The CommonGround Story

45 years in the making

  • When Pat was a teenager she experienced a first episode of psychosis. Eventually, she was hospitalized and diagnosed with schizophrenia. Pat was told that schizophrenia was a disease from which no one gets well. She was told she would have to take high dose antipsychotics for the rest of her life and that she should forget about her dreams and avoid stress. Pat found this prognosis of doom more disabling than psychosis. At 18, after 3 hospitalizations, Pat experienced a turning point as a new thought came to her: “I am going to become Dr. Deegan and change the mental health system so no one ever gets hurt in it again.” This became Pat's vocation, which she is still fulfilling to this day. The first step in her recovery process? At the invitation of her grandmother, Pat pushed a cart down the aisles of a grocery store.
  • 1984: One small step led to another. Eventually Pat completed a PhD in clinical psychology. While completing her dissertation, Pat was appointed Clinical Director of Continuing Care Services for the Mid-Cape Region of Cape Cod for the Massachusetts Department of Mental Health. She developed respect for how challenging it is to work in the system and maintain values and ideals. 
  • 1986: Pat gave her first talk in public to a group of clergy in Boston who wanted to reach out to folks diagnosed with mental illness. In this talk, Pat publicly outed herself as a person with a diagnosis. Invitations came in quickly after that. This first speech was eventually published in 1988 in a widely read, peer-reviewed journal: Recovery: The Lived Experience of Rehabilitation, better known as the Sea Rose talk. The paper was picked up around the world and by 1990 there was a national call for “The Decade of Recovery” (as opposed to the Decade of the Brain). Also in 1986, Pat left the Department of Mental Health and joined a spiritual community to share her life with adults with developmental disabilities. While there, she was recruited by a community organizer named Deborah Anderson MSW, to help found a statewide organization of consumer/survivor/ex-patients. The organization, still running today, is called M-POWER (Massachusetts People/Patients Organized for Wellness Empowerment and Rights). Pat was the first president of the Board. As all that was going down, Pat and Deborah fell in love.
  • 1988: Pat continued to bake chocolate chip cookies with Debbie and enjoyed life in the l’Arche community. However, invitations to speak and write kept coming in. Pat received permission from the community to take a part-time job she was offered. Her mission: To found the first program for people with psychiatric disabilities in an Independent Living Program.
  • 1989: Pat left the l’Arche community. She helped found the National Empowerment Center, a peer-run, government-funded, national technical assistance center on recovery and empowerment. Pat continued to give speeches and workshops. In that pre-internet time, she brought copies of her speeches to these events and distributed her text along with her email and street address. Her speeches were faxed to places near and far. Soon, requests for Pat and Deborah to speak and give workshops were coming in from around the world.
  • 1996: Pat developed the Hearing Voices Simulation. Soon after, Janssen Pharmaceuticals asked to use the simulation in a national tour of college campuses to promote mental illness awareness (and to sell their drugs). Pat declined.
  • 1997: Pat and Deborah began consulting work with a local mental health organization. During that time Pat pulled together learning modules on recovery-oriented approaches to client choice, creating a culture of respect, professional boundaries, the role of the direct services worker, and the role of medications in the recovery process. Pat called this work “Intentional Care”. It sought to operationalize the principles of recovery (choice, self-determination, hope) in the real world of everyday practice.  Pat continued to refine this material over time and it is now part of the CommonGround Program.
  • 1999: Pat launched a national state hospital cemetery restoration effort culminating in the film From Numbers to Names. She organized groups around the U.S. to replace forgotten, numbered markers, with people’s actual names. Pat became deeply interested in the untold story of mental health services, including racially segregated asylums for the “colored insane” and “indians.” Pat began to talk about, not just individual recovery, but collective recovery. She was realizing that human community is like a fabric. When threads are deemed not worthy of being part of the fabric, the fabric of the human community is torn and incomplete. When people with psychiatric disabilities, intellectual disabilities, or mobility impairments are pushed out of the mainstream into “special programs” for “special people”, when mass human warehousing trumps social inclusion, then justice has not been served. Pat set out to document the exclusion of people with disabilities from mainstream culture. During her speaking travels she took time to explore forgotten cemeteries and basement archives at state hospitals. She photographed and archived a large collection of never-before-seen materials. For example, she traveled to Berlin Germany to document the Third Reich's mass killing of 275,000 mental patients and other lives deemed unworthy of life. She slowly pulled all this material together into a film called The Politics of Memory.  
  • 2000: Pat's materials continued to be translated in many languages and her Hearing Distressing Voices Simulation started going viral.  
  • 2001: Pat & Deborah began PDA as a consulting company. Both Pat and Deborah are psychiatric survivors living in recovery. They began to travel around the world lecturing and training on recovery and the empowerment of people with psychiatric disabilities. Also in 2001, Pat & Deborah contracted with Advocates for Human Potential and began part-time work on a National Technical Assistance Olmstead project. Olmstead was a Supreme Court decision that held if people with disabilities were kept inside of institutions longer than clinically indicated, this was a form of segregation. The segregation was based, not on race, but on disability. The Supreme Court via Olmstead said that if a person with any type of disability was ready to be discharged from an institution, but was kept back because of a lack of community alternatives, this was a form of discrimination. This work culminated in Pat and her friend Terry Strecker making the nationally acclaimed film “Inside Outside: Building a Meaningful Life After the Hospital.” Also in 2001, Pat received the David E. Ray Award from the Northeast Independent Living Program.  
  • 2002: Charlie Rapp invited Pat  to work on an independent research study at the University of Kansas School of Social Welfare. She began a qualitative study of How People Use Psychiatric Medications in the Recovery Process. The ideas of Personal Medicine, Power Statement, Decision Support and Shared Decision Making were born during this study. Pat piloted these new ideas in a peer-2-peer self-paced curriculum titled: Using Medications in the Recovery Process.
  • 2005: Pat & Deborah realized that personal appearances, lectures, training and videos can only go so far. Mental health professionals got inspired by Pat & Deborah but then returned to their jobs and quickly resumed practice-as-usual which involved:
    • Working to fix diseases (mental disorders), instead of working in partnership with people to support their recovery
    • Stabilization and maintenance as the goal of treatment, not recovery (i.e., a life of meaning and high purpose in the community)
    • Making decisions for people, rather than supporting choice and self-determination
    • Emphasizing medications above all other treatment, even if side effects are unbearable

So Pat & Deborah began to explore how to create recovery-oriented tools and technologies that train staff while they are working, and help get a message of recovery and hope to an even wider audience of peers. Also in 2005, Pat’s paper describing her Kansas research was published: The Power of Personal Medicine.

  • 2005-06: Pat & Deborah used their own money to have the CommonGround Software developed. The original version of the software was written in C+ for a local computer (i.e., no Internet). In collaboration with Charlie Rapp, Melody Riefer and the good folks at the University of Kansas School of Social Welfare, the Software was piloted in a peer-run decision support center at the Wyandot MH Center in KCKS in October of 2006.  It worked. People used it and clinicians found it informative. We were amazed. 
  • 2007: In January of 2007, Pat contracted with developers to re-write CommonGround Software via Ruby on Rails. In June, we launched the web-based version of CommonGround at the Wyandot Center in KCKS. Also in 2007, Pat received an appointment as Adjunct Professor at Dartmouth, Geisel School of Medicine. Collaboration on shared decision making accelerated and publications continued. In addition, PDA signed its first large contract with Community Care Behavioral Health Organization, a forward-looking managed care organization in PA affiliated with the University of Pittsburgh Medical Center (UPMC). CommonGround experienced its greatest growth in partnership with Community Care. 
  • 2008: The second CommonGround Software site in the nation was launched under Community Care. Others were added and PDA concentrated efforts on how to scale and streamline implementation.  We sold a license to develop CommonGround Software as an offering with New York State Office of Mental Health's PSYCKES platform. It added 10 new sites using Software in New York State.
  • 2010: Telecare Corporation became PDA’s second largest partner in number of clinics running CommonGround Software and helped to establish its use with Assertive Community Treatment (ACT) teams. ACT teams are specialty services with a focus on people diagnosed with serious mental illness (SMI) and to date remain a great fit for CommonGround. Also in 2010, CommonGround Software was celebrated as a finalist in the Ashoka Foundation Changemakers Competition: Patient|Choice|Empowerment contest.
  • 2009: Pat joined a National Institute of Mental Health (NIMH) study as a consultant. The project was called Recovery After an Initial Schizophrenia Episode (RAISE) and eventually developed the OnTrackNY model of working with young folks experiencing early psychosis. The OnTrackNY model includes shared decision making and recovery as foundational principles. Outcomes were impressive and the model was adopted by other coordinated speciality care teams around the U.S. Pat continued work with OnTrackNY, offering consultation to psychiatrists and clinical care teams. She also helped develop the peer role within the OnTrackNY model. In 2011, Pat was awarded the Clifford Beers Award from Mental Health America. Pat also received a Lifetime Achievement Award from the New York Association of Psychosocial Rehabilitation Association
  • 2013: PDA launched RecoveryLibrary.com on the web and began signing up subscribers. In April, CommonGround Software received the Scatttergood Foundation Innovation Award for Behavioral Health. In October, CommonGround Software and Community Care Behavioral Health received the American Psychiatric Association’s Psychiatric Services Gold Achievement Award.  Pat also received a Lifetime Achievement Award from the Connecticut Psychological Association. 
  • 2014: CNN's Anderson Cooper tried the Hearing Voices Simulation and interviewed Pat on a half-hour special with over 2.9 million views on YouTube.
  • 2015: An innovative partner in Texas holding a grant from the Hogg Foundation invited PDA to help them transform their clinic’s culture toward person-centered and recovery-oriented care. The original proposal resulted in the development of a new offering: the CommonGround Academy.
  • 2016: Academy + Library became a proven vehicle to scale the CommonGround Program. PDA pivoted away from calling itself a technology company. We see our methods, content and coaching capabilities as the true core of what we do, and technology as the conduit/delivery mechanism for Pat’s work.
  • 2017: Pat was awarded the Steve Harrington Award by the International Association of Peer Supporters.  
  • 2018: Pat continued her prolific content creation. We experimented with organizing CommonGround into a comprehensive, programmatic collection of how-to Guides to help people in recovery and the people supporting them in navigating complex health needs and decision points in the recovery journey. Amid a massive undertaking to chart Pat’s body of work, PDA increasingly began to see itself as a publishing platform. We wrote a one-page manifesto speaking our true identity and commitment to nourishing and growing the CommonGround community.

The CommonGround Story Continues

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