Choose life… Insure Tennessee

by hopeworkscommunity

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.

Insure Tennessee

Larry Drain ~

This is a new campaign launched by national DBSA. Remember, "I'm here. "

https://www.facebook.com/story.php?story_fbid=10153744595606122&id=95920556121

Thanks to BP magazine for shining a bright light on a dark topic. I am glad to be a part of a support group that helps prevent suicide. For over 13 years our group has served the Jackson, Tn. community faithfully. "Thank you" to , A Better Tomorrow inspirational support group.

TAKING SUICIDE PREVENTION UPSTREAM

Across the country, school districts are providing mental health awareness and suicide prevention training for teachers and school personnel. Some are mandated or encouraged to do so by state law, others are motivated by recent incidents, and some introduce this kind of education because suicide is now the second-leading cause of death among youth aged 15-24.

Teacher and parent training are key components in any plan to address teen suicide. Increasingly, however, communities are recognizing that kids need to learn about mental health, too. Social and emotional learning across the lifespan reduces risk factors and promotes protection factors for violence, substance abuse, negative health outcomes, and suicide. One way to provide universal student training is by including a mental health component in the standard wellness or health curriculum. School districts and individual schools can implement individual, more targeted programs as well.

Knowing how to cope and developing resilience are at the core of mental health awareness and suicide prevention efforts being implemented in Massachusetts with children as young as elementary school. The Commonwealth of Massachusetts places a high value on suicide prevention, with dedicated line-item funding in the state budget for the Department of Public Health Suicide Prevention Program. With support from state officials, the DPH has launched suicide prevention programs across the state and for people across the lifespan.

Some of the skill-building and suicide prevention programs in Massachusetts schools are

• The PAX Good Behavior Game, which has been introduced by schools in collaboration with the DPH, teaches students self-regulation, self-control, and self-management in order to create an environment that is conducive to learning. (Ages 6-12)
• The Open Circle program, which strengthens students’ social and emotional learning skills to increase pro-social behaviors and reduce problem behaviors, is utilized by many school districts. (Grades K-5)
• Whyville utilizes problem-solving and other skills to help kids learn about their emotions in an online computer game. (Teens and pre-teens)
• SOS Signs of Suicide® focuses on prevention through education by teaching students to identify symptoms of depression, suicidality, and self-injury in themselves and their peers. (Grades 8-12)
• Break Free from Depression, developed by the Boston Children’s Hospital, focuses on increasing awareness about adolescent depression, how to recognize it, and how to get help. (High school)

There are dozens of programs that schools can use to promote skills development while fostering students’ mental health and their willingness to seek and accept help for mental health concerns. SAMHSA’s National Registry of Evidence-based Programs and Practices and the Suicide Prevention Resource Center Best Practices Registry include searchable descriptions for a wide variety of educational programs. For high school students, the SAMHSA Preventing Suicide: A Toolkit for High Schools has a comprehensive list of programs, but a search of the NREPP and BPR may yield programs added since the Toolkit was published.

What can you do? Find out how your school district handles mental health training and emotional skill building for students. If there is not currently a program and there is no interest from school officials, you might work with the parent-teacher organization, local mental health groups, and the local board of public health to raise awareness of the issue, then advocate for implementation of one or more programs. There may be grants available to cover the cost of training or there may be organizations in your community that would help subsidize the program.

The bottom line is that suicide prevention requires a comprehensive approach. It’s never too early to start and everyone – families, schools, communities, and peers that create supportive environments; individuals who learn and leverage positive coping skills; and mental and public health systems that treat and prevent risk factors – plays a part.

Your Turn

• What do you think about the mental health awareness and/or suicide prevention programs that are provided to kids in your community?
• What role should a school have in developing kids’ emotional and social skills?
• What steps will you take to improve mental health awareness and suicide prevention in your local schools?

Editor’s Note: The Families for Depression Awareness Teen Depression Webinaris an accessible, free resource for training parents, teachers, and others who work with youth to recognize depression, talk about depression with parents and youth, and know what to do to help a young person struggling with depression. Register for the Teen Depression Webinar live with Dr. Michael Tsappis on September 30. 

Thanks to the MA Department of Public Health Suicide Prevention Program and the Suicide Prevention Resource Center for their support in developing this post.

Thank you, Larry Drain, for making us think and feel about the serious matter of mental illness in the light of reality . . . Reality check, anyone?

hopeworkscommunity, Larry Drain

What is Murphy selling?

Donald Trump gave me the clue.

Even more than AOT or any other policy idea Tim Murphy is selling something far more visceral, far more compelling and far more appealing. Like Trump he is selling anger to those who feel like they or their loved ones have been hurt by a system that often doesn’t help very much. Like Trump he is selling justification and direction by telling them who is to blame. Like Trump he is selling redemption and hope by telling them if they just follow and support him he can change it. His message is one of quest and crusade and rescue of those hurt and victimized.

Like Trump he has never let the facts get in the way but that is not the subject of this post.

Murphy has tapped into something very real. It is far more than a few overcontrolling parents frustrated with their kids. I sat one night with one 72 year old man talking about his 38 year old schizophrenic son. The pain and outrage was real. His son had been attacked by police in a parking lot who thought he was drunk a couple of weeks before he sat down with me. He had been tased more than once and they thought some damage to his legs might be permanent. He was furious at the police but equally furious at a system that had never been there for his son and furious….well just furious that the son he loved was seemingly stuck in the life he had. I remember listening to a mother describe the day she screamed and begged the police not to shoot her son. He had a towel wrapped around his hand and they thought he might have a gun. I have heard a hundred more stories.

It is not so very different than the rage I hear when I hear people talk about the damage they feel the system has done to them. It is the rage of the 22 year old girl with no history of diabetes in her family who now, courtesy of the medication a psychiatrist had prescribed her, had just found out she now had diabetes. She screamed at me….”What the fuck am I supposed to do now?”

It is my rage. My nephew one night laid down in front of a train and died. He believed that treatment was for crazy people and he could think of few things worse than being crazy. He believed what the wider society told him about “mental illness.” He didn’t want to be embarrassed. He didn’t want to stick out. He tried to hide his desperation. He tried to macho his desperation. Finally he decided to kill it.

The rage is real. It may express itself different for different people but it is real.

I think people can find better lives. My nephew, my friend’s son and literally hundreds of thousands of other people deserve something better. And it literally makes me want to scream and scream and scream that so many never find it. It makes me want to scream when people are treated as less than people. It makes me want to scream when the only options people have are things that have already not worked. And it makes me scream when people in their zeal to control symptoms destroy the quality of the life they are trying to save.

Murphy is not going away. The rage is real.

I think back often to something I heard Robert Whitaker say once. He wondered if we would ever have an honest mental health system. What if it was just about what worked?

What if it was?

Maybe in the end that is the only real answer to the Murphys…

Mother Teresa practiced what she preached, serving her neighbors in great need. In contrast, every year Americans feel they must leave their suffering children "next door" to fly off to an exotic land to do God's work. Personally, I try to follow these words of the person who epitomized service and devotion to God.

I say, thank you, Mother Teresa, for leaving these words of wisdom and guidance.

I'm writing my story in hopes that it will inspire others to share their story. I don't know if there is a "book" in everyone but I know for certain there is a story in there. I encourage you to share your story of overcoming some of life's challenges. Someone needs to hear what you have to say. They are waiting!

The big payoff of well-chosen words

By Stephen Propst

You may think that talk is cheap. But, when words are used thoughtlessly, carelessly, or hurtfully, they can take a heavy toll. Like an arrow, “wrong” words can be sharp, piercing a person’s spirit, ripping away at self-esteem, and making a person feel belittled or even betrayed. Ill-chosen words can strain friendships and create stress. And especially vulnerable are people who have bipolar disorder.

Now, let’s be honest. Dealing with bipolar disorder is not only tough for the people who have the illness, but it’s also a challenge for those who live with them. Taking time to consider the impact of what you say before you “fire away” makes it easier. Choosing your words carefully can strengthen relationships, fuel recovery, and make for a better quality of life for everyone.

“Never tell anyone that he looks tired or depressed,” says H. Jackson Brown Jr., in his book Life’s Little Instruction Book (Rutledge Hill Press, 1991). That’s good advice! Now, let’s look at 10 more comments to avoid making to someone who has bipolar disorder. These observations come from more than two decades of dealing with the illness and from years of leading support groups and consulting with families. The goal is to help family and friends to more peacefully coexist with those of us who have bipolar.

What not to say

You sound a little down today.
That’s what a friend said to me within the first 30 seconds when she phoned the other day. No kidding! Since I live with bipolar disorder, of course I don’t always feel 100 percent up to par. I just don’t need my symptoms constantly gauged or continually evaluated. It’s like having a never-ending physical. Most people with a mental illness know how they feel. Being told you are not sounding well is not constructive, nor is it a substitute for true compassion.

I thought you were taking your medication.
Dealing successfully with bipolar disorder cannot be reduced to whether or not someone has taken a pill. There are no quick fixes. Confronting a chronic, serious illness is an ongoing process, and there are bound to be ups and downs. The more you take the time to learn about bipolar disorder, the more you will understand how difficult managing such a condition can be. There are countless resources—books, videos, support groups, etc.—that address and reduce the mystery and misunderstanding surrounding bipolar disorder.

You’re too smart to have bipolar disorder.
When I first heard that remark, I felt so horrible, as if I could have prevented what had happened. Even worse, I felt that someone, such as a homeless person, was somehow more “deserving” of such an illness than I. The brain, like any organ in the body, is subject to having problems. It is cruel to say something that suggests that bipolar disorder doesn’t exist, isn’t legitimate, or isn’t as significant as any other medical condition.

You know he’s ‘bipolar,’ don’t you?
Reducing someone to the illness he faces is destructive. In fact, it is cruel to see a person only through the lens of a diagnosis. Unfortunately, it happens all too often. A person who has bipolar disorder should not be defined by that with which he might struggle. Guard your tongue. Focus on the person you know and love, and dwell on all that makes that individual special. Your friend or family member still has a life.

Stop acting like a fool!
Granted, some conduct associated with bipolar disorder can be very difficult to contend with. When you realize, however, that a particular behavior is actually symptomatic and born of the illness, it makes accepting and dealing with it much easier. I see families who think that their situation is unmanageable, until they meet other families facing the same circumstances. With education and patience, these families come to realize that there is an explanation for what they’ve been witnessing.

Guard your tongue. Focus on the person you know and love, and dwell on all that makes that individual special.

It doesn’t take much to set you off!
Those of us who have bipolar disorder are often more vulnerable and responsive to what happens around us. When you make careless statements, your tongue becomes a trigger that can rouse a reaction and escalate symptoms. You unnecessarily incite a mood change in the person you really want to help.

You’re lazy and don’t have a life anymore.
Are you pushing someone who has bipolar disorder to get on with life? Doing so might create stress, counteract recovery techniques, and worsen overall health. If you have a family, a job, social engagements, etc., consider yourself not only lucky, but also far apart from the typical individual who deals with bipolar disorder. Such a person has often dealt with a radical departure from any sense of a normal routine. Recovery takes time and work, and the role you play is critical. Help by using constructive dialogue that acknowledges progress. Don’t push too hard and don’t expect everything to happen overnight.

We used to have high hopes for you.
I sat at a support group and heard a mother say: “My son was going to be a doctor and have a wonderful family, but now he has bipolar disorder.” As I listened, I watched the young man’s face just drop. He was crushed by his mother’s words. Such a statement is not healthy, because it does not convey unconditional love. What you say does matter. Remember that we are all human beings, not human “doings;” the more you acknowledge our being, the more we can end up doing. There is no need to squash hope or diminish dreams.

Don’t take everything so personally.
With bipolar disorder, there are obvious physical symptoms, such as changes in appetite or sleep; the mind, as well as the brain, are impacted. The patient’s self-esteem also takes a tremendous hit. That’s why a promised phone call that never comes may be taken much harder than you might imagine. Likewise, saying things that ignore or make light of someone’s sense of self-esteem should be avoided.

You seem a little overly enthusiastic.
Remember that someone who has bipolar disorder is still entitled to a personality. Before I had bipolar disorder, I was outgoing, happy-go-lucky and quick-witted. Now even though I have this illness, those same personality traits still exist. At a support group recently, a young man was very energetic and expressive. Someone accused him of being manic. Fortunately, a psychiatrist was present. He said that the young man was displaying no manic symptoms whatsoever and that it was cruel to strip a person of his personality merely because he has a diagnosis. The doctor added that anyone is entitled to a full, normal range of emotions.

What you can say
Sticks and stones can break bones, but words hurt, too. Talking carelessly can shatter self-esteem and stifle a person’s motivation to have a life again. Instead, use statements that are more likely to strengthen relationships and support recovery.

Here are some simple phrases to get started:

“I love you, and I care.”
“You’re not alone in this.”
“I’m sorry you’re in so much pain.”
“I’m always willing to listen.”
“I’ll be your friend no matter what.”
“This will pass, and we can ride it out together.”
“You are important to me.”
“When all this is over, I’ll still be here.”

Speaking of differences
Last year, at the Fernbank Museum of Natural History in Atlanta, Georgia, an amazing, special exhibit revealed that every imaginable genetic differentiation—body size, health, anything—is attributable to less than one percent of all genes (Human Genome Project). We are more than 99 percent identical. So, if you know someone who has bipolar disorder, why not concentrate on speaking to the 99 percent of that person’s humanity that really matters?

Talk is not cheap. It pays to use words that encourage, enlighten, and empower. You can make a positive difference in your loved-one’s recovery and in your peace of mind.

Tragic California Case Exposes Failings in Our Mental Health Care System

CareforYouMind Feb 10,'15

Rusty Selix
Executive Director, Legislative Advocate
California Council of Community Mental Health

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
While Mr. Paroutaud’s story is unique, his circumstances were not. Upon his release from the hospital, he needed intensive, monitored care. That’s not what he got. Generally speaking, commercial health plans limit coverage to two levels of care: level one is a once a week therapy visit for mild to moderate problems and medication management; and level two is hospitalization.

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
My hope for a health system that offers comprehensive mental health services to better address the needs of individuals with a mental health condition is not pie-in-the-sky wishful thinking. In fact, this model of care, with multiple levels and degrees of intensity, already exists within the California Medicaid system. In our public programs, care ranges from community-based health management through low-intensity community-based services, high-intensity community-based services, medically-monitored non-residential services, medically-monitored residential services, and medically-managed residential services (i.e., inpatient treatment).

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
Fred Paroutaud was denied access to stepped treatment and his story is tragic. It is thanks to his widow and her persistence that we know about it at all. Unfortunately, many people suffer similar situations and denials of care, but we do not hear about them.

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.

Questions

• How have you been denied equal insurance coverage for a mental health condition? Tell us your story.
• What levels of treatment are available to you under your health plan? Are they sufficient?

Bio

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.

I'm grateful for all of the support that got me through my time of recovery. Today I appreciate the support I have in gaining more wellness each day.

Allen Reflects on Thriving in 2014

As DBSA’s 2014: The Year of Thriving comes to a close, it seems appropriate to reflect on what we’ve accomplished this past year, and to think about what’s yet to come.

At the beginning of 2014, we outlined our vision of a future where every adult and child living with a mood disorder has the opportunity not just to survive, but to thrive. To some, this was a message of hope; to others, it seemed a goal almost impossible to imagine. I completely understand how some of my peers might find total wellness to be an unattainable goal. Indeed, I too have experienced times in my life when the only reality I could imagine was the intense pain of depression. In fact, I experienced times this very year when thriving seemed so very far away for me personally. But amidst messages about the danger and drain of people with mental health conditions, and my own concurrent thoughts of self-loathing and self-stigma, to know that there was a community that would hope for the return of my best self was a blessing. To hold hope when we cannot carry it ourselves: this has always seemed, to me, the fundamental purpose of peer support. DBSA was founded on a model of peer support, and DBSA will always be about creating opportunities for peer support, and through peer support—the thousands of people meeting in communities across the country—we are creating a world in which all of us may be reminded of our potential, our strength, and our best selves.

For me to return to a place of thriving took a lot of time and work and collaboration. It also took some luck. For I have been very lucky: to have found clinicians that do not put limitations on what my life can be; to have the support of loved ones and colleagues who remind me of who I am, not what condition I live with; to have insurance that gives me access to quality health care that covers both my physical and mental health; and to find inspiration in my work and the amazing people I have the privilege of working with, and for, in my role at DBSA.

Such good fortune—in clinical collaboration, in supportive community, in access to resources, in meaningful work—are what I, and the DBSA Board and staff, want for everyone, not just the very lucky.

So in 2014, we asked our peers, families, clinicians, researchers, politicians, and the public to expect more. We asked our community to promote and seek full wellness—because better is not well, and everyone deserves the opportunity to thrive. 

I am proud of the work DBSA accomplished in 2014, and I encourage you to review our 2014: Year of Thriving programs. I believe that we did open minds—and even a few doors—to the possibility of thriving. A few highlights include:

• In January, DBSA welcomed the Balanced Mind Parent Network into our family of programs to enable us to provide critical support for parents and to create a thriving future for children living with mood disorders.
• In April, Target Zero to Thrive asked clinicians and peers to set zero, not just reduced, symptoms as a new standard for successful treatment. 
• In May, DBSA kicked off our six-month Positive Six: Thrive campaign, challenging us to make a small change each month to support our health.
• In June, DBSA completed a third contract with the VA to train their Veteran peer specialist workforce.
• In August, DBSA joined forces with DBSA New Jersey to host the From Surviving to Thriving weekend of public and chapter educational events featuring a special interview with Demi Lovato.
• In September, DBSA hosted Better Is Not Well—a peer and professional panel that explored ways to elevate mental health treatment to complete wellness.
• This fall, DBSA hosted a series of webinars on Treatment Choices, Health Care Reform, and Restoring Intimacy.
  
• In November, DBSA issued the WHO-Five Challenge to mental health professionals to integrate wellness measurements, like the WHO-Five, into their practice.

But so much more must be done. So we ask,

“What needs to happen for us to have wellness change from being a possibility for some to a probability for most?”

It will require:

• Better Treatments: DBSA will continue to work with our esteemed Scientific Advisory Board to integrate peers into the development of new and better treatments— medical and non-medical. And, to connect our peers and parents to studies that hold the promise of a brighter future for ourselves, our children, and our peers.
• New Measurements: DSBSA will continue to promote widening the definition of treatment success to include not just elimination of symptoms, but presence of wellness.
• Access to Quality Mental Health Care: DBSA will continue to advocate for the rights of all adults and children living with mood disorders to receive access to quality mental and physical health care.
• Increased Expectations: DBSA will continue to spread the message that better is not good enough. That wellness IS possible. That everyone deserves the opportunity to not just survive, but thrive.
• Peer Support: DBSA is committed to continuing, and increasing both the availability and quality of, life-saving in-person and online peer support for people who have diagnoses, parents, family, and friends.
• Inspired, Imperfect Action: DBSA will continue to ask ourselves, our peers, our parents, our clinicians, our legislators, and our communities to take action. It may be small. It most certainly will not be perfect. But it will be progress—action inspires action, which in turn inspires more action.

We made some significant strides this past year, but we do not fool ourselves by believing that these first steps have produced monumental change. That will take persistence. That will take courage. That will take time. That will take hope. That will take ALL of us.

It is through thousands, indeed millions, of inspired, imperfect actions that we will slowly transform these small steps into big changes and create a future where wellness is no longer a possibility for only some lucky few, but a probability for all.

Thank you for joining us on this journey,

– Allen

I have many cherished friends living with major, "invisible" health challenges. Everyday they work very hard to prevent others from knowing of their struggles. They work to "pass" as being just another face in the crowd.

http://wp.me/p4E9xY-aD

Governor Haslam says he is not as "optimistic" about a Tennessee Plan as he was 6 weeks ago.  I take this to mean the federal government is unlikely to accept any proposed elements of the Tennessee Plan that violate or contradict federal law or regulation.  He is not going to be able to write the rules.  He is going to have to follow them.  If the condition of him fighting for Tenn Care expansion is for it to be an easy fight he is not going to make the fight.

The election has been in the strangest of circumstances the "dead period" (What kind of political system makes it off limits to talk about the most important issue to face for fear someone would have to take a stand on it?)  It is now time to define the conversation that will govern the decision on Tenn Care expansion.

The people who would have us vote no on Tenn Care expansion will try to make us believe that a no vote is the only way to save us from a federal menace that will lead us to chaos.  In face of all the facts to the contrary that is momentous argument to make but that has never stopped a politician yet.

The voice missing is ours.  It is time for Tennessee to be for Tennesseans regardless of their socioeconomic status and for politicians to talk to the people they work for.  Share your story and your concerns today.  Call your legislator and speak to him today.  You will only be heard if you speak.

You are invited to legislative plaza in Nashville on November 10.  Linda and I will be having a "Speak to the people" rally.  46000 people have spoke.  They have signed a petition urging Governor Haslam to expand Tenn Care and we will deliver that petition.  Other people in the coverage gap will be speaking.  We hope to see you there about 11am. Please share this post and spread the word.

Thanks a lot.

Larry and Linda

Ordinary heroes: Drains honored for speaking out for health care equality

B

y Linda    Braden

Larry and Linda Drain are quiet, unassuming people. But when circumstances arose that threatened Linda’s life, they both began speaking out, their voices ringing loudly to bring awareness to — and a solution for — themselves and others who have fallen through the cracks of the health care system in Tennessee. Their income is too high to qualify for TennCare, Tennessee’s public insurance program, and too low to qualify for federal subsidies under the Affordable Care Act, also called Obamacare.

In acknowledgement of their efforts, the Tennessee Health Care Campaign presented the Drains with the 2014 Heroes for Health Award in August at the John Seigenthaler First Amendment Center, Nashville. The award was given “for your dedicated support to affordable access to high-quality health care for all Tennesseans.”

The event honoring the Heroes was part of the Tennessee Health Care Campaign’s 25th Anniversary celebration. In addition to the Drains, Laura Sell was honored for the major work she did as a volunteer to promote and support enrollment in the Patient Protection and Affordable Care Act, collaborating with the Blount County Public Library.

Larry said, “It was a very eventful night. We got to speak to a lot of people, meet a lot of people that were heavy-hitters that we knew about or read about. That was neat. And to get people to treat us like we were important. As we were walking out the door, I said, ‘Linda, do you ever get over being surprised when people treat us nice?’ I’m surprised every single, solitary time. It’s just been a strange happening. When it first started out, we didn’t have a clue ... The way we look at it is that we are extraordinarily ordinary people, and the idea that people would know who we are or that people would listen to what we have to say — I wouldn’t have predicted that in a thousand, million years. Then when it took off, it went insane.”

Story begins

The story began with Linda, who has been drawing Supplemental Security Income (SSI) for some time because of epilepsy, brain surgery and additional health conditions. Larry said, “She has TennCare. She has to have the TennCare in order to live. If she does not have the medication, if she doesn’t have the medical care, she will die.

“Ten years ago, a good day for her was having 10 to 15 grand mal seizures. She went through brain surgery, and the last 10 to 14 years have been extraordinarily eventful, but the medication is her pathway to life.”

After Larry turned 62 last September, he decided to take early retirement and begin drawing Social Security.

“If I had to take all the dumb, stupid, worst things in my entire life that I have ever done, that one is so far to the top that there is not a second place,” he said. “The way we had it figured out, we could live if we took what she made in SSI and what I made in retirement. We weren’t going to be rich — in fact, we were going to be poor — but we would be able to pay our bills, do what we needed to do. We were going to be OK.

“After a couple of months, Social Security called us in and said, ‘You guys make way too much money.’ They were very nice, not cruel or mean or anything like that. ... But they said, ‘We have a limit on unearned income, and you guys are way over it.’”

Larry questioned how that could be, and was told that his Social Security retirement is considered unearned income. He said, “I asked them, how could that be unearned income? I worked 47 years for that. It’s my money. They said, legally it’s unearned income. They told Linda that her check for $720 was going to become $20. We were going to lose $700. I said, ‘I’ll just give the retirement back. I’ll just get another job and we’ll be OK.’ And they said, ‘Well, you can do that, but the only way you can do that is to give us back every single penny we have given you today.’ Well, if I could give it all back today, I would never have needed it to begin with.”

No recourse

Larry thought he could continue drawing his retirement and also have a job to make ends meet. He said, “What they said after that has basically driven the whole situation. They said, ‘You have to understand, that because your wife is on TennCare, if you make over $85 in a month, she will lose her TennCare.’ So we went home, and we did all the figuring we could.”

Their projected budget for January would leave them with $30 for essentials such as food and gasoline, and the following months would be worse. “We looked at everything we could, trying to find a way. ... But there wasn’t a way,” Larry said. “We were in a position where, if I got a job to give us enough money to live on, it would kill my wife. It would take her insurance away, and it would kill her. If I didn’t get a job, we couldn’t live. We couldn’t live on a dollar a day. It just wasn’t doable. So on Dec. 26, after 33 years of marriage, we separated.”

The original plan was for Linda to stay with a relative until they could find her a permanent place so she could retain her SSI and TennCare. Larry would then find a place as close by as he could. Larry said, “At that time, our understanding was that, according to the way the laws were in the state of Tennessee, we would never again live together as man and wife.”

There were two possible solutions: Change Social Security laws or expand TennCare, the state’s managed Medicaid program which provides health care coverage primarily for low-income children, parents, pregnant women and elderly or disabled adults. Social Security laws were not going to be changed, but Tennessee Gov. Bill Haslam could spearhead expansion of Medicaid. Larry said, “If he expanded Medicaid, then Linda didn’t have to be a member of a category, she didn’t have to be ‘disabled,’ to get it. All she had to do was be poor. If he expanded Medicaid, then she would have her insurance, which meant we could live together, I could get a job, and although we’d struggle, we would live. Without him expanding Medicaid, we had no help at all.”

Letters to governor

Larry began drawing attention to the need for TennCare expansion by writing a series of letters to the governor. Some were very personal, some general and policy oriented, but in each letter, Larry pleaded with Haslam to submit a plan for TennCare expansion. The 100th letter was emailed on Sept. 2. As of that date, the governor had not responded to the Drains, but he did announce on Aug. 28 that he plans to submit a proposal to Washington to expand Tennessee’s Medicaid program. He did not release any details, however.

Larry said more than 1,200 individuals from across Tennessee have told him they also contacted Haslam. Larry’s 100th letter to the governor begins to list the names, and he plans to continue adding names in subsequent letters until every one is included.

Each letter is available atdeargovernorhaslam.wordpress.com and is viewed by 4,000 to 6,000 persons daily. In addition, a petition entitled “Gov. Haslam: Expand TennCare and Let Me Stay With My Wife!” at www.thepetitionsite.com has almost 46,000 signatures in support of the Drains.

The Drains’ story was told in the Nashville Tennessean and other major news outlets, drawing even more attention to those who, as Larry said, “didn’t fall through the cracks — we live in the cracks.”

Twenty-five miles separate this couple now. Linda is in Knox County, while Larry is in Blount County. They are waiting for the time when they can once again live together as man and wife without Linda losing her life.

Larry said, “I should not have to drive 25 miles to see my wife. It’s wrong in every sense of the word.”

Linda and Larry Drain

Exciting news is always welcome. One of our own steps out to bring national attention to those suffering due to lack of medical healthcare coverage.  Links to articles in The Tennessean and USA Today are below.

Larry Drain, DBSA Tennessee Legislative Liaison, is well known among many for his staunch work in advocacy for health care for all. Larry and Linda Drain share their story, open up their lives, in hopes that many will find the help they need. After 33 years of marriage, Larry and Linda had no other choice but to separate in order for Linda to keep the healthcare coverage she so desperately needs. Also, Larry is without healthcare coverage because his income is "too low" to meet the requirements for coverage.

The NBC Today show asked to interview Larry and Linda. The interview is expected to happen today. Airing of their interview is expected some time this week. Let's all send our best wishes and thoughts to this couple as they do all that they can to see that no one else needlessly suffers in like fashion.

Respectfully, 
Steve Brannon
State Director
DBSA Tennessee
sbrannon@DBSATennessee.org

Links to Larry and Linda's story:

http://usat.ly/VSQXne

http://tnne.ws/VSQCAY

KNOXNEWS.COM

Decision on Medicaid Expansion holds coverage for many Tennesseans in balance

By Kristi Nelson

Posted June 2, 2013, updated June 4 2013

It was supposed to be one of the strongest tenets of the 2010 Patient Protection and Affordable Care Act. Instead, it became a political football, a metaphor for states’ rights. After the Supreme Court ruled that the ACA could not force states to expand Medicaid, Gov. Bill Haslam was among those who rejected the Medicaid expansion, instead offering his alternative “Tennessee Plan” for federal government approval.

But whether the federal government and the General Assembly will accept Haslam’s plan remains to be seen, along with how well it will work to cover those who currently don’t have health insurance.

“He’s either politically brilliant, or he’s making one of the worst mistakes he could make,” Rep. Joe Armstrong, D-Knoxville, told the News Sentinel in March.

What the ACA intended

Originally, the Medicaid expansion provision was to give state health insurance coverage to a group of people who made too much to qualify for Medicaid but too little to afford insurance on the health insurance exchanges, even with the planned government subsidies.

It expanded Medicaid to qualify people younger than 65 whose income is below 138 percent of the federal poverty guideline (a little more than $15,860 annually for an individual, a little less than $32,500 annually for a family of four).

It meant that, for the first time, low-income adults who don’t have children could get state Medicaid coverage, and it standardized other qualifications.

Many states, including Tennessee, limit Medicaid enrollment to certain categories of people. To qualify for TennCare, for example, you have to be low-income and pregnant, a child, blind, disabled, aged, or fall under multiple, specific categories.

Tennessee has nearly 1 million uninsured residents, of whom at least 140,000 and maybe more than twice that number, by some estimates, likely would enroll in Medicaid if it were expanded under the ACA guidelines. About three-quarters would have been previously uninsured. Under the ACA expansion, the federal government would pick up the entire cost of new, previously ineligible enrollees for the first three years, phasing to 90 percent by 2020. In Tennessee, federal funds would have amounted to about $1.4 billion in the first year alone.

States could receive federal matching funds for covering additional low-income residents under Medicaid as early as April 2010, with wide-scale enrollment beginning this October and coverage starting Jan. 1, 2014. However, in June 2012, the U.S. Supreme Court ruled that the federal government could not make states expand Medicaid — making a linchpin of the ACA optional.

So far, 20 states have moved forward with Medicaid expansion. Ten have rejected it outright, while 10 others are not doing it now but are looking at alternatives and have not ruled it out for the future (the government gives no deadline, though states waiting much longer to decide stand to lose federal funds for the first year). Three states are still undecided, while seven — including Tennessee — are crafting their own, alternate plans.

On March 27, Gov. Bill Haslam announced that Tennessee would not expand TennCare rolls under the ACA, instead offering up an alternative he called the Tennessee Plan.

“I don’t think just pure expanding of a system that we all agree is too costly for us, is too costly for the federal government to afford long-term, is the right way,” he said then.

The ‘Tennessee Plan’

Haslam’s proposal is that the state use federal funds not to expand TennCare but to purchase private insurance through the insurance exchange for people who would have qualified for coverage under Medicaid expansion.

He outlined the proposal in the broadest terms, including five “key points”:

Individuals identified as being eligible for the Medicaid expansion group would instead be directed to the exchange, where they would be allowed to choose any qualified health plan that offers a certain level of benefits (the Silver Plan).

The state would pay the monthly premiums, matchable with 100 percent federal dollars, for those people to enroll in the Silver Plan.

People in the Medicaid expansion group would be treated like all other people enrolled in the Silver Plan, with access to the same benefits and appeals process as other people in the plans.

People in the Medicaid expansion group would have the same cost-sharing as other Silver Plan enrollees with incomes below 250 percent of the federal poverty guidelines. (On average, Silver Plan policies would pay for 70 percent of health care costs, with the remaining 30 percent paid by the planholder.)

The arrangement would have a “circuit-breaker,” or “sunset,” ending after the three-year period of 100 percent federal matching dollars, and could be renewed only with approval of the General Assembly. (This is true for states accepting the Medicaid expansion as well; they can stop using federal funds and drop the expanded coverage at any time.)

In addition, Haslam would seek to reform the way providers are paid for services, with payment based on outcomes rather than a set fee for services. The money saved, he said, would be enough to cover the state’s 10 percent share of costs after the government’s share goes to 90 percent.

“One option for covering the Medicaid expansion group is simply to add them to the Medicaid rolls, or the TennCare rolls, in our case,” Haslam said of the plan. “We don’t want to do that. There are a lot of federal requirements that come with Medicaid that make it difficult to provide quality care in the most cost-effective way possible.”

But the federal government may not allow Haslam to forgo some of those requirements. While national Centers for Medicare and Medicaid Services guidelines indicate that the main tenets of the plan — using federal dollars to pay premiums for low-income people to have commercial insurance, and reforming payment — meet federal requirements, some of the details don’t align with federal requirements intended to protect Medicaid enrollees.

For example, Tennessee would need to give those with serious health conditions a choice of enrolling in TennCare or private insurance, unless CMS were to grant Tennessee a waiver to that requirement.

The federal government would require supplementation of benefits (sometimes called “wraparound”) to make sure the commercial insurance plans include all services that would be available through Medicaid. Hypothetically, this could be done through a supplemental premium to the Silver Plan insurance provider.

The government also limits co-payments for Medicaid-eligible enrollees.

There is also an appeals process in place, required by past Supreme Court rulings, so that Medicaid patients and their doctors can challenge insurance companies’ refusals to cover “necessary treatments.” Under federal law, Tennessee would have to allow Medicaid-eligible patients this due process.

A federal entitlement program, Medicaid was designed for a population upon whom “poverty imposes special needs and the need for special protections,” said Carole Myers, a nurse practitioner and associate professor in the University of Tennessee’s College of Nursing. “They don’t have the same voice in government as those with different economic statuses and organizational affiliations.”

Haslam acknowledged in April that Tennessee probably would have to limit co-payments and provide the wraparound services for Medicaid-eligible enrollees for the federal government to approve his alternative, but he said he still thinks his overall plan is “workable.”

What’s next?

Haslam’s plan is modeled on a plan by Arkansas, which also wants to use federal matching dollars to pay commercial insurance premiums for those eligible for the Medicaid expansion. But while Arkansas got legislators’ approval before approaching the federal government, Haslam has taken the opposite approach, presenting his plan to CMS first.

Haslam did not ask state legislators to vote on whether to take the federal Medicaid expansion funds this session, though he said he has not ruled out calling a special legislative session later this year to meet federal deadlines for the health exchange enrollment starting in October.

The Medicaid expansion is the only provision in the ACA that provides insurance coverage specifically to those between 101 percent and 138 percent of the federal poverty guideline. If Haslam fails to reach an agreement with the federal government, or does not opt to accept the federal Medicaid expansion plan (which he could still do), that population likely would remain uninsured.

However, the latest word among hospital executives and advocates is that an agreement could be near.

“I think (Health and Human Services) Secretary (Kathleen) Sebelius is really eager to find some alternative plans that meet the goals of the ACA but do so in creative ways and allow states to create plans beneficial to those individual states,” said Jerry Askew, senior vice president for governmental relations for Tennova Healthcare.

Through Tennova’s parent company, Health Management Associates, Askew works with hospitals in seven states. All of them, except those in Kentucky and West Virginia, have said no to the expansion.

“They’re all trying to figure out what to do. It’s really interesting to watch how the state is to meet their individual objectives,” Askew said. As for Tennessee, he added, “It is fair to say that the governor’s plan is being built on principles that the majority in the Legislature would agree with. But it’s not a given. It’s a lot of hard work.”

Consumer-advocate groups and hospitals were in favor of the expansion, especially since hospitals stand to lose money on uncompensated “charity” care that would have been partially covered, at least, if more people were insured through Medicaid. The Tennessee Hospital Association has said the state stands to lose 90,000 jobs and nearly $13 billion.

Having that population continue to go uninsured also means higher costs in the long run, Myers said, as studies have shown that those without insurance are less likely to get preventive or early care.

“When you are resorting to getting care only when it becomes so bad you can’t stand it, and you’re in the emergency room, it’s causing a major human toll,” she said. “We know that intervention on the earliest point of the illness trajectory is the most cost-efficient. The true measure of whether we’re successful in what we’re doing in health care is in whether people have long, happy, productive lives.”

Business writer Carly Harrington contributed to this report.

 © 2013, Knoxville News Sentinel Co.

Thanks for the support
by Larry Drain, hopeworkscommunity

The following organizations have offered support of "Dear Governor Haslam".  They have put links to this site or printed the letters on their websites.  I really appreciate it.  I invite you or your organization to do the same.


Tennessee Health Care Campaign.
Tennessee Citizen Action.
Tennessee Disability Coalition.
Tennessee Chapter Depression and Bipolar Support Alliance.

AGAIN THANKS.

WRITE GOVERNOR HASLAM TODAY

hopeworkscommunity | June 1, 2014 

Murphy misunderstandings

byLarry Drain, hopeworkscommunity

Rep.  Murphy has not went gently into the good night.  Dr. Torrey will never go gently into the good night.  They are trying it sounds like to provide cpr to their bill. Rather the things that didnt work the first time will work on second effort is anyone's guess.  I think sometimes it is really hard for annointed national spokesmen to realize they are not and never were.

But this post is not about that.  It is about a fundamental misunderstanding of the American mental health system that was part of the reason that may have doomed the Murphy Bill from the start.

Murphy seemed to believe we were doing far too much for too many.  He thought people who were doing better in the system were robbing those who were doing poorly of help and resources. And he thought if resources were properly allocated things would be okay. Using terms like "worried well" he seemed to want to pit one group against another or at least give worried family members someone to blame. Somehow, I never really understood how, he seemed to think that this misallocation of resources was the fault of Samsha. It was us against them, with guys in black hats, just lacking an afternoon channel from being great soap opera. People were getting rich, famous and powerful off the worried well and just abandoned those in serious need. It had drama, moral outrage, and more than a little passion. It just lacked truth.

Anyone who had watched or been part of the last few years would tell you that state after state year after year had cut their mental health budgets to the bone. In some places there was only skin. The bone had long since disappeared. It was not that too much was done for too many. Too little was done for everyone. Many people lacked insurance and couldnt even access the services that were there. It wasnt misallocation of funds. It was abandonment. Never, not once, have I ever heard anyone touting the Murphy bill ever acknowledge this.

The baggage from Dr. Torrey obscured their vision. No state bought his love affair with psychiatric hospitals. It was too little bang for way too much bucks. No one believed. It was a cash cow around their necks that threatened to bankrupt their community systems. There was little or no proof it worked. When insurance companies basically stop paying for a service that service is on borrowed time. No one drank the kool aid any more.

There will probably always be psychiatric hospitals. But they will never be the centerpiece of the mental health system again. Putting your money into backline services, what you do when things go wrong, destroys your ability to keep things from going wrong. There was never any conspiracy. People just decided what they thought mattered and all of Dr. Torrey's pr and marketing campaigns just didnt change that. In the end I dont think federal law can bring back psychiatric hospitalization as the gold standard of mental health care. The truth is that even people with "severe mental illness" can and do make it in their communities with effective support and services.

The notion that one group of people needing help was more worthy than another and that they were in competition just seemed like such a mean and stupid notion. It completely just ignored the reality of the bloody battle for funding that is the reality for so many states. It was a pseudo explanation for the fact that state after state just said "Dr. Torrey we dont buy what you say and your way will not increase the amount of services for people with severe needs but radically decrease it."

Count me cynical. Count me way cynical. Murphy lost because it was never about a battle for the "severely mentally ill." It was a battle for Dr. Torrey and a vision found lacking a long time ago.

hopeworkscommunity | June 11, 2014

Will you speak???

by hopeworkscommunity

The opposition to Medicaid expansion is loud, organized, powerful, aggresssive and persistent.  Many people believe that the fight is over with in Tennessee. They point to the opposition in the legislature and wonder how they can make a difference. Expansion seems like such a no brainer in so many ways. I cant remember when the state of Tennessee had a chance to do something with the ability to help so many people so much. Yet it seems so far away.

It will take people who believe in it speaking up, speaking a lot, and speaking a lot more. Silence will only confirm what is. If what you say matters, saying nothing matters even more. Will you speak up??

There is no assurance it will make a difference. There is no promise you will be heard. The only promise is what will happen if you dont.

We need each other. Badly. Speak out. Write. Call. Email. Do something and then support someone else in doing the same. Vote each and every day the matters of your heart.

If are voice is to matter then what we do must matter.

Speak today for Medicaid expansion. Speak tomorrow and the day afterward. And continue speaking until you are heard and make a difference. If you dont speak for the people in need now who will speak for you in need.

Tomorrow will be my 13th letter to Governor Haslam. The day after that will be the 14th. Please join me. Contact Governor Haslam today.

hopeworkscommunity | May 29, 2014

The Murphy bottom lines

by hopeworkscommunity

When you strip away all the fancy words and the tons and tons of rhettoric about what the Murphy Bill says and simply ask yourself "What is the plan?" you get a few core ideas.  What does Rep. Murphy think we actually need to do to serve the severely mentally ill?    There are many other provisions of the bill that has nothing to do with what I am about to talk about. Many of them are the most positive features of the bill.  But this is what I think the essence of the Murphy plan is.  These are his bottom lines.  These are his "new ideas."

He believes, in effect, that many of the severely mentally ill suffer from a defiency of psychiatric hospitalization.  He seems to see that as the answer to so many people with "mental illness" being in jails and prisons.  He thinks that way too many hospital beds are gone and it is time to increase hospitalization radically.

 Perhaps I am wrong but I believe that ship has sailed.  A mental health system with psychiatric hospitalization as its corner stone is not financially sustainable in this country.  Insurance companies pay less and less for it.  They do not see it as medically necessary but in the most extreme circumstances and then for brief periods of time.  In Tennessee I believe most psychiatric hospitals are struggling to break even and most of them are losing that struggle.   States are getting out of the business.  They realize that a large hospital system leaves them unable to finance a community system and if you dont have a community system to serve the people coming out of the hospital what is the point of the hospital.  If you look at how often and how quickly people leaving the hospital system end up back there you begin to realize the impact of disemboweling the community system.  I cant even imagine the circumstances under which Tennessee would act to increase the beds in any kind of dramatic way, indeed in any way at all.   It is far too little bang for way too many bucks.  

His method for making psychiatric hospitalization possible is to remove the IMD exclusion on medicaid funding.  Basically it makes it possible for medicaid to then pay for state psychiatric hospitals.  One question comes to me immediately.  If Congressman Murphy thinks that medicaid funding is such an important part of mental health reform why did he vote to repeal the ACA over 50 times?  That bill through its provisions for medicaid expansion would have given millions of people with "mental illness" access to programs and services that if he has his way they will never access.

A couple of other questions come to mind.  What about the people who dont have medicaid access?  Many people with "mental illness" and particularly many people who are having serious problems in life simply dont have insurance.  Another question is the response of states to finding out now that medicaid funds can pay for psychiatric hospitals.  In most states that I am aware the medicaid program eats up a considerable portion of their state budget and I really question, particularly in the states that choose not to expand medicaid, how receptive they will be to finding out that medicaid expenses are about to soar through the roof.  In Tennessee the most likely two responses are to adopt the private insurance definitions of medical necessity and decide not that many people need hospitalizations and/or cut benefits and provider payments to pay for any any expenses the increase in hospitalization is likely to cause.  The provider rates for psychiatric care, at least in Tennessee, are so low that very few people will even provide services anyway and there is a serious real question about where the professionals to do all this treatment are to come from.

Even if you start to use medicaid funding it does not begin to pay for all the new costs.  The state institutions in Tennessee for example are aging. There is a need for new buildings and new spaces if beds are added.  Who pays for new hospitals??  What about the cost of new staff??  Who pays?  I can only speak to Tennessee but there is no commitment to psychiatric hospitalization, especially on a massive scale, as the answer to anything by state officials, by mental health professionals. by anyone that I know and removing the IMD exclusion is unlikely to change that.  The strong perception is that the community system is the most cost effective and effective means to help people meet their needs and that it is defiencies in that system that lead most to people falling through the cracks.

And even if it was possible would it work?? I know of no evidence, that other than providing a place for stabilization, that psychiatric hospitals work in any enduring fashion. They dont, if you look at return rates, even work well enough to keep people out of psychiatric hospitals.

I dont know but would be willing to hazard a guess that many of the "mentally ill" in the prisons and jails have had considerable psychiatric experience with little or no solid gains. Criminal behavior is not a symptom of mental illness and the "put them in the hospital" solution ignores things like poverty, drug addiction, racism, lack of work, homelessness and history of trauma and other adverse events that lead to someone actually committing criminal acts. The other thing to consider is not the degree to which "mental illness" causes criminal behavior but the extent to which incarceration causes "mental illness." Is treatment needed?? Are mental health resources needed and might for some people those resources be inpatient resources??? Of course. I wonder what percent of those people in jail would even meet the criteria for hospitalization?? I dont know the answers but tend to believe it is the lack of effective and accessible community resources that engender emotional involvement with the people they serve that is the root of the great numbers of "mentally ill" in jails and prisons.

Another core point of Murphy is that he believes that too many people get mental health services and that it is the "worried well " that are basically stealing resources that are better used by the severely mentally ill. Given the fact that most mental health systems have been starved and cut back over the last few years it seems a little like telling one person eating bread and water that the the person next to him is eating too much bread and water and not considering that the problem is the diet of bread and water. It is an argument of little integrity that resorts to an us vs. them argument as a pseudo explanation. It ignores totally the fact that state legislature after state legislature has sacrificed their mental health system on the fires of "financial responsibility" over the last few years.

There are without question people who are victims of a psychiatric system eager to diagnose every event in life as an enotional illness. There is a reason that pharmaceutical companies make money. But there are also people who struggle every day with serious mental health issues, trauma, and distress and to dismiss those people as dupes or malingers is stupid, dishonest and evil. If you think the biggest problem in the mental health system is that too many people need or are seeking help then you are a simple minded person not worthy of being taken seriously.

If you take the notion of "worried well" seriously it takes you to some strange places. How do you decide who is "worried well"? Who decides? Based on what criteria? What do you do to the "worried well"? Do you limit their access to services? How? How much and why? If you dont limit their access to services arent you being complicit in the people who need help being hurt?? And how much is all this going to cost?? Do we need programs to make sure that people who need services get them and another program to make sure those that dont are kept out. This is a treacherous notion that if you take serious leads to nightmares.

Another core notion is making assisted outpatient treatment a law in every state. They tell you that aot is a major problem solver but dont really explain why most of the 45 states that have it dont really use it. And they dont really explain why you need to make something a federal law that is already a state law. And they dont really explain why if 45 states can choose to have it 5 states cant.

I think the truth is that most states who are not willing to throw $32 million a year at it like New York find it more irrelevant than anything. It costs too much and does too little and in an environment of increasingly limited resources is not something that a lot of people are going to turn to to solve many things. And none of this even begins to touch on the questions of choice and coercion that so many people find so fundamentally troubling.

Another core notion of the Murphy Bill is that too many people complain about the human rights of people in the system being important and those people need to be quiet. It would basically eviscerate the protection and advocacy programs like Paimi and legislate away their voice. The idea that people in the system dont need protection is naive and self serving and something you might figure a psychologist or psychiatrist might come up with. Ask anybody in the system. See how safe they feel in the system.

The final key element is to do away with the notion of recovery and the best way to do that is to cut the legs out from under Samsha. Samsha is as close to a boogeyman as there is in this play. They are blamed for everything bad that has happened or will happened. The fact that thousands of people have found recovery to be a real thing is explained away by saying they probably didnt need help anyway or that they are in a remission that would have happened anyway regardless of what they did. If you dont like what you see it works really well to convince yourself that it was really something else.

Samsha is blamed for many things it doesnt decide about. The state of Tennessee decides what kind of services it will offer the people it serves....not Samsha.

Like I said at the start there is more to the Murphy Bill than what I have described here. He took a lot of peoples good ideas and made them part of his bill. None of them seem though to be core elements that define the bill and that is a shame. He has told people he will work with them on a better bill but no one knows what that means because he has compromised on nothing. I have been told by a lot of people I know that is bill is in trouble and very unlikely to be passed as written. I dont know how true that is, but know it is in everybodies best interest to know the bottom lines of what he proposes and decide what that means for them and the way they would like to see the mental health system change.

hopeworkscommunity | May 16, 2014

If the mental health system was sane…

By Hopeworkscommunity

There would be a range of services availible reflecting the human needs of those it serves.

Those services would be availible to those that need them.

Those services would be based on what works, not what makes money, reflects any particular philosphy or interest, and not because it is what we are used to doing.

Asking for help would not label someone, brand them, be a cause of shame, a source of discrimination.  Asking for help should not be a problem.

It would realize that lack of a place to live, lack of food, lack of adequate clothing, lack of a job are frequently barriers and problems for the people they serve and address them in a direct and effective manner.

It would know that inadequate health and inadequate health care are common problems for the people they serve and be part of an effort to serve the entire person in an integrated fashion.

The goal would be to empower, educate, and support people towards gaining control over their lives so as to maximize their chances of leading happy, meaningful and successful lives.

This would not be empty words, but a passionate conviction that fuels and structures everything done in the system.

It would not mistake the people it serves for the labels it places upon them.

It would know that the most important thing about help is that it is what you do with people and not what you do to them. It would see itself as partnering with the people it serves.

It would know that people can say no and that not be a symptom of illness or distress.

It would view peoples values, hopes, thoughts, and aspirations as a source of strength and not a symptom of illness.

It would take substance abuse ultimately seriously. Drinking and drugging are the two primary ways people with mental health issues try to treat themselves.

It would make sure that one of the core experiences that someone seeking help has is contact and interactions with others who have dealt with similiar issues. It would treat seriously the idea that you can learn from the experience of others and them from you.

It would not tell people who have hard times or more problems they have failed or are failures.

It would take the issue of trauma seriously. Knowing how people have been hurt and not being part of hurting them further should be cornerstones of the system.

It would treat the issue of what happens in jails and prisons to people with mental health issues as a moral outrage and the impulse to do something about it as a moral necessity.

It would be honest about the risks and benefits of psychotropic medication. Help people to make real and informed choices.

It would treat families as important and not as irrelevant or a threat to what it is doing.

It would treat justice as a driving force and value in everything it does.

It would be honest with the people it serves about what it doesnt know if it wants them to have trust in what it does know.

It would attack the issue of suicide with passion. No one should ever feel like death is the best solution to life.

It would tell people that no problems make you less human,

It would view hope as realistic and know that when they dont they do more harm than good.

Larry Drain

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.”