I also worked with a lot of consumers with dual-diagnoses: a mental illness complicated by some sort of substance abuse. It is hard for me to see so many Native Alaskans falling into this category, especially when they are my family members. It just reminds me how much progress can be made, and what leaps and bounds of improvement are destined to occur. I spent time at all the different care programs in Juneau, including the mental health unit at the hospital. I loved them. Every single one. The Juneau Alliance for Mental Health works so hard for the consumers. It really is inspiring. JAMHI owns multiple apartment buildings and has minimal care programs set up to facilitate independent living and a feeling of community. There is a day center where consumers can congregate to work out, play games (pool, ping pong, etc), eat, talk, do arts and crafts, take workshops provided by JAMHI, pick up their meds, and see a doctor. There are weekly outings and camping trips. JAMHI is underfunded, but always finds new and innovative ways to provide the consumers with the facilities they need. JAMHI is prepared to care for adult consumers experiencing difficulties of all severity levels. There is simple outpatient care consisting of therapy, medication monitoring, etc, as well as full case-management and 24-hour monitoring (for the most complicated consumers). Although JAMHI has the verve and drive to provide holistic and comprehensive health care to all Juneau consumers who could benefit from such attention, it saddened me repeatedly to see how bullied by medicaid and medicare the mental health system really is. There is still an ancient, outdated stigma about mental health care and the people who receive it. This stigma and the ignorant people who perpetuate it are the single most salient cause for holes in the mental health system. These holes mandate that many consumers do not have access to the essential resources that could be available to them in a more enlightened environment.
What can be done? Education. Willingly opening minds. Taking the chance and letting go of old stereotypes for just a moment--enough time to let go of our own pride and fears and see people for people, not just numbers or some scary unknown. The only reason there are scary unknowns is because we personally have not taken the time to let go enough to learn. Invest the time, energy and faith to explore the unknown and feel the refreshing light of knowledge pervade the darkness of primitive ignorance. What a difference it will make!