DBSA Jackson provides a weekly support group meeting for people living with mood disorders. The group facilitators are volunteers with problems of their own. For the past 15 years, these facilitators have proven themselves to be among the "strongest people".
Choose life. When in doubt, when you are not sure... When there is a question choose life.
The question of Insure Tennessee is a question of whether or not we will choose life. It is not a question of a better way to choose life. It is not a question of not this but that. As more and more stories pour in it is obvious. For thousands of Tennessean it is increasingly each day a question of life or death... a question of life or needless and preventable suffering... a future of hope or one bound by despair. It is not about finding an answer. It is about the common sense and political will to grab the one (the only one) in front of us and stop the unnecessary misery that defines the lives of so many vulnerable Tennesseans.
Chattanooga voted last night to choose life. Their city council voted overwhelmingly in favor of a resolution supporting Insure Tennessee. They joined a growing movement of cities and towns saying they support their neighbors, their friends, their families. No one should have to unnecessarily suffer or suffer as a direct result of governmental policy. Insure Tennessee.
The movement is growing. Thanks to the leadership of people like Pam Weston in East Tennessee and Meryl and Randall Rice in West Tennessee and the stories and words of more and more Tennesseans the movement is growing. It is the growing crescendo of more and more ordinary Tennesseans saying "CHOOSE LIFE!!!!!"
Imagine a flood, a hurricane in Tennessee. The waters are rising.. People are dying.... Many are on top of their houses waiting for a miracle.. a boat... a something... someone who cares.... hope. The government has boats. But they decide to wait. "Let's make sure this is a good idea..."
The waters still rise. For some it is too late. For others it will soon be too late. Action matters. The hurricane is here for thousands of Tennesseans. And they are on top of their houses waiting.
Join the movement to choose life. Talk to your local government. Ask them to join Chattanooga and the other towns and counties that have acted.
Today. Today please choose life.
Larry Drain ~
This is a new campaign launched by national DBSA. Remember, "I'm here. "
After the diagnosis, I have had to walk through a grieving process. I grieve for the “death” of who I was, for the person who I am, and for my future self. Confusion and loss of self are huge players in this grief process. Of course, sadness does too, much sadness. I believe it is the same type of journey we go through when we lose our loved ones. Except this time, the person is me.
Those five stages of grief are denial, anger, bargaining, depression and acceptance. I would imagine the denial stage is probably the most difficult to move out of after being diagnosed with a mental illness. It has been for me. The denial phase looked similar to this: I cannot believe I am bipolar; all I went in for was for ADD; the doctor can’t be right; I don’t even know what bipolar is, how is that ME? As Gru’s minions say “Wha???” It even looks like: these meds are making me worse; I’m not sick or have mental problems; maybe I was misdiagnosed; maybe I’m really not bipolar since the medicines are not working. On and on and on…
Since I am still fairly new with the diagnosis, I can see the reoccurrence of denial throughout the past few years. Thankfully, I am not stuck in the vortex of complete denial. It helps to read, to learn, to use the internet, to search for others who are walking the same walk. Thankfully, you are out there for me to glean from and from you I have hope.
Tragic California Case Exposes Failings in Our Mental Health Care System
CareforYouMind Feb 10,'15
In April 2012, Fred Paroutaud, a California man with no history of mental illness, experienced a psychotic episode. Mr. Paroutaud was hospitalized and diagnosed with bipolar disorder. Just 72 hours after he was admitted, and despite the fact that he was still experiencing hallucinations, he was discharged and referred to outpatient group therapy. Because his condition remained unstable he requested alternate therapy and one-on-one sessions with a psychiatrist. He was denied both by his health plan and his condition deteriorated.
Concerned by his worsening depression, his wife appealed to the health plan again and again. She pleaded that her husband required more supervised and personalized treatment. While waiting for an appointment with his psychiatrist, and just two months after his first psychosis, he died by suicide.
Mr. Paroutaud’s widow is convinced that if more intensive and timely care had been available, her husband would still be alive. In October 2013, she and two other plaintiffs filed a class-action lawsuit against the health plan claiming they were harmed by its systemic denial of timely access to mental health services.
Why this story sounds familiar
Those two narrow levels of care are appropriate for many people, but not all, and certainly not for all stages of mental illness. The absence of those critical, in-between levels of care is one of the ways that our mental health system falls short and where it fails people like Fred Paroutaud and his family.
When someone is in the midst of a manic episode or considering suicide, hospitalization can provide the opportunity to stabilize the condition. Upon discharge, many patients require medically monitored care in a residential facility or highly personalized care in a medically-monitored outpatient setting. Unfortunately, that level and type of care is almost impossible to find in commercial health plans.
There is another way
This structure, with six levels of care, is the backbone of the mental health system under California’s Medicaid system, and it provides a complete, stepped approach to rehabilitation.
This type of care should not be exclusive to the Medicaid population. One of the 10 essential health benefits under the Affordable Care Act is rehabilitation; another is mental health care. This means that rehabilitation for mental health care isan essential benefit, and all Americans in commercial health plans are entitled to more rehabilitation-focused mental health services.
What you can do now
With increased national attention on access to mental health care, now is the time to tell us about the problems you are having in accessing the care you need. We want to know what services you were denied and the barriers you faced, such as unaffordable out-of-pocket costs, transportation issues, or lack of trained providers in your plan’s network, etc. We also need to know what you did or didn’t do in response and how this impacted your or your family member’s recovery. As advocates and advocacy organizations, we are positioned and prepared to knock on the door of government regulators and health plans and point out the disparity in care and demand access to appropriate rehabilitative services.
Many commercial insurers don’t cover rehabilitation services because they don’t believe they have to. And if no one demands otherwise, they are unlikely to ever change. Share your story. Don’t take ‘no’ as the only answer. Let’s realize the parity we deserve.
Rusty has been Executive Director and Legislative Advocate for CCCMHA since 1987. He is co-author of California’s Mental Health Services Act, a tax on personal incomes over $1 million to expand community mental health care. At CCMHA, he has been instrumental in moving forward a variety of critical mental health-related initiatives, including ensuring the implementation of the federal Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program to serve children with severe emotional disturbances. He also serves as Executive Director of the Mental Health Association in California.
What are some symptoms of BP? See what bipolar disorder can be like. Pass this along to someone in need. Dark Glasses & Kaleidoscopes - YouTube http://bit.ly/1ExeuNA
I found this article very meaningful for me. I believe it takes a lot of effort today, for most of us, to stay positive in a negative world. These are some lighthearted points on how to do just that.
12 Steps To Stay Positive In A Negative World
BY DR. JOEL KAHN
OCTOBER 8, 2014
This weekend we celebrated the Jewish holy day of Yom Kippur. One of the clergy scheduled an hour-long healing session sandwiched between the full day of prayers on this fast day. Fifty people showed up, some willing to share the pain they were feeling from recent diagnoses of cancer, loss of loved ones, or family traumas, and others remained silent.
When it was my turn, I brought up the challenge I felt trying to stay positive in a negative world. Cruelty, brutality and insecurity seem to me more palpable than in the past, perhaps due to 24/7 connectivity with reports of wars, tragedies and beheadings. I described steps I use to emphasize the positive during the day while still being grounded in the events occurring in the world.
Here are 12 of the techniques I use to maintain a positive outlook when the world seems so incredibly negative:
1. Control the amount of negative news in my life.
While I want to stay up on the events occurring in the world, sometimes a headline is sufficient to grasp new developments. I limit the time I spend with TV, radio and Internet, selecting only a few stories to read in full.
2. Control the number of negative people in your life.
I spend most of my days talking to patients about their problems, and some days are filled with more uplifting reports than others. However, I can select how much time I spend with relatives and friends that dwell on the negative. As painful as it may be at times, my calendar may not open to those who consistently drag me down.
3. Listen to music.
I find positive music playing in the car, my home and at work to be a great source of uplifting spirit. One of the most positive collections of music is what I have found in Kundalini yoga. I can feel bountiful, beautiful and blissful with just a few clicks of my phone.
I choose to practice a Kirtan Kriya as taught by Dr. Dharma Singh Khalsa, since it takes 12 minutes with a mantra and mudras that are simple. I often do this in the sauna, something I call saunitation, as it seems to clean out the junk in my brain.
5. Live consciously.
Awareness of my breath, the origin and nutrition of my food while eating, a blue sky, a purple flower, a bird’s song all can draw me into a feeling of gratitude for the moment that overcomes forces that can drag me down.
6. Practice gratitude.
Appreciating people for anything they may do to help during my day is always my goal, some days more successfully practiced than others. Helping others, holding a door, buying a surprise coffee for someone behind me in line (I call it random acts of caffeine), or letting someone merge into an intersection can be uplifting.
In my faith there are a couple prayers that are recited on awakening. A simple two-phrase prayer expresses thanks for the return of the spirit to the body after a night’s rest. Another prayer is odd, but one of my favorites: a prayer written over 1000 years ago to be recited after urinating or defecating to acknowledge that the body is still performing its daily miracle. Although an odd blessing, when I care for patients with bowel and bladder illness, I appreciate both how grounded this moment of reflection is.
8. Read positive books and interviews.
I've read my share of Dale Carnegie, Tony Robbins, Og Mangino, and Louise Hay but going back to them every now and then is a positive moment. Also, I select TED talks that describe new innovations, survivors of challenges, and insights into nature and feel better after viewing them.
9. Give hugs.
I love hugging others and, if my patients permit, I hug and scratch backs on most visits, which brings out huge smiles. I can just watch the stress of others diminish and my own stress decrease.
My phone is my pager, my social media, my calendar, and my tether 24/7. The smartphone is a wonder of technology that is on my waist, in my hand, or with me in the car. Some sacred time requires that it be shut off, whether it's one day a week as many religions mandate, an hour in the yoga room, or while meditating. I work to keep my phone and my brain far apart using speakerphone, Bluetooth or headsets.
Years ago, author Norman Cousins demonstrated the healing power of comedy on the course of ill patients and humor can play a healing role today as well. I often end my day with a few minutes of comedy that I have recorded on the DVR. I put the days’ worries behind, enjoy a few belly laughs, and think positively about the coming day.
12. Connect with animals.
My medical work day ends when I walk in my home and see two tails wagging with joy for the fact that I've returned. I have to lie down right then, whether in a suit or scrubs, to let Jake and Eva lick my face over and over. I doubt there's a better therapy after a long day, and I'm sure many of you feel that the love from a pet can counter so much negativity.
My wife and I have joked for years about moving to an isolated island where life is simple. Decades later, careers, children, and goals have kept us from fantasy. The Dalai Lama was quoted as saying, “When we meet real tragedy in life we can react in two ways, either by losing hope and falling into self-destructive habits or by using the challenge to find our inner strength.”
Healthy Lifestyle May Buffer Against Stress-Related Cell Aging
UC San Francisco Study Suggests Healthy Diet, Sleep and Exercise Can Mitigate Negative Impacts of Stress
Newswise, July 24, 2014 — A new study from UC San Francisco is the first to show that while the impact of life’s stressors accumulate overtime and accelerate cellular aging, these negative effects may be reduced by maintaining a healthy diet, exercising and sleeping well.
“The study participants who exercised, slept well and ate well had less telomere shortening than the ones who didn’t maintain healthy lifestyles, even when they had similar levels of stress,” said lead author Eli Puterman, PhD, assistant professor in the department of psychiatry at UCSF. “It’s very important that we promote healthy living, especially under circumstances of typical experiences of life stressors like death, caregiving and job loss.”
The paper will be published in Molecular Psychiatry, a peer-reviewed science journal by Nature Publishing Group.
Telomeres are the protective caps at the ends of chromosomes that affect how quickly cells age. They are combinations of DNA and proteins that protect the ends of chromosomes and help them remain stable. As they become shorter, and as their structural integrity weakens, the cells age and die quicker. Telomeres also get shorter with age.
In the study, researchers examined three healthy behaviors –physical activity, dietary intake and sleep quality – over the course of one year in 239 post-menopausal, non-smoking women. The women provided blood samples at the beginning and end of the year for telomere measurement and reported on stressful events that occurred during those 12 months. In women who engaged in lower levels of healthy behaviors, there was a significantly greater decline in telomere length in their immune cells for every major life stressor that occurred during the year. Yet women who maintained active lifestyles, healthy diets, and good quality sleep appeared protected when exposed to stress – accumulated life stressors did not appear to lead to greater shortening.
“This is the first study that supports the idea, at least observationally, that stressful events can accelerate immune cell aging in adults, even in the short period of one year. Exciting, though, is that these results further suggest that keeping active, and eating and sleeping well during periods of high stress are particularly important to attenuate the accelerated aging of our immune cells,” said Puterman.
In recent years, shorter telomeres have become associated with a broad range of aging-related diseases, including stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis diabetes, and many forms of cancer.
Research on telomeres, and the enzyme that makes them, telomerase, was pioneered by three Americans, including UCSF molecular biologist and co-author Elizabeth Blackburn, PhD. Blackburn co-discovered the telomerase enzyme in 1985. The scientists received the Nobel Prize in Physiology or Medicine in 2009 for their work.
“These new results are exciting yet observational at this point. They do provide the impetus to move forward with interventions to modify lifestyle in those experiencing a lot of stress, to test whether telomere attrition can truly be slowed,” said Blackburn.
Co-authors include senior author Elissa Epel, PhD, department of psychiatry, Jue Lin, PhD, department of biochemistry and biophysics, both of UCSF and Jeffrey Krauss, MD, division of physical medicine and rehabilitation at Stanford University. Lin, Epel and Blackburn are the co-founders of Telome Health Inc., a diagnostic company measuring telomere biology.
The study was supported by the Baumann Foundation and the Barney & Barbro Foundation. Puterman is supported by the National Heart, Lung and Blood Institute of the National Institutes of Health.
UCSF is the nation’s leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and two top-tier hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco. Please visit www.ucsf.edu.
Source: University of California, San Francisco (UCSF)
Support for mood disorders: Allen Doederlien shares information Thursday
By Linda Braden Albert | email@example.com | July 20, 2014
A series of presentations focusing on mental health issues that began in March at the Blount County Public Library will continue Thursday as Allen Doederlein, president of the Depression and Bipolar Support Alliance (DBSA), speaks on bipolar disorder and depression. The presentations, sponsored by NAMI (National Alliance on Mental Illness) Maryville, are free and open to the public.
Doederlein said, “Our headquarters are in Chicago, Ill., and yet, we are really all over the country and have some incredible and important affiliates in Tennessee. The work they do is entirely volunteer. It’s done as a labor of love and it’s done from a very personal place.”
The organization is by and for people who live with depression or bipolar disorder. “That lived experience informs everything we do,” Doederlein said. “We provide information that’s easy and understandable, not written in ‘medicalese,’ not confusing but gets directly to what these conditions are and what you can do to live and get well. We provide empowerment. These are conditions that can make people feel disenfranchised, that can carry great stigma. We want to make sure that people are strong advocates for themselves.”
Doederlein said another goal is to raise concerns and needs to elected officials but also on a more personal level. “Also in their work places and their families — anyplace people with mood disorders may find themselves, to say, let’s work collaboratively and constructively to make sure everyone does well,” he said.
DBSA support groups provide valuable assistance and education for those with mood disorders. Doederlein said, “Our chapters operate free, in-person peer support groups. That’s a group that meets without a doctor or clinical professional present, just the people with a lived experience. There’s a great deal of scientific literature that shows that peer-to-peer experience is greatly beneficial and helps people get well and stay well.”
About 53,000 people are reached nationally in a year by these peer support groups, he added.
Doederlein said Larry Drain, president of the NAMI (National Alliance on Mental Illness) Maryville and initiator of the mental health informational series, is a wonderful example of someone with a great deal of power and intellect who has been challenged by mood disorders.
“He had taken that lived experience and made something in terms of giving back to others,” Doederlein said. “When you think that there are people doing that all over the country, it’s really, really something. Larry’s not only done that in terms of support but also as an advocate.”
At the national level, 50 percent of the paid professional staff and volunteers must, by charter, have personal experience in dealing with mood disorders.
“That perspective informs everything that we do,” Doederlein said. “That’s really important. Very often in health-related education or advocacy, it will be doctors talking to doctors, not really related to a person getting herself or himself well. We make sure that’s at the center of what we do.”
Mood disorders include a spectrum of conditions, including depression and bipolar disorder. Doederlein said, “About 21 million American adults are estimated to be affected by depression and bipolar disorder. That breaks down to about 14 million affected by depression, and between 6 and 7 million affected by bipolar disorder.”
Mood disorders are challenging, but they can be managed and those with the disorders can thrive and contribute to society, Doederlein said. A prime example — Abraham Lincoln.
To learn more, visit the DBSA at www.DBSAlliance.org or attend Thursday’s presentation. It begins at 6:30 p.m. at the Blount County Public Library.
Will you speak???
TMHCA is, once again, excited to announce an upcoming FREE WRAP® “refresher” course in Nashville, Tn. This training is funded by TDMHSAS.
Location: TAADAS Conference Room
1321 Murfreesboro Pike
Nashville, Tn.; Office 155 37217
COURSE DESCRIPTION: The WRAP Refresher Course is a three day, interactive course co-facilitated by TMHCA Advanced Level WRAP® Facilitators. The primary purpose of this Course is to sharpen & expand facilitation skills to further engage students in Wellness Recovery Action Planning.
Through attendance in this course, WRAP® Facilitators will:
1. Recognize expanded options on how to give group introductions.
2. Identify additional knowledge areas, Values & Ethics of WRAP®
3. Apply new skills to sharpen & expand group facilitation skills.
4. Develop new, creative approaches to Facilitation to accommodate participant challenges & different group needs.
The Copeland Center strongly recommends that WRAP® Facilitators attend a Refresher Course @ least every two years to stay up on new developments and best practices.
May 2014: Kathy Flaherty
Kathy Flaherty works as a senior staff attorney at Statewide Legal Services of CT, Inc. She has dedicated her professional life to advocating for the rights of the underserved. A graduate of Kingswood-Oxford School, Wellesley College and Harvard Law School, Kathy has 17 years of experience in poverty law, specifically focusing on housing, benefits, and consumer law.
Kathy lives with bipolar disorder. She makes full use of her work place’s very generous sick leave benefits and a flexible schedule. Kathy was diagnosed her first year of law school after being civilly committed. She was not permitted to return to Harvard until the next fall, at which point the school put conditions on her return.
During her third year of law school, she used the Harvard Law School newspaper as the forum to come out about her illness. Against the advice of the Office of Public Interest Advising, when applying for jobs after law school, she included her position on the council of former patients of McLean Hospital, making her disability fairly obvious. “If someone didn’t want to hire me because of my disability, I didn’t want that job.” Kathy says that she has gotten jobs because she has disclosed.
Kathy shares that her biggest barrier to the legal profession was getting admitted to the Connecticut Bar. Despite the fact that she had already been admitted to the Massachusetts and New York Bars, she had to wait for a year and a half and then was conditionally admitted. For the next nine years, she had to report that she was taking her medication, as well as provide a doctor’s note twice a year confirming that she was in fact taking her medication.
Since 1999, Kathy has served as a volunteer trainer, presenter, and facilitator for Connecticut’s chapter of the National Alliance on Mental Illness (NAMI-CT). Combining her personal experience as a recipient of mental health services and her legal background, she is able to speak to issues affecting those living with mental illness from a multi-faceted perspective. Her advocacy work has earned her numerous honors including the Dr. Karen Kangas Advocacy Award from Advocacy Unlimited in 2010. “Winning an award named for someone who is a role model for advocacy and a very dear friend is humbling.”
Kathy currently serves as a member of the Board of Directors of Advocacy Unlimited, Lawyers Concerned for Lawyers-CT, and the Connecticut Alliance to Benefit Law Enforcement (CABLE). She also serves on Governor Malloy’s Sandy Hook Advisory Commission. Her goal for the future? “To continue to do work I enjoy.”
Target Zero to Thrive This April
DBSA targets raising expectations for mental health treatment.
A month-long social media campaign, Target Zero to Thrive, challenges mental health care professionals, researchers, and individuals living with or affected by mood disorders to raise treatment goals to complete remission—to zero symptoms.
Of course the first priority for treatment is ensuring a person living with depression or bipolar disorder is out of crisis. However, too often the end goal established for successful long‐term care is for the person to maintain a stable mood. Better, or even stable, is not always well. Every person deserves the opportunity to not just survive but thrive, and to do that we need to ensure true wellness is the end‐goal for mental health treatment.
Consider this, successful treatment for cancer proceeds with the goal of removing every cancerous cell—to achieve complete remission. Why then, do we consider treatment for depression or bipolar disorder to be successful when symptoms persist, even if the person is considered to be stable?
The cost of settling for reduced symptoms is simply too great. It is, in fact, a matter of life and death—for when symptoms persist, individuals who have mood disorders are:
DBSA President Allen Doederlein shares, “Living with a mood disorder can damage hope and lower expectations; so a person may not expect or think they deserve a full life. We, as peers, clinicians, researchers, and family, need to help them expect and achieve more—by raising the bar for treatment. Targeting zero symptoms may seem like a formidable goal, but there are over 21 million reasons and Americans living with depression or bipolar disorder to make it a goal worth pursuing!”
(1) Am J Psychiatry. 2000 Sep;157(9):1501-4.
(2) J Clin Psychiatry. 2007 Aug;68(8):1237-45.
(3) Bipolar Disord. 2004 Oct;6(5):368-73.
(4) Psychiatr Serv. 2013 Dec 1;64(12):1195-202. doi: 10.1176/appi.ps.201200587.
Larry Drain, Legislative Liaison for DBSA Tennessee, offers this blog with its many references that provides points for and against the Murphy bill. Please take time to self educate. Larry gives us a good start.
[Children's Mental Health Network
The Morning Zen]
Congressman Tim Murphy introduces controversial Helping Families in Mental Health Crisis Act of 2013
2 Comments | Posted December 15, 2013
On Friday, one day before the anniversary of the Newtown school shooting tragedy and on the same day of yet another tragic shooting at a school in Colorado, Congressman Tim Murphy introduced the Helping Families in Mental Health Crisis Act of 2013, a bill that would effectively rewrite how the Substance Abuse and Mental Health Services Administration (SAMHSA) operates and significantly narrow the focus of the types of mental health services and supports it helps promote through its grant programs. While the bill is at this point just a proposal, it is an important read for Network faithful as it sheds a light on the thinking of many individuals across the country about how to improve mental health services in America. Unfortunately, with the continued tragedies occurring at schools across the nation the tendency to equate guns and violence with mental illness leads to recommended solutions in this bill that are narrow in focus and could potentially set back the advances in the field of mental health 20 to 30 years.
What makes writing this Morning Zen piece difficult for me is that I have the utmost respect for Congressman Murphy. A child psychologist by training, co-author of two books ("The Angry Child: Regaining Control When Your Child Is Out of Control" and "Overcoming Passive-Aggression), it is obvious that Congressman Murphy cares deeply about improving mental health services. For that he is to be applauded. But what is in this proposed bill for the most part is either mystifying or antithetical to what the research tells us works best for young people with emotional challenges and their families. In fairness, at the end of this post I have included links to position statements on the proposed bill from national organizations and thought leaders both for and against the bill. As always, we pride ourselves on providing as many perspectives as possible so that our educated readers can make up their own minds and respond to their elected officials accordingly.
The response from mental health advocates and provider groups both for and against the bill was swift. As is the general approach of the Children's Mental Health Network we took the weekend to read and digest the 135-page bill before making our comments. The list is long so grab a cup of coffee for this one.
The proposed bill is complex in that mixed in with proposals that are administratively bureaucratic, relying on reference resources that in some cases are twenty years old and frankly dismissive of anything outside of the realm of narrowly defined evidence based practice, are some excellent proposals such as continuing funding for the Garrett Lee Smith and National Child Traumatic Stress initiatives.
However, overwhelmingly the recommended changes in the bill set the advances made in knowledge about what works for youth with mental health challenges and their families back a good twenty to thirty years.
Clouding the picture of how to interpret this proposed bill was the timing of its release – on the eve of the anniversary of the Newtown tragedy and on the day of yet another shooting at a school in Colorado, where emotions were already running high and the popular press was flooded with news stories about guns, violence and mental illness. Even though research shows that those with a mental illness are significantly more likely to be a victim of violence than a perpetrator of violence, discussions in Congress about what to do tend to fall too easily into the guns + violence = mental illness equation.
Okay, with all of this in mind as a backdrop for what is in the proposed bill, let’s take a walk through some of the highlights. The 135 page document is one I encourage you to read to get your own sense of its merits and drawbacks. In this post I will focus on some of the key areas that are important to highlight. Page numbers of the bill are cited so that you can read the full text in the copy of the proposed bill that you can download here.
Additional layers of bureaucracy added while diminishing the decision-making role of key SAMHSA personnel (Page 4)
National Mental Health Policy Laboratory (page 7)
The description of the NMHPL goes on to say that "In selecting evidence-based practices and services delivery models for evaluation and dissemination under paragraph (2)(C), the Director of the NMHPL
On page 10 the language continues with "In carrying out the duties under this section, the Director of the NMHPL shall consult with representatives of the National Institute of Mental Health on organization, hiring decisions, and operations, initially and on an ongoing basis; (B) other appropriate Federal agencies; and (C) clinical and analytical experts with expertise in medicine, psychiatric and clinical psychological care, and health care management.
The Children’s Mental Health Network is troubled that there is no mention of youth and family involvement in such a consulting pool, especially with the impressive track record achieved by SAMHSA in cultivating a family-driven, youth guided approach through its system of care grants and cooperative agreements over the past 20+ years.
Interagency Serious Mental Illness Coordinating Committee (page 14)
The responsibilities of this Committee include:
There is a long list of required members for this committee (page 15), including the Director of NIH, the Attorney General of the United States; the Director of the Centers for Disease Control and Prevention and more. Members of the Committee serve 4-year terms and would be required to meet a minimum of two times per year. In addition, the Committee “may establish subcommittees and convene workshops and conferences "to enable the subcommittees to carry out their duties."
And finally, with regard to administrative duties, on page 70 it is noted that the administration of block grants would be removed from the Director of the Center for Mental Health Services and shifted to the Assistant Secretary for Mental Health and Substance Use Disorders. Gonna be one busy Assistant Secretary if this proposal goes through!
I can't help but think that if this plan were to come to fruition there would be bureaucratic gridlock. Two new significant leadership positions assuming key duties of currently existing high ranking officials within SAMHSA and a large Committee with sub-committees to "assist the Assistant Secretary in carrying out the Assistant Secretary's duties" (Page 14). In my mind, this is a huge duplication of duties already ascribed to the SAMHSA Administrator, the Director of the Center for Mental Health Services and others within SAMHSA.
Let's move away from administrative duties to some of the new grant programs proposed, specifically the Assisted Outpatient Treatment Program. The proposed bill calls for up to 50 grants each year for a 4-year pilot program to focus on assisted outpatient treatment programs (Page 19). Each grant would be eligible for one million dollars per year for four years - $15,000,000 per year would be authorized totaling $60,000,000 over the four-year period.
Assisted outpatient treatment is a controversial topic, with some saying it is the best option for an adult with a mental illness who "lacks capacity to fully understand or lacks judgment to make informed decisions regarding his or her need for treatment, care, or supervision." Others, including the Children's Mental Health Network, see this as a potentially dangerous road to travel in that it could have wide-ranging impact on those who might be swept up unnecessarily. You can review both sides of the argument regarding Assisted Outpatient Treatment at the end of this post.
Number of seriously mentally ill who are imprisoned (page 63)
Reducing the stigma of serious mental illness (page 79)
Title XI-SAMHSA Reauthorization and Reforms (page 99)
In addition, it would be required that "Before awarding a grant, cooperative agreement, or contract, the Secretary shall provide a list of the members of the peer review group responsible for reviewing the award to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate." This is yet another opportunity for delay and bureaucratic red tape.
Transfer of all functions and responsibilities of the Center for Behavioral Health Statistics and Quality to the National Mental Health Policy Laboratory (page 102)
Establish a clearinghouse of evidence-based practices (page 106)
Unfortunately there is no mention of consumers, families or youth involved in this review.
Limitations on Authority (page 133)
No financial assistance to any program without evidence-based practices (page 133)
If you have made it this far in this lengthy post you know that this leads back to the question "What is an evidence-based practice and who is involved in deciding that?" From reading the full text of the proposed bill the decision makers are definitely skewed toward the medical community with a strong focus on a narrow slice of the overall population of individuals needing mental health services.
Elimination of unauthorized SAMHSA programs without explicit statutory authorization (page 134)
The proposed bill goes on to say "The Assistant Secretary for Mental Health and Substance Use Disorders shall seek to enter into an arrangement with the Institute of Medicine under which the Institute (or, if the Institute declines to enter into such arrangement, another appropriate entity) agrees to submit a report to the Congress not later than July 31, 2014, identifying each program, project, or activity to be terminated under subsection (a).
So, there you have it. Quite a bit to chew on and I cut this post down significantly. Please take the time to read the proposed bill. Whether it gains traction in the House or not it is important to remember that this proposed bill reflects the thinking of many. If you are concerned about this, as we are, then you might want to consider an education campaign.
Next week we will share our collaborative efforts with Maryland-based mental health providers, adult and youth representatives with experience receiving mental health services, and family advocates and other agency representatives to put together a site visit for Senate and House Appropriations Committee staff to not only show them what a coordinated system of care approach looks like in the effective provision of services and supports for young adults with mental health challenges, but also to provide them the opportunity for one on one dialogue with youth and adults who utilize mental health services, families and the amazingly dedicated professionals who work side by side with them. We began organizing this effort for Senate Appropriations staff as a result of our inquiry into the Healthy Transitions Initiative in August of this year. Senate Appropriations Committee staff have agreed to come and we will be extending an invitation to House Appropriations Committee staff this week. I will give you full details in the Morning Zen post this coming Friday.
What is so important about our education campaign is that it is not focused on one grant or particular service. We are not bringing staffers to a visit to ask for money. We are bringing staffers to a visit to let them experience firsthand the importance of a comprehensive approach to meeting (in this case) the needs of young adults with mental health challenges. Sounds like a systems of care approach to me!
And finally, here is a sampling of different individual and organizational analyses and reactions to the proposed bill, both pro and con. Remember, an educated voice is a powerful voice.
For the proposed bill
Against the proposed bill
On my mind: Fighting stigma, building communitiy
By Bob Carolla
The power of two
Your partner can become a pillar of strength when you work together as a couple
By Barbara Boughton, BP Spring 2013
There’s no doubt that the nature of your relationship with a “significant other” has a major effect on managing bipolar. Research now shows that having a supportive partner may be just as important as medication and psychotherapy in preventing relapse, according to Sagar Parikh, MD, a professor of psychiatry at the University of Toronto.
Likewise, the stress of high-conflict relationships or the emotions that accompany breakup and divorce can sometimes exacerbate symptoms of the disorder, Parikh says.
So what can you do to make your partner an ally in recovery?
The first step, says Parikh, is education—for both of you.
The more that both partners know about symptoms, treatments, and coping strategies, the more they can work together to address common challenges. Reading and online research, workshops presented by mental health organizations, discussions with mental health practitioners, and peer support groups are all good ways to get informed.
A partner or spouse who is up to speed on what it takes to live with bipolar will find it easier to understand when you ask for support.
The next step is learning to discuss matters relating to your illness openly and honestly.
For one thing, being able to share what’s going on in your life and your head provides your partner with a context for any irritability, sadness or high spirits you exhibit. For another, it gives you both a touchstone for recognizing early signs of a mood shift.
Elizabeth and her husband, Rory, who have been married since August 2012, have a conversation at least once a week about any symptoms Elizabeth might be experiencing.
“Regular communication is really important,” says Elizabeth, 32, of British Columbia. “We talk about what I’m feeling and things that he notices about me. Sometimes, it’s hard for me to see the forest for the trees, especially if I’m not feeling well.”
Rory’s feedback provides her with a reality check, Elizabeth says.
“Last year I had a manic episode and Rory realized something was wrong when I told him: ‘I want to go on a 5K run.’ I’m a pretty sedentary person, so for me that’s out of character. It gave Rory a clue that I might be experiencing mania,” she recalls.
In most intimate relationships, it’s important to make significant others aware of red flags, according to David Miklowitz, PhD, a professor of psychiatry and director of the Child and Adolescent Mood Disorders Program at the Semel Institute for Neuroscience and Human Behavior at the University of California–Los Angeles.
“People with bipolar disorder can make a list of symptoms and behaviors that they know indicate early signs of a manic or depressive episode. The partners can then refer back to these lists in order to spot early symptoms,” Miklowitz says.
comfort levelWith education and experience, partners often become adept at spotting subtle signs, Miklowitz notes—sometimes before the person with bipolar does.
“Then the question becomes: If your partner spots early signs of mania or depression, what do you want them to do with that information?” Miklowitz says.
“Do you want them to call your doctor? Do you want them to go in with you for a therapy session, or encourage you to take your medicines? Some people like that kind of active support from their partners, and some do not.”
In some cases, Miklowitz says, intervention from a spouse can be seen as “too parental or too controlling.”
The bottom line is this: In order to tell your partner how to be helpful, you first need to know what kind of help you want. That’s highly individual, so every couple will find a different fit. After a disturbing interaction with a friend or boss, one person may simply want to vent while another seeks advice on how to resolve the situation.
Bill, 67, has never looked for a lot of hands-on involvement from his wife, Telle. The couple lives in California, and has been married for 20 years.
“The main way that Telle has supported me is through her acceptance of me—and that’s been very important to me and our relationship. She knows that I can stand on my own two feet, and she doesn’t judge me,” says Bill, a retired refrigeration pipe fitter.
What Bill appreciates are Telle’s understanding and compassion for his symptoms, her trust that he is working to get the best treatment he can, and her emotional support when he’s had to be hospitalized.
Still, Telle has occasionally taken an active role in Bill’s care. In May 2012, Bill became delusional while being assessed at a hospital for a blood clot in his lung. Telle spoke to his psychiatrist, who arranged for Bill to be admitted for psychiatric intervention.
If your partner does take an active role, Miklowitz says, it’s important to understand that the person will probably make mistakes.
“It’s crucial to give your partner some leeway, especially in the beginning of a relationship, when they’re just getting to know you and the effects of your illness. They’re not trying to control you. They’re just trying to help, and they don’t always know how to best do that,” he says.
talking pointsOnce you are clear in your own mind about what role you’d like your partner to take, Miklowitz notes, it’s crucial to be direct in expressing your wishes—and also to listen to what your partner has to say.
Miklowitz recommends asking “clarifying questions” to make sure you understand your partner’s point of view. To doublecheck that you’re interpreting correctly, practice repeating back what the other person said—a technique known as reflective listening or mirroring.
Nancy Poirier, MPs, a clinical psychologist at the Douglas University Institute for Mental Health in Montreal, stresses the need to express your wants and feelings with compassion.
With mirroring, for example, first reflect your partner’s viewpoint, then express understanding and empathy to validate how the other person feels.
In addition, she says, “both partners should be careful to use ‘I statements’ rather than blaming the other person in talking about the bipolar disorder. The important thing is for both partners to feel understood.”
As far as practical approaches, Poirier recommends developing a relapse prevention plan that details early warning signs of a mood shift and how to respond. The Elizabeth and Rory’s plan includes a list of people whom Rory should call to get Elizabeth treatment and/or medication, as well as the name and contact information for the hospital where she’d like to be treated.
As a further step, Poirier notes, you and your partner can write a contract about what each of you will do when warning signs appear. A document you signed when well may be more effective against denial when you’re ill than a partner’s reminders.
There are other small but helpful ways partners can counter symptoms, she says. During a manic phase, reduce stimulation by decreasing light and loud music in the household, and keep credit and cash cards inaccessible. During a depressive phase, let more light into the house, encourage exercise, and gently urge completion of at least one pleasant activity each day.
On a day-to-day basis, agree on a system that keeps encouragement from feeling like nagging. Again, this will vary from couple to couple. Some might be comfortable with a daily check-in about medication compliance, for example, while others will prefer a more emotionally neutral chart system that both partners can refer to.
Couple’s therapy can be an effective way to develop strategies for coping with the disorder together, Miklowitz says.
“The counseling should help the couple solve problems that arise around the symptoms of bipolar disorder, and learn to communicate effectively about them,” he says.
In addressing specific issues, Miklowitz adds, it helps to realize that you may not get everything you want.
“You have to be willing to compromise,” he says. “You have to start with the assumption that everyone—you and your partner—are doing their best.”
“Doing your best” might involve taking as much responsibility as you can for your recovery and well-being, Poirier points out. For your partner, that might mean cutting you a little slack for symptomatic behavior.
Elizabeth says that when she succumbs to what she calls her “ooh, shiny!” syndrome, Rory usually accepts the impulsive action as part of her illness.
When she bought several hundred dollars’ worth of tea towels, she recalls, Rory commented that they were now stocked up for a few years. When she took their cat to the vet and came home with an extra kitten, Rory “accepted the kitten with open arms,” she reports—and they now have a rule that they only go to the vet’s together.
“He isn’t a pushover,” she says, “he just knows that in the spring, I pull a few whoppers and that is OK.”
In fact, she says, Rory took the news of her diagnosis better than she did. They were dating at the time, Elizabeth says, and Rory made it a point to find books that would be helpful.
“He never judged me for having bipolar,” she adds. “I’m very lucky to have found Rory.”
Barbara Boughton, a freelance health and medical writer, writes for Reader’s Digest, Medscape.com and other outlets. She lives in the San Francisco Bay area.
Learning when a hug can helpWhen Heather and Ken first met in fall 2002, Heather certainly wasn’t in the mood for romance. She was experiencing serious depression and “very resistant to dating,” but Ken waited patiently.
“When we did start dating, I was very forthright about having bipolar disorder, and he was very understanding,” recalls Heather, 44.
Now Heather’s relationship with her husband is a rock that steadies her when symptoms crop up. In Heather’s case, that’s often behaviors that signal depression—not getting out of bed, failing to eat healthy foods, and crying a lot.
After nine years of marriage, Ken has come to understand what his wife needs when she is ill. And Heather made it a priority to communicate to her husband about what kind of support she finds the most helpful.
“Sometimes it’s just the simple things that are important,” Heather says. “A hug from Ken can be very grounding when I’m having a difficult time. He also knows when to give me space, such as when I get irritable, angry, and when I lash out.”
Perhaps more importantly, Ken and Heather have an agreement that they’ll promptly address any worrisome symptoms.
Heather admits she’s not always receptive when Ken spots signs of depression or hypomania, such as being quick to anger or spending too much on online shopping, yet she will usually agree to call her doctor.
“Couples therapy has also helped us,” she says. “We’ve learned not to blame each other when we discuss sensitive issues such as my bipolar disorder, and to respectively express our feelings. Sometimes that may mean taking a break or even going to different rooms when a discussion becomes too heated.”
She adds, “What has been most important is for both of us to realize that I’m more than the identified patient in our relationship. I’m Heather, a wife who is more than her illness, and who needs and wants hope and love from her partner.”
In sickness and in healthDan and Dolores have weathered 43 years of marriage—and Dan’s bipolar swings.
Dan, now 73, was accurately diagnosed in his late 20s. He and Dolores were contemplating marriage, and she accepted the news along with the man.
“He was a real charmer and had a wonderful sense of humor,” Dolores remembers.
Dan was in a stable period when they met, but shortly after the wedding he slipped into depression. For the next decade, he cycled from months of mania marked by reckless spending and anger, to months of immobilizing depression, to stretches of stability that might last half a year. He went through a series of jobs, never keeping one for long.
“I was ill and non-productive and she was the provider and caretaker,” Dan says.
Dolores held down several part-time jobs, taking their two children to work with her because they couldn’t afford child care. The couple went through two bankruptcies.
“It was painful and it was devastating, but I didn’t leave because I don’t believe in divorce,” says Dolores, 75. “But even in the most difficult moments, Dan’s sense of humor would come shining through.”
They held on until Dan found the treatment he needed at Washington University. An equally important turning point was their decision to start a peer support group in 1980, which became one of the founding chapters of what is now the national Depression and Bipolar Support Alliance (DBSA).
The work not only helped his wife become more educated about the disorder, Dan says, but through running meetings “she gained many skills in talking with me in a very helpful and therapeutic way.”
“We learned how to communicate even around tough topics—and not blame the other person,” Dolores adds.
Dolores admits to “mixed feelings” about their marriage over the years, but says that their life improved as their ability to address Dan’s health got better.
“He has changed in a really positive way over the years,” she says. “And our communication strategies just got better and better. We feel so blessed now.”
Another definition of partnerPeople who are single may find a family member who becomes a partner in recovery. For Jackie that’s her dad, Larry.
“We’ve become an amazing team at managing my bipolar I,” explains the 25-year-old. “We even have a special binder that we keep on the coffee table that has copies of the most important papers about my illness and how we should handle things.”
The binder includes a list of her medications and what they’re for, contact information for her doctors, steps to take in various crisis situations, even copies of some of her homework from psychotherapy.
Jackie has found the skills she’s learning in dialectical behavior therapy especially helpful in managing her symptoms. When she comes home from group, she shares new information with her father. Also really helpful, she says, is “both of us reading everything we can get our hands on about bipolar. We test out new techniques for managing things to see what works best for us.”
For example, Jackie now keeps track of when (or whether) she’s taken her medications on a dry-erase board that hangs on the fridge. The chart not only reminds her to take the meds, but also keeps her father in the loop without having to bug her.
Jackie, who was diagnosed at 14, has seen a huge change since her father started educating himself. When she’s in a mood shift, they’re able to talk through what may have triggered it and how to get her back in balance. When her dad learned that people with mental illnesses sometimes use cigarettes to cope with stress, he stopped insisting she quit smoking. Instead, he encourages her to cut back.
“Before he started reading he didn’t understand nearly as well as he does now, which really goes without saying,” she reflects. “We fought a lot more and he really didn’t ‘get’ me. Now we fight less and he’s much more compassionate to what I’m enduring.”
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It is unacceptable that people who are suffering from and struggling with mental health issues in their life be at risk of injury, trauma, assault or even death in their interactions with police officers whose only training as "being a good police officer" leads them to a course of action that produces tragedy. There is ample evidence that CIT training (Crisis Intervention Training) makes a difference. The "Memphis Model" has made an impact in many communities both large and small. Tragedies may continue to happen, but to expect and accept them as the cost of doing business as normal is simply and deeply wrong.
A few days ago I talked with a man whose 39-year-old "mentally ill" son had been attacked, beaten up and tasered by police in this community who "were doing their job." Over the last few days I have spent a lot of time thinking about other incidents I either have direct knowledge of or I have heard about. And it has left me deeply troubled.
There are lots of people to blame and many people seem intent on solving the problem by trying to figure out who to blame. I hear people talk about needing more psychiatric hospitals, more coercive treatment options etc. I dont think there are really going to be an appreciable increase in psychiatric beds regardless of where you stand on the argument, rather you think it is a good idea or not. Financially it simply not an option. Arguments that vastly increasing AOT (assisted outpatient treatment) can solve the problem are not honest or realistic.
Someone will be the next Kelly Thomas. Someone will be the next person a police officer faces on the street corner or in their home or in the jail. It is happening right now. It will be happening in a few minutes. It will be happening tomorrow. And what stops it from being someone you know, someone you care about, or even you.
It is pointless to bemoan the fact that police are being asked to do things they are not trained to do and then do absolutely nothing about providing them that training. It is as unfair to the officer who is trying to do the best he can as it is to the person he is trying to deal with.
As far as I know the decision to implement CIT training is a local decision and depends very much on the financial resources of that community as well as the commitment to training that local officials may have. Many communities, like the one I live in, have gotten officers involved in a piecemeal fashion but they are largely at the mercy of who offers the training and when.
Again, no one should be the victim of where they live. I have been following in recent days the effort of New York state to deal with the same issue. The proposal that is currently being fought over is whether or not to include in the state budget funds for what they are calling a "center of excellence for CIT training." The idea, as I understand it, is for the state to establish a resource that could help communities access CIT training in a way they can afford and in a way that is most effective to them. It shifts the burden of the argument from "is it practical? Can we afford to do it?" to "Can we afford to not do it?"
It is too late for anything like that to happen in Tennessee this year, but is not to late to start the conversation. Several other states already have chosen to establish something like "a center of excellence for CIT." Some have found access to federal funding. Others have found grants from other sources.
In the end, it not only saves lives but also saves money because of the injuries and traumas it prevents.
A couple of days I had a post which included a video of the beating of Kelly Thomas. I made myself watch the video several days before the post and was horrified. If you havent watched the video and still doubt the importance of what I am talking about watch the video yourself. I have also seen videos of other beatings from virtually all over the country. It is more than a Tennessee problem but it is a Tennessee problem.
In the days and weeks that follow I will be revisiting this conversation over and over. I am by no means anywhere close to an expert. If you think you know more than me on the subject there is a good chance you are correct. My goal is to start a conversation, a widespread conversation, in Tennessee that prepares the ground to talk about this issue not as one that affects isolated localities but every person in this state.
It is a conversation I hope you will join.
Larry Drain, hope works community blog
I'm sharing the news of my being among national Award Winners for accomplishments over the past year. It has been a pleasure to serve as State Director and local chapter President. And I consider it an honor to be recognized by DBSA national.
I appreciate all the wonderful support I was given by my fellow officers, Board members, and the chapter membership throughout the year. You may view the announcement on the national web site athttp://www.dbsalliance.org/site/PageServer?pagename=peer_chapter_spotlights
Congratulations to our 2013 Chapter Service Award Winners!
The DBSA Chapter Service Awards recognize exemplary service by DBSA
chapters, state organizations, and their leaders. Winners will be honored at the 2014 Chapter Leadership Forum in addition to receiving a cash award.
Steve Brannon of DBSA Jackson (TN) and DBSA Tennessee - Outstanding
Steve is an excellent role model for pursuing a wellness-focused life while living with a mood disorder. He fights stigma by openly sharing his journey in the local newspaper, on DBSA’s website, and on his weekly online newsletter. He has worked with the local police department to help educate and train police officers for crisis response teams. Steve was selected for DBSA Peer Advocacy Training and was a representative of DBSA for Hill Day in Washington, D.C.
At his local chapter, DBSA Jackson (TN), Steve gently encourages, trusts, and believes in support group participants. He instituted a monthly “share your inspiration” night in which group members report on what keeps them going, creating an environment of hope and personal growth. Steve is dedicated to further advancing DBSA’s mission into surrounding communities and across the state. The number of support groups has doubled in the past year under his direction, encompassing all major cities and some smaller cities across the state. He has traveled hundreds of miles at his own expense to conduct local chapter visitations as state director. Steve’s passion for the advancement of DBSA’s mission in Jackson and the state of Tennessee is so strong that he has diligently dedicated his time and resources for over a decade.
DBSA Tennessee - State Organization Service
DBSA Tennessee's amazing accomplishments made 2013 a rewarding year!
They supported chapters in their state by hosting educational presentations and training programs, giving them the tools necessary for successful chapters. With help from DBSA Tennessee, five local chapters were interviewed on television or radio to promote DBSA to the community. Leaders encouraged one chapter’s community outreach, resulting in a city-wide Mental Health Day declared by their mayor. DBSA Tennessee’s robust plan to help new chapters in the startup process helped find free meeting locations, assistance in affiliation fees and paperwork, and provided a sponsor from an already established chapter to assist the new chapter.
Five members of DBSA Tennessee attended DBSA’s Peer Advocate Training in Washington, D.C. and then created an advocacy plan for their state including a campaign against proposed budget cuts to close all 45 of Tennessee’s Peer Support Service Centers. DBSA Tennessee is a growing, thriving organization. With its advocacy for peer support and local chapter start-up, community outreach and commitment to peer education, DBSA Tennessee is one of the most energetic affiliates of DBSA.
DBSA Murfreesboro (TN) - Rookie Chapter Service
DBSA Murfreesboro began in July of 2013 with support from DBSA Tennessee.
The chapter started out with one support group, which saw its attendance
double in fewer than six months, becoming one of the fastest growing local
chapters in the state. The growth of the chapter can be attributed to the forces behind it that work tirelessly to get the word out about the group. Flyers and pamphlets are distributed to agencies and health care providers, the Salvation Army, local hospitals and businesses, and more. DBSA Murfreesboro provides post-hospitalization support for those who would otherwise have none. Educational materials, resources, and wellness tools are provided to each chapter participant. They have also started a family and friends support group.
Members of DBSA Murfreesboro participated in the state chapter meetings and backing of their U.S. Representative. For a chapter that achieved all of this in six months, DBSA Murfreesboro has a fine resume of accomplishments, but they consider their greatest success to be the level of support offered to each person who walks through their doors.
Mental health issues topic of presentations
By Linda Braden Albert | firstname.lastname@example.org | Posted 14 hours ago
A series of presentations on mental health issues will begin Thursday at the Blount County Public Library. The first presentation is by Sita Diehl, past executive director of the National Alliance on Mental Illness (NAMI) Tennessee and currently national director of state advocacy for NAMI National.
Larry Drain, recently named president of NAMI Maryville, said, “When they asked me to take the job, I really wanted to figure out a way not only to help NAMI but to help the community. Every day, nowadays, when you read the paper or watch TV or whatever, in one way or another, mental health issues are there. There’s a lot of bad information, misinformation, so the idea I had was that if we could bring a series of people to Maryville to talk about mental health issues, that would be a real, real positive thing for this community.”
Diehl’s current position entails her traveling from state to state, organizing efforts to make outcomes for mental health possible in each state, Drain said. “I’ve known her for years, and she was the very first person I asked. Her topic will be about finding support, whether you’re a family member, whether you’re somebody with a mental illness. She will talk a lot about NAMI, some about the mental health system in Tennessee. There will be a question and answer period after she gets through talking. Anybody who comes will be enriched by her.”
On April 24, Doug Varney, commissioner of mental health and substance abuse services for the state of Tennessee, will speak on mental health and drug addiction. Drain said, “I think he will talk some about prescription drugs and meth, what the state is trying to do to deal with some of these things. Especially in Blount County, it is such a live issue. ... He knows the topic inside out.”
Additional speakers in upcoming months include Ben Harrington, executive director, East Tennessee Mental Health Association; Scott Ridgeway, director, Tennessee Suicide Prevention Network; Allen Doderlain, national president, Depression and Bipolar Support Alliance; Pam Binkley, recovery coordinator, Optum Health, who will talk about emotional first aid; Lisa Ragan, director, Office of Consumer Affairs, Tennessee Department of Mental Health, who will speak on peer support, recovery, etc.; and Elizabeth Power, a nationally known expert on post-traumatic stress disorder. Mental health professionals from Blount Memorial Hospital have also been invited to speak.
Drain said, “I think this will be a quality addition to the Maryville community and I hope lots of folks will come. ... For a lot of folks here, the whole area of mental health, mental health treatment, the resources involved and things like that are so confusing. My hope is that all these speakers can shed some light, bring some facts and really help people in the Blount County area.”
Larry Drain, hopeworkscommunity
7 Things a Child with Depression Should Know
By Deborah Serani, Psy.D. on February 2, 2014 - 8:42am I know depression.
I lived with it as a child, watched it almost destroy me as a teen, and learned to manage it as an adult.
As a clinician who specializes in mood disorders, I like to teach kids and teenagers how to live with their depression. These tips offer children ways to understand their own unique self, become aware of their thoughts and feelings, and build resiliency as they manage the chronic illness of depression.
1) Understanding the texture of feelings: Many children in this era of super technology aren’t skilled at reading facial cues, understanding eye contact and complex emotions. Studies show that children with depression struggle further, however, having difficulty differentiating the differences between different kinds of emotions. Sad is different than lonely. Lonely is different disappointed. Often, depressed children need help understanding the textures of emotions. When they become confident identifying their feelings, they can set into motion the best plan of action to improve their mood.
2) How to spot negative thinking: I like to teach children about the quality of their thoughts by using a thumbs up and thumbs down technique. Is what you’re thinking a good thought….one that would get a thumbs up from other people? I studied for my test. But if I get a bad grade, it’s okay because I know I tried my best. Or is it a hurtful or negative? One that really is untrue and realistic. It doesn’t matter if I studied. I’m stupid and I’ll fail the test anyway. Teaching children to catch the negative talk helps them approach every issue in life from a place of positivity.
3) How to use positive self-care: Learning to live with depression requires a child to be clever and ever-ready to use soothing ways to address sad moods. Teaching kids and teens to use their 5 senses – sight, touch, hearing, taste and smell – really helps. Things like cozying up to a stuffed animal, hugging loved ones, snacking on healthy, flavorful foods, taking in the fresh air, listening to upbeat music and making time to see colors, nature and sunshine. All of these raise dopamine and serotonin levels improving mood, and teach children how to self-soothe.
4) Why exercise is important: The fatigue that comes with depression leaves kids tired and irritable. Physical complaints like aches and pains also knock them out for the count too. When we take the time to teach children about the importance of physical exercise, it will become part of a lifelong skill-set. Be it playing tag with friends or catch with the dog, swimming or riding a bike, kick-boxing or yoga, or a simple walk, the shift in neurochemistry boosts mood.
5) When too much of something isn’t good: It’s also vital for kids to learn how too much of anything can upset the apple cart. For example, the fatigue of depression can leave children tired, with many prone to sleeping all day. Instead, children should learn that a nap is better than a full-on sleepfest. Some depressed children eat in excess, while others lose their appetite altogether. Both of these extremes are unhealthy. Too much crying, too much avoidance or too much irritability raises the stress hormone cortisol, which heightens anxiety and alertness. When we teach children to monitor their experiences with healthy limits, we give them the ability to balance and self-manage their well-being. Daily stickers for young ones and journaling for the older set can teach children how to better monitor symptoms and moods.
6) Know the difference between a bad day and a sad mood: When depressed kids learn how to measure the moment, they learn that a sad mood doesn’t have to ruin a day. However, if they can’t shake off the sad mood – and the rest of the day feels like an epic fail, it’s great for kids to know that a bad day doesn’t equal a bad life. Tomorrow is a new day. One to be measured for its own value.
7) How to let others know you need help: When children are depressed, they often don’t know how to reach out for support. Their fatigue and irritability dulls problem solving skills. Others might not feel they deserve help or would rather isolate themselves from family or friends. Depressed children need to know that everyone needs help now and then – and that no one can …or should… handle everything alone. I like to teach children to communicate their needs verbally and non-verbally. With words, through crying, by touch – it’s okay to show you others that you’re having a tough time.
S.L. Brannon D.Div..