It’s undeniable. The brand of behavioral health peer advocacy I champion has an uncomfortable effect on a contingency of folks in our state. It’s not purposely abrasive, and my empirical analysis isn’t based upon “shit-stirring” or “knee-jerk sensitivity” (I’ve heard both from colleagues at meetings). If anything, the peer perspective I provide at behavioral health meetings is engineered for a primary purpose:

To provide my peers with what I believe is as direct of information as possible so they can make reasoned, well-informed conclusions and decisions for themselves.

Notice I didn’t claim my thoughts and interpretations are “unbiased” or “objective.” They are naturally biased and consistently subjective because I live with the symptoms of bipolar. It’s impossible to avoid having a skewed take on world events as someone with bipolar, particularly those world events that affect peers directly. There is nothing detrimental about this skewed worldview.

Further, as a committee member on MHRAC (Mental Health Response Advisory Committee), an executive board member with BCFIC (Bernalillo County Forensic Intervention Consortium), and a peer presenter for the APD CIT training (Crisis Intervention Team), I easily own that my collaboration with law enforcement as a peer advisor also skews my beliefs. Again, there is nothing detrimental about this skewed worldview.

Living with bipolar, or any mental health issues, skews peer perceptions well enough on its own without imposing an undeserved additional echelon of skewing of already rickety constructs. So, when reading Jeff Proctor’s “New Mexico In Depth” article from June 2, 2016, relating his interpretation of APD Chief Gordon Eden’s response to City Councilor Pat Davis’ concerns about the “reverse stings” carried out by APD on May 9, 2016, my peer instinct and natural scientific skepticism questioned the authenticity of Proctor’s interpretation without direct comparison to Chief Eden’s letter.

These are the three documents cited:

“Controversial ‘reverse stings’ on drug users will continue despite outcry” by Jeff Proctor

May 20 Letter from Councilor Davis to Chief Eden

June 1 Letter from Chief Eden to Councilor Davis

My interest in these documents isn’t about the ethics of the “reverse sting” operations. The constitutionality of any statute or policy will always be challenged no matter how pure the intent. My interest is in the structure of Mr. Proctor’s partial quotations and an appearance of a leading conclusive standard that I believe doesn’t accurately represent the intent of Chief Eden’s response to Councilor Davis, nor does it accurately reflect the peer experience.

A source of great strife in the peer experience is the concept of “forced treatment.” To me, this means being forced to take medications I don’t want to take, and this means being forced to go to providers I don’t want to see. Peers hear “forced treatment” and there is a very real (and often necessary in terms of self-advocacy) knee-jerk response of “Yeah, that’s not going to happen to me if I can help it.” If you want the perfect illustration of the “forced treatment” debate, look no further than the recently passed AOT statute (Assisted Outpatient Treatment, SB 113).

It’s the explicit use of the phrase “force people into treatment” in Proctor’s article that caught my attention, and it’s what prompted me to make the direct comparison to Chief Eden’s letter.

From Proctor’s article:

Eden also wrote that felony drug possession arrests can have positive impacts on peoples’ lives. At the Metropolitan Detention Center, he wrote, they get access to drug treatment and mental health services. […]

From Chief Eden’s letter:

Further, when these subjects are arrested and charged with felony narcotics possession as a part of a reversal operation, they will be afforded both substance abuse and mental health assistance (if needed), which are both offered at the Metropolitan Detention Center. […]

I’m uncertain how “Eden also wrote that felony drug possession arrests can have positive impacts on peoples’ lives” is drawn from “[…] when these subjects are arrested and charged with felony narcotics possession […], they will be afforded both substance abuse and mental health assistance (if needed).” As someone who has received mental health assistance since 1999, after living with bipolar undiagnosed since 1987, I can say with 100% authority that mental health assistance is a trial and error crap shoot at best, and there’s no way I’d say the first decade of my professional treatment of psychotropic medications, numerous inpatient hospitalizations, and intensive outpatient therapy was “positive,” and that what got me into treatment (a suicide attempt) precipitated “positive impacts.”

In retrospect, I can say with 100% authority that the majority of my mental health assistance prior to 2012 was less than positive. For example, taking Depakote for my manic symptoms had the excellent side effects of significant weight gain (nearly a 20% jump of my pre-Depakote body mass) and incessant lethargy and “flatline” affect. This was the common ineffective theme in my mental health assistance, and chances are if you speak with a wide sampling of peers (I have), they would also share that the majority of their mental health assistance history was by and large less than positive. For Proctor to extrapolate “can have positive impacts” from “afforded both substance abuse and mental health assistance” is misinformed and does not accurately reflect the peer experience. It’s an unfounded qualification.

Proctor also wrote:

“At the Metropolitan Detention Center, he wrote, they get access to drug treatment and mental health services. And judges who adjudicate such cases often force people into treatment.”

And the correlating excerpt from Chief Eden’s letter:

“[…] they will be afforded both substance abuse and mental health assistance (if needed), which are both offered at the Metropolitan Detention Center. Most judges will include mandatory substance abuse treatment as a part of the sentencing agreement.”

“Judges who adjudicate such cases often force people into treatment” is, stated plainly, intellectually dishonest. “Mandatory substance abuse treatment” sounds like “forced treatment” for sure, and without the remaining phrase “as a part of the sentencing agreement” for context, I’d agree, that sounds a lot like “forced treatment.” But it’s not.

For a better understanding of peers in the criminal justice system, I’ve sat in on numerous sentencing proceedings related to Mental Health Court in Downtown Albuquerque over the last four years. What I’ve observed is a judge offers this deal (my simplified phrasing):

Stay in treatment, be accountable to me, and this will keep you out of jail.

The convicted peer has a choice (again, my simplification):

1.) Agree to mandatory, accountable treatment , otherwise,
2.) Go to jail.

The first option is a choice of agreement. The second option is truly forced treatment.

This isn’t splitting hairs or a twisty exercise in semantics. A sentencing agreement (the peer must accept the agreement, which is the nature of an agreement) of mental health treatment is an option not given the general population who commits a crime. It’s a conditional opportunity of mental health services, which is not at all the same as forced treatment. The peer can say, “I don’t want substance abuse treatment.” And the peer can then consider other sentencing agreements divorced of treatment, which is essentially incarceration.

The point is, nothing in the letter from Chief Eden claims these reverse sting arrests have a “positive impact,” nothing in the letter explicitly states “forced treatment,” and from my peer perspective, nothing in the letter from Chief Eden implies “forced treatment.” It’s that simple.

Now, whether in context or not, I’m not fond of the phrasing (from the Chief Eden letter) “This will often be the only reason these subjects will actually participate in treatment options.” Personally (and with all respect to Chief Eden), it sounds and feels condescending, it has the appearance of being manipulative, and it’s far too simplistic. Using the absolute “the only reason” isn’t part of the human experience, regardless of mental health issues.

Let’s try this for an analogy. I don’t want to go to West Texas ever again. One reason is that it’s flat and geologically boring, and that is a very convincing reason for me not to want to go to West Texas. It is not the only reason. I also remember driving in one lane traffic from the Texas border to Amarillo on Interstate 40 at 35 mph because of supposed “road construction” (there was a backhoe sitting idle on the highway shoulder about 100 miles into Texas). To make things worse, I made this drive in a car with a sporadically functioning air conditioner, and it was July. And, I was in the car with my Queen of the Harpies wife (ex-wife, so yes, the qualification is biased). And, we had to be in Chicago by 8 AM the next morning for a job interview, which would now be impossible. So, if you were to ask me, “Why don’t you want to go to West Texas?”, as a geologist my default answer is “Because it’s flat and geologically boring.” However, the traumatic memory of that road trip with the disagreeable spouse is definitely a contributing factor.

I must believe that a peer opting out of mental health services has reasons that are multifaceted and cannot be distilled down to a single reason.

So there’s a lot of prose for what might seem a trivial point. It isn’t trivial, and it’s fair that I explain succinctly why:

Proctor’s article infers and then claims Chief Eden supports forced treatment. Forced treatment is a triggering and inflammatory phrase in the peer community. The volunteer work I do with MHRAC, BCFIC, and CIT training is a personal passion because it is important for APD to understand why peers fear encounters with law enforcement, and it is important for peers to understand that APD personnel are often our only advocates when in crisis. There must be trust, respect, and understanding, and while initially MHRAC only exists by DOJ mandate, unfounded extrapolations like “forced treatment” in media articles erode what I’m trying to build for myself, my friends, and our families. Together, we’re building the all too important and long absent bridge between our communities and our law enforcement, and if the need and purpose of MHRAC is any indication, there has been too much mistrust and misunderstanding already.

Albuquerque has a unique opportunity with peers and police working towards positive, safe, and successful encounters, and because this opportunity is so important and valuable, as a city we can’t afford to use our words irresponsibly. It could be publishing “forced treatment” without substance, it could be stating “the only reason” in an official letter, and it could be allowing me to continue having my blog without external refereeing.

I love anecdotes and analogies (and work under the presumption everyone loves my anecdotes and analogies), so I’ll close off with my first experience being on the radio when I was in college working for the Bureau of Land Management.

Back in the early 1990s there were several deaths in abandoned mines on federally administered public lands around New Mexico. The BLM offered a student co-op position to head a survey of identifiable abandoned mine lands and coordinate field assessments for high risk lands. The job was intended to go to a grad student, but I was able to convince the BLM to give me a chance at the job as a sophomore.

For a few months, I was stationed in Las Cruces and the Mimbres Resource Area, and it was in Southern New Mexico where the majority of these mine deaths occurred. Earlier that year, a very high profile death of a teenage boy occurred at the Stephenson Bennett mine in Organ which is just up the slope to the Organ Mountains from Las Cruces. I think for funsies my supervisor sent me in to the local radio station to see how I’d do representing the BLM live on the airwaves. His only words of encouragement and/or warning to me were: “Prepare to be ambushed.”

He wasn’t kidding. No sooner did we exchange pleasantries and I introduced myself as heading the BLM Abandoned Mine Lands Reclamation project in New Mexico than the radio host jumped at me with, “Tell me, Steve, why did it take the death of one our community’s teens before the BLM decided to do anything?”

Wow. That was sharp. And quick. The thing about me is I enjoy talking, and I think very quickly when I talk, but this was my first time on the spot with a radio audience out there listening in. So while it was sort of surprising how quickly the words came to me on my first time live on the air, I was able tap into this rapid-response skill set and say (this was transcribed years ago from a recording my BLM colleague Chuck made for me, so it is accurate in spirit if not word for word):

“You’re right, this is a horrible tragedy, and it’s a real problem that needs real action to protect the safety of our teens and everyone who enjoys their public lands. As a community we need to work together to create the solutions we need so tragedies of this type won’t happen again. Can we count on your support and this station’s support to help create the solutions we need?”

There wasn’t anywhere else the radio host could attack me, which was a relief because I was nervous as all get out and I could feel the sweat leaking from my palms into the chair arms I was gripping in a panic-clasp. I meant what I said, and the gist of the radio interview is we can’t diffuse a bomb that’s already exploded, so there is no sense in trying to put the shrapnel back together.

The importance of that first radio appearance, and what I learned from that first radio appearance, is that while it was a natural facilitation talent that got me out of that nightmare, the truth is it does take everyone working together to create the solutions our community need, and lending any energy to reconstructing shrapnel is a pointless and wasted effort. This is precisely why I’m passionate about peer and APD collaboration, and this is precisely why I absolutely believe that excising needless rhetoric like “forced treatment” from the narrative is worthwhile, necessary, and fundamental as we build the solutions our community deserves.