24. Peer Crisis Intervention Counselors

The State of Washington, through its Division of Behavioral Health & Recovery, trains those who live with behavioral disabilities to have a career as recovery peer counselors. This is a very different concept then what was practice before the Mental Health Act of 1963 and changes the picture of community behavioral health services. Before our modern era, the idea of incorporating someone with a psychiatric impairment into professional treatment services would have never happened. Thankfully times have changed and today the presence of recovery peer counselors bring a strong message of hope and resiliently. As individuals in recovery and consumers of community behavioral health services, the work oriented day for recovery peer counselors is very therapeutic and builds their self-esteem in ways that clinical treatment programs cannot.

Under the recovery peer counselor umbrella you will find many individuals serving as paraprofessionals in a variety of fields. Some individuals serve as peer mentors (coaches), these are professional relationships that can last for several years; some serve as peer specialists in inpatient facilities or other specialized programs; while others serve as peer bridgers, these are often short term professional relationships that assist individuals existing inpatient services; and there are many more occupations under this umbrella.

One of these additional occupations is membership on crisis response team, sometimes known as a mobile crisis outreach team, these individuals serve as a member of a crisis intervention program. Throughout the landscape crisis response teams are being created to assist First Responders involved with crisis incidents that involve an individual whose mental health is severely compromised. These teams play a critical role at these incidents, because they can assess the psychological health of individuals and address their immediate needs. Recovery peer counselors who are members of these crisis response teams perform a variety tasks, both in the office and in the field. In the office, they write reports, record entries into logs, participate in team meetings, and assist with team readiness for crisis calls and responses. Team cohesiveness and preparation is very important to the mission of any crisis response team, because when the team can respond to an incident safely and effectively individuals in crisis can receive appropriate care. When the team is at an incident, these peer counselors are typically under the supervision of a Mental Health Professional. Because the role of a Mental Health Professional is to perform a field assessment of the mental health of an individual, the recovery peer counselor preforms any task or responsibility that would otherwise interfere with the assessment and to be a safe second. True to the very nature of a recovery peer counselor, at every incident they offer their fellow peer attention and support. During the short time span they have with a person in crisis, they encourage them to accept services and activities that will help them reach greater levels stability and recovery. These crisis response teams are not clinical programs that have a scheduled routine and programs. Their shifts can be very unpredictable and the people in crisis can be extremely unstable and potentially dangerous to themselves and others. In this context, these teams have more in common with a fire station than they do with a clinical program. Like a fire station, these teams have routine duties that need to be performed, but they are often interrupted by a crisis call. Every fire or medical emergency that fire stations receive is different and presents its own challenges, this is the same for crisis teams. Every call to a crisis team is uniquely its own and requires the full attention of every team member. The individuals of the team bring different skills and abilities that enhance and strengthens the team. The mental health professionals bring their clinical training and field experiences and the recovery peer counselors bring their life experiences and training to the team.

In closing, any recovery peer counselor who is looking for a challenging and very rewarding occupation under the recovery peer counselor umbrella, I would encourage them to research the possibility of working as a member of a crisis response team. Although I will strongly emphasize this, you should only consider this if you are by nature a team oriented person and have an outgoing personality. It is a great way of working side by side with highly skilled mental health professionals in a team environment.


21. Thoughts on Leadership

If your actions inspire others to dream more, learn more, do more, you are a leader.”
John Quincy Adams
Leadership is something that many want and once they receive it, they find it to be very uncomfortable. It is one of those positions in life that leave one exposed and without a place to hide. It is accepting responsibility of things that went wrong, even if you did not actually participate in it. Therefore, leadership by its very nature is unsettling and problematic.
A leader is someone who does not ran away from the difficult decisions. When difficult decisions arise, a leader recognizes the weight they bring and seeks counsel from those who have wrestle with a similar matter. A leader knows that after all advice has been given and the facts reviewed, he/she will have to render the final word on the matter.
On the desk of President Truman was a sign that read, “The buck stops here.” There are many people who attempt to pass responsibilities on to someone else and when things go bad they attempt to pass the blame onto someone else. For a leader, this kind of irresponsibility and dodging is unacceptable. A leader must recognize that they are responsible for everything that happens in their domain, even if they did not do it or say it. Every leader is responsible for the actions of those who they lead and they are accountable for every success and failure within their domain.
A leader does not have the option of staying out of the business of those whom they lead. A leader understands that we are indeed our brother’s keeper. While a leader is careful not to get into every detail of an individual’s life, they do have a responsibility to be aware of things that can directly affect an individual’s work performance and safety of others. This awareness does not give a leader the privilege of being a counselor or a doctor, but instead a leader should use this awareness to offer information on social services and professional assistance when needed.
Leadership requires an individual to be aware of their strengths and weakness. Meaning, a leader does not have the skills to perform every job within their domain, but the skills to perform the jobs they were trained to do. Leaders always get in trouble when they attempt to perform tasks they have not been trained to do. Therefore, a leader needs to know what they can do and know who can perform the skills they cannot. By avoiding “being all things to all skills” a leader shows the strength of their character and a willingness to depend on the skills of others.
Jesus of Nazareth, a Jewish Rabbi, denounced authoritarianism and micro-management when he said, “Whoever wants to be a leader among you must be your servant, and whoever wants to be first among you must become your slave.” What he is promoting is a servant based form of leadership, a form of leadership that is in the services of others. Jesus practiced what he preached, in addition to his responsibilities as a leader he washed feet, cook food, and took time to listen to the intimate concerns of strangers.
William Arthur Ward said, “Leadership is based on inspiration, not domination. On cooperation, not intimidation.” Today, a wise leader should avoid micro-management of their domain and adopt a form of leadership that is free of authoritarianism and domination. Because when someone closely observes and controls the work of those under his/her leadership it creates a strong boss environment and not a leadership environment. Tight control over others and the work environment is generally unhealthy and does not allow for subordinates to develop a broader understanding of their skills, confidence in expressing their opinions, and a general understanding that mistakes are learning opportunities. It is always a better choice, to choose to be a leader and not a boss.
The difference between a boss and a leader: A boss says, “Go!” A leader says, “Let’s go!”
E.M. Kelly

Written by Dave Pflueger August 15, 2016 (c) copyrighted by Pflueger

6. Clash of Realties


Notice to the reader – the following is a challenging read and may be troubling; therefore please read with care and wisdom.

As it stands today, those who commit any act of domestic violence must face the laws of the state and are punished through the criminal justice system. Acts of domestic violence could be physical harm, psychological harm, or environmental harm (intimidation). In other words, striking someone, playing mind games with someone, or destroying property to ensure conformity.
Now that we have reviewed public law, let us review a segment of society that is challenged by the laws. Individuals who live with developmental and psychological disabilities face many challenges and barriers in their daily lives. One of their greatest struggles is their mental health, when their mental health is compromised they often become emotionally unstable. When they are like this they also can become unpleasant and vulnerable to the intermittent explosive disorder (a common co-occurring condition with developmental and psychological disorders).  When this happens in private homes and in the city parks the police are called and this often means they are arrested. This is an unintended and real consequence of the anti-domestic violence laws and has led to the institutionalization of disable individuals as criminals. When they become inmates they do not receive the professional care needed for appropriate stabilization and management of their disabilities. In other words, they are separated from their network of care and support.
Therefore, many individuals who live with establish disabilities must contend with anti-domestic violence laws that cast such a wide net that they often find themselves entangled in its webbing.

Those who are very passionate about domestic violence have created many laws to protect domestic partners and families from domestic abuse through someone’s need to use violence to control and dominate individuals (as if they were property). In their zeal to seek out justice and social reform these advocates against violence did not offer any kind of consideration towards those who have an established medical history of developmental or psychological disabilities and the intermittent explosive disorder that is often associated with these disabilities. This lack of acknowledgement also creates conflicts between the basic concepts of the 1963 Community Mental Health Act and the anti-domestic violence community.

The idea of treating everyone who commits any kind of domestic violence in the same way is another way of seeking a one size fits all approach. If a one size fits all approach is the direction that society wants to go, then we need to completely change the criminal justice systems on both the federal and state levels and remodel many correctional buildings. This kind of major change is grounded on the fact that correctional facilities are currently designed for the detainment of those who have committed a criminal act and are not designed to be the primary care and treatment centers of those who have developmental and/or psychological disabilities. This is especially true for city and county jails, they often do not have the staff and funding that would allow them too properly care for those with these kinds of disabilities. Sadly, this lack of resources has already led to abuse and even death of those with disabilities.

As a rule, I do not have a disagreement with the process and punishment of those who have harmed their domestic partner for the sole purpose of controlling, dominating, and perversely coveting them. However, I strongly believe that the criminal justice system is the wrong place for those who have been professionally diagnosed with a developmental or psychological disability. Instead, I believe that they need to be dealt with by the health and social services community, so that they may receive a thorough mental health evaluation and inpatient treatment. In addition, if they cannot be stabilized they need to be confined for an extended period to a facility for those who have seriously impaired mental health.

Concerning medication. Science has not kept up with the general concerns of society and Federal and State laws; the development of medications to control the genetic based behavior of the intermittent explosive disorder and other similar disorders that often co-occur with developmental and psychological impairments is still in its infancy. It will be a long time before medications are developed that will successfully control this behavior in all individuals with these impairments; as it stands today the only way medication can pacify the impairments of an individual is to be in a high enough dosage that it renders a person into a zombie state.

Criminalization. When anti-domestic violence laws do not take in consideration the medical science of the symptoms of developmental and psychological disorders and make provisions for them, there is only one out come, the criminalize of the genetic nature of these disabilities. Without consideration and provisions in the laws, the impaired DNA that is at the center of the disability and the cause of the symptomatic behavior, will make disabled individuals candidates for criminal prosecution by virtue of their genetic code.

Another serious matter. What makes things really difficult for those who work with those with these disabilities is the fact that all “First Responders (police officers, mental health counselors and case workers, teachers and so forth)” must to report any “person to person violence (verbal, attempt and actual).” This has forced advocates and supporters of those with either with psychological and developmental disabilities underground or into the shadows of society.

What would go a long way in reconciling all these parties and bring them together would be an acknowledgement that the current domestic violence laws need to be reformed and work together to bring about a revised code of law that acknowledges that violence committed by those with established psychological and developmental disabilities is a symptom of these disorders and not a criminal act.

Written by Dave Pflueger March 2012 © copyrighted by Pflueger

Dave Pflueger is certified for mental health peer counseling

3. 1963 Community Mental Health Act – After 50 Years

It has been almost 50 years since the creation of the Community Mental Health Act of 1963 and the creation of the Medicaid program in 1965. The Mental Health Act deinstitutionalized the care and support for those who were diagnosed with psychological and developmental disorders and Medicaid provided a means for the disabled to receive professional medical care. During this fifty year period, American society has gone from a workable network of support and services for those who live with psychological and developmental disorders to a point where the network is fractured and services have been reduced to dysfunctional levels. The Community Mental Health Act is still the norm, but the broken network and lack of services creates serious public safety issues; if a nation is going make deinstitutionalization its gold standard, it better provide the highest levels of public funding for community based programs or acknowledge to the citizens that public safety and health is not a priority. In our nation we have a real crisis facing us and if we do not address it, things are going to become very dangerous; because when a disability has destabilized the mental health of someone without a network to provide them with pro-active treatment and services, something very bad can happen in the city parks. As a nation we need to decide if we want to continue with deinstitutionalization or start building secured facilities with professional staff members to operate them. Failure to decide is an unwise and unhealthy option. As faith-based communities, Christians need to decide what direction they are going to take on this serious matter and take steps towards their decision and promote it. For Christians this is an issue of social justice and a matter of social morality.

Before us we have three options: deinstitutionalization (fully funded community based programs), public institutions (secured facilities funded by the government), or make no decision (the most dangerous option).

Written by Dave Pflueger May 2012  © copyrighted by Pflueger