State of Oregon pays $2 mil to ask, "How do we fix psychiatric institution culture?"

Fly Back to the Cuckoo's Nest with Justice

The statewide alliance Oregon Consumer/Survivor Coalition came up with a slogan, based on the title of that famous movie that was filmed inside Oregon State Hospital.

"Fly Back To the Cuckoo's Nest.... with Justice."

We had both advocates and inmates from Oregon State Hospital present meet with us.

But a challenge is that "ZERO" number. Above is a photo from three years ago, when Oregon's Governor Ted Kulongoski promised to support the voice of consumer/survivors. He did not.

But somehow Governor Kulongoski has now found $2 million rattling around, to hire a consulting firm - Kaufman Global of Indianapolis - to analyze the 'culture' at OSH.

Hey could it be the word:

    DISEMPOWERMENT?

Below is my own e-mail on behalf of MindFreedom to Kaufman Global on this topic. At the BOTTOM is a news article about the $2 million dollar payment.

I'd encourage everyone to quickly write a civil but strong message to Mr. Clark as soon as possible. Try to include some specific points based on your experience. Ask that the voice of consumer/survivors be truly included.

His e-mail address is:

    gclark@kaufmanglobal.com

~~~~~~~~~~~~


9 December 2010

To:
        George Clark, Kaufman Global -- gclark@kaufmanglobal.com

From:

        David W. Oaks, Director, MindFreedom International

Re:

        Inclusion of organized state-wide consumer/survivor voice about OSH

Thanks for your asking about my perspective about your work on Oregon State Hospital culture. I understand the State of Oregon has contracted with your organization -- Kaufman Global -- to try to quickly find out what is wrong, and what can be improved, about the culture of Oregon State Hospital.

I understand you have already lined up 500 interviews about this, but you have not heard about the issue of including organized state-wide voices of Oregon's mental health consumers and psychiatric survivors.

I'll keep this brief, because I have one main point:

    "Why zero?"

Let me explain:

There is an emergency need to include the organize state-wide voice of Oregon's mental health consumers and psychiatric survivors.

But there is zero support in the State of Oregon for that state-wide voice.

The social change movement led by former mental health clients has been going on continuously for 40 years. In fact, Oregon had one of the first such groups back in 1970.

Since the mid-1980's, federal and state funding has supported -- to a limited extent -- the principle that the empowerment of the mental health client was related to their long-term recovery.

At that time, Oregon appeared to be out in front.

Up to eight years ago, Oregon had least had some very basic support to hear from the key stakeholders -- those who actually use mental health services.

This included an office for mental health consumer technical assistance, with training and mini-grants to support small group efforts. Each year there was at least an annual conference of several hundred mental health clients for training and awards. Each summer there was also a training retreat on the Oregon coast.

It wasn't a lot. But at least Oregon was like most USA states, which tend to have something to help amplify the marginalized voice of one of the most discriminated-against constituencies, those diagnosed with serious psychiatric disorders.

I should say that I was largely out of this sector. For the past 34 years I've been a community organizing for a small part of this social change movement that is independently funded, through memberships, grants, sales, etc. For 24 years I've led one of the main independent groups, MindFreedom International. We have a policy of not having government or mental health system funding, so that we can help provide an independent voice.

What I've witnessed happen in Oregon, is that the tiny amount of infrastructure for the state-wide voice of mental health consumers was 100 percent wiped out eight years ago, largely by the legislature. My understanding is that Gov. Kitzhaber personally and passionately supported that voice, because of his experience (he had done a medical rotation as a young physician in a state institution, and never forgot the horrifying abuse).

For whatever reason, 100 percent of all funding for the state-wide voice of Oregon's mental health consumers was zeroed out 8 years ago.

As I said, the nonprofit I direct is independent, and we are not impacted. But it was such a sad day to see the rally of mental health consumers and psychiatric survivors at the State Capitol, as they heard about this symbol of our society's discrimination against our constituency: Zero.

For the past eight years, about 15 grassroots nonprofit groups in Oregon have obtained funding in a variety of ways, and three years ago we formed our own state-wide coalition, with a grant from an independent foundation, McKenzie River Gathering.

The name of this coalition is Oregon Consumer/Survivor Coalition. (Note this not the same as the "Council" which is an advisory committee to AMH.)

For three years, OCSC -- with no funding -- has been working to unite mental health client organizations. We have a wonderful board, we won 501(c)(3) status this past Spring. Both our board president and treasurer have masters degrees in nonprofit administration, which we've found important to help support the nonprofit development.

My point is that for eight years, Oregon has had NO support for this state-wide voice. So we've done this ourselves. Our state of Oregon motto is about how 'She Flies With Her Own Wings," because of our sense of independence here. And I'm proud that our state-wide coalition has done just that.

But now it's time for change. It's time for Oregon to have what the vast majority of other states have, and that is some kind of resources, staffing, funding to 'accelerate' the state-wide wide empowerment of this marginalized and key stakeholder.

A culture is not something that exists alone, without context.

Let me mention an objective question you can ask: Why is Oregon one of the very few states not to have adopted a state-wide Olmstead plan?

We saw a draft of it months ago, and -- revealingly -- support for the state-wide voice of mental health clients was not in the plan. Now, an Olmstead Plan doesn't guarantee money. It's not a checkbook. It's not a bill or a budget item. It's a plan. But even in the early draft plan, there was no support for the state-wide voice.

We spoke out, met with Richard Harris, head of AMH. A later draft was better, not perfect, with many significant problems, but it at least included that voice. Please note that the Olmstead plan is still not out. They say it will be out 'soon.' But it's revealing that Oregon is one of the few that is violating the US Supreme Court in one of its main decisions about deinstitutionalization.

Because of the 'zero' support for the state-wide voice, you have a difficult task.

You yourself told me that you were hesitant to direct the mass interviewing of many mental health clients, because that could go on and on.

But there are organized voices by and for mental health clients, including OSH inmates. It will take you special initiative, outreach, effort, and cultural competency to reach that voice, and let these organizations know that you are going to be inclusive and respectful.

Frankly, for a long time we've had this question of "Why zero?" But Oregon has somehow found half a billion for bricks and mortar for new institutions... and has found millions for your report.... Oregon has found hundreds of thousands of dollars for parents organizations such as NAMI and OFSN.

But Oregon, to this day, still has zero for the state-wide voice. This will make it especially difficult for you, if you are serious for the inclusion of that organized voice. It can be done, but it will take skill, communication, staffing and -- since your report is due soon -- great speed.

Let me know  how we can help. I am also on the board of Oregon Consumer/Survivor Coalition. We have several email discussion lists, we are in touch with many parents of OSH patients, we work with advocates and inmates of OSH. For you to engage these grassroots resources, you won't have one phone number to call -- because, as I have pointed out, Oregon has zeroed out funding for such a phone number for eight years .

I hope you can help us discover "Why Zero?" Note this is not about a 20 percent cut back. Or an 80 percent cut back. It's about 100 percent cut back.

It's not about zero funding for one year, or three years. But for eight years.

This is not about Oregon pioneering at this point. This is about being like just about every other state in the USA. At least.

How we can always have fair funding for the state-wide voice of this excluded and marginalized constituency, a voice of, by and for psychiatric survivors and mental health consumers, many of whom have or actually do utilize OSH as customers.

Please, find out, once and for all:

    "Why zero?"

Best wishes in your organization's journey to this report.

David

David W. Oaks

director, MindFreedom International
board member, Oregon Consumer/Survivor Coalition

office phone: 541-345-9106

~~~~~~~~~~~~~~~~

THE LUND REPORT

OSH Spends Nearly $2 Million to Change Culture

A firm based in Indiana, Kaufman Global, has been hired to turn Oregon State Hospital into a first-class psychiatric facility

By:  Diane Lund-Muzikant

December 1, 2010 – State officials signed a nearly $2 million professional services contract on Monday to change the culture and turn Oregon State Hospital into a recovery-oriented organization.

An Indianapolis-based firm, Kaufman Global, was chosen from a field of three consulting firms by the Department of Human Services to implement the Oregon State Hospital Excellence Project.

During the next seven months, consultants will provide expertise to help OSH become a first-class public inpatient psychiatric facility, according to Greg Roberts, superintendent.

“It’s all about having a different focus, he said, “helping people recover so they can live again successfully in the community for extended periods of time. That ranges from how we conduct assessments, put treatment plans together and how we facilitate discharging people back into the community.”

The recommendation to undertake a major transformation came from an earlier consultant study done by Liberty Healthcare, at a cost of $175,000. It found that the hospital had “invested great energy and vigor in striving to improve,” however the results had been disappointing.

Among the problems identified by Liberty consultants:

The need to establish clear authority and accountability at all staff levels. There’s a pervasive culture of indecisiveness at the hospital with staff members expecting that their decisions are tentative and changeable
The lack of uniform policies and practices with various units acting independently because they perceive a leadership vacuum

An excessive reliance on too many committees, many of which perform uncoordinated and redundant functions, which has led to confusion about who has authority to resolve issues
A perception that managers cannot discipline or remove employees who are not doing a good job

Serious confusion about which entities hold the authority to resolve issues and are accountable for results

“It’s paradoxical that the very efforts to improve the hospital have contributed to the current confusion because changes have been implemented on so many fronts and with such rapidity,” according to Liberty’s report. “The sheer volume of change at OSH would overwhelm any organization, but we believe that the essential problem has been the lack of adequate planning and coordination of these improvement efforts.”

Kaufman Global is expected to work with hospital staff to help them bring about a cultural change, not necessarily implement that change, Roberts said. “Our job is to help people recover and stabilize so they can go back to the community. It’s a different way of conducting business in a psychiatric hospital than 10 to 15 years ago where people stayed for a very long time.”

- end -

For more about the "Why Zero" campaign, click here:

http://mindfreedom.org/zero