Peers in recovery are often advocates and educators. Ripple believes that through sharing our stories and experiences, we can raise awareness while fighting for a world free of stigma. It is also common for members of the mental health and addiction recovery community to be interviewed or write letters to editors and their elected officials. In Connecticut, there are hundreds of active peer advocates, and as members of Ripple, we are proud to stand among them.
This page serves to archive testimony at the Legislative Office Building (LOB) in Hartford, letters to the editor, op-ed’s, interviews and other notable encounters with the mainstream media. We hope that by reading through some of our material, you will be inspired to connect with others, share your story and add your voice to the already hundreds of peers who are working to create positive change in the mental health and addiction services treatment system.
Testimony before the Insurance and Real Estate Committee
HB 6588 – AN ACT CONCERNING MENTAL HEALTH CARE AND
SUBSTANCE ABUSE SERVICES.
Jeffrey Santo, RSS
Senator Lesser, Representative Wood, and distinguished members of the Insurance Committee thank you for reading my testimony today. My name is Jeffrey Santo. I am a registered voter currently residing in the city of Norwalk. Three years ago, I became a Certified Recovery Support Specialist, which is why I have come before you today. I specifically want to talk about Section 5 of House Bill 6588. This section discusses creating a task force to study any means available to increase health coverage for peer support services provided to individuals in this state. I strongly support the creation of this task force because I believe it is necessary for our future. Not just to fill service gaps in the current mental health and addiction services system but also to bring new ideas and practices to the table that are proven to aid in a person’s recovery.
In 2017 the Substance Abuse and Mental Health Services Administration, better known as SAMHSA, created a presentation called, Value of Peers, 2017, which contained the following observation. “Peer support offers a level of acceptance, understanding, and validation not found in many other professional relationships. By sharing their own lived experience and practical guidance, peer support workers help people develop their own goals, create self-empowerment strategies, and take concrete steps towards building fulfilling, self-determined lives for themselves.” The insight provided in the SAMHSA publication was not new information to those of us living in Connecticut. We know the value of peers. The Insurance and Real Estate Committee introduced two bills, HB 6887 in 2017 and HB 5270 in 2019. Both addressed reimbursement for peer services, but both bills failed to pass.
Today we still have no reimbursement strategy for peer support services in place. Even though this obstacle exists, DMHAS funded programs are still training these peers for recovery support roles in the workforce. Over the last decade or so, a few thousand people in our state have been trained, and they have become recognized as peer supporters by the agency through which they received their educations. This is astonishing, considering that the certifying agencies can’t even reach an agreement on the term “certified.” While attending a conference call over Zoom to discuss peer advocacy and billable peer support in Connecticut, I learned something. According to the Executive Director of the Connecticut Certification Board, who was also in attendance, I am not a certified peer. In fact, according to him, no one who has gone through the Recovery Support Specialist training is actually “certified.”
His statement is contrary to the information posted on the Department of Mental Health and Addiction Services website, which says: “DMHAS is pleased to support Advocacy Unlimited Inc. Recovery Support Specialist Training and Certification process to assist individuals in becoming Certified Recovery Support Specialists in Peer Delivered Services under the new Medicaid Waiver program.” DMHAS defines me as a certified peer, yet the Connecticut Certification Boards Executive Director tells me I am not. Is he right, and If so, where does he get the authority to make that determination? Does it have something to do with national accreditation vs. state recognition? I honestly don’t know, but it is one example of an issue that needs to be ironed out by the task force.
Let’s talk about employment. I know by my certification number that Advocacy Unlimited alone has trained over 1,100 of us as Recovery Support Specialists, but only a small percentage of us find work. Jobs we do find that call for the RSS title have requirements and responsibilities well outside our purview. Some of us wonder why there is so much confusion as to our intended role. Many postings do not require the certification that allows the use of the Recovery Support Specialist title. As an advocate for peer supporters, I often reach out to these agencies and explain what an RSS is and what the requirements are to become one.
In one of those correspondences, I discovered something disturbing in the response I received. “Thank you for reaching out to Clifford Beers. The job title is a requirement of our funder, the Department of Children and Families for the SAFEFamily Recovery program. SAFE-FR is a Statewide network of providers (5 contracted agencies) working in collaboration with DCF on parents/ caretakers with substance abuse concerns.” This means we have two separate state agencies, DCF and DMHAS, using the Recovery Support Specialist title for two different jobs with different job requirements and responsibilities.
This leads to confusion about how Recovery Support Specialist should be used on a treatment team. Why is it essential to resolve this confusion? In the future, if a DMHAS service recipient asks for an RSS, we can’t guarantee the level or type of support they will receive. Peer support starts by building trust. How can a client trust us if they can’t even be sure we are, in fact, a peer? This is another question that a dedicated task force should be able to answer. At this time, I would like to share some personal information about how my role as a Certified Recovery Support Specialist has affected my community and the people around me.
Since my graduation, I have talked to 23 people who were all dealing with some level of suicidal ideation. I have spoken to dozens more, helping them through episodes of depression, anxiety, PTSD, and feelings of severe isolation. Even though I am not employed in the mental health field, I have become known for these conversations. Members of the local NAMI chapter have given out my phone number on several occasions to people in crisis who needed to reach out and talk to someone. Sometimes it takes hours to comfort a person and return them to a safer place and state of mind.
I believe that I am successful in doing this for two reasons. First, I understand the mechanics that create suicidal thoughts and depression. I know what it does to the mind and body because I live with the effects of them on a fairly regular basis. The second reason is the training that taught me how to turn my experiences into a powerful force to give people hope. SAMHSA didn’t exaggerate when it said peers could offer a support level that can not be found anywhere else. Without the task force, there will be an ongoing discussion, and in some cases, arguments, on the validity of current certifications already held by peers around the state. More importantly, it will finally end the debate on what fair reimbursement should look like for these dedicated mental health peer professionals. In our state, a social worker must complete 15 hours of continuing education every year as a requirement to renew their certification.
They must abide by the rules set forth by HIPAA, conform to a code of conduct, and the ethical guidelines put in place by the state and the agencies where they are employed. As a Certified Recovery Support Specialist, I must also abide by the rules set forth by HIPAA, conform to a code of conduct, and any ethical guidelines put in place by the state and the agencies where I may become employed. The difference is that I must accumulate a total of 60 hours of continuing education credits over three years. Five hours a year more than my social worker counterpart. If we are not considered professionals by the greater mental health services community, I would be the first to point out that we certainly conduct ourselves as such. What I find most exciting about creating this task force is that it might also open the doors for peer-led organizations to implement new services for the community. This could potentially lead to methods that will allow us to create self sustaining programs running on the revenue generated from the reimbursable peer services we can provide.
Peer respites and retreats could be established and run without the need to rely on grants or state funding to operate. We could increase the number of community bridgers, create more holistic healing centers like Toivo, and perhaps even build peer staffed community clubhouses that are not reliant on DMHAS funding. I invite you to consider what Connecticut’s mental health landscape would look like if properly trained and certified peers could achieve these things in the future. Some of you may question if we are capable of turning any of these ideas into a reality. Let me give you one example of what could happen.
After becoming a Recovery Support Specialist, I entered the volunteer role and currently serve as the Executive Director of Recovery Innovations for Pursuing Peer Leadership and Empowerment (RIPPLE). By mid-2020, we had become legally incorporated and recognized by the IRS as a not-for-profit organization. On September 15, 2020, while the Covid19 pandemic had many people isolated, RIPPLE created the state’s first late-night peer support group using the Zoom platform. On paper, the group runs three nights a week from 10:00 PM to midnight, though in reality, some sessions end closer to 2:00 AM. Eventually, our goal is to expand to seven nights a week and offer services from 9:00 PM until 6:00 AM, the hours where many people find themselves struggling and no one around to provide support.
At this time, two peers with lived experience co-host our late night peer support group, I am one, and the other is Desiree Barton, RIPPLE’s board secretary and soon-to-be student in the upcoming RSS class. Desiree and I routinely open the zoom room for one-on-one sessions outside of our regularly scheduled support groups. Those who attend our meetings know that we will make ourselves available whenever we are able. They contact us through text message and request some time with us.
In December, we logged over 50 hours above and beyond our late-night peer support meetings. We do all of this as volunteers. We draw no income even though we are in demand and perform a service. I should add that on top of these volunteer hours; I also work a full-time job. If insurance reimbursement for peers can be established, an organization like ours could potentially bill for some of the services we provide. The revenue produced could allow us to hire a full-time staff, increase the numbers of hours we are available, maybe even build that respite we mentioned earlier. In 2017 with HB 6887, we started asking how reimbursement for peer supporters in the mental health services system work? As I sit here four years later, I believe the time to create the task force and finally answer that question is long overdue. Thank you for your time.
Testimony before the Public Safety and Security Committee
March 10, 2020
SB 428 – AN ACT CONCERNING ASSISTED OUTPATIENT TREATMENT FOR
CERTAIN PERSONS WITH PSYCHIATRIC DISABILITIES
Jeffrey Santo, RSS
Senator Bradley, Rep. Verrengia, and members of the Public Safety and Security Committee, thank you for taking the time to read this submitted testimony.
My name is Jeffrey Santo, a resident of Norwalk, CT, and a registered voter. I am a state-certified Recovery Support Specialist, a SMART Recovery facilitator, Board Member of Recovery Innovations for Pursuing Peer Leadership and Empowerment (RIPPLE), and the webmaster for RockingRecovery.org.
This testimony I provide today is to challenge the moral standard of this bill and to use my lived experience as an example of how dangerous SB 428 can be. The name of this bill itself is extremely derogatory as many people living with a diagnosed mental illness are still competent enough to make their own medical choices. These choices include the type of treatment that is right for them, who they want on their treatment team, and whether or not they require the use of any medications to move forward in their recovery.
I can tell you with absolute certainty that a person forced into a treatment program is not likely to succeed. Any person who is in recovery from a mental illness or addiction will tell you recovery is not possible until that person is ready to do the work. Even with the best intentions, wanting someone to become well and lead a healthier life, we can not force someone into wellness. Just as you can not force open the peddles of a flower to make it bloom when you choose, and it is not your or anyone else’s choice to make. If a person can’t find a reason within themselves to start their recovery journey, why do you think they would start it for you?
I would also submit to you that a person in an intensive outpatient program who does not want to participate could also create a negative experience for other clients in the group. This would cause people who have started their recovery to seek services elsewhere or abandon the processes altogether. If a clinician feels that a person is not a good candidate for an IOP group, they do not have to let that person attend that group. Mental health professionals treat mental illness, not lawmakers, judges, lawyers, probation officers, or anyone else. When we let legal professionals make mental health choices for a person, it not only takes away the voice and choice of that person; it also ties the hands of the clinicians who are forced to service them.
My experience with being forced to take medications started in 2009. I was charged with threatening someone over the phone. The state’s attorney asked that I be evaluated by a mental health professional, which I was, I was diagnosed with depression. At that time, I had no lawyer, and according to the public defender, I was not eligible to receive their services because I owned a home. Even though I was unemployed and my mortgage payments were delinquent, I was in a position where I was left to represent myself. To make a long story short, I accepted a plea deal even though I believed in a trial. I would have been found innocent of the charges against me.
The prosecutor put a clause in my probation that stated I must comply with any medication recommendations from a mental health provider. Since I was not on any medication, I didn’t think it applied to me. That changed when I met with my probation officer for the first time. He asked me who my therapist was and what medications I was taking, I replied, I do not have a therapist, nor do I take drugs of any kind. Before I left his office, I was ordered to report the following day to meet with a doctor at the Birmingham Group in Ansonia, CT. After a 15 minute appointment, he concluded that my original diagnosis was wrong, and I was, in fact, bipolar.
He prescribed Depakote, which is used to treat manic episodes related to bipolar disorder, and Risperdal, also known as Risperidone. This drug is used to treat certain mental/mood disorders (such as schizophrenia, bipolar disorder, irritability associated with autistic disorder). I objected to his findings and told him I would not be drugged after a hasty 15-minute drive-thru appointment. It was at that point I was told that if I did not, I would violate my probation and face time in prison.
Two weeks after I started taking these drugs, I started experiencing side effects, mainly shifts in my perception of reality and my blood sugar levels going out of control. My glucose levels were so high my meter could no longer read them. I kept getting the error “OL” message on the screen. I soon discovered it stood for Over Limit. At that time, my meter maxed out at 650. A normal blood sugar level is between 80 – 120. My levels constituted a medical emergency and meant that I was very close to a coma. For reference, a diabetic coma is a life-threatening emergency that can affect you if you have diabetes. In a diabetic coma, you are unconscious and unable to respond to your environment. You are either suffering from high blood glucose (hyperglycemia) or low blood glucose (hypoglycemia).
Thankfully I had people around me who cared enough to investigate why this was suddenly happening. Their research found a side effect warning from one of the two drugs I was ordered to take. The warning refers to the increased risk of hyperglycemia and diabetes in patients treated with Risperidone and other atypical antipsychotics. The FDA has received reports of hyperglycemia, in some cases extreme and associated with ketoacidosis, in patients treated with these medications.
I stopped taking the medication and made an appointment with the Birmingham doctor the next day. I brought the pills with me and explained the problem I was experiencing. His response shocked me; he said, “I am not that kind of a doctor, if you are having diabetic issues go to a clinic.” The more I tried to argue my position, the ruder he became. Finally, I opened the bottles, dumped them onto his desk, and said, if you like them so much, you take them. I then walked out of his office and drove home. Not even a full day later, the Connecticut State Police came to my home in Oxford and took me into custody on a violation of probation warrant.
When I arrived in court, they assigned me a public defender. I told him that I wanted to withdraw my original plea and address the charge that brought me to his point with representation. He declined even to try that as an option as I had already entered a plea deal, it didn’t matter that I felt that I had no choice to do so. I even argued that having a public defender for the violation of probation hearing proved I should have had one before since my financial situation did not change. I admit I was combative with the public defender, I felt that not only had my rights been trampled on, but I could also have been killed by a mistake a doctor made, a doctor I was ordered to see.
The public defender knew that I would not address the violation of probation charges against me. He told the court I was not able or willing to aid in my own defense. This meant that under Connecticut law, I was not competent to stand trial. After a review, the judge ordered that I be taken into custody and sent to Whiting Forensics on the Connecticut Valley Hospital campus. I would spend 60 days for competency restoration. On my second day at that facility, I met with the Unit 2 psychiatrist, Dr. Ken Galen. I told him my story and all of the things that happened. He expressed his belief that I should not have been sent to the hospital and that, in his opinion, I seemed to be competent.
On page two of my first Whiting treatment plan, it was Dr. Galen who had been tasked with the following: “Psychiatrist will conduct a psychiatric evaluation to determine the appropriateness of a medication as an intervention.” At no point during my stay did Dr. Galen ask that I be put on medication of any kind. After a solid 60 days of observation, there was absolutely no recommendation for drugs of any kind. The state of Connecticut took two months of my life and spent an excess of sixty thousand dollars to prove what I had been saying all along. The doctor at Birmingham did nothing short of committing malpractice, but no one cared.
When I arrived at the violation of probation hearing, I informed my public defender that it had been confirmed, not only was the medication prescribed unnecessary, it was entirely inappropriate. I was told the findings made by Whiting were beside the point. The issue was that I violated the conditions of my probation, and therefore I had to plead guilty, I refused. I was then told that if I did not go into the courtroom and enter a plea of guilty, I would be sent back to Whiting for another 30 days.
I walked into Whiting with depression; when I left 60 days later, because of the things I witnessed there, my diagnosis had two more forms of mental illness, PTSD, and a general anxiety disorder. The story of my experience at Whiting is a matter of public record as it was recorded in detail by the Southwest Regional Mental Health Board and submitted as oral testimony in front of the Public Health Committee on November 13, 2017. The abuse I lived through that facility still shows its side effects in my life today, mostly in the form of nightmares and the continued presents of PTSD.
Since 2017 I have been telling my story, to professional mental health providers, to public officials, and my peers in recovery. Even though I have been told dozens of times by people in every level of Connecticut’s government that these events should never have happened, I have yet to have any form of meaningful closure. I can not begin to imagine how many lives will be negatively impacted if SB 428 passes.
Regardless of how our legislative leaders choose to describe “Assisted Outpatient Treatment,” it has already been defined by the United Nations. Quoting an article written by Tina Minkowitz, Esq. she talks about the UN report findings:
“This report issues the strongest condemnation to date of involuntary psychiatric interventions based on the supposed “best interests” of a person or on “medical necessity.” Such interventions, the report says, “generally involve highly discriminatory and coercive attempts at controlling or ‘correcting’ the victim’s personality, behaviour or choices and almost always inflict severe pain or suffering. In the view of the Special Rapporteur, therefore, if all other defining elements are given, such practices may well amount to torture.”
Forcing more people into the Mental Health and Addiction Services system will only add more burden to what are already limited resources. More demand equals less time per client, and when you consider our legislature has cut the DMHAS budget by 17% over the last ten years, what you are proposing here is not only immoral, it is outright careless.
I will conclude my testimony with one final thought. When you force someone to do anything that is against their will, you lose their trust. I knew I was living with depression, and I knew I was having thoughts of suicide; I did not trust anyone enough to talk openly. Given my experience, having my rights stripped away and forced into the system, I did not turn to that system when I needed help. I did not trust I would be listened to or respected. I was afraid of my life being in someone else’s control. “Assisted Outpatient Treatment” setback my recovery for more than five years. Today I have a talk therapist, I am still medication free, and as I stated at the beginning, I am a certified Recovery Support Specialist. I did not get here because of Connecticut’s mental health treatment providers; I got here despite them.
Thank you for reading my testimony. I do regret not being able to deliver it in person. Should you have any questions, you are more than welcome to contact me at any time through the email address from which my testimony was submitted.
Testimony before the Insurance Committee
February 27, 2020
H.B. No. 5248 AN ACT ESTABLISHING A TASK FORCE TO STUDY HEALTH INSURANCE COVERAGE FOR PEER SUPPORT SERVICES IN THE STATE.
Jeffrey Santo, RSS
Senator Lesser, Rep. Scanlon, and members of the Insurance Committee,
My name is Jeffrey Santo, and I am a registered voter in the city of Norwalk. I am here to testify regarding H.B. 5248 An Act Establishing A Task Force To Study Health Insurance Coverage For Peer Support Services In The State. Unfortunately, I can not be there in person to deliver this testimony to you, but my absence should not undermine how important this issue is to me.
I am a state-certified Recovery Support Specialist and, as such qualified to work alongside treatment teams for mental health care, people living with addiction, or a co-occurrence of the two. Peer Recovery Coaches, as well as Recovery Support Specialists, are held to the same professional and ethical standards other providers are to adhere. I want to support the creation of this task force in any way I can and feel that it is a step in the right direction. My one disappointment is that this was not done before bills were put forward in the past. One example of this was HB 5270: An Act Concerning Peer Support Specialists and Requiring Health Insurance Coverage for Outpatient Peer Support Services Provided By Certified Peer Support Specialists. This bill was raised in the 2019 legislative session, and many certified peers, including myself, came to testify before the Insurance and Real Estate Committee on March 5, 2019.
We have known for a long time about the benefit that Peers in recovery can provide, as far back as 1935 when Bill Wilson talked to another alcoholic, Bob Smith, about the nature of alcoholism and a possible solution. This was when Alcoholics Anonymous, more commonly known as AA, was founded. An article written by Brian Prioleau in 2014 titled “Peer Support Recovery Is the Future of Behavioral Health” remains posted on the SAMHSA (Substance Abuse and Mental Health Services Administration) website. In this article, he says,
“Peer support specialists are becoming more vital to the field. Mr. Cameron believes peer supporters fill an important role in the behavioral health workforce. “The real value a peer supporter has is that they are uniquely qualified to engage people with mental health issues.” In a 2017 presentation, SAMHSA answered the question, What Does A Peer Support Worker Do? “A peer support worker is someone with the lived experience of recovery from a mental health condition, substance use disorder, or both. They provide support to others experiencing similar challenges. They provide non‐clinical, strengths‐based support and are “experientially credentialed” by their own recovery journey (Davidson, et al., 1999). Peer support workers may be referred to by different names depending upon the setting in which they practice. Common titles include: peer specialists, peer recovery coaches, peer advocates, and peer recovery support specialists.”
As a Recovery Support Specialist, I am a mental health professional. I am required to adhere to HIPAA guidelines which protect the privacy of any client who works with me. I am required to take additional classes and continue my training just as other professionals in the mental health and addiction services field. To keep my certification in good standing, I must earn 60 continuing education credits every three years. If SAMHSA is right, and many peers believe they are, we are the future of mental health, not only in the United States but around the world. This task force is necessary to prepare for that future and to make sure the residents of Connecticut have access to the level of care and services they will need now and many years to come.
Thank you for reading to my testimony this today and providing this forum for all of our voices to be
February 21, 2020
DMHAS BUDGET HEARING
H.B. No. 5005 AN ACT ADJUSTING THE STATE BUDGET FOR THE BIENNIUM ENDING JUNE 30, 2021
Jeffrey Santo, RSS
Good evening Senator Osten, Representative Walker, and members of the Appropriations
My name is Jeffrey Santo, and I am a registered voter in the city of Norwalk. I am here to testify regarding H.B.
5005 AN ACT ADJUSTING THE STATE BUDGET FOR THE BIENNIUM ENDING JUNE 30, 2021.
I could tell you today about how past budget cuts have affected me personally, but I am here to share my
experiences with the hope it will positively affect our entire statewide community. Since I live with depression and still experience suicidal thoughts and ideations on a very regular basis, I have needed to learn coping skills throughout my recovery that works for me. Becoming a Certified Recovery Support Specialist was a huge step and opened my eyes to a wide range of problems that other people face every day. Many of these obstacles include such as finding accessible mental health providers, addiction treatment and support services, housing, employment, transportation assistance, and some basic material needs that are out of reach for them.
With this in mind, I created a website called RockingRecovery.org. In our CT RESOURCE LINKS section, we currently provide connections to over 960 unique resource links that lead to over 1,440 programs, services, and information. The goal of this site is to help people find resources throughout Connecticut quickly and efficiently. The reason I mention any of this is we try to vet every agency, service, and program we list on the site. Whether it’s a full service mental health inpatient facility or a soup kitchen, we don’t want to generate dead ends for people seeking help.
Since the site’s launch in May, I have made over 300 phone calls to verify that they are still offering all of the
services listed on their websites and that the description of their services is accurate. Many conversations along the way has brought an all to familiar story into focus. Service availability has become more limited, and waiting lists are getting longer. Some programs have been merged, their focus narrowed or just eliminated entirely. Some agencies have lost valuable employees due to past budget cuts or new budgets that remain flat. The environment in which they are working forces them to do more with less, and some have not seen a raise since these cuts started ten years ago.
Even with everyone who came to testify here today, it is unlikely we can paint a complete picture of how past
budget cuts have impacted all those receiving DMAHS services. It is also fair to say that even with added resources, we would still be facing an uphill battle. A battle on multiple fronts that include the suicide rate among young adults, the rise of drug overdoses, the opioid crisis, vaping, and meeting the demand for peer addiction recovery groups.
Many things in this world influence our mental health and overall wellbeing. It is true; we do not have the power
to make the world a perfect place, but we do have the ability to help others find stable footing within it. Every
dollar added to the DMHAS budget is another step in the right direction, and every resource we can offer creates a better community for everyone living in our state.
Thank you for listening to my testimony this evening and providing this forum for all of our voices to be heard.
In July, the citizens of Connecticut witnessed a victory for those living with mental illness and addiction. Gov. Lamont signed the mental health parity bill into law. With suicide rates among children up 73 percent in the last decade, and the opioid crisis taking life after life, this new legislation could not have come at a better time. One disappointment in the last session was the second straight failure to pass a law requiring insurance companies to cover services provided by certified peers. Why are peers important?
A peer is unique on a person’s treatment team, having lived experience with mental illness or addiction; it creates trust between themselves and the person they are trying to help. A traditional mental health treatment team has several professionals; these may consist of a talk therapist, a psychologist, a psychiatrist, and so on. It is often against policy that any professional disclose experiences they might have had with mental illness or addiction with their client. A peer will share their story with whoever they are working with and use it as a tool creating common ground. It generates hope by demonstrating that recovery is possible. Peers have been using these methods for decades.
Alcoholics Anonymous started back in 1935; it’s an organization of people from all walks of life who come together in self-supporting groups all over the world. Thousands have found encouragement and hope from people just like them, people who knew what it was like to fight addiction. This method, peer to peer support, is proven to help in other areas of life as well. From grief support groups to trauma survivors and victims of sexual assault, it is a basic need to be in a safe space with people who understand you.
The bill that failed was HB 5270, titled: “An Act Concerning Peer Support Specialists and Requiring Health Insurance Coverage for Outpatient Peer Support Services Provided By Certified Peer Support Specialists.” Being a short legislative session in 2020, peer support services might not be readdressed and could be tabled until 2021. Why can’t we afford to wait? Once this law passes, doors open to services not yet available in Connecticut, as an example, a Peer Respite. A respite environment is similar to what’s found in a bed and breakfast. It’s a warm homelike setting, non-threatening and welcoming.
Respites are methods of diversion redirecting a person from a psychiatric hospital to a short-term voluntary program staffed by certified peer supporters. Anyone experiencing a decline in their mental well being can sign themselves into a respite, they typically stay 3 to 5 days, and clients are free to come and go as they please. Today, in Connecticut, a person experiencing psychosocial stressors only has hospitalization as an option. A traditional hospital costs an average of $2,000 per night. A person brought in through the ER adds about $5,000 to their bill. A respite could cut the per night cost in half, and ER fees are eliminated.
With thousands of hospital stays every year, it is easy to see how costly the old way of doing things can be. In an April 2018 article, the Connecticut Mirror reported a yearly cost of more than $560,000 per patient per bed at the Connecticut Valley Hospital. What do you need to know? First, peer support is evidence-based and proven with years of success. Second, it’s cost-effective and will save more money with every peer added to the workforce. Third, there is a shortage of mental health professionals across the country. In Connecticut, there are more than 1,100 trained Peer Specialists who could enter the workforce immediately. Lastly, the state believes in the effectiveness of a peer system. The Department of Mental Health and Addiction Services continues to fund the organizations tasked with the training and certification of these peers.
Mental health is important. It’s necessary to provide the best services possible to those who need it. One in every five people in the United States lives with mental illness. As a community, we can’t wait until 2021 to bring this resource online. If you believe in what peer support can bring to the table, I encourage you to write your state representatives and senators today. Ask them to support and pass the legislation to get Certified Peer Specialists into the field as soon as possible. The next legislative session starts on Feb. 5, 2020. Don’t let another year pass without action from our leaders in Hartford.
Jeffrey Santo is a Norwalk resident.
In early July Gov. Ned Lamont signed the mental health parity bill into law. Insurance companies will soon be required to provide annual reports that detail their mental health and substance abuse recovery coverage. Why is this so important to our community?
In October of 2012, the World Health Organization called depression a global crisis. On average, we lose 16 veterans and four active-duty personnel/reservists a day. In a March 2018 article, USA Today reported the suicide rate for children and teens between the ages of 10 and 17 was up an average of 73 percent from 2006 to 2016. USA Today also reported in April of 2018 that more officers and firefighters died of suicide than line-of-duty deaths in 2017.
There is a tremendous need for mental health, and just as it is in areas of education, homelessness, and nutrition programs, the funding required to support the services is in short supply. I am writing this letter today with the hopes of starting a conversation, one that could perhaps lead to fresh ideas and better ways to get people the help that they need.
In 2017 Connecticut made national headlines when reports of patient abuse surfaced at Whiting Forensic Services on the Connecticut Valley Hospital campus in Middletown. This July members of the Whiting state task force questioned whether patients would be treated more effectively in another facility. I believe one problem with the entire mental health system is that no one knows what effective inpatient care looks like, mainly because long-term inpatient stays are not productive.
My mental health diagnosis is depression, PTSD, and generalized anxiety disorder. It is estimated that one out of every five people in the United States live with some form of mental illness. It is also estimated that one out of every two people will experience a mental health crisis at some point in their lives. To properly care for all these people, the resources needed would bankrupt most states. I want to describe what the average inpatient setting looks like through the eyes of someone who has been in several different facilities, including Whiting.
Over 80 percent of our days on a mental health unit are spent drawing, writing, watching television, talking to other patients, or just sitting idle. We may talk to a social worker for 30-to-45minutes. If we see a psychiatric professional that day, the average interaction lasts fewer than 20 minutes. If we are lucky, there could be a couple of groups on weekdays.
Weekends are not productive at all, with most of the professional staff off the clock. A 24-hour-day living in an inpatient treatment setting roughly consists of 10-to-14 hours of sleep. Two to three hours are used up in professional interaction with doctors and staff. About an hour and 30 minutes by meals, and the remainder of the time is passed by whatever method the patient has access to on the unit. My question is, why does this service cost anywhere from $1,500 to $2,000 a day?
In a November 2017 article, the CT Mirror reported that the estimated yearly cost for a bed at the Connecticut Valley Hospital was as much as $560,000. Anyone who takes a close look at the numbers involved versus the services provided can easily see that we are not getting our monies worth.
I agree that insurance should cover services related to mental health and addiction recovery. With that said, I also think it’s fair to ask treatment providers to justify the costs that in many cases are being paid for by Connecticut taxpayers.
Jeffrey Santo, a Norwalk resident, is a Recovery Support Specialist.
Testimony before the Insurance and Real Estate Committee March 5, 2019
HB 5270: An Act Concerning Peer Support Specialists and Requiring Health Insurance Coverage for Outpatient Peer Support Services Provided By Certified Peer Support Specialists.
Jeffrey Santo, RSS
Senator Lesser, Representative Scanlon, and distinguished members of the committee,
My name is Jeffrey Santo, and I am a registered voter in the city of Norwalk, Connecticut. I am a member of Recovery Innovations for Pursuing Peer Leadership and Empowerment, better known as RIPPLE. On March 2, 2018, I became a certified Recovery Support Specialist. I’ve come before you today to voice my support for HB 5270 because I believe Recovery Support Specialists bring something unique to the table. The RSS is perhaps the easiest person on a client’s treatment team to identify with and trust. We understand what it is like to be in crisis and live with mental illness. For that reason alone we have one of the most powerful tools of recovery, common ground.
I have been diagnosed with depression, PTSD, and generalized anxiety disorder. It is estimated that one out of every five people in the United States live with some form of mental illness. It is also estimated that one out of every two people will experience a mental health crisis at some point in their lives. A properly trained Peer with lived experience can be a tremendous resource on someone’s recovery journey. Thanks to the certification classes offered by Advocacy Unlimited that resource is abundant in our community and it is always growing.
In October of 2012, the World Health Organization called depression a global crisis. On average we lose 16 veterans and 4 active-duty personnel/reservists a day. In a March 2018 article USA Today reported the suicide rate for children and teens between the ages of 10 and 17 was up an average of 73 percent from 2006 to 2016. USA Today also reported in April of 2018 that more officers and firefighters died of suicide than line-of-duty deaths in 2017.
It is impossible for us to predict when a mental health crisis will occur or who will have one. No one is immune and mental illness does not discriminate. On February 23, 2019, the Middletown Press reported that a state social worker with nearly 19 years of service died by suicide on the Connecticut Valley Hospital campus. Not only was this woman surrounded by mental health professionals she was one herself. I can’t explain why she did not reach out and try to talk to someone she trusted. All I can tell you is that in my experience mental health is fluid and can change from one day to the next.
During my recovery, I have worked with Psychiatrists, Psychologists, Licensed Clinical Social Workers, and many other psychiatric professionals. While it is true traditional treatment providers gave me the foundation to begin rebuilding my life; it was my peers in recovery that help me put all the pieces back together. I am living proof that peer support is an effective part of a person’s treatment plan, and the federal Substance Abuse and Mental Health Services Administration (SAMHSA) agrees.
Peer support is an evidence-based mental health practice. SAMHSA recognizes that a Recovery Support Specialist can be an important part of treatment for those living with mental illness or addiction. By supporting this bill, you will allow mental health providers to expand their services to clients while increasing the effectiveness of the overall treatment experience.
I’d like to thank you for giving me the opportunity to speak today and for considering new ways to help members of our community who live with mental illness.
Testimony before the Appropriations Committee March 1, 2019
HB 7148: AN ACT CONCERNING THE STATE BUDGET FOR THE BIENNIUM ENDING JUNE THIRTIETH, 2021 AND MAKING APPROPRIATIONS THEREFOR.
Good evening Senator Osten, Rep Walker and members of the Appropriations Committee.
My name is Jeffrey Santo, and I am a resident of Norwalk. I am a person living with depression, PTSD, and generalized anxiety disorder. I have come before you today to talk about the budget for the Department of Mental Health and Addiction Services.
In an April 2018 article, the Connecticut Mirror reported a cost of $567,000 a year for each patient treated at the Connecticut Valley Hospital. At the time of this Articles publication, they reported 87 patients were receiving treatment at Whiting. If Whiting has an average of 80 patients a year, the State of Connecticut is paying over 45 million dollars annually.
My question is what does a patient get for a half million dollars in services? Are you abused like William Shehadi, a man whose story led to the arrest of ten members of the treatment staff and another 37 of them put on administrative leave? Are you forcibly placed into restraints as you choke to death with a cookie lodged in your throat? That is Andrew Vermiglio’s tragic story. At this point, it would be extremely difficult for you to convince me that the high cost is related to the quality of care especially since I to was once a patient there.
We cannot continue down this path and expect anything to change in the future. We must find new and cost effective methods to treat those living with mental illness. I believe this will happen when there is more collaboration between treatment recipients and their providers. What if we found an alternative for just one patient at CVH? $567,000? The state could hire 12 Recovery Support Specialists full time at $22 an hour for a year.
DMHAS should focus in prevention, treatment, and recovery equally. Money used to focus on prevention would be directly fighting the opioid epidemic and the high rate of suicide. In a recent Hartford Currant report, we learned of a clinician with 19 years of service at CVH who had taken their own life at the hospital. This was a person surrounded by mental health professionals trained in noticing the signs of someone experiencing suicidal ideations.
Why is prevention so important to me? I was lucky enough to survive my attempt, and not everyone gets a second chance. On average we lose 16 veterans and 4 active duty personnel or reservists a day. It is estimated that there are two suicide attempts per secondary school per year in the United States. There are over 37,000 secondary schools in our country. Lastly, a 2017 study revealed that police officers and firefighters are more likely to die by suicide than to die in the line of duty.
The choices we make about mental health today will ultimately determine how much we are going to pay tomorrow. Thank you for your time and for listening to my testimony today.
I have never liked the term “War on Drugs” because a drug is an inanimate object; I prefer to look at it more as a war on drug trafficking. People who live with addiction are not the enemy and we should not be waging a war with people who need our help. There are two sides to this problem, the supply of drugs and where they come from is one. The other is addiction and the stigma associated with the lifestyle and behavior of an addict. I want to address the addiction side of this issue.
First, we should never wage a war against someone who truly needs our help. We should be standing beside them and help them get a stronger foothold in the battle they are fighting against addiction. I believe the only way to win this fight is by helping one person at a time rather than addressing this as a systemic problem in our society. Not everyone uses drugs for the same reason and no two people are exactly alike. A one-size-fits-all solution will not solve this problem; if it were going to work it would have already yielded much better results.
I have never had a problem with any type of chemical addiction, I’ve been lucky. Since becoming more involved in the mental health awareness movement, I have met a large number of good people who have had treatment in the Department of Mental Health and Addiction Services system. They have struggled to take their lives back and free themselves from the hold drugs had on them. Eventually I was able to take the Recovery Support Specialist (RSS) training and become certified to help people living with mental illness, addiction or a co-occurrence between the two.
Trained peers in the workforce are an often overlooked option by the state agencies trying to deal with the problems created by drug use, one of the biggest is the opioid epidemic. In Connecticut there have been trainings on how to administer Narcan, they have been free of charge and open to the public. This is a huge step in the prevention of deaths as a result of overdose, but does little to address the issue of addiction. Last month in New Haven, dozens of people were transported to area hospitals after overdosing on a tainted batch of K2 or “Spice,” which is a synthetic marijuana. A city official said 114 calls for people needing medical attention came in, at least 10 people overdosed more than once.
My RSS certificate number is 00979 and I was not a part of the last class to graduate. This leads me to believe that there are more than 1,000 certified peers within my state who are trained to help. The rapid response of EMS and police certainly saved lives, but no one addressed the fact that even though the emergency had passed the crisis was still happening for some of these people. At one point, volunteers walked around New Haven just keeping an eye out for anyone showing signs of a drug overdose. When it came to saving lives and the response of the system, it worked as it should have. I do, however, have to ask the question about the level of follow-up support considering how many people overdosed more than once.
If they want to call this a “war,” then let’s look at it from that point of view. You can’t fight a war without soldiers, boots on the ground. They need to be trained, they need to know the enemy and they need to know how to beat that enemy. Peers working in the field have been proven to be a valuable asset and they have the skill set needed to make a difference. I, for one, would volunteer and step forward to help someone start their path of recovery and I know I am not the only RSS who would.
In military terms, the number of graduates from the Advocacy Unlimited RSS trainings are roughly the same number of soldiers in a battalion. If someone from the state Department of Mental Health and Addiction Services ever reads this, I want you to know one thing — You are not going to win a war without troops. We are here, we are willing and we are ready.
Jeffrey Santo, a Norwalk resident, is a recovery support specialist.
Senator Gerratana and Representative Steinberg,Thank you for your service on my behalf and the behalf of others affected by the horrendous negative aspects of the mental health services system in Connecticut. My name is Jeffrey Santo, a resident of Norwalk, Connecticut and I vote. I
have been living with depression for almost as long as I can remember…
On December 2, 2008, I was arrested and charged with “Threatening in the 2 nd degree” which is a “Class A Misdemeanor”. I know this statement may seem unrelated to mental health but I can assure you it will become relevant in a moment. In 2007, when I lost my job, keeping up with my bills was impossible, especially my mortgage. On a phone call from my loan servicer I had gotten quite heated and I just before I slammed the phone down, I yelled, “You would not care if I burned this house to the ground or put a bullet in my head, just as long as you get your dammed money!”
About three hours later, I received another phone call. This time it was from the Ridgefield Police Department.
They informed me that I needed to turn myself in. The accusation made against me was that I had threatened to go to the bank and shoot someone. To shorten the story, I am going to skip to the part where the public defender I was eventually assigned had a very different idea on a defense than I did. He wanted me to enter a guilty plea and accept a deal for probation. I wanted a trial because I firmly believed there was more than enough “reasonable doubt.”
I was steadfast in my position that I was innocent and wanted to protect my record. The public defender’s office sent me for an evaluation. The end result was that I was found not competent, citing that I was being unable or unwilling to aid in my own defense. I was then sentenced to 60 days at Whiting Forensic on the Connecticut Valley Hospital campus. Even though I was sent only for competency restoration, I found myself on a unit where some people had a history of violence –
one that still stands out in my mind was a man serving time with seven counts of “felony sexual assault.”
The staff at Whiting treated us all the same: in their eyes we were all guilty, dangerous and crazy. If you tried to stand up for yourself, they reminded you who was in charge. They were!
One of their favorite things to do at night was every 15 minutes they would perform a bed check. The staff was required to make sure no one was missing, that was the only stated reason for the check. However, some of them would use their flashlights and wave the beam back and forth across our eyes in an effort to keep waking us up.
To this day, in a completely dark bedroom, I still have moments where I could swear to you I see flashes of light when I know that it is impossible. I walked into Whiting for “competency restoration” and left with nothing more than severe trauma that still affects the way I sleep almost eight years later. The State of Connecticut paid $60,000.00 for this to happen, and what truly adds insult to injury was what happened when I returned to the courtroom. I informed my public defender that my point of view had not changed and I still wanted to take this to a trial.
He said, “Then the situation has not changed. If you do not accept the plea deal, I will recommend that you be returned to Whiting for another 30 days.” While I was at Whiting, I took note of at least one other person on my unit that happen to be there for “competency restoration”. His story was similar to mine – right down to being represented by the public defender’s office. My second day
on the unit at Whiting, I told my story to the unit psychiatrist. Afterwards, he told me that, in his judgement, I should not have been sent there. But he could not send me home, however, because I was court ordered to be there.
If I take my time at Whiting and add it to the time spent there by the other individual (also there for competency restoration reasons) a bigger picture begins to come into focus. I can tell you that, at $1,000 per day, the state paid approximately $150,000 for two people, because in the final result their lawyers did not want to work with the clients the court assigned to them. At the end of this ordeal, I only wonder how many programs all over the state could have been saved or fully funded if waste like this was addressed. As a peer in recovery who uses DMHAS services, I am asking that you take a closer look at the State of Connecticut’s mental health system.
I am not asking for more money. I am asking that the money we are spending be put into the hands of the people who will use it wisely and know where it is needed most. Thank you.
Link to testimony: Note they spelled the name wrong in the records, Jeffrey Santos should be Jeffrey Santo: https://www.cga.ct.gov/ph/related/20171113_DMHAS%20Whiting%20Forensic%20Division%20Informational%20Forum%20and%20Public%20Hearing/Jefferey%20Santos.pdf
Jeff was among several people interviewed by NPR while at the Legislative Office Building (LOB) in Hartford on November 13th, 2017. Both Peers and providers came together for a hearing held by the Public Health Committee, nearly 30 people testified offering personal experience at the facility and opinions on how to prevent patient abuse in the future.
Since this article was written by a journalist it is considered copyrighted material, we will not post the article here but will provide a link at the bottom.
Members of Ripple, including Jeffrey Santo attended a free community Narcan training in Wilton Connecticut. Since this was the start of a response to the opiod crisis that has been plaguing our country it was a good story to cover.
Jeffrey was quoted as saying, “This is just another tool in my toolbox,” and “It’s one of those things that you hope you never have to use, but if you ever find yourself in that situation you don’t want to be kicking yourself, saying, ‘I wish I took that class.’”
Now Narcan trainings are offered almost monthly, now that it is common it is not covered by the media as much.
Past members of Recovery Innovations for Pursuing Peer Leadership and Empowerment have also submitted testimony and were interviewed by various media sources. Those who have moved on from Ripple are not listed in this archive, we do not have written permission on file to add their intellectual property to this site. Ripple holds no copyrights over its members content unless otherwise stated. All writings, artwork, photographs, and any other media they produce revert back to them after their separation. The testimony of past members is available in Connecticut state records and can be searched for online.