THE BLOG

The Need for Health Activism in the Criminal Justice System

03/30/2015 09:26 pm ET | Updated May 30, 2015

It has been said, "The social power to define and categorize another person's experience is not a power to be ignored." The health activation movement is alive and well at the 2015 College for Behavioral Health Leadership Conference. Last week, I had the privilege of presenting about health activation with Adam Slosberg, peer specialist and managing director, Beyond Today International. Declaring 2014 the year of the peer health activation has taken center stage for peer training and professional enhancement, in behavioral health and in the criminal justice system.

According to The National Council for Behavioral Health, Whole Health Action Management (WHAM) training is a peer-led intervention to activate whole health self-management in community mental health centers, federally qualified health homes and Veteran Administration programs. Designed by The Substance Abuse and Mental Health Services Administration (SAMHSA) and Center for Integrated Health Solutions, this initiative will assist and intervene with those persons working to activate their health and recovery from mental illness and co-occurring addictive and other medical disorders.

The WHAM Training Program consists of five keys to success, which according to its national council include the following:

  • A person-centered goal based on 10 science-based whole health and resiliency factors.
  • A weekly action plan that breaks the goal into small, achievable successes.
  • A daily/weekly personal log.
  • One-to-one peer support.
  • A weekly WHAM peer support group.

The 10 science-based health and resiliency factors include:

  • Stress management.
  • Healthy eating.
  • Physical activity.
  • Restful sleep.
  • Service to others.
  • Support network.
  • Optimism based on positive expectations.
  • Cognitive skills to avoid negative thinking.
  • Spiritual beliefs and practices.
  • A sense of meaning and purpose.

I have included peers in Broward's Mental Health Court. The unique connection often made in the courtroom where an individual may be appearing for the first time in mental health court can be a very powerful and significant intention, which can help shape an individual's attitude and belief about mental illness and whether or not to seek treatment in the community.

In economic terms, health activation through peer support is a win-win dynamic. It offers many mental health consumers an opportunity to break out of cycles of poverty as a result of disability and an upward economic ladder of mobility. Moreover, for the peer wanting to be successful in their ability to activate their health, this initiative provides a mentor and guide who has been there and has gained a high level of confidence and success in their own behavioral health management and wellness.

The significance of health activation cannot be overstated. According to Judith Hibbard, DrPH, principal researcher and lead author of the Patient Activation Measure, a key health policy question is, what would it take for consumers to become effective and informed managers of their health and health care? Noting that 90 million Americans are diagnosed with a chronic disease, and as stated by Dr. Hibbard, in order to reduce health care costs, individuals must play an active role in their on-going care.

As critical as health activation is to wellness and health care costs, my presentation focuses on the human and civil rights costs related to stigma, discrimination and failed governmental policies which lead to crisis, health deterioration, and often incarceration. As it relates to the horrific trend of the criminalization of persons with mental illness in the U.S., health activation through peer intervention when viewed through a civil and human rights lens becomes a significant form of health and social justice activism.

For example, each day, in Broward's Mental Health Court, my judicial role, together with my clinical staff includes that of messaging, identification of personal strengths and recovery coaching, system navigation, behavioral health literacy, public health educator, and motivator. For our therapeutic court team, this part of problem solving court process is essential and deemed to be as important as life and death.

I believe specialized treatment courts and courts of general jurisdiction in the criminal justice system would benefit greatly by peers trained in health activation. Further, as asserted by Mr. Slosberg in his remarks, I would add there is a role for trained peers across the criminal justice continuum. For many, a civil rights vector where health activation intersects with social justice activism. For more information, click on the above link for The National Council for Behavioral Health.