As of July 1, 2018, the 24-hr Bay Cove Crisis Line will be changed to:
833 BAY-COVE (229-2683)
From the desk of Jackie Lane, Executive Director NAMI CC&I
Mental health issues have often been dominating the news of the day. High profile suicides, childhood trauma (immigration policy), school shootings and other criminal acts of violence, and the constant battle to stem the use of illegal drugs are making the headlines on a daily basis. Statistically, 16 to 20% of our school children exhibit a social/emotional disorder and globally one person out of four will be affected by a mental or neurological disorder at some point in his life. All of the above can be perceived as being symptomatic of a national/world mental health crisis.
What is different about a mental health crisis as opposed to any other health crisis? Why are we lagging in addressing not only root causes, but care and treatment of those with serious mental illness, situational mental health issues, and emotional problems? One can make the case for when it comes to mental health, there is a stigma attached, a stigma that prevents individuals and families from seeking much needed help, a stigma that prevents us as a society from treating and funding mental health as aggressively as other kinds of health. A recent Harris Poll survey showed that 92% of participants believe "that there is a stigma in our society against those with mental illnesses." Paul Gionfriddo, president and CEO of Mental Health America, is quoted, "Far too long, individuals dealing with mental illnesses have been subject to shame and stigma." The above survey also found that "among those who know someone with mental illness, 62% said that that person is or has been afraid to seek treatment."
In order to fight mental illness in the same way that we fight other chronic and debilitating diseases, we need to help society to overcome the misconceptions about the disease. We at NAMI CC&I believe that education can be a major force in combatting the stigma that permeates our society. Our family programming, Family-to-Family, Basics, and the soon to be implemented, Homefront program, educate the participants and foster the understanding of mental illness as a disease that needs to be accepted and treated as a disease. It is very satisfying for our teachers when they see the class members realize that the mental illness of their loved one is not a reflection on them or their parenting and it is not a moral failing of the individual. It is a physical disease like any other physical disease. We have also made great strides in the sizable Cape Brazilian community with family programming conducted in Portuguese by a bi-lingual therapist hopefully helping to change the prevailing attitude toward mental health in this community.
Our community programming which reaches out to all the Cape police departments, Cape and Island public school teachers, and local social service workers, explains mental illness as a disease that needs to be treated as such. Our CCIT training educates the police and others who attend, not only how to handle those with mental illness, but also addresses the physical aspects and symptoms of the disease. The theme of the Think:Kids (Collaborative Problem Solving) program is: "Kids will do well if they can!" Children who are difficult or failing do not have the skill sets to do what is being asked. Mental (brain) development varies and issues need to be addressed individually. Our new community program, Mental Health First Aid instructor training, is producing a group of diverse people who can now go out into the community and teach an eight-hour course on mental illness. We are also conducting an intensive marketing campaign on the importance of mental health on the Island of Nantucket which has experienced a high rate of suicide.
Education goes far in producing understanding and empathy. Hopefully an understanding and empathetic society can help erase the stigma attached to mental health issues and help to make way for mental health to be treated like any other health with equal respect and resources.
Mental illness is illness! Mental health is health! Working together we can erase the stigma!
Mental Health First Aid
Thanks to a generous grant from Cape Cod Healthcare Community Benefits, NAMI Cape & Islands brought Mental Health First Aid Instructor training to the Cape Codder this month, and will offer it again this Fall. Participating in this 32 hour training session were members of local law enforcement/EMT's, Bay Cove, Councils On Aging, Cape Coalition, Outer Cape Health, Home Care providers, and NAMI's Kim Lemmon.
Mental Health First Aid is an eight hour course designed to take the fear and hesitation out of starting conversations about mental health and substance use problems by teaching an action plan to safely and responsibly respond. People interested in participating in an eight hour Mental Health First Aid course, or becoming a Mental Health First Aid instructor (32 hour training) this Fall, please contact the NAMI office at 508-778-4277.
Graduates of the 1st Mental Health First Aid Instructor Training
ADVOCACY NEWS...
From the desk of Mary Zdanowicz, Esq.
DMH Community Mental Health Services Will Change on July 1, 2018
And There Are Some Things You Should Know
Massachusetts is in the midst of reforming services delivered through MassHealth and the Department of Mental Health (DMH). The overall goal is to improve coordination of health care services and to integrate behavioral health with the greater health care system.
MassHealth implemented changes on January 1, 2018 and March 1, 2018. DMH services will change July 1, 2018. During this period of transition, advocacy will be important to ensure that individuals do not "fall through the cracks" and that elements of the programs that are key to success are implemented properly.
Program elements that are key to success
The new model for DMH community services will be called Adult Community Clinical Services (ACCS). There are several promising elements of this new program. For example, we've been told that DMH is issuing new HIPAA guidelines and providers must ensure that "family involvement is routinely encouraged, in recognition that families can be key allies in the treatment process and their involvement often can help facilitate better treatment outcomes."
This is a significant improvement for families who are accustomed to hearing "I can't talk with you because of HIPAA ." But it will also be a significant change for providers who have been trained to give that response. With input from our members, we will be able to identify cases in which this change is not implemented and advocate for better training. Furthermore, our members will play a vital role in spreading the word that HIPAA does not necessarily mean "no."
Potential for falling through the cracks
MassHealth members and DMH clients will be assigned a care coordinator responsible for managing their medical and behavioral health care services. Care coordination will be provided by various entities, such as the new Behavioral Health Community Partner (BHCP) organizations, DMH case managers, Adult Community Clinical Service providers, etc. But, it is not yet clear how care coordinators will be assigned for some DMH clients.
For now, let's just say that it is complicated. It will be important for NAMI CC&I members to inform us of potential problems during the transition. We can use that information to find solutions and help people advocate for themselves.
ACCS Ombudsperson
The Department of Mental Health (DMH) established a new position to assist individuals who have questions about Adult Community Clinical Services (ACCS). The ACCS Ombudsperson helps people receiving ACCS, their families, and ACCS Providers to obtain information about services and resolve issues.
The ACCS Ombudsperson serves as a liaison between the community and DMH, but does not personally investigate individuals' complaints against agencies administering ACCS programs; however, they will assist in connecting them with the correct person at DMH.
The ACCS Ombudsperson recommends contacting the appropriate DMH Area Office to resolve general issues related to DMH services; however, the Ombudsperson will assist as a liaison if there are challenges in connecting with the Area Offices.
For a list of DMH Area Offices and contact information, refer to the DMH Resource Guide:
The most common questions to date concern individuals who are receiving CBFS services from a provider that will be replaced by a different provider under the ACCS services. For example, Vinfen will be assuming responsibility for all ACCS services on the Cape beginning July 1, 2018. Individuals may have questions about who will be providing services when CBFS ends and ACCS begins.
The ACCS Ombudsperson can be accessed through phone or email:
The editorial board represents the opinions of the board, its editor and the publisher. It is separate from the newsroom and the Op-Ed section.
When President Trump mused that the mass shooting at a high school in Parkland, Fla., in February might have been prevented if the United States had more mental institutions, he revived a not-quite-dormant debate: Should the country bring back asylums?
Psychiatric facilities are unlikely to prevent crimes similar to the Parkland shooting because people are typically not committed until after a serious incident. Still, a string of news articles, editorials and policy forums have noted that plenty of mental health experts agree with the president's broader point.
The question of whether to open mental institutions tends to divide the people who provide, use and support mental health services - let's call them the mental health community - into two camps. There are just 14 or so psychiatric beds per every 100,000 people in the United States, a 95 percent decline from the 1950s. One camp says this profound shortage is a chief reason that so many people suffering from mental health conditions have ended up in jail, on the streets or worse. The other argues that large psychiatric institutions are morally repugnant, and that the problem is not the lack of such facilities but how little has been done to fill the void since they were shut down.
Neither side wants to return to the era of "insane asylums," the
warehouselike hospitals that closed en masse between the 1960s and 1980s. Nor does anyone disagree that the "system" that replaced them is a colossal failure. Nearly 10 times as many people suffering from serious mental illnesses are being kept in jails and prisons as are receiving treatment in psychiatric hospitals.
What's more, both sides broadly agree that mental institutions alone would not be the solution. "Bring back the asylums" sounds catchy, but here are some more useful slogans to help steer the conversation:
1. DEMAND SENSIBLE COMMITMENT STANDARDS Exact wording varies by state, but commitment standards in general dictate that people cannot be hospitalized against their will unless they pose a clear and significant danger to themselves or others. That sounds reasonable, but with so few inpatient facilities, mental health workers have a strong incentive to determine that even someone who needs to be committed - perhaps someone dangerously delusional - does not meet that standard.
2. CREATE A CONTINUUM OF CARE Deinstitutionalization was predicated on the 1963 Community Mental Health Act, which was supposed to create well-staffed, well-funded community mental health centers in about 1,500 catchment areas across the country. These centers were supposed to provide clinical care, housing and employment support, and community outreach. When President John F. Kennedy announced the legislation, he estimated that it would ultimately return about half of the 500,000 or so people then living in state psychiatric hospitals to be "treated in their own communities and returned to a useful place in society."
If only the law had been given a chance to work. States failed to devote their savings from the closure of large institutions to community-based care, and few communities were willing to host the centers in their backyards. In the end, only about 750 centers were ever built, and zero were ever fully funded. Today, less than half of all adults suffering from mental health conditions receive help, and mental illness is the leading cause of lost workdays in the United States, costing about $193 billion in lost earnings a year.
People who suffer from behavioral and psychiatric disorders need and deserve a wide range of care options: community mental health centers, short-term care facilities, and - yes - longer-term arrangements for the small portion of people who can't live safely in the community. The pro-asylum camp is right that the number of people needing those longer-term placements is greater than zero. But the figure is also small enough to avoid the need for the thousand-plus-bed facilities that were once the sites of so much abuse.
3. STAND UP FOR INSURANCE PARITY This October marks 10 years since Congress passed the Mental Health Parity and Addiction Equity Act, which requires health insurers to provide the same level of benefits for mental health treatments and services as they provide for medical and surgical care. On paper at least, both the Affordable Care Act and the 21st Century Cures Act bolstered that 2008 statute by requiring plans on the health insurance exchange to cover a list of essential behavioral health benefits and by enacting greater enforcement of the parity rules.
In practice, though, the three laws have yet to create true equity. "In some situations, you still can't get into a psychiatric facility unless you are suicidal or otherwise near death," says Ellen Weber, vice president for health initiatives at the Legal Action Center, a nonprofit that is fighting parity violations in several states. "That's an abhorrent double standard. We don't do that for medical or surgical need."
And because regulators at the federal Departments of Labor and Health and Human Services are required to investigate complaints, not prevent them from happening, the burden of proving a parity violation falls on the consumer. "This is a law that's almost impossible to enforce as it stands," Ms. Weber says. "It requires a tremendous amount of information gathering and sophisticated analysis that most consumers are not equipped to take on, especially in the middle of a medical crisis."
Why not have regulators certify that plans meet parity rules before they go to market? Officials at H.H.S. and the Department of Justice could then step in to police insurers for violations - before problems become clear. While we're at it, Medicaid ought to lift its longstanding exclusion of inpatient psychiatric care.
Because "asylum" is a loaded term, it can draw attention to crucial issues facing vulnerable Americans, but it also tends to foreclose discussion of real solutions. Most of those solutions aren't even controversial. There just needs to be the collective will, and basic decency, to act.
Book Review
Insane
America's Criminal Treatment
of Mental Illness
By Alisa Roth
I recently read about the following true story. A woman called the police because she was concerned that her husband was going to commit suicide. He was on his way to their church where she thought he had hidden a gun. The police arrived and took him into custody and then searched inside the church and indeed found the gun. He was then arrested (and convicted and sentenced) for illegal possession of a gun. Did anyone ever address his underlying mental health problem? I dare say no.
Alisa Roth has written an excellent and well researched book examining the complex relationship between the criminal justice system and people with mental illness. I think it's well known now that a large number of prisoners have serious mental illness (over half of all prisoners) and that prisons have become one of the largest "providers" of mental health services. Roth has looked at this problem across the country, visited with families, visited jails and prisons, met with police and prison officials, and met with mental health providers. She writes about the factors that have gotten us to this point and some of the ways communities are starting to deal with these issues. It is at times a sad and discouraging book but at the same time valuable in understanding all sides of the issue.
At the beginning of the book Roth debunks the simplistic but widespread notion that this is all due to the closing of the large hospitals for the mentally ill. While that indeed was a factor, the larger factor has been the mass incarceration of people in the name of being tough on crime. Over the last thirty years or more prison populations have skyrocketed. Along the way those with mental illness have been particularly hurt. Another crucial factor has been the lack of community based mental health services. Roth writes, "More than a third of prisoners with mental illness show signs or have symptoms of their disease when they're arrested but haven't been diagnosed or treated within the past year."
Roth then discusses the challenges of providing mental health services in prisons and jails. These challenges exist for both the mentally ill, as well as, the criminal justice system caring for them. Mental health treatment is incompatible with incarceration. The primary functions of prisons are control, punishment and often isolation of inmates. On the other hand, mental health care is based on trust, empathy and human connections. Jail as a hospital is in Roth's words "destined to fail." In fact, for many prisoners with mental illness being incarcerated makes their symptoms much worse.
One of the biggest steps in dealing with this problem is to keep those with mental illness out of the criminal justice system. That first step makes all the difference. We all know that there is a great need for timely access to community mental health services. Without access to these services, it is often only a matter of time before one faces the criminal justice system. Those that have a substance problem are at particular risk of behaviors that bring them into the criminal justice system. Once that occurs then the next step has to be how to divert people away from jails and prisons and into the mental health system. But for that to happen there have to be options available for police to turn to.
Roth describes two important steps that communities are taking to impact this problem. One is the development of Crisis Intervention Teams (CIT). This is well known to Cape Cod and The Islands NAMI and congratulations to Cape Cod and The Islands NAMI for the great work that has been done here. The second step is the development of "Restoration Centers" which provide acute short-term intervention on a 24 hour a day seven days a week basis. These centers provide short term stabilization, detox and initial rehab and connect individuals to mental health care and housing.
Let me conclude by pointing out that there is an effort on the part of the criminal justice system to provide better services to prisoners with mental illness. This is laudable but inevitably inadequate. As I pointed out providing mental health care in prisons is almost an oxymoron. Roth concludes her book with the following. "We have begun to understand, again, that jails and prisons are not appropriate places for dealing with mental illness. Yet the push continues to medicalize criminal justice in response to the criminalization of mental illness, often at the expense of diverting people out of the criminal justice system or of keeping them out of there from the beginning."
Written by Dr. George Vitek, retired pediatrician who practiced for 28 years in Wilbraham, MA. Married father of four and grandfather of 9.
NAMI Statement on Family Separations at the Border
NAMI, the National Alliance on Mental Illness, was created based on the foundation of family involvement and through our years of experience, we believe that strong family support is vital to a child's long-term mental health.
The forced separation of families is highly stressful and can result in trauma-and these separations can profoundly impact children who do not yet have a mental health condition, as well as those who are experiencing symptoms, by ripping away vital family support. There is growing evidence that exposing young children to trauma is toxic to the development of their brains. Traumatic experiences can negatively impact development and mental health as children grow.
NAMI joins the American Psychiatric Association, American Psychological Association, American Academy of Family Physicians and others in urging an immediate end to the practice of separating families. The future well-being of vulnerable children is at stake. We believe it's critical to children's mental health to be with their families and caregivers.
How the toxic stress of family separation can harm a child
Federal officials at the U.S.-Mexico border separated nearly 2,000 children from their families between April 19 and May 31. While it's not clear how the political fight about the practice will play out, researchers do know how a traumatic event like being separated from a parent affects a child.
"Taking children away from their mothers is harmful to them," said Jack Shonkoff, who directs the Center for the Developing Child at Harvard University and for decades has researched how stress affects the brain. "There's nothing complicated about that, and there's incredibly strong science and a big hunk of common sense that both lead us to the same
conclusions."
Children being separated from their parents at the border experience toxic stress - intense, repetitive or prolonged adversity without an adult's intervention - a situation that's usually seen when a child is placed in an orphanage, survives a natural disaster or lives in poverty, a war zone or a refugee camp.
This kind of stress can have lifelong impact. Here's what we know about how toxic stress affects children and what's happening to those being detained at the border.
What does toxic stress do to the body?
When humans and animals feel threatened, their bodies producestress hormones. This biological response triggers a chain of events that evolved to help us recognize and survive dangerous situations.
First, your amygdala - where fear registers in the brain - fires off signals. Your brain's hypothalamus sounds the alarm for the rest
of your body. Your body's adrenal glands and tissue, located near your kidneys, release adrenaline -the "fight-or-flight" hormone - along with norepinephrine and cortisol, another stress hormone. With these hormones surging through your body, your heart races, your muscles contract, your breath quickens and your blood pressure rises. Your brain is preparing the body for how to handle trauma, said Nim Tottenham, a psychologist and researcher with the Developmental Affective Neuroscience Lab at Columbia University.
This happens when a child cries because they are hungry or throws a tantrum over a toy. In a stable environment, a familiar adult calms them, which tells their body's alert system to stand down. In response, the child's heartbeat slows to its normal pace. They can take a deep breath and relax.
How is this playing out along the border?
For nearly 2,000 immigrant children removed from their families and held in custody along the U.S.border with Mexico, the person who can flip that off-switch is gone. When Colleen Kraft, the president of the American Academy of Pediatrics, visited a Texas shelter this spring, she said staff were not allowed to touch children. Kraft, a pediatrician with 30 years of experience, said she saw one young girl weeping for her mother. The staff offered toys and books to console the girl, but they told Kraft they were not allowed to hold her.
"We, in this action, are inflicting toxic stress on these children," she said.
When both children and adults are in a state of toxic stress, the brain and body are fixated on ensuring immediate survival, Tottenham said. But children are especially vulnerable because they are undergoing major brain development, which means survival takes priority over things like academic development and physical growth.
Trauma that children who are separated from their parents and placed in migrant detention centers "has biological consequences on brain development in ways that are enduring for a lifetime," Tottenham said. There is not one bellwether study that tells us separating children from their families is bad for their brains and development, Shonkoff said - there are "hundreds of studies" produced over several decades that have established the negative longterm consequences of toxic stress on children.
Some of the effects include:
Brain development
In a situation where children are separated from their parents for a long period of time, they remain on high alert, and their bodies endure prolonged and severe toxic stress as a result. That interrupts the brain's architecture at a critical time of development, when neural circuits - the pathways necessary to carry information toand from the brain - are forming rapidly, at a rate of more than 1 million neural connections each second in infants and toddlers. Stress hormones block those neurons. This can lead to delayed development in reason, learning and emotional development. This stress can overwhelm the hippocampus, the brain's built-in shutdown valve for the stress hormone cortisol. If continuously exposed to toxic stress over time, damage done to the child's brain cannot be changed, studies have shown.
Emotional toll
When a child is primed to experience fear and anxiety, thoseemotions can superimpose themselves onto how the child interacts with another person, even if that person wants to nurture and love the child. This condition is called reactive attachment disorder, and it can start as early as infancy if a child's basic needs aren't met by a parent or caregiver, preventing a healthy bond from forming between them. If you try to hug a child diagnosed with this disorder, they may react by biting or hitting you, Kraft said: "Any activity with these children, even if it's a loving activity, they're going to react."
In other words, children with this disorder don't recognize nurturing behavior and therefore don't know how to respond- so instead, they perceive these gestures as a possible threat.
Long-term effects
People often think that an infant or toddler who experiences trauma won't remember the fear and anxiety that filled their early years once they're placed into a stable environment, like a foster home. But "that is absolutely wrong," Shonkoff said.
Toxic stress is more subtle than a broken bone or distended stomach, but it can leave permanent mark on a child's brain and can "create a weak foundation for later learning, behavior, and health," according to a 2012 study published in the journal Pediatrics that explored how adversity and toxic stress in early childhood can manifest itself throughout a child's life.
After a long period of sustained toxic stress, a child who had seemed inconsolable may become quiet, dull or withdrawn. That doesn't mean they have adjusted to what's going on, said Shonkoff, who led the committee that produced the 2012 study. Those symptoms emerge because their cortisol levels are depressed and their stress levels are blunted.
Long-term consequences of toxic stress are as much about physical health as they are about mental health, Shonkoff said. These children are more likely to experience behavioral problems, drop out of school, struggle with substance abuse or be diagnosed with chronic illnesses, such as diabetes or heart disease.
"The bigger danger to children are the long-term consequences, and the longer they're separated from their mothers, the greater the risks become," he said.
What treatments are available?
Pediatricians, including Kraft and Shonkoff, say prevention is the best cure for toxic stress in children - simply put, don't expose them to trauma in the first place.
Therapy has been designed to combat the effects of toxic stress, but they are often expensive, need to be delivered over time and are not widely available, Kraft said. And as with any medication or therapy, individual children respond to this treatment differently. For some children, play therapy may relieve some symptoms of trauma, but for others, the strategy may not produce any real change no matter how much time is spent trying to find the right treatment.
Time is critical for delivering these services if the goal is to relieve the child from the fear and anxiety gripping them. As soon as they are identified as needing help from trauma, they need to be connected with services, said Kelly Whitener, associate professor of practice of Georgetown University's Center for Children and Families.
The Department of Health and Human Services did not indicate when asked by the PBS NewsHour whether the federal government's shelters provide any kind of treatment or therapy to children at-risk for or experiencing toxic stress.
To develop those kind of services would take enormous effort and cost, Shonkoff said. And even if children receive such support, Kraft said, it's unlikely they would be fully restored mentally, emotionally and physically to who they were before they reached the United States.
What's next?
Children in detention facilities eventually are placed in a shelter or with a sponsor while they navigate immigration court proceedings. At the same time, they are grappling with multiple levels of separation, Tottenham said. The initial trauma of watching a parent or guardian being taken away is compounded by further trauma of life going on without that person. On top of that, the child is wondering whether they will ever see that parent again.
The Trump administration on Monday continued to defend the separation of children and parents at the border. The House is considering several immigration proposals, some of which address family separation, but it's unclear at this point whether any of them have enough support.
If the policy ended today, Tottenham said entire families will need therapy and interventions to account for the trauma they have already endured. If that doesn't happen, a population of children will grow up at great risk of developing behavior and mental health challenges, she said: "They're going to be living in the United States and know that the U.S. government is the source of this trauma early in life."
Suzanne Fronzuto
NAMI on Nantucket Program Coordinator
Mental health and wellness providers gathered on June 14th at the Nantucket Lifesaving Museum for a reception sponsored by Bob and Marsha Egan and the Egan Maritime Institute. The reception brought together advocates and providers for the opportunity to meet and learn about the work being done by individuals and organizations who support better behavioral health for island residents and visitors.
Representative Dylan Fernandes announced the commitment of $100,000 in state funds for behavioral health transportation for the islands of Nantucket and Martha's Vineyard. Jackie Lane spoke on the NAMI media campaign which kicked off in May as part of Mental Health Awareness Month and the continuing need to address the role of stigma, as it applies to island residents and the greater community. Margaret Hannah, Director of William James College, described the referral helpline for behavioral health needs which will debut in September and is funded by a grant from NAMI. Other guest speakers were Dr. Margot Hartmann, President and CEO of Nantucket Cottage Hospital , who spoke of the recent contract signing between the hospital and Cape Cod Ambulance that will make it easier for individuals on the island to be transported to a psychiatric facility or drug treatment program, Tess de Alberdi, Executive Director of Fairwinds, an organization with deep roots in the community, that provides an extensive array of behavioral health services and programs for island residents and Allie Anderson, Chief Clinical Officer for Gosnold, that provides 24/7 emergency response as well as comprehensive behavioral health and psychiatric services and programming for individuals in various stages of recovery or crisis. The efforts of the Nantucket Behavioral Task Force which works tirelessly to keep the community informed and aware of the full range of mental health and substance abuse services available on the island and the generosity of Bob and Marsha Egan highlighted what can be accomplished when everyone works together.
NAMI Cape Cod & the Islands will be offering Homefront teacher training soon. We are in the process of identifying community members on Nantucket who are interested in participating in this training and offering this 6-week program for family, friends, and significant others of military members or veterans. The class will help families understand what the service member/veteran is experiencing related to trauma, stress, transition to civilian life, PTSD or other mental health conditions.
At Great Harbor Yacht Club, enjoy drinks & hors d'oeuvres, music by Jeff Ross, & bid at the silent auction.
Please note: Dragonfly will be held at
The Great Harbor Yacht Club
96 Washington Street, Nantucket, MA
Valet parking provided.
Net proceeds from Dragonfly will be donated to NAMI CC&I on Nantucket, an organization that serves individuals and their families who are affected by the broad spectrum of mental illnesses and neurological disorders through support, education and advocacy, and promotes wellness for all.
Thank You to the Dragonfly Committee: Kate Kling, Founder, Katie Keith, Kate Coe, Kerryann Leddy, Emme Duncan, Barbara Dale, Tamara Greenman, Cara Marquis, Amanda Wright, Candace Alexander
And From NAMI on Martha's Vineyard
Summer is finally here and the island is bustling. NAMI on MV continues to make progress. Dr. Charlie Silberstein, Head of Psychiatry at MV Hospital attended two F2F classes and wrote a wonderful article in our local paper. Great to raise awareness.
We have identified 9/14 as a date for our NAMI MV "Friendraiser". The evening will include a silent auction and proceeds will be earmarked for MV. We are looking for members to help organize this event.
We'll be adding a part time paid Coordinator to assist with marketing, outreach, and resource sharing. A position description will be circulated separately. If interested please reach out to me at [email protected]
Cecilia Brennan
NAMI CC&I
MV Representative
From the MV Times:
What to do if you have a mentally ill family member?
Here are two facts: First, when there is family involvement in the care of people with serious mental illnesses, everyone does better. Second, family involvement in mental health care does not occur in the majority of cases. According to Lisa Dixon, M.D., who is the director of the Center for Practice Innovations at the New York State Psychiatric Institute and a professor at Columbia University Medical Center, the single most important intervention for families of adults with mental illnesses is the 12-session Family to Family course offered by the National Alliance on Mental Illness (NAMI).
To read the rest of this excellent article on the value of Family-to-Family:
Suicide is the 10th leading cause of death across all age-groups, with suicide rates increasing 30% since 1999 and half of states experiencing an increase in suicide of more than 30% during that time period. There were 44,965 deaths by suicide in the United States in 2016, almost 20% of all injury-related deaths, according to new data released from the Centers for Disease Control and Prevention (CDC) last week.
Factors contributing to suicide risk are extremely complex and can include mental illness as well as a host of other factors including substance misuse or financial instability. New data from the CDC indicates that more than half of people who died by suicide in 2016 had no known mental health disorder at the time of death. As the CDC so rightly states, however, "it is possible that mental health conditions or other circumstances could have been present and not diagnosed, known, or reported."
Of the total suicide deaths in 2016, 10.3% of individuals had a diagnosed serious mental illness, according to a 27-state sample analysis conducted by the CDC. Extrapolated to the entire United States, this indicates that approximately 4,649 individuals with schizophrenia or bipolar disorder died by suicide in 2016.
Suicide risk by firearms or other means
A new research article published in Psychiatric Services this month supports the CDC data while highlighting the importance of caution when drawing broad conclusions from any one-time results.
Jennifer Boggs and authors analyzed 2,674 non-adolescent suicides and 267,000 controls of patients of health care systems that are part of the Mental Health Research Network, a network of health care systems that provide both general medical and mental health care to more than three million Americans. Through a complex statistical analysis of matching suicide cases to controls, Boggs and authors were able to determine different risk factors for suicide, including the risk for suicide by firearms or other means.
Individuals with schizophrenia had significantly higher rates of suicide compared to the general population by the largest magnitude than any other mental or physical health condition. The odds varied by means, individuals with schizophrenia had much higher odds of suicide by other means as compared to firearms. The following is a sample of the findings from the study:
The odds of suicide by other means is 24-times higher for individuals with schizophrenia; 10-times higher for suicide by firearms.
The odds of suicide by other means is 23-times higher for individuals with bipolar disorder; 8-times higher for suicide by firearms.
The odds of suicide by other means is 12-times higher for individuals with depression; 8-times higher for suicide by firearms.
The odds of suicide by other means is 3-times higher for individuals with epilepsy; 3-times higher for suicide by firearms.
The authors found that the odds of having a mental illness or substance use disorder is significantly less among suicide cases with firearms when compared to suicide cases by other means. This is despite the fact that approximately 50% of all suicides occur by firearms and that 63% of all firearm injuries in the United States are self-inflicted. However, this does not imply that the contribution of mental illness to suicide risk in the United States is insignificant. Rather, the results show that individuals with serious mental illness have more than a 20-times higher risk of suicide compared to the general population.
Conclusions
The results from these two studies indicate that untreated sever mental illness is a significant factor contributing to the rising rates of suicide in the United States. Steps need to be taken to reverse this trend that include ensuring access to timely and effective treatment for individuals with the most severe psychiatric disorders.
Violence, Victimization and Serious Mental Illness
The connection between violence and mental illness is seen in headlines almost every day in the United States and throughout the world, often when trying to explain inexplicable acts of mass violence.
Although a very small proportion of individuals with serious mental illness who are untreated may exhibit violent behaviors or commit violent acts, individuals with serious mental illness are more often the subjects of crimes not the perpetrators. New research utilizing the Danish National Registry and police data in Denmark brings first-of-its-kind evidence to the risk of being subjected to crime for individuals with mental illness, published last month in JAMA Psychiatry. Jeffrey Swanson, PhD, arguably the most-renowned expert in serious mental illness in violence, published a piece in the same periodical on how the results of the Danish study compare to the United States.
Using longitudinal data of more than two million individuals and multiple independent variables, the Danish study found that individuals with mental illness are at 2.5 times higher risk of being subjected to any crime compared to the general population, and at even higher risk of being subjected to violent crimes.
The authors found that the risk of being subjected to crime varies depending on mental illness diagnosis, sex and the individual's own history of crime.
For example, women are at significantly higher risk of being a subject of a crime compared to men with the same illnesses, and individuals with serious mental illness such as schizophrenia or bipolar disorder were at greater risk than other mental illnesses. An individual's risk of being victimized increases if the individual also has a history of their own criminal offending, which the authors argue is due to similar risk factors for both being arrested for offenses as well as being victimized.
Violence and victimization in the United States
In his editorial on the piece, Swanson points out the important differences between the two countries and how these may explain some of the causal mechanisms behind victimization and mental illness. A 2005 study conducted in the United States found that individuals with mental illness are at 12 times greater risk of being a subject of a crime, compared to the 2.5 times greater risk in the Denmark study. This suggests that individuals with mental illness in the United States are at a disproportionately greater risk for victimization, which raises important considerations as to what might make people with mental illness more vulnerable to crime.
"Compared with Denmark, the United States has more of the factors that increase crime (such as poverty and inequality) and less of the factors that might ameliorate it (such as a strong social safety net and universal health insurance)," argues Swanson. An environment in which crime vulnerability increases when mental illness and poverty occur together suggests the importance of supportive resources for mental illness treatment and recovery and overcoming poverty is essential to reverse this association.
Swanson ends the piece by reiterating the Danish authors' call for more research into the relationship between mental illness and becoming a victim of a crime but argues "a larger lesson from their findings is that things could be worse in Denmark; certain other countries might do well to follow their example."
My name is Wil Wheaton. I live with chronic Depression, and I am not ashamed.
This is an excellent first-person account of a successful 45-year old man who none-the-less lives with chronic depression. These are his remarks at NAMI Ohio's statewide conference. Anyone who has lived with depression, anxiety and panic attacks will resonate with his feelings.
NAMI Cape & Islands is proud to be bringing Homefront to Massachusetts! Coming September 29th and 30th we are offering a free, two day training for individuals to become NAMI Homefront facilitators.
Based on the Family to Family model of education, Homefront is a six week course for family members who are coping with issues specific to military related challenges.
Registration is now open for the Homefront Facilitator training coming to Hyannis in September 2018. Requirements to participate are:
-Have a relative who is a Service Member or Veteran with symptoms of a mental illness/mental health condition (includes PTSD & TBI).
-Be a Service Member or Veteran AND have a relative with a mental health condition (the relative with a mental illness need not be a Service Member or Veteran but the NAMI Homefront teacher MUST have a personal/family connection to the military).
-Have a relative who is a Service Member or Veteran AND have a relative with a mental health condition (the relative with a mental illness need not be a Service Member or Veteran but all NAMI Homefront teachers MUST have a personal/family connection to the military).
For more information on this training, and to obtain a registration application, please contact Kim Lemmon, Director of Family Programs at 508-778-4277 or email her at [email protected]
The Key Idea
The Key to Understanding * Stories of Struggle and Healing will expose the deep fears and sincere hopes of individuals who suffer from mental health issues, their caretakers and first responders. This moving exhibit will give a voice to folks who suffer from an illness that is hard to explain to others. Your disorder does not define you. The key is to deal with my bipolar disorder.
People participating in NAMI Cape Cod & The Islands (National Alliance on Mental Illness) programs gathered together in NAMI Peer and Support Groups or Family to Family classes and were invited to add their experience to a collective art project though The Key Idea™. Individuals were given an opportunity to reflect on their experiences with mental health and create a meaningful piece of art inspired by a key. They each were asked to select a used key, draw it and answer the simple question,
What does your key open or start or do? This key unlocks the chains that shackle my happiness.
The Key Idea, Inc. will fund this project through a grant from the hope & grace fund, a project of the New Venture Fund in partnership with the global women's skincare brand Philosophy, inc.
Project developer Lenore Lyons and project partner Tamara Harper expect to gather and display several hundred KeyStories. The goal is to give people an opportunity to share their unique experiences through art and writing as well as to raise awareness and reduce the stigma of mental illness through this large-scale community engagement project.
The KeyStories were collected over a six -month period; the exhibit will travel to three regional libraries.
See The Key to Understanding at the Mashpee Library in July
Dance In The Rain
Dance in the Rain Whole Person Approach is a non-profit organization that supports peers who struggle with mental illness. Located in the heart of Hyannis, we provide this population with an opportunity to expand their lives, despite their condition, to grow, engage and heal. The staff, from executive director to volunteers, live with a history of mental illness as well. Our staff is well vetted to work with other peers who wish grow and seek to define themselves beyond mental illness. We are the only program in New England to have an organization that is conceived, developed and designed by peers for peers. Daily programs are offered to enhance self-esteem and positive identity.
The Cape Cod Regional Transit Authority provides a daily general public demand service called Dial-A-Ride Transportation (DART) that is a door-to-door ride by appointment transportation service. It is available to all 15 Cape towns, runs from 7:00 am to 7:00 pm on weekdays and more limited hours on weekends. It is easy to access and use.
For more information, call them at 800-352-7155 or visit their website at:
WE'RE PUBLISHED!! You Are Not Alone: A Primer on Mental Illness, which has been in development for the past 18 months, is now available. (Call or email the office to make arrangements for your personal copy or copies for your organization.) The Primer has been hugely popular--we published 2,000 copies
and have only 200 left!
The Primer is also online on our NAMI CC&I web site. The production and publication of this 88-page booklet was made possible by generous support from the Cape Cod Healthcare Community Benefits Fund, The Kelley Foundation, Inc. and The Cape Cod Five Foundation.
Tidbits...
If you shop at the Orleans Stop & Shop or the downtown Nantucket Stop & Shop, take a closer look at your shopping cart. NAMI CC&I will have its signature sunset ad posted on the cart. We hope this will bring more
awareness of NAMI to that area.
Mark Your Calendars:
Family-to-Family
Family to Family is a 12 week course for family members, partners, and friends of individuals with mental illness. The course is designed to facilitate a better understanding of mental illness, increase coping skills and empower participants to become advocates for their family members.
NAMI Cape & Islands would like to offer Family to Family in FALMOUTH to begin this summer. There is currently a small list of individuals waiting for this course to be offered.More participants are needed to schedule this course in Falmouth.
Family to Family on the Outer Cape - Fall 2018: Attempting to organize a Family to Family in either Wellfleet or Provincetown. Please contact the office to register.
Family to Family - Barnstable: There is currently a small list of individuals waiting to participate in Family to Family when available in the Barnstable area. More participants are needed to schedule this course in Barnstable.
If you or someone you know would benefit from this type of education, please contact Kim Lemmon, Director of Family Programs at 508-778-4277 or email Kim at [email protected]
The 2018 Siobhan Leigh Kinlin Memorial Golf Tournament will be held on Monday, September 10, 2018 at the Oyster Harbors Club. There are opportunities to play, join us for dinner and an exciting auction, become a Sponsor or have a Tee & Green sign for your company. Visit our website for more information or to register.
This tournament supports NAMI Cape Cod & the Islands programming for the coming year.
Suicide: The Ripple Effect
July 31 at 7:30 pm
Cape Cod Mall Stadium 12
793 Iyannough Road. Hyannis, MA
This screening will only happen if 44 ticket(s) are reserved by 2:00pm on July 22
If you are interested in viewing this excellent performance, call or email Vanessa:
Grandparents with questions about guardianship/options can visit the Probate Court on the 3rd Thursdayof the month between 8:30 AM-1:00 PM.
They can also call the Bar Association (508-362-2121) or Susan at the courthouse (508-375-6730) for an appointment with Kathleen Snow on Mondays between 10:00 AM-1:00 PM.
There is no fee for either of these consultations.
Lawyer For A Day--Free Legal Advice
Held daily at the Barnstable Probate Court. It is advisable to arrive promptly when it opens at 9:00 am as it is first come, first served and fills up quickly.
Inclusions in the Newsletter
We have recently been asked for last minute inclusions of events in our newsletter. We have instituted a new policy: It is at the discretion of the Executive Director to determine whether content being submitted for distribution to the membership is aligned with our mission. If the content is determined to be appropriate, it may be included in the monthly e-newsletter if it is submitted prior to the first of the month.
When shopping on Amazon, think NAMI CC&I and Amazon Smile.
Every dollar you give to NAMI CC&I goes to help support, educate and advocate for the residents of Cape Cod, Nantucket and Martha's Vineyard.
AmazonSmile is a simple way to give when you are shopping on Amazon
Amazon donates 0.5% of your eligible purchases.
It's so easy, you can still use your Amazon Prime and you still collect points. All you need to do is: When you are going to make a purchase on Amazon, first enter
