Jun15

Forgotten People — Never to Be Forgotten — A Series: Lesson #10

by admin-tca on June 15th, 2014 at 3:18 pm
Posted In: Uncategorized

People Need to set Their own Goals, not What Others set for Them

The first nine lessons were devoted to identifying the never-to-be-forgotten Forgotten People and the importance of developing relationships in order to provide opportunities for such people to succeed. The next lessons are devoted to describing how to take advantage of those opportunities. In an intentional community, such as Fountain House, one of the prime purposes of discovering who are the members of that community is to identify what it is that they would like to achieve, and to support their efforts in attaining those goals.

At the memorial service for John Beard in 1982, Michael put into words the role that having desirable goals can mean for any of us. He used the metaphor of the High Point Project (a Fountain House-owned 500 acre farm located near High Point State Park-the highest point in New Jersey) to say:  “I met Mark… in the Snack Bar a couple of months ago and we got to talking about High Point, and he referred to it as the Ultima Punta. Doesn’t that sound nice, Ultima Punta? It meant just what it sounds like, ultimate point. You can translate it as High Point. It can mean that – it’s not a bad translation. But more properly, Ultima Punta refers to the world of ideas and particularly, man, any man as high and as deep as he can go or become.“

Fred remembered me from when we were both at Westborough State Hospital. As a member of Boston’s Center Club, he spoke at a conference held at Jordan Hall in Boston. In response to a statement by Executive Director of Horizon House in Philadelphia that members there are told to either “get with” the program or they would be told to leave, Fred’s comment was …(given the choice) “to shape up or ship out, I will ship out every time.” He went on to say that at Center Club, he had never been given that charge, which is why he has stayed active there.

Soon after I meet someone I will ask something along the lines of “If you could choose whatever you want to do what comes to mind? It can be a job, school, social life, etc. It can be in say six months, a year or career-wise, whatever you wish.” The answers can be most informative, for example:

John B. thought for a moment and said that he wanted to go to school to be an accountant.

Jeff wanted to become a professional photographer.

Nielly stated her short-term goal was to return to college and get her degree.
Stephen G. said that in the long run he wanted to become a nurse, and for the short term he wanted to become proficient in American Sign Language in order to work with the deaf members of Fountain House.

Efua related that she had always wanted to have a career in Tourism and Hospitality.

Chris, after being discharged from Manhattan Psychiatric Center, stated: “I am presently seeking full-time work within the graphic design industry and plan on freelancing as an illustrator for greeting card companies and magazines. Future plans also include graduate work in Fine Arts and Illustration at either NYU or at Pratt Institute.”

Jill said after her pet dog died that what she wanted most to do was to be a dog walker.

It is plain to see that people’s goals are both varied and achievable. It is also clear that in most cases goals are job-related. The next lesson will begin to address the employment issue as relating to the never-to-be-forgotten Forgotten People.

This series is an abstraction from a larger writing, pending publication; therefore, any reference to (or quotation from) any of the series must be made with the expressed permission of the author. Requests may be directed to this E-mail address

tandcassociates@gmail.com

As always, readers’ comments and feedback are cordially welcome at the URL below, or at the same e-mail address listed.

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Nov17

Forgotten People — Never to Be Forgotten — A Series: Lesson #9

by admin-tca on November 17th, 2013 at 6:27 pm
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The Importance of Communicating to Others in their Terms

Zoltan was a survivor of the abortive 1956 Hungarian Revolution.  This young freedom fighter spoke no English and was perceived at the immigration point in New York City as suffering from schizophrenia.  He was sent to Westborough (MA) State Hospital where one of the doctors was Hungarian.  The doctor, however, whose specialty was treating patients with TB, refused to see Zoltan because he wasn’t a medical case.

Zoltan got into fights, primarily because, I believe, he could not understand a word of English, and therefore could not do what he was asked to do.  I first met Zoltan when I and a number of other attendants were called to the “back” ward where Zoltan was angrily faced off against anybody and everybody.  I was very impressed with the attendant who by tone and action calmed Zoltan down, treating him as a person, not a monster.

A short time later, he was transferred to my ward, a continuing treatment ward, and with his shy, wistful manner I took a liking to him. We played chess, a non-verbal interaction, and slowly I learned Hungarian words for the chess pieces; he, the English.  I also took him on passes for walks on the grounds, and he would try to teach me the words for “rock”, and “water”, etc.  He had a very nice smile, a wry gleam in his eyes, and, judging from the way he played chess, very bright.

As I was preparing to go back to college at the end of the summer, I arranged for a Hungarian exchange student from the International House in Boston to be brought in as an interpreter.  Zoltan was discharged within six months.  About a year later, I received a Christmas card from him, thanking me (in English) and letting me know that he was gainfully employed and moving ahead with his life.

The importance of how one communicates was further emphasized for me when, as an US Army enlisted man, I volunteered at the Army Education Center located at my post in Korea.  I helped prepare young men for their GED certificate exams.  Many of the students had not had much formal education, so it was imperative to develop ways to make subjects such as math relevant for them. Geometry became real when one of the students, who had a talent with the use of graph paper, was able to show how to find the difference in the areas of a rectangle versus a parallelogram having the same lengths in the four sides but of different shapes.  By drawing the two figures and then counting the graph squares contained in each, it became clear how the areas are different. Percentages became real, when students compared the differences in price for goods at the Post Exchange vs. stateside, and the amount of money saved in beer at the Enlisted Men’s club, compared to regular bars.

I applied this paradigm to my work at Fountain House, as I found ways for members to understand the purpose of being in the clubhouse by using their own terms.  In 1969, Fountain House was asked by the staff at Rockland State Hospital to provide openings for patients from their Deaf Unit.  The prospects of providing opportunities for this very special group excited us, but we were also very clear of the obstacles we had to address, especially the fact that not one of us knew American Sign Language (ASL).  Over the ensuing years, with the help of interpreters and by some of us (although not me) learning ASL a robust and successful project evolved.  We came to understand that in discussions about the core values and programs offered at the clubhouse, our language had to be expressed in terms that the deaf could easily understand.  By and large, translating these ideas into physical images, rather than metaphysical terms proved to be most successful.  On the other hand, we had to learn to translate their questions or comments expressed in physical images into language that were used to, in order to respond usefully.

Mark described how he came to understand the process by calling it a “Transformation.”
“ I credit my transformation to an awakening I had about how the clubhouse could work for me. I came to understand that to be transformed I had to go through the clubhouse process, where before I was trying to go around it. I had to do the work of the units, do the placements, take advantage of the housing and bond with my fellow members and the staff to become who I wanted to be, a strong and independent person in the world.”

This series is an abstraction from a larger writing, pending publication; therefore, any reference to (or quotation from) any of the series must be made with the expressed permission of the author. Requests can be made at

tandcassociates@gmail.com

As always, readers’ comments and feedback are cordially welcome at the URL below, or at the same e-mail address listed.

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Oct21

Monday Afternoon, September 9th — Meeting with the Administrator of State Adult Mental Health Division in Hawai’i

by admin-tca on October 21st, 2013 at 5:57 am
Posted In: Uncategorized

Prior to coming to Hawai’i, we had been appraised of the streamlined organization of the Adult Mental Health Division, as well as the relationship between community mental health centers and the clubhouses in the community. We also knew that currently 10 clubhouses – 5 of which are on the island of Oahu – are up and running on all 8 of the neighbor Hawaiian islands. Furthermore, 4 of the clubhouses have been certified by the Clubhouse International (formerly known as the International Clubhouse Community Development or ICCD). The other 6 are in the process of renewing (or undergoing initial) certification as clubhouses. In addition, Kathleen Rhoads Merriam, our consultation coordinator in Hawai’i, had updated us regarding: 1) The current stage of development of some clubhouses’ transitional employment programs; 2) The need for ongoing research; 3) The issues of reaching out to engage homeless mental health consumers; as well as 4) The impact of public transportation accessibility to clubhouses impacts attendance rates by members who do not drive or have cars.

As we mentioned awhile ago, we wanted to write separately about our meeting with Mark Fridovich, Ph.D., MPA, who is the Administrator of the Adult Mental Health Division for the State of Hawai’i.  On our consultation agenda, this meeting was scheduled for 2:00 pm on Monday, September 9th, lasting approximately one half-hour. We were introduced to his staff and Kathleen’s colleagues on our way into the meeting.  Mark wasted no time in opening up the discussion with the question:  “Why are you here and how may I be of help?”

With such a straightforward approach, we had no difficulty in laying out our goal:  To establish an ongoing consultation to promote continued development and expansion of the clubhouse model of psychosocial rehabilitation in Hawai’i.  We noted that we had just come from Waipahu Aloha Clubhouse, having been driven past 2 other of the 5 Oahu clubhouses , and were looking forward to seeing those located at Makaha and Diamond Head later in the week.  So in response to Mark’s offer of help, we stated we had heard that because of the lack of public transportation – i.e., buses – some of the outer clubhouses had issues of attendance.  We then related how clubhouses in New Jersey, for example, had initiated and expanded their own means of transporting members to the clubhouse before and after transitional employment placements.  This issue was dispatched as a non-item rather quickly.

Our discussions then turned to the relationship between the clubhouse and the psychiatric community, with the examples given about the “Rehabilitation Alliance” that was started at Fountain House in the ‘90’s.  This supportive engagement of the member, a helping partner of the member’s choice (whether a staff worker or other stable member) and the psychiatrist — at a storefront nearby the clubhouse — has proved to reduce psychiatric hospitalizations further.  It has also allowed for the collection of health related data by a general practitioner attached to the storefront, documenting the rates of co-morbidity among some 700 Fountain House members over time.  This part of the discussion caught Mark’s attention immediately.  He indicated interest in and support of both the “Rehabilitation Alliance” and such research were it to be established in the clubhouses in Hawai’i.

Before we knew it, our allotted half-hour with Dr. Fridovich had lasted over an hour, and we quickly concluded this cordial meeting with him.  We came away with the impression that the opportunity for innovative expansion of clubhouses services could be facilitated with the organizational set up of the Adult Mental Health Services in Hawai’i.   Further news of our first consultation in Hawai’i will describe our participation in a Clubhouse Coalition meeting, and not one but two presentations at the University of Hawai’i.

We at TCA welcome your comments and feedback at the URL below or at our e-mail address:

tandcassociates@gmail.com

We will edit contributions for brevity before posting them to start a dialogue, which we invite all to join.  Again, we wish to remind readers that any reference to or quotation from this website posting must be with the expressed permission of TandC Associates, which may be obtained through contacting us at the URL and e-mail address posted above.

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Oct01

Day 1 of TCA Consultation in Oahu – Monday, September 9th

by admin-tca on October 1st, 2013 at 11:41 am
Posted In: Uncategorized

We begin our first day of consultation, visiting Waipahu Aloha Clubhouse, where a huge banner signed by the members and staff welcomed us .

We were greeted warmly by many members and Kim Golis, Clubhouse Director, who introduced us to Sharon, a member who had made us leis, and our member tour guide, Cindy.  From the beginning of our tour, Cindy communicated her deep pride in her clubhouse as she took us through the program.  The Waipahu Aloha Clubhouse is located in a repurposed government building, consisting of two large rooms, with office space off to the right and rear of the main room, and a kitchen off the left large Dining Room. Waipahu Aloha Clubhouse has utilized this space very adroitly. Coming in the front door, the Reception Desk is “front and center,” and yes, the member greeted us enthusiastically and asked us to sign in!  To the right, the Clerical Unit occupies both the right wall and front corner, with members’ pictures cleverly hung on a wire with clothespins, showing off their membership — who was in or out, on TE placement, or in need of reach-out contact.

Further to the right through an open door is the Clerical Unit, where computers are set up for members to work on daily statistical reports, the newsletter and watching online news (or catching up on missed programs during breaks!).

Each corner of this main room is devoted to member units and their displays.  The back right corner leads to an exercise area, with a donation of equipment which we think is in keeping with Michelle Obama’s “Let’s Move!” health advocacy programs.

A small office with a window overlooking the exercise area along the hall has been designated for a Thrift Shop, which would open later in the day.  The Thrift Shop, operated by the members, provides more meaningful activity – sorting, washing, ironing, pricing and selling donated items.

In the left rear section of this main room, was O Grinds, a Snack Bar that is also operated by members, where everyone could get a cup of coffee or snack before lunch and heading out to TE (or coming in from TE after lunch).  More meaningful activities for and by the membership.

In the left corner next to the Snack Bar, the Education Unit members’ pictures were on display.  Cindy took great pride in pointing out that some of her peers were studying at the community college, as well as others who were working on their high school GED’s.  This strategic placement of the Education Unit members’ display next to Ono Grinds would subliminally remind other members of future goals whenever stopping by to grab a cup of coffee or healthy snack.

In the left front corner of the main room, pictures of members on TE were exhibited, and large banner proclaiming “CAREER DEVELOPMENT UNIT” caught our attention, very astutely placed where members would see their peers out at work in the community each day, while passing through the doorway to the Dining Room.

The Dining Room and Kitchen Unit are located in the other large room, on the left side of the main room.  On the day of our visit, in the airy, clean kitchen a staff member was assisted competently by the Kitchen Unit members in preparing lunch for 70+ members, staff and visitors, utilizing a 4-burner stove with one oven.  The L-shaped space has large refrigerators, stocked and rotated by members, and the stainless steel sinks and dishwasher for clean-up (not included in this photograph, unfortunately).  But three cheers were roundly sounded out for the Kitchen Unit crew on our tour!

At the end of our tour, we joined the Community Meeting that starts Waipahu’s mornings, and each unit reported out their goals and news of the day.  This day, in addition to our visit, Dr. James Westphal, Chief of Psychiatry at AMHD, Yara Sutton, AMHD Housing Service Coordinator, Steve Balcom, AMHD Crises Service Coordinator, as well as Dr. Carol E. Minn, Medical Director at Central Oahu CMHC — all would be joining the luncheon meeting at Waipahu Aloha Clubhouse.  Dr. Westphal made the outstanding announcement that budgetary approval had just come from the Governor’s office to fill AMHD staff vacancies, which was met with a great deal of applause by all members, staff and visitors.

We were then introduced by Kathleen Rhoads Merriam, who is warmly regarded by the membership.  We spoke briefly about the purpose of our visit – Presenting the Clubhouse (Past, Present and Future – at a forum to be held on Thursday, September 12th at the University of Hawai’i auditorium.  All were invited. (More about this presentation later.)

For lunch, Waipahu Aloha Clubhouse members and staff served Kailua pork (a traditional pulled pork and sautéed cabbage entrée) with Loma salmon (spicy salsa!), steamed rice, salad and a berry pie dessert, all of which had been prepared with Kim’s pitching in as Dining Room Hostess, Server and Moderator of the Meeting.  At Waipahu Aloha Clubhouse on this day, for example, Kim and one other staff were in the clubhouse, with two other staff out on placement or other business in the community.  The entire luncheon activity – shopping, food prep, setting up the Dining Room, setting the tables, serving, and clean-up that contributed to the smooth running of this special lunch meeting – could not have been done without every member’s participation.  True to the clubhouse model:  Members make the difference! And Kim demonstrated the “Generalist” role of clubhouse staff, especially the Director.

By this time, the Facilities Unit was beginning to clean up the Dining Room, and we went outdoors for a tour of the Horticulture Unit. Off the Dining Room, is a patio with a beautifully landscaped back yard maintained by the Horticulture Unit that happens to overlook Pearl Harbor.

It would be like having a clubhouse right down on Battery Park in New York City!  The blooming tree, many flowering shrubs and green ground cover show signs of the attention the Horticulture Unit members devote to their plant care.  One Horticulture Unit member spontaneously introduced himself.  He spoke feelingfully not only of the clubhouse and the meaning it has given his life, but also of how his work with the plants gives him a sense of purpose and calm. So apt!

The Waipahu Aloha Clubhouse is the happening place to be!!  As we prepared to leave, a group shot of the visitors, staff and members was taken on our way out the front door.

Mahalo, Waipahu Aloha Clubhouse community — Well done, you!!

With such a fulsome site visit at Waipahu Aloha Clubhouse, you might think it was enough to take in for one day… but wait, there’s more! Afterwards we had a very productive meeting with Mark Fridovich, Ph.D, MPA, Administrator of Adult Mental Health Division for the State of Hawai’i.  Be on the lookout for the next excerpt from TCA’s “Diary of Consultation in Hawai’i.”

We at TCA welcome your comments and feedback at the URL below or at our e-mail address:

tandcassociates@gmail.com

We will edit any comments for brevity before posting them to start a dialogue, which we invite all to join.  Again, we wish to remind readers that any reference to or quotation from this website posting must be with the expressed permission of TandC Associates, LLC which may be obtained through contacting us directly as mentioned above.

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Sep28

Diary from TandC Associates, LLC Consultation with Clubhouses in Oahu, September 2013

by admin-tca on September 28th, 2013 at 12:16 pm
Posted In: Uncategorized

The TCA partners have known Kathleen Rhoads Merriam since 1994, when she came to work at Fountain House as International Training Coordinator. Since her move to Hawai’i in 2003, Kathleen has advocated for development and expansion of the clubhouse model of Psychosocial Rehabilitation through her office in the Hawai’i Adult Mental Health Division – Department of Health. Through her strong ties to the Honolulu business community, Kathleen has been elected 2013-2014 President of the Honolulu Rotary. TCA contacted Kathleen last summer to offer our consultation services as we have heard that the clubhouse movement is alive and well there, and we were eager to offer any additional support needed. The timing could not have been better, Kathleen assured us: The Hawaiian Department of Mental Health had recently undergone a major reorganization, and the clubhouses attached to Community Mental Health Centers could benefit from hearing the clubhouse mission and model from the TCA partners.

Saturday, September 7th and Sunday, September 8th

Met by our hosts, Kathleen and Mark Merriam, and driven through Honolulu to the Eastern side of Oahu, to their home, where we spent the weekend getting caught up and reviewing Kathleen’s very intense schedule for the coming week.  Time for photographing their view of the mountain and the side of their property abutting the Ho’Omaluhia Botanical Gardens

View of Mountains on Eastern Side of Oahu

as well as driving around the island and stopping at four of the loveliest beaches imaginable, except for Diamond Head (to be seen later, we were promised).  We are trying not to sound like travel guides here, but the water was clear as aquamarine, with deep azure blue shades where the shelf dropped off steeply under the ocean. Sand was such a clean white, soft texture. The lack of air pollution made the sunshine radiate strongly against the sand and the blue sky, which could be cloudless one minute and full of puffy cumulous clouds the next. Not even the passing tropical showers dimmed the sky or lush flowers and vegetation for long.

 

(To be continued)

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