Russell D. Pierce

Director Office of Recovery and Empowerment

Remarks and Perspective

State House Forum Event

November 20, 2014

THROUGH ALL THE SORROW OF THE SORROW

SONGS THERE BREATHES A HOPE—A FAITH IN THE

ULTIMATE JUSTICE OF THINGS

W.E. B. Du Bois

Which reminds me necessarily as it di d our

ancestors that though we take time to celebrate in

part on this day, we do not, dare not, deign not,

avert our eyes, our attention to troubles here. And

there are challenges here—lifespan disparity in

health outcomes and death for those in a

behavioral system owing largely to preventable and

modifiable behaviors, chief of which is smoking,

heart disease and obesity, made more complicated

by mental health and substance use issues.

But we carry on, knowing that as reformers in this

Commonwealth understood, that there can be

really no progress without hope, and no real hope

without progress. But when progress and hope are

joined together then that bodes well for the

entirety of the community. So believed the

Commonwealth’s Dorothea Dix and one of my

favorite historical shapers of change, Frederick

Douglass—

Reformers of a certain age were not always blessed

with dollars, but they did have ideas—and this is

what gives me great joy as a Director in the

Commonwealth. I see the power of biography,

truth telling and the strength of collective eperiene

allows as managers to access program with useful

data information

Now we have fancy word for this type of

knowledge, wisdom and information—and it is

‘data analytics’. But here is something I want us all

to carefully consider as we look at data and hear

compelling stories, as the one presented by Mr.

Butler.

According to Bob Damon, Executive Chairman of

North America Korn/Ferrry , managers and

government officials must know when to turn off

the data spigot; he notes correctly that data means

little if it does not advance relationship, decision-

making and both judgment and execution which

may be oftentimes associated with experience.

These qualities are essential for the making of

excellent leaders. I am convinced that narratives

like those that predominated a century ago, even

those by Mandela, King, Douglass, Stowe, Ellison

and of course the writings like Death of a

Salesman,Antigone and Notes from the

Underground, are all not great forms of literature,

they continue to spur ideas in asserting truth

against power, lesding to democratic reforms,

innovations in design of whole societies including

both policy, legislation and how people are treated

among courts of law, including our own U.S,

Supreme writing in Olmstead and recognizing the

continuing barriers to community integration based

on misperception, bias and prejudices that so

affected every aspect of public life, concluded in its

Decision that such separation was no longer

routinely acceptable, and that persons particularly

be in the least segregated environment as possible,

while acknowledging financial burdens on the

States.

It is a blessing to know that the Commonwealth is

walking in the spirit of this landmark decision

It is an honor and a privilege to be here in this, The

People’s House, to discuss an issue all of us in the

mental health community and beyond care about,

well-being, as one – in--four Americans are beset

with these challenges in any given year. We know

also that there is tremendous unmet need as

persons, particularly those who are young and

adrift, and those on the margins of our society,

usually isolated in community life have limited

access to quality care that is both specific to their

needs including language and culture.

It is doubly an honor to share this stage with our

special guests and to witness anew their

unwavering commitment to a more civil and just

Commonwealth. Gov. Patrick, Gov-Elect Baker and

others, I am thrilled to celebrate with you on behalf

of DMH and the Office of Recovery and

Empowerment our shared vision for a recovery-

focused and person centered approach to care,

including trauma informed approaches to crisis

among, families and in communities.

But I have long recognized that we treat health not

only with what amounts to a fixation on reducing

risk factors and preventive factors by an almost

exclusive orientation on symptom abatement or

even case management—many of us in systems of

care, do not feel that we are in fact ‘cases’ to be

managed, nor just an aggrieved interest. Rather we

believe that we are full human beings—and that

health in any real sense means caring for, if you will

the whole person—his environment, his community

that may give him definition, strength and history,

as well as attending to his economic and spiritual

needs. In this way we really begin to address health

holistically, as a matter that connects the mind,

heart, soul and spirit. Understanding this today, we

know that Descartes was only partially correct or

totally wrong: while the mind is the center of

thought, thought alone does not make the whole of

the person—the person is because he ‘belongs’ to

something, much like our Recovery Learning

Communities, where individuals can freely associate

with ‘others who have bee there’ in hospitals or

emergency rooms and provide thus solace, belief,

and model upward behaviors that suggest recovery

is within reach.

Those of who embrace a recovery framework,

believe essentially in voluntariness, mutuality,

community, connected, relatedness and hope, but

recovery without cash is empty to many of us—so

we are designing as innovators strategies not at

traditional employment options, as those with

these conditions account for a huge users of social

security benefits. I believe the near 80 per cent

unemployment rate makes a lot of noise as a

statistical matter, as people want income, certainly

not poverty, we just need to find some creative

ideas that will build up our income-generation

momentum and idea and idea innovation on

business itself as these are not mere words, but

suggest a change in how persons ‘differently abled’

view work and how excellent organizations are

going to have find ways to develop these potential

labor pool in the years to come, as I am convinced

that those of us who find ourselves temporarily

abled, now will want to work for organizations

where we are celebrate, and where our values, like

peer support and mutuality are wrapped around

the business model of the organization or entity.

This to me is the new accommodation, the new

diversity—as talent is moveable an skills, like

attention to detail, the value of lived experience

and the power to engage with diverse stakeholders

across multiple platforms, all skills valued in our

peer roles at the ground and executive level, will

have increased significance going forward.

I think DMH as a system recognizes and I am sure

that it is why in substantial part I am still here, with

my rants and all. To know your value, is to

understand not boastfully, that you are somebody,

have arrived and can most of contribute given the

totality of your experience, giving you and the

organization vibrancy, energy and perspective so

necessary for designing policies that are fitted to

the needs of the person and the payors and citizens

who develop budgets.

At this gathering I would like to say though that I am

hopeful about our progress but ever mindful that

we have quite a distance to travel, for preparing this

generation and the next for better health care

outcomes will be a daunting task as budgets are

stretched and communities distressed by trauma,

unemployment and other factors that dispose a

people of hope—the wellspring of opportunity

realized in community life. The challenges ae great

in terms of housing and economic supports that will

support individuals in their recovery and self-

defined path of growth either through peer support

which my Office supports with the backing of this

Commonwealth and the Department and

Commissioner Fowler.

As recovery champions we believe and profess

aloud that life is one of ‘infinite possibilities’—one

in which we are unbounded by set limitations, even

due to illness or popular prejudices. We know that

the human mind, can stretch and that the human

being is a part of ‘infinite experience’ Lucky for

many of us we let go of the notion when diagnosed

perhaps that: ‘we were ot good enough’; ‘would be

forever in care’; ‘always reliant on programs,

caregivers and supportive services’ or that even

‘your life will never be the same’.

But we listened to the voice within us.

And that voice said: Well, as if in church, “Yes, I

can”

And yes we have, have, overcome, significant

adversity, giving us reason as the singer Tracy

Chapman sings, ‘a reason to stay here.’ We know as

recovery champions, words and meaning matter,

but perhaps just as importantly, we understand that

actions in community life are shaped by this

language and part of role if we assume it, is to

diplomatically challenge the practice that would

consign either ourselves or someone else to a

devalued social status

But it was my black history teacher Ms. Johnson and

a community of folks who invested in me as a

child—telling before I was determined to be grand,

and grandiose by those who projected their

limitations onto me, that yes I was a dreamer, today

they would use the language of ‘innovator’ or

change agent or ‘visionary’. But because I was in a

traditional care unit, I even had a doctor tell me and

inquire if my sister if in fact I had a law degree let

alone having attended selective liberal arts school.

As if tht was not enough I would experience in care

settings the notions that I wasa acting too normal

and didn’t I know I was sick. And when I told the

nice appearing doctor that I was conversant in

common law and tht law school was indeed a part

of my background, he smiled, took more notes and

left the room.

This is when I started to remember my teachers in

grade school who had warned me that the ever-

present they would make matters worse for you

either because of prejudice or simple ignorance, but

as my older would; ‘that their baggage, and that’s

with them.’ Just remember that the women down

the street thought highly of you, that you are going

to be somebody.

We are making a difference through our

increasingly targeted messages around mental

health being essential and fundamental to overall

health, as the economic and social burdens of poor

mental health results in consequences that can not

only be life-disrupting, but also impair significant

relationships within families and the larger

community.

This Department is a champion and long before it

cane a trend0line—and peers have responded:

Yes, we can. We can do this

Indeed we have a message of active engagement in

the therapeutic milieu and our person-centered

approach to care, we are seeing that people with

the proper supports can reclaim their lives in

community by frank conversations pivotal to health

to include wellness coaches, better nutrition,

exercise and connectedness—all of which promote

integration consistent with evolving standards of

decency. There is now widespread recognition of

the value of these whole health strategies and an

emphasis on holistic approaches to the ecology of

care—and better still, satisfaction, which we now

measure, as providers increasingly understand that

there be no business as usual: income follows

necessarily outcomes.

But the scourge of prejudice and discrimination

continues apace and interferes with both the

delivery of services, as mental health care was once

delivered in such ‘controlling ways’ according to the

World Health Organization, and in many countries,

that is still the case, as peers or those of us in

recovery are routinely treated as ‘wards’ and

‘objects of care’ rather than as autonomous

individuals who strive as other—‘other’—citizens to

participate as citizens fully in community life. Is

there any wonder why people are not engaged in

care? But what better reason to support those of us

who have ‘been there’ as administrators, diectors,

managers, and one day, dare, I say, commissioners.

Yet, as with many other states Massachusetts is a

trend-setter in the development and cultivation of a

robust peer work force and one of my future efforts

is to expand on this practice, to message it to the

wider public for adoption, as I believe that the ‘lived

experience’ as a peer can translate over to almost

any environment that values communications,

skilled listening, intense negotiation, and

engagement with technology and diverse

organization.

One of the lessons that I learned while a Public

Health Advisor at the U.S. Substance Abuse and

Mental Health Services Administration (SAMHSA)

with the Center for Substance Abuse Prevention

(CSAP), was that in order to create change, be it

substance use strategies or mental health which co-

occurs with it, you must have a message and that

message must resonate across all community

sectors to include business, faith forums, schools,

the arts and media. In other words there must be

multiple strategies over multiple sectors. Todays’s

gathering I suspect is a step in this direction and is

what the Office of Recovery and Empowerment is

attempting to do with an emphasis on targeted

outreach, community engagement and policy.

It is though the feeling—and feelings matters, of

‘otherness’ that separate us out from wise and

considered public policy, as a society though

evolving to recognize the gifts many of bring to

leadership, the arts, entertainment and academe,

the majority of persons with a psychiatric label, are

believed either not to be competent in directing

their own care, let alone designing systems that

provide this care. As the true Renaissance Woman,

Maya Angelou said: “I may not remember what you

said, or how you said it, but I will never forget how

you made me feel.” Indeed a sense of past wrongs

and continuing assaults, call forward our effort to

address still existent civil wrongs, in care settings, in

community life, where discrimination itself is an

insult, an assault on difference.

Those who are familiar with me and my work know

that I care a lot about how language is and has been

used to describe people, either those labeled with a

disability or those who did not have equal privilege.

Words do matter—and another reason why we

need to be careful in describing even those we are

allies with—and remember always that we are

working with people and not ‘for’ them, as the

latter is paternalistic and effectively disposes people

of their own efforts towards independence, self-

determination and empowerment, which is a

healthy respect for the choices made by people, not

just ceding someone the right to do something that

we personally prefer.

But we know that ‘care’ must begin with a hopeful

psychiatry and not a hope –sapping one, one that is

attuned to the strengths of the person and the

assets he or she has and the desired future one may

have across the lifespan. It is my contention here

that the only effective outcome that matters in the

last analysis are ones determined by the person and

we should support people in whatever way they

want to be engaged in either treatment or life in the

community, and not supplant them in their efforts,

if it is to be gainfully employed as a peer specialist

or a manager or director of a program, as is my

case.

But more significantly when we begin to look at

people through the lens of citizenship—as illness

will impact everyone, then our attitudes

fundamentally change, and we no longer look at

people as ‘others’ but as our neighbors, friends,

colleagues—and even leaders, those for whom

respect and honor is accorded, as it is today for Jim

Butler, because people, who are beset with

challenges, are deserving and demonstrate to us all

that hard work, redemption, style, grace and

comportment are worthy of our highest

consideration, as such persons have ‘value’ as

contributors even if they do not contribute because

of illness to the integrity of the public treasury; they

have as I have and others volunteer in community

lifr, on boards, neighborhood drop-in centers, and

otherwise law-abiding and this is valuable in my

estimation.

I am personally delighted to be here in the

Commonwealth at this time and bear witness to the

many stories of triumph in our peer community—

we are people who love, who demonstrate

compassion, highly skilled researchers; and if these

skill-sets are routinely recognized not only will wise

policy and judgment result, the whole of society will

have a different understanding that ‘recovery’—

generating to the highest possible potential in

community is both realizable, achievable and

sustainable. Today we stand here as the evidence

of this. We are the data, as we sometimes forget

that ‘data’ is a word picture and not just a table on

a flash-drive or projector screen.

As I so often say at DMH and in my public speaking,

a diagnosis is not a destination point or a terminal

malady. Rather it can signal an ‘awakening’ of sorts

as you take stock of what your passion is and how

you might make a difference with your struggles, as

struggles inform the narrative that it life. Indeed, I

can think of no one who has achieved anything

worth having without endurance, struggle, but at

the same time while these struggles may be life-

informing, perhaps it is best and wise not to

promote struggles of this sort through policy. There

is a better way for character development,

formation.

It is my fervent hope at DMH to enhance this

understanding that ‘data’ likewise must not lose the

human dimension, as I think legislators, want to

know the impact of dollars on real people, and data

gathering is only as useful as the story behind it.

And we have some wonderful stories—many of

which you have heard at our State House

Breakfasts.

My own story, like most Americans storie of uplift

has been marked by both triumph, success and

pain, and I have not yet written comprehensively

about all of these events, but suffice it to say ,I

marvel at those who creatively and boldly proclaim

their truths, because to make oneself this

vulnerable is indeed a courageous act, especially

when the community may despite all your

successes differently regard you, as with race,

gender, sex or national creed.

Ultimately, I have learned through my many

friendships in peer alliance that people have their

significance not because of the ‘title’ they have, but

the ‘value’ they project. I am reminded of the

wisdom that ‘some people know the ‘price’ of

everything and the ‘value’ of nothing’ It is a

privilege to be in a community where we are all

striving to accord one another the inherent value

that dwells within us as human beings.

My role here in substantial part is to be not only an

‘ambassador’ for DMH, but to model that recovery

is possible, to emphasize in my work that ‘hope’ is

part of the recovery paradigm, but to underscore

that ‘hope’ is actually an intensive verb, as in

‘hoping’—it requires something of us all—work, fair

play, a commitment to justice in terms of

opportunity and a societal dedication to principle,

lofty, but worth striving for.

So the celebration here today is not to herald the

successes of the system or Mr. Jim Butler and this

great Commonwealth. I think today’s effort is to

remind us of the ‘fierce urgency of now’ as we

grapple with the challenges of drug use, addiction,

the intersections of mental health, complex medical

conditions, the constant demand for outcomes that

are peer and consumer-driven, and the need for

new heroic shapers of history and innovation who

will bring fresh energy and perspective to these

daunting realities.

As our Founding Charters indicate and have evolved

to mean, we are the ‘future posterity’ to which we

are called upon to risk our treasure and talents to

creatively and boldly build more inclusive

communities reflective of differences as well as

similarities that bind us in a ‘struggle’—as Frederick

Douglass, the great orator, statesman and anti-

slavery told us nearly two centuries ago, that

struggle is always with us if we want to savor

freedom or experience life as one people, one

union.

I can think of no time other time than this to

recommit ourselves to each other in community,

not as a matter of distancing ourselves as

‘others’==consigning one for whatever reason to

‘the other as object’, less regarded, less a citizen,

because of an illness, the result of a fortuity – does

not deserve our recognition, ethical commitment,

embrace—and distorts the possibility of recovery in

community life.

Thank you for the wonderful opportunity to briefly

share with you DMH’s vision of recovery in

community, and to celebrate deservedly so the

tremendous accomplishments of Jim Butler.