It’s been a while

It’s about time I post something.

First, some new items at the Moonsoup Mart-

Like: Pink Rose Nova Keychain

pink_rose_nova_landscape_keychain

 

Department of Redundancy Department Journal

Department of Redundancy Department Journal

Department of Redundancy Department Journal

 

 

 

 

Into the Light Rectangular Magnetinto_the_light_rectangle_magnet

Orange Roses Coffee Mugorange rose mug

And much much more!

Lately I have been busy caring for my elderly mother. She fell and broke her arm. That would be bad enough but she is also 92 years old, has advanced cancer (untreated, metastasized for 5 years),  has trouble walking, she’s mostly blind and also deaf. I had gone on a vacation- my first real vacation ever, to Palm Springs for a week. The night I got back she had fallen and was in the hospital. She needed 24 hour care (up until now she’s lived by herself).  Within a couple days the hospital was going to discharge her to the first Intermediate Care Facility on their list.

I’ve been off work for a month and a half but mostly housebound. Not going stir crazy but getting more than a little irritable.

ir·ri·ta·ble
ˈiritəbəl/
adjective
  1. 1.
    having or showing a tendency to be easily annoyed or made angry.
    “she was tired and irritable”

A picture from my son Andrew’s “Phone Photo Blog on Tumblr (more about Tumblr)-

Well, spring is here in the Northern hemisphere. Time for birth and reproduction in the natural world. Mostly just a few early bloomers in my part of the word so far. I’ve heard some frogs croaking. The weather is mostly wet, not too cold. Regular western Oregon climate.

Speaking of birth…

Larvae from a parasitic wasp are being born from a caterpillar which will be their first meal.

Larvae from a parasitic wasp are being born from a caterpillar which will be their first meal.

seahorse having babies (!)

seahorse having babies (!)\

Cockroaches are mommas too

Cockroaches are mommas too

Just starfish and eels having a party

Just starfish and eels having a party- maybe it’s someones birthday

What else is new? Hell if I know. I’m out of the loop.

Pictures from my vacation (click for full size):

My fiance, Candace

My fiance, Candace

Courtyard view from our motel room

Courtyard view from our motel room

It was so fantastic to be somewhere with the daily temperature in the 80s, no rain, palm trees everywhere. A stark contrast to what was happening back home.

Candace by some rocks at Joshua Tree National Park

Candace by some rocks at Joshua Tree National Park

Me, Joshua Tree in background. Notice how blue the sky!

Me, Joshua Tree in background. Notice how blue the sky!

Series of pictures from Hidden Valley:

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20140219_143749

 

20140219_143829

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 The view from the Palm Springs Elmer’s restaurant-

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 Other photos from the Palm Springs area:

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Lizard on rock

Lizard on rock

 

On Mt. Jacinto

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Also! Don’t forget to shop at Moonsoup Mart!!

new products…

Gozzirra Stainless Steel Coffee Mug!!!

      Wear Socks!!!                                bIG mONSTER Drinking glass!!!                            Love Chomped Rectangular Cocktail Plate!!!

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VLUU L100, M100  / Samsung L100, M100

From Andrew’s other Tumblr Blog- 5cc, but re-blogged from tacofiesta-

image

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The Struggling Romantic

The Struggling Romantic.

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New Product, + Gif Dump

Effidol T-Shirt-

effidoltshirtavbhgif10

perfect-angle-funny-dog-train

perfect-loop-ralph-wiggum

perfect-loop-monkey-hit

perfect-loop-dog-jump

perfect-loop-lego

nope

Ping Pong All Alone

Little Leauge WTF

Cat Juggle

hildatroj

Grenade

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2013 in review

The WordPress.com stats helper monkeys prepared a 2013 annual report for this blog.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 31,000 times in 2013. If it were a concert at Sydney Opera House, it would take about 11 sold-out performances for that many people to see it.

Click here to see the complete report.

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The Poetry of the Bauls (Thanks Leroy)

The Poetry of the Bauls.

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Friday Soup Dump

Check out recent Amuseless.

Shop!

___

SAMHSA sez:

43.7 Million Americans Experienced Mental Illness in 2012

$31 Million Announced To Improve Mental Health Services for Young People

Nearly one in five American adults, or 43.7 million people, experienced a diagnosable mental illness in 2012 according to SAMHSA. These results are consistent with 2011 findings.

[Does anyone else besides me suspect that the reason so many are diagnosed is because of marketing of psycho-pharmacological drugs?]

Top Three Reasons Adults Did Not Get Mental Health Treatment in 2012

  • They worried about affording the cost.
  • They thought they could handle the problem without treatment.
  • They did not know where to receive services.

“The President and Vice President have made clear that mental illness should no longer be treated by our society—or covered by insurance companies—differently from other illnesses,” said HHS Secretary Kathleen Sebelius. “The Affordable Care Act and new parity protections are expanding mental and substance use disorder benefits for 62 million Americans. This historic expansion will help make treatment more affordable and accessible.”

Related note (click to read whole article):

The British drug maker GlaxoSmithKline will no longer pay doctors to promote its products and will stop tying compensation of sales representatives to the number of prescriptions doctors write, its chief executive said Monday, effectively ending two common industry practices that critics have long assailed as troublesome conflicts of interest.

Caught Nuzzling Mic

Another news item:

On December 12, 2013, Congressman Tim Murphy (R-PA) introduced the “Helping Families in Mental Health Crisis Act of 2013″. While the National Federation of Families for Children’s Mental Health applauds Congressman Murphy’s inclusion of provisions that would reauthorize the Mental Health First Aid Act (S.153/H.R.274), the Garrett Lee Smith Memorial Act (S.116/H.R.2734), the Children’s Recovery from Trauma Act (S.380), the Excellence in Mental Health Act (S.264/H.R.1263), the Justice and Mental Health Collaboration Act of 2013 (MIOTCRA;S. 162/H.R.401) and the Behavioral Health IT Act (S.1517, S.1685/H.R.2057), we decry provisions that would effectively reverse the progress made in mental health treatment and support over the past 30 years.

For decades, organizations such as the National Federation of Families for Children’s Mental Health have been working to add a more balanced approach to mental health services and treatment. The National Federation advocates for the rights of children, youth and young adults who experience mental health challenges. As family members, we feel it is important that our loved ones are able to receive the support they need while remaining at home and in the community. We realize that mental illness does not affect just one person, it is something that the entire family experiences; therefore, it is crucial that initiatives are in place to support the entire family unit.

Rep. Murphy’s bill magnifies the stigma of mental illness by creating an extremely biased link between mental illness and violence. Countless studies have determined that the relationship between mental illness and violence is minimal and that individuals experiencing mental health challenges are 11 times more likely to be the victims of violence than the general public.

The National Federation rejects the expanded use of involuntary outpatient commitment (IOC) and urges Congress to champion practices proven to be effective in facilitating a holistic approach to treatments and supports for children and youth who are experiencing mental health challenges and their families.

Finally, the National Federation strongly opposes legislation that threatens to essentially dismantle key efforts and programs of the Substance Abuse and Mental Health Services Administration (SAMHSA) which functions as the lead public health agency dedicated to mental health and addiction treatment, services, and supports. Transferring authority away from SAMHSA and decimating significant activities within the Department of Health and Human Services are not in the best interest of our most vulnerable citizens who are striving to be participating members of their communities.

The details in this bill reflect the continued, urgent need for a national conversation with individuals who experience mental illness, their families, and their communities to facilitate the creation of systems and networks that support maximal health, safety, and welfare for all community members. We urge Congressional leaders to take this opportunity to create legislation on behalf of their constituents that solidifies a bond among all stakeholders that highlights the dignity, respect, and self-determination of all individuals.

-The National Federation of Families for Children’s Mental Health issued this statement in response to the bill.

Cat Bowling

More old Cuckoo’s Nest poetry by JN:

01-30-2009AD

5:20pm

Spoken Cold-Mountain

 [I had given him a copy of Cold Mountain Poems and this was his reply]

Breeze is cold, wet and fresh

Unknown writer I read his writing

Chilled the soul to touch his spirit

Vast as the array of description

Oneness not disconnected was He

Truth in the sporadic words- adrift the snow

Cliffs for bed softened his head

Reading the stone carved wit

Closer to the mountain I get

As I thought those rolling weeds in the wind

Climate is cold to touch, but normal for the universe

Who is wittier?

Mother Nature or the man who wrote?

Void isn’t the mountain with minerals galore

Treasures of the mind I must find

Breaking illusions is for me

This is my trail to this mountain

Entering meditation is salvation

A bird and animal not to sight!

Vast self to roam

Free indeed is the writer in me

Wrote a letter to karma

Issued a food through the threshold

Moonlight glistening snow winds I see

Cold-Mountain: we’re all alone, so it spoke these words

You are home sparkled the stream of life

Years ago I would not have stayed

Fleshy thing in the way

Ghosts are the host that talks wisdom to thee

By JN

Kitten Laundry Hamper

Cat Walks on Hind Legs

Turn Off Your Kitten

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Hello My God

Hello My God.

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Even More From the Cuckoo’s Nest

This came in my work email:

Dear Staff:

This morning I gave the following assignment to my writing group: “What was the favorite gift you have ever either received or given for any occasion (Christmas, Birthday, Anniversary)?  Write about it and answer these questions:

What was the occasion?

Who were the players—giver and recipient?

What emotions were felt or expressed?

J.N. from Bird 3 (Salem) answered:

“Liz, my group home manager in Grants Pass, when I spent Christmas there gave pajamas to me for a present.  I laugh because I needed P.J.’s.  They were navy blue.  I could put them on before bedtime and unwind in writing on the computer.  They were light and comfortable.  I felt like a million bucks in them because it was decades [since] I had a bed, and P.J.’s to sleep in.  You see, I had spent years on the streets and I slept anywhere out of the weather.  My clothes stayed on me, but my shoes came off when I climbed into the sleeping bag.

 When my care-provider gave P.J.’s to me I acted like a child of joy.  The smell of new P.J.’s was pleasant.  Crisp, fresh P.J.’s were like I was high class.  I did thank Liz for the thoughtful gift.  She is a wonderful person and considerate.  Now, feeling human and high class I wrote better with a new mentality…..Liz [fed] us a balanced diet and shows love in working around the house. 

 Love for P.J.’s is the tender feeling while nights pass.  And I sleep…”

When our patient read this aloud to the class, my eyes filled with tears.  What a wonderful expression of thanks flowed from this patient’s pen!  There are a lot of things to be sad and disappointed about in our world today, but as you reflect on this story I urge you to consider “Who can I bless with “P.J.’s” during this Christmas/Hanukkah/Holiday season?”

Dr. **** ******, Clinical Psychologist

If you have followed this blog you are acquainted with JN and his powerful images, intensely emotional poetry. Of course, he is no longer in the 50 Building- which is now abandoned across the street. He lives in this giant new beast, shiny and deceptive. They rolled up the old hospital and brought it here into a new edifice. Here’s something else-

01-31-2009AD

7:24pm

Believe

Understood into self as the clouds drift away

Sun rises to the word of reality with shinning focus

Wind whispers it while awake in the Desert

Mountains’ tree sings it out with a hoot

Rocks roll in the snowy water stream

The birds fly with uplifting wings

Chairs hold you in faithful promise

I absorb it like food for nourishment

Rain falls to the gravities law

Air gives way to breathe of life

Monks hum to it in meditation

Spirit listens in ah while thought is created

Soul will carry it to heaven

God rewards you for understanding

Flowers wilt by it after seeding

A Babies cry with it when born

Believe while doing all things and it will be

Stories are written with the thought of it

Companions make love for a child

Can’t touch it with your hands, but imagination flourishes

Wake- that sun will make it today

Why then doesn’t it happen when we speak?

Truth and lies are from this tongue of ours

By JN

anigif_enhanced-buzz-28846-1383854317-15

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Get unique stuff

Everything in the shop is a design, drawing or photo by myself or my son Andrew.

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$28.00

Wear socks Aluminum Photo Keychain

Wear socks Aluminum Photo Keychain
$9.50

Wear socks 3/4 Sleeve T-shirt

Wear socks 3/4 Sleeve T-shirt
$40.00

Standing guy Wine Label

Standing guy Wine Label
$5.00

Standing guy Travel Valet

Standing guy Travel Valet
$32.50

Standing guy Teardrop Wine Charm

Standing guy Teardrop Wine Charm
$19.50

Standing guy Tea Tumbler

Standing guy Tea Tumbler
$19.50

Standing guy Sticker (Rectangle)

Standing guy Sticker (Rectangle)
$5.00

Standing guy Sticker (Oval)

Standing guy Sticker (Oval)
$5.00

Standing guy Stainless Water Bottle 0.6L

Standing guy Stainless Water Bottle 0.6L
$18.00

Standing guy Small Teardrop Pet Tag

Standing guy Small Teardrop Pet Tag
$19.50

Standing guy Small Portrait Pet Tag

Standing guy Small Portrait Pet Tag
$19.50

Standing guy Small Oval Pet Tag

Standing guy Small Oval Pet Tag
$19.50

Standing guy Small Luggage Tag

Standing guy Small Luggage Tag
$12.50

Standing guy Silver Teardrop Necklace

Standing guy Silver Teardrop Necklace
$49.50

Standing guy Silver Teardrop Charm

Standing guy Silver Teardrop Charm
$39.50

Standing guy Silver Portrait Necklace

Standing guy Silver Portrait Necklace
$49.50

Standing guy Silver Portrait Charm

Standing guy Silver Portrait Charm
$39.50

Standing guy Silver Oval Necklace

Standing guy Silver Oval Necklace
$49.50

Standing guy Silver Oval Charm

Standing guy Silver Oval Charm
$39.50

Standing guy Round Pet Tag

Standing guy Round Pet Tag
$6.50

Standing guy Rectangular Cocktail Plate

Standing guy Rectangular Cocktail Plate
$14.50

Standing guy Rectangle Magnet

Standing guy Rectangle Magnet
$5.00

Standing guy Rectangle Car Magnet

Standing guy Rectangle Car Magnet
$6.00

Standing guy Puzzle

Standing guy Puzzle
$14.50

Standing guy Power Bank

Standing guy Power Bank
$65.00

Standing guy Postcards (Package of 8)

Standing guy Postcards (Package of 8)
$12.00

Standing guy Portrait Wine Charm

Standing guy Portrait Wine Charm
$19.50

Standing guy Portrait Keychain

Standing guy Portrait Keychain
$24.50

Standing guy Padfolio

Standing guy Padfolio
$29.00

Standing guy Oven Mitt

Standing guy Oven Mitt
$14.50

Standing guy Oval Wine Charm

Standing guy Oval Wine Charm
$19.50

Standing guy Oval Ornament

Standing guy Oval Ornament
$12.50

Standing guy Oval Ornament

Standing guy Oval Ornament
$12.50

Standing guy Oval Car Magnet

Standing guy Oval Car Magnet
$6.00

Standing guy Note Cards (Pk of 20)

Standing guy Note Cards (Pk of 20)
$29.50

Standing guy Note Cards (Pk of 10)

Standing guy Note Cards (Pk of 10)
$19.50

Standing guy Necklace Oval Charm

Standing guy Necklace Oval Charm
$25.00

Standing guy Mousepad

Standing guy Mousepad
$14.50

Standing guy Large Portrait Pet Tag

Standing guy Large Portrait Pet Tag
$22.50

Standing guy Large Luggage Tag

Standing guy Large Luggage Tag
$15.00

Standing guy Journal

Standing guy Journal
$14.50

Standing guy iPhone 4 Slider Case

Standing guy iPhone 4 Slider Case
$24.50

Standing guy iPad Mini Switch Case

Standing guy iPad Mini Switch Case
$29.50

Standing guy Hexagon Ornament

Standing guy Hexagon Ornament
$12.50

Standing guy Greeting Card

Standing guy Greeting Card
$4.00

Standing guy Galaxy S3 Switch Case

Standing guy Galaxy S3 Switch Case
$24.50

Standing guy Galaxy Note Case

Standing guy Galaxy Note Case
$24.50

Standing guy Flask Necklace

Standing guy Flask Necklace
$19.50

Standing guy Earring Oval Charm

Standing guy Earring Oval Charm
$22.50

Standing guy Dog Tags

Standing guy Dog Tags
$22.00

Standing guy Christmas Stocking

Standing guy Christmas Stocking
$16.50

Standing guy Business Card Case

Standing guy Business Card Case
$19.50

Standing guy Beer Label

Standing guy Beer Label
$5.00

Standing guy Apron (dark)

Standing guy Apron (dark)
$28.00

Standing guy Apron

Standing guy Apron
$28.00

Standing guy Aluminum Photo Keychain

Standing guy Aluminum Photo Keychain
$9.50

Standing guy Aluminum Oval Keychain

Standing guy Aluminum Oval Keychain
$9.50

Standing guy 35x21 Wall Decal

Standing guy 35×21 Wall Decal
$24.00

Standing guy 35x21 Oval Wall Decal

Standing guy 35×21 Oval Wall Decal
$24.00

Standing guy 20x12 Wall Decal

Standing guy 20×12 Wall Decal
$15.00

Standing guy 20x12 Oval Wall Decal

Standing guy 20×12 Oval Wall Decal
$15.00

Mushy Women's Cap Sleeve T-Shirt

Mushy Women’s Cap Sleeve T-Shirt
$32.50

Mushy Womens Burnout Tee

Mushy Womens Burnout Tee
$35.50

Mushy Travel Valet

Mushy Travel Valet
$32.50

Mushy Stainless Water Bottle 1.0L

Mushy Stainless Water Bottle 1.0L
$19.50

Mushy Stainless Water Bottle 0.6L

Mushy Stainless Water Bottle 0.6L
$18.00

Mushy Small Portrait Pet Tag

Mushy Small Portrait Pet Tag
$19.50

Mushy Rectangular Cocktail Plate

Mushy Rectangular Cocktail Plate
$14.50

Mushy Rectangle Magnet

Mushy Rectangle Magnet
$5.00

Mushy Puzzle

Mushy Puzzle
$14.50

Mushy Power Bank

Mushy Power Bank
$65.00

Mushy Postcards (Package of 8)

Mushy Postcards (Package of 8)
$12.00

Mushy Portrait Wine Charm

Mushy Portrait Wine Charm
$19.50

Mushy Portrait Keychain

Mushy Portrait Keychain
$24.50

Mushy Oval Ornament

Mushy Oval Ornament
$12.50

Mushy Oval Ornament

Mushy Oval Ornament
$12.50

Mushy Note Cards (Pk of 20)

Mushy Note Cards (Pk of 20)
$29.50

Mushy Note Cards (Pk of 10)

Mushy Note Cards (Pk of 10)
$19.50

Mushy Necklace Oval Charm

Mushy Necklace Oval Charm
$25.00

Mushy Mousepad

Mushy Mousepad
$14.50

Mushy Large Portrait Pet Tag

Mushy Large Portrait Pet Tag
$22.50

Mushy Jr. Raglan

Mushy Jr. Raglan
$38.00

Mushy Greeting Card

Mushy Greeting Card
$4.00

Mushy Earring Oval Charm

Mushy Earring Oval Charm
$22.50

Mushy Christmas Stocking

Mushy Christmas Stocking
$16.50

Mushy Boxer Shorts

Mushy Boxer Shorts
$20.00

Mushy Apron

Mushy Apron
$28.00

Mushy Aluminum Photo Keychain

Mushy Aluminum Photo Keychain
$9.50

Mushy 3/4 Sleeve T-shirt

Mushy 3/4 Sleeve T-shirt
$40.00

Mandala Teardrop Wine Charm

Mandala Teardrop Wine Charm
$19.50

Mandala Tea Tumbler

Mandala Tea Tumbler
$19.50

Mandala Small Teardrop Pet Tag

Mandala Small Teardrop Pet Tag
$19.50

Mandala Small Portrait Pet Tag

Mandala Small Portrait Pet Tag
$19.50

Mandala Small Oval Pet Tag

Mandala Small Oval Pet Tag
$19.50

Mandala Silver Teardrop Necklace

Mandala Silver Teardrop Necklace
$49.50

Mandala Silver Teardrop Charm

Mandala Silver Teardrop Charm
$39.50

Mandala Silver Portrait Necklace

Mandala Silver Portrait Necklace
$49.50

Mandala Silver Portrait Charm

Mandala Silver Portrait Charm
$39.50

Mandala Silver Oval Necklace

Mandala Silver Oval Necklace
$49.50

Mandala Silver Oval Charm

Mandala Silver Oval Charm
$39.50

Mandala Round Pet Tag

Mandala Round Pet Tag
$6.50

Mandala Rectangle Magnet

Mandala Rectangle Magnet
$5.00

Mandala Portrait Wine Charm

Mandala Portrait Wine Charm
$19.50

Mandala Oval Wine Charm

Mandala Oval Wine Charm
$19.50

Mandala Oval Ornament

Mandala Oval Ornament
$12.50

Mandala Necklace Oval Charm

Mandala Necklace Oval Charm
$25.00

Mandala Large Portrait Pet Tag

Mandala Large Portrait Pet Tag
$22.50

Mandala Flask Necklace

Mandala Flask Necklace
$19.50

Mandala Earring Oval Charm

Mandala Earring Oval Charm
$22.50

Mandala Dog Tags

Mandala Dog Tags
$22.00

Mandala Christmas Stocking

Mandala Christmas Stocking
$16.50

Mandala Business Card Case

Mandala Business Card Case
$19.50

Mandala Aluminum Photo Keychain

Mandala Aluminum Photo Keychain
$9.50

Mandala Aluminum Oval Keychain

Mandala Aluminum Oval Keychain
$9.50

Mandala 20x12 Wall Decal

Mandala 20×12 Wall Decal
$15.00

Mandala 20x12 Oval Wall Decal

Mandala 20×12 Oval Wall Decal
$15.00

Love Chomped Womens Burnout Tee

Love Chomped Womens Burnout Tee
$35.50

Love Chomped Tea Tumbler

Love Chomped Tea Tumbler
$19.50

Love Chomped Sticker (Rectangle)

Love Chomped Sticker (Rectangle)
$5.00

Love Chomped Sticker (Oval)

Love Chomped Sticker (Oval)
$5.00

Love Chomped Stainless Water Bottle 1.0L

Love Chomped Stainless Water Bottle 1.0L
$19.50

Love Chomped Stainless Water Bottle 0.6L

Love Chomped Stainless Water Bottle 0.6L
$18.00

Love Chomped Rectangular Cocktail Plate

Love Chomped Rectangular Cocktail Plate
$14.50

Love Chomped Rectangle Magnet

Love Chomped Rectangle Magnet
$5.00

Love Chomped Rectangle Car Magnet

Love Chomped Rectangle Car Magnet
$6.00

Love Chomped Power Bank

Love Chomped Power Bank
$65.00

Love Chomped Postcards (Package of 8)

Love Chomped Postcards (Package of 8)
$12.00

Love Chomped Oval Ornament

Love Chomped Oval Ornament
$12.50

Love Chomped Oval Car Magnet

Love Chomped Oval Car Magnet
$6.00

Love Chomped Nook Sleeve

Love Chomped Nook Sleeve
$29.50

Love Chomped Large Luggage Tag

Love Chomped Large Luggage Tag
$15.00

Love Chomped Journal

Love Chomped Journal
$14.50

Love Chomped iPad Switch Case

Love Chomped iPad Switch Case
$39.50

Love Chomped iPad Mini Switch Case

Love Chomped iPad Mini Switch Case
$29.50

Love Chomped Greeting Card

Love Chomped Greeting Card
$4.00

Love Chomped Flask Necklace

Love Chomped Flask Necklace
$19.50

Love Chomped Earring Oval Charm

Love Chomped Earring Oval Charm
$22.50

Love Chomped Boxer Shorts

Love Chomped Boxer Shorts
$20.00

Love Chomped Aluminum Photo Keychain

Love Chomped Aluminum Photo Keychain
$9.50

Love Chomped 35x21 Wall Decal

Love Chomped 35×21 Wall Decal
$24.00

Love Chomped 35x21 Oval Wall Decal

Love Chomped 35×21 Oval Wall Decal
$24.00

Love Chomped 3/4 Sleeve T-shirt

Love Chomped 3/4 Sleeve T-shirt
$40.00

Love Chomped 20x12 Wall Decal

Love Chomped 20×12 Wall Decal
$15.00

Love Chomped 20x12 Oval Wall Decal

Love Chomped 20×12 Oval Wall Decal
$15.00

Looks like fall Womens Burnout Tee

Looks like fall Womens Burnout Tee
$35.50

Looks like fall Travel Valet

Looks like fall Travel Valet
$32.50

Looks like fall Rectangular Cocktail Plate

Looks like fall Rectangular Cocktail Plate
$14.50

Looks like fall Rectangular Canvas Pillow

Looks like fall Rectangular Canvas Pillow
$24.50

Looks like fall 3/4 Sleeve T-shirt

Looks like fall 3/4 Sleeve T-shirt
$40.00

Hyperdoodle 1 Teardrop Wine Charm

Hyperdoodle 1 Teardrop Wine Charm
$19.50

Hyperdoodle 1 Tea Tumbler

Hyperdoodle 1 Tea Tumbler
$19.50

Hyperdoodle 1 Small Teardrop Pet Tag

Hyperdoodle 1 Small Teardrop Pet Tag
$19.50

Hyperdoodle 1 Small Portrait Pet Tag

Hyperdoodle 1 Small Portrait Pet Tag
$19.50

Hyperdoodle 1 Small Oval Pet Tag

Hyperdoodle 1 Small Oval Pet Tag
$19.50

Hyperdoodle 1 Silver Teardrop Necklace

Hyperdoodle 1 Silver Teardrop Necklace
$49.50

Hyperdoodle 1 Silver Teardrop Charm

Hyperdoodle 1 Silver Teardrop Charm
$39.50

Hyperdoodle 1 Silver Portrait Necklace

Hyperdoodle 1 Silver Portrait Necklace
$49.50

Hyperdoodle 1 Silver Portrait Charm

Hyperdoodle 1 Silver Portrait Charm
$39.50

Hyperdoodle 1 Silver Oval Necklace

Hyperdoodle 1 Silver Oval Necklace
$49.50

Hyperdoodle 1 Silver Oval Charm

Hyperdoodle 1 Silver Oval Charm
$39.50

Hyperdoodle 1 Round Pet Tag

Hyperdoodle 1 Round Pet Tag
$6.50

Hyperdoodle 1 Rectangle Magnet

Hyperdoodle 1 Rectangle Magnet
$5.00

Hyperdoodle 1 Portrait Wine Charm

Hyperdoodle 1 Portrait Wine Charm
$19.50

Hyperdoodle 1 Portrait Keychain

Hyperdoodle 1 Portrait Keychain
$24.50

Hyperdoodle 1 Oval Wine Charm

Hyperdoodle 1 Oval Wine Charm
$19.50

Hyperdoodle 1 Oval Ornament

Hyperdoodle 1 Oval Ornament
$12.50

Hyperdoodle 1 Necklace Oval Charm

Hyperdoodle 1 Necklace Oval Charm
$25.00

Hyperdoodle 1 Large Portrait Pet Tag

Hyperdoodle 1 Large Portrait Pet Tag
$22.50

Hyperdoodle 1 Flask Necklace

Hyperdoodle 1 Flask Necklace
$19.50

Hyperdoodle 1 Earring Oval Charm

Hyperdoodle 1 Earring Oval Charm
$22.50

Hyperdoodle 1 Dog Tags

Hyperdoodle 1 Dog Tags
$22.00

Hyperdoodle 1 Christmas Stocking

Hyperdoodle 1 Christmas Stocking
$16.50

Hyperdoodle 1 Business Card Case

Hyperdoodle 1 Business Card Case
$19.50

Hyperdoodle 1 Aluminum Photo Keychain

Hyperdoodle 1 Aluminum Photo Keychain
$9.50

Hyperdoodle 1 Aluminum Oval Keychain

Hyperdoodle 1 Aluminum Oval Keychain
$9.50

Hyperdoodle 1 20x12 Wall Decal

Hyperdoodle 1 20×12 Wall Decal
$15.00

Hyperdoodle 1 20x12 Oval Wall Decal

Hyperdoodle 1 20×12 Oval Wall Decal
$15.00

Go-zirra Wine Stopper

Go-zirra Wine Stopper
$19.50

Go-zirra Tie Clip

Go-zirra Tie Clip
$14.00

Go-zirra Teardrop Wine Charm

Go-zirra Teardrop Wine Charm
$19.50

Go-zirra Tea Tumbler

Go-zirra Tea Tumbler
$34.00

Go-zirra Sticky Notepad

Go-zirra Sticky Notepad
$19.50

Go-zirra Stainless Steel Travel Mug

Go-zirra Stainless Steel Travel Mug
$24.50

Go-zirra Square Wine Charm

Go-zirra Square Wine Charm
$19.50

Go-zirra Square Purse Hanger

Go-zirra Square Purse Hanger
$15.00

Go-zirra Square Pill Box

Go-zirra Square Pill Box
$15.00

Go-zirra Square Keychain

Go-zirra Square Keychain
$24.50

Go-zirra Square Compact Mirror

Go-zirra Square Compact Mirror
$15.00

Go-zirra Small Teardrop Pet Tag

Go-zirra Small Teardrop Pet Tag
$19.50

Go-zirra Small Square Pet Tag

Go-zirra Small Square Pet Tag
$19.50

Go-zirra Small Round Pet Tag

Go-zirra Small Round Pet Tag
$19.50

Go-zirra Small Portrait Pet Tag

Go-zirra Small Portrait Pet Tag
$19.50

Go-zirra Small Oval Pet Tag

Go-zirra Small Oval Pet Tag
$19.50

Go-zirra Silver Teardrop Necklace

Go-zirra Silver Teardrop Necklace
$49.50

Go-zirra Silver Teardrop Charm

Go-zirra Silver Teardrop Charm
$39.50

Go-zirra Silver Square Necklace

Go-zirra Silver Square Necklace
$49.50

Go-zirra Silver Square Charm

Go-zirra Silver Square Charm
$39.50

Go-zirra Silver Round Necklace

Go-zirra Silver Round Necklace
$49.50

Go-zirra Silver Round Charm

Go-zirra Silver Round Charm
$39.50

Go-zirra Silver Portrait Necklace

Go-zirra Silver Portrait Necklace
$49.50

Go-zirra Silver Portrait Charm

Go-zirra Silver Portrait Charm
$39.50

Go-zirra Silver Oval Necklace

Go-zirra Silver Oval Necklace
$49.50

Go-zirra Silver Oval Charm

Go-zirra Silver Oval Charm
$39.50

Go-zirra Shot Glass

Go-zirra Shot Glass
$12.50

Go-zirra Round Wine Charm

Go-zirra Round Wine Charm
$19.50

Go-zirra Round Purse Hanger

Go-zirra Round Purse Hanger
$15.00

Go-zirra Round Pill Box

Go-zirra Round Pill Box
$15.00

Go-zirra Round Pet Tag

Go-zirra Round Pet Tag
$6.50

Go-zirra Round Ornament

Go-zirra Round Ornament
$12.50

Go-zirra Round Keychain

Go-zirra Round Keychain
$24.50

Go-zirra Round Compact Mirror

Go-zirra Round Compact Mirror
$15.00

Go-zirra Round Cocktail Plate

Go-zirra Round Cocktail Plate
$14.50

Go-zirra Ring

Go-zirra Ring
$35.00

Go-zirra Ring

Go-zirra Ring
$35.00

Go-zirra Portrait Wine Charm

Go-zirra Portrait Wine Charm
$19.50

Go-zirra Portrait Keychain

Go-zirra Portrait Keychain
$24.50

Go-zirra Oval Wine Charm

Go-zirra Oval Wine Charm
$19.50

Go-zirra Necklace Oval Charm

Go-zirra Necklace Oval Charm
$25.00

Go-zirra Necklace Heart Charm

Go-zirra Necklace Heart Charm
$25.00

Go-zirra Necklace Circle Charm

Go-zirra Necklace Circle Charm
$25.00

Go-zirra Money Clip

Go-zirra Money Clip
$18.00

Go-zirra Money Clip

Go-zirra Money Clip
$18.00

Go-zirra Mini Button

Go-zirra Mini Button
$3.00

Go-zirra Magnet

Go-zirra Magnet
$5.00

Go-zirra Luggage Handle Wrap

Go-zirra Luggage Handle Wrap
$12.50

Go-zirra Large Square Pet Tag

Go-zirra Large Square Pet Tag
$22.50

Go-zirra Large Round Pet Tag

Go-zirra Large Round Pet Tag
$22.50

Go-zirra Large Portrait Pet Tag

Go-zirra Large Portrait Pet Tag
$22.50

Go-zirra Heart Pet Tag

Go-zirra Heart Pet Tag
$6.50

Go-zirra Golf Balls

Go-zirra Golf Balls
$18.00

Go-zirra Flask

Go-zirra Flask
$24.50

Go-zirra Earring Oval Charm

Go-zirra Earring Oval Charm
$22.50

Go-zirra Earring Heart Charm

Go-zirra Earring Heart Charm
$22.50

Go-zirra Earring Circle Charm

Go-zirra Earring Circle Charm
$22.50

Go-zirra Drinking Glass

Go-zirra Drinking Glass
$16.00

Go-zirra Cufflinks

Go-zirra Cufflinks
$35.00

Go-zirra Cufflinks

Go-zirra Cufflinks
$35.00

Go-zirra Cocktail Shaker

Go-zirra Cocktail Shaker
$29.50

Go-zirra Charm Bracelet, One Charm

Go-zirra Charm Bracelet, One Charm
$22.00

Go-zirra Canvas Lunch Tote

Go-zirra Canvas Lunch Tote
$16.50

Go-zirra Canvas Lunch Bag

Go-zirra Canvas Lunch Bag
$16.50

Go-zirra Can Insulator

Go-zirra Can Insulator
$16.00

Go-zirra Bottle Wine Chiller

Go-zirra Bottle Wine Chiller
$34.50

Go-zirra 3.5

Go-zirra 3.5″ Button
$7.00

Go-zirra 2.25

Go-zirra 2.25″ Button
$5.00

Flower Ring

Flower Ring
$35.00

Flower Rectangle Magnet

Flower Rectangle Magnet
$5.00

Flower Power Bank

Flower Power Bank
$65.00

Flower Postcards (Package of 8)

Flower Postcards (Package of 8)
$12.00

Flower Picture Ornament

Flower Picture Ornament
$12.50

Flower Oval Keychain

Flower Oval Keychain
$24.50

Flower Large Oval Pet Tag

Flower Large Oval Pet Tag
$22.50

Flower Large Landscape Pet Tag

Flower Large Landscape Pet Tag
$22.50

Flower Landscape Keychain

Flower Landscape Keychain
$24.50

Flower Dog Tags

Flower Dog Tags
$22.00

Flower Cufflinks

Flower Cufflinks
$35.00

Flower Cufflinks

Flower Cufflinks
$35.00

Flower Business Card Case

Flower Business Card Case
$19.50

Flower 20x12 Wall Decal

Flower 20×12 Wall Decal
$15.00

Flower 20x12 Oval Wall Decal

Flower 20×12 Oval Wall Decal
$15.00

Find a gem Women's Cap Sleeve T-Shirt

Find a gem Women’s Cap Sleeve T-Shirt
$32.50

Find a gem Womens Burnout Tee

Find a gem Womens Burnout Tee
$35.50

Find a gem Travel Valet

Find a gem Travel Valet
$32.50

Find a gem Stainless Water Bottle 1.0L

Find a gem Stainless Water Bottle 1.0L
$19.50

Find a gem Stainless Water Bottle 0.6L

Find a gem Stainless Water Bottle 0.6L
$18.00

Find a gem Rectangular Cocktail Plate

Find a gem Rectangular Cocktail Plate
$14.50

Find a gem Jr. Raglan

Find a gem Jr. Raglan
$38.00

Find a gem Christmas Stocking

Find a gem Christmas Stocking
$16.50

Find a gem Boxer Shorts

Find a gem Boxer Shorts
$20.00

Find a gem Apron

Find a gem Apron
$28.00

Find a gem 3/4 Sleeve T-shirt

Find a gem 3/4 Sleeve T-shirt
$40.00

Figure erasing Wine Label

Figure erasing Wine Label
$5.00

Figure erasing Tea Tumbler

Figure erasing Tea Tumbler
$19.50

Figure erasing Sticky Notepad

Figure erasing Sticky Notepad
$19.50

Figure erasing Silver Teardrop Necklace

Figure erasing Silver Teardrop Necklace
$49.50

Figure erasing Silver Portrait Necklace

Figure erasing Silver Portrait Necklace
$49.50

Figure erasing Round Pet Tag

Figure erasing Round Pet Tag
$6.50

Figure erasing Rectangular Cocktail Plate

Figure erasing Rectangular Cocktail Plate
$14.50

Figure erasing Rectangle Magnet

Figure erasing Rectangle Magnet
$5.00

Figure erasing Power Bank

Figure erasing Power Bank
$65.00

Figure erasing Postcards (Package of 8)

Figure erasing Postcards (Package of 8)
$12.00

Figure erasing Portrait Keychain

Figure erasing Portrait Keychain
$24.50

Figure erasing Oval Ornament

Figure erasing Oval Ornament
$12.50

Figure erasing Oval Ornament

Figure erasing Oval Ornament
$12.50

Figure erasing Note Cards (Pk of 20)

Figure erasing Note Cards (Pk of 20)
$29.50

Figure erasing Note Cards (Pk of 10)

Figure erasing Note Cards (Pk of 10)
$19.50

Figure erasing Necklace Oval Charm

Figure erasing Necklace Oval Charm
$25.00

Figure erasing Necklace Heart Charm

Figure erasing Necklace Heart Charm
$25.00

Figure erasing Large Luggage Tag

Figure erasing Large Luggage Tag
$15.00

Figure erasing iPhone 4 Slider Case

Figure erasing iPhone 4 Slider Case
$24.50

Figure erasing Hexagon Ornament

Figure erasing Hexagon Ornament
$12.50

Figure erasing Heart Pet Tag

Figure erasing Heart Pet Tag
$6.50

Figure erasing Greeting Card

Figure erasing Greeting Card
$4.00

Figure erasing Flask Necklace

Figure erasing Flask Necklace
$19.50

Figure erasing Earring Oval Charm

Figure erasing Earring Oval Charm
$22.50

Figure erasing Earring Heart Charm

Figure erasing Earring Heart Charm
$22.50

Figure erasing Beer Label

Figure erasing Beer Label
$5.00

Figure erasing Aluminum Photo Keychain

Figure erasing Aluminum Photo Keychain
$9.50

Figure erasing Aluminum Oval Keychain

Figure erasing Aluminum Oval Keychain
$9.50

Eyescape Women's Tracksuit

Eyescape Women’s Tracksuit
$59.50

Eyescape Women's Raglan Hoodie

Eyescape Women’s Raglan Hoodie
$44.50

Eyescape Tea Tumbler

Eyescape Tea Tumbler
$34.00

Eyescape Snowflake Ornament

Eyescape Snowflake Ornament
$12.50

Eyescape Small Round Pet Tag

Eyescape Small Round Pet Tag
$19.50

Eyescape Small Heart Pet Tag

Eyescape Small Heart Pet Tag
$19.50

Eyescape Shot Glass

Eyescape Shot Glass
$12.50

Eyescape Round Wine Charm

Eyescape Round Wine Charm
$19.50

Eyescape Round Ornament

Eyescape Round Ornament
$12.50

Eyescape Round Keychain

Eyescape Round Keychain
$24.50

Eyescape Round Compact Mirror

Eyescape Round Compact Mirror
$15.00

Eyescape Round Cocktail Plate

Eyescape Round Cocktail Plate
$14.50

Eyescape Mens Wallet

Eyescape Mens Wallet
$40.00

Eyescape Large Round Pet Tag

Eyescape Large Round Pet Tag
$22.50

Eyescape Large Heart Pet Tag

Eyescape Large Heart Pet Tag
$22.50

Eyescape Jr. Spaghetti Tank

Eyescape Jr. Spaghetti Tank
$24.50

Eyescape Jr. Hoodie

Eyescape Jr. Hoodie
$44.50

Eyescape Heart Wine Charm

Eyescape Heart Wine Charm
$19.50

Eyescape Heart Keychain

Eyescape Heart Keychain
$24.50

Eyescape Golf Shirt

Eyescape Golf Shirt
$34.00

Eyescape Golf Balls

Eyescape Golf Balls
$18.00

Eyescape Flask

Eyescape Flask
$24.50

Eyescape Drinking Glass

Eyescape Drinking Glass
$16.00

Eyescape Cocktail Shaker

Eyescape Cocktail Shaker
$29.50

Eyescape Classic Thong

Eyescape Classic Thong
$15.00

Eyescape Canvas Lunch Tote

Eyescape Canvas Lunch Tote
$16.50

Eyescape Canvas Lunch Bag

Eyescape Canvas Lunch Bag
$16.50

Eyescape Can Insulator

Eyescape Can Insulator
$16.00

Eyescape Bottle Wine Chiller

Eyescape Bottle Wine Chiller
$34.50

Drewdle Womens Burnout Tee

Drewdle Womens Burnout Tee
$35.50

Drewdle Tea Tumbler

Drewdle Tea Tumbler
$19.50

Drewdle Sticker (Rectangle)

Drewdle Sticker (Rectangle)
$5.00

Drewdle Sticker (Oval)

Drewdle Sticker (Oval)
$5.00

Drewdle Stainless Water Bottle 1.0L

Drewdle Stainless Water Bottle 1.0L
$19.50

Drewdle Stainless Water Bottle 0.6L

Drewdle Stainless Water Bottle 0.6L
$18.00

Drewdle Rectangular Cocktail Plate

Drewdle Rectangular Cocktail Plate
$14.50

Drewdle Rectangle Magnet

Drewdle Rectangle Magnet
$5.00

Drewdle Rectangle Car Magnet

Drewdle Rectangle Car Magnet
$6.00

Drewdle Postcards (Package of 8)

Drewdle Postcards (Package of 8)
$12.00

Drewdle Oval Ornament

Drewdle Oval Ornament
$12.50

Drewdle Oval Car Magnet

Drewdle Oval Car Magnet
$6.00

Drewdle Nook Sleeve

Drewdle Nook Sleeve
$29.50

Drewdle Large Luggage Tag

Drewdle Large Luggage Tag
$15.00

Drewdle Journal

Drewdle Journal
$14.50

Drewdle iPad Mini Switch Case

Drewdle iPad Mini Switch Case
$29.50

Drewdle Greeting Card

Drewdle Greeting Card
$4.00

Drewdle Flask Necklace

Drewdle Flask Necklace
$19.50

Drewdle Earring Oval Charm

Drewdle Earring Oval Charm
$22.50

Drewdle Christmas Stocking

Drewdle Christmas Stocking
$16.50

Drewdle Boxer Shorts

Drewdle Boxer Shorts
$20.00

Drewdle Aluminum Photo Keychain

Drewdle Aluminum Photo Keychain
$9.50

Drewdle 35x21 Wall Decal

Drewdle 35×21 Wall Decal
$24.00

Drewdle 35x21 Oval Wall Decal

Drewdle 35×21 Oval Wall Decal
$24.00

Drewdle 20x12 Wall Decal

Drewdle 20×12 Wall Decal
$15.00

Drewdle 20x12 Oval Wall Decal

Drewdle 20×12 Oval Wall Decal
$15.00

Dragon Lick Tie Clip

Dragon Lick Tie Clip
$14.00

Dragon Lick Square Keychain

Dragon Lick Square Keychain
$24.50

Dragon Lick Small Heart Pet Tag

Dragon Lick Small Heart Pet Tag
$19.50

Dragon Lick Silver Heart Necklace

Dragon Lick Silver Heart Necklace
$49.50

Dragon Lick Silver Heart Charm

Dragon Lick Silver Heart Charm
$39.50

Dragon Lick Ring

Dragon Lick Ring
$35.00

Dragon Lick Rectangle Magnet

Dragon Lick Rectangle Magnet
$5.00

Dragon Lick Oval Keychain

Dragon Lick Oval Keychain
$24.50

Dragon Lick Money Clip

Dragon Lick Money Clip
$18.00

Dragon Lick Magnet

Dragon Lick Magnet
$5.00

Dragon Lick Luggage Handle Wrap

Dragon Lick Luggage Handle Wrap
$12.50

Dragon Lick Large Square Pet Tag

Dragon Lick Large Square Pet Tag
$22.50

Dragon Lick Large Oval Pet Tag

Dragon Lick Large Oval Pet Tag
$22.50

Dragon Lick Large Landscape Pet Tag

Dragon Lick Large Landscape Pet Tag
$22.50

Dragon Lick Large Heart Pet Tag

Dragon Lick Large Heart Pet Tag
$22.50

Dragon Lick Landscape Keychain

Dragon Lick Landscape Keychain
$24.50

Dragon Lick Heart Wine Charm

Dragon Lick Heart Wine Charm
$19.50

Dragon Lick Heart Keychain

Dragon Lick Heart Keychain
$24.50

Dragon Lick Earring Circle Charm

Dragon Lick Earring Circle Charm
$22.50

Dragon Lick Dog Tags

Dragon Lick Dog Tags
$22.00

Dragon Lick Cufflinks

Dragon Lick Cufflinks
$35.00

Dragon Lick Cufflinks

Dragon Lick Cufflinks
$35.00

Dragon Lick Charm Bracelet, One Charm

Dragon Lick Charm Bracelet, One Charm
$22.00

Dragon Lick Bone Pet Tag

Dragon Lick Bone Pet Tag
$6.50

Dragon Lick 20x12 Wall Decal

Dragon Lick 20×12 Wall Decal
$15.00

Dragon Lick 20x12 Oval Wall Decal

Dragon Lick 20×12 Oval Wall Decal
$15.00

Dragon Lick 2.25

Dragon Lick 2.25″ Button
$5.00

Don't be afraid Tie Clip

Don’t be afraid Tie Clip
$14.00

Don't be afraid Teardrop Wine Charm

Don’t be afraid Teardrop Wine Charm
$19.50

Don't be afraid Sticky Notepad

Don’t be afraid Sticky Notepad
$19.50

Don't be afraid Square Pill Box

Don’t be afraid Square Pill Box
$15.00

Don't be afraid Small Teardrop Pet Tag

Don’t be afraid Small Teardrop Pet Tag
$19.50

Don't be afraid Small Portrait Pet Tag

Don’t be afraid Small Portrait Pet Tag
$19.50

Don't be afraid Small Oval Pet Tag

Don’t be afraid Small Oval Pet Tag
$19.50

Don't be afraid Silver Teardrop Necklace

Don’t be afraid Silver Teardrop Necklace
$49.50

Don't be afraid Silver Teardrop Charm

Don’t be afraid Silver Teardrop Charm
$39.50

Don't be afraid Silver Portrait Necklace

Don’t be afraid Silver Portrait Necklace
$49.50

Don't be afraid Silver Portrait Charm

Don’t be afraid Silver Portrait Charm
$39.50

Don't be afraid Silver Oval Necklace

Don’t be afraid Silver Oval Necklace
$49.50

Don't be afraid Silver Oval Charm

Don’t be afraid Silver Oval Charm
$39.50

Don't be afraid Round Pet Tag

Don’t be afraid Round Pet Tag
$6.50

Don't be afraid Ring

Don’t be afraid Ring
$35.00

Don't be afraid Rectangle Magnet

Don’t be afraid Rectangle Magnet
$5.00

Don't be afraid Portrait Wine Charm

Don’t be afraid Portrait Wine Charm
$19.50

Don't be afraid Portrait Keychain

Don’t be afraid Portrait Keychain
$24.50

Don't be afraid Oval Wine Charm

Don’t be afraid Oval Wine Charm
$19.50

Don't be afraid Oval Ornament

Don’t be afraid Oval Ornament
$12.50

Don't be afraid Oval Ornament

Don’t be afraid Oval Ornament
$12.50

Don't be afraid Note Cards (Pk of 20)

Don’t be afraid Note Cards (Pk of 20)
$29.50

Don't be afraid Note Cards (Pk of 10)

Don’t be afraid Note Cards (Pk of 10)
$19.50

Don't be afraid Necklace Oval Charm

Don’t be afraid Necklace Oval Charm
$25.00

Don't be afraid Necklace Heart Charm

Don’t be afraid Necklace Heart Charm
$25.00

Don't be afraid Luggage Handle Wrap

Don’t be afraid Luggage Handle Wrap
$12.50

Don't be afraid Large Portrait Pet Tag

Don’t be afraid Large Portrait Pet Tag
$22.50

Don't be afraid Heart Pet Tag

Don’t be afraid Heart Pet Tag
$6.50

Don't be afraid Earring Oval Charm

Don’t be afraid Earring Oval Charm
$22.50

Don't be afraid Earring Heart Charm

Don’t be afraid Earring Heart Charm
$22.50

Don't be afraid Dog Tags

Don’t be afraid Dog Tags
$22.00

Don't be afraid Cufflinks

Don’t be afraid Cufflinks
$35.00

Don't be afraid Christmas Stocking

Don’t be afraid Christmas Stocking
$16.50

Don't be afraid Beer Label

Don’t be afraid Beer Label
$5.00

Don't be afraid Aluminum Photo Keychain

Don’t be afraid Aluminum Photo Keychain
$9.50

Don't be afraid Aluminum Oval Keychain

Don’t be afraid Aluminum Oval Keychain
$9.50

Don't be afraid 20x12 Wall Decal

Don’t be afraid 20×12 Wall Decal
$15.00

Don't be afraid 20x12 Oval Wall Decal

Don’t be afraid 20×12 Oval Wall Decal
$15.00

Crazy by Voln Yellow T-Shirt

Crazy by Voln Yellow T-Shirt
$32.50

Crazy by Voln Women's Zip Hoodie

Crazy by Voln Women’s Zip Hoodie
$49.50

Crazy by Voln Women's V-Neck T-Shirt

Crazy by Voln Women’s V-Neck T-Shirt
$35.50

Crazy by Voln Women's T-Shirt

Crazy by Voln Women’s T-Shirt
$32.50

Crazy by Voln Women's Tracksuit

Crazy by Voln Women’s Tracksuit
$59.50

Crazy by Voln Women's Tank Top

Crazy by Voln Women’s Tank Top
$24.50

Crazy by Voln Women's Raglan Hoodie

Crazy by Voln Women’s Raglan Hoodie
$44.50

Crazy by Voln Women's Nightshirt

Crazy by Voln Women’s Nightshirt
$32.50

Crazy by Voln Women's Long Sleeve T-Shirt

Crazy by Voln Women’s Long Sleeve T-Shirt
$38.00

Crazy by Voln Women's Light T-Shirt

Crazy by Voln Women’s Light T-Shirt
$32.50

Crazy by Voln Women's Light Pajamas

Crazy by Voln Women’s Light Pajamas
$44.50

Crazy by Voln Womens Burnout Tee

Crazy by Voln Womens Burnout Tee
$35.50

Crazy by Voln Wine Label

Crazy by Voln Wine Label
$5.00

Crazy by Voln White T-Shirt

Crazy by Voln White T-Shirt
$32.50

Crazy by Voln Tote Bag

Crazy by Voln Tote Bag
$22.00

Crazy by Voln Tile Coaster

Crazy by Voln Tile Coaster
$12.50

Crazy by Voln Teardrop Wine Charm

Crazy by Voln Teardrop Wine Charm
$19.50

Crazy by Voln Tea Tumbler

Crazy by Voln Tea Tumbler
$34.00

Crazy by Voln Sweatshirt

Crazy by Voln Sweatshirt
$41.50

Crazy by Voln Sticky Notepad

Crazy by Voln Sticky Notepad
$19.50

Crazy by Voln Square Wine Charm

Crazy by Voln Square Wine Charm
$19.50

Crazy by Voln Square Sticker 3

Crazy by Voln Square Sticker 3″ x 3″
$5.00

Crazy by Voln Square Purse Hanger

Crazy by Voln Square Purse Hanger
$15.00

Crazy by Voln Square Pill Box

Crazy by Voln Square Pill Box
$15.00

Crazy by Voln Square Locker Frame

Crazy by Voln Square Locker Frame
$9.50

Crazy by Voln Square Keychain

Crazy by Voln Square Keychain
$24.50

Crazy by Voln Square Compact Mirror

Crazy by Voln Square Compact Mirror
$15.00

Crazy by Voln Square Cocktail Plate

Crazy by Voln Square Cocktail Plate
$14.50

Crazy by Voln Square Coaster

Crazy by Voln Square Coaster
$12.50

Crazy by Voln Square Car Magnet 3

Crazy by Voln Square Car Magnet 3″ x 3″
$6.00

Crazy by Voln Snowflake Ornament

Crazy by Voln Snowflake Ornament
$12.50

Crazy by Voln Small Teardrop Pet Tag

Crazy by Voln Small Teardrop Pet Tag
$19.50

Crazy by Voln Small Square Pet Tag

Crazy by Voln Small Square Pet Tag
$19.50

Crazy by Voln Small Round Pet Tag

Crazy by Voln Small Round Pet Tag
$19.50

Crazy by Voln Small Heart Pet Tag

Crazy by Voln Small Heart Pet Tag
$19.50

Crazy by Voln Shot Glass

Crazy by Voln Shot Glass
$12.50

Crazy by Voln Round Wine Charm

Crazy by Voln Round Wine Charm
$19.50

Crazy by Voln Round Purse Hanger

Crazy by Voln Round Purse Hanger
$15.00

Crazy by Voln Round Pill Box

Crazy by Voln Round Pill Box
$15.00

Crazy by Voln Round Ornament

Crazy by Voln Round Ornament
$12.50

Crazy by Voln Round Ornament

Crazy by Voln Round Ornament
$12.50

Crazy by Voln Round Keychain

Crazy by Voln Round Keychain
$24.50

Crazy by Voln Round Compact Mirror

Crazy by Voln Round Compact Mirror
$15.00

Crazy by Voln Round Cocktail Plate

Crazy by Voln Round Cocktail Plate
$14.50

Crazy by Voln Round Coaster

Crazy by Voln Round Coaster
$12.50

Crazy by Voln Ringer T

Crazy by Voln Ringer T
$32.50

Crazy by Voln Reusable Shopping Bag

Crazy by Voln Reusable Shopping Bag
$19.50

Crazy by Voln Racerback Tank Top

Crazy by Voln Racerback Tank Top
$31.50

Crazy by Voln Organic Women's T-Shirt

Crazy by Voln Organic Women’s T-Shirt
$38.00

Crazy by Voln Organic Women's Fitted T-Shirt

Crazy by Voln Organic Women’s Fitted T-Shirt
$38.00

Crazy by Voln Organic Men's T-Shirt

Crazy by Voln Organic Men’s T-Shirt
$38.00

Crazy by Voln Organic Men's Fitted T-Shirt

Crazy by Voln Organic Men’s Fitted T-Shirt
$38.00

Crazy by Voln Necklace Heart Charm

Crazy by Voln Necklace Heart Charm
$25.00

Crazy by Voln Necklace Circle Charm

Crazy by Voln Necklace Circle Charm
$25.00

Crazy by Voln Mini Button

Crazy by Voln Mini Button
$3.00

Crazy by Voln Mens Wallet

Crazy by Voln Mens Wallet
$40.00

Crazy by Voln Men's V-Neck T-Shirt

Crazy by Voln Men’s V-Neck T-Shirt
$35.50

Crazy by Voln Men's Sleeveless Tee

Crazy by Voln Men’s Sleeveless Tee
$28.50

Crazy by Voln Men's Light Pajamas

Crazy by Voln Men’s Light Pajamas
$44.50

Crazy by Voln Maternity T-Shirt

Crazy by Voln Maternity T-Shirt
$37.00

Crazy by Voln Maternity Tank Top

Crazy by Voln Maternity Tank Top
$35.00

Crazy by Voln Magnet

Crazy by Voln Magnet
$5.00

Crazy by Voln Luggage Handle Wrap

Crazy by Voln Luggage Handle Wrap
$12.50

Crazy by Voln Long Sleeve T-Shirt

Crazy by Voln Long Sleeve T-Shirt
$38.00

Crazy by Voln Long Sleeve Maternity T-Shirt

Crazy by Voln Long Sleeve Maternity T-Shirt
$45.00

Crazy by Voln Light T-Shirt

Crazy by Voln Light T-Shirt
$32.50

Crazy by Voln Large Square Pet Tag

Crazy by Voln Large Square Pet Tag
$22.50

Crazy by Voln Large Round Pet Tag

Crazy by Voln Large Round Pet Tag
$22.50

Crazy by Voln Large Heart Pet Tag

Crazy by Voln Large Heart Pet Tag
$22.50

Crazy by Voln Keepsake Box

Crazy by Voln Keepsake Box
$29.50

Crazy by Voln Jr. Spaghetti Tank

Crazy by Voln Jr. Spaghetti Tank
$24.50

Crazy by Voln Jr. Ringer T-Shirt

Crazy by Voln Jr. Ringer T-Shirt
$32.50

Crazy by Voln Jr. Jersey T-Shirt

Crazy by Voln Jr. Jersey T-Shirt
$35.50

Crazy by Voln Jr. Hoodie

Crazy by Voln Jr. Hoodie
$44.50

Crazy by Voln Jr. Football T-Shirt

Crazy by Voln Jr. Football T-Shirt
$35.50

Crazy by Voln Jewelry Case

Crazy by Voln Jewelry Case
$29.50

Crazy by Voln Hooded Sweatshirt

Crazy by Voln Hooded Sweatshirt
$44.50

Crazy by Voln Heart Wine Charm

Crazy by Voln Heart Wine Charm
$19.50

Crazy by Voln Heart Pet Tag

Crazy by Voln Heart Pet Tag
$6.50

Crazy by Voln Heart Keychain

Crazy by Voln Heart Keychain
$24.50

Crazy by Voln Green T-Shirt

Crazy by Voln Green T-Shirt
$32.50

Crazy by Voln Golf Shirt

Crazy by Voln Golf Shirt
$34.00

Crazy by Voln Golf Balls

Crazy by Voln Golf Balls
$18.00

Crazy by Voln Girl's Tee

Crazy by Voln Girl’s Tee
$28.50

Crazy by Voln Gel Mousepad

Crazy by Voln Gel Mousepad
$19.50

Crazy by Voln Framed Tile

Crazy by Voln Framed Tile
$16.50

Crazy by Voln Flask

Crazy by Voln Flask
$24.50

Crazy by Voln Fitted T-Shirt

Crazy by Voln Fitted T-Shirt
$35.50

Crazy by Voln Earring Heart Charm

Crazy by Voln Earring Heart Charm
$22.50

Crazy by Voln Earring Circle Charm

Crazy by Voln Earring Circle Charm
$22.50

Crazy by Voln Drinking Glass

Crazy by Voln Drinking Glass
$16.00

Crazy by Voln Dog T-Shirt

Crazy by Voln Dog T-Shirt
$19.50

Crazy by Voln Dog Hoodie

Crazy by Voln Dog Hoodie
$22.00

Crazy by Voln Cookie Jar

Crazy by Voln Cookie Jar
$22.50

Crazy by Voln Cocktail Shaker

Crazy by Voln Cocktail Shaker
$29.50

Crazy by Voln Classic Thong

Crazy by Voln Classic Thong
$15.00

Crazy by Voln Charm Bracelet, One Charm

Crazy by Voln Charm Bracelet, One Charm
$22.00

Crazy by Voln Canvas Lunch Tote

Crazy by Voln Canvas Lunch Tote
$16.50

Crazy by Voln Canvas Lunch Bag

Crazy by Voln Canvas Lunch Bag
$16.50

Crazy by Voln Can Insulator

Crazy by Voln Can Insulator
$16.00

Crazy by Voln Bottle Wine Chiller

Crazy by Voln Bottle Wine Chiller
$34.50

Crazy by Voln Baseball Jersey

Crazy by Voln Baseball Jersey
$38.00

Crazy by Voln 3/4 Sleeve T-shirt

Crazy by Voln 3/4 Sleeve T-shirt
$40.00

Crazy by Voln 3.5

Crazy by Voln 3.5″ Button
$7.00

Crazy by Voln 2.25

Crazy by Voln 2.25″ Button
$5.00

Butch Guineas Wine Stopper

Butch Guineas Wine Stopper
$19.50

Butch Guineas Square Purse Hanger

Butch Guineas Square Purse Hanger
$15.00

Butch Guineas Small Round Pet Tag

Butch Guineas Small Round Pet Tag
$19.50

Butch Guineas Silver Round Necklace

Butch Guineas Silver Round Necklace
$49.50

Butch Guineas Silver Round Charm

Butch Guineas Silver Round Charm
$39.50

Butch Guineas Shot Glass

Butch Guineas Shot Glass
$12.50

Butch Guineas Round Wine Charm

Butch Guineas Round Wine Charm
$19.50

Butch Guineas Round Pill Box

Butch Guineas Round Pill Box
$15.00

Butch Guineas Round Keychain

Butch Guineas Round Keychain
$24.50

Butch Guineas Ring

Butch Guineas Ring
$35.00

Butch Guineas Ring

Butch Guineas Ring
$35.00

Butch Guineas Rectangle Magnet

Butch Guineas Rectangle Magnet
$5.00

Butch Guineas Oval Keychain

Butch Guineas Oval Keychain
$24.50

Butch Guineas Necklace Circle Charm

Butch Guineas Necklace Circle Charm
$25.00

Butch Guineas Mini Button

Butch Guineas Mini Button
$3.00

Butch Guineas Magnet

Butch Guineas Magnet
$5.00

Butch Guineas Luggage Handle Wrap

Butch Guineas Luggage Handle Wrap
$12.50

Butch Guineas Large Round Pet Tag

Butch Guineas Large Round Pet Tag
$22.50

Butch Guineas Large Oval Pet Tag

Butch Guineas Large Oval Pet Tag
$22.50

Butch Guineas Large Landscape Pet Tag

Butch Guineas Large Landscape Pet Tag
$22.50

Butch Guineas Large Heart Pet Tag

Butch Guineas Large Heart Pet Tag
$22.50

Butch Guineas Landscape Keychain

Butch Guineas Landscape Keychain
$24.50

Butch Guineas Heart Keychain

Butch Guineas Heart Keychain
$24.50

Butch Guineas Golf Balls

Butch Guineas Golf Balls
$18.00

Butch Guineas Dog Tags

Butch Guineas Dog Tags
$22.00

Butch Guineas Cufflinks

Butch Guineas Cufflinks
$35.00

Butch Guineas Cufflinks

Butch Guineas Cufflinks
$35.00

Butch Guineas Cufflinks

Butch Guineas Cufflinks
$35.00

Butch Guineas Charm Bracelet, One Charm

Butch Guineas Charm Bracelet, One Charm
$22.00

Butch Guineas Bone Pet Tag

Butch Guineas Bone Pet Tag
$6.50

Butch Guineas 20x12 Wall Decal

Butch Guineas 20×12 Wall Decal
$15.00

Butch Guineas 20x12 Oval Wall Decal

Butch Guineas 20×12 Oval Wall Decal
$15.00

Butch Guineas 2.25

Butch Guineas 2.25″ Button
$5.00

bIG mONSTER Women's Tracksuit

bIG mONSTER Women’s Tracksuit
$59.50

bIG mONSTER Women's Raglan Hoodie

bIG mONSTER Women’s Raglan Hoodie
$44.50

bIG mONSTER Teardrop Wine Charm

bIG mONSTER Teardrop Wine Charm
$19.50

bIG mONSTER Tea Tumbler

bIG mONSTER Tea Tumbler
$34.00

bIG mONSTER Sticky Notepad

bIG mONSTER Sticky Notepad
$19.50

bIG mONSTER Square Wine Charm

bIG mONSTER Square Wine Charm
$19.50

bIG mONSTER Square Sticker 3

bIG mONSTER Square Sticker 3″ x 3″
$5.00

bIG mONSTER Square Purse Hanger

bIG mONSTER Square Purse Hanger
$15.00

bIG mONSTER Square Pill Box

bIG mONSTER Square Pill Box
$15.00

bIG mONSTER Square Keychain

bIG mONSTER Square Keychain
$24.50

bIG mONSTER Square Compact Mirror

bIG mONSTER Square Compact Mirror
$15.00

bIG mONSTER Square Coaster

bIG mONSTER Square Coaster
$12.50

bIG mONSTER Square Car Magnet 3

bIG mONSTER Square Car Magnet 3″ x 3″
$6.00

bIG mONSTER Snowflake Ornament

bIG mONSTER Snowflake Ornament
$12.50

bIG mONSTER Small Teardrop Pet Tag

bIG mONSTER Small Teardrop Pet Tag
$19.50

bIG mONSTER Small Square Pet Tag

bIG mONSTER Small Square Pet Tag
$19.50

bIG mONSTER Small Round Pet Tag

bIG mONSTER Small Round Pet Tag
$19.50

bIG mONSTER Small Oval Pet Tag

bIG mONSTER Small Oval Pet Tag
$19.50

bIG mONSTER Shot Glass

bIG mONSTER Shot Glass
$12.50

bIG mONSTER Round Wine Charm

bIG mONSTER Round Wine Charm
$19.50

bIG mONSTER Round Purse Hanger

bIG mONSTER Round Purse Hanger
$15.00

bIG mONSTER Round Pill Box

bIG mONSTER Round Pill Box
$15.00

bIG mONSTER Round Pet Tag

bIG mONSTER Round Pet Tag
$6.50

bIG mONSTER Round Ornament

bIG mONSTER Round Ornament
$12.50

bIG mONSTER Round Ornament

bIG mONSTER Round Ornament
$12.50

bIG mONSTER Round Keychain

bIG mONSTER Round Keychain
$24.50

bIG mONSTER Round Compact Mirror

bIG mONSTER Round Compact Mirror
$15.00

bIG mONSTER Round Cocktail Plate

bIG mONSTER Round Cocktail Plate
$14.50

bIG mONSTER Oval Wine Charm

bIG mONSTER Oval Wine Charm
$19.50

bIG mONSTER Necklace Heart Charm

bIG mONSTER Necklace Heart Charm
$25.00

bIG mONSTER Necklace Circle Charm

bIG mONSTER Necklace Circle Charm
$25.00

bIG mONSTER Mini Button

bIG mONSTER Mini Button
$3.00

bIG mONSTER Magnet

bIG mONSTER Magnet
$5.00

bIG mONSTER Luggage Handle Wrap

bIG mONSTER Luggage Handle Wrap
$12.50

bIG mONSTER Large Square Pet Tag

bIG mONSTER Large Square Pet Tag
$22.50

bIG mONSTER Large Round Pet Tag

bIG mONSTER Large Round Pet Tag
$22.50

bIG mONSTER Jr. Spaghetti Tank

bIG mONSTER Jr. Spaghetti Tank
$24.50

bIG mONSTER Jr. Hoodie

bIG mONSTER Jr. Hoodie
$44.50

bIG mONSTER Hexagon Ornament

bIG mONSTER Hexagon Ornament
$12.50

bIG mONSTER Heart Pet Tag

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News from the Cuckoo’s Nest

One-Flew-Over-the-Cuckoo-s-Nest

We got a look at a new report today. The hospital is all about hiring consultants and then systemically ignoring what they tell us. Our latest visit was from Dr. Ragins of MHA-LA.

I suspected we would never see a non-redacted version of his recommendations but I’ve been proven wrong.

Here it is, along with a older report he did as a pdf link. I’ve also included the introductory letter from our CMO, Dr. Rupert Goetz.

December 6, 2013

 

To:                          All affected staff

 

From:                    Rupert Goetz, MD

 

Subject:               Attached Consultative Report

 

 

 

As we move into this biennium, one of the changes we are pursuing is to strengthen our understanding of “Recovery” at OSH. Hope, Safety and Recovery are after all the three core concepts in our Vision Statement.

In strengthening our understanding, we want to build on our past (remember the collaboration between Dean Brooks and Maxwell Jones around the Therapeutic Community concept; remember more recently the visit by Sandra Bloom around the Sanctuary Model). But primarily, we want to look forward. We want to look at the many ways we can grow together. For example, we also want to better understand how peer-delivered services can help us build our desired culture.

To that end, I asked Mark Ragins, M.D., who has for years helped implement the recovery model at The Village in California, to visit with us and share his thoughts. Attached is his report.

The purpose of the visit and of sharing the report is to provide us with an outside perspective. While we want to honor our past, as well as our many current internal champions, we want to creatively plan our path forward together. This additional perspective is intended to help us do so.

There are minor details such as the “not guilty” reference (it is in Oregon “guilty except for insanity”) that we might want to quibble with. There may also be the assumption that this is the blueprint for our work in the coming year – it is not. I hope rather that you find it a thought-provoking place to begin our conversation about how we strengthen recovery at OSH.

 

 

 

 

 

 

Oregon State Hospital Recovery Transformation Consultation Report

Mark Ragins, MD

 

 

 

Acknowledgements:

 

I want to thank the Oregon State Hospital for welcoming me to share your work and your lives with me. A friend of mine defines welcoming as “opening a space in your life for a guest to feel comfortable and opening yourself up to them, knowing full well your guest may change you in unexpected ways.”  I have felt truly welcomed by you.  I hope I have been a good guest.

This report is not meant to be an expert, authoritative evaluation and orders for you.  Recovery transformation is a complex problem and complex problems are not solved by outsiders or by definitive answers. Successful transformation is an evolving, collaborative process that never ends.  At best my influence can by to support, nurture, inspire, instruct, guide, and share your organic process of growth. The explorations, observations, thoughts, and suggestions I’m writing here are just the current iteration of my evolving reactions.

I have attached a large volume of reference material from our work at MHALA and the Village. These are not meant to be blueprints for you to replicate the Village or even an instruction book for you to build your own program.  They are concrete, real world, useful tools we have evolved in our own process that may inspire your imagination of what possibilities you might pursue. Remember that they have evolved over decades of work at MHALA and the Village…and we’re not slow learners; we’re aggressive innovators.

 

A note on language in this report: The words I most commonly heard you use to describe the people you serve were patient and client. There was widespread distaste for the word inmate. In other places I’ve seen people also called residents, guests, members, students, consumers, people in recovery, etc. It’s likely that each of those words would be an accurate description of roles people have experienced along the way.  There is a considerable power in the words we choose and how they reflect our mission and values. Your choice has evolved and may evolve further.  I will use patient and client interchangeably in this report to “meet you where you are”.

 

Recovery and the Oregon State Hospital:

 

For me the initial overriding question for this consultation was “Is it possible to use recovery as an overarching philosophy and approach at a place like OSH?” Recovery emphasizes concepts like empowerment, self determination, self responsibility, and community integration. The patients at OSH have been specifically selected for people who are unsafe, untrustworthy, incompetent to be held self

 

responsible, and who have been forcibly excluded from community life.  Even for a true believer in recovery and strong advocate like me that seems a difficult challenge.

Can people at OSH actually recover? Over my few days at OSH I saw several things that impressed me that the answer is yes. Firstly, the enormous majority of people at OSH will be living free from restriction in our community at some point in the future. Their day-to-day reality at OSH emphasizes risk assessment, confinement and restriction. But if we take the long view, the vast majority of people realistically should be preparing for freedom, not ongoing confinement.  Second, the long term staff I met were all hopeful for the clients they’re working with.  They believe things will get better for them. Third, and probably most importantly, there were widespread examples of patients at all points in their journey who are making progress and recovering. These ranged from someone who was soothing himself with a guitar to reduce his assaultiveness and seclusion from every day to a few times a week to a young man doing Calculus homework for his online college class who has been approved for discharge to a group home hoping to continue his studies on campus. Whether you describe yourselves in recovery terms or not, recovery is happening at OSH now.

For recovery to be a pervasive culture, the wide range of hopes, dreams, and personal journeys of each patient’s recovery need to be unified into a shared collaborative vision and destination. My proposal is: People living at OSH are engaged in a hopeful, healing journey towards freedom, safety, and self responsibility. I believe that those three characteristics of the destination – freedom, safety, and self responsibility – are all mutually interdependent.  None can be sustained independently without the other two. Whichever of the three are not addressed and achieved will ultimately drag down the other two. I believe that vision of recovery can be applied throughout OSH.

My next concern about implementing recovery was “Is it possible for the staff to have relationships with the clients that regularly support and facilitate their recovery?”

The clients at OSH are in a strange, awkward moral place where society has rejected them without convicting them of any crime. The staff must be “abnormal in a certain special way” in order to reach out supportively to people who have been cut off and exiled by our society.  To create a “counterculture of acceptance” at OSH staff must be consistently accepting of them. It seems as though the majority of your staff is already there.

It would be helpful to have a unifying “moral stance” regarding the clients that everyone accepts. I would propose: These people have been determined not to be guilty, bad people who should be punished, but rather incapable people who should be supported to become capable again.  This stance is consistent with the recovery vision above. Staff who become punitive instead would need to be sanctioned. It would also be helpful to include the ability to accept your clients on that basis as part of your recruitment, hiring, orientation, training, and retention.

The other serious obstacle to forming recovery relationships is the danger staff are in because of the patients’ violence and the fear the staff feel as a result.  It is extremely difficult to collaborate with and empower someone we’re frightened of. A good deal of the staff seem to have embraced trauma

 

informed care as a tool for reducing fear, conflict, power struggles, and actual danger.  This should become universal.

Beyond that, the most impressive thing I saw at OSH was the innovative and exemplary practice on a very dangerous unit:  They have come together as an amazingly unified team, using a detailed, highly individualized “engagement” tool that assesses each person’s dangerous behaviors including their triggers, warning signs, helpful relationships, self soothing and care combined with a DBT approach.  The staff never give up and continue to seek out creative approaches for each person gaining administrative approval when exceptions to policy need to be made. They appear to have drastically reduced the dangerousness on the ward.  Beyond that, even though there continue to be assaults and seclusion and restraints, the staff feel safe and are allied with the clients.  This is a remarkable accomplishment that should be analyzed, replicated, rewarded, and treasured.  I believe that if it can be done widely alongside trauma informed care, it can get you through the fear barrier to recovery relationships.

I think more work could be done proactively and on an ongoing basis to keep staff from becoming too fearful and traumatized. Your staff have to have the resilience to feel safe even though they’ve been assaulted and likely will again. They may need to be selected for that trait (from a variety of experiences). They need support when they’re weakened and need recharging. They need each other most of all. Toughing it out alone or feeling trapped with a certain patient or unit are both likely to lead to burnout. Ongoing attention to staff nurturance to avoid fearfulness is essential.

My conclusion is that – with ongoing support and emphasis –  enough hope, acceptance, alongside enough avoidance of fearfulness and punitiveness could be maintained to have recovery relationships throughout OSH.

 

What advantages would recovery likely have at OSH that would make it worth the effort?

 

  • Integration of services:  There is a dazzling array of services at OSH ranging from psychiatric medications, to external controls, to sex offender therapy, to art and music therapy, to supported employment, to peer advocacy and bridging, to access to a legal library, to discharge resource development, to an Empowerment center, to yoga and mindfulness, to anger management and substance abuse groups, to Basketball and a woodwork workshop, etc. Although there are some team meetings and a coordination plan much of what is done is not integrated together.  A recovery focus brings the utility of each activity into focus: Does this activity move the person closer to freedom, safety, and self-responsibility from where they are now?  There is far less need for power struggles and hierarchies to determine whose work gets priority if you’re all in alliance working on the same goals in the same direction. It would also be clearer to the patient how everything fits together to benefit them.
  • Decreasing “staff vs. patient” conflicts:  Recovery emphasizes collaboration, shared decision making, and empowerment rather than compliance, informed consent, and professional authority. Those differences radically reduce conflict. Safety would likely be improved for both staff and patients as a result.
    • Decreased staff burnout and increased satisfaction: One of the most powerful factors behind the spread of recovery is how much staff prefer it once they are doing it openly and together and confidently compared to their previous work. At bottom, recovery feeds our hearts more than standard treatment does.
    • Alliance between administration and staff: if administration embraces and adopts recovery practices for themselves in addition to prescribing it for their line staff the entire program works more synergistically.
    • Improved community advocacy: When community advocacy is based on fear and “demonizing” our patients we can get extra money, but we badly decrease community welcoming and reintegration for our patients.  When community advocacy is based upon recovery, we can ally with our patients, and we have a foundation for promoting community welcoming and reintegration. Telling stories of patients achieving safety, freedom, and self responsibility are far more likely to help them be accepted than billboards of staff injuries at the hands of dangerous, frightening patients.
    • Protection against slipping into dehumanized, punitive, coercive relationships:  Any program that is involuntary, locked, and largely hidden from society is prone to slip into increasingly dehumanized, punitive, relationships and from there into overt abuse. Power is corrupting.  A recovery culture can provide a counterinfluence to these destructive trends.

 

 

Recovery   implementation:

 

Recovery is primarily a treatment culture. It emphasizes less what is done and more how and why it is done. Therefore, implementing recovery is a prolonged, organically evolving, complex process.  It needs to be tended and nurtured like a farmer does, not blueprinted and built like an engineer does.  Take  your time.  Be gentle to the land and be a good farmer:  Till the soil to prepare it, help pick out seeds and pay for them, plant alongside the staff and clients, fertilize and nurture seedlings, pull out weeds (but  not with widespread poisons),  rotate crops to avoid exhaustion, and celebrate the harvests together.

There are many recovery principles and practices – like “client-driven” or managing relationships during times of transition to promote growth and self responsibility or strengths based community advocacy – that require years to explore and master. Be patient. Here’s a link to something I wrote to comfort and guide transformational leaders:  http://mhavillage.squarespace.com/storage/69KeepingPerspectiveandStayingSane.pdf.

 

The land can be plowed by mapping recovery. There are a number of “maps” of recovery to adopt from, but you should create your own and it should be very specific to your clients’ journeys. Years ago I created a four stage “map” for the Village based on the work of Elizabeth Kubler-Ross that includes four stages– hope, empowerment, self-responsibility, and achieving meaningful roles.  http://mhavillage.squarespace.com/storage/08ARoadtoRecovery.pdf  is a link to my short book “A Road to Recovery” that describes this map using lots of stories and learning from our direct experiences at the Village.

 

Your map could include stages like:

 

  • Being involved in a tragic, socially forbidden action,
  • being determined to be incapable of self responsibility and punishment and referred to OSH to rebuild capability,
  • being faced with unwanted external control and coercion,
  • being stuck in resentment and rebellion,
  • resisting change and trying to “fake it to evade it”,
  • feeling ongoing pressure for internal change,
  • demoralization and giving up,
  • maladaptation to living in the institution,
  • having seeds of trust and collaboration with staff to try to rebuild,
  • prolonged internal self-evaluation and skill building in a variety of ways,
    • repeated cycles of failing to do enough to be released,
  • achieving release status but no community opportunities or resources,
  • being released and facing ongoing coercion and control and community rejection,
    • returning to unsafe behaviors and environments,
    • achieving full freedom, safety, and self responsibility.

 

It is essential that this map be from the clients’ point of view to be a recovery map.  (If it’s from the staff’s point of view it’s a treatment map, not a recovery map.)  The “gold standard” is that the clients can recognize themselves and their journeys on the map.  Make every effort to amplify the clients’ voice and experience.  Embellish the map with client stories, artwork, music, video, poetry, etc.   Here’s a link to a touching example of a video created by a group of consumers in Porterville, California:  http://www.youtube.com/watch?v=uH9gV_7jmiQs.

 

You can gain some cultural depth by connecting the map to other human journeys (like achieving death with dignity, Joseph Campbell’s hero’s journey, 12 step journeys, or other recovery narratives, etc.)

You can also gain some spread of this map from just applying to clients to applying to everyone by creating a narrative of the recovery process OSH has experienced going through the same stages as the clients. It almost seems uncanny to me how closely these stages describe the last few years at OSH. MHALA applied the same four stages our members go through to what staff go through when we structured our Recovery Oriented Supervision trainings to emphasize that we need to treat our staff the way we want them to treat our clients.

Your recovery map can then be a direct guide for determining how staff relationships facilitate or hinder recovery at each stage, how services should be organized and integrated “meeting clients where they are at”.  A standard for valuing staff and services becomes “How does this promote your client’s recovery?” rather than which staff has more power or influence within the system or hierarchy. This also makes the resolution more often “and” rather than “or” valuing each staff and service for their strengths and figuring out how they can work together instead of competing against each other. (For example, a team with a united front demonstrating a “show of force” standing behind an individual staff with a soothing relationship trying to help an aggressive client problem solve and re-establish self

 

control can work together without either one being “wrong”.)  It should be possible to promote efforts that strengthen people without weakening someone else.

The Village found that our treatment principles mapped directly onto our four stages map too (see attachment 1).  Notice how precisely stated and focused our principles are. You may have staff that are good at developing clear treatment principles that apply across OSH defining the “beliefs” that underlie your evolving recovery culture.

Administratively, you want to develop parameters to guide staff as they develop individualized recovery relationships rather than highly prescriptive policies, especially avoiding pervasive “thou shalt not” policies that “straightjacket” them. This link has a set of parameters that the LA County Department of Mental Health developed and adopted with our assistance:  http://mhavillage.squarespace.com/storage/82NewRulesforStafftoWorkBy.pdf.

 

OSH staff expressed a lot of change fatigue and burnout. My overall impression is that there are more people who think there have been too many changes, especially administratively engineered changes, than people who think that OSH is stagnant at present. Top down engineered changes engender more change fatigue and resistance than bottom up, organically emerging changes.  Except for three pointed exceptions I’ll describe below, I would recommend cultivating currently emerging changes instead of directing new mandates. (For example, after I visited a state hospital in Provo, Utah each staff member made a large cutout of a helping hand with one thing they would do differently to support hope, empowerment, self responsibility, or meaningful roles and then the patients responded by each of them making a large cutout of a foot with one thing they would do to walk a path with more hope, empowerment, self responsibility, and meaningful roles.  A lot of excitement and empowerment was generated there by this approach.)

 

Promising examples of emerging changes I heard about at OSH included:

 

  • Trauma informed approaches to reducing seclusion and restraint and increasing self control
  • Team based integrated engagement and DBT approaches to reducing aggression and assault
  • Creating more “nimble teams” that could rapidly solidify trust even with staff movement and turnover
  • Enhancing peer support services
  • Specialized ethnic and sexual orientation specific peer support
  • Using music recording to explore personal growth and create positive roles
  • Using yoga to address trauma wounds and healing in non-verbal ways
  • Create a robust family and community volunteer presence in the treatment malls to increase community connections and acceptance
  • Create a client key card system so that increase privileges and self responsibility are directly connected with increased freedom of movement around OSH. (BTW I saw this done successfully in that same state hospital in Provo Utah)
  • Openly discuss and develop parameters for including positive, permissible sexual activities including dating, hugging, dancing together, and conjugal visits.
  • Increase peer bridging to peer run organizations n the community to increase community supports and connections upon initial release from OSH
  • Creating a newsletter with stories of hope and recovery

 

 

I’m sure there are many more seeds and saplings of ideas around that need nurturance.

 

Hope requires a lot of consistent nurturance built into your program or we end up focusing on the crises of the day and the things that go wrong. ( Examples of hopeful rituals include beginning team meetings with stories of hope, regular celebrations, special staff acknowledgments and rewards, etc.) Too many policies are made to make sure one serious incident “never happens again” instead of strengthening us so when something tragic happens, and it inevitably will, we’re able to continue on.

The three area in which I would recommend you do serious course corrections (or to use our sailing metaphor, three places where I think you should tack – including communicating the need for a course change, micromanagement of the course change, and bringing people together to handle the change as a team) are: 1) personal dedicated recovery relationships, 2) peer support services, and 3) board hearings.

 

1)      Personal dedicated recovery relationships:

 

Your present system tries to ensure that everything is in place to facilitate someone’s recovery.  They have written goals and a recovery treatment plan. They have the availability of a wide variety of supports and services which they are scheduled into. And they have clear objective assessments to prepare them for hearings and release.  What they don’t always have is a trusting, collaborative relationship with a single dedicated staff to guide them through the process. This staff also needs to guide them through the internal process of recovery – engagement, motivational enhancement, commitment, dealing with grief and loss, internalizing skill building and role changes, moral development, building self responsibility and self reliance, preparing for discharge and community belonging.

I strongly prefer a “therapist case manager” model to a “broker case management” model for this primary relationship so that the internal and external processes of recovery can be integrated. At the Village we call this person a “Personal Service Coordinator” and have adopted Kansas University’s “strengths based case management” model.

I fear that implementing a PSC model at OSH will require substantial top-down structural reorganization, precisely of the kind resented by your staff and causing change fatigue and burnout.  Nonetheless, I think it’s a crucial course correction.

This is an opportunity to emphasize some of the more personal aspects of recovery relationships instead of making administrative assignments: Which staff is the best personal fit for this patient? Who has the most hope? Who has the least fear? Who has personal life experiences that enable them to connect to this person and inspire them? Who is strongest at the particular phase of recovery this person is in?

Client empowerment can also be overtly included: Who do you want to work with? Who do you trust

 

the most? The Village even has “open enrollment” periods every six months when our members can switch PSCs or teams within the same level of care without needing to give a justification.

2)      Peer support services:

 

There comes a point in the development of peer services when they need to move from being “angry outsider advocates” to “collaborative, insider reformers” to move forwards. As the walls keeping the patients’ voice silenced are lowered, other voices besides aggressive, antagonistic, self righteous voices can be heard. This is a disorienting time for peer advocates. The traits that have been absolutely essential to lowering those walls and bringing about change, that have been nothing less than heroic, are now being criticized and blamed for not being able to progress further. Newer peer staff may not respect their contribution and what they’ve been through so they could have a voice. These experienced peer advocates may not even agree that there has been substantial progress or that the walls have been lowered. They may fear a “trick” to weaken them or co-opt them.   And sometimes they will be right.

But at other times, when the swords are put down, there is a flourishing of other voices and relationships. Sometimes a Nelson Mandela emerges from the fight instead of dying on the battle field like Che Guevara did. Sometimes unions that were regularly striking and being repressed engage in collective bargaining or even shared ownership.

In my opinion, OSH has made enough progress to try to put the swords down. I would recommend substantially increasing the number of peer staff, while substantially decreasing their adversarial “peer advocacy” in favor of collaborative “peer support” services.

Making that course correction will likely be quite difficult. In my experience in other places what usually happens is that some of the most valued and successful long term peer advocates end up removed or reassigned out of the mainstream to move forwards. That seems a shame to me and I don’t know that it’s the only possible strategy.  It does however, open the door for a wider acceptance of, and integration of the other peer supporters with the treatment teams improving the patients’ recovery services directly.

At OSH there is a legal restrictiveness that exists side by side with the clinical services that is very important. This brings up the possibility that some of the most valued, but most dedicated to advocacy, peer staff could be moved into a new robust “peer advocacy” department and separated from the “peer support” department that would become co-supervised by the teams and by peers.  I don’t know if that’s been done in other forensic settings.  If the peer advocacy service was robust and respected enough it could be a valuable “check and balance” against the corruption of power and coercion that is an ever present risk in involuntary, locked settings.

I would advise having a small team of clients, staff, peers, and administration charged with developing a plan to move to a larger peer staff that is no longer emphasizing advocacy. They should seek out guidance from other exemplary peer services. I’ve been exposed to successful programs at Recovery Innovations, Riverside County and Tulare County in California, and King’s County Hospital in Brooklyn.

 

NAPS (National Association of Peer Specialists) can probably point you towards further resources. The team would be expected to inform and guide the process of changing course, but the course itself wouldn’t be negotiable.

In my view, the main emphasis at this point in your development is not to accentuate the differences between clients and staff but instead to blur those differences. Justice and righteousness are less crucial than trust and reconciliation.   Desegregation, power sharing, collaboration, mutual respect, inclusion, and interdependence would be my points of focus. Towards that end I would hire more “blurred people” – both peer staff who have professional skills and degrees and probably more importantly, professional and para-professional staff that have lived experience of mental illnesses.  In addition we need to remember that there are a substantial number of staff who are currently hiding their lived experience out of fear.  That is a terrible burden on them and deprives the patients of a considerable source of support and hope.  Those staff shouldn’t have to take sides. They should be proud of both their personal and professional gifts and be able to use them without fear.

 

3)      Board hearings:

 

Although there have been changes in these hearings recently, they are still clearly the cause of major distress, antagonism, hopelessness, and divisiveness. A patient complained that they are arbitrary and unpredictable, often not following the clinical input of the staff, leading him to withdraw and give up in helplessness. A psychiatrist said that he pisses off the public defenders, the district attorneys, and the hearing officers about equally so he must be doing something right. Frankly, that doesn’t’ sound like a collaborative relationship either.

Over the last decade there have been substantial innovations within mental health legal hearings. There are mental health courts and drug courts scattered around where the hearing officer has a personal relationship with the client and actively participates in their recovery: They engage and motivate clients. They grieve and celebrate with clients. They mediate between staff and clients working to improve their collaboration. They actively secure community resources and services for clients. They even hug clients.  I am aware of an exemplary court and judge in Nevada County, California who handles the involuntary outpatient commitments (Laura’s Law AOT).  The Elyn Saks institute at USC is connected with a large number of resources who could inspire and guide you.

I realize that this recommendation is beyond the scope of my consultation and expertise, but I think these hearings could become a major force promoting recovery – especially as defined by freedom, safety, and self responsibility.

 

Recovery  Accountability:

 

Recovery sometimes seems so nebulous that it can’t be measured or promoted in an accountable manner. This argument maintains that it’s too non-specific, too subjective, too individualized to quantify or track.  Either you have it or you don’t.  I don’t agree.

 

Broadly speaking there are three areas to try to create accountability:  1) Recovery service provision, 2) recovery outcomes, and 3) recovery culture.  There will always be a tension between the accuracy and detail of the measurements in the accountability tool and the burden it places on clients and staff.  (The Mental Health Center of Denver is very sophisticated in their use of data driven management and accountability.)

 

1)      Recovery Service Provision

 

This is the most common way mental health services are held accountable:  Are we providing the services we’re supposed to in sufficient amounts.  In many parts of the system our payments are directly tied to service provision.  It is also the weakest way to assess accountability. There’s no way of knowing if a service is being provided well or not, effectively or not, compassionately or not, etc. All we know is that, at least on paper, someone did something.

 

Recovery services can be described and counted as well as traditional psychiatric or rehabilitation services.  I attached a list of recovery service areas that MHALA uses (attachment 2).  These are included in our EHR alongside the medical service codes.

 

2)      Recovery outcomes

 

It would be nice to know if we’re actually helping people recovery. We can track outcomes that are desirable whether they resulted from recovery or not, and we can track correlates of the recovery process.

California’s statewide AB2034 program that enrolled people who “deinstitutionalization failed” had four targeted outcomes:  Psychiatric hospital days, incarceration days, homeless days, and employment days. The 70% reduction in hospitals, jails, and homelessness alongside a 400% increase in employment days were powerful outcomes for California’s legislature and Governor Schwartzneger.  These four outcomes were specifically chosen to monitor the outcomes society had assigned to us and are relatively easy to track reliably. You could make a small set of similarly targeted outcomes, for example, reduced  incidents of assault or other violence, increased incidence of competency restoration at hearings, employment earnings within the hospital, increase in board approved discharges to lower levels of community care, etc.

MHALA didn’t feel that the variables on our four stage map of recovery (hope, empowerment, self- responsibility, and meaningful roles) would be reasonably measurable to track recovery although they successfully captured subjective experiences of recovery. We created a tool that is uses staff ratings to track individual’s progress through recovery using three correlates of recovery – risk, engagement with mental health services, and skills and supports. This link has the eight point Milestones of Recovery Scale (MORS) and describes its development, validation, and use:  http://mhavillage.squarespace.com/storage/84AGuidetotheMORS.pdf.

 

You could create a similar tool using the three most crucial outcome dimensions for your program – safety, freedom, and self-responsibility to define stages you could track people through; for example

 

stages like extreme danger, high external restriction, low internal control and self responsibility. Remember that the map shouldn’t be linear and should include forward and backward movements to realistically map recovery.

 

3)      Recovery culture

 

On the face of it, culture is the most difficult thing to measure. MHALA has developed a tool for adult community based mental health programs that begins with seven core valued dimensions of a recovery culture and then describes concrete indicators of whether the program is doing nothing, exploring, emerging, maturing, or excelling in each area.  This link  http://mhavillage.squarespace.com/storage/87ARecoveryCultureProgressReport.pdf  has the Recovery Culture Progress Report and a discussion of its rationale, development and usage.  Note how each domain flows from a value statement. You could develop a tool like this for your own program.

 

Conclusion:

 

The same friend of mine I began with said that for hope to be useful it has to include three elements: 1) A vision of where you’re aspiring to get to that is clear and specific enough to become believable (not that you ever get to exactly where you imagined or hoped for), 2) A commitment to take a few concrete steps that lead towards your vision (and see what happens), and 3) Enough passion and understanding of why this vision is important enough to you that you’re resilient enough to make it through the inevitable blockades and setbacks.

 

I think you have enough useful hope to achieve recovery transformation at OSH. Thank you for including me in your journey.

 

 

WE BELIEVE…

MHAVillageGuidingPrinciples and the Stages of Recovery

 

 

  1. Hope makes recovery possible; it facilitates healing of the mind, body and spirit.

 

 

  1. Welcoming people includes creating a culture of acceptance with easily accessible integrated supports and services.

 

 

  1. Focusing on the whole person includes their strengths and weakness, abilities and barriers, wounds and gifts.

 

 

  1. Each person creates their path and determines the pace of their recovery.

 

 

  1. The recovery process is a collaborative journey in support of individuals pursuing their life goals.

 

 

  1. Relationships are developed through mutual respect and reciprocity, including openness to genuine emotional connections.

 

 

 

  1. A solid foundation for recovery is built by helping people to honestly and responsibly deal with their mental illness, substance abuse and emotional difficulties.

 

 

  1. People thrive, grow and gain the courage to seek change in respectful environments that promote self responsibility.

 

 

  1. The practical work of recovery takes place in the community.

 

 

  1. Each person has the right to fair and just treatment in their community ensured through advocacy and social responsibility.

 

 

  1. Everyone deserves the opportunity to have a place to call home.

 

 

  1. Promoting natural supports, having fun and a sense of belonging enhances quality of life.

 

 

  1. Employment and education are powerful means to help people build lives beyond their illness.

 

 

  1. Program success is based on achieving quality of life and recovery outcomes.

 

Recovery Based Service Categories and Vignettes

1)      Welcoming / engagement – connecting the member with staff, program and peers, relationship building, demonstrating our “usefulness” to the member, engaging in collaborative goal setting, shared decision making, connecting with the member through self-disclosure

I asked Ann to bring in the drawings she’d made with the art supplies her mother had sent to the Board and Care, admired them, and made a couple copies to put on the wall.  I also showed them to other members and staff who were sitting around the team area, introducing Ann as a “real artist”.

2)      Crisis interventions / Responding to basic safety needs and community expulsion threats – accessing, collaborating with and/or diverting from hospitals and jails, advocating with the legal system to prevent incarceration, locating, placing in and/or paying for emergency shelter to prevent homelessness, , safety interventions – medical, substance abuse harm reduction and prevention, responding to threats of dangerousness, suicidality, and impending harm (e.g., domestic violence)

Donna wandered into the team area looking quite confused.  She didn’t respond to anything I said, just staring at me. Yesterday she had been coherently calling checking her status on the waiting list for a rehab program, so it seemed likely she was high or coming down. We tried to get her to take some medication, but she wouldn’t.  We watched over her and gave her a ride home where they know she gets like this a lot and can take care of her.

3)      Assessments – assessing goals and needs, understanding their view of themselves, mental health status assessment, Quality of Life assessment, co-occurring conditions (e.g., medical, substance abuse, developmental disability), “eligibility” determinations (voc rehab, disabled students, SSI, bus passes), fitness determinations (legal competence, child custody and driver’s license)

Mike says he wants to get a job, but he seems far too disorganized and our employment staff is hesitant to work with him. We decide to give him a “we pay” job using client support funds to put together new charts and shred paper for us for one hour a day to see if he can show up and if he does, how he’s able to function at those tasks, and if he follows directions. The information gathered can also be used as part of his SSI disability report.

4)      Building and maintaining the safety net / “protective factors” –  assisting in obtaining benefits and entitlements, connecting to poverty services (e.g., COA food bank, multi-service center), charity (e.g., bus tokens, food, clothes, toiletries), safe and secure housing, family connections, assisting in obtaining basic documentation (e.g.,  ID, birth certificate), connecting to basic social

 

services (DPSS, SSA), connecting to cultural connections, (Native American services, UCC), connecting to spiritual strength and security (faith community)

Anna has been staying with a variety of men she finds, but they all end up taking her money and short lived. She seems always surprised when they pressure her for sex. We make a deal with Ann that if she contributes $150 per month out of her GR check, we’ll give her a hotel voucher worth $650 to have a safe place to stay for the month, but she can’t have any one stay in her room with her.

5)      Motivating / Engaging in growth oriented activities – engaging in motivational interviewing, outreaching to isolated members, exposure to opportunities e.g., plays, sports, dances, hobbies, job fairs, schools), exploration of possibilities for the future, career exploration, core gift activities, goal visualizing, peer bridging

Carl hangs out at the sober living all day long, using pot and not following up with anything.  He says he doesn’t have any money to do anything.  I offer to take him out to lunch with a small group of members and on the way intentionally take him by one of the other member’s apartment starting a conversation about what it would take for him to get an apartment of his own too.

6)      Treating mental illnesses and substance abuse disorders to reduce barriers – helping members to gain control over their mental illness, helping members to identify and control their symptoms (e.g., WRAP), 12-step step work, medication services, providing psychotherapy, building emotional coping skills (e.g., CBT, coping with past traumas, anger management, relationship skills), building wellness skills (e.g., meditation, eating and sleeping routines, yoga), treatment of acute symptoms and relapses

Renee is struggling with panic attacks and flashbacks of being raped and is overtaking the Klonipin she’s been prescribed combining it with alcohol.  I teach her several anxiety reducing techniques including a “butterfly hug” to use during flashbacks, relaxation imagery for when she’s not quite as anxious, and to carry around a small tin of coffee grounds in her pocket that immediately calm her by reminding her of her mother when she was a child.

7)      Treating physical illnesses – providing basic wound care, monitoring and treating chronic physical illnesses (e.g., diabetes, hypertension, chronic pain), medication management for physical illness medications, seizure response, physical illness education (e.g., diabetes, hepatitis), smoking cessation, promoting physical wellness (e.g., exercise and nutrition)

Dennis fell in the bathroom at the Village and said he was “knocked out” for a second.  I called a nurse to check his vital signs and make sure he didn’t have any neurological signs that would indicate we should take him to an Emergency Room.

 

8)      Providing and building support – connecting to Village resources (e.g., job development, educational) and community resources ( Jewish Community Center, Gay and Lesbian Center, primary care provider, 12-step support groups, warm lines), connecting to social services (e.g., In Home Supportive Services, Family Preservation), participating together in community

 

activities and opportunities (“giving moral support”), helping families to support members (e.g., family education, consultation, problem solving), providing help directly (e.g., “doing it for them,” adding structure to their lives, making decisions for them, ”caretaking”)

Martin needed to get help to move his stuff from his hotel room into a permanent apartment. He couldn’t get any friends or family to help him and he didn’t have $15 to pay day labor to do it with him. Since there wasn’t that much stuff, I drove my own car over and helped him put his stuff in my trunk and then helped him unload it into the apartment.

9)      Rehabilitation / Skill building – teaching, job coaching, supported models (employment, education, housing), in-vivo teaching, providing work experience, teaching self-help skills (e.g., budgeting, shopping, laundry, hygiene, medication management), helping the member to build and practice meaningful roles

 

Kenny’s shower head broke off in his apartment. His girlfriend who lives with him demanded that he do something about it and threw it at him. He brought it in and put it on my desk demanding that I do something about it.  First I coached him through the process of calling his manger with him on the phone talking but that got nowhere. Then we got in my car and I coached him through the process  of actually getting a replacement part at the hardware store.  Once again, he did the talking while I stood by his side giving him hints. He screwed the shower head back on himself. He wrote a letter to the manager, enclosing a copy of the bill, to get the money back sitting at my desk going over it step by step.

10)   Building personal growth and responsibility – Helping members understand and move through normal stages of life (e.g., prolonged adolescence, first parenting, mid-life crisis, empty nest syndrome), building self- responsibility (learning cause and effect, not blaming others), building self- efficacy (building the ability to positively impact one’s life), empowering members

Andy was offered a catering job with the Village Deli on a Saturday for four hours, but that was also the day his case worker was taking some members on an outing to Universal Studios. Andy was torn between fun and responsibilities. While another immature member urged him to go to Universal Studios with them and just have fun, I helped them both see how cancelling out on his boss at the  last minute would make him a less responsible employee and that fun has to scheduled around work.

11)   Community integration – developing and facilitating members’ connections beyond mental health and social services (Taking a member to a Mommy and Me group, helping a member to join a bowling league, creating a calendar of low-cost community events), helping member to discover niches, roles, and opportunities in the community, promoting being a good neighbor and citizen, helping member to invest in and give to community in positive ways, helping the member to learn to give to others

Francis had been raised Catholic, but hadn’t been back to Church in many years while she’d been on the streets and using drugs and prostituting.  Now she was clean, but felt too ashamed to return to

 

Church. I connected her up with another staff member who goes to Catholic Church regularly and he agreed to go with her and just sit in the back together during services to see how it felt.

12)   Community development – making the community a better place for people with mental illnesses, increasing tolerance and acceptance of mental illness, reducing segregation, reducing stigma, developing welcoming hearts in the community, building connections with other community social causes

The East Village Association arranged for a community clean-up day. A group of members and staff came in together as a Village team to help this neighborhood effort.

13)   Promoting self reliance, separation from services, and graduation – building financial independence (getting off SSI and Section 8), obtaining private insurance, preparing for graduation, facilitating relationship changes with staff, finding and providing opportunities to give back to others still struggling, developing self-advocacy skills, developing friendship skills

When Kathy called asking for my advice in her problem with her boyfriend, instead of giving her advice, I helped her explore who else she had in her life whose advice she could rely on, so she wouldn’t need me anymore.

87ARecoveryCultureProgressReport

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