DECEMBER 2019 We wish you a peaceful new year!
From the desk of Jackie Lane, Executive Director NAMI CC&I

Happy New Year! As we move into a new decade as well as a new year, we at NAMI CC&I are in the process of establishing goals and priorities as we struggle with the mental health system in attempting to help families and friends get desperately needed resources.

Advocacy, one the three principle roles of NAMI CC&I, has been moving rapidly to the forefront. During November and December, I have attended 5 listening sessions on mental health issues with Senator Julian Cyr and his staff. Senator Cyr, who represents a large portion of the Cape and Islands at the State House, is the Co-Chair of the Joint Commission on Mental Health and Substance Misuse, giving us direct input into ideas concerning possible legislation on this health care issue. Also, as was re-iterated in the Boston Globe this morning, the President of the Senate, Karen Spilka, when asked about her priorities for the new year, strongly endorsed mental health. Now is the perfect time to advocate for the Cape and Islands!

The following is a copy of a document that I took to one of these listening sessions and left with the senator. I think that it covers most of the issues that we, the NAMI CC&I staff, have dealt with as we have responded to the several hundred support calls that we have received at the office this past year.

We will continue to be a strong voice advocating for mental health services with the goal being:
1.     The integration of mental health care into primary health care from birth to death.
2.     The development of an easily assessable continuum of mental health care for all of those on the Cape and Islands.

Please feel free to call and respond to the following, give examples, or add to the list! Working together with legislators, perhaps we can make a difference. We have to!


Observations Concerning the Mental Health System on the Cape & islands

November, 2019
Jacqueline Lane, Executive Director, NAMI CC&I

These are the observations (broad, general overview) I have made after three years of helping clients and their families and caretakers navigate the mental health system:

·        The mental health system is fragmented and broken, leaving one to question, “Is there a system?”
·        There is a lack of a Continuum of Care on the Cape and the Islands, leaving those who need acute care without the necessary services or underserviced at best.
·        Mental health has been separated from other health care without integration into primary care from birth to end of life.
·        Insurance companies have been allowed to have “carve outs” minimizing mental health coverage in spite of the parity laws.
·        There is no well-known assessable entry point into the system. People have no idea of where to even start when faced with a family mental health situation.
·        The legalities involving the sharing of information between agencies and entities (such as police and hospital) or with parents of adult children in a mental health crisis. HIPAA laws need to be re-evaluated and perhaps redefined when mental health is involved.

The above are the broad issues that need to be addressed if we are to “change the way mental health care is delivered in the Commonwealth” as I believe Senate President Spilka desires. We, at NAMI CC&I, have helped hundreds of families during the past three years and we have documentation of the difficulties involved. There are several specific recurring themes:

·        Lack of supervised residential housing for those who have nowhere to go. Group homes are not the answer or a permanent solution. Nantucket does not even have a group home for males and only one for five females.
·        Lack of assessable partial hospitalization programs, the islands have none and those on the Cape require long distance transportation for many.
·        Lack of “step down” beds, to be used after discharge from acute care.
·        Lack of children’s beds on the Cape and Islands.
·        Lack of necessary insurance coverage – the first question we ask a client is, ”What kind of insurance, if any, do you have?” This is unacceptable!

We could fill a room with consumers of the system, our clients, who would be happy to elaborate on these comments with their own personal stories. I feel fortunate to be addressing this from the consumers’ points of view. Perhaps one should remember that no matter how well developed a plan is, if it does not meet the needs of the consumer, it is doomed to failure. Any business person or company owner can tell you this. Success lies in meeting the needs of the consumer!

It is interesting to see that in Charlie Baker’s plan, he is requesting that 30% of the health care expense be invested in primary and mental health care. This also dictates that there be no increase in spending. How will the bills that are being prepared by the Senate and the House address this goal?
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Why You Struggle With Self-Care
By Britt Mahrer | Dec. 16, 2019

You may see self-care as a luxurious act of pampering yourself. You may have thought to yourself,  I should enact this ritual of personal dedication , resolving to begin a self-care practice immediately. That is, right after those things on your to-do list. And after you help your friend move. And when you get your next paycheck, so you can afford candles. Maybe self-care starts next week? But that deadline next Friday…maybe you’ll just add self-care to your to-do list. You’ll get to it eventually.
 
Consistently practicing self-care can feel impossible. Here are a few reasons why.

1. You’ve Got The Wrong Definition
Once upon a time, self-care meant “care of self.” It was the act of performing one’s own low-risk medical treatments (insulin shots, exercise, etc.), freeing doctors for more advanced work. But today’s image and hashtag-driven culture points us toward a new definition of self-care: prolonged pleasurable time resulting in peace, happiness and beauty. 
 
In theory, it’s lovely and filled with things we enjoy. But the problem is that this version of self-care takes a lot of energy. It is a massive undertaking. It mandates a very specific process with a very specific result: create a peaceful space, sink into presence and reflection and come out refreshed and filled with self-love (and perhaps with better hair). 
 
The roots of self-care are still there, if you look hard enough. Engaging in practices that prevent the decline of our health and well-being is a powerful notion. Yet this hashtag version of self-care means we are only successful if our actions result in self-improvement. The result? We tell ourselves to create a #selfcare practice, but we don’t. We simply don’t have the energy.
 
Conclusion: The moment that self-care produces reluctance, it is no longer self-care. It is self-growth. And while there is a time and place for self-growth, it doesn’t have to happen at the same time as self-care.  

2. You Think Putting Yourself First Means Putting Others Last
We learn about opposites in grade school (happy and sad, awake and asleep, etc.). In many ways, this all-or-nothing thinking never leaves us. Thus, it’s natural to think the opposite of selfless is selfish, that to care for others, we must sacrifice the care of ourselves.
 
In particular, new relationships (babies, romances, friendships) often result in a battle between time and to-do list, forcing us to choose something left undone. Prioritizing our new connection becomes a sign of love and dedication, an indication we are good people who care about the needs of others.
 
Yet anyone who’s flown on an airplane knows the rule: if the oxygen masks come down, secure yours first. Why? Because you have to be okay before you can help others be okay.
 
This is why prioritizing self-care is important. You can’t drive a car without fuel. Maintaining a self-care practice is not an act of selfishness — it is an act of improving our ability to care. 
 
Conclusion: When self-care feels selfish, we aren’t seeing the long game. Taking time for our physical and mental health makes us more capable for others. 

3. You Think You Can’t Afford It
The more expensive it is, the better it works. Right? At least, that’s what we’re told by advertisers. As self-care rises in popularity, so does the opportunity to profit. Suddenly, taking care of ourselves means buying the latest and greatest. Only the fanciest candles, softest sheets and most exclusive shampoos can make us feel good.
 
If these things bring a person joy, then more power to them. But the issue arises when we start to listen to the subconscious message:  if you can’t afford this, you don’t get self-care.
 
The result of these messages is that what was originally a practice of self-empowerment is now inaccessible for lower economic classes. It leads people to think that either we can afford self-care or we must accept it’s not for us.  
 
There are thousands of practices that improve physical and mental well-being, many of which are free and quick. Yes, an expensive hour-long yoga class is self-care. But so is a five-minute yoga video on YouTube.
 
Conclusion: We do not need fancy things to practice self-care. We simply need to knowingly engage in practices for our own benefit. Sometimes they’re big, sometimes small, but they are ours, and they work. 

4. You Don’t Know When You Need It
Blame that old banner-waving motto: hard work pays off. Our push-through-it mentality saturates politics, economics and even gender expectations. It’s practically hollered from the rooftops: Work hard. Be strong. Overcome weakness. 
 
But at some point, on our quest for mental fortitude, we began to believe that listening to our feelings prevents the strength needed for success. 
 
When we numb ourselves to feelings, we don’t develop self-assessment skills. We never learn how to pause and ask,  what is happening within me right now? What do I need to do to address it? This makes self-care a daunting concept. How do we take care our ourselves if we don’t know what parts need taking care of? 
 
Integrating self-care into our lives means redefining, and learning to respect, our relationship with our feelings. With time, feelings no longer feel like weaknesses. They become information, data telling us what part of us needs addressing.  
 
Conclusion: Don’t ignore how you feel. Rather, use how you feel to recognize when you need self-care. And if you just thought “other people might need self-care, but I don’t,” then you might be exactly the person who needs self-care. 
 
  Britt Mahrer, MA, LPCC is a psychotherapist and author in Denver, Colorado.For more information or to schedule an appointment, visit  brittmahrer.com . This blog was taken from the NAMI blog.

“It Takes A Community”
Community Crisis Intervention Team Training
  The latest CCIT Training was held on December 3-5 and December 10-11, 2019 at the Cape Codder Hotel. It was the largest group to date with over 35 police offices and 5 mental health professionals.
Sen.Julian Cyr & Jackie Lane
Sean Sheehan, Barstable Probation & Jackie Lane
Chief Mark Pawlina of Chatham
For this CCIT program, we were delighted to welcome J. Stuart Ablon of Mass General Hospital's Department of Psychiatry and one of the founders of Think:Kids Collaborative Problem Solving (CPS). Dr. Ablon has worked with many police departments, including New York City, to bring CPS to community policing.
NEW NAMI ON NANTUCKET PHONE #:
508-280-8777
Mental health matters, you matter” is a phrase frequently associated with NAMI CC&I on Nantucket and I’m looking at those words with a fresh eye as we face the end of 2019 and turn in expectation to the new year which promises endless possibilities .

What can we hope to accomplish in 2020? Family to Family, our 12-week program educational program for family members, significant others and friends of people living with mental illness, will be offered this winter and our monthly Family to Family support group continues to meet, but 2020 finds me looking for new opportunities to reach out to people so I will be exploring offering online support groups.

Although we’ve enjoyed several sunny days complete with blue sky lately, the holidays and upcoming winter months bring their own challenges. Wishing everyone a blessed New Year! Stay safe and remember “kindness is giving hope to those who think they are all alone in the world”. Be that hope. 
December has been a fun and busy month. The High School Peer Outreach Group is growing and thriving. We met twice again in December, focusing on self-care. We also ran a ten-day giveaway on Instagram, which over 100 students followed, liked, and commented on.
         
Ianna Oliveria won two gift baskets, one for herself and one for a friend. The baskets contained lots of great self-care items: Panda Journals, Water Bottles, Journals, Pens, Facemasks, Cozy Socks, Chocolate, Mocha Motts Gift Certificates, Aromatherapy, Fidget Cubes, I-buds, Stickers, movie passes, and more.
         
Next month the Peer Outreach Group will be focusing on Stress and Anxiety. We are hoping to bring therapy dogs into the school during mid-term week. And, we now have our own bulletin board in the High School.
         
NAMI MV, the Island Wide Youth Collaborative, and the Youth Task Force are combining efforts and finances to bring the new movie, “Like,” to the Vineyard for multiple showings this winter.
         
Board Member Cecilia Brennan and I met with the Superintendent and school staff to plan Think Kids training in Oct 2020. NAMI’s Jackie Lane phoned in and guided our discussion. We’re super excited that Stuart Ablon will be leading our program.
         
Our next Family-to-Family class will begin March 5. Planning will start after the New Year festivities. 
         
Our first 2020 event will be a Dine-to-Donate lunch and dinner at Off Shore Ale on Thursday, January 9. We will also hold a small silent auction throughout the day. If you have any auction items to donate, please let me know.
         
I hope your holidays were joyous, peaceful, and filled with laughter and laugh.
Happy New Year to all, Lisa
    
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From the MV Times newspaper:

NAMI is an acronym you likely recognize. It stands for the National Alliance on Mental Illness, and it’s the nation’s largest grassroots mental health organization, with local chapters throughout the country. Its presence on Martha’s Vineyard may be recognized through the annual Darkness into Vineyard Light suicide awareness walk, the 12-week Family to Family education and support group, or the lengthy lineup of activites offered during Mental Health Awareness month in May. 

But NAMI’s presence on the Island wasn’t as widely known until about three years ago, when Cecelia Brennan joined the board.
“There wasn’t a huge presence of NAMI on Martha’s Vineyard,” Brennan told The Times. “The whole purpose of me joining was to try and expand NAMI, and make their offerings more visible to the community.” It was a matter of getting the name out, and Brennan started by attending NAMI Cape Cod board meetings, where she got a feel for how other chapters utilized various programs. 
“I became the liaison between NAMI Martha’s Vineyard and the larger NAMI network,” Brennan said. 

Three years later, NAMI became a household name. Through fundraising and grants from NAMI Cape Cod, the Island chapter was able to hire part-time employee Lisa Belcastro. “I’m so grateful for Lisa,” Brennan said of Belcastro. “Now we have a paid employee, and we can get a lot more done.”

NAMI added another support group, and now offers two per month. They also trained two new facilitators to help lead support groups. And NAMI recently partnered with first responders and police chiefs for mental health first aid training. “They’re responding to the call first. Now they can be better equipped to handle mental health issues,” Brennan said. This year, 45 local police officers and first responders were trained in mental health first aid, according to Brennan. “Now they know we exist, and they know to give people our cards,” Brennan said. 

NAMI also partnered with the Martha’s Vineyard Hospital, and four nurses also received NAMI’s first aid training. “If there’s a mental health crisis, that person will likely end up in the ER,” Brennan said. “It’s important for us to get nurses trained on how to handle and diffuse situations.” 
NAMI is also working its way into Island schools. “We’re working with a student who wants to implement a peer support group,” Brennan said. “Which is wonderful. There’s a lot of opportunity in school to reduce stigma and open the conversation around mental health.”

Additional NAMI partnerships include M.V. Community Services, the Island Wide Youth Collaborative, the Island Disability Coalition, and the Substance Use Task Force.“Now we’re a thought,” Brennan said. “People know they can call Lisa and [me].”

Brennan’s work is entirely volunteer. She has a full-time job in human resources, and got involved with NAMI after experiencing its support for herself. 
“I moved here with my husband three years ago, and at the time, we had a family member dealing with mental health issues, so I started going to these support groups,” Brennan said. She attended the free 12-week Family to Family class, which is part education and part support group. 
“The class was a complete eye-opener for me,” Brennan said. “Learning the details of various mental illnesses, learning about the pharmaceuticals, medication, and referral process. But most valuable was listening to other people’s stories, and knowing you’re not alone in what you’re going through.”

At the end of the 12 weeks, an educator asked Brennan if she was interested in getting involved. “I knew I wanted to become more involved in the Island in some way, and this seemed like a good fit,” Brennan said. “It’s not easy when you have a family member dealing with mental health issues.”

Brennan believes communication is key in combating mental illness, as well as the stigma around it. “The more we hide behind it, the more it perpetuates the problem,” Brennan said. “One in four people have mental health issues. If you’re struggling, you’re not alone.”
She said the most challenging part about her role as a board member is navigating the mental health space, agencies, and programs. “There’s a lot of services out there,” Brennan said. “It’s about getting it all into a logical, one-stop shop, so people know where they can go. It’s about helping people through the red tape of treatment.”
And living on an Island presents bigger challenges. “We don’t have mental health beds or hospitals,” Brennan said. “If someone has a mental health crisis, they can be stuck in the ER because no boats are running, or there are no off-Island beds.”
The Island also lacks enough mental health professionals, therapists, and psychiatrists. “Those who are here are wonderful; we just need more,” Brennan said.
Brennan said the most rewarding aspect of her role is watching families and individuals open up in what they’re going through. “Just knowing you helped ease someone’s burden is huge,” Brennan said. 
When asked if she ever pictured herself as a mental health professional, she said she did. “I was a psychology major, and instead of going into therapy, I went into HR,” Brennan said. “I’m not surprised I’m on this path.”
Looking forward, Brennan is considering going back to school to get a master’s in mental health counseling. “That way I can help more people on the Island,” she said. “So that’s underway.”
Education and Support News
 
  • The Family to Family scheduled in Wellfleet to begin January 8th has been cancelled.

  •  Family to Family is being planned in Harwich and on Martha’s Vineyard for the Spring.

  • Homefront (the Family to Family for military families) is being planned for this Spring in Barnstable.
 
  • The Harwich Support Group has changed their meeting time. They continue to meet at St. Peter’s Church, 310 Rt 137, but now meet 6:00 – 7:00 p.m. on the first Thursday of each month (effective October 3rd).
 
  • The Sandwich Support Group has changed their meeting time. They continue to meet at Spaulding Rehabilitation, 311 Service Road, but now meet 6:00 – 7:00 p.m. on the second Tuesday of each month (effective December 10th).
 
  • The Support Network for parents of school-aged children through college is now meeting at the Gus Canty Center in Falmouth on the 1st Thursday of the month at 7:30 p.m. For information about this group, email Mary at marynewlim@gmail.com
      **Due to the school holiday schedule, the January 2 nd meeting is canceled. 

  • The Support Network for parents of children diagnosed with schizophrenia is meeting on the first Tuesday of the month, 400 Nathan Ellis Highway Suite B, Mashpee, at 6:30 p.m. For information about participating, email Cliff at cliff.jazzdog@gmail.com
 
To register for the upcoming classes in Harwich and Barnstable, or to be notified about another offering in the future, call or email Kim Lemmon, Director of Family Programs.  508-778-4277 or klemmon@namicapecod.org

To register for the upcoming class on Martha’s Vineyard, contact Lisa Belcastro at namionthevineyard@namicapecod.org   or 508-776-3746.

Study Shows NAMI Homefront Program Produces Major Benefits
By Richele Keas, Senior Manager, Media Relations, at NAMI
This article was originally published in the Winter 2019 issue of the NAMI Advocate.
The NAMI Homefront program produces significant benefits for both in-person and online participants, according to a study published this July in Psychiatric Services, a journal of the American Psychiatric Association.

NAMI Homefront is an adaptation of the evidence-based NAMI Family-to-Family program, designed to address the unique needs of family members, caregivers and friends of active-duty military service members and veterans experiencing post-traumatic stress disorder (PTSD), traumatic brain injury (TBI) and other mental health conditions. According to a RAND Corp. study, approximately 18.5% of service members returning from Iraq or Afghanistan have PTSD or depression, and 19% report experiencing a TBI during deployment. Another RAND study found that post-9/11 caregivers are more likely to care for an individual with a mental health or substance use condition than their pre-9/11 or civilian peers. Post-9/11 caregivers are also more likely to be lacking a network of support.

“We know that NAMI Homefront has helped countless military families across the country, and now there is science to prove it,” said Angela Kimball, NAMI’s Acting CEO. “This study reinforces the vital role family members, caregivers and friends can play in supporting service members and veterans with mental health conditions.” The study saw improvements in empowerment, coping, psychological distress, family functioning, experience of caregiving, and knowledge of mental illness for both in-person and online participants.

NAMI Homefront is free to participants and consists of six 2.5-hour peer-taught sessions for the family members, caregivers and friends of military service members and veterans with mental health conditions. The program launched in 2014 and has since enrolled over 2,500 individuals — 1,100 in person, 1,470 online — to date.

NAMI HOMEFRONT PARTICIPANTS LEARN HOW TO:
• Care for themselves, including manage stress
• Support a family member with compassion
• Identify and access federal, state and local services
• Stay informed about the latest research and information on mental health, including posttraumatic stress disorder, traumatic brain injury, anxiety, depression and substance use
• Understand current treatments and evidence-based therapies
• Navigate the challenges and impact of mental health conditions on the entire family
• Manage a crisis, solve problems and communicate effectively
RESEARCH WEEKLY: Looking Back on 2019  
 
The Office of Research and Public Affairs (ORPA) is now going into its fifth year. Since its inception, ORPA has produced original research on the role and impact of serious mental illness on public service systems, including the role of mental illness in fatal law enforcement encounters and the dwindling supply of civil and forensic hospital beds. Also central to its mission is filling the informational void around severe mental illness by making relevant research accessible to family members, policymakers, clinicians, media, and the general public. 
 
Below are a few key ORPA highlights from 2019:  

·     Assisted outpatient treatment in California  – The first ORPA report of 2019,  A Promising Start , analyzed publicly available information on the implementation of Laura’s Law, California’s form of assisted outpatient treatment. The report found that only 39 of California’s 58 counties have implemented Laura’s Law. Although the majority of county programs reported improved outcomes after implementing the program, our analysis found that the partial implementation of programs continues to underserve the population it was created to help.  
 
·     Law enforcement’s role in psychiatric crisis response  – In May, ORPA released its original research that investigated the outsized role law enforcement plays in psychiatric crisis response and transport, titled  Road Runners.  Although members of law enforcement do not serve as treatment providers for any other illness, they have become “road runners,” responding to mental health emergencies and traveling long distances to shuttle people with mental illness from one facility to another.  Road Runners  provides a unique glimpse into the burdens law enforcement departments must shoulder as well as the fiscal and societal implications of the current situation. 
 
·     Psychiatric boarding in emergency departments  – People with serious mental illness are disproportionately impacted by long wait times in emergency departments, a phenomenon known as “boarding.” Something very familiar to family members with loved ones with severe mental illness, ORPA released an evidence brief on the topic last month, titled  Delayed and Deteriorating . The evidence presented shows that serious mental illness is a significant contributor to emergency department boarding, and any solutions to combat psychiatric boarding must address treatment gaps for individuals suffering from these conditions.  
 
·     Research Weekly  – ORPA monitors the scientific and academic literature base on serious mental illness and translates the most relevant and interesting findings into weekly summaries for our followers. This unique service is a core value of ORPA’s mission and the most important work that we do.  If you are reading this online, you can subscribe,  here , to receive  Research Weekly  directly in your email inbox as soon as it is released.  
 
Lastly, the Treatment Advocacy Center has submitted a public comment to the National Institute of Mental Health’s (NIMH) five-year strategic plan and  urges you to do the same. Your feedback will be valuable in encouraging the NIMH to prioritize research into new treatments for serious mental illness.   
 



Diet and Depression:
A New Year's Resolution to Feel Better
Diet and Depression:
A New Year's Resolution to Feel Better




While evidence between nutrition and depression is mounting, experts say there is more to learn about the diet-mind connection. (Photo by dulezidar/iStock)

A growing number of studies over the last decade are showing a healthy diet can help to prevent depression. And for those with depression, diet has the potential to improve symptoms.

Kathy McManus MS, RD, LDN, director of the Department of Nutrition at the Brigham, says she and her team of five nutritionists often recommend the Mediterranean diet as a healthy eating pattern for many reasons.
“This diet involves eating more fruits, vegetables, extra-virgin olive oil, nuts, whole grains, and legumes, and less unhealthy snacks and red meat,” she says. “It has many benefits, including reduced risk for cardiovascular disease, diabetes, and potentially depression.” McManus says the advice she gives patients is influenced by studies published in a variety of journals, including those focused on gerontology, nutrition, and psychiatry.

“One study showed those who closely follow the Mediterranean diet are about 33% less likely to develop depression than those not following it,” she says. “Another study looked at people with depression who adopted the Mediterranean diet. After three months, they noted a significant improvement in how they felt versus those that didn’t follow this eating plan.”

As people change their diets, McManus suggests measuring progress. “Take inventory of what you’re currently eating and in three months look again,” she says. “What’s the quality of foods you’re consuming? Do you feel like you have more energy?”

For those interested in trying the Mediterranean diet, there are simple steps to begin. For example, she says, “Use olive oil in place of butter. Begin or end your meal with a salad. Try fruit for dessert.”

While evidence between nutrition and depression is mounting, McManus says there is more to learn.
“People are becoming more aware of diet-mind connection,” she says. “We’re still studying and trying to understand it.”
From Brigham & Women’s Hospital newsletter



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TIDBITS



We Can has groups beginning in the new year:

Circle of Support: For women experiencing separation or divorce - In Barnstable

Everything Women Want to Know About Family Law but are Afraid to Ask-- Wed, Jan 15 in Orleans

Call 508-430-8111 for more information.


Important Dates
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MA Health Insurance Open Enrollment Period is
November 1, 2019 -January 23, 2019
Now is the time individuals and families can apply and enroll in health and dental coverage and see if you qualify for free or lower cost coverage like MassHealth, ConnectorCare plans, or a tax credit.
 
Open Enrollment is also the time of the year where consumers can buy a new health insurance plan or change their current plan through the MA Health Connector. If your employer doesn’t offer health insurance or you cannot afford the plan offered by your employer, you can apply for individual insurance through the Massachusetts Health Connector. The open enrollment period in MA is November 1, 2019-January 23, 2020
 
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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. 


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
http://smile.amazon.com i n your internet browser. On your first visit to AmazonSmile, you will be prompted to select a charitable organization . Select NAMI Cape Cod Inc. It costs you nothing, but provides funds for NAMI CC&I.
Thank You!

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