Hi

Friday August 17^th the Santa Clara County Mental Health Department held an Educational Retreat for senior managers and ‘stakeholders’. Approximately 20 participated, and approximately 21 activists which includes 14 members of the Accountability Caucus and 9 Silicon Valley clients (unduplicated client total 20) and one psychologist, Philip Cushman of C.S.P.P.-Alameda, facilitated this event. Related info is online — the program for the day is linked.

This was an effort to change the dialogue structure between clients and providers. We wanted to go past the adversarial logic of the patients rights agenda and introduce a ‘new tradition’ of dialogical interaction —and we did. Philip spoke to the question of dialogue, the County patients rights advocate Alison Brunner spoke to the discriminatory nature of behavior management as treatment, and Mental Health Director Nancy Pena spoke to reorganizing the system in order to construct a better moral interface with the clients. Aside from this, all the presenters were veteran client activists and — without exception — all presented from the heart and most effectively.

The soul of the event was in the 2×2 groups, which proved to be a format that enabled direct, meaningful, and personal conversations between facilitators and participants. We did four sets of these on a 45-minute basis, and they pulled the day together. One of the facilitators described the experience thus:

Because this is not a clinical setting, each small group is able to discuss the issue at hand in a peer to peer manner. This creates a completely different dynamic from the normal client to staff interaction.

The intimate setting at the Los Gatos Lodge and the absence of an organized feedback system produced an air of reflection and seriousness of purpose. Our correspondent continues:

Perhaps the most pleasant part of the “2 on 2” sessions is that we were not expected to report back to the main assembly afterward; there was nobody there with a board taking down notes. Nice!

The core discussion was organized around four modules which as a unity were meant to develop the implications of looking at the mental health reorganization issue morally and thence to develop the ground of dialogue around ‘trauma of treatment’. It is fair to say that the clients entertained their role in the situation as ‘treating’ the system — that is, pursuing a targeted reform process aimed at upgrading the operant helping agenda. Nancy formulated this in the language of imposing a union recognition model where independent client organizing would operate in negotiated relation to the provider system. The new Santa Clara client network MHCSCC also raised its voice to the concern for this task.

The high caliber of the facilitators who were drawn from veterans both around the state and also locally was especially uplifting. Despite the gravity of the issue of ‘trauma of treatment’ there was very little rage displayed and there was a great deal of Vision, insight, and love brought forward. Even though I was the consultant who brought this approach to term, I have to say that the contributions of the facilitators and the good dispositions of the participants were a surprise — exceeding my expectations — as much as they were a joy to behold.

In the broader scope of things, this is not an end but a beginning. We presented a sketchy introduction to where we hope to go: We need to do short-term ‘spread the word’ workshops and we need to develop long-term ‘appropriate re-organization’ agendas. And one does not have to go far to notice that there are conservative forces ‘out there’ firmly in place, running the gamut from HCFA requirements to the rage-driven disorganization of the clients. Nonetheless I hope and believe that the old-time agenda of mental patients taking responsibility can and will ultimately engender a transformative process that brings the dialogical structure of human interaction to the fore and changes the way society relates to madness.

Respectfully

Andrew Phelps