Ask the Expert
Treatment and Recovery in Behavioral Health for Americans With Disabilities
Ask the Expert:
Barbara L. Kornblau, JD, OTR/L, FAOTA, DAAPM, ABDA, CDMS, CCM, CPE, served as the Dean of the School of Health Professions and Studies at the University of Michigan - Flint.
1) Question: My disabled mother lives with us and is just starting her recovery. We bring her to different service providers related to her disability, and now we will be seeking recovery support services for her as well. How can I get her current service providers to coordinate or assist with her recovery services? What steps should I take?
Answer: Try to get all of the service providers to participate in a team meeting to coordinate care. If you have a case manager, the case manager can help make this happen or can speak to all of the providers to coordinate care. If you don’t have a case manager, you might want to contact a local social service agency such as a community mental health center or vocational rehabilitation services to see if you can locate a case manager.
2) Question: I understand the model in which the consumer is the expert on their own needs, as was shown in the program. But how does someone know what they need when they are just starting out on their path of recovery? Many people don’t have any idea of what they need, what is available, and where to go to get services, and this can be true for people with disabilities as well. Is there any kind of simple self-assessment tool someone can use to figure out what they might need?
Answer: The University of Missouri has an online self-assessment at http://samhi.mimh.edu/mh.asp that allows consumers to get feedback after they answer 15 questions regarding their mental health. It also makes suggestions for intervention and services based on the answers to the questions. It refers people to providers for those services but unfortunately for people who do not live in Missouri, the referrals are only to Missouri providers. (See question 4 below for other provider resources for people with disabilities)
3) Question: I work with people with disabilities, and in your program you stress the importance of family support. I often find that families get burnt out on caregiving, or reach a caregiver fatigue state in which they just can’t provide any more support than they are already providing. In cases such as this, what other supports are available for people with disabilities who need treatment or recovery services? Who can ‘stand in’ for family?
Answer: Families should work out arrangements to get respite care from time to time so they have a break from caregiving. Family support groups can also help support the family. For assistance with caregiving, families may want to contact a case manager – either one from a private agency, an insurance carrier, or Medicaid waiver program that encourages community-based living. Case managers can stand-in for families who are reaching the point of caregiver fatigue. Explore other family members, people from the family’s religious community, and community volunteers to put a team together that can rotate responsibilities
4) Question: Is there an online directory of recovery services or providers specifically for people with disabilities?
Answer: People with disabilities can call their local Centers for Independent Living, Statewide Independent Living Councils, or State Protection and Advocacy organizations for referrals to local providers who provide recovery services to people with disabilities. Center for Independent Living and Statewide Independent Living Councils in your community and/or state can be found at the following links: http://www.ilru.org/html/publications/directory/index.html and http://rtc.ruralinstitute.umt.edu/CIL/centersShowAll.asp . State Protection and Advocacy organizations may be located at http://www.ndrn.org/en/ndrn-member-agencies.html . Keep in mind however, that providers of recovery services may not discriminate against people with disabilities in the provision of recovery services.
5) Question: My husband recently began his recovery, for which I am very thankful. However, now that he is no longer self-medicating with marijuana, it is clear that he has PTSD or some other mental health problem that he needs some assistance with. However, I don’t think he will listen to me when I tell him he needs help for it and that there is help or treatment for it. It was hard enough getting him to see that his pot smoking was becoming a problem. How can I help him get treatment for his PTSD/mental health problem?
Answer: If you can get him to a support group for people in recovery, he may accept input from his peers. If he is a veteran, a veterans’ assistance center might be of assistance. Getting someone to seek help or treatment is often difficult until they realize they need help. You might enlist the help of other family members to encourage him to seek assistance or your primary care provider if your husband sees a primary care provider.
6) Question: I am in recovery and because of pain the doctor advised me to take methadone. What are the pros and cons of using methadone?
Answer: Methadone is a good drug for pain management but there are two issues with it. Since Methadone is a long-lasting drug in the body, it is very important to follow the instructions for the amount prescribed and take no more than the doctor prescribes. You also need to make sure the doctor is prescribing the correct amount. When you go from other pain medications to methadone for pain, the dose of methadone must be cut significantly compared to the dose of your previous pain medicine. However, since it is so long-lasting in the body, you will receive the pain relief from the much smaller dose. The problems come when people increase their dose on their own or their health care provider is not familiar with dosing. A little bit of methadone goes a long way when it comes to relieving pain.