual's behalf to obtain benefits or third-party payment for services rendered.

The expectation of DMH is that: "In most instances, individuals should be permitted to review their records and/or obtain a copy."

For DMH operated inpatient facilities, private inpatient units located within a DMH operated facility, and any private inpatient facility which has contracted with DMH to follow a recent DMH policy regarding patient rights, DMH provides further direction regarding the "best interest" analysis. For these facilities, DMH defines disclosure as being in the individual's "best interest" unless:

There would likely be serious harm to the individual, defined as physical or psychological harm which is tangible or concrete, and not hypothetical or insignificant, as a result of disclosure, as determined by a clinician who has reviewed the record and is knowledgeable of the individual;
The likelihood of harm as a result of disclosure may not be satisfactorily addressed through a staff person reviewing the records with the individual;
The denial and reasons for it are reviewed with the individual; and
The denial and reasons for it are noted in the individual's record.

The facility's chief executive officer or designee must review all decisions to deny disclosure.

Community programs operated by DMH, contracted for by DMH, or licensed by DMH

At community programs operated, by DMH, contracted for by DMH, or licensed by DMH, access to and release of mental health records is governed by DMH regulation. This regulation provides an individual the absolute right to inspect and copy the record upon request.

Residential programs licensed by the Office of Child Care Services (OCCS)

An individual may be able to access the records kept by a residential program licensed by OCCS (formerly the Office for Children). Such programs must have written procedures regarding access to the record by the resident (taking into account the resident's capacity to understand), parent(s), persons other than the parent who has custody, and persons not directly related to the service plan. The procedures must identify the person or persons, if any, whose consent is required before information in the resident's record may be released.

Facilities operated or licensed by DPH

An individual receiving inpatient or outpatient services at hospitals or clinics operated or licensed by the Department of Public Health (DPH) (and not operated or licensed by DMH) has a right to access his or her records. These facilities must allow the individual to inspect and copy their mental health records; there is no "best interest" standard. There is one exception to the right of an individual to access records under DPH law: when the records have been generated by a psychotherapist. This exception is described in the following section, entitled "Other health care providers."

Other health care providers

An individual receiving services from a health care provider, other than those providers who fall into any of the above categories, has a right to access his or her entire record. The individual's "authorized representative" is also entitled to the record. One exception exists to this general rule: a psychotherapist may prohibit access to that portion of the mental health record generated by the psychotherapist, if the psychotherapist believes that access to those specific records would "adversely affect the patient's well-being." If a psychotherapist limits access, he or she must provide the individual with a summary of the psychotherapy records. However, the psychotherapist must provide the entire record to the individual's attorney or to another psychotherapist if the individual consents to its release.

II. REQUESTING A RECORD AND CHALLENGING THE DENIAL
OF A REQUEST FOR RECORDS

Requests for mental health records should be made in writing to the appropriate body, as outlined below. If an individual believes that a request for a copy of the records has been improperly denied, he or she may seek review of that decision. The individual should make all requests and subsequent contacts in writing and keep copies of all correspondence.

Inpatient facilities operated, funded, or licensed by DMH and IRTPs

An individual may request a record from an inpatient facility operated by DMH, contracted for by DMH, or licensed by DMH or an IRTP by writing to the facility director, who shall be the DMH Commissioner's designee to determine whether access to records is appropriate. If the facility director denies the request, the individual may appeal the decision to the DMH Commissioner. The Commissioner may be reached at 25 Staniford Street, Boston, MA 02114, (617) 626-8000.

Community programs operated, licensed, or funded by DMH

An individual may request a record from a community program operated by DMH, contracted for by DMH, or licensed by DMH by writing to the program director. If the program director denies the request, the individual should appeal the decision to the DMH Commissioner. The Commissioner may be reached at 25 Staniford Street, Boston, MA 02114, (617) 626-8000.

Residential program licensed by OCCS

An individual may request a record from OCCS licensed residential program by writing to that person designated in the program's procedures. If the request is denied, the individual may seek a remedy pursuant to the program's procedures or file a complaint with the OCCS Regional Director for the region within which the program is located.

Facilities operated or licensed by DPH

An individual may request a record from a facility operated or licensed by DPH by writing to the head of the facility. If the request is denied, the individual may file a complaint with the DPH Division of Health Care Quality, 10 West Street, 5th Floor, Boston, MA 02111, (617) 727-5860.

Other health care providers

An individual may request a record from a health care provider by writing to that provider directly. If the request is denied, the individual should seek legal advice. The individual may also file a complaint with the division of the Board of Registration which licenses that provider.

III. FEES FOR COPYING

Facilities and providers supplying copies of an individual's mental health record are entitled to charge a reasonable fee. Inpatient facilities licensed by DPH or DMH may charge no more than the actual cost of copying. By department regulation, the same standard applies to community programs licensed or contracted for by DMH.

Facilities and providers may waive the fee in special circumstances, such as when an individual cannot afford to pay. If the records are needed to support a claim or appeal under any provision of the Social Security Act or any federal or state needs-based benefit program, such as SSI, SSDI, EAEDC, or Medicare, a hospital licensed by the DPH or supported by the Commonwealth to any degree may not charge a fee for copying.

IV. AMENDING THE RECORD

While an individual may not delete information in his or her mental health record, in certain cases he or she may add information. Under Massachusetts law, agencies of the executive branch of government, such as DMH, are considered "holders . . . of personal data" and must allow an individual to correct or amend his or her record when the individual so requests. If the holder and the individual disagree as to whether a change should be made, the holder must ensure that the individual claim is noted and included as part of the individual's record and included in any subsequent disclosure or dissemination of the record. Thus, DMH operated inpatient facilities and community programs, and DPH operated facilities, must accept an individual's additions to the record and include them whenever forwarding the record.

Other kinds of "holders . . .of personal data" must also allow an individual to correct or amend his or her mental health record. If a facility has a contract or arrangement with one of the agencies covered by this law, the facility is considered a "holder" of those records which the facility maintains because of the contract or arrangement. Thus, many of the types of records discussed in this brochure could be amended by the individual including those held at DMH licensed or contract inpatient facilities and community programs, IRTPs, OCCS licensed group care facilities, and DPH licensed facilities.

Further, facilities and programs operated, by DMH, contracted for by DMH, or licensed by DMH must allow for information to be added to an individual's inpatient record. Inpatient facilities are required to include in the individual's record, among other information, "any other information deemed necessary and significant to the care and treatment of the patient." Community programs are required to maintain records containing "accurate, complete, timely, pertinent and relevant information. If an individual or legally authorized representative believes that the record contains inaccurate or misleading information, he or she may prepare with assistance, if requested, a statement of disagreement which shall be entered in the record."

When amending his or her record, an individual should request that the additional information be placed next to the material in the record which he or she seeks to modify or correct. This request is important as medical records are often extensive and a letter of correction could easily be buried in the stack of papers.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Your rights regarding Department of Mental Health treatment plans

RIGHTS REGARDING TREATMENT PLANS

FOR DEPARTMENT OF MENTAL HEALTH

CONTINUING CARE SERVICES

A treatment plan determines the services you receive from a facility or program. This pamphlet discusses treatment plans for continuing care services which are operated by, or provided through contract with, the Department of Mental Health (DMH). This pamphlet discusses both individual service plans (ISPs) and program specific treatment plans (treatment plans). An ISP describes the range of services the individual receives from all providers, while a treatment plan identifies the specific services provided by a particular facility or program.

I. ELIGIBILITY FOR DMH CONTINUING CARE SERVICES

Individuals have the right to an ISP when they are eligible for DMH continuing care services and some or all of the services they need are available. DMH continuing care services are community-based services contracted for or operated by DMH; they do not include services of brief duration, outpatient services, court evaluations, or acute mental health services, such as crisis intervention or emergency screening.

II. ISP MEETING

As soon as an individual is determined eligible, DMH will assign a case manager. Within 20 days, the case manager must formally assess the individual’s service needs. Within 10 days of completing this assessment, the case manager must convene a meeting to prepare an ISP. The case manager must invite the client, any legally authorized representatives of the client, current and potential service providers, DMH staff, and anyone else, including family members, whom the client or their representative requests be invited. Each service provider who will administer DMH continuing care services must submit a written treatment plan to the case manager no more than 20 days after this initial ISP meeting.

III. THE ISP

The case manager must prepare a written ISP within 25 days of the initial ISP meeting, and include the treatment plans prepared by the service providers. An ISP must be individualized, identifying the client’s goals, strengths, and needs, as well as all DMH services and programs that address those needs. Services identified in the ISP, to the greatest extent possible, must be consistent with the client’s preferences, and provided in the least restrictive setting.

IV. TREATMENT PLANS

Treatment plans included in the ISP should be based on information gathered during the application process as well as the assessment of service needs. These plans must include both long and short-term treatment objectives (including the criteria and a timeline for gauging achievement), as well as the specific treatment modalities that will be used.

DMH regulations include additional requirements regarding treatment plans specific to the type of facility or program.

Inpatient facilities licensed by, funded by or contracted with DMH (including intensive residential treatment programs) must prepare a written treatment plan for each patient. A representative from each facility discipline (for example, a nurse, psychiatrist, psychologist, rehabilitative specialist, and social worker) must contribute to the plan. The plan must be developed with the maximum possible participation of the patient or the patient's legally authorized representative. Staff must conduct a periodic written evaluation of treatment progress, at which time the responsible clinicians must record significant modifications of the plan and the rationale for them.
Community-based programs licensed by, funded by or contracted with DMH must develop and implement a treatment plan for each resident.

V. ACCEPTING OR REJECTING THE ISP

Once the ISP is complete, the case manager sends it to the client or the client’s legally authorized representative for acceptance or rejection. If the client or the client’s legally authorized representative fails to object to the ISP within 20 days of receipt, the plan is considered accepted. The ISP will be implemented as soon as it is accepted. The client or the client's legally authorized representative may reject all or part of the ISP, in which case the case manage must provide notice within five days of the right to meet and discuss potential modifications to the plan. If that meeting fails to yield an agreement, the client has the right to appeal the ISP. The appeal may be filed by the client, a legally authorized representative, or if one does not exist, a person designated by the client to act as a representative. If portions of the ISP are accepted, they may be implemented (when appropriate) even when an appeal is pending on other portions.

VI. APPEALING THE ISP

Some issues that may be brought up on appeal include:

Whether the assessment, the ISP or the treatment plans meet regulatory requirements;
Whether the assessment is sufficient to serve as the basis for the ISP or the treatment plans;
Whether the assessment, the ISP, or the treatment plans are reasonable in the circumstances;
Whether the goals, objectives, and timelines in the ISP or treatment plans are appropriate and reasonably related to the client's needs, as identified in the application and assessment process;
Whether the services identified in the assessment, ISP, or treatment plans are consistent with the client's needs, and meet those needs in the least restrictive setting possible;
Whether proposed modifications of the ISP, the treatment plan, services, or the service provider are reasonable in the circumstances;
Whether the regulatory procedures for developing the ISP and treatment plans have been followed.

An appeal is filed by submitting a written statement to the DMH Area Director, indicating the issue being appealed and the basis for the appeal. An appeal must be filed within 30 days; however, the Area Director may accept an appeal after 30 days for good cause.

Within 20 days after an appeal is filed, the Area Director or a designee will hold an informal conference with the client, their legally authorized representative (if any), the case manager, the program director (if appropriate), and other invited persons. If this conference fails to yield a resolution, the Area Director or designee will identify both the issues of fact that are not in dispute and those that remain the subject of the appeal. The Commissioner (or a designee) may waive this informal conference if the appealing party agrees to do so.

VII. HEARING

If the issue remains unresolved, within 10 days of the conference or its waiver the client may petition the Commissioner or designee for a hearing. Within 10 days of that petition, the Commissioner must appoint a hearing officer, who will schedule a hearing date that is agreeable to the parties. The hearing must be consistent with Massachusetts statutes, including chapter 30A of the Massachusetts General Laws, DMH regulations, and the state's informal fair hearing rules. The hearing officer must issue a written decision within 20 days of the close of the hearing. The parties have the right to petition for re-hearing or to appeal the decision (of either a hearing or a re-hearing) to the Superior Court. Appeals to the Superior Court must be filed within 30 days of the receipt of the decision of a hearing or a re-hearing.

VIII. RE-HEARING

A petition for re-hearing may be made on the following grounds:

Discovery of new evidence likely to materially affect the appealed issues;
That the hearing was conducted in a way that was inconsistent with DMH regulations or was prejudicially unfair to a party;
That the decision was based upon inappropriate standards or contained other errors of law;
That the decision was unsupported by any substantial evidence.

Throughout the appeal process, DMH has the burden of showing that its proposed plan is the most appropriate in the circumstances. The standard of proof on all issues is a preponderance of the evidence. This means that if the client can show that it is more likely than not that the evidence supports a different plan, he or she should prevail on appeal (whether it is at the hearing, re-hearing, or Superior Court level).

The portions of an ISP that are in controversy will not be implemented during the appeal process, even if the proposal is for the modification or termination of an existing plan. However, in an emergency, or when necessary to comply with state contracting requirements, an existing treatment plan may be modified without the consent of the individual or his or her legal guardian. The emergency must pose a serious threat to the health, mental health, or safety of the client or others in order to make such a modification allowable.

IX. PERIODIC REVIEW OF TREATMENT PLANS

Massachusetts statute and DMH regulations require the periodic review of treatment plans:

Inpatient facilities licensed by, operated by or contracted with DMH (including intensive residential treatment programs) must conduct a periodic review of the treatment plan and progress of each adult inpatient upon admission, during the first 3 months, during the second 3 months, and annually thereafter, and must review minors' plans quarterly. The facility must provide reasonable advance written notice of the periodic review to the individual, the individual's legally authorized representative, and, unless the individual knowingly objects, to the individual's nearest living relative; the notice must give the date of the review and invite participation. For each periodic review, a senior clinician must evaluate the individual's competency to remain on or apply for conditional voluntary admission, to consent to ordinary or extraordinary treatment (including antipsychotic medications), and to manage his or her funds. Alternatives to hospitalization also should be evaluated. The person in charge of conducting the review must enter in the patient's record the following: the information presented; the reasons for the determination that you need continuing inpatient care and treatment; and the alternatives to hospitalization which were considered and why they were rejected.
Community-based programs must conduct periodic reviews of each resident's treatment plan and progress within 3 months of admission, within 6 months of admission, and annually thereafter.

Periodic reviews for individuals within the care of DMH must include, but are not necessarily limited to:

A thorough clinical examination, including a review of any treatment, response to treatment, and medications administered;
An evaluation of the legal competency of the person and the need for a guardian or conservator;
Any alternatives to continued hospitalization or residential care;
Unless a guardian or conservator has been appointed, an evaluation of competency to manage funds (and, if the team finds the individual unable to manage certain funds, a plan for managing those funds).

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Your rights regarding hospitalization and discharge

YOUR RIGHTS REGARDING
HOSPITALIZATION AND DISCHARGE

Massachusetts General Laws Chapter 123 provides individuals with certain rights regarding hospitalization and discharge. Your rights regarding admission to and discharge from a hospital depend on your legal status. If you are at a hospital, you can ask staff for information about your status.

I. EMERGENCY ADMISSIONS: "THE PINK PAPER" ("SECTION 12")

In Massachusetts, any individual may be forcibly admitted to a facility for up to four business days. The application for this kind of admission, called an "Application for Temporary Hospitalization" is known by several names, including an "emergency admission," a "pink paper," or a "Section 12."

A physician, qualified psychiatric nurse, qualified psychologist, or police officer may apply to admit anyone to a facility for up to four business days if he or she believes that, without hospitalization, the person would "create a likelihood of serious harm by reason of mental illness." "Likelihood of serious harm" means one of three things:

The person poses a substantial risk of physical harm to him/herself as manifested by evidence, threats of, or attempts at suicide or serious bodily injury; or
The person poses a substantial risk of physical harm to others as evidenced by homicidal or violent behavior or evidence that others are in reasonable fear of violent behavior and serious physical harm from that person; or
The person’s judgment is so affected that there is a very substantial risk that the person cannot protect himself or herself from physical impairment or injury, and no reasonable provision to protect against this risk is available in the community.

If an examination of the individual is not possible because of the emergency nature of the case or because the person refuses to consent to such examination, a doctor, qualified psychologist, or psychiatric nurse does not even need to see the person before signing the Application for Temporary Hospitalization. He or she may rely instead on whatever facts and circumstances have come to his or her attention. If none of those three medical professionals is available, then a police officer is allowed to make the application without an examination. Since the law does not say what "facts or circumstances" might be considered relevant, a mental health clinician may have considerable leeway in making the decision.

Following this procedure, an individual may be admitted to a psychiatric facility without a court hearing and against his or her will for up to four business days, provided that a physician designated by the hospital has examined the person and signed the admission papers. If the paper is signed either by a physician who is not designated by the hospital, by a qualified psychologist, by a qualified psychiatric nurse, or by a police officer, it is considered only an application for hospitalization; a designated physician at the facility must still actually admit the person.

At the time of admission, the hospital must inform each individual that the facility will, upon the person's request, notify the state public defender agency, the Committee for Public Counsel Services (CPCS), of the admission. In those cases in which the hospital notifies CPCS, CPCS will "forthwith" appoint an attorney to meet with and, unless the person voluntarily and knowingly declines assistance, represent the person.

Additionally, if the confined person believes that "an abuse or misuse" of the admission process has occurred, the person or his or her counsel may seek emergency judicial review in district court. Unless the individual seeks a delay, the hearing must be held no later than the next business day after the request for the hearing.

At any time during these four business days, the hospital may: 1) discharge you if it determines that you are not in need of care and treatment; or 2) petition the district court for involuntary commitment. At any time during the four days, you may: 1) change your status to that of a conditional voluntary patient; or 2) seek emergency judicial review in district court (discussed above).

II. VOLUNTARY ADMISSIONS

If you admit yourself to a hospital as a voluntary patient, your status is totally voluntary and may be terminated by you or the hospital at any time. Nevertheless, the hospital may restrict your right to leave to normal working hours and weekdays. Although the law allows for voluntary admissions, in practice hospitals rarely offer them. When facility staff describe a patient as "voluntary," typically they mean that the patient has "conditional voluntary" status.

III. CONDITIONAL VOLUNTARY ADMISSIONS ("10 & 11")

If the hospital considers you competent to make the decision, you may apply for conditional voluntary admission status. As a conditional voluntary patient, you remain on this status at the hospital indefinitely, until the hospital decides to discharge you or you ask to leave by filing a "three day notice."

Signing into the Hospital as a Conditional Voluntary Patient

Before signing in as a conditional voluntary patient, you must be given the opportunity to consult with an attorney or legal advocate.

A facility may accept an application for conditional voluntary admission only if, upon assessment by the admitting or treating physician, the physician determines that the person understands the conditional voluntary admission process.

By signing a conditional voluntary admission, you forfeit certain rights:

You waive the right to a hearing before a judge to determine whether you meet the legal standard for involuntary commitment. However, you regain this right by signing a three day notice.
You waive the right in some situations to certain guarantees of the federal constitution (right to safety, right to adequate treatment, and freedom from harm and undue restraint). However, the facility may be compelled to provide these rights under the state constitution.

The Three Day Notice

You may at any time submit a written notice to the hospital of your intent to leave. During these three days you may be held at the hospital while the staff evaluates your clinical progress and suitability for discharge. You may not be held against your will for longer than three days unless, prior to the end of the third day, the hospital petitions for your commitment. Saturdays, Sundays and legal holidays are excluded from the calculation of the three days.

Practical advice: In deciding whether to submit your three day notice you may want to consult with your physician about your discharge plan and timetable for release. You may be able to negotiate an agreeable date for discharge. You may want to ask if the hospital would petition for your commitment were you to submit a three day notice.

IV. CIVIL COMMITMENT ("7 & 8")

Your Rights

If a hospital petitions the district court for your involuntary commitment, you have certain rights:

Notice

Of the time and place of the court hearing, which must be held within four business days of the filing of the petition (unless you or your attorney requests a delay).
The appointment of an attorney to represent you at the state's expense if you cannot afford one. The district court will notify you of the name of the attorney. You have a right to communicate with your attorney and to participate in the preparation of your case.
An independent psychiatric examination (which you may request through your attorney).
A full adversarial hearing which you can attend, cross-examine witnesses through your attorney, and testify on your own behalf.

The Hearing

At any time prior to the hearing the hospital may withdraw the commitment petition if:

You agree to sign a conditional voluntary admission, or
The hospital decides that you no longer need hospitalization and can safely be discharged.

To commit you, the judge must find, beyond a reasonable doubt, that you pose a present danger to yourself or others by virtue of a mental illness and that no less restrictive alternative is appropriate or available. If this standard is not met, the hospital must discharge you. The judge must issue a decision within ten days unless she provides written reasons for the delay.

Length of Commitment

The first commitment is valid for six months; subsequent commitments for 12 months. During your commitment, if the hospital determines that you no longer need treatment and care, it must discharge you. Prior to the end of each commitment period, the hospital must file a new petition in order to continue holding you involuntarily.

V. DISCHARGE UNDER CIVIL COMMITMENT

If you are involuntarily committed, your options for discharge are limited to judicial and administrative reviews.

Judicial Review

The 9(a) Appeal of a Commitment Order

You may request with the appellate division of the district court a review of matters of law arising in commitment hearings. You must claim that an error of law occurred regarding the prior hearing (for example, the judge improperly allowed a witness to be qualified as an expert). Using this method to obtain your discharge has drawbacks: it usually requires an attorney's help, is a slow process, and is an uphill battle. Regardless of the outcome of the appeal, you are likely to be confined for several months before it is heard.

The 9(b) Application for Discharge.

Any person may petition for a patient's discharge by applying in writing to a superior court. This application may be filed at any time and in any county and must state that the person named is improperly or unnecessarily retained.

Within seven days of receiving the petition, the superior court must notify the hospital and other interested persons (your physician, spouse or family) of the time and place of the hearing. The hearing must be held promptly before a superior court judge. The court will appoint an attorney to represent you if you cannot afford one. If the judge determines that you do not presently meet the commitment standard, you must be discharged.

Practical Advice: You may file the application at any time following your commitment. Ask the attorney who represented you in your district court commitment hearing to file the paperwork for the 9(b) proceeding in the superior court; he or she is required to initiate this proceeding upon your request. The superior court will then appoint a new attorney to handle your 9(b) proceeding. Because you will have the burden in this proceeding of proving that you do not need hospitalization, it is usually helpful to enlist an expert to conduct an evaluation of you and to testify on your behalf. Your attorney may request funds from the court to pay for this evaluation.

Administrative Review

Discretionary Discharge by the Facility

The hospital must discharge you when, in the hospital staff's opinion, you no longer need inpatient care. Therefore, you need not necessarily be confined for the full term of your commitment order.

Periodic Review by the Facility

The hospital must review your status at least once during the first three months of commitment, once during the second three months, and annually thereafter. The review must include a consideration of all possible alternatives to continued hospitalization. If you are found no longer to need hospitalization, you must be discharged. Both you and your nearest relative or guardian have a right to advance notice of the review, as well as the right to attend and participate.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Your rights regarding medication

YOUR RIGHTS REGARDING MEDICATION

Massachusetts law protects your right to decide your course of treatment and, more specifically, to refuse medication. You have this right whether you are receiving inpatient or outpatient treatment, voluntarily or involuntarily hospitalized, in a public or private setting, or in a mental health or mental retardation facility.

I. INFORMED CONSENT

Before administering any type of treatment, including medication, your physician must obtain your informed consent. Harnish v. Children's Hospital Medical Center, 387 Mass. 152, 154-155 (1982).

In order to exercise informed consent, you must be told in terms you can understand:

See Harnish at 155, ("We hold, therefore, that a physician's failure to divulge in a REASONABLE manner to a competent adult patient...")(emphasis added).

The nature and extent of your illness;
What medication the doctor wants to prescribe for you and why;
The benefits the doctor believes will result from taking the medication;
The nature and probability of the risks associated with the medication generally, and any special risks which the medication may pose for you specifically (for example, if you are pregnant or have a heart problem, some medications may be particularly dangerous);
Alternative treatments
Including not having treatment; and
The prognosis with and without treatment.

Harnish at 156. Further, if you are in a facility that is operated or funded by the Department of Mental Health, your doctor must:

Respond to your questions about the medication;
DMH Policy #96-3R (V)(A)provide you with medical information written in "everyday language" about the benefits, risks and side-effects of the medication prescribed to you;
DMH Policy #96-3R (V)(B)(5)explain that you have the right to freely refuse the treatment without coercion, retaliation, or punishment; DMR Policy #96-3R (V)(B)(7) and
Explain that you have the right to withdraw your consent to treatment, either orally or in writing, at any time. DMR Policy #96-3R (V)(B)(8)

The fact that you have been admitted or committed to a mental health or retardation facility does not mean that you are incompetent to give or withhold consent. To the contrary, in Massachusetts, an adult is presumed competent to make his or her own decisions regarding antipsychotic medication until he or she is proven incompetent to do so in court.Rogers v. Commissioner of the Department of Mental Health, 390 Mass. 489, 497 (1983).

Neither your doctor nor the staff may threaten or punish you for refusing to consent to treatment.Jones v. U.S., 463 U.S. 354, 369 (1983). The hospital may not deny you privileges because you refuse to take medication.

II. EXCEPTIONS TO INFORMED CONSENT

The law recognizes only two situations in which your informed consent to treatment is not required: incompetency and emergency.

Incompetency

When your physician believes that you do not understand the nature of your illness or the proposed treatment, she may conclude that you are not competent to make your own treatment decisions, and, therefore, that she may not legally treat you on the basis of your consent. The only consideration for competency should be whether or not you are able to make or communicate informed decisions. The physician's opinion must not be based upon her belief that you made a "bad" treatment decision. Rogers, 390 Mass. at 500.

Rogers Hearings

When a doctor believes you are incompetent, she may initiate a guardianship proceeding, popularly called a Rogershearing. Rogers, 390 Mass. at 497.

At this court proceeding you have the right to be represented by an attorney, and, if you cannot afford an attorney, the court will appoint one for you. M.G.L. c. 201 s. 6(c) The court shall authorize treatment with antipsychotic medication only if:

It finds you not capable of making informed decisions regarding medication; Rogers, 390 Mass. at 497.
by applying a substituted judgment test, it finds that you would accept the treatment if competent;Rogers, 390 Mass. at 500. and
it approves and authorizes a written antipsychotic treatment plan. Rogers, 390 Mass. at 504.

Probate Court Rogers and District Court Rogers

Probate Court Rogers hearings are commenced in probate court. The statute governing probate court Rogers guardianships does not establish a time period for the duration of the guardianship.M.G.L. c. 201 s. 6 The Supreme Judicial Court, however, has ruled that all probate court Rogers orders must provide for periodic review and include a termination date.Guardianship of Weedon, 409 Mass. 196 (1991). You may file a petition with the probate court at any time for termination of the guardianship.

District Court Rogers hearings are commenced in district court. They may be initiated only when you are hospitalized and the subject of a petition for commitment. The petition for guardianship with authority to administer antipsychotic drugs is separate from the commitment proceeding and the court may consider it only after the judge issues an order for your commitment. A district court guardianship expires at the end of your commitment. You may petition the court at any time for termination of the medical treatment authorization. M.G.L. c. 123 s. 9(b)

Emergency

Absent a court-ordered Rogers guardianship you may be medicated against your will in only two emergency situations: to prevent violence against yourself or others or to prevent irreversible medical damage to yourself.

Chemical Restraint

A physician may authorize the use of chemical restraint to prevent violence in an emergency situation "such as the occurrence of, or serious threat of, extreme violence, personal injury, or attempted suicide." M.G.L. c. 123 s. 21

Emergency Psychiatric Treatment

If your doctor believes that you have a serious mental illness, you are incompetent, and an "immediate, substantial, and irreversible deterioration" of your medical condition will occur unless you receive the medication, she may administer a single treatment of medication without your consent. However, this emergency treatment cannot continue without a judge's authorization.Rogers, 390 Mass. at 511-12.

III. HEALTH CARE PROXY

In 1990, Massachusetts enacted the Health Care Proxy law. The proxy allows you to choose, while competent, a trusted relative or friend to make medical treatment decisions for you if, and when, you are no longer competent to do so. The proxy only takes effect after your doctor determines that you lack the capacity to make decisions about your course of treatment.M.G.L. c. 201D A health care proxy may negate the need for future substituted judgment determinations by a court.

IV. WHAT TO DO IF YOU HAVE BEEN ILLEGALLY MEDICATED

If you believe that you have been illegally medicated while at a program or facility operated by DMH, contracted for by DMH, or licensed by DMH, ask to speak with the Human Rights Officer. You may also file a written complaint with the Person in Charge of the program or facility. You may give your complaint to any facility employee; he or she must forward it to the Person in Charge. If you are dissatisfied with the response of the Person in Charge and believe that additional fact-finding should occur, you have 10 days to request reconsideration. You also may file an appeal to a higher level up to 10 days after receiving a decision. In most cases, you have the right to a further appeal, which must be filed within 10 days of receiving the appeal decision. If you have questions about the complaint process, contact the Human Rights Officer or the Mental Health Legal Advisors Committee (1-800-342-9092).

Your rights under the community residence tenancy (CRT) law

YOUR RIGHTS UNDER THE

COMMUNITY RESIDENCE TENANCY LAW

WHAT DOES THE COMMUNITY RESIDENCE TENANCY (CRT) LAW DO?

The CRT law, Chapter 237 of the Acts of 2002: (1) clarifies who in Department of Mental Health (DMH) community housing is entitled to regular summary process eviction proceedings in court; and (2) establishes procedures which must be followed prior to removing those DMH clients who are not entitled to summary process.

WHO HAS A RIGHT TO THE EXISTING SUMMARY PROCESS?

A person has a right to summary process if he or she is a client living in a community residence operated by DMH, contracted for by DMH, or licensed by DMH and: (1) is a lawful housing occupant who is a client in a program of residential care and services; (2) receives from the program care and services in a housing unit equipped with a kitchen and bathroom; and (3) occupies the unit either alone or with the occupant's family, as defined in the regulations of the department.

WHO HAS A RIGHT TO THE NEW ADMINISTRATIVE DUE PROCESS

PROTECTIONS OF THE CRT LAW?

Every occupant in a community residence operated by DMH, contracted for by DMH, or licensed by DMH who does not qualify for summary process is entitled to the due process protections of the CRT law.

WHAT ARE THE NEW DUE PROCESS PROTECTIONS OF THE LAW?

The housing provider gives written notice to DMH and to the occupant of the proposed eviction, including reasons, facts and the sources of the facts; the right to a hearing and to be represented; and the occupant's right to look at his or her file.
DMH appoints an impartial hearing officer who then conducts a hearing between 4 and 10 days after DMH receives the notice (unless a later date is agreed upon). Each side may present evidence, examine adverse evidence, and examine and cross-examine witnesses.
The provider must prove, by a preponderance of the evidence, either that the occupant "has substantially violated an essential provision" of a written occupancy agreement or "is likely, in spite of reasonable accommodation, to impair the emotional or physical well-being of other occupants, program staff or neighbors."nce, which is within the scope of the reasons for eviction set forth in the notice give In making its case, the provider may only present eviden to the occupant.
The hearing officer issues a written decision based on the evidence, with findings of fact and legal conclusions. If there seems to be an appealable legal issue, the occupant or advocate should give the provider and the hearing officer notice of intent to appeal the matter to the Superior Court, ask for a stay, and find an attorney to handle the appeal. The provider may also appeal.
If the occupant loses and would otherwise be homeless, DMH must find appropriate housing in the least restrictive setting appropriate to the mental condition of the occupant.

Mental Health Legal Advisors Committee

294 Washington Street, Suite 320

Boston, MA 02108

(617) 338-2345

(800) 342-9092

Intake Hours: Monday & Wednesday 10:00 a.m. to 1:00 p.m.

Two Hats

http://madpride.org/twohats.html

Voter Education Project

The Voter Education Project

Who?

The Voter Education Project was comprised of a core group of consumers/survivors who were interested in developing a consumer/survivor voice in the political process. Through its members’ diverse perspectives and experiences, the Voter Education Project group reflects the challenges faced by a spectrum of consumers/survivors.

What?

Concerned with the absence of the consumer/survivor perspective, the Voter Education Project team strives to develop a powerful voice in the political process, and aimed to foster the development of individual members’ skill sets. The Voter Education Project worked to accomplish the aforementioned goals through evaluating the strengths and obstacles that consumers/survivors face in voting, identifying resources to overcome the obstacles, and developing an action plan that integrates consumer/survivors existing strengths and the identified resources.

When?

The Voter Education Project has been completed. The core group of consumers/survivors developed a curriculum guide, which was completed in the end of March 2003. While the curriculum was being developed, the Voter Education Project was focusing on relationship building and working toward the project kickoff events. Following the completion of the curriculum guide, the core group of consumers/survivors gave a series of presentations about the project. The project ran from 2003-2004.

M-POWER members encourage every one to register to vote. Here are some helpful resources to help you register.

http://www.sec.state.ma.us/

Email: election@sec.state.ma.us

and

www.wheredoivotema.com

Resources

Job listings

Jobs at The Transformation Center

Director of Operations

Under the supervision of the Executive Director, the Director of Operations (DO) is on-site daily and is responsible for oversight of the day-to-day operations of the Transformation Center. The DO supervises the Program Leaders of the Peer Specialist Certification Program, the Leadership Academy, WRAP Facilitation, Recovery Conversations for Providers, Empowered, R& S Initiative, Peer Facilitators, Recovery Network, and Statewide Youth Coordinator. The DO is responsible for ensuring that all contract/grant requirements are being met, monitoring the quality and quantity of work being done, and is responsible for orientation of all new staff and volunteers. The DO oversees the hiring/termination process, although all final hiring/termination decisions rest with the Executive Director. Requires rolling up your sleeves and a people-friendly, skill-building and inclusive approach.

ESSENTIAL RESPONSIBILITIES

Supervision of all Program Leaders;
Meet with each Program Leader one-on-one at least twice monthly to provide support and discuss issues specific to their programs;
Provide support/mentoring to all Program Leaders to ensure team empowerment and cohesiveness;
Work with Program Directors on matters related to staff retention, job descriptions, interviewing , and hiring recommendations;
Create and implement an employee/volunteer evaluation system;
Create and implement an orientation process for employees/volunteers;
Create and implement an employee/volunteer grievance process;
Create and implement an employee/volunteer termination process;
Recruit and interview applicants for job openings within the organization in order to refer final candidates to ED for hiring;
Ensure that all contract/grant requirements are being met including written reports;
Monitor quality and quantity of work and take necessary steps to ensure that both remain at satisfactory levels;
Oversee space management of Transformation Center and ensure that all staff have specified work space; and
Other tasks as may be assigned by the ED.

Demonstrated and proven leadership qualities;
Knowledge, skills, temperament and ability to train/mentor staff;
Knowledge, skills, and ability to create and implement personnel policies;
Strong organizational, administrative, communication, and interpersonal skills required;
Proficient computer skills with Internet and MS Office (Outlook, Word, Excel etc.);
Acceptance of a variety of lifestyles, behaviors, cultural, and spiritual practices.

Ability to frequently or occasionally lift between 10-50 lbs
Ability to use office equipment
Ability to drive a car

SALARY & BENEFITS

This is a full-time position requiring 40 hours per week with some flexibility in scheduling. Salary is in low to mid-forties, range based on experience. Full-time employees are eligible for medical, dental, life insurance and vacation and sick leave after successful completion of the introductory period of ninety (90) days.

EQUAL EMPLOYMENT OPPORTUNITY

The Transformation Center provides equal opportunity for all persons seeking employment without regard to race, age, color, religion, gender, marital status, sexual orientation, military status, national origin, disability, or any other characteristic as established by law.

RESPONSES

Send Resume and Cover Letter to:
Ann Stillman – Administrative Coordinator
M-POWER & The Transformation Center
98 Magazine Street Roxbury, MA 02119
617-442-4111; ann@m-power.org

updated 12/2007

Project Director

POSITION AVAILABLE: Project Director

LATINO PEER SUPPORT NETWORK PROJECT

SUMMARY OF POSITION:

MAJOR RESPONSIBILITIES:

This position requires a degree in human service or related field, and five or more years experience related to community organizing, public health, or mental health supports. An understanding of Massachusetts’ peer support networks and Latino culture is preferred. Bilingual, Spanish/English, and bicultural capabilities is a must. Personal lived experience of mental health recovery is preferred. This position requires strong project management skills and partnership building skills. Candidate must have demonstrated the ability to work both independently and well with others. Candidate must be able to effectively integrate work activities led by him/her with a variety of tasks managed by others. Candidate must drive and be able to travel to service locations across the state of Massachusetts. Essential skills for this position include the ability to work with diverse stakeholder groups, state agencies, and people of a variety of class backgrounds, manage contracts, develop and implement work plans, multi-task, and build internal and external relationships.

EQUAL EMPLOYMENT OPPORTUNITY

Send Resume and Cover Letter by 7/31/08 to:

Director of Operations,

98 Magazine Street Roxbury, MA 02119
ann@m-power.org

Jobs at various locations

Metro Suburban Recovery Learning Community

Peer Support Coordinator

Metro Suburban Recovery Learning Community
Peer Support Coordinator

Job Summary: The Peer Support Coordinator will be responsible for the development of peer support groups, recovery groups and one-to-one peer support activities. Additionally the Peer Support Coordinator will develop training programs for consumers/survivors who would like to provide peer support, recovery skill building, WRAP training and group facilitation. The Peer Support Coordinator will train consumers to provide trauma-informed peer support that is directed by the core values of the recovery movement and the mission of the Recovery Learning Community. He/she will provide continued support and supervision for group leaders and those providing 1:1 peer support.

Supervisory Relationships: The Peer Support Coordinator will be supervised by the Program Coordinator.

Employment Status: Regular four-fifths time (.8 FTE) employee.

Salary Range: Starting Salary ranging from $32,000-35,000 annualized.

Duties and Responsibilities:
Training
* Develop & compile training materials for recovery group facilitators, mutual support group facilitators & consumers providing 1:1 support.
* Recruit consumers to be trained to provide peer support.
* Schedule and conduct trainings on providing 1:1 peer support and on recovery group & mutual support group facilitation.
* Use own recovery story and teach others to use their recovery stories in their work.

Supervision
* Provide supervision, support & mentoring to hourly workers providing peer support.
* Supervise RLC’s Peer Support Worker.

Other Duties
* Provide peer trauma-informed peer support, information & referral to consumers calling or walking in to the Resource Connection Center.
* Facilitate support group for Peer Specialists & other Peer Workers working in traditional mental health settings in the Metro Suburban area.
* Assist with the Personal Wellness Recovery Planning Project and the Healthcare Access and Improvements initiative.

Qualifications:
* Experience as a mental health consumer/psychiatric survivor important.
* Extensive experience providing peer support.
* Prior experience facilitating groups.
* Must have training experience.
* Must be an excellent listener.
* Excellent written and verbal communication skills.
* Supervision experience necessary.
* Familiarity with core values of the recovery movement & trauma-informed care.
* Certification as Massachusetts Certified Peer Specialist preferred.
* Certification as a WRAP trainer (or be willing to begin training asap).
* Valid driver’s license and access to reliable transportation with ability to travel regionally.
* Ability to work as a team.
* Must have a strong commitment to the consumer movement.
* Ability to juggle several tasks at once.
* Creative problem solving skills a must.
* Sense of humor necessary.
* Being Bi-lingual/Bi-cultural a big plus.

Please send resume and cover letter to:
Metro Suburban RLC
460 Quincy Ave.
Quincy MA. 02169

For more information, please call (617) 472-3237

M-Power/The Transformation Center is an affirmative action equal opportunity employer.

The Metro Suburban Recovery Learning Community (RLC) is an exciting new project funded by the Department of Mental Health. The RLC’s goal is to develop a regional consumer/survivor community supporting consumers in mental health recovery. The RLC will collaborate with current peer-run organizations within the region & create additional peer-run activities. The RLC will offer information & referral, access to a variety of peer support & self-help activities, individual & systems advocacy and training opportunities. The RLC will stimulate and participate in culture change among mental health services which will focus on promoting resilience, self-determination, empowerment and wellness, rather than a narrow focus on symptom reduction. The Metro Suburban RLC’s office is located in Quincy.

posted 1/31/2008

Program Coordinator, Riverside Peer Support Program

gplante@riversidecc.org

The Western Mass Recovery Learning Community

The Western Mass RLC has ongoing volunteer and stipended opportunities for individuals interested in facilitating groups, workshops and trainings, etc! Contact the Western Mass RLC for more info.

And, be sure to check back in the fall when the Western Mass RLC anticipates posting the following positions:

Berkshire County Peer Worker (16 hrs)

Franklin County Peer Worker (16 hrs)

Deaf Supports Coordinator (10 hrs)

Contact info is:

Resource Connection Center

187 High Street, Ste 303

Holyoke, MA 01040

413-539-5941

866-641-2853

www.westernmassrlc.org

info@westernmassrlc.org

Web Resources: Links To Sites And Online Articles

Dual recovery support websites

Dual recovery supports for those with substance abuse issues in addition to mental illness

JoinTogether - Advancing effective alcohol and drug policy, prevention and treatment

Family support resources

Links to family support websites

General support resources

General support websites

Legal, protection, and mental health advocacy links

A collection of websites dealing with mental health advocacy, legal matters, and protection.

Recreational resources

Links to recreation related websites

Resources for senior citizens and elderly people with mental illness

links for senior citizens and elderly people

800-AGE-INFO: Resources for Massachusetts Elders & Persons with Disabilities

Vocational resources

Links to vocational services

Get Involved

MPOWER is growing:

MPOWER & The Transformation Center

98 Magazine St, Roxbury, MA 02119
617-442-4111
TTY: 617-442-9042
Toll-free: 877-769-7693 (Website under construction at www.transformation-center.org)

An Overview of Our Activities

(the Transformation Center website is still under construction)

Contact Us

M-POWER
98 Magazine Street
Roxbury MA 02119
(phone) 617-442-4111
(toll free) 877-769-7693
(fax) 617-442-4005
email us at info@m-power.org

Directions to M-POWER

Directions to M-POWER and the Transformation Center: 98 Magazine Street, Roxbury, MA 02119. 617-442-4111 or toll free 877-769-7693

On the T

98 Magazine Street is located close to the B.U. Medical Center and the Transitional Assistance Center at 1010 Massachusetts Avenue. The #5 and #10 buses stop at Magazine Street and also serve Andrew Sta., South Bay Center, B.U. Med. Ctr., Back Bay Sta. and connections to the Red, Green, Orange & Silver lines. The #8 bus stops at Magazine Street and also serves South Bay Ctr., B.U. Medical Ctr., Dudley Sta., Wentworth Inst., Longwood Med., Fenway Park and connections to the Red, Orange & Silver lines. All are wheelchair accessible.
If you are not sure where the Magazine Street Stop is, ask the bus driver. There is a UHAUL and the Liberty Diner on the right side of Mass Ave right before Magazine Street. Turn right on Magazine St and walk 1.5 blocks to the brown building on right. At our entrance there is a sign for Eliot Iron Works, Max Ultimate Foods and S&S Welding, M-POWER is inside the gate.

From the North

Take I-93 South to Exit 18, Mass. Avenue - Roxbury. At the set of lights at the end of the ramp, turn right, following the sign for Mass Ave. Immediately begin merging left, and turn left at the set of lights onto Massachusetts Avenue (Hampton Inn is on the other side of this intersection on the right side). You will pass UHAUL on your right; at the next set of lights (at a “T” shaped intersection) Magazine Street is on the right. Turn right at the lights onto Magazine Street, continue for 1 ½ blocks. M-POWER is at #98, on your right. Go through the large gate; we are on the left.

From the South

Take I-93 North to Exit 16 – Southampton Street/Andrew Square. At the first set of lights turn left onto Southampton. Proceed .6 miles to the third set of lights. You need to be in the LEFT LANE in order to bear left onto Massachusetts Avenue (at the sign with the McDonald’s arches). At the second set of lights (U-Haul and Liberty Diner will be on your right) turn RIGHT onto Magazine Street. M-POWER is 1.5 blocks down on the right (.1 miles). You will see a couple signs (Pinck Co. and M-POWER) on a black gate at the entrance to our parking lot.

From the West

Take the Mass Pike East (Rt. 90 East). As you near Boston, the Copley/Prudential Exit will be on you right in the tunnel. Continue on Mass Pike but get in the far left lane. Stay in this left lane and it will bring you/turn into to I93 South. Take I 93 South to Exit 18, Mass Avenue – Roxbury. Take a right at the light, following the sign for Mass Ave. Immediately begin merging left, and turn left at the set of lights onto Massachusetts Avenue (Hampton Inn is on the other side of this intersection on the right side). You will pass UHAUL on your right; at the next set of lights (at a “T” shaped intersection) Magazine Street is on the right. Turn right at the lights onto Magazine Street, continue for 1 ½ blocks. M-POWER is at #98, on your right. Go through the large gate; we are on the left.
*NOTE For All: The #98 is not that visible at our entrance; instead you will notice a couple signs at our entrance for Eliot Iron Works and Max Ultimate Foods. M-POWER is inside the gate.

Parking

M-POWER has parking for three to four cars near the entrance and two more around back, facing the brick building. M-POWER spaces are marked with M-POWER signs. If M-POWER spaces are used up you may use CQI spots that are also marked with signs around towards the back of the lot.

Welcome

MPOWER and the Transformation Center are becoming two separate organizations.

MPOWER will continue its grassroots action and will be funded by membership dues and donations. Call to join and get an update on our progress with bylaws and fundraising plan: a membership meeting will be held to discuss them. After June 2007 this website will become more focused on our continuing fight for rights, respect, and decent treatment. Stay tuned ! The Fresh Air Campaign and Emergency Room Rights legislative effort are unfolding now!

The Transformation Center is a peer-operated center that is spinning off from M-POWER to strengthen a mental health focus on wellness and life recovery. We currently offer training for Peer Specialist Certification, Leadership Academy, WRAP Facilitation, Recovery Conversations for Providers and more. Efforts will expand advocacy, resources & information, peer programs & evaluation, and policy input from people with lived experience of mental health conditions and/or addictions. Watch for the new website after June 2007 at Transformation-center.org. Visit our supporters now at mamhtransformation.org.

The Transformation Center works closely with Recovery Learning Communities (RLCs). RLCs will be funded in the future as local networks. They will offer training and support for peers working and volunteering to promote wellness and recovery close to home. RLCs will help you find out about resources, join support meetings, use and develop talents as a facilitator, get training, and be an advocate for mental health and addiction recovery.

Conference and scholarship information: From Innovation to Practice: The Promise and Challenge of Achieving Recovery

M-POWER AND THE TRANSFORMATION CENTER
PRESENT SCHOLARSHIPS FOR UPCOMING CONFERENCE!
We are offering a limited number of scholarships, from the Department of Mental Health, to Massachusetts residents with mental health recovery needs. Individuals must fill out a scholarship application and commit to sharing what they learned after the conference.
Applications are due March 19, 2008.

The Boston University Center for Psychiatric Rehabilitation in association with the World Association for Psychosocial Rehabilitation Presents:
From Innovation to Practice: The Promise and Challenge of Achieving Recovery for All

When: April 13^th, 14^th and 15^th^{Begins Sunday Evening and ends Tuesday afternoon}

Where: The Hyatt Regency Hotel in Cambridge, MA
Scholarships through the Transformation Center include registration, meal stipend, and overnight accommodations (for those outside of the Greater Boston)

To learn more and/or apply for a scholarship please call The Transformation Center at:
617-442-4111 (toll free 1-877-769-7693) ext 308 and ask for Sara
or
ask your local Recovery Learning Community for information and an application.

For more information about the conference itself, click here: http://www.bu.edu/cpr/conference/index.html
And be sure to look at the agenda by clicking here: http://www.bu.edu/cpr/conference/agenda/index.html

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Compliance Officer II

A testing page

Ad lib center

Bay Cove

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Events

Massachusetts Leadership Academy

First News Item

Jobs at the Edinburg Center

Just do It

Just Do It !

New Directions:

Consumer-Driven Mental

Health & Wellness Interpretation for the Deaf and Spanish Speakers Provided

Thursday June 15, 2006

The Best Western Plaza Hotel

and Trade Center

Please Register by 5pm Monday June 12th

9:30 to 10:30am

10:30 to 12:30

“The Role of Peer Specialists: Giving Voice to Mental Health Recovery”

12:30 to 1:30pm

1:30 to 2:30pm

3:00 – 4:00pm

Please provide this information to register:

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The Greater Lawrence Peer Counseling Project

"Sharing as Equals"

Benefits...

Project Description

Peer Counselors Recieve Training about:

The Greater Lawrence Peer Counseling Project

is sponsored by and based at

and is staffed by

Quotes from Peer Counseling Participants

Medicaid Reimbursement

Mind Freedom Calendar 2006 - 2007

MindFreedom

links and calendar of upcoming events

Nationwide Resources

Peer Specialist

Peer Specialist Program Coordinator

PT Peer Education Specialist

Recovery Learning Communities & Allied Orginizations

RECOVERY LEARNING COMMUNITIES ARE REGIONAL

WHAT DOES A RECOVERY LEARNING COMMUNITY DO?

WHO CAN USE THE RLC?

EVALUATING PROGRAM OUTCOMES

WHEN WILL RECOVERY LEARNING COMMUNITIES BE OPEN AND HOW CAN I GET INVOLVED?

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WHAT WE DO

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Informed Consent

INFORMED CONSENT RIGHTS

* Rogers Hearing

it finds you not capable of making informed decisions regarding medication;

by applying a substituted judgment test, it finds that you would accept the treatment if competent; and

it approves and authorizes a written anti-psychotic treatment plan.

From: Mental Health Legal Advisors Committee "YOUR RIGHTS REGARDING MEDICATION"

Sections

About Us

Legislation

Coalition for Fresh Air Rights (CFAR)

Dental Health Legislation - update

Emergency Room Rights Fact Sheet

Improving Conditions In Emergency Rooms

PLEASE CHECK BACK SOON FOR THE LATEST INFORMATION ON THIS IMPORTANT TOPIC, OR CONTACT CATHY LEVIN AT 617-442-4111 (TOLL FREE 877-769-7693) EXTENSION 360, OR VIA EMAIL AT:

News

Online Articles

Health & Wellness

Interpretation for the Deaf and Spanish Speakers Provided

Please Register by 5pm Monday June 12^th

Right to fresh air sought for patients
By Felicia Mello, Globe Correspondent | July 8, 2007

Metro Suburban Recovery Learning Community
Peer Support Coordinator