:
D ecem ber 2, 1987, Portland O bserver, Page 9
Treatment in Defense of Life
Health Watch
Community Mental Health
by Danny Bell
An Introduction to
Mental Health Services in N/NE
StevtHt Buticy. N D
A ID S a n d th e Im m u n e S y s te m
To understand AIDS, it is helpful to know a little bit about the human
immune system. The following section will hopefully provide a base under
standing of the immune system that will assist you in understanding the
Have you ever asked yourself, "What's wrong with so-and so?
Or
commented on how he or she seems to act funny or odd? Many of us have
been touched by those whose behavior seems inappropriate or reflects sen-
various aspects of AIDS.
0691 The common response is to relegate these individuals as victims of an
The A ctive Im m une System
The immune system is a marvelous composition of a wide variety of the
body's cellular and functional components. The white blood cells, the skin
and mucous tissues, the thymus gland, bone marrow and the lymph nodes
and tissues all have specific functions in a health immune system. There are
also many less specific elements of the immune system which include ade
quate nutrition, adequate function of the liver, adrenals, good circulation,
heredity and a wide range of secondary influences such as stress, life style
abusive lifestyle or not to think of them at all.
However, one in ten individuals experience in their life time some form
of mental illness.
What we propose is to explore in the upcoming articles what is myth
and what is fact concerning mental health, and to reveal what facilities in
our community are attempting to address health in terms of mental and
psychological health.
ir u u n
The North/Northeast Community Mental Health Center, Inc. (CM C),
is one such facility, serving people who reside in North and N°rth«ast ort-
land regardless of race, color, creed, age, or ability to pay. N/NE CM
provides a program which caters directly to the client in a manner that helps
and psychological factors.
The W h ite Blood Cells
The white blood cells (WBC's) account for the majority of what we call
the "immune response". These are the cells that identify and combat bac
terium, viruses, fungi and protozoans collectively known as "m icro
organisms". The white blood cells are divided into five groups: the baso
phils, neutrophils, monocytes, eosinophils and lymphocytes. These names
reflect laboratory properties of the various cells, i.e. "p h il" is Latin for love
and, thus, basophils are cells that attract a basic dye in laboratory staining
techniques as others attract eiosin dye or are neutra to these two dyes.
"C yte" is Latin for "ce ll", and lymphocytes are WBC's that do not have
granuals or " A " , Latin for absent, agranulocytes. The lymphocytes are the
cells that are affected in AIDS.
These five cell groups are further divided into two populations: the
granulocytes and the agranulocytes. The three granulocytes (eosinophils,
basophils and neutrophils) all have granular structures that contain immune
chemicals to combat micro-organisms. This is called the "cellular immune
response. The agranulocytes (lymphocytes and monocytes) do not have
granular structures and the lymphocytes work by the "humoral immune
response, which means by releasing chemicals into the blood stream (the
Humors) to combat infection. The monocytes are a cell alone as they act
as scavengers in cleaning up immune debris and combating on a cellular
level.
The granulocytes are not affected in AIDS as are the lymphocytes and,
thus these cells can play an important role in suppressing opportunistic in
fection that are common to AIDS. Some of the things that we can do to
strengthen this segment of the immune system will be mentioned in the con
clusion of these articles.
Lym phocytes and the H um oral Im m une Response
The lymphocytes primarily work through humoral immunity although
certain "killer" lymphocytes can work at the "cellular" response level. The
lymphocytes are divided into two groups, the T cells and the B cells. The
" T " comes from "thym us" but functionally represent cells that send infor
mation to the B cells (we now know that not all T cells are created in the
thymus). The B cells are cells that produce chemicals called immuno
globulins which are specific chemicals to combat varous micro-organisms. It
is in the T cell numbers and function that AIDS identifies itself.
The T cells can be likened to advance scouts, who look out for dangers
in the form of bacteria, viruses, protozoans, allergins and other parasites.
Certain T cells called "m em ory" cells maintain a "m em ory" of previously
encountered organisms and immediately begins the immune response which
is why we "develop" an immunity to such conditions as small pox, measles,
whooping cough, etc.
T cells can also create original responses in the event of a new organism
entering the blood system or inflamed tissue.
Two other T cell groups exist. These are the helper and suppressor
populations. These cells take the information from the scout T cells and
either help increase or decrease the production of B Lymphcytes. The B
lymphocytes being the army that confronts the invading organisms, releasing
their chemical weapons.
Another lymphocyte, the "K iller" cell, is a recent discovery. This cell
appears to work independently, having the ability to confront and destroy
organisms on a one-to-one basis.
In AIDS there is a marked decrease in the helper T cells that results in
an inability to activate B cells for maintaining acquired immunity to a variety
of illnesses. As the number of helper cells decrease the ratio of helper to
suppressor cells becomes inverted and the B cells actually decrease their
normal state of involvement. The helper/suppressor ratio is actually one of
the best indicators of the state or progression of AIDS. Recently orthodox
medicine has come to appreciate this test and M .D.'s are using it much more
frequently to monitor the course of AIDS. It is interesting that M.D. s shun
ned this test for so long as it truly gives the most useful information in moni
toring the early and middle stages of the AIDS population. Coincidentally,
unrelated to the AIDS virus, homosexuals, I.V. drug users and hemophiliacs
show inverted helper/suppressor ratios as general populations.
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T h u rs d a y
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Program 5:30 p.m.
by Nyewusi Askari
For a long time, African-Ameri
cans didn't understand the dangers
of alcohol and drug addiction. At
first it was viewed as a white man's
weakness: an inability to control the
intake of drink or drug. And those
Blacks who suffered the affliction
were looked upon as outcasts
whose souls had been taken over by
the devil. Religious conversion was
the recommended treatment and
cure.
Since those early days, the Black
community's perception and under
standing of drug and alcohol addic
tion has changed. Drug and alcohol
centers have become common
place, and the Blacks addicted are
now treated as patients rather than
outcasts. In Portland's Black com
munity, the Project For Community
Recovery is one such treatment
center.
A joint effort of the Center for
Community Mental Health and de
Paul Center, Inc., the Project For
Community Recovery was esta
blished in July 1984. The staffs of
the three agencies work together on
designing the most effective treat
ment plan for each individual in
treatment. While the Center for
Community Health provides assess
ment and outpatient services, and
de Paul provides inpatient and resi
dential alcoholism treatment, the
Project For Community Recovery
provides multicultural alcoholism
and drug addiction treatment ser
vices with emphasis placed on Black
chemically dependent persons in
Portland's North/Northeast com
munity.
Unlike many treatment centers in
the country, the Project For Com
munity Recovery strongly believes
that alcoholism and drug addiction
are disease processes that affect the
spiritual, emotional, physical and
social life of affected African-Ameri
cans, and that these problems can
be diagnosed, treated and prevent
ed when the cultural context is
taken into consideration.
serious violation of cultural upbring
ing.
"Since we know alcoholism and
drug addiction are disease pro
cesses that cross racial and ethnic
lines, we believe the addiction is
treatable. So what we do at the
time of assessment is to ask certain
questions to determine what level of
dependency that person has, whe
ther they be Black or white. Using
this approach, we can determine
the type of treatment that is neces
sary. Most of the people we see
are either in the early stages of ad
diction or at the middle stage. If the
client is in the late stages, we usual
ly refer him or her to a residential
treatment facility," Mr. Ings said.
Bernard Ings, Director for the
program, explains: "In the past,
the conventional approach didn t
work for the Black client, because
it didn't take into consideration the
cultural factor. Often, Black clients
would drop out of programs that
failed to deal with these differences.
For example, many Black families
teach their children to refrain from
looking a person of authority direct
ly in the eye. This cultural behavior
was passed down from African an
cestors and is considered a show of
respect. However, many conven
tional treatment programs thought
the behavior pointed to the client s
inability to face his or her problem of
addiction. In many settings, the
Counselor would touch the Black
client in a way of showing reassu
rance, not realizing that it was a
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need for voluntary or involuntary commitment.
Individuals who are accepted by the clinic are seen regularly for indivi
dual-and/or group therapy.
. ..
Due to the fact that many clients lack social support from family
and friends, they tend to become withdrawn and isolated. The NE Connec
tion is a socialization center which provides clients the opportunity to meet
people and feel connected to others. Social-, recreational-, and self-help
are available.
. . *
■ „ „„
Many clients need to learn, or re learn, the skills needed to survive as
independent adults in the community. The semi-independent living staff
teach clients adaptive tasks such as apartment maintenance, cooking, and
use of public transportation. Mastery of such tasks improves clients self
esteem and gives them a sense of control over their own lives.
Certain clients can benefit from very focused and structured activities
that provide them with a sense of mastery and effectiveness in life. Craft
and group pre-vocational activities are organized in a day treatment setting.
A crisis respite house, called Sacramento House, is maintained by the
staff of the Center. In addition, housing development specialists are employ
ed to arrange a variety of residential and housing-related services. These
include group homes and adult foster care.
N/NE Community Mental Health Center invites our readers to write us at
128 N E Russell, Portland, OR 97212; attention Danny Bell.
„
Upcoming articles will focus on such topics as "The NE Connection .
"Drugs and Mental Health” , "Depression", and "Domestic Violence.
PORTLAND OBSERVER
The Eyes and Ears of the Community
288-0033
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. All bus lines/validated parking
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Phone (503) 228-3009
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Clients with long-term mental illness have a regular case manager. I he
case manager is a trained therapist who develops a plan for each client to
stabilize, improve and support life within the community.
. ,
Working in conjunction with the case manager is a team of physician»
and nurses who provide regular consultation with the clients concerning
psychiatric medicine, good diet, and positive health practices~
Crisis services are provided by a special team available 24-hours-a-day,
seven-days-a-week, on an on-call basis to all residents of North and North
east Portland. Services include crisis intervention and psychiatric assess
ment and referral for long-term services.
Crisis respite housing is available for those at risk of hospitalization.
Clients in need of hospitalization are evaluated by a specially trained
investigative team which makes recommendations to family concerning the
Copian
Freci
p a rkin g
behind
center
lity to pay.
.
(
The Center offers a varied array of services, as well as a variety of
approaches and community activities. The Center accepts children and
Mr. Ings explained that the pro
gram has encountered some pro
blems trying to meet the terms of its
contractual agreement with the
county. These terms state that in
order for the Project For Community
Recovery to be defined and to ope
rate as a culturally-specific program
for Blacks, 51 percent of its clients
must be Black. "Blacks are some
what reluctant to come to treat
ment, and since we've only been in
existence for three-and-a-half years,
the process of generating commu
nity awareness has been somewhat
slow. Even so, we are seeing
changes," Mr. Ings said.
The presence of the Project For
Community Recovery in Portland's
Black community represents the
growing effort by African-Ameri
cans to revitalize the ancient African
tradition of self-help. Drug and al
cohol addiction is a serious problem
in this community. Currently, it is
spreading to all parts of Black
society: the young, the worker,
the family, and others who are not
yet aware that they have the
disease.
Said Mr. Ings, "It's our job to give
attention and treatment, and this is
why we are encouraging Blacks to
get involved with our program. If
you suspect that you, your child,
your relative, your husband, or a
friend is suffering from addiction,
call us or visit our facility. It's a
matter of life and death, and right
now, death is winning the battle.
Special
Guests!
///
become a client of the N/NE CMHC.
.
The Center is funded in part by the Multnomah County Social Service
Division and the Oregon State Mental Health Division. Fees are based on a
sliding scale according to income. No one is denied service because of inabi
Presently, the Project For Com
munity Recovery provides assess
ment, evaluation, and referral; out
patient and inpatient counseling ser
vices; individual, group, family and
self-help; residential treatment ser
vices; A A /N A support network;
medical and psychiatric services;
and education, training and consul
tation. Although the program offers
outpatient services, it has a general
contract with the de Paul Center
where 11 beds have been earmarked
for Project For Community Re
covery clients. The program has
182 clients on outpatient status.
Tours!
( ( Refreshments!
/
the individual remain in the community.
Many of those who use the N/NE CMHC services have histones of long
term mental illness. They experience confused thought or emotional illness
that interferes with daily living.
However, with proper medicines and regular support services, they can
remain in the community and lead useful lives. There is not a waiting list to
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Bernard Ings, D irecto r o f P roject For C om m unity Recovery - "In the
past, the conventional approach d id n 't w o rk fo r the Black clie n t,
because it d id n 't take in to consideration the cu ltural facto r.
Photo by Richard J. Brown
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