Wednesday, July 2, 2014

"lets not separate the brain from the body" ~ House Bill 527

Better strategies aimed at mental health in Ky. could improve health, economy and public policy
06/10/2014 07:55 PM
Knowing how to identify and properly treat mental illness could spark the single biggest shift in bringing efficiency to the health care system while improving Kentuckians lives, two experts said.
Currently Kentucky spends 4 percent of the $3 billion dollars in Medicaid managed care on mental health programs. But an estimated 40 percent of Medicaid enrollees have mental illnesses or issues — many that go undiagnosed, according to the Centers for Medicare and Medicaid.
Kentucky, unlike states like Colorado , hasn’t tracked how undiagnosed mental health issues, like depression or bipolar disorders, fuel other medical costs or spill into the school system in the form of behavioral problems — or fill up jails and prisons.
But Rep. Jimmie Lee, D-Elizabethtown and the chairman of the House budget panel that deals with health programs, said if Kentucky can get its approach to mental health right it would have broad effects across the board.
“The savings itself would promote the expansion of the system without having any additional revenue,” Lee said (at 3:40).
Lee and Steve Shannon, executive director of the Kentucky Association of Regional Mental Health Programs, said the health care system — and government-funded Medicaid — could save money by treating patients for physical and mental issues at the same location. Shannon said it’s like the “fram oil filter” model of pay now or pay later. It is time for the mental health system to pay early to avoid later costs, he said.
“Lets pay now and lets pay less now,” Shannon said (at 4:30). “Lets look at the whole person and lets not separate the brain from the body so when someone goes, lets really understand what is happening when they see a doctor and have that doctor realize ‘maybe this person does need to see a clinician.’”
The General Assembly passed a bill this session, House Bill 527, that would allow mental health centers to provide physical care by hiring a doctor or nurse practitioner — something both Shannon and Lee believe will help. But Shannon said people with mental illness die 25 years younger than the average age of death from preventable illnesses because they don’t get the care they need.
Shannon said dollars could be spent more wisely by looking at spending in areas like the corrections system.
“How much dollars are we spending in the corrections system for folks who could be in the community, never go to the corrections system, and never be seen there but be treated here and not have a record that reduces housing opportunities and employment opportunities, all those negative consequences,” Shannon said (at 6:30).
As for how the Medicaid managed care companies are handling mental health patients, Lee said representatives from the managed care companies have told him they will be changing the way they do business because it is effecting their bottom line. (See that conversation starting at 11:00 in video above).
Other bottom lines are affected by the way the state handles mental health as well. Lee said the state will have a budget shortfall for available behavioral health funds. And Lee and Shannon agreed any money saved through efficiencies in behavioral health needs to stay in behavior health and not be diverted else where as it has been in the past.
“That’s got to stop,” Lee said (at :30 in video below). “We can not treat and work with this population if you’re not going to let me or the folks that work with these dollars to keep those dollars within this budget in order to be able to expand on what we saved.”

Tuesday, July 1, 2014

Patrick Kennedy Visits Mentally Ill Inmates Of Cook County Jail, Largest Illinois Mental Health Facility

Legislators ask, "Where do we find $$'s to monitor 'patients' who need AOT?" Disablity Rights advocates say, "It is inhumane to lock up individuals with mental illness!" 

Yet places like Cook County Jail are recreating their own mental institutions ~ even growing food in gardens just like the assylms did years ago. Imagine what our world would be like if we didn't punish people for having a brain disease? 

This article is a must read!

"The number of people here talking about hearing voices and seeing things, it's hard for me to accept that we as a society can't make a better distinction between someone who made a decision that is reprehensible and you want to punish it versus someone who is ill and acts out that illness through symptoms we deem criminal behavior. Then we treat them in a prison as opposed to where they need to be treated: in a mental health clinic."
Kennedy said improving treatment -- and ultimately, perception -- of mentally ill Americans is a civil rights issue.

Saturday, June 28, 2014

Shooting Spree Inspires Call For Mental Health Reforms

Mental illness is a medical emergency
Published 3:09 pm, Friday, June 27, 2014

In the nearly year and a half since I have been investigating America's broken mental health system — even with my 30-year background in clinical psychology — I have been shocked to learn just how much our country has failed those with severe mental illness.
Take Elliot Rodger, a 22-year-old whose instability was known but went overlooked before he killed six college students and himself in California last month. Or take Gus Deeds, another young man who was in mental health crisis, but was denied extended inpatient care before he killed himself and stabbed his father, a Virginia state senator. There was Adam Lanzain Connecticut, Jared Loughner in Tucson, James Holmes in Aurora, Aaron Alexis at the Washington Navy Yard, and on and on.
Shooting Spree Inspires Call For Mental Health Reforms: Friday's stabbing and shooting spree in Santa Barbara has renewed the debate over how and whether to require people with serious mental illness to get psychiatric care. Many families and advocates for people with serious mental illness say the country needs to reform its standard for civil commitment, which allow people to be hospitalized against their will. Doris Fuller, executive director of the Treatment Advocacy Center, said changing these laws could help provide treatment for people like Elliot Rodger, the 22-year-old police say stabbed or shot six people to death near the University of California-Santa Barbara.??

All had untreated or undertreated serious mental illness. All were essentially known to the mental health system, had the benefit of early identification and intervention, and yet all spiraled out of control because the basic tools to help in a crisis were missing.
"The status quo is not just uncompassionate; it is inhumane."
While these are extreme cases, they highlight how our broken system does not respond until after a crisis when we could be doing something to stop it from happening. Even in the face of tragedy, we are too uncomfortable to acknowledge the facts because the last bastion of stigma in mental health concerns those with serious mental illness.
The facts are that mental illness is a brain disease, and, of the 9.6 million adults in this country with a serious mental illness like schizophrenia, bipolar disorder or major clinical depression, approximately 40 percent won't even receive treatment this year.
We have found it easier to focus both the discussion and public resources on gauzy programs for "behavioral wellness" and "emotional well-being" than to confront the painful reality that those with schizophrenia or severe psychosis are more likely to go without care (4.4 million), be homeless (250,000), be in prison or on parole (1.3 million), or are dead by or attempting suicide (1.38 million) than are in appropriate psychiatric treatment (approximately 4 million).

Monday, June 23, 2014

Mental Illness 101: Overcoming Harsh and Hateful Comments (Sometimes Our Own Families Just Don't Understand)

A powerful post by my friend Leisl Stoufer – that 'every family member' who has a loved one living with a severe brain disease should read.

Everyone one of us has at least one family member who doesn't get it.  They continue to hurt us and our ill loved ones suffering with a mental illness  and they will, until we become so outraged to do something about the discrimination and injustice. Read Leisl's story here:

Mental Illness 101: Overcoming Harsh and Hateful Comments (Sometimes Our Own Families Just Don't Understand)
For all of history, society has done everything in its power to sweep the issue of mental illness under the rug.  No one wants to be associated with mental illness.  No one wants to admit that mental illness exists.  Certainly no one wants to have a mental illness in their family; and what could be worse than being the one who  actually has a diagnosis?  No one wants to be mentally ill. Nobody wants to be “crazy”.

Friday, June 6, 2014

Finally, someone is listening to the families!

Last week, as I watched Rep Tim Murphy’s latest briefing I cheered with total triumph! For too long families like mine have been ignored. We have watched our loved ones suffering with acute psychotic episodes, deteriorating to the point we're afraid for our safety and the safety of others. 

Instead of systems working together for solutions, people look the other way, ignoring the warnings – yes this happened in Isla Vista, it happened in the Navy Yard, and it will happened again – somewhere in the USA.

And oh my God, what do these very individuals say after the latest preventable tragedy hits the airways?  
“How could we have prevented this unspeakable tragedy? Do we need better gun laws? Where were the parents of these individuals, and why didn't they do something?”
Let me explain what it’s like to be a parent of a brilliant young man who has a 21-year documented history of living with a neurological brain disease. Now as an adult, it has developed into a psychotic disorder and like other diseases will continue to deteriorate without treatment. Currently he lacks capacity, due to anosognosia or an inability to recognize he has symptoms and refuses treatment! 

1.) We have reached out to our family and church – but they alienated our son by turning away, not knowing what to say.   

2.) We reached out to the local community mental heath system (CMHC) and they are unable to help unless our son seeks help voluntarily. He doesn’t believe he has symptoms so there is no way he’ll agree to see a doctor.

3.) We reached out to our local and state law enforcement agencies and they said, "It's not our job” or “it's not against the law to be delusional.” 

4.) Out of desperation, we turned to the justice system, criminalizing our son, hoping to have him hospitalized against his will – a horrific ordeal that no family or individual should endure! Yet instead, our son wound up behind bars, punished for the brain disease he was born with.

Yes, only in America!  
Many naysayers report that ‘trauma’ causes brain diseases. The lack of treatment creates more traumas than a person can bear! My point, last year there were over 40,000 suicides and over a million suicide attempts! Additionally, 356,000 individuals with serious brain diseases were in the United States’ de facto institutions: jails and prisons last year. 
The cost of not caring: Nowhere to go
by Liz Szabo, USA TODAY

5.) We reached out to state advocacy groups asking them to lobby for policy amendments and they said, “Now is not the time – maybe next year.” Or we heard, “We need to be careful what we advocate for – or we might lose our funding from SAMHSA!”

6.) We contacted CEOs of state agencies and they said, “We need to be careful about asking for system changes or the FEDs might close the psychiatric hospital!” (How is that for intimidation when you have joined forces with other exhausted family members to advocate to replace a 200-year-old antiquated hospital?)

7.) We reached out to state leaders such as the Governor, Commissioners and Secretaries of the Cabinet of Health and Family Services, (CHFS). We spent countless hours arranging meetings and their response was: “The system is broken and sorry we have failed your family members.”

8.) Then finally years later, when we are so exhausted we think we can do no more, we generated hundreds of letters and phone calls and attended dozens of strategic planning meetings with state legislators, and they said, “We will sponsor bills to amend the current mental health law, but the CHFS added expensive fiscal notes, stating it would cost too much.”

Year after year, we have watched our son cry out for help in the most inhumane way and no one listens. Due to symptoms of his untreated illness, he has been discriminated against, labeled moderate risk of violence’ , with a file marked CASE CLOSED’ by ‘service agencies’ that receive federal funds, with absolutely no accountability.

Finally, families like mine have a hero in Congress who is listening and his name is Rep. Tim Murphy. 

For over 2 years, Rep. Murphy has worked tirelessly to bring changes to the federal government’s wasteful spending of your tax dollars, by sponsoring a bill that would over-haul a broken and dysfunctional mental health system.

As of today, Rep. Murphy’s bill H.R. 3717, The Helping Families in Mental Health Crisis Act has 89 Cosponsors – Republican [57] Democratic  [32].

H.R. 3717 needs a few additional co-sponsors so it can pass out of committee.  

"Our loved ones need treatment before tragedy!"   

Please help us! Call your US Representative in Congress today and ask them to cosponsor this important bill. 

Click here to contact your US REP

Tuesday, June 3, 2014

Congressional Briefing after Isla Vista -- We need HR 3717 now more than ever

Mental Illness Report
Representative Tim Murphy (R-PA), chair of the Energy and Commerce Committee’s Oversight and Investigations Subcommittee, held a briefing on the subcommittee’s report on its investigation of federal programs that address severe mental illness. Topics included a bill to overhaul the current mental health system sponsored by Representative Murphy and a competing bill sponsored by Representative Ron Barber (D-AZ). Representative Murphy, a practicing clinical psychologist, was joined in responding to questions by a forensic psychiatrist, a mental health advocate, and a father whose son suffers from schizophreni
"We've found it easier to focus both the discussion and public resources on gauzy programs for "behavioral wellness" and "emotional well-being" than to confront the painful reality that those with schizophrenia or severe psychosis are more likely to up without care (4.4m), homeless (250,000), in prison or on parole (1.3m), or dead by or attempting suicide (1.38m) than in appropriate psychiatric treatment (approximately 4m)."


Tuesday, May 20, 2014

How Nancy Pelosi Broke My Heart, By Susan Inman

Susan Inman


Posted: 05/20/2014 12:30 pm


The U.S. is in the midst of a historic battle about how to fix its disastrous mental health system. During the decades that mental health care has been under the control of the Substance Abuse and Mental Health Services Administration (SAMHSA), there have been significant changes. Now there are ten times as many people with mental illnesses who are incarcerated as there are psychiatric hospital beds.
These horrific conditions have developed because SAMHSA, headed by a human rights lawyer, has chosen to support the beliefs of the alternative mental health movement rather than to promote science based care. These beliefs make it inconvenient to acknowledge that most psychotic people have a brain based inability to understand that they are ill. As a result, SAMHSA funds groups like Protection and Advocacy for Individuals with Mental Illnesses (PAIMI) that help ill people refuse treatment that could help them get better. Families wish someone would protect their severely ill family members from the groups that advocate for their right to be severely psychotic. As well, these groups block efforts of families to get the information they need to care for very ill relatives.
To remedy this situation, a Congressional subcommittee, after a lengthy investigation,developed a bipartisan bill, the "Helping Families in Mental Health Crisis Act." Developed under the leadership of Republican Tim Murphy, a clinical psychologist, the bill currently has 28 (out of 80) Democratic co-sponsors. However, other Democrats have been slow to come aboard.
Now the lack of Democratic support has morphed into something even more dangerous. Under the guidance of House Minority Leader Nancy Pelosi, the Barber bill has been introduced. It guts every important change proposed in the Murphy bill.
Nancy Pelosi justifies the Barber bill by saying that she wants legislation which "the mental health community can support." She seems to think that the vast array of psychiatric survivor groups that SAMHSA's largesse has nurtured represent the "mental health community." These groups have organized an intense campaign to lobby members of Congress with petitions, and letter writing campaigns.
Meanwhile, there's been a lack of leadership from the groups that should be actively lobbying to get the Murphy bill passed.
For decades families coping with mental illnesses were represented by the National Alliance on Mental Illness (NAMI), an organization that was started by family caregivers of people with schizophrenia. There are over 1100 chapters of NAMI across the US and many might have expected the NAMI website to be teeming with initiatives to support the Murphy bill. Unfortunately, NAMI no longer represents the perspectives of families advocating treatment for people with the most severe mental illnesses.
During the years that I have attended NAMI's national conferences, I have noticed a disturbing trend. A growing number of families talk about being unable to get any care for their daughters and sons who have become psychotic. When I ask what their NAMI chapters are doing about this, they have told me the chapters have come to rely on SAMHSA money to operate and don't want to anger these funders.
It has become harder to distinguish NAMI's beliefs from those of SAMHSA. Its new Executive Director, Nancy Giliberti, is a former lawyer for the Bazelon Center, the major force behind efforts to block any involuntary treatment of people with mental illnesses.
And SAMHSA's perspectives on mental health care have been well represented by Board President, Keris Myrick, who blogs for Mad in America. Ms Myrick is part of an upcominggroup presentation in Toronto that promises new perspectives on psychosis, or what the group prefers to call "extreme mental states." Characterizing neuroscience based understandings of psychotic disorders as "reductive" and "narrow," presenters at this event bring their "existential and intellectual authority" to explain how psychosis is a state of mind that "passes." They believe it can leave people "weller than well."
This might come as quite a shock to the many American families I know who can't get treatment for their very ill sons and daughters whose psychotic states aren't 'passing.' Instead, these are families whose deeply loved and sensitively nurtured children have joined the millions of Americans living with untreated severe mental illnesses. They are homeless, victimized, and cycling in and out of jails and prisons.
I hope Ms. Pelosi will watch the reception that Rep. Murphy received last week at the American Psychiatric Association, a group she apparently doesn't consider to be part of the "mental health community."
And she needs to read the testimony of parents in her own state. Last week, families in California finally persuaded the Board of Supervisors in Orange County to fund Laura's Law which provides Assisted Outreach Treatment services to those who stumble back and forth between the street, emergency rooms, and prisons. The delays in implementing this common sense and proven strategy have occurred because of the opposition of the groups SAMHSA helps fund.
The Democratic Party has mostly been consistent in its support of the value of science. However, it has failed to protest when, as Rep. Murphy says, SAMHSA has behaved as if schizophrenia and bipolar disorder don't exist. As a lifelong Democrat and enthusiastic supporter of President Obama, I urge Ms. Pelosi to get the Democratic leadership to endorse a sensible approach in responding to the reality of severe mental illnesses. They must stop blocking the desperately needed transformation of the US mental health system.