Sunday, 25 February 2018

RLC Articles

The RLC produces a newsletter each and every month that offers monthly calendars, announcements and articles. Although old newsletters are archived on the website, the articles - often on important advocacy-related issues - run the risk of being buried and difficult to find. In an attempt to make that information more accessible, we still also list RLC-published articles from the newsletter (and other relevant sources) here for your ease and perusal.


The Right to Smoke?

Originally published in the RLC Newsletter, October, 2012

The Right to Smoke?

At this point, we all know the risks of smoking. We’ve heard about (and perhaps seen play out) the link to cancer and a variety of other health issues. We’re aware of the highly addictive nature of nicotine. Many of us cigarettesalso know that a higher percentage of people receiving services within the mental health system seem to smoke than those in the broader community, and that those same people tend to smoke more cigarettes on average than other smokers. Additionally, we’ve been told that smoking plays a major role in the fact that people in the mental health system die, on average, 25 years younger than most (although the role that psychiatric medications play in that same figure is most often ignored or misrepresented).

But what does that mean and more importantly, whatshouldthat mean about the right of people receiving mental health services to smoke and the role and responsibilities of providers in relationship to that question? 

In Western Massachusetts, there are at least 10 hospitals that have in-patient psychiatric units. Only one of those 10 (Holyoke Medical) still allows people hospitalized there to smoke at all during their stay. That means that someone hospitalized against their will – who is already likely experiencing great loss and distress – also loses the freedom to smoke. This point is not to be minimized. Pause for a moment and imagine the sense of loss and trauma you might experience when being removed from your day-to-day life unexpectedly and not by your own choice.

This approach is only gaining steam. In August, one of the local providers of Community Based Flexible Supports (CBFS) also announced that they would begin a new policy of not hiring smokers (even those who smoke only in the privacy of their own home) as of January 2013 in large part because their employees reportedly have a responsibility to ‘role model’ healthy behavior. (Similar policies for people receiving services through CBFS have been suggested but not yet come to pass.)

Read more: The Right to Smoke?

Mandated Reporter: A Common Misconception

Originally published in the RLC Newsletter, December, 2012


There is a popular misunderstanding that ‘mandated reported’ means that you are mandated by law to report if someone is talking about hurting themselves or someone else. This is not true. ‘Mandated reporter’ refers to the legal requirement of many professions and organizations to report observed or suspected abuse or neglect of someone who is considered elderly, disabled or a child by a care giver. While organizations may still have clear policies for their employees around reporting perceived risks of self-harm or hurting others, that is an organizational decision and not a black-and-white legal mandate outside of the organization’s control as is the ‘mandated reporter’ law.

What does this mean? It means there IS a potential discussion to be had within your organization about what their policies say regarding the need to report suspected risk of harm. For example, does this include when someone seems at risk of non-lethal self-harm like cutting or burning? Does it include situations where someone says they are suicidal, but upon further conversation, you find they are just venting or wanting to be heard? The reality is that many people who have received services within the mental health system have learned to use words like ‘suicide’ to get their needs met, and sometimes it can be genuinely valuable to simply ask them what that means to them, rather than jumping to an emergency intervention. Similarly, it can be really valuable to recognize many types of self-injury as a way someone has learned to cope with trauma and pain that is separate from suicide, and does not require an emergency intervention.


Check in with your co-workers and organizational leadership. It’s worth a conversation!

A Word on the Word 'Peer'

Originally published in the RLC Newsletter, June, 2012


According to www.dictionary.com, the word ‘peer’ is defined as follows: “a person who is equal to another in abilities, qualifications, age, background, and social status.” By that definition and as it peershas boiled down in our world to its most common usage, most of us have several ‘peer’ groups. Parents, doctors, students, authors, actors, nurses, artists, politicians, baseball players… all are one another’s peers. More importantly, in order to be a ‘peer,’ by definition, one person quite literally has to be connected to another. There is no such thing as a ‘peer’ standing alone, because then, well… whose peer are they?

Strange then, that – within the mental health system and recovery movement – we should be taking on this word ‘peer,’ as if it is the next best word for patient, client, consumer, ‘person served,’ participant, and/or member. It’s strange for two reasons. The first is that no ‘peer’ should be able to stand alone. There should be no such thing as ‘a peer,’ unless there is another ‘peer’ standing next to him or her. No person should be able to talk about ‘the peers’ as some group separate from themselves because it is antithetical to the very meaning of the word. Peer does not mean ‘someone receiving services.’ It means people who exist as a part of a community of some sort and who share commonalities and relationships with one another. It’s ‘my peers’ or ‘our peers,’ if it’s ‘peer’ at all. It’s stranger still because – in this work of recovery and ‘peer work,’ – we talk so often about how healing through relationship is at the core of what we do. And yet, in essence, we have begun to refer to ourselves by a word that originally was all about relationship and now, through our very usage of it, has lost that relational focus.

And so, before we go beyond the point of no return with our usage of this word, we encourage everyone to consider the impact and to remember that, if we use the word as it is defined, no ‘peer’ can stand alone.

Our Bodies, Our Selves

Originally published in the RLC Newsletter, July, 2010

 modern abstract figure drawing of irenka

Society puts a tremendous amount of   pressure on us to look and be a certain way. As a result, many of us can be very unkind to ourselves. We criticize our bodies, call ourselves names, or focus on the many ways in which we’re not good enough. Unfortunately, it’s often considered ‘normal’ for people to talk about hating their bodies or their appearance openly and on a regular basis.

This article is intended as a call to all of us to find ways to be kinder to ourselves individually and as a community.

When we speak unkindly about ourselves, consider these possible effects:


  • It Can Make Change Harder: It’s easy to think that being hard on ourselves will lead us to change. However, in reality, being unkind and overly critical is more likely to result in treating ourselves badly than it is to result in making any positive changes.
  • We Impact Others’ Views: Each one of us is a role model within our community. Intentionally or not, if we talk badly and overly critically of ourselves, we encourage a culture where others continue to do the same.
  • We Indirectly Insult Others: When we insult our bodies, our size, our appearance, or our intelligence, individuals who have similar appearances, sizes, shapes or other related concerns will often hear us as if we are also talking about them. For example, if one person says that their body shape is “wrong” or “bad” in some way, they are essentially (though often unintentionally) implying the same about another person with a similar body type.

Read more: Our Bodies, Our Selves

Food Police

Originally published in the RLC newsletter, February, 2013

Food Police?

 police whistle

“Donuts saved my life. You can quote me on that!”

“Raw carrots almost sent me to the hospital once.”

“Wheat bread is the worst thing I can eat.”

“A diet high in fruits and veggies makes me unbelievably sick.”

“Have you heard about that study where the women who drink the most coffee are the least likely to be diagnosed with depression?”


These are just a few excerpts from a variety of conversations within our community that demonstrate one common theme: ‘Healthy eating’ is in the eye (and body) of the beholder and cannot be universally determined or described with simplistic pyramid graphics. Yet, for a variety of reasons from financial to health-related, there’s a strong tendency throughout our culture to evaluate everyone’s nutritional choices according to the same narrow standards. As it is so in the media and our broader communities, so is it within the mental health system. In fact, a sense of responsibility for the health and well being of people receiving services combined with stretched resources and other practical challenges may sometimes drive providers to even more stringent measures.

“When I was in the hospital, I would tell them that I have Celiac disease and can’t eat gluten. They would give me a veggie burger or a salad. Every time. It’s incredibly stressful to not have access to food you can eat or to be told that a salad is good enough to eat for basically every meal.” Stories like this one are commonplace and speak loudly to the potential impact of lack of understanding and loss of control. In fact, people have reported a variety of personal outcomes, including the aforementioned higher stress levels, physical illness, distorted body image, unhealthy patterns of eating based on fear of future restrictions, and a general feeling of loss of control that, for some, leads to a greater sense of sadness and/or hopelessness.

Read more: Food Police

Outpatient Commitment Laws & Massachusetts

 Originally published in the RLC Newsletter, March 2013


44 states in the US currently have outpatient commitment laws in place. They are often referred to as ‘Assisted Outpatient Treatment’ or AOT, though they also go by other names (e.g., Kendra’s

Top 5 Biggest Concerns with AOT laws:

1.It will lead to many human rights violations

2.Depending on how the law is written, it’s not  

   even limited to people with a history of  

   violence, but to anyone who is perceived to be

     at risk for hospitalization

3.It uses FORCE as the primary approach

4.It ignores the fact that people being treated in

   the mental health system are dying 25 years

     younger than others in the community

   5. It ignores or devalues people’s preferences,

     culture and personal belief systems

Law, etc.). Connecticut, Massachusetts, Maryland, Nevada, New Mexico, and Tennessee are the only states that do not have current outpatient commitment laws.

What is AOT?: Laws can look somewhat different from state to state. For example, the New York Office of Mental Health says that AOT was enacted in their state in 1999 to “ensure that individuals with mental illness and a history of hospitalizations or violence participate in community-based services appropriate to their needs.” Essentially, requirements under AOT can include

1. Medication
2. Drug testing to measure whether or not someone has been taking
prescribed medication
3. Therapy (individual and/or group)
4. Day or partial day programs
5. Vocational training

Read more: Outpatient Commitment Laws & Massachusetts


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