Let’s Rock and Roll

“Let’s Rock and Roll” poster at Senior & Disability Action office

“It’s shocking how age-segregated American society is …Nothing changes if we stay in our silos, and one of the really, really important things about living in society is having friends of all ages. It connects people empathetically, and that’s critically important.”

--Ashton Applewhite, author of This Chair Rocks: A Manifesto Against Ageism (2016) on why ageism is not ok

  

About a year ago after pondering the value of age-segregation, I left my job at a senior-focused organization to work in disability rights advocacy and later supportive housing.  Since the latter organizations served all ages, my intention was to bring a gerontologist’s perspective and promote intergenerational relationships. 

However, in these environments for all ages, I was disappointed that the concerns of older adults were often marginalized (in favor of investing in the future of younger ages; staff training involved chanting “Youth matters!” and ideas for after-school programs) or equated with children (so occupy their time with bingo games).  Like the late gerontologist James Birren, who found that residents in retirement “age ghetto” communities actually were more satisfied with their lives than were community residents of the same age, I learned from my senior residents that they really preferred the quiet and safety of living in senior housing (--just as I am enjoying this Spring Break week’s peaceful commute on Muni bus, without younger, often boisterous, students onboard).

Like the Parable of the Prodigal Son, I soon realized the error of my idealism for an age-less society when the real world remains ageist, and returned to the Aging Network!

At senior sites where I worked in supportive housing, homebound tenants appeared to be almost as vulnerable as nursing home residents since they must depend on and wait for others’ availability to access food, healthcare, transportation, assistance with activities of daily living, etc.  Thus, I decided to join a senior-focused organization serving seniors who are mostly homebound due to disability (including low-grade agoraphobia, but not by choice like shut-ins who use on-demand economy for convenience).

Disability rights

I learn how to be a better advocate of community living for homebound seniors when I meet disability rights advocates. 

At LightHouse for the Blind, Summer Beasley-Hoffman, an ACVREP certified Orientation & Mobility specialist at Veterans’ Administration, demonstrated two-point touch technique of tapping long white cane from left to right.  She said studies show that using white cane increased yield to pedestrians about 90%!  Good information to share with older adults who believe using a cane makes them more vulnerable because this “advertises” their disability.

 

At Ed Roberts Campus, Ralf Hotchkiss (Whirlwind Wheelchair founder), Anthony Tusler (About Disability consultant), Cathy Kudlick (Longmore Institute Director) and Corbett O’Toole (author of Fading Scars: My Queer Disability History) were panelists in celebration of Paul K. Longmore’s posthumous publication, Telethons: Spectacle, Disability, and the Business of Charity (2016).  The Jerry Lewis telethon for the Muscular Dystrophy Association (MDA) was ageist in parading cute disabled kids as poster-children needing audience’s donations to cure them, while adults who made up two-thirds of MDA’s clients were invisible. The MDA telethon ended last year after a 60-year run.  I like Andrew Pulrang's "Telethon Thoughts" from Disability Thinking: 

  

“Unless you have a disability yourself, you have to think actively and practice deliberate empathy to understand how a well-intended fundraiser can be not only distasteful, but even harmful…

I don’t really object to raising money for medical research into disabling conditions. I resent the fact that the general public is consistently more excited about supporting those efforts than they are about supporting equal rights, equal access, and the nuts-and-bolts stuff disabled people need to live decent lives with our disabilities. It’s strange, when you think about it. “Medical Research” is so abstract, and outcomes so fleeting, while building ramps and buying people speech synthesizers is entirely concrete, with immediate payoff. You would think all us practical-minded Americans would rather give to pay for things people can use, than to provide open-ended funding for fuzzy dreams.”

At SFSU Campus, Smith-Kettlewell scientist inventor Joshua Miele delivered Longmore Institute on Disability lecture on How Access Really Happens: Disability, Technology, and Design Thinking.  Dr. Miele talked about his role as scientist/scholar who is blind and member of disability community to “demand, require, cajole the world into giving what we need to do things we want.”  Dr. Miele’s work involves designing and developing technology for people with visual disabilities relating to access to information, such as tactile maps.  This might involve breaking the rules to get what we want until the rules change, and then real access happens; he said permission is less valuable than the outcome as in the case with his tactile BART station map project, which was completed two years ago without waiting for BART to provide plans, and his ongoing YouDescribe project (to add audio description to YouTube videos).  He reminded us that accessibility principles are not guidelines/standards so we need to go to users who understand what needs are.  

Seniors dominate in end-of-life issues

At SF End-of-Life Network meeting, Co-Chair Nate Hinerman introduced Roy Remer, Director of Guest House Facility and Volunteer Programs at 6-bed Zen Hospice residential care facility for chronically ill and 60-bed hospice/palliative care floor at Laguna Honda Hospital.  Zen Hospice integrates social and medical services with spirituality (Zen mindfulness) to enable the dying to live fully toward the end. Its caregiver volunteer program is rigorous, involving 43 hours of training, minimum 1 year commitment of 5 hours each week.  Outside of Zen Hospice, Roy guides wilderness rites of passage to prepare us for death and help us in the process of grief.  

At SFSU, Gerontology Professor and Interim Faculty Director at the Institute for Palliative Care Brian de Vries moderated a panel discussion with BJ Miller, MD (Zen Hospice), Rabbi Eric Weiss (Bay Area Jewish Healing Center), Redwing Keyssar, RN (Jewish Family and Children Services) and Daphne Stuart, LCSW (UCSF Symptom Management Service) on Everything You Wanted to Know About Palliative Care in San Francisco.  In a nutshell, palliative care is person-centered and multidisciplinary focused on improving quality of life, including pain and suffering relief, psychological/spiritual support for patient and family, and conversation on choice and hope.  Hospice is a form of palliative care, but most palliative care is not end-of-life care or hospice. 

Shireen McSpadden, Interim Director of San Francisco Department of Aging and Adult Services, remarked that several panelists (Miller, Keysaar, Weiss) serve on San Francisco Palliative Care Task Force, which produced its 2014 Final Report. 

At The Booksmith, Ann Neumann and Katy Butler discussed their respective books, The Good Death: An Exploration of Dying in America (2016) and Knocking on Heaven's Door: The Path to a Better Way of Death (2013).  Katy noted their commonalities (journalists who wrote books about their fathers’ deaths) and differences (20 years apart in age; Katy’s father had too much treatment prior to his death at age 80, while Ann’s father had too little treatment prior to his death at age 60).  According to Ann, who became a hospice volunteer after her father's death, there is no “good death,” but always pain, loss, disparities in health care, etc.  Katy is writing her next book, Good End-of-Life: A Practical Guide, which will include ideas like tripling payments to hospice, lengthen Medicare hospice eligibility from last 6 months of life to 1 year, and consumer lobbying.

Listening

The Doobie Brothers gave good advice when they sang, Listen to the Music, written by Tom Johnston:

Wo, we got to let the music play 
What the people need
Is a way to make 'em smile
It ain't so hard to do if you know how
Gotta get a message
Get it on through
Oh now mama's goin' to after awhile
Wo, oh, oh, listen to the music
Wo, oh, oh, listen to the music
Wo, oh, oh, listen to the music
All the time 

Like executing advance health care directives, those who can listen to music should document our favorite music while we still have capacity.  

At San Francisco’s Opera Plaza Cinema, filmmaker Michael Rossato-Bennett showed Alive Inside, a documentary about the transformative power of “personally meaningful” music to “re-awaken” memories of persons with dementia. (Screen shows nursing home resident Henry becoming animated while listening to his favorite music, in photo above.)  It follows New York social worker Dan Cohen dispensing iPods first at a nursing home and seeing the benefits (regain self-expression, memory recall, physical movement) as residents listen to their favorite music, then he brings iPods to a private residence in the community with similar effect.  Neurologist Oliver Sacks, author of Musicophilia:Tales of Music and the Brain, reminds us that Kant called music the “quickening art” because of its ability to bring listeners immediately to life.  For persons with dementia, this is possible because musical memories activate more parts of the brain last touched by Alzheimer’s, the most common form of dementia.  Alive Inside provides these facts:

5 million Americans have dementia

10 million care for them

1 million in nursing homes lose their connection to life

In Alive Inside, Dr. Bill Thomas discussed how music creates spontaneity in contrast to the regimented world of nursing homes (total institutions), where residents lose independence, dignity and control over meds that sedate them; as they struggle to adapt, they end up withdrawing inside as "living dead" people.  However, he notes that a $1,000 anti-depressant is “real business” (reimburseable under health insurance system), while a $40 music system does not count as a medical intervention; Western medicine views the body as a machine, while music touches the heart and soul of the patient. 

Twenty years ago, Dr. Thomas published The Eden Alternative: Nature, Hope and Nursing Homes, critiquing the prevailing nursing homes modeled after hospitals. Based on this medical model of treatment focused on disease, disability and decline (body system failures), residents are overtreated with psychotropic drugs, unnecessarily restrictive diets that take pleasure out of eating, endless activities programs to meet needs of regulators (rather than true needs of residents), and a therapeutic mentality that remakes ordinary life activities (e.g., pleasure of animal companionship, enjoyment of children, music, art, movement and touch) into treatments rendered by certified therapists.

In its place, Dr. Thomas proposed his holistic Eden Alternative model of personalized care that promotes growth in an enlivened human habitat so residents have “close and continuing contact” with a harmonized diversity of plants, animals and children to combat the “three neglected plagues of nursing homes”—loneliness, helplessness and boredom (social system failures that can be addressed by providing companionship, usefulness and variety).  Instead of scheduled visits for pet therapy, pets would live with residents.  Dr. Thomas acknowledged the role of music when he stated “few human hearts are immune to the uplifting effect of a bird’s song” and suggested parakeets—though imprisoned in bird cages, while dogs and cats roam freely. 

I had many questions, but I was reluctant to ask during the 15-minute Q&A with both filmmaker Michael and social worker Dan after the screening because the audience seemed so enamored with the idea of bringing iPods to nursing home residents with dementia.  During this Q&A, Dan mentioned that a resident listening to just one hour of music in the morning is “good for the day.”  He also reminded us that long-term memory is retained longer and hearing is the last sense to go when one dies.  I wondered if this suggested that one-hour of personalized music alone for the hearing was sufficient to combat loneliness, helplessness and boredom—without adding Eden Alternative elements like plants, animals and children?

My critical mind wondered why the woman living at home in the community was deprived of music until social worker Dan got her an iPod playing her favorite music? Did she stop listening to her favorite oldies music when her 8-track became obsolete, and did not transition to cassette tape or compact disc? Is the takeaway message for us to avoid music (nature) deficit disorder so we should “listen to the music all the time” and be alive to experience every moment of life as a gift, prayer or sacrament like e.e. cummings' the gladdest thing?

Why select so many happy-dance songs? For example, the film featured Bobby McFerrin of Don’t Worry, Be Happy (1989 Grammy Award Song of the Year):

In every life, we have some trouble

When you worry, you make it double

Don’t worry, be happy . . .

The landlord say your rent is late

He may have to litigate

Don’t worry, be happy

In light of the increasing rates of evictions when renters can lose their home within three weeks for failure to pay rent and the fact that 90% of tenants in eviction cases go without legal representation, listening to this song is creepy . . . though last month San Francisco approved funding $1 million for eviction legal defense services.

How about listening to songs that arouse other emotions like anger (Pat Benatar’s Hell is for Children), sadness (Rolling Stones’ Angie), grief (Tracy Chapman’s Behind the Wall), pensiveness (Beatles’ Revolution), etc. to fully express the range of emotions instead of simply joy? How about songs about social justice (Shane Philips’ Rise Up) to inspire change? All honest emotions that flow through (unstuck) can engage us with life.

Like Dr. Thomas’ The Eden Alternative, a non-profit organization that offers culture change training to de-institutionalize long-term care environments and membership in Eden Registry for $3,300, Dan Cohen’s opportunistic Music & Memory is a non-profit that provides training and certification for $1,600. When Music & Memory asks, "Can an iPod change a life?" I wondered whether it has any financial interest in Apple company stock for marketing its products? Also, I wondered about potential hearing loss from use of headphones/earphones? 

In the audience, I spotted California Advocates for Nursing Home Reform (CANHR) Senior Attorney Prescott Cole, who was guest lecturer in my Ethical and Legal Issues in Aging and Social Services course.  He also wrote and composed Shady Manor, a 22-song musical about “a nursing home run by an ambitious and corrupt administrator trying to make Shady Manor show a profit so he can get promoted by his corporate higher-ups.  To make a profit he cuts corners on supplies and under-staffs, causing misery for the residents.”  Shady Manor was performed last year as a fundraiser for University Mound Ladies Home, a non-profit assisted living that was ultimately “saved” from closure when acquired by for-profit AgeSong this month. 

 

At the San Francisco Main Library, People With Disabilities Foundation hosted a seminar, Abuse Against People with Mental and/or Developmental Disabilities: Physical, Sexual and Verbal Abuse in Institutional or Community Settings, to address the potential causes, ramifications, and preventive measures related to the abuse of people with mental and/or developmental disabilities.  Dr. Clarissa Kripke (seated 2nd to left behind table, in photo above), UCSF Clinical Professor of Family and Community Medicine, provided 10 tips for improved communication between professionals and people with psychiatric and developmental disabilities:

1. Speak directly to patients.  Figure out how people communicate best and support it.
2. Presume competence.  Give access information and education as well as support for people to make their own decisions.
3. Give people the tools to communicate about mistreatment, boundaries and choices.
4. Teach people to set boundaries and protest to help people maximize their potential and to participate fully. Compliance training is a set up for abuse.
5. Train families and professionals how to listen and respond. Communication is a two‐way street. Put people with disabilities in charge of developing the curriculum.
6. Take all complaints about mistreatment seriously. Investigate them, and protect people from the accused during that process. 
7. Give people opportunities to try and fail when the stakes are low, so that people have experience with natural consequences when the stakes are higher.
8. Get a history of baseline function. In people with communication challenges, illness presents as a change in behavior or function. 
9. Respect personal boundaries. Offer assistance, but wait for a response and instructions before acting. Treat assistive devices such as wheelchairs and communication devices as personal space. 
10. Give people access to their chosen advocates and supporters. Many people need support to communicate and to make decisions, especially when they need it the most such as when they are in crisis or transition.

Dr. Kripke, who received the Chancellor Award for Disability Service and has a son with autism, noted Autistic Self Advocacy Network (ASAN) drafted model state legislation to enable Persons with Disabilities a trusted person to help communicate with doctors, understand health care information, make informed decisions about health care, and/or carry out daily health-related activities. This would be like a power of attorney for health care, except there would be no transfer of decision-making to another person. 

CANHR Staff Attorney Tony Chicotel said chemical restraints have been the primary treatment for behavioral expressions related to dementia, such as memory loss, confusion and loss of ability to communicate.  He asked, “what do you do with a crying baby? A. Give them drugs, or B. Tend to their needs and comfort them?”  Instead of drugs, the focus should be the least medicating approach recognizing behavior is communication, knowing care recipient, and meeting them where they are (versus correcting mistakes); and comfort-focused care involving culture change components (liberalized diet, personalized sleeping and showering schedule); active observation, notation and collaboration; and comfort as the goal of every experience.  Tony suggested we reframe the language: for example, viewing the person with dementia resisting care v. exercising self-protection; or wandering v. expressing underlying boredom or lack of physical activity. 

This reminded me of Dr. Thomas saying, “If only we could care for nursing home residents as we care for children. After all, we expect children to grow and we do everything we can to nurture that growth.”  I wondered how can we support growth when caring for persons with dementia (particularly in its progressive and degenerative form like Alzheimer's disease) who grow more dependent as they lose capacity for decision-making? 

I did a lot of listening and learning at Discover You: A Day of Connections, Information and Possibilities! an all-day seminar presented by National Federation of the Blind of California and LightHouse for the Blind.  The main message was set high expectations to do what you want, focus on your strengths, talk about your disability and figure out how to do things and ask for accommodation if needed.  GK Callahan’s The Beaded Quilt (2011, photo above) mural represents the colorfulness and diversity of the Bay Area blindness community who assembled it from almost 150,000 colored beads, and over a year in the making.

Architect Chris Downey, Attorney Shannon Dillon, and CEO Kevan Worley (also Executive Director of National Association of Blind Merchants) participated in breakout session, Discovering Employment Opportunities.  Chris related how soon after he lost his vision in mid-life, a social worker began talking to him about career alternatives.  As an architect, Chris said his work is about trying different points of view and problem-solving, so he ignored the social worker’s advice and found adaptations to continue working as architect while carving out a niche in designing for the blind!  Because architects are obsessed about the world around them, he rediscovered the world without the visual—paying more attention to space and sound—so it was like being a kid again. 

Deborah Kendrick, author of Jobs To Be Proud of and Jobs That Matter from AFB Press, is also columnist for Columbus Dispatch with her latest article, How much do you know about disabilities?

Coming out: disability awareness

Nearly 1 in 5 Americans has a disability, the nation’s largest minority.  Fewer than 15% are born with their disabilities; if you live long enough, you’re likely to acquire a disability. 

The U.S. has a long history of discrimination against persons with disabilities, keeping them out of public view via institutionalization.  As a result, most Americans may have learned about disabilities through popular media’s distorted images.  For example, disability portrayals feature younger persons more often than older adults, who actually represent the largest group of persons with disabilities.  Instead of perpetuating ableism and ageism, it’s time to learn from the experts—actual persons with disabilities!

Superfest: The Dissies

“Whether films take us somewhere far away outside or deep down inside, they involve an intimate dance between projection and reflection, a giant flickering mirror, not just back to us, but to the society and culture we live in.  They shape how we see ourselves individually and collectively, how others see us, and how we see others.  This is why movies matter, why they occupy a key intersection where entertainment, psychology, and social justice meet.” – Why the Dissies, by Catherine Kudlick, SFSU Professor of History and Director of Paul K. Longmore Institute on Disability 

SFSU’s Paul K. Longmore Institute on Disability  and SF LightHouse for the Blind and Visually Impaired provided an empowering opportunity to critique disability portrayals in their joint presentation of Superfest International Disability Film Festival to a full house at the Women’s Building in the Mission District. This event was fully accessible beginning with the program brochure, which was prepared in both large print and Braille.  The program included ASL interpreter on stage with closed-captioning (for hearing challenged), audio description of video clips (for visually impaired), and ample space for wheelchairs/walkers/canes.

Culture! Disability!Talent! passed Superfest Torch to Bryan Bashin of SF Lighthouse for the Blind and Catherine Kudlick of the Paul K. Longmore Institute on Disability. 

Superfest Committee member Emily Smith Beitiks (Longmore Institute) and Judge Todd Higgins (SFSU’s Disability Programs and Resource Center) mingled with guests, enjoying drinks + popcorn before show began.

Being volunteer usher was an awesome experience for a behind-the-scenes look at putting together a fully accessible event for persons of all abilities! “Bossy” Corbett O’Toole showed me the best seats for the hearing impaired to be close to ASL interpreter, center aisle for those in wheelchairs, back seats for guests with service dogs, etc.

This year’s Superfest featured The Dissies, a one-night retrospective of the “worst of the worst” film clips portraying cringe-inducing disability stereotypes in mainstream movies.  The audience, or experts, then voted by sound ("howl, heckle and hoot") and movement (“have a seizure”).  After a panel of three judges declared the winners, Vannas presented Tiny Tim statuettes to leaders from the disability community who took the stage to deliver fake acceptance speeches.

Master of Ceremonies Lawrence Carter-Long, founder of disTHIS! Film Series (and in his second week as a furloughed federal government employee at the National Council on Disability), watched 230 films to whittle down to 22 contestants.  Based on expert opinion, the winners were (drum roll . . .):  

Worst Portrayal of a Disability by a Non-disabled Actor awarded to Gene Hackman as a blind hermit in Young Frankenstein (1974) for cluelessly ladling soup on his guest's lap and then shattering a wine mug while toasting.  Hey, what happened to a blind person compensating with an acute sense of hearing?! asked Carter-Long. UC Berkeley English Professor Georgina Kleege accepted the award on behalf of Hackman for his representation with such effect that no one would want to come to a blind person’s home for soup.

So Sweet (that They’re Not) honor went to Shirley Temple in Heidi (1937) for urging Clara to walk without crutches “if only you try hard enough.”  This category was a tough call as contenders—other nominees were Mary of The Secret Garden (1987) and Pollyanna (1960)—featured almost indistinguishable "cute, little white girls" helping “pathetic” disabled. 

The Most Amazing Miracle award went to paralyzed Allan Mann of Monkey Shines (1988).  This was another close call with Forrest Gump (1994) for Run, Forrest, Run! scene when Forrest’s leg braces fall off as he sprints like an Olympic track and field athlete away from the bullies. Scientist Joshua Miele put on eyeglasses to get in character for his hilarious acceptance speech, noting that he was “drinking beer earlier and the fact that he didn’t miss his mouth one time was amazing. . . you people are so inspirational” and then thanking the “differently crippled, or whatever.”

The Most Tragic win was Million Dollar Baby (2004 Academy Award Best Picture) for its "better dead than disabled" scene of the former boxer, depressed over her sudden quadriplegic state, asking her coach (played by Clint Eastwood) to put her down like her family’s old dog instead of fighting to change her situation and environment.  Big audience applause when award acceptor Victor Pineda noted that the film’s protagonist would have been better off without Eastwood character.

Audio Eyes (mostly spoken by blind actor Rick Boggs) deserved honorable mention for audio description of video clips.  For example, after The Most Tragic nominee Al Pacino, who played a blind and retired Army officer, in Scent of a Woman (1992), attempts suicide saying, “I got no life! I’m in the dark here!” the sarcastic audio description says he “closes his useless eyes.” 

The Worst Disabled Villain:  Peter Sellers as Dr. Strangelove (1964) who has alien hand syndrome and uses a wheelchair

Crips Gone Wild! (And Ruining Everything):  Danny in Blind Dating (2006)

Hey, only we can laugh at that!: The Ringer (2005)

I enjoyed this view of the stage from the balcony, which was mostly standing-room. After the last laugh, there seemed to be a collective cathartic release from confronting tiresome tragic/heroic stereotypes of disability.  I’m looking forward to next year’s Superfest showcasing more diverse and complex representations of disability culture—as Carter-Long told us, “No handkerchief necessary, no heroism required.”

  

Mental health disabilities

At The Dissies, Glenn Close in Fatal Attraction (1987) was nominated for Worst Portrayal of a Disability by Nondisabled Person.  At the White House Conference on Mental Health this past June, the actress came out to apologize for her portrayal of the obsessive spurned lover who boiled the bunny to death.  Portrayals of persons with mental health disabilities as having suicidal and homicidal tendencies contribute to the stigma that silences those who need support toward recovery to regain control over their lives.

This October 31 marks the 50^th anniversary of the Community Mental Health Act, which helped de-institutionalize persons with mental disabilities back into the community.  Yet, the three largest mental health providers in the nation today are jails. 

Depression is a leading cause of disability.  Women, who tend to ruminate on sources of problems rather than solutions, are twice as prone to depression as men. Depression can cause cognitive impairment: executive function deficit, slower processing speed, psychomotor slowness, attention problems, and lower working and verbal memory.  Depression is emotional suffering, as opposed to apathy, which is loss of motivation that is typical in Alzheimer’s disease or dementia.

Depression actually declines with age, but is the most common emotional problem among older adults.  Yet many older adults are reluctant to talk about depression, seek psychological help, and tend to be noncompliant with medications.  At the SF Main Library, I attended gerontologist Hope Levy’s Brain Fitness class featuring guest speaker Charles Vella, who recommended SPEAK UP for self-care:

Schedule: sleep, eat

Pleasant activities: fun, people

Exercise

Avoid alcohol/drugs

Kind thoughts: challenge negative thinking

Unwind: relax

Practice assertiveness

In addition to self-care, Dr. Vella said that depression can be treated through medications, patient education, cognitive behavioral therapy, and relapse prevention.    

Dr. Vella also discussed suicide = permanent solution to temporary crisis:

·         Elderly make up 13% of U.S. population, but 16% of suicides

·         Most at risk for suicide are older white males; contributing factors are depression, chronic health problems, difficulty adjusting to life change, isolation

·         79% of all firearm suicides are white males age 85+ 

·         61% of gun deaths in America are suicides (50% of all U.S. households admit to having firearms, which is risk factor for completed suicide)

·         Firearms remain most common method of suicide: 46 Americans commit suicide with guns everyday.  Firearms are used in only 5% of suicide attempts, but almost always fatal.

·         Suicide completion rate for men is 4x higher than women

·         50% of completed suicides are done under influence of alcohol, which is a depressant

Suicide Prevention

SFSU hosted Suicide Prevention Regional Conference’s We All Matter: Creating a Community of Caring.  Keynote speaker was Kevin Hines, author of Cracked, Not Broken: Surviving and Thriving After a Suicide Attempt.  As a 19-year-old college student with a recent bipolar disorder diagnosis, he attempted suicide by jumping from the Golden Gate Bridge.  As a survivor, he advocates for a suicide barrier and mental health wellness.

 

In the closing keynote, clinical psychologist Wei-Chien Lee shared her Reflections, or casual sayings that can make depressed persons feel worse – reminding us that “the symptoms of our people are the symptoms of our culture.”  For example, do people really care or mean what they say, “How are you? Let’s do lunch.”  How do predominant American cultural values like rugged individualism (pull yourself up by your own bootstraps) and the exaggerated pursuit of happiness (“don’t worry, be happy” at the expense of other emotions like “smile and the world smiles at you, cry and you cry alone”) affect our well-being?  She concluded her presentation with a sincere Small Actions Count (El Llanto), similar to random acts of kindness philosophy.

Active Mind’s Send Silence Packing is a traveling art exhibit of over 1,100 backpacks that represent the number of students who die by suicide each year. 

Much of the conference and accompanying exhibit focused on suicide prevention among younger adults, but I spotted this backpack about Grandmother.  In addition to stories on some backpacks, white poster boards carried messages like:

Stigma is shame, shame causes silence, silence hurts us all

We may often suffer in silence, but we do not suffer alone

Each suicide produces as many as 100 survivors or people left to grieve

By the way, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) eliminated the two-month bereavement exclusion so now people who grieve the loss of a loved one can be diagnosed with depression, making anti-depressants more readily available. 

Nihil de nobis, sine nobis (Nothing about us, without us)

As I reflect on disability awareness month, I think about having the cultural humility to meet people where they are, instead of imposing the medical model of disability.  For example, it’s disturbing that the American Psychiatric Association (APA) attempted to pathologize introversion in its DSM-5.  Instead, let people who are the experts in their own lives define their needs; respect the individual and provide a supportive environment.  In this social model, disability is a social construction:  the problem resides in the environment that fails to accommodate people with disabilities, and in the negative attitudes of people without disabilities.