Hello Everyone ,
I am overdone with process! Endless meeting that consist of circular conversations, plan of actions , that leads to no action! Paid facilitators/consultants who come with “feel good” exercises designed I assume to break down barriers, but only add to the confusion. I am starting to feel like the guy in the commercial for Hanes socks . The one where the wife comes in the house, and the husband is sticking the kids feet in a pan of plaster of paris. The wife inquire “what are you doing” and the guys responds ” We can’t find socks that fit to our feet, and we are sick of it” The kid chimes in and says”sick of it”
I am sick and tired of engaging in processes that in my humble opinion do not fit the diversity that exist in Contra Costa County. This blog was created for others who may or may not share my views. Please feel free to post as often as you would like.
More Progress > Less Process 
In total agreement with you Brenda!
Mmmmmmmm…well…thank you for starting a conversation on this much experienced topic…if you work in the field of human services(mental health; social services;alcohol and drugs, etc) you know what is being talked about here…if you don’t work in these fields long story short it’s about meeting for a year (or many more) to decide what and how you will do something.
Initially it started out this way when we decided it was good to collaborate and not try to do something on our own–hey why invent the wheel again when someone else has expertise and more capacity than we do…well that was cool made sense…then it went to “wait a minute” many people are missing at the table…we need and should have more diversity…and then the power dynamics started who is going to have the most power here…uh lets process it so we can make sure everyone is heard (not a bad thing) but just cause you say something doesn’t mean I’m going to adjust my thinking, change my assumptions, became the bane of being heard…and then “oh lord” please don’t say anything about institutional racism, homophobia, class disparities, etc… and please don’t have an emotion connected to what you are saying, these meetings are for objectified conversations not feelings…
Tongue in cheek or cheek in tongue is what the above my sound like…and don’t get it twisted…I believe all that I have written so far…I will now share the meaning of what I have witnessed and have come to make meaning of, not all my personal beliefs but what I believe to exist…
1. Changing our communities is not always pretty work, sometimes it takes long hours, talking to people that for many if not for their job would never have given the time of day…Soooo many people are not too anxious to actually get started…thus an 18 month planning process.
2. Most institutions are governed by folks who do not look like the majority of folks receiving the services…how can they possibly be useful if the work is asking for “cultural specificity and nuanced strategies.” No one is telling me how I can still keep my job.
3. Process protects government systems…public funds are in play here…what you want is just not possible…humane treatment is not the goal…funds must be accounted for and this is the only way that we know how to do it…
4. Every time someone reminds us what we forgot to think about I feel stupid…and no way I am going to let you know I feel stupid…so I counter with something that doesn’t make sense…and that prolongs the process…
5. My personal and family life is hectic…you just don’t know or would never understand…that’s why I sit here in the meeting tired, disconnected or so anxious when I speak it sounds like an attack, I don’t participate in regular self-care, or how did this happen but my creative juices are on hold…I can’t take on another thing…uh let’s process…
–uh…it really is time for a conversation..the youth call it real talk.
Progress would be achieved if liberals wold re-register as Republicans and conservatives would re-register as Democrats at their Election Offices.
Nuff Said! Thank you my sister. I am not oppose to all processes just the ones that do not address the issues you identified in your post. Processes that are not framed in social justice. Processes where people at the table think it is OK to exclude consumers of services from the initial conveneing/steering committees. Mental health,AOD and consumers of homeless services are the experts in systems intergration! For many folks their lives are dependant upon developing creative ways of accessing these life affirming services on a daily basis. I agree that it is time for us to stop with the “process-speak” and engage in real talk.! Thanks, again for your post .
I agree Process has its place…and I believe we have gotten so much into process that getting something done that is tangible, meaning do the people in need experience a change in their lives gets lost…how can we respectfully say when we have fallen into the process black hole it’s time to just do it…if there are mistakes made then lets look at them as opportunities not failures. Process-speak needs more Progress-speak as part of the “process.”
Write on, Sista! You summed it up beautifully. I wasn’t sure why that commercial intrigued me, and now I know. . .
The county is a beauracratic mess. There are so many still suffering who need support and resources. Instead of taking care of business they (highly paid county personnel)would rather make sure that they follow a process. I guess that is ok since they (highly paid county personnel) get to go to bed at night and not worry about real life. There are hundreds of mentally ill people who will go to bed on the streets, who will be hungry and who will have no one to comfort them…………because “we must follow the process”. I dont see any progress in that…….do you? It took me a long time to figure out who they are. Anyone want to write to them let me know………I’ll give names and addresses where to write.
Some folks think that this blog was created as a way to be critical of the County mental health. That was and is not the intentions. This blog was developed for several reasons one, is to give those of us who are on the front line a vehicle to express the frustration, fear and sometimes the overwhelming sense of powerlessness that many of us experience on a daily basis! The new Behavioral Health Division is considering hiring a consulting firm that uses a model based on the twelve steps to integrate homeless , AOD and mental health services. I am still on the fence in terms of if I think this model will be effective in bringing about the kinds of relationships and changes that in my humble opinion can only occur when as my friend Colette Winlock posted people engage in “real talk”.
I have been to three meeting so far, and all I have heard is “process speak’ which is now starting to sound like mindless chatter and white noise! I have lived my life by the twelve step model for the last thirty years. On August 24, 2011 I celebrated thirty years of being clean and sober and I now have ten years of recovery from chronic and persistent depression.
I know the power of the twelve step model that is based on peer support and spiritual principles. These principles are designed to bring both mental and spiritual well being to the people who practice them. However, I was always told and believe that the first three steps are the foundation for the remaining nine. In my opinion if the first three steps are not address, them this model can be just another useless process, which leads to anger, resentment and silos becoming even stronger.
If indeed we are committed to using this model then I would suggest we should work the steps in the order that they are written and intended to be applied by Bill W. and Doctor Bob founders of AA and the twelve step movement.
Step one- I am not sure everyone who is sitting around the table believes that we are powerless and that the current system is unmanageable. If this has been publicly acknowledged by all who are a part of the integration process, I must have missed that meeting.
Step Two-Do we all believe that we have the power to integrate the systems, which all come with their own values, belief, cultures, myths and operating styles?
Step Three- If we do believe that we can integrate Behavioral Health in ways that provide consumer/family driven services based of resiliency and recovery then let’s make a decision to move forward engaging in “real talk”. Let’s make a decision that we will be empowered partners in change(first we need to define what that means for this group) and that we will employ the best scientific and tested theories on system change/ integration and that the process will be driven by F.A.C.T.S.—Families and Consumers True Stories.
Well done Brenda! I am delighted that you have taken the lead to host this discussion. The comments thus far reveal a powerful message. I look forward to contributing to the discussion and more importantly to learning about the perspectives of others.
In partnership,
Anna Roth
Thank you, Anna! I appreciate the partnership that exist between MHCC and CCCRMC.
I am the Executive of an Alaska Native non-profit organization operating both a behavioral health and primary care health system. We are currently working towards integrating both systems into a unified system modeled after work done by two entities: Cherokee Health Systems based in Knoxville, TN and the now discontinued Kaiser Permanente Department of Preventive Medicine in San Diego. We are using Lean Management practices for planning the integration. We are also looking at innovative and leading edge therapies to use. These are not always listed as best practice, and are frequently vilified by the mainstream health care providers. But they are proving of value to our clients and patients. Our Villages are being prepared for this change through education, engagement, Village discussion and analysis using the Community Readiness Model developed by the Tri-Ethnic Center at the Colorado State University. We also have processes and other organizations that provide hindrances, but since we have a dream of helping our Villages heal, we keep a positive problem solving approach. Our meetings are typically short and productive because we follow a scientific process. And we haven’t hired consultants to come in and muddy the waters. We are building a team that wants to do what we are doing and fits us. Good luck with advocating for change. We do need it.
Brenda, thank you for your leadership and courage to open up a public conversation about the need to “occupy process” in the public health system and beyond. This topic has been explored in many forums. The Vice Chair of the Contra Costa Mental Health Commission stated her desire to see more progress and less process in 2012 at our annual planning meeting. I believe Governor Brown and the legislature have invited us to explore process efficiency in order to benefit community progress. We must not shy away from difficult conversations. As our partner, Dave Kahler said at a recent meeting when someone mentioned an elephant in the room, “Why don’t we shoot it?” The process Emperor has had no clothes for a long time. You have bravely exposed the nakedness with all of its beauty and flaws.
As a partner with you and MHCC at the Contra Costa Regional Medical Center’s Behavioral Healthcare Partnership, we have witnessed how personal progress and system progress can occur in unity. We have succeeded by not giving up and not settling for anything less then a consumer/patient and family centered process. It has not always been pretty and there are times when we fall down. But we keep getting back up because people are dying and giving up is not an option.
You and I have sat at many tables together. We have seen good process and we have seen bad process. Some people have the ability to lead good process and others don’t. To have good process requires time and talent. It requires the ability to guide and direct others in a shared decision making partnership. It requires communication skills that are non-threatening and invite dissent. It requires the ability to let go and not control. Sometimes you need a little “process speak” to get to that safe place where progress can shine through. A few examples where I believe we have experienced this is in the Behavioral Healthcare Partnership, CPAW Planning meetings, at times, and I believe we had glimpses of it at the MHCC meeting with Senator De Saulnier. The trick is to make it happen more often.
For me personally to participate in good-shared decision making processes required improving my own awareness of others and recognizing that my needs and perspectives can’t dominate. I had to develop my ability to influence but not control. I had to use my observing ego to find grace and show respect. I had to depend on science and stories and let go of shame and blame. I had to stay or come back and not give up.
My personal process will be to continue to reveal my humanity, the good, the bad and the ugly. I will invite trust and expect transparency and shared power. I will hope to influence a culture shift that will allow others to change their own behavior by considering a higher purpose. I believe that we all have to make it about others rather then ourselves while giving special attention to the most vulnerable among us if we are to achieve progress.
How will we develop a shared understanding of process and progress? How will we know when we have a good process and how do you measure progress? Maybe we should consider a Contra Costa County Healthcare Quality Improvement Partnership. This partnership could embrace the values of system integration and transformation. We could utilize a continuous learning cycle, a Partnership Plan DO Study ACT/Abandon (PPDSA) process.
I believe that we must abandon the competitive and divisive processes that allow toxins to enter the room. We must abandon internal only processes where truth is hidden. We must abandon the status quo that protects bad process. We must abandon waste, overprocesseing and duplication. We must also abandon the fear to speak up.
I believe that we must adopt change and do change efficiently. We must adopt a transparent process that is consumer/patient/family/ centered that will promote primary, behavioral health and psychiatric system integration and transformation. We must adopt a true partnership, across all silos that will provide hope for the consumers/patients, the families and the staff who serve them both. This is my New Year’s wish.
“The fate of the World lies in the hands of the creatively maladjusted.” … The Rev. Dr. Martin Luther King, Jr.
“Human salvation lies in the hands of the creatively maladjusted.” … The Rev. Dr. Martin Luther King, Jr.
Thanks, to everyone for your insightful post on the new MHCC blog. Please spread the word and assure people that they can post without any identifiable information and that email addresses are never published.
It is my hope that this will be a venue for those of us who often don’t speak up at meeting (I am not one of those folks) and who are passionate and dedicated to ensuring the consumers of mental health, AOD and homeless services play key and vital roles in the new behavioral health department and in all areas of healthcare reform.
With all the integration, and reform that is occurring in behavioral and primary health I would hope that we can think outside of the “box” Just because we have been operating, in certain ways for many years is no reason not to challenge ourselves to bring our “A” game to the table.
It is limited thinking that will curtail our abilities to reach and achieve a revolutionary level of creativity that has the potential to have profound and life altering impacts on the lives of consumers and families.
I would challenge us to think of how we can provide new effective, peer /clinical supportive warm and welcoming permanent in-county residential services for people who are chronic and persistently mentally ill.
Is the Board and Care model the best we can do? Many provide only “board” and very little care!
One of MHCC staff had a conversation with a B/C employee recently around trying to work out a transportation issue that would allow a consumer to attend the Concord Wellness Center on a daily basis.
After several minutes of frustrating and highly emotional exchanges, the MHCC staff asked the employee “don’t you care”? The employee responded “I cook and clean for them, but I don’t get paid enough care”
When the consumer’s case manager was contact about the conversation and MHCC’s inability to work out a plan with the B/C that would allow the consumer to attend the center, and what she had said about not getting paid to care, the case manager responded that this was one of the better facility that the county used to place people!
It is a common practice for B/C operators who house mental health consumers to lock people out between the hours 8AM-4PM daily in essence we have MH consumers in this county who are homeless during the day because the operators claim they are not paid enough to have staff coverage twenty four hour seven days per week !Several B/C put padlocks on the refrigerators, claiming that folks steal food and they can’t afford the replacement cost .While others primarily serve process or fast food for dinner on a regular basis. It is also common practices for many B/C employees to infantilized, and speak to consumers in disrespectful and sometimes abuses ways. Often there are language barriers that prevent consumers from effectively communication with the care provider because of their limited skills and proficiency in English.
If this is the best that we can do then we need to abandon words like, recovery, resiliency transformational, client and family driven/centered care. Instead replace them with words like warehousing and institutionalizing!
However, I know that the current system does not reflect our best. I had a conversation with my 80+ year old mother (she told me to stop telling people her age) recently. I was complaining about all the things in the system that I consider unjust and sometimes inhumane . My mother asked me a simple question, where is your faith? I told her I did not know, and I had to think about that question. After the conversation with my mom was over I thought have I lost faith in our abilities to transformed the system in ways that adds value, wellness, recovery and self sufficiency to consumers and families lives and does not rob people of their dignity and respect?
After thinking about it the answer is NO, I still have faith! Despite all of the system dysfunction, serious life threaten issues that family members, providers and consumers are confronted with on a daily basis I still believe that we are all people who have good intentions. That we all want a system where any door that people come in leads to the doors and rooms that will provide quality treatment and recovery services for all the people we serve and love!
Regarding the use of slang names in meetings or in print: Traditionally, African-Americans call themselves Niggers, but no one else should. The GLTB community calls themselves Queers, but no one else should. So do persons diagnosed with a mental illness call themselves Crazy, Mad or Nuts, but no one else should.
Ralph,
Get a Grip! Let me take you to lunch.
Brenda
Brenda: Would you like to eat soul food or weinerschnitzel? Ralph
The consumers at MHCC- WCWRC are the bomb! Srenthtastic!
The California Network of Mental Health Clients (CNMHC)
funding was suspended by the California Department of Mental of Health on Friday . This is the second large funding source that pulled the plug! A state-wide civil and human rights organization that was founded by a group of mental health consumers over twenty years ago has in essence died!
I am incredibly sadden by this occurrence however , what pains and concerns me more than the demise of the organization are the low expectations, reporting and service goals that were tolerated by the funders for years These low expectations allowed crisis, turmoil and upheavals to be tolerate in silence without any manadated corrective action plan.
I was elected to the board of directors of CNMHC last year by a group of my peers but was never officially seated. I along with others who were elected and never seated were forced to sit by without any power to influence change or provide intervention while the organization spiraled completely out of control!
I am not sure why the State and Feds who provided the majority of the financial support failed to hold CNMHC accountable or maintain standards of operations that none mental health consumer run organizations must maintain as a matter of course before it all came crashing down?
Is it that the State,County and Federal folks think because we are mental health consumers that chaos,dysfunctional management structures and constant state of confusion are viewed as cultural characteristics of our organizations, that mirrors our diseases?
Having a mental health diagnoses is not an excuse for poor job performance.Low expectations and enabling behavior by funders and other supporters are forms of organizational involuntary commitments,force restraints and seclusion!
Mental Health Consumers in recovery are amazingly strong and resilience group of people and we shall come back from this devastating blow! Consumers in the State of California will rebuild an organization that is powerful, strong,well managed,outcome based and framed in social justice principles!
Everyone knows that the way the Redwood forrest regenerates is through fire. As the old trees burn they drop seeds to the forrest floor which gives birth to new strong trees.Through the rain and the fire we will rise! As an old Holly Near song states “we are easy gentle people who are fighting for our lives”