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".
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.
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:
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:
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,
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
Help available for dealing with depression
Beth Knoll 12:39 a.m. CDT August 27, 2014 The Jackson Sun
A life lived with depression can feel like a "deep, dark place," said Steve Brannon. But with a variety of pathways to recovery, hope is never out of reach — even during the toughest times.
Society often views depression in extremes, said Brannon, state director of Depression and Bipolar Support Alliance of Tennessee, as depression is often seen as an untreatable illness — or not as an illness at all. Depression should be taken very seriously, he said, but it shouldn't be approached in a "fatalistic" manner.
"Depression is treatable, and it responds quite well to treatment," Brannon said.
Describing depression as the "common cold of emotional mental disorders," Paul Deschenes — clinical psychologist and director of counseling services at Union University — said most people experience depression at some point in their life
Deschenes said depression can be caused by a variety of factors, including the weather or the loss of a loved one. Because depression can be genetically based, it has the potential to be passed from one generation to the next, Brannon said.
In many cases, feeling depressed is normal, as no one is happy all the time, Deschenes said. What is not normal is when the grief and sadness continues indefinitely and begins to interfere with major areas in a person's life — signaling a more significant form of depression.
"They might experience things like negative thinking, self-criticism," Deschenes said. "They might experience feelings of hopelessness. Some people have thoughts of self-blame, and generally the thinking gets very negative, pessimistic. They might see the glass as being half-empty rather than half-full."
Additional symptoms can vary and even seem contradictory, Brannon said. Some people develop an increased appetite when they are depressed, while others may lose their appetite. Some people may sleep more often, while others experience insomnia. Some people may voice their thoughts of hopelessness, while others may not say a word.
Brannon said that a person with depression may stop bathing or using proper hygiene, and he or she may stay in the same clothes for weeks at a time. Deschenes also noted that a person may feel a loss of energy in accomplishing everyday tasks, as well as experience a decreased sex drive.
People who are depressed are more likely to develop other health conditions such as diabetes and heart disease, Brannon said. Their lifespan also can be shortened up to 25 years.
"It might affect their relationships," Deschenes added, because people experiencing depression often decline invitations for social engagements or drop out of church. "Ultimately, left untreated, some depression might get so bad that it turns to suicide."
Deschenes said a depressed person often wants to sit at home and be alone with their thoughts, which can fuel negative feelings. As a result, he said people should get out of the house and begin taking small steps to return to a healthy level of functioning.
Picking up an enjoyable hobby or volunteering can help ease depression, Deschenes said. Because depression can cause distorted thinking, spending time with positive people can halt irrational and harmful thoughts as well.
Exercise also can help people overcome depression and could be as effective as medication in some cases, Deschenes added. In addition, he encouraged people to return to church if they have stopped attending, as a person's faith speaks to issues such as hope.
"Whatever help an individual goes for, we recommend that folks not only be very religious about medication but also go to counseling," Brannon said.
With new medical treatment options introduced regularly, Brannon said treatments can include transcranial magnetic stimulation, in which part of the brain is stimulated with magnetic waves. While the success rates can vary, he said the results have been encouraging and the technology is expected to continue improving.
Brannon added that people with depression should develop a support group. The individuals who form a person's support group need to check up on how the person feels emotionally, know whether the person is taking his or her medication and be available to talk whenever the person may need them.
The support group also needs to be able to recognize the symptoms of depression, as well as know when the depressed person is in need of medical attention, Brannon said.
Noting that teenagers and the elderly are more susceptible to suicidal tendencies, Deschenes said people should not be afraid of causing a suicide by asking if someone is suicidal. If someone is hinting at suicide or displaying suicidal tendencies, he said family and friends should approach the situation seriously and take the person to a mental health professional.
People also should not think that a suicide is inevitable for someone experiencing suicidal thoughts, Deschenes said. Most of the time, a person averted from a suicide attempt and helped by professionals can regain and lead a normal life.
"When people get into a deep, dark place like Robin Williams did, trust seems to go away," Brannon noted, as a dangerous sign of suicide is when a person stops trusting others to help them manage their depression. "It is times like that the support network has to realize that they can't help this individual they love — they need someone to call."
The National Suicide Prevention Lifeline, which can be reached at 1(800) 273-8255, is a valuable resource for people contemplating suicide, Brannon said.
Brannon noted that Jackson also has a mood disorder support group, called "A Better Tomorrow." Meeting at 6:30 p.m. each Monday at St. Mary's Catholic Church, the group provides encouragement, education and information services for people with depression, as well as their family and friends.
The group often becomes like an extended family for members, Brannon said, as people with depression can understand what other group members face.
"It's something about being understood that's healing in itself," Brannon said. "That is so valuable for someone living with depression. You can't put a price on that."
To learn more about the Jackson depression support group, visit the Depression and Bipolar Support Alliance of Tennessee's website at www.dbsatennessee.org. The alliance also can be reached at (731) 215-7200.
Reach Beth Knoll at (731) 425-9641. Follow her on Twitter @merribethknoll.
What to know
• The National Suicide Prevention Lifeline, which can be reached at 1(800) 273-8255, is a valuable resource for people contemplating suicide.
• Jackson's mood disorder support group, called "A Better Tomorrow," meets at 6:30 p.m. each Monday at St. Mary's Catholic Church. The group provides encouragement, education and information services for people with depression, as well as their family and friends.
• To learn more about the Jackson depression support group, visit the Depression and Bipolar Support Alliance of Tennessee's website at www.dbsatennessee.org. The alliance also can be reached at (731) 215-7200.
Steve Brannon(Photo: Submitted)
Paul Deschenes(Photo: Submitted)
Haslam may submit Medicaid expansion plan in fall
Tom Wilemon, firstname.lastname@example.org and The Associated Press
1 day ago
Larry McCormack / File / The Tennessean
Gov. Bill Haslam said Thursday that the state may soon submit a proposal to Washington to expand Tennessee’s Medicaid program but did not release any new details on how it might work.
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.
If the mental health system was sane…
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.
by Larry Drain
GOP Newtown bill hits impasse | TheHill
It sounds based on reports like these that the Murphy Bill is not going to pass as written. Things change I know, but it looks that way. There is I understand a democratic bill being written by Rep. Barber. Things dont seem to look really great. The really interesting thing is that it might not matter rather or not the Torrey crowd thinks they have made a great case. It may only matter whether or not they find common ground with people up to now they have shown no interest in finding common ground with. Rhettoric that they are so good with may not be their friend. Winning the battle may cause them to lose the war.
The next few weeks, next few months may be interesting. Common ground.... what a weird approach to American politics.
hopeworkscommunity | April 23, 2014
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
ACA Enrollment Ending Soon -
Hi folks, we just want to remind everyone that the enrollment period for Patient Protection and Affordable Care Act is drawing to a close for this season. The last day to enroll will be March 31st. To be covered by April 1st, the last day to enroll is even earlier - March 15. Enrollment will start up again November 15th and go through January 15th.
Below are links to Tennessee events and resources you might contact for enrollment assistance. Please forward this email to anyone and everyone you know who needs assistance or needs to hurry up and get covered already!
If you've already enrolled we'd love to hear from you. Click here to share your story and tell us about your enrollment experience.
Thanks everyone and best of health to you from all of us at THCC
By: Tennessee Health Care Campaign
Mental health stigma resides everywhereStigma resides everywhere, especially mental health stigma. The urge to quiet the voices of those who live with challenges, those who are different or those whose choices don’t mirror the “norm,” seems to be overwhelming as of late. “Don’t air your dirty laundry.” How many of us heard that admonition as children? When we talk about mental illness, too often there are only two approaches discussed: sick or well, right or wrong. We talk about strong people and the weak people, those who feed their depression and mental illness and those who stoically rise above. When we talk about mental health in such limited parameters, we strip it of the crippling humanity that makes it possible: agony, loneliness, shame, trauma and stigma. We just tell people to think the right way, get the right amount of sleep and exercise, take the right meds, and when they don’t, we tell them to go away. In our current society, the mentally ill are considered the disease as much as the illness itself.
Here’s the rub: Change and recovery occur when things are faced. An acquaintance asked me recently why I speak openly about mental health recovery and surviving domestic violence and sexual assault. This well-meaning person felt that by airing my “dirty laundry,” I would cause myself more pain. Actually the opposite is true. When the mentally ill speak openly, others know they are not alone. Others learn what worked and what didn’t. By speaking – at first a whisper, then a roar – we lessen pain’s power. We learn to cope, we change the norm and we affect the changes we want to see.
Be part of the conversationThere is a well-known saying in mental health and social work circles:
“Nothing about us, without us.”
Only by being part of the conversation can we affect legislation, self-advocate for better care and show society that those with mental health conditions can live healthy, productive lives.
Why should we stand up and “air our dirty laundry?” To help those unaffected by mental illness but whom are the gatekeepers of the systems we need access to, to understand our reality. Because it reflects one-in-four person’s realities. Because stigma born from misconceptions can only be corrected by those who are affected. Because society needs to see us living lives and being productive with the proper treatment. Because we learn the most from those whose voices society tries the most to silence.
Mental Health Stigma: Airing our “Dirty Laundry” Posted on February 8, 2014 by Paulissa Kipp
The bill, Helping Families in Mental Health Crisis Act (H.R. 3717), introduced by Rep. Tim Murphy of Pennsylvania, would cut funding for the Protection & Advocacy for Individuals with Mental Illness (PAIMI grant) by 85% and restrict DLAC from engaging in systemic or public policy advocacy.
S.L. Brannon D.Div..