full, productive, and fulfilling life. and i absolutely agree with the discussion surrounding the exact terminology. but i really can't take issue with the concept. and whatever words we use to describe that experience of moving forward with our lives, of finding things that work for us, of finding ways to be happy and fulfilled in our lives, that is what we're talking about with recovery. the word may change, but the concept stays the same. >> thank you so much. thank you so much. >> thank you for inviting us. >> thank you. we're going to keep moving on and we're going to move to team c, mental health and veterans. lara star. >> hi good afternoon and thank you for giving me an opportunity to talk to you guys all again. it's always a pleasure to be

back. good to see you all. the offices have moved, so we're not nearly as close as we were in the past and i think you can't have a conversation in regards to mental health and not in addition, have the conversation of how that intersects with the veteran population? so i am thankful it was allowed to continue to be part of the agenda and that we continue the conversation, and that the conversations that happened in the disability world don't exclude the conversations that also need to happen within the veteran community. so thank you again. in keeping with the mental health awareness month, the national center of ptsd has june 27 as the post traumatic stress disorder day and for the entire community to realize the issues revolving around post traumatic stress disorder. in keeping with the language,

. post traumatic stress disorder and that post traumatic stress disorder doesn't have to identify you for the rest of your life. so just in keeping with the theme, we are a veterans service organization with direct services with mental health services, case manager, social workers, clinicians and we are veterans helping veterans. so a little brief history about ptsd. ptsd has been termed and coined many different terms, shell-shocked, battle fatigue

and vietnam syndrome and in the late '80s, several elements are unique to the veteran population. so saying all right, look at the post traumatic stress disorder and in regardss to the civilian population how different is that from what the military and what the veterans experiencing combat experiencing? and paralleling those with mental health conditions and mental health diagnoses. it's necessary in order to seek specific types of treatment in regard to post traumatic stress disorder. but for the rest of the presentation, i will drop the d to reduce the stigma around the disorder. one of the things that we offer associate with post-traumatic

stress is combat and that is the unique experience that veterans bring and the unique experience that makes post-traumatic stress in veterans different and unique to the population. also saying that that population is requires specific types of treatment that are unique to dealing and coping with -- and learning coping skills to function and having fulfilling, wonderful lives after the experience. so the idea that combat-related issues, combat-related stressors, and of course, anyone who follows the news and the media, there is improvised explosive device, rocket-propelled grenades and other individualized blasts, but the actual combat experience itself can many times cause severe symptoms of post-traumatic stress. an additional level of post-traumatic stress when we think of just combat is a new concept called "moral injury." it's something that is beginning to take a little bit

of interest in the lot of the communities and they are trying to figure out how to best serve veterans with post-traumatic stress? moral injury is the guilt element and how you live with your experience and you live with your decisions of combat. so identifying that post-traumatic stress has different levels and not everyone responds equally to treatment, nor does everyone have the exact same experience, because everyone's experience is unique, regardless of the con flict or the amount of time that you served in the military. in addition, to the combat-related issues there are issues that aren't necessarily isolated or selective in the military that are wrapped around the combat element. so that is something that i am sure many of you have heard about in the military, which is military sexual trauma. so the survival of military sexual trauma is likely to then relate and have the exposure to those

traumas ending with post-traumatic stress. so these three categoreys are how the veteran's affairs communities tries to provide treatment. regardless of which mode that you are identified to have experienced in which created the post-traumatic stress is avoidance and numbing. so it's one of the main issues that makes it very difficult to get veterans treatment. and many veterans, especially those returning from current conflicts will often isolate themselvess from communities and from the mental health communities and the mental health initiatives in place to help address these issues. hyperarousal, or the exaggerated startle response. quickly responding to outside stimulants and triggers and once again, that ties in with

the need to prevent and avoid situations and circumstances that might cause severe symptoms of post-traumatic stress and just the reexperiencing. avoiding certain situations, which might make you feel you were right before where you were what created that post-traumatic stress. some common causes for post-traumatic stress with our current combat veterans, ied, traumatic brain injury and military sexual trauma and death of military individuals. within the disability community, and with our veteran community and within our populations in san francisco, one of the ways that the veterans who are dealing -- and really having a difficult time

coping with post-traumatic stress, many find coping mechanisms in drug and alcohol and other substance-abuse and it's a coping mechanism that hasn't just begun to affect your current veterans, but many vietnam-era and world war ii veterans are struggling with the coping mechanisms of drug and alcohol. recovery and what "recovery" means. if you receive treatment, and you are actively engaged in your own mental health, that post-traumatic stress doesn't have to identify an individual and that through this process, and through many different modalities of treatment, an individual with live with their post-traumatic stress and live with what is required for them to live a happy and healthy life. there are some who never really get there and unfortunately,

that leads to post-traumatic stress and our overall numbers of suicide and currently reporting 22 veterans who commit suicide every single day and that that number will continue to rise with the number of veterans that we have during multiple deployments and extended period of time that many of our young people are serving in the military. with recovery, there are many aspects of our community that are really doing a lot of outreach and peer support, which is found to be the no. 1 -- the best way that younger veterans are recovering from post-traumatic stress is that here are my experiences, here is how my experience has shaped me, and now i am sharing this experience with someone who isn't there yet and hopefully, together, we will all find a better tomorrow. and so in addition to organizes like swords, the va has come a very long way in updating its services and ensuring that they

are the foreleader in addressing post-traumatic stress. so i couldn't give this presentation without that additional element and post-traumatic stress and how we finally try to break down some of the stigma and someone who is suffering from post-traumatic stress can lead a healthy and fulfilling life. someone who had conditions, can fulfill all of their employment obligations, take care of their families, because they are still spouses, wives, husbands and individuals of the community. so finding the way that our disability rules, regulations and ideas take that part and understand that the veteran experience is unique. and just identifying that it is

unique, really can break down a whole lot of barriers. that is all. any questions? >> thank you. is there any questions from the council? any questions from staff? seeing there are no questions. thank you very much. >> thank you. you have a great day. >> thank you. next we have david elliot from the mental health board of san francisco and roland wong will be taking over as co-chair now. thank you. >> i don't know how much time we have here. about ten minutes or so. >> you have about that, eight minutes. >> my name is david elliot lewis and i'm glad to have the chance to be here to be able to talk to access to services in the city, from my own experience, my observations of

others. this city is blessed in many ways and we probably have more access to mental health services per capita than i think any other city in the circuit city and that is good, but pain and suffering still exists. and it's actually pain and suffering that i have known firsthand. first let me talk a little bit about myself and you can see where i am coming from. in addition to being co-chair of the mental health advocate, i have been successful in many ways in my life and i have been a consumer and if it wasn't for the services actually offered in this city to help people with mental illness, i wouldn't have been able to pull myself out of the darkness. i wouldn't have been able to

bring myself here to talk to you. i wouldn't be able to serve on mental health board and i wouldn't be able to do volunteer work that i do for the mental health association and nami and other groups, but i couldn't have done it if i hadn't gotten help from the city, from the city's services. so first and foremost, i am grateful and there are excellent services and there are gaps too. it's not a perfect system, but i am sort of a late bloomer in terms of mental illness and i actually managed to go through most of life without having a problem. and i am not saying that i didn't have problems, but i didn't think i had problems, but it took a series of crises in my 40s, situations happening together that put me in a

tailspin of darkness that i didn't know how to function. still, i thought up to that time, mental illness happens to other people; it would never happen to me. i never came from a family with a crazy uncle and crazy aunts and those are terms that i used, stigmatizing terms that i used to use, not really knowing about these words and about the importance of language. so the first thing, the first sign that i thought that i had a problem was that i had friends telling me david, why are you missing meetings? why are sleep ing so late? why aren't you participating? why aren't you returning calls? that was sort of a clue that was something was wrong. i would tell them i was depressed, sad and my friends didn't get it. they would say snap out of it.

what is wrong with you? since i had no history with depression or so they thought, they thought it was something that i could just "snap out of." and i actually thought, wouldn't it be nice? maybe i could just snap out of it. and well, 15 years later, i am still slowly snapping out of it. but it was a really long journey and i think the first barrier to seeking treatment in the city, the first barrier that most people face is sort of a self-imposed barrier of a self-recognition that help is needed. some people talk about it as self-applied stigma. i didn't want to admit that i had the problem, because if i had the problem, that i needed help. that maybe i had mental illness and maybe something was wrong with me and maybe i was somehow lesser for having this, and for having suffered this. so having overcome that, i thought well maybe i will reach out.

so before i had no idea as someone not connected to the mental health system or public safety system. i had private health insurance. i had no idea how do i even get help? where do i go? so i would ask friends and interestingly, you ask people in the community, how do you get help for mental health problems? you get a range of input. i was told to go to mediation, which did prove to be good advice, but others advocates spiritual practice or to go to religious practice and others said i need a good exercise program and get my endorphins up and all excellent suggestions that can promote mental well-being, but each, of

themselves were maybe necessary, but insufficient conditions for mental illness and pulling myself out of that mental illness i was suffering. finally i thought, some people said you should talk to somebody, get help, but where do you get help? it actually wasn't clear to me. it was before 311 and 211 and the ability just to call up and get information. okay, google existed back then, but it was a lot simpler and a lot less indexing of mental health services. so i thought i would try it and walk into a clinic and i actually managed to do it and get up the courage to do so. i was told that you need to make an appointment for me, but here is the thing about appointments. while appointments are very well-meaning and of course services have to be allocated based on limited resources, when you are actually in the middle of a panic attack or a

severe depression, it's hard to keep appointments at times and you are actually suffering yourself. unless you have someone really guiding you through it, maybe a full service partnership and not a word i even knew back then, by the way. i had no idea how to kind of keep appointments. and i came from a professional world. so i knew intellectually about appointments, but when you are in the darkness, to have to show up a week or two later for services at the right time, at the right place, or you lose your place, at least temporarily in line. it's hard. it's hard. there are a lot of stops and starts before i started to get connected with services and some of those stops and starts were my own doing, my own sort of self-imposed barriers. yet, i persisted. finally started to talk to someone. and one of the first things

that i noticed is that you need the right match between sort of the client or i actually at the time i use the term "patient." i don't use that term any more, but the patient, the client, the consumer, and the therapist and over the years i have seen a variety of people in the health care profession, psychiatrists, mds who tried to help, psychologists and i found that title was less important than sort of the match of that person's approach and abilitis and where i was at. their ability to kind of understand me and some people got me within one hour, based on their feedback, i felt they understood me. others i went to for months and i felt i was never quite understood. so while i think everyone who works in these health professions all mean well and i believe they all

mean well, not all have the ability to help every consumer and one of the lessons that i learned, if i am not getting help, i just need to switch providers. not to give up and go back to the darkness, but switch providers. because by and large, there are good matchs that can be found. of course this is true in relationships, true in jobs and true in all aspects of life and certainly true in psychotherapy or any cognitiive-based therapy. finely finally i started to get help, but that help came very slowly. another thing i needed to leash how learn how to manage is how fast you can recover? for any kind of managed care

program that would limit the number of sessions, say psychiatric or psychological sessions that someone would receive, i think a profound disservice is happening and we'll see what happens when the affordable care act takes effect next year, 2014 and what we'll have in terms of managed care and there will be managed care for mental health. if i was limited to even a 20-session limit, i wouldn't have even gotten to the point i have gotten today. i would still be in the darkness. i would still be a horrible mess. so it took me years, years' of therapy and it did finally work for me to pull out of the darkness. and finally, what helped me, and was something that i would recommend to anyone seeking help in mental health is to actually do volunteer work in

the healthy professions. i started to do volunteer work for the mental health association and that actually increased my awareness about other programs and services. i started attending mental health board meetings as a member of the public and learning about mental health programs and services. doing the volunteer work sort of opened my eyes to what is available to me as a consumer, to get help. and not only that, it gets to other volunteers and pulled me out of my own kind of inner-focus and pulled me to a external-focus and volunteers themselves are nice people who want to help others and actually led to personal growth as well. i strongly advocate volunteering as a path towards healing for darkness, for people who suffer from mental illness. my journey continues. i continue get better and i

have backslides, but i am getting better. i want to thank you for your time. >> thank you, dr. lewis for your presentation. i would like to open it up to the council, if there are any questions or comments. i don't see any. how about the staff, do you have any questions or comments? no. what about the members of the public? no? thank you. >> good afternoon, council, my name is jackie bison and i want to thank the doctor for his presentation. it was absolutely excellent. one of the books i intend -- is this thing going? i am very

honest. okay. somebody -- okay now it's going. one of the books that i intend to write when i am able to slay the social services evil incarnate people who are preventing me from learning one of the ten computers in our computer lab on-site. they are scared of me as it is with the pen. god forbid i have learned how to use the computer and have access to the cloud and the internet. the reason that that is important is that one of the books that i intend to write is my so-called psychiatric history and that my experience with mental health is that mine is usually better than the person who is trying to treat me, and say that there is something wrong with me, because that is a way of

legally shutting me up. that ain't possible. i will find another way, if i have to invade your dreams. there is a real important aspect of what the doctor said and that is that it's imperative -- i was a guidance counselor to watch up the therapist wanna be with the consumer and i love that word "consumer." and that is the word i use. when i was a guidance counselor and i was required to provide service to students, i could have sabotaged them and i said look, i am here as a tool. and i am here to help you get out of here and get to the next phase in your life and get on, but we need to be able to get along. so what do i need to present to you differently, so that you can hear what you need? like i said, i am a tool. i am a sponge. use me to suck up what you need. very few people in the mental

health professions actually look upon their roles as facilitator. they are there because they want to have cocktail-party conversation fodder. they want to be able to check off certain boxes in sunset in the surveys for funding and grants and those are frankly psychotics unleashed on people and that has to stop. they are not licensed to diagnosis and treat, i don't care how many staff and service that they have or easel boards that they fill with terms and this type of setup in san francisco attracts predators of all kinds and there are those

who come hire to prey upon the mentally fragile with impunity. >> thank you. next on our agenda is another topic called in our own voice, the stories of hope and recovery. a unique public education presentation that offers insight into the hope and recovery possible for people living with mental illness. it includes an overview of nami san francisco and the various programs offered. presentation by anne fischer program director national alliance on mental illness.

san francisco gillan croen. >> she is unable to be here today. >> and nami peer-to-peer mentor and ioov speaker and id yell wilson co-chair mayor's disability council nami peer-to-peer mentor and ioov speaker. >> thank you. we are the san francisco affiliate of the national alliance on mental illness. our mission is to advocate for a life of quality and dignity by providing education resources and emotional support to families and those affected by mental illness.

we strive to end discrimination and stigma for all those persons affected by these illnesses through broader education and collaboration with the whole community. so we partner a lot with the mental health association. we have similar programs to them and where we differ is we have many programs for family members. we have a family to family class that is a free 12-week program taught by family members for family members. providing insight and information to help them help their loved ones who are suffering from a mental illness. then we offer a peer-to-peer program, which idell wilson is one of our peer mentors, a 12-week free course also, taught by peers for peers. sort of a roadmap for recovery. we have provider education

which is a new program we're started geared towards providers of mental health and taught by mentors and family members to give the alternative perspective of living with mental illness. similar will solve, we have a public speaking bureau called in our own voice, which is idell is a speaker and gillian is also one of our speakers, where we go to businesses and schools, and tell our own stories in an effort to fight stigma and educate the public about mental illness. we have a similar program geared towards high school students, called "ending the silence." and parents and teachers are allies where we go into high schools and colleges and middle schools, and try to put a face and a personal story to mental illness as a way to destigmatize and help people