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An activist is someone who cannot help but fight for something. January 2016 Journal That person is not usually motivated by a need for power, or Email: [email protected] money, or fame, but in fact driven slightly mad by some injustice, Website: www.namigdm.org some cruelty, some unfairness – so much so that he or she is Mailing address: Box 12174, Des Moines 50312 compelled by some internal moral engine to act to make it better. ----- Eve Ensler Phone number: (515) 277-0672 “Education, Support, Advocacy and Research” A Dear NAMI Greater Serving Polk, Dallas, Warren, and Madison counties Des Moines Board Mission statement Member Lost, Empowering individuals, families and community by providing An Activist hope and education about brain disorders In this issue – We lost a wonderful Page 1 Tributes to those lost, membership information Board member just Page 2 MH Statistics and locations for more information prior to Thanksgiving Page 3-5 Resources, Support Groups, Crisis Services in 2015. Her name Page 6-13 Articles of interest was Andrea Addington. Page 14 How Can You Help, Calendar Events
Andrea grew up in Des Moines and became a nurse. For the last two decades, she was a Professor of Nursing, most recently with Help Our Allen College in Waterloo.
Her greatest pride was her family. She was married to attorney Membership Steven Addington and adopted two children, Anastasia and Anya, from Russia. Grow!! Andrea’s passions were nursing and social justice. She was a member of many organizations which included AMOS, the legisla- Join NAMI on-line to become a member tive advocacy team for the United Methodist conference and was at the local, state, and national level. www.namigdm.org (at the a Board member for NAMI Greater Des Moines. top of the screen, click on blue “donate” box in the upper right of Andrea was diagnosed with an inoperable brain tumor late last the task bar)- or –go to www.nami.org/JOIN – or - spring and had entered hospice care in early fall. Please make checks payable to NAMI Greater Des Moines. As one of her friends observed - such a loss for her family, her $35 for an individual or family membership - $3 for persons with church, her students, us, the world! limited income Name ______We will certainly miss her wisdom, her enthusiasm, her activism and friendship as well. -----Teresa Bomhoff, President Address ______Memorials Received in 2015 ______Email ______Memorial gifts were given in 2015 to NAMI Greater Des Phone ______Moines on behalf of the Do you want to receive our monthly newsletter by mail _____ following people: Mrs. Beckwith or email _____? We need your support to continue Ramona Wifvat to provide this newsletter. If paying by check, please Jeff Cornick mail to NAMI-GDM, Box 12174, Des Moines, Iowa 50312 Peter Percival ------William Easter Mary E. Clogg You’re off to great places John Murphy Today is your day Your mountain is waiting Our prayers go to the So get on your way. families for the loss of their ------Dr. Seuss loved one and our gratitude for their generosity.
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Mental Health Total # # adult # child & # PMIC Dual Substance Some of the bed numbers in the Institutes of Beds beds adolescent geriatric Beds* Diagnosis Abuse corrections system located on MHI or (MHI) beds beds Beds Beds former MHI campuses Cherokee 36 24 12 100 bed Civil Commitment Unit for MHI Sexual Offenders at Cherokee MHI Clarinda 35 15 20 The entire Clarinda MHI campus is now MHI controlled by Dept. of Corrections – they Governor Loss of Loss of Loss of have a 795 bed prison and a 147 bed closed beds beds beds minimum security unit. Independence 60 40 20 15 MHI Mt. Pleasant 9 9 19 50 The entire Mt. Pleasant MHI campus is MHI – now controlled by the Dept. of Governor Loss of Loss of Loss of Loss of Corrections – they have a 914 bed prison closed beds beds beds beds at the Mt. Pleasant MHI. Iowa is: Total MHI 140 – 88 – 32 20 – 20 15 19 – 19 = 50 – 50 = 47th in the nation for # of acute care beds 44 = 24 = = 0 0 0 beds based on our population. th 96 64 44 in the nation for mental health workforce availability
47th in the nation for # of Staffed 630 475 90 61 psychiatrists Hospital Beds 46th in the nation for # of Statewide psychologists Total 770 563 122 81 – 20 -44= = 61 726
Iowa’s Financial Status Contact the Governor and your legislators to let them know we Projected FY 16 Cash Reserve (rainy day fund): $538.9 million need adequate funding and workforce to be able to have a mental Projected FY 16 Economic Emergency Fund: $179.6 million health system outside of the corrections system. FY 16 ends June 30, 2016 These numbers provided by LSA Legislative Services Agency These are Medicaid waiver programs Iowa offers eligible residents to allow persons to receive necessary services to remain in their Iowa is at the bottom of the 50 states in mental health care. Checkhome out and www. communityinfonetiowa rather than an.org/ institutional for legislative setting. 4.1% of Iowa’s population has severe mental illness or approxi- information,Waiver Programs too. # slots there # on Waiting FY 2014 are $’s for List May Ave. Cost mately 123,000 people. Listed above are the beds available for 2015 per person acute care. 726 vs. 123,000 – beds are full every day, 365 days
Health & Disability 2800 3585 $10,251 a year, access is difficult and will get worse. AIDS/HIV 73 0 $11,25 http://www.nimh.nih.gov/health/statistics/prevalence/serious- mental-illness-smi-among-us-adults.shtml Elderly 9500 0 $9261
Intellectual Disabilities 12912 944 $38,690 Acute Care Psychiatric Hospital Beds Brain Injury 1400 1255 $24,867 Available in the Des Moines Area Physical Disability 1250 2707 $6039 Location Adult Geriatric Children & Total Children's Mental Health 1237 2148 $12,335 Adolescent Beds 29172 10,639 Mercy Hospital 18 16 34 https://dhs.iowa.gov/sites/default/files/5.7.15%20Monthly%20Slot downtown %20and%20Waiting%20list%20%28public%29.pdf Iowa Lutheran 40 12 16 68 Broadlawns 30 30 Since Oct.2014, the # of slots available has increased by 1195. Des Moines VA 10 10 During the same time frame the waiting list has increased by Total 142 1350. These beds are full every day, 365 days a year and access is ------difficult. Letters have been sent to the 560,000 persons in the Medicaid Legislative Branch www.legis.iowa.gov program and Iowa Health and Wellness program. Iowa Senate: (515) 281-3271 2% will not be moved to the MCO’s. Iowa House: (515) 281-3221 98% have been assigned to a managed care organization Executive Branch www.governor.iowa.gov (515) 281-5211 If the member wants to be assigned to a different MCO, they MHDS Website http://dhs.iowa.gov/ can do so by contacting the enrollment broker by March 17. Iowa Medicaid http://dhs.iowa.gov/ime/about After March 17, the change to a difference MCO must have good cause. www.namigdm.org (515) 277-0672 [email protected] 2
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Tell Me Where to Turn Support for Family Members
Community Resources SUPPORT GROUPS for Family Members Eating Disorders - Coffee Connection for Parents Polk County Mental Health Services The Coffee Connection is open to parent(s) who have a child of Polk County River Place – 2309 Euclid Avenue, DM – 243-4545 any age struggling with an eating disorder and would like to www.pchsia.org. connect in a supportive effort with other parents. We will meet the Warren County Mental Health Services 2nd Sunday of the month from 4:00-5:30 pm at the Cafe Diem, 1007 S. Jefferson Way, Indianola, IA 50125 2005 S. Ankeny Blvd., Ankeny, IA. Check under Events Calendar 515-961-1068 email: [email protected] for specific dates. Direct your questions to [email protected] http://www.co.warren.ia.us/mental_health.shtml Des Moines – 3rd Sunday of Dallas County Mental Health Services the month –Family members, if 902 Court Street, Suite 1, Adel, IA 50003 515-993-5869 you are interested in Toll free: 877-286-3227 E-mail: [email protected] participating in a NAMI family support group, please contact Susie http://www.co.dallas.ia.us/department-services/community-services & Richard McCauley 274-5095 or [email protected] Madison County Mental Health Services Meetings are at Eyerly-Ball Community Mental Health Center- 209 East Madison, Winterset, IA 50273 515-462-2931 1301 Center 2:30-4 PM
http://www.madisoncoia.us/OFFICES/comservices/index.htm 4th Monday of each month – 5:30 – 7 PM – a support group for
Polk County Community Mental Health Centers Polk County parents and caregivers of children and adolescents Child Guidance Center – 808 5th Ave – 244-2267 with severe emotional disturbance (SED) or mental illness – a Eyerly Ball Community MH Center 1301 Center St. – 243-5181 sibling support group meets separately - at Capitol Hill Lutheran Broadlawns Medical Center- 1801 Hickman Road – 282-6770 Church, 511 Des Moines St., in the basement – child care New Connections Co-Occurring Oupatient Services – 282-6610 provided, can also provide free transportation and interpretation Eyerly Ball Golden Circle – 945 19th St – 241-0982 services – pre-register, if possible – call Angie at 558-9998.
Ankeny – 1st Tuesday of each Dallas County Mental Health Center month – Family members if you Eyerly Ball Community Mental Health Center th are interested in participating in 109 S. 9 St., Adel – 515-993-2158 a NAMI family support group, please contact Nora Breniman at
Madison County Mental Health Center 964-1593 or Regina Murphy at 777-0191, Group meets at Ankeny Bridge Counseling Center First United Methodist Church, 206 SW Walnut, Ankeny, RM 310/314 at 7-8:30 PM 300 West Hutchings St. – 515-462-2931
nd Primary Health Care & Behavioral Health 2 Thursday of each month – Engebretsen Clinic, 2353 SE 14th St. – 248-1400 6:30 P.M. – a support group for The Outreach Project, 1200 University, Suite 105 – 248-1500 Family members – Lutheran East Side Center, 3509 East 29th St. – 248-1600 Church of Hope, 925 Jordan Creek Parkway, West Des Moines–in Primary Health Care Pharmacy,1200 Univ.,Suite 103 262-0854 Conference room (main floor behind offices across from small chapel. Supper (free will offering) is available at 5:30 prior to the Urban Dreams Mental Health support group. Grace and Dawn are facilitators.
Serving those who speak English and Spanish Friends of Iowa Prisoners has a meeting at Noon on the 3rd 1410 6th Avenue, Des Moines, IA Tuesday of the month at Wesley United Methodist Church, 800 515-288-4742 – www.urbandreams.org 12th St., Des Moines. Clubhouse Passageway,305 15th St., Des Moines 515-243-6929 1st and 3rd Tuesdays of each month –Voices to be Heard Iowa Medicaid Non-Emergency Support group – Wesley United Methodist Church –800 E. 12th - Medical Transportation Program Light meal at 5:30 P.M. Support group for adults and program for When you have a need for Non-Emergency Medical children from 6 PM to 7PM. –If you have a loved one in prison or Transportation, call TMS. Once you have provided all the parole system you are concerned about or if you are concerned necessary information, a TMS operator will explain how your trip about those in prison, please feel free to join us. If you have request will be met. To request a ride please call 1-866-572- questions, please call Melissa Nelson at 280-9027. 7662. To find out more about forms and policies, go to: TACA chapter in Des Moines area http://tmsmanagementgroup.com/index.php/iowa-medicaid-net- program TACA (Talk About Curing Autism) is a national non-profit organization whose mission is to educate, empower and support Joy Ride Transport families affected by autism. Please call Susan at 515-867-8330 for Joy Ride is a transportation service available in the more details or visit the website at http://www.tacanow.org greater Des Moines area and surrounding Coping After a Suicide Support Group – Polk Co. Crisis and communities To make a reservation, call 515-331-1100 Advocacy Services – Contact: Joann-286-3600 - Meeting day – nd or 855-225-7433 [email protected] http://ridejoyride.com/ 2 Thursday of each month 6-7:30 P.M. and last Saturday of each Office Hours: Monday – Friday 8:00 AM – 5:00 PM They try to month 9-10:30 A.M. Meeting place is 2309 Euclid Avenue - park accommodate same-day requests for transportation. Weekend at the west end of the building near the flags and come in the and holiday transportation is also available with advance notice. glass doors. Victim Services Phone: 515-286-360 www.namigdm.org (515) 277-0672 [email protected] 3
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Support for Persons with Lived Experience
SUPPORT GROUPS for Persons in Recovery Every Saturday evening-“The Road”-Christian Life Center th location, 710 NE 36 street in Ankeny (easy access from the new Every Monday evening 7-8:30 exit off I-35) – the schedule: 6 PM Pizza supper with free will P.M. – a support group for persons offering, 7:15 PM Worship, 8 PM recovery groups. Child care with mental illness – facilitated by available for infants and toddlers. For further questions, call 515- persons with mental illness - at the Plymouth Congregational 777-8333 to speak to a team member. Facebook page: nd Church, 42 & Ingersoll – Room 305 TheRoad@AFUMC
First Monday of each month – 7-9 P.M. –GDM CHADD Support
Group – support for those families struggling with ADHD – Excellent Magazines to Subscribe to: Attention Deficit Disorder - West Des Moines Public Library, 4000 Esperanza http://www.hopetocope.com/ Mills Civic Parkway –call Julie for more info –515-223-6730. for articles on Anxiety and Depression
2nd & 4th Mondays of each month – 7 P.M. – depression and BP magazine http://www.bphope.com/ for articles on Bipolar SZ Magazine http://www.mentalwellnesstoday.com bipolar support group., St. Boniface Catholic Church, 1200 Warrior for articles on Schizophrenia – only offered on-line Lane, Waukee. [email protected] Julie 710-1487 Bullying, Suicide Hotline - Available 24/7, Your Life Iowa is a Every Tuesday afternoon 2-3:30 phone call or text away at www.Yourlifeiowa.org or 855-581-8111. P.M. – a support group for persons Trained counselors will provide guidance and support about with mental illness – facilitated by bullying, and critical help to youth persons with mental illness – at Plymouth Congregational Church, 42nd and Ingersoll in the Burling Room. For more information, Consult www.namigdm.org for more community resources. contact Matthea Little Smith 783-2763 [email protected] Crisis Services in Polk County Every Tuesday evening – 8-10 P.M. - Recovery Inc., a self-help Mobile Crisis Response Team group for people who have nervous and mental troubles – at St. th Emergency Calls: 911 – 6:30 AM to 2:30 AM Mark’s Episcopal Church, 3120 E. 24 St., Des Moines – Call 266- Non-Emergency Calls: 515-564-5742 2346 – Marty Hulsebus. Pre-Commitment Screening Service
Tuesday evenings 5:30-7:00 Dual Diagnosis support group at During Business Hours: 515-729-1772- 8 AM to 4 PM Eyerly Ball Mental Health Services – call 243-5181 for more info. After Business Hours: 515-564-5742 Crisis Observation Center – open 24/7 Tuesday evenings 7:30 PM - 4211 Grand – Friends House – in 1420 Mulberry St, West entrance, Des Moines the Meeting House – Meditation and Mindfulness Group – Phone: 515-564-5742 sponsored by Crossroads of Iowa Crisis Stabilization Center – transitional housing up to 90 days
Every Wednesday afternoon at 1 PM - Emotions Anonymous can only be accessed through the Crisis Observation Center on a at Central Iowa Center for Independent Living, 655 Walnut (enter referral basis - 1212 E. McKinley Avenue, Des Moines on the 7th St. side) - contact Duane at 243-1742 for more info. Phone: 515-777-1972 Fax: 515-777-1794 Broadlawns Crisis Team 515-282-5752 – mental health Every Thursday evening 6:30-7:30 PM – 4211 Grand – Friends professionals on duty 24/7 for responding to mental health House – in the Conference Room – H30 - a support group with a emergencies Broadlawns Community Access 515-282-6970 focus on opiate, heroin and prescription pill addiction for Women – Suicide is now the first cause of injury deaths, followed by car sponsored by Crossroads of Iowa 633-7968 – please pre-register crashes, poisoning, falls and murder. Suicides are terribly Every Thursday evening – 7:45 – 9:45 P.M. – Recovery, Inc. - a undercounted. There may be 20 percent or more unrecognized self-help group for people who have nervous and mental troubles suicides. –Sept. 20, 2012 American Journal of Public Health
th – at St. Timothy’s Episcopal Church, 1020 24 St., in West Des Moines. Call – 277-6071-Deb Rogers. Suicide Prevention Lifeline 1-800-273-8255 Every Saturday afternoon – 2:00 – 3:30 P.M. – the Depression If you are thinking of hurting and Bipolar Support Alliance meets at Iowa Lutheran Hospital – yourself, tell someone who can University at Penn Avenue – Level B – private dining room. help. If you cannot talk to your Contact Ron at [email protected] or call 279-5710 parents, your spouse, a sibling - For persons suffering from postpartum depression – a support find someone else: another relative, group entitled “Amazing Girls Accepting Peace Everyday a friend, or someone at a health (AGAPE)”. Information can be found at Meetup.com – enter clinic. Or, call the National Suicide AGAPE. You need to request to be a part of the group – contact Prevention Lifeline at (800) 273- Tricia at [email protected] TALK (8255) - http://ok2talk.org/
An Epilepsy Support group – the Epilepsy Empowerment Group Warning: Regular or heavy alcohol use can worsen most is held the 4th Thursday of every month at 6 PM at Mercy Medical psychological states, such as anxiety, depression, bipolar, Center, East Tower, Room 3, 1111 6th Avenue, Des Moines. For schizophrenia, or eating problems. Alcohol can change the more information, contact Roxanne Cogil 515-238-7660 or way a person feels in the short run; however, the overall [email protected] effect only worsens a disorder. Marijuana and other drugs can have similar or more serious effects on the brain.
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If you have a mental health crisis in your family and are in need of emergency assistance – call 911. Be clear with the dispatcher what the situation is, that it is a mental health crisis, and you need the Polk County Mobile Crisis Response Team to assist. The goal is to keep everyone safe and to seek the appropriate level of assistance for At Amanda the Panda, 1821 Grand Avenue, West Des Moines the ill family member or friend. Bring a friend and join us for our monthly group where you can laugh, play games, talk to peers and just be yourself. This is open The Mobile Crisis Response Team provides short term on-site to high school and college aged students. Free Pizza!! crisis assessment and intervention for children, youth and adults experiencing a mental health crisis. 2nd Sunday of every month 5-7 pm Sponsored by Please Pass the Love The non-emergency phone number for the mobile crisis team is Phone: 515-329-0220 email: [email protected] 564-5742. The police liaison to the Mobile Crisis Team is Officer Facebook/pleasepassthelove www.pleasepassthelove.org Kelly Drane. Her hours are 8 to 4 Mon-Fri phone is 205-2270.
If the crisis situation is in Polk County - in response to your phone Suicide Support Group for Teens ages 13-17 call, the first people to arrive to the situation will be police officers. When: first Thursday of each month, starting Oct. 1 Officers will determine if it is a mental health related issue and Time: 6:30 to 7:30 PM maintain safety at the scene. Officers make a request through Where: Pioneer Columbus Community Center dispatch if the Mobile Crisis Team is needed. Mobile Crisis only 2100 SE 5th St., Des Moines, IA 50315 takes referrals from law enforcement. Contact: Joann McCracken-Young 286-3600
When the Polk County Mobile Crisis Team staff arrive, a mental [email protected] health assessment will be done, on-site counseling and problem NAMI Greater Des Moines Board of Directors solving, crisis plan development, coordination with hospitals if transport to a medical facility is necessary, and medication can be Effective February 2015 given, if needed and appropriate. The Mobile Crisis Team is President Teresa Bomhoff [email protected] 274-6876 available 6:30 AM to 2:30 AM – 7 days week. It is staffed by Vice-Pres – vacant Board position licensed mental health professionals and registered nurses. Treasurer Regina Murphy [email protected] 277-0672 Secretary Chris Espersen [email protected] 277-0672 Invitation to join Online Support Group for Board members Parents of minor children Terri Shipman [email protected] 277-0672 with mental health needs: Dawn Hansen [email protected] 277-0672 Matthea Little Smith [email protected] 277-0672 Closed FaceBook Group: "NAMI IOWA's Casserole Club" or NICC (as in the nick of time!) Matt Connolly [email protected] 975-9600 Brittany Peterson [email protected] 277-0672 Please feel free to invite others to join - this group is limited to Sherri Sinclair [email protected] 277-0672 those Gary Rasmussen [email protected] same in Iowa who are primary care givers to minor children with mental Vacant Board position illness / brain disorder. It includes foster parents, grandparents, Vacant Board position relatives, etc., that are involved in the daily care of the child. November NAMI GDM activities This is a safe place to find support and understanding. We are not "Casserole moms" - as they say - that is, when your child is NAMI family support groups meet in 3 locations 1X/month seriously physically ill, it is common for neighbors, friends, and NAMI Connections support groups meet in 2 locations weekly community members to bring casseroles, offer to help, etc. But On-line parent’s support group meets when your child has a serious mental illness or mental health The Hang-out support group meets crisis, people often do not know how to respond and often simply Two Family to Family classes conclude don't. So let us be a casserole club - let us offer those needed kind 11-1 – Iowa Wild hockey game – 5050 Split the Pot raffle words of encouragement and a listening ear. 11-2- Legislative Children’s MH and Well-Being committee meeting For more info, contact Tammy [email protected] 11-2 – AMOS Health Care workgroup meeting 641-990-9974 11-3 – Meeting with ILEA Director – Judy Bradshaw and staff http://iowahousingsearch.org/ 11-3 – Legislative Health Policy Oversight committee meeting A free resource to help you find a rental 11-4 – Meeting with ACLU staffer home/apartment that fits your needs and 11-5- Iowa Energy luncheon meeting budget. 11-5 – IOOV presentation to F2F class
11-6 – Presentation to Guardianship Association of Iowa Network
Please send a big THANK YOU to Cindy Gross and conference at Iowa Bar Association offices
Plaza Printers and Ruby Van Meter Students for 11-7- Iowa Wild hockey game – 5050 Split the Pot raffle their assistance in printing and assembling our newsletter - 6762 11-8 - Iowa Wild hockey game – 5050 Split the Pot raffle Douglas Avenue, Urbandale, IA 50322 11-10 – CMS Listening Session on Medicaid managed care 11-10 – Presentation on advocacy to F2F class www.namigdm.org (515) 277-0672 [email protected] 5
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11-11 – Teleconference call on Chronic Care Consortium Family ties were not ordinarily relevant; neither was drug 11-11 – NAMI GDM Board meeting addiction. Mental health issues were largely ignored. Factors everyone would agree are meaningful to determine culpability, 11-12- Legislative Children’s MH and Well-Being committee meeting even the risk of reoffending, were irrelevant. 11-12 – IDAAN advocacy meeting 11-13 – Olmstead Task Force meeting I did what I could to find out about the human beings before me, 11-13 – RespectAbility breakfast meeting with presidential candidate even when their humanity did not seem to “count” in the law. And staff on disability issues when statutes (or the appellate court) prevented me from imposing a humane sentence, I protested in opinions, articles, and 11-13 – Iowa Social Worker’s conference – resource table speeches. 11-13 - Iowa Wild hockey game – 5050 Split the Pot raffle 11-14 - Iowa Wild hockey game – 5050 Split the Pot raffle I did what I could, but wish I had done more. I left the bench to 11-14 – AMOS Health Care Workgroup meeting undo the damage I (and others) had done. So much had been written about mass incarceration in the abstract, but I wanted to 11-16 – AMOS MH Workgroup meeting write concretely about the men (and they were largely men) I had 11-16 – AMOS Health Care Workgroup meeting come to know. I kept files on each of them. I had a spread sheet 11-17 – Meeting at IDPH on Certified Behavioral Analyst grant listing their sentences, my reasoning, and, more important, what 11-17 – Evelyn Davis Center – caucus training planning meeting became of them.
11-18 – ACES Policy Coalition meeting Did jail make a difference? Rarely. It hurt more than it helped. It 11-18 – Iowa Mental Health Planning Council meeting was a waste of money, and a waste of lives. 11-19 – Veteran Advisory Council meeting More than writing, now I am doing. I am identifying those who 11-19 – Meeting at Mercy downtown with Sara Eide, Bob Ritz, and should get presidential clemency — because of changes in the Dr. Khosravi law, or because their sentences were wildly disproportionate. I 11-19 – Teleconference with Optum staff on peer programs write letters on their behalf, even reach out to lawyers for them. I 11-21- Resource table at DMU Suicide Survivor’s conference want to envision them resentenced under a humane system. 11-21- Iowa Wild hockey game – 5050 Split the Pot raffle But my efforts — and even those of the president — are puny 11-23 – AMOS One to One meeting compared to what needs to be done. David Cole, a professor of 11-23 – Meeting with representative of Human Rights Symposium law at Georgetown University, and Mark Mauer, executive director 11-23 – NAMI GDM Board meeting – discuss results of survey, of the Sentencing Project, have proposed a Marshall Plan for interviews and first draft of strategic plan communities decimated by our failed war on drugs. Through the 11-24 – Trauma Informed Care meeting Marshall plan after World War II, the United States rebuilt the countries we had vanquished rather than punishing them. Undoing the damage of mass incarceration Although the judicial system did not destroy American By Nancy Gertner NOV 04, 2015 communities with bombs and ammunition, it did so with Over a 17-year judicial career, I sent prosecutions, prisons, and punishment. The impact is clear. A hundreds of defendants to jail — and about generation of African-American men are missing from their 80 percent of them received a sentence neighborhood’s economic life, barred from federal aid, subsidized that was disproportionate, unfair, and housing, and employment. They are silenced, unable to vote or to discriminatory. Mass incarceration was not serve on juries. The sons and daughters of jailed parents too often an abstraction to me. Sadly, I was part of it. follow them to jail. Last weekend’s release of 6,000 prisoners Thoughtful people on all sides have come to realize how woefully from federal prison is an encouraging start skewed our policies were, ill befitting a great country. to reform, but it’s only a start. When I oppose mandatory minimums and onerous guidelines, I was a judge during the most punitive when I work to get clemency for the men I sentenced, and when I period of US history — the ’90s — when we imprisoned more than write about it, it is not an abstraction. I know what it felt like to any other country, even the most autocratic. I did what I could to pronounce a heartbreaking sentence on a human being who did mitigate the impact of the laws I had to apply. There were 10-, 15-, not remotely deserve it. I want others to feel it too. and 20-year mandatory sentences for drugs, which made no sense under any rational social policy. There were mandatory- Nancy Gertner is a retired federal judge and a professor at sentencing guidelines, which often led to absurd results. When I Harvard Law School. made a small downward adjustment, explaining what I did in a Brain science shows that toxic stress affects the ability for written opinion, I risked reversal by an appellate court that saw connections in the brain to occur. Especially critical ages 0 to 25. only sentencing calculations, not people.
To say that we treated human beings like numbers is not an Trauma Informed Care emphasizes the importance of connections overstatement. What mattered most was the quantity of drugs or with others that build relationships to provide protection and how many guideline “points” were in their criminal record. What safety, demonstrates respect, and redirects to encourage skill did not matter were facts like whether the defendant dealt drugs building. out of the car he was living in rather than dealing to buy a fancy The Department of Justice reports that 85% of girls involved in car. What did not matter was whether his record was violent or just Juvenile Justice have been victims of physical or sexual abuse. a collection of petty offenses.
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Helping College Kids With Depression Be aware of how your own college or first work experiences What to watch for and who can help affect your expectations for your child. Child Mind Institute Work toward creating a dynamic in which your child feels Going to college is an exciting time in the lives of young people, supported and heard, but try not to pry for information. but for some of them depression gets in the way. Whether it's their Eighteen-year-olds, in particular, want to feel independent. first brush with the disorder or not, college can act as a catalyst for Remind your child that the first year away from home is a the onset of depression in many young people, and, on their own very difficult transition. While some teens are at ease from for the first time, the timing couldn't be worse. day one, there is no set time for “normal adjustment.” Leave
Dr. Roy Boorady, a child and the door open for conversations about the challenges and adolescent psychiatrist at the Child new responsibilities that come with attending college. Mind Institute, says he gets "lots of Discuss your expectations with regard to financial calls first semester" about college responsibility and school or work obligations. kids who are having a hard time. Encourage your child to develop healthy friendships and to "Usually what they end up doing is have a support system outside of the family. It’s a good idea calling their parents in the middle of to talk about what constitutes a “healthy” friendship, because the night. Then their parents call me teens, lacking in real-world experience, may be less selective and say, 'I'm getting two and three when making friends in new social settings. o'clock in the morning calls from my child who is crying and Prepare your child for new relationships, including sexual depressed and unhappy. What do we do?' " relationships. Talk about how to manage potential conflict
Children can be depressed at younger ages, but the older you are with roommates as well as friends and boyfriends/girlfriends. the higher the prevalence rates. Experts consider risk factors for Discuss the consequences of risk-taking behaviors, drugs, depression to be a combination of genes and environment. Some and alcohol. While you’re at it, start a conversation kids might be genetically at risk for developing depression, but about eating disorders, which are especially prevalent among they will be fine until they experience an environmental stressor college-aged women. that flips the switch and sends them into depression. It makes Talk to your child if you observe changes in emotions, sense that college could be that stressor. behaviors, or social activities. These may be signs of a
"Leaving home is a huge transition for kids, and I think we under- serious mental health problem. estimate the difficulty that a lot of kids have," says Dr. Boorady. Remind your teen, weekly—or even more often, if Away at college, suddenly kids find themselves in a new environ- necessary—that help is available if he feels stressed, anxious, overwhelmed, or sad. ment without any of the structure or supports—academic or emo- tional—they've always been able to rely on. Kids might have College is a time to become more adult and independent, and complex feelings about how they should be relating to the people parents should respect this and give kids the space they need to back home, or think that they don't fit in with their new peers. grow. But if you notice any changes in his mood or behavior that Independent for the first time, they might also be embracing the worry you, don't ignore them. His fellow students and new college lifestyle: erratic sleeping habits, non-nutritious (or professors don't know him as well as you do, so they might not nonexistent) meals, and an unstructured schedule—especially if recognize when there is a problem. they're skipping classes—that can leave them feeling unglued. Getting help College is also something of a pressure cooker for depression because the more you're surrounded by people who are Treating depression when kids are away at college can be depressed, the more likely you are to become depressed yourself. complicated. Colleges have health centers on campus with professionals who can help, but convincing kids to go there can be What to look out for "a feat in itself," notes Dr. Boorady. That's why he advises that
Detecting depression in kids who are away from home can be kids who have already struggled with depression should contact difficult. Some symptoms, like uncharacteristic sadness and the mental health professionals on campus before going to crying, are straightforward, but others, like trouble concentrating college. Having already made that initial contact and already and irritability, are less so. People with depression also tend to knowing who and what to expect makes asking for help much isolate themselves and take less pleasure in things they used to easier. If your child hasn't used the health center yet but seems to need support, let her know that they can help. enjoy, so if you hear that your child is spending too much time alone in his dorm room or quitting the things that used to make Kids are often reluctant to take the first step, so be supportive and him happy, he might be depressed. Worrisome alcohol and encouraging. Parents may also be able to schedule an substance use can also be a sign. For many kids, things come to appointment, but because of confidentiality laws you shouldn't a head towards the end of the semester, when academic expect the school to give you information about your child's health demands become more pressing and seem insurmountable. unless she has given them her authorization to do so.
Your job isn’t done. College kids want independence, but they still Keep in mind that health centers typically limit the number of need support to succeed. sessions students can receive, but they will make referrals to other
Here are some important ways to support your child in college and professionals located nearby. If your child has depression she will to stay involved in his or her life despite the distance. likely need ongoing treatment, either for therapy or for monitoring Establish regular times for phone calls and/or visits with your medication or both. Traveling back home for health care often isn't child. www.namigdm.org (515) 277-0672 [email protected] 7
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realistic and receiving consistent treatment is important, so it's professor emeritus of psychiatry at Vanderbilt University, said in good to find a provider your child can rely on in the community. an interview. “He actually foresaw what we later learned” from neuroscience. Finally, it isn't uncommon for kids who have already been diagnosed with depression to want to stop taking medication Scientists have since isolated a number of so-called before going to college so they can get a "fresh start." This can be neurotransmitters, like serotonin and dopamine, which circulate very dangerous if unsupervised. With depression there is a risk of more heavily in some areas of the brain than others. The details of relapse, so if your child wants to stop taking her medication, the how such brain chemicals alter behavior are still largely unknown, dosage should be lowered very gradually and she should be but most of the psychiatric drugs doctors prescribe today target closely monitored by her doctor throughout the process—going the activity of one or more of these chemical messengers. cold turkey is never a good idea. “Joel Elkes introduced the modern paradigm for psychiatry,” said Stopping treatment right before college is also risky for another Dr. James Harris, a professor of psychiatry and behavioral science reason: "The first year is so stressful, so I want kids to have a at Johns Hopkins University, “and it was a unique blend of successful first year," says Dr. Boorady. "Then when they come neuroscience and humanity.” back we can discuss if it's a good idea to go off medication." Joel Elkes was born on Nov. 12, 1913, in Konigsberg (now the Updated: November 24, 2014 Russian city of Kaliningrad), in what was then eastern Prussia, to Joel Elkes, Who Cast Light on Brain Chemistry and Behavior, Miriam Albin and Elkhanan Elkes. His father, a prominent doctor, Dies at 101 became a medical officer in the Russian Army during World War I and the Russian Revolution, after which the family settled in New York Times, NOV. 17, 2015 Kovno (now Kaunas), then the capital of the newly formed Dr. Joel Elkes, who published the first Lithuanian Republic. scientific trial of a medication for schizophrenia and became a Joel Elkes graduated with high honors from a Jewish high school foundational figure in modern psychiatry, and enrolled in medical studies at St. Mary’s Hospital in London in describing a framework to understand how 1930.
brain chemistry shapes behavior, died on He was completing his medical studies when World War II cut him Oct. 30 in Sarasota, Fla. He was 101. off from family support. In 1941, the Nazis herded Kovno’s Jews Dr. Elkes (pronounced EL-kess) was a into a ghetto; the group chose Elkhanan Elkes as its leader, and young researcher in England when a pair he worked for two years to protect them. But in 1944 the Germans of French doctors reported that a new attacked the ghetto and shipped survivors to a concentration antihistamine, called chlorpromazine, had camp, including his father and other family members. His father a remarkably calming effect on people with schizophrenia. He and died there, along with three uncles, an aunt, and nieces and his wife at the time, Dr. Charmian Elkes, both then at the nephews.
University of Birmingham in England, tested the drug against a Dr. Elkes cited his parents as exemplars of humane leadership placebo pill in people with schizophrenia and related conditions. throughout his career, which took off in the wake of the war. In The study was “blinded,” in that neither the doctors nor the nurses 1951, he was appointed chairman of the newly formed department delivering the treatment knew who got the drug and who received of experimental psychiatry at Birmingham. a placebo. In the Sept. 4, 1954, issue of The British Medical In 1957, he was invited to establish a similar program for the Journal, the couple concluded that the drug “may have its place” in National Institute of Mental Health in Washington. There, working the management of psychosis, the signature symptom of at the affiliated St. Elizabeth’s Hospital in the city, he published a schizophrenia. series of papers on brain chemistry.
The trial was seminal in two respects. Its design, blinding people He also established a culture — rare today, when there is so much to treatment and comparing to a placebo, has become standard in specialization — in which researchers mixed with the people who such drug trials. And chlorpromazine, known more widely by the were subjects in their experiments. trade name Thorazine, became the first-line treatment for psychotic symptoms, helping to end the practice of lobotomy — “There was, always and always, the presence of the patient,” Dr. particularly common in the United States — in which tissue in the Elkes wrote. “You go to the canteen for lunch, and there’s a frontal lobes is blindly destroyed to “calm” people with mental patient with schizophrenia hallucinating under a tree. You’re never disorders. very far away from the problem that brought you here.”
The dozen or so drugs developed since then for psychosis are all He left the institute in 1963 to become the chairman of psychiatry based, at some level, on the molecular properties of at Johns Hopkins. He left that post in 1974 and later took positions chlorpromazine. at McMaster University in Hamilton, Ontario, and the University of Louisville. Dr. Elkes drew on this and other work to formulate a theory of brain function, arguing that chemical messengers are central to Along the way, Dr. Elkes helped form several professional driving behavior and that those messengers operate differently in organizations to anchor the study of brain chemistry and behavior different neural regions, in the same way that dialects are better as a science in its own right; among them are the American understood in some places than in others. College of Neuropsychopharmacology and the National Institute for Psychobiology, housed at the Hebrew University of Jerusalem. “At the time, people thought that transmission in the brain was mainly physical, that it was electricity,” Dr. Thomas Ban, a Dr. Elkes’s first marriage ended in divorce. His second wife, Josephine Rhodes, died. www.namigdm.org (515) 277-0672 [email protected] 8
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Besides his wife, survivors include a daughter, Anna Elkes Parris, The IAB is a voluntary working group of over 150 emergency and a granddaughter, Laura Parris. He lived in Sarasota. preparedness and response practitioners from a wide array of professional disciplines dedicated to strengthening the nation's Dr. Elkes won most of his field’s major awards and published ability to prepare for and respond safely to emergencies and some 40 scientific papers, as well as more than a dozen influential disasters. book chapters. The entire document of recommendations can be found here: He was both formidable and personable, those who knew him said http://www.interagencyboard.org/sites/default/files/publications/Unt — an enthusiastic presence, with a touch of old-world eccentricity. reated%20Severe%20Mental%20Illness%20in%20US%20and%2 “He had the biggest desk and the smallest pipe I’d ever seen,” 0Burden%20on%20FRs_0.pdf said Dr. Floyd Bloom, a professor emeritus at the Scripps Research Institute in San Diego. “The first time I met him, he was Trauma Informed Care Facts sitting behind that desk, twirling a pipe the size of your thumb, just 50% of women in substance use programs are victims of incest. commenting on absolutely everything with his English accent. It National Center for Trauma Informed Care, Joan Gillece in Healing Neen. was exciting.” Being abused or neglected as a child increases the likelihood of National EMS Group Recommendations arrest as a juvenile by 59%. Treatment Advocacy Center An organization representing emergency Arrest rates of trauma-exposed youth are up to 8 times higher preparedness and response practitioners than community samples of same-age peers. has endorsed assisted outpatient treatment Abused children are more likely to and other evidenced-based practices as Be in special education effective interventions for people with Have below-grade-level achievement test scores severe mental illness who struggle with voluntary treatment adherence. Have poor work habits Fail a grade (Shonk, et. al 2001) The InterAgency Board for Equipment Standardization and Interoperability (IAB) – whose mission is to Approximately 1 in 6 children that experience a traumatic medical strengthen the nation's ability to prepare for and respond safely injury still have a traumatic stress reaction 6 months after the and effectively to emergencies and disasters – said the injury, (Children’s Hospital of Philadelphia for Injury Research and Prevention) prevalence of untreated severe mental illness in U.S. communities places an unmanage-able burden on first responders and law 24.3 % of Iowa children age 4 months to 5 years are at moderate enforcement across the country. or high risk of developmental behavioral or social delays.
“Our nation’s public mental health system is failing to meet the Estimated 46.7% of children in Iowa, age 0-5, who needed mental treatment needs of individuals with severe mental illness,” the IAB health care were not able to access services. said in a paper containing recommendations to address serious mental illness. “However the lack of treatment manifests in each The Next Mad Gunman – Wall Street Editorial Board 11-30-15 case, the burden of addressing it in the community has largely Murphy Press, Wash., D.C. fallen to first responders––police, fire and medical––and to our The Wall Street Journal editorial board today published a piece nation’s sheriffs." highlighting Congressman Tim Murphy’s Helping Families in Mental Health Crisis Act, H.R. 2646, crisis mental health The agency recommended several policies and practices proven legislation that requires SAMHSA to focus on evidence-based to help the most challenging individuals with severe mental illness care and fixes HIPAA to allow medical professionals and family receive the care they need to avoid further psychiatric members to share critical information regarding their loved ones’ deterioration, criminality and/or self-harm: mental health treatment. Implement assisted outpatient treatment (AOT), Improve inpatient civil commitment standards, and “The Next Mad Gunman” Editorial Board Wall Street Journal November 29, 2015, 6:15pm. Restore a sufficient number of inpatient psychiatric beds. If the reaction to Friday’s mass shooting at a Planned Parenthood Voting at their annual meeting in Virginia, the recommendations clinic in Colorado Springs follows the Washington script, it will go were officially adopted by the IAB after consensus was reached by something like this: Amid the public mourning will come the fights the Executive Committee and the Leadership Team. This over gun control, and then nothing. endorsement adds more weight to the momentum building in Congress can change that cycle of intellectual poverty by shaking states and in Congress to reduce the criminalization of mental up federal mental-health policy. A law enforcement official says illness. the suspect, 57-year-old Robert Lewis Dear, made a remark about The Treatment Advocacy Center has served as a resource on “no more baby parts” after his arrest, which suggests an anti- interactions between law enforcement and people with severe abortion motivation for the shooting. But even the initial reporting mental illness by publishing the following reports: on Mr. Dear’s life shows that he is a longtime malcontent who Justifiable homicides by law enforcement officers: What believed the government was out to get him. We may find he is the role of mental illness? suffered from paranoid delusions—that is, mental illness. Prevalence of mental health diversion tactics: A survey of the states As it happens, this month a House subcommittee passed one of the more consequential bills of this Republican majority—the Helping Families in Mental Health Crisis Act. Recent mass killers www.namigdm.org (515) 277-0672 [email protected] 9
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have nearly all had some kind of mental illness, yet few received These Democrats are way ahead of some Republicans, who proper treatment. One reason is a national mental-health system object to involuntary commitment for the mentally ill, despite that has been ruined by 50 years of bad policy and oversight, and overwhelming evidence of the risks to society and the sick. GOP that fails to identify and help the severely ill. leaders have also failed to make this a priority. Energy and Commerce Chairman Fred Upton has been reluctant to move the Representative Tim Murphy (R., Pa.) spent more than a year bill past Mr. Pallone, the ranking Democrat on his committee. investigating the dysfunction and writing an overhaul. Mr. Murphy’s problem now is politics. Democrats once seemed A disturbed loner like Mr. Dear might be untreatable by any medi- interested in a bipartisan bill, but of late the left has decided that cal system, but some future young man might be stoppable with mental illness is a diversion from its gun-control agenda. President proper mental treatment. Congress should do what it can to make Obama set the tone after the recent shooting in Roseburg, this more likely. Oregon, claiming that the “majority” of these shooters are “angry, Read more: http://www.wsj.com/articles/the-next-mad-gunman- young men” with access to an “arsenal.” Plaintiffs lawyers and the 1448838919 anti-psychiatry movement have mobilized against Mr. Murphy’s reform. Peer Recovery Specialist Credential Now
The opposition comes despite Mr. Murphy’s efforts at compro- Available mise. His original bill denied federal funds to the slightly less than Todd Lange half of the states that lack “need for treatment” standards in their The Iowa Board of Certification (IBC) is involuntary commitment laws, which give family and doctors more excited to announce that the Peer Recovery ability to assist the seriously ill. It would also have denied money Specialist (PRS) credential is open for application starting December 1, 2015! to five states that don’t have assisted-outpatient treatment laws, which let courts require the mentally ill to receive treatment as a The PRS credential is for any peer (who is also in recovery) condition of remaining in a community. working in the mental health or substance abuse field. This
Mr. Murphy has since modified the bill to give states an incentive credential is reciprocal with other IC&RC states/countries that also to make these changes by offering more grant money to those that carries the PRS (currently 17 states and Canada - for a full list of do. But a liberal phalanx led by New Jersey’s Frank Pallone is these jurisdictions, refer to the PRS Handbook on the IBC website). resisting any effort to require treatment for the dangerously ill, preferring to let those in the middle of psychotic episodes decide IBC is offering a 90-day grandfathering period which will run their own (non)care. from January 1 - March 30, 2016. This grandfathering process is open to any peer who is certified as a MHPSS by March 1, 2016. Democrats also misrepresent the bill to claim it eviscerates privacy protections. The reform does change federal rules to allow medi- In order to grandfather into the PRS credential, you need to be cal professionals and family members to share more information, certified as a MHPSS by 3/1/16, and you need to have taken the though very narrowly. The changes would only apply to people 40-hour peer support training as well as 6 additional hours in diagnosed with a handful of severe illnesses—like schizophrenia. ethics. Complete the PRS application (available free on the IBC Even then it limits the sharing to basic “medical” information—the website) and send it with a copy of your certificates of completion diagnosis, medications, a treatment plan. Psychiatrists are still and the $75.00 fee to IBC no later than March 30, 2016. You will barred from sharing “therapy notes” in which patients talk about NOT have to take another exam. how they feel. Democrats here are aiding the trial-lawyer lobby, After March 30, 2016, MHPSS's may still upgrade to the PRS which loves filing privacy lawsuits. when they wish, but will need to apply and pass the computer- Liberals also object that Mr. Murphy would overhaul and impose based exam. spending oversight on the wayward Substance Abuse and Mental IBC will continue to carry the MHPSS credential for those who Health Services Administration. SAMHSA blows $3.6 billion a year wish to obtain or maintain it. on “prevention” programs for the “worried well,” with such invest- ments as anti-bullying coloring books and “anxiety” programs. It More information about the PRS credential can be found within the scorns medically driven care and is in thrall to an anti-psychiatry PRS handbook and application on the IBC website. Feel free to movement that opposes drug treatment in favor of patient contact the IBC office at 515-965-5509 if you have any questions. “empowerment.” Giving Mental Health Support
Mr. Murphy’s bill requires SAMHSA to focus on evidence-driven When Living With Mental Illness care, and Democrats are using this to claim that the bill will cut Healthy Place.com vital money for prevention and substance-abuse programs. The Living with mental illness Murphy bill does attempt to steer more dollars toward the severely doesn't diminish someone's ill, but it still makes room for other priorities—so long as advocates ability to be a friend, to care, can demonstrate effectiveness. SAMHSA’s agenda is to keep the or to provide mental health cash flowing without accountability. support. It can, however, be stressful and leave people fatigued, overwhelmed, and vulnerable to triggers. Despite this, there are Mr. Murphy’s bill has 162 co-sponsors, including 45 Democrats. advantages to reaching out to a friend or family member in need of California’s Anna Eshoo, Illinois’s Bobby Rush and Pennsylvania’s mental health support: Mike Doyle support gun control but aren’t using that as an excuse Shared experiences are powerful; when both people know to ignore the urgent need for mental-health reform. Oregon’s Kurt they're not alone, a healing connection is formed; Schrader is the only Democrat on the subcommittee to put his A shared toolbox of healing strategies is created; constituents ahead of partisanship and vote for the Murphy reform. www.namigdm.org (515) 277-0672 [email protected] 10
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Helping a friend can keep each person positive through lifting • Total loss to regions - $40 million each other's spirits and motivation. o Private insurance • Medicaid pays for far more services Helping a friend with mental health challenges when you're • Mental Health Parity not being enforced dealing with your own works as long as you remember some Priority - Expansion of MH workforce capacity guidelines: o Coordination between the following to work together to Set healthy boundaries and limits. You want to be a friend address building and retaining the MH workforce capacity – and it's okay to expect the other person to be a friend, too. MCO’s, Office of Consumer Affairs, U. of Iowa, MHDS Dept. Practicing self-care is important. You don't have to take and 14 Regions calls into the night or be expected to be available constantly. o Mental health training for existing primary care physicians and Nurture yourself as much as you nurture others, then their staffs (designate colleges in all four quadrants of the helping a friend when you live with mental illness is wise. state to carry this out?) o A curriculum for direct care workers in positive behavioral Iowa Dept. of Public Health Receives Grant supports, mental illness, autism, and alzheimer’s/dementia Polk County Suicide Prevention coalition meeting minutes o A lead agency or bureau to lead - focused on building the Mental Health and Disability workforce capacity Binnie LeHew from the Iowa o Establish a loan forgiveness and/or tax credit program Department of Public Health specifically for Mental Health and Disability professionals presented on Iowa’s Violent Death o Create additional training program locations for Certified Reporting System (IAVDRS). Behavioral Analysts IDPH received a grant from the o A centralized credentialing center for providers and insurance CDC in 2014 to create a violent companies – so providers only have to re-credential at one death reporting system which will location be part of the national system. o Use the $750,000 in IDPH workforce program funds and $2 IAVDRS tracks suicide as well as homicide, deaths from terrorism, million in medical residency funds to provide incentives to law enforcement related deaths, unintentional firearm deaths, and local/regional collaborations to expand training opportunities undetermined deaths. for psychiatrists, ARNP’s, PA’s, and psychologists. An
Deaths are reviewed using information received from death example is the Broadlawns plan to: certificates, law enforcement reports, medical examiner reports, . Establish a second psychiatric residency program at autopsy results, and other data including information from the Broadlawns and Unity Point and Mercy (4/yr) family. The individual is de-identified and the records are not . A doctoral clinical program for ARNP’s and PA’s at released. Broadlawns . Internships for psychologists at Broadlawns. Binnie reported that it takes a year and a half to get data entered o Help providers become more viable through adequate and to close a case so we won’t see results for Iowa for another reimbursement from all types of insurance and making year (next fall). training a reimbursable expense.
Current data received does show that rates are consistent with the o Make insurance companies more accountable national statistics and the majority of deaths are by suicide. . Require to cover the entire continuum of services similar to Medicaid – both core and core plus services. All Legislative Priorities – insurers need to be “in” to support the mental health 2016 Legislative Session needs of the community. . Establish a floor for MH services reimbursement
. Approval of reimbursement for “certified” Find Help. Find Hope. Critical co- issues Workforce Insurance o Of 726 acute care beds, how many adult beds and how many children’s beds are available per day, or Independent entity for children’s issues average daily per week,or average daily per month (with the authority to braid funds from multiple funders) 9. Administrative rules for mental health advocates – will be Education for all presented to Commission at December 3 meeting o Uniform standards, training, basis for pay Multiple o Pay comes from the Region Crisis Services (Phase I) o Co. Bd. Of Supervisors is the boss Funders o But are a county employee Core Services (Phase II) o Pay attention to travel demands & caseload in hiring MH Advocates 10. Certified Community Behavioral Health Clinics Planning Grant Advisory Council of providers and parents - $1million o Plan due by October 2016 Priority - Continued implementation of adequate multiple o Who are the two clinics the plan will be based on? levels of care separate from the county jails and Dept. of o MH, SA, primary care for children and adults Corrections o Eventually plan will be submitted for an o Need additional core service domain administrative rules – for implementation grant jail diversion and other additional core service domains (only 8 states to be chosen) o Legislation to combine core and core plus services so all http://www.thenationalcouncil.org/topics/certified-community- domains are mandated. behavioral-health-clinics-3/ o Mandate a mental health and/or substance abuse evaluation 11. The progress of the within 24 hours of arrest (prior to release of custody) to divert peer specialist and to treatment – and - the appointment of a case manager family peer specialist o A re-write of chapter 229 – the commitment law training program by the We need a robust mental health system in the private sector. U. of Iowa The following activities will require monitoring Approximately 1 in 4 adults in the U.S. or 25%—experiences mental illness in a given year. in the coming year 2. Implementation of Medicaid managed care Approximately 1 in 25 adults in the U.S. or 4.2%—experiences a o Advisory councils for each MCO serious mental illness in a given year that substantially interferes o Legislative oversight committee with or limits one or more major life activities. o MAAC – Medicaid Advisory Council Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a o Long term care ombudsman office severe mental disorder at some point during their life. For o Adequate rates children aged 8–15, the estimate is 13%. o Handling of HCBS waivers 1.1% of adults in the U.S. live with schizophrenia. o Adequate provider network 2.6% of adults in the U.S. live with bipolar disorder. o Financial viability of safety net providers 6.9% of adults in the U.S had at least one major depressive o Transportation (NEMT) episode in the past year. o Monitor and prevent service changes and/or reductions 18.1% of adults in the U.S. experienced an anxiety disorder such 3. Reports on implementation of core and core plus services as posttraumatic stress disorder, obsessive-compulsive disorder statewide and specific phobias. 4. Reports on the financial viability of regions state-wide Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5%—had a co-occurring mental 5. Update of the Olmstead Plan 6. 50% participation by families and persons with disabilities on illness. legislative workgroups Suicide is the second leading cause of death among persons 7. Refueling Assistance bill – is in House Ways and Means aged 10 – 24. Youth suicide is more prevalent in Iowa than in Committee – eligible for debate at beginning FY 16 legislative the nation as a whole session. The suicide rate for African American children has doubled since 8. Inpatient bed tracking – CareMatch received the contract the 1990’s. – all hospitals are connected – Karen Hyatt is the DHS 90% of those who die by suicide experience mental illness. contact person Over 20% of children have a seriously debilitating mental illness o How often are beds available being updated? 1X/day during their lifetime. (Over 45% of children have had any mental is present goal – eventually 3X/day illness.) o 29 hospitals, 2 MHI’s connected - Connect VA Half of all lifelong cases of mental illness begin by age 14 (75% hospital? by age 24). o Feedback from hospitals, sheriffs, magistrates – and others –on how it is working 80% of children who need mental health treatment never receive treatment. o Who’s being turned away? Where are they going? Why were they turned away? Minority children are half as likely to receive any mental health services and more likely to receive services that are inappro- www.namigdm.org (515) 277-0672 [email protected], fragmented, or inadequate. 12 70% of youth in state and local juvenile justice systems have Find Help. Find Hopemental. illness. Yet the U.S. Dept. of Justice has found that juvenile facilities fail to provide adequate mental health care. 50% of youth in the child welfare system have mental RAISE Connection, which was tested at two sites, one in illness. Baltimore and one in New York City. Approximately 50% of students with mental illness drop out Beyond the success of established early intervention models of school. “Once they leave school, these students lack combining therapy, family support and other treatment modalities the social skills necessary to be successfully employed; with medication, the Affordable Care Act created a new they consequently suffer from low employment levels and awareness among lawmakers that the existing approach to poor work histories financing care for long-term disorders was expensive. States and the federal government were beginning to consider Restore. A program at Eyerly Ball Community MH Services based on the Navigate Program Model by NIMH for First Episode Psychosis that, if earlier intervention produced better outcomes, it might R reach out reduce taxpayer costs. Headline violence involving young adults 1st E first episode of psychosis was heightening public awareness of the “paucity of readily S support and medical stabilization available, youth-friendly mental health services” in the United T team approach States. workO outlook histories positive from the start The convergence of all these factors led to RAISE. R rehabilitate self and family E employment assistance The Who of RAISE Program Criteria: RAISE was developed for and tested in a narrow population, a key o Persons age 16-40 feature that has been overlooked in some general reporting on its o On medication for 6 months or less results. o Loss of contact with reality for extended periods of time o Disruptive moods Both NAVIGATE and RAISE Connection primarily targeted o Problems with organizing thoughts individuals from 15-35 years of age, when psychotic spectrum o Symptoms interfere with life goals disorders such as schizophrenia and schizoaffective disorder are For more information, please contact: Project Director, Glen Baughman most likely to develop and before treatment has begun. Phone: 515.243.5181 (Individuals up to the age of 40 were accepted only if they were NIMH’s seven-year-old experiencing a first episode of psychosis.) The duration of Recovery After Initial Schizophrenia Episode project – RAISE symptoms and whether symptoms were active or stable were not determining factors, but being untreated was. Treatment Advocacy Center Generalizing from the RAISE findings to the entire population of Why RAISE? people with psychotic disorders, as some mass media reports Recognition that have done, is a misrepresentation of the findings. comprehensive and As the authors of “The NAVIGATE program for first-episode aggressive early psychosis” wrote in Psychiatric Service “People with a first treatment can change the episode of psychosis often encounter challenges, barriers and trajectory and prognosis contradictory information about engaging with mental health of schizophrenia and services, with long delays and multiple pathways into treatment, other psychotic disorders often through the criminal justice system. When treatment is is not new. Damage to cognitive and social functioning from found, it is often not well suited to address the unique needs of psychosis is known to be most dramatic in the first five years after those persons who, along with their family members, often the onset of psychosis. Thus, shortening the duration of untreated struggle with the dual challenges of understanding the complex symptoms has become seen as a key to improving long-term and confusing nature of psychosis and entering the similarly outcomes. complex and often confusing mental health system.” The authors In countries with unified health systems – Canada, Australia, describe this moment as “the haze of mental illness and the maze Great Britain, Norway - collaborative, multidimensional early of the mental health system.” intervention treatment models have been widely used for decades. Next month: (Dr. E. Fuller Torrey advocated them more than 30 years ago in How RAISE Models Cut through the Haze and the Maze his groundbreaking book, Surviving Schizophrenia.) References from Psychiatric Services, 66(7), July 2015: In Great Britain, for example, the median duration between the onset of psychosis and treatment is two weeks. In the US, it is 74 Addington, J., et al. Duration of untreated psychosis in weeks. community treatment settings in the United States; pp 753-756. Dixon, L. B., et al. Implementing coordinated specialty care for The goal of RAISE was to develop and test an early-intervention early psychosis: The RAISE connection program; pp. 691-698. model that would work in “real world” of the fragmented US health Essock, S. M., et al. State partnerships for first-episode system, with its thousands of community settings and multitude of psychosis service; pp 671-673. payers. The NIMH funded two contracts to this end, from which emerged: Mueser, K. T., et al. The NAVIGATE program for first-episode psychosis: Rationale, overview, and descriptions of NAVIGATE, which was tested in 34 sites in 21 states and psychosocial components; pp. 680-690. was the subject of the widely publicized September 2015 ------report in The American Journal of Psychiatry. The best way out is always through. -----Robert Frost www.namigdm.org (515) 277-0672 [email protected] 13 Find Help. Find Hope. National Alliance on Mental NONPROFIT ORG. Illness of Greater Des Moines US POSTAGE PAID Box 12174 DES MOINES IA Des Moines, Iowa 50312 PERMIT NO. 34 RETURN SERVICE REQUESTED On your first visit to AmazonSmile (smile.amazon.com), you need to select a charitable organization to receive donations from eligible purchases before you begin shopping. They will remember your selection, and then every eligible purchase you make at smile.amazon.com will result in a donation. 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