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Peer-Run Crisis Alternatives: Warm Lines, Respites, Wellness Centers, Community Response Teams, and PAD’s - Shared screen with speaker view
Mia Mantri
15:11
I'm from Durham in the north-east of England. I've spoken to Rebecca & Eamonn in Soteria meetings.
Francesca Simpson
15:19
Thanks, Chere!
Cheren Caraco
15:45
good morning, Carolyn
Felix Ullrich
15:47
Felix Ullrich, Cherrry Hill/Delran nj
Cheren Caraco
15:56
Hi Felix :)
Paulissa Kipp
16:02
Hello from sunny Omaha, NE
Cheren Caraco
16:11
Welcome, Paulissa
Cheren Caraco
16:33
Hi Mia
Rachel Robinson
16:45
Where will the webinar about warm lines and respite will be offered? Looking for repite for niece.
Eamonn
16:55
Hi Mia
Cheren Caraco
17:25
Rachel, they are all posted on the Family Café TA website
Dean Clickner
17:41
Dean Clickner, Director, Warren Washington Rose House/People USA, Glens Falls, NY
Cheren Caraco
17:47
Hi Dean
Cheren Caraco
17:59
Rose House in the house
yulia mikhailova
18:24
Hi everyone, Yulia from New Mexico Tech. Happy to be here on time, finally
Dean Clickner
18:28
We are People people!
Cheren Caraco
18:39
Hi Yulia, welcome back
Rachel Robinson
18:55
Cannot see anyone waving.
Jacek (Jack) Haciak
19:26
Rachel, look in the archives of this series re: respites.
Francesca Simpson
19:43
In BC, psychiatric patients are specifically excluded from the Representaton Agreement Act, the legislation which allows Advance Directives.
yulia mikhailova
22:22
So sorry, for some reason I could not mute myself when there was an interruption
Francesca Simpson
23:14
BC likely has the most regressive, draconian legislation in North America.
Rachel Robinson
23:27
What archives? Where willi
Jacek (Jack) Haciak
24:13
Began supporting individuals using PADs in Oregon in 1993 when they were officially adopted here.
Jeremy - CAFE TAC
24:15
Rachel, all of the recordings are on our website at cafetacenter.net
Rachel Robinson
24:19
Where will I look? I'm new here. This is my first on here.
Rachel Robinson
24:41
Thank you
Jeremy - CAFE TAC
25:17
it's the second article when you scroll down our homepage
Jacek (Jack) Haciak
25:17
Welcome, Rachel.
Anne Turner
25:59
Morning Hi it is Anne from Nanaimo, B.C. Sorry to be late.
Francesca Simpson
26:39
Hi, Anne!
Stan Rossowski
26:50
You will find links to the recordings at https://cafetacenter.net/a-webinar-and-learning-community-series-on-peer-run-crisis-alternatives/
Jeremy - CAFE TAC
27:25
Thanks Stan! I couldn't go get the link myself while running the Zoom.
Jeremy - CAFE TAC
29:42
www.nrc-pad.org
Francesca Simpson
31:19
When they're psychotic?
Dean Clickner
31:41
In shock
Jacek (Jack) Haciak
31:53
Note well: "Capacity" is not the same as "competency." Important difference.
Paulissa Kipp
32:06
When my executive functioning is gone with chronic pain
Francesca Simpson
32:26
Jack, do you have a definition for "competency"?
Mia Mantri
33:06
In the UK we have what is known as a Health Passport, I think it's more for physical health like if someone is admitted to the ER. I've been thinking of getting one to explain what my needs are if that ever happens to me. But I have been invalidated and ridiculed by a lot of people so am anxious about it. I don't know if there are people who'd be able to help me with that.
Francesca Simpson
34:49
Great, clear explanation, thanks.
Jeremy - CAFE TAC
35:14
That is interesting Mia. In the US there are medical advance directives for physical health too.
Jeremy - CAFE TAC
35:48
Medical advance directives have been around for much longer than psychiatric advance directives.
Francesca Simpson
36:21
Could one have a PAD that declines treatment?
Francesca Simpson
36:38
I mean, generally.
Francesca Simpson
37:13
Same here, Cherene.
Rachel Robinson
37:38
What is ECT?
Jeremy - CAFE TAC
37:50
Electro-Convulsive Therapy
Francesca Simpson
37:57
They didn't' honour my request for meal replacement. When I'm manic, I can't eat solid food.
Francesca Simpson
38:13
electroconvulsive "therapy"
Jacek (Jack) Haciak
39:11
PAD = Self-determination via our chosen proxy.
Rachel Robinson
40:51
Thank you
sam plover
41:07
If I can refuse being examined by a physician, can I refuse being "examined" by a shrink?
Michele Koppinger
49:23
...the things that are NOT "standards of care" are industry standards and not with concern for individuals' physical/biological/psychological baseline and, therefore, their standards are not necessarily in your best internet, often do not actually heal, and are often variations of harm/violence.
Francesca Simpson
49:45
Michele, I agree.
CAROLYN GREEN
49:48
Have to leave early. Great information! Thank you. Carolyn ❤️
Jeremy - CAFE TAC
50:17
Yes, Michele, I think the challenge would be to explain that with specificity in the PAD
Michele Koppinger
50:24
Internet = Interest * (typo)thanks auto correct 🥴
Stan Rossowski
52:01
From the Bazelon Centre: http://www.bazelon.org/wp-content/uploads/2017/04/PAD-Template.pdf and from SAMSHA: https://www.samhsa.gov/sites/default/files/a_practical_guide_to_psychiatric_advance_directives.pdf
Michele Koppinger
55:51
The insurance industry often sets this tone. Unless a doctor is willing to Bill (invoice) outside the insurance ministry nothing will charge unless consumers can afford out of pocket for alternative health practitioners and orthomolecular/functional medicine doctors that are willing to NOT play in the insurance industries sandbox. Then, the consumer would have to pay out of pocket, and have enough wealth to do that. Of course, pHARMa also sets tone of all above but pHARMa topic is another chapter for another day.
Michele Koppinger
56:17
charge = change *
Jacek (Jack) Haciak
57:08
Any time these activities become anchored in legal definitions, then common sense and medical definitions get put in second place importance. Just like how "mental illness" in statutes do not necessarily correspond with "mental illness" clinical or commonly used terms.
sam plover
57:11
not if they work for psychiatry
Stan Rossowski
59:08
Psychiatric Advance Directives and the Right to Refuse Treatment in Canada: https://journals.sagepub.com/doi/10.1177/070674370705200610. Greetings, fellow Canucks:) We've got a lot of work to do here!
Francesca Simpson
59:11
I'm so sorry but I have to leave very soon. Thank you for these wonderful webinars.
Jeremy - CAFE TAC
59:30
Our pleasure!
Michele Koppinger
59:36
(ugh) from my previous comment: insurance ministry should be insurance industry *pardon me
Francesca Simpson
01:00:10
Stan, that link is dead.
Jeremy - CAFE TAC
01:01:06
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2793222?fbclid=IwAR3ueUw-Ptqp8ebswK5OyUsTRbGbszxcxfJy0R1RUFUEphvPpRV-BBASwqE
Stan Rossowski
01:03:13
Francesca, it works for me. This one should take you straight to the PDF: https://journals.sagepub.com/doi/pdf/10.1177/070674370705200610
Jacek (Jack) Haciak
01:05:39
I have found that PADs are responsibly implemented more often in rural settings where there can be more personal relationships among providers, supporters, and community members. No guarantee, and some rural settings can invite even greater stigma at times, but on average I have found that when the relationships are positively developed, the PADs are adhered to more often. Much more likely in large urban settings with multiple hospitals and less personal relationships.
WILLAMETT DELOIS ENNIS BARNETT
01:05:53
Thank you
Jacek (Jack) Haciak
01:06:46
much more likely THAN in large urban settings. Sorry.
John Ferrone
01:06:54
Have you seen people integrate their PAD with their WRAP in any way? Also, as a person's recovery journey evolves, do you have tips or guidance as to when to review it for accuracy?
Stan Rossowski
01:07:59
It's always about the relationships.🤝 ❤️
Jacek (Jack) Haciak
01:09:11
Exactly, Stan. Trust and relationship.
Jim Gottstein
01:11:02
North Carolina's law seems to have particularly weak protection compared to other states I know about. Thus, I don't know about this for North Carolina, but my experience is being a substitute decision maker is more likely to be successful than being the person's attorney.
Jim Gottstein
01:12:49
Because the number one reason I have seen for ignoring PADs I recommend having someone sign the PAD that the person is competent or has capacity. The higher ranking letters after their name, the better.
Jacek (Jack) Haciak
01:13:04
Most medical providers I have met know that there is no consistent legal precedent across regions of the country to protect a physician who honors a PAD, but then gets sued when a practice standard was ignored and the "patient" experienced severe changes or medical decline. So, they are very wary about honoring a PAD when the terms are more unique.
Jim Gottstein
01:13:47
The question is whether you had capacity when you signed it.
Jim Gottstein
01:13:56
No guarantees.
Yoshiko Miwa
01:14:32
I am Japanese and living in Japan. On my job as a journalist, I have been covering some involuntary hospitalization cases related to heritage disputes. Someone in family easily make other one inpatient because of fictional psychiatric symptoms. I read a report about these problems about 50 years ago when I was a child. I am sad I have to report similar cases half a century later.
Yoshiko Miwa
01:15:30
Terrible!
sam plover
01:15:57
also shows you how not clever the mh people are
Jacek (Jack) Haciak
01:17:19
The point I made about a physician getting sued when a PAD was honored but the "patient" experienced a serious/dangerous event afterward, have become important when a family member sued the physician believing the physician irresponsibly ignored standard practices.
yulia mikhailova
01:18:52
I wonder if we can create a database of such cases as this person hospitalized by roommate? I heard about cases of domestic abuse, when people call about the alleged mental crisis their partner is having for the purpose of retaliation. It would be good to publicize such cases to raise awareness about how problematic the current laws are
Mary Ann Widenhouse
01:18:52
How can children/adolescents/teens create a document? I have a grandchild with ongoing mh issues and I know it would be helpful. When she was hospitalized recently, under IVC, her mother tried to advocate for certain things but it took a Dr's order for anything the mother knew would be helpful for her daughter.
Jacek (Jack) Haciak
01:19:14
Court findings re: PADs are all over the map across the country.
Michele Koppinger
01:20:30
They (docs/psychs) actually don't have to follow these legal papers and speaker just gave case example. Medical can err on medical judgment and they have that protected medical liberty, even if wrong, causes injury and made in good faith. Also, an injured patient is more lucrative to the system than a healed one.
Michele Koppinger
01:21:01
I don't like it but is what it is.
yulia mikhailova
01:23:00
Cheren, this is the root at the issue. This is a legal discrimination on the basis of a medical diagnosis. What about framing this as a case of systemic discrimination and fight the underlying laws as unconstitutional? Also. it appears that campaigning against the laws making MH professional liable for not committing someone, but not liable for any bad things that happen after, or in the course, of treatment
Michele Koppinger
01:23:19
There is DEFINITELY an assumption of incapacity pertaining real or perceived mental health issues, indeed.
sam plover
01:23:22
that is why i'm surprised that MH industry allows a pad, it is basically assumed that competency is lacking
Jacek (Jack) Haciak
01:23:34
Psychiatric advance directives are subject to the same limitations as the concept of "mental illness" treatment because "mental health" is far different than physical illness/health in the "medical model." The concept of "mental illness" does not conform to the medical model.
sam plover
01:25:53
along with pads perhaps we should struggle and approach governments to have crisis centers that are totally free of "clinicians"
Jacek (Jack) Haciak
01:26:52
The challenge is how to define shared decision making in legal terms to protect everyone involved.
Yoshiko Miwa
01:27:16
I feel PAD like guns in the US. Once some people have tools of force against others, the people addicted to the tools, I think. The PAD and involuntary treatment addiction should be treated :-)
Mary Ann Widenhouse
01:27:23
There are those with IDD issues that may well be in a position to need a PAD. So how does that affect the use of a PAD?
Michele Koppinger
01:27:34
Medical/Psychs - and others - do go into a mind controlled trance and are seemingly unable to think out of the box surrounding their perceptions and limited understandings of patient competencies. I guess the legal definition wins and everyone else loses ?
Jacek (Jack) Haciak
01:28:52
I am "autistic," and I have a PAD. Never used it, but I don't see how the diagnosis would be different than my diagnosis of Schizophrenia or PTSD.
Mary Ann Widenhouse
01:29:15
Not just autism, but all across the IDD spectrum
Yoshiko Miwa
01:29:19
I agree to Michele. The US did not ratified UN CRPD, so no international legal force can affect.
Mary Ann Widenhouse
01:30:31
So if the mother develops a PAD for her child/teen, is that a legal document that has to be followed?
Mia Mantri
01:30:38
Children should have the right to make one imo. I think children should have more rights in general.
John Ferrone
01:34:29
or... regarding requests... language that simply empowers. Such as: "No medication may be administered without my consent, or the consent of my advocate". Is that possible?
Michele Koppinger
01:34:33
((( Not all things LEGAL are ethical, moral, for the good or betterment of others, etc. and are often in place to protect those driven by greed like industry giants ))) Meaning, closer to home, some doctors (and others) are blinded by fears of legal repercussion and not driven by common sense or what's actually in best interest of patient. Darn those standards of "care"!...me, preaching to the choir with this group, howeverthank you
Mary Ann Widenhouse
01:37:35
I have heard from those providing services here how helpful it is to have an already developed crisis plan in the record they can refer to in these incidences.
Jacek (Jack) Haciak
01:38:32
Same here, Mary Ann.
Stan Rossowski
01:39:08
It might be helpful to filter this through the Power Threat Meaning Framework lens: https://www.bps.org.uk/power-threat-meaning-framework. Power begets violence begets trauma. The greater the power the greater the violence the greater the trauma. Who holds the power? Hint, follow the money.
yulia mikhailova
01:40:17
Is there any reference or link to the statistics of Black men being overdiagnozed? I am trying to change MH policies in my school, and for this purpose, I am trying to get it inserted into the DEI initiatives. This statistics about racial disparities will help greatly
Michele Koppinger
01:42:50
thanks Stan
Jacek (Jack) Haciak
01:42:51
This has been a wonderful presentation. You covered so many aspects of PADs and their use. Very helpful. Thank you.
yulia mikhailova
01:43:05
Thank you. I have some questions
Rebecca Nichol
01:43:14
Thank you, very interesting
Cheren Caraco
01:43:28
my email: ccaraco@promiseresourcenetwork.org
yulia mikhailova
01:43:36
Thank you, Cherene and Jeremy, it was great
Stan Rossowski
01:44:06
Thank you Cherene and Jeremy for another great presentation. Once more, I feel enlightened and inspired.
Mia Mantri
01:44:12
I e-mailed you yesterday Cherine. Sorry it was a bit long and intense.
Michele Koppinger
01:44:13
Thank you so much for this offering and the comments that allow us to sound of.Love your offerings!!!!!have a lovely day
sam plover
01:44:13
thanks Jeremy and Cherene
Yoshiko Miwa
01:44:22
Thank you this series. Good night from Tokyo
Mia Mantri
01:44:48
I struggle being heard so I find it hard to say what I need to in a concise way sometimes.
Rebecca Nichol
01:44:58
Thank you and good evening from the UK
Michele Koppinger
01:45:01
🤍