http://azstarnet.com/news/opinion/editorial/article_a1372367-3bd9-5f49-8ea7-91fb0d25e4df.html

Local pyschiatric beds are commonly filled, but I wasn’t aware that psychiatric beds in our prison system are also filled.  Hummmmmm, I wonder what’s going on? Is it possible that we’re starting to see the results of continued budget slashes to mental health care in our state?  Or, is it because more people are becoming mentally ill? I think it’s the former.

Let’s look at some statistics.  One in four families are effected by mental illness in a given year and at least 10% of the population lives with a serious mental illness like schizophrenia or bi-polar disorder.  If Tucson’s population is one million, then that’s 100,000 people right here in the Old Pueblo.  Some are being successfully treated and some are not.  Many are in denial about their illnesses and don’t know about the high success rates of treatment – sometimes as high as 90%  do achieve mental health recovery.  But, not without proper treatment that can include medication, therapy and a strong support system.

Last time I checked there weren’t that many psychiatric beds in Tucson.  Even with the new psychiatric crisis hospital opening soon there won’t be new beds as it will only replace the currently existing beds at UPH.  Without more funding I don’t see any growth for new tratment facilites, but unfortuanately I do see growth in the prison facilities.  It seems like that’s one of the few areas of growth in our state.  Some legislators in Phoenix have stated that it’s time for families and loved ones to “step up” and take care of those struggling with menta illness. I wish it were that simple.

But, I’m glad to see that the Arizona Daily Star is initiating this dialogue.  Hopefully some inovative solutions will come about…….and they won’t cost anything!

So, even if President Reagan was a great man, it was during his presidency that treatment for our nations most vulnerable went from bad to worse.  The following article is a reprint because I found it expresses my concerns adequately and one month after the horrible shootings in Tucson, people seem to be more receptive to learning about this issue.

Ronald Reagan, Mental Health, and Spin . . .

Man Behind the Myth

By Phyllis Vine

For the next twelve months, the Ronald Reagan image machine will be turning out countless vignettes of the nation’s 40th president, the man neighbors called “Dutch.” He will be described as no-nonsense yet kindly, remote but avuncular, a movies-star-turned-politician, and remembered as a local lifeguard rescuing people in troubled waters. With dashing good looks, a sonorous tone that became the voice of General Electric, and an affable smile, even those who disagreed with his policies will say he was genuinely kind-hearted.

So what did this mean practically for policies about mental health? Here we need to  ask how the image departs from the reality.

Contrary to the spin about trimming government, which he called “the problem,” we all know he oversaw increases in federal spending that exploded the national debt, and grew the size of the government he impugned. Another part of the reality, rarely the image, is how he attempted to savage the  entitlement system and roll back supports for people with a mental illness.

When Ronald Reagan arrived in Washington, he inherited the Mental Health Systems Act of 1980. One of the last achievements of Pres. Jimmy Carter, this was passed by the House 277 to 15, in the Senate, 93 to 3. With as many critics as there were special interests, it was far from perfect. Yet it expanded the federal government’s commitment to services, to research, to training professionals, and to patient rights. It identified stigma as an impediment to seeking and receiving services.  It established parity in Medicaid and Medicare. It recognized the link between physical health and mental health. And it dedicated $800 million over 4 years to redress the gross neglect of the commitment to mental health in earlier administrations.  In short, it moved an agenda that minimized homelessness, the reliance on expensive nursing homes, jails and prisons, and one that to more hopeful choices for those who needed help.

The Mental Health Systems Act was a milestone. It came on the heels of four years of hearings and a presidential task force benefiting from First Lady Rosalynn Carter’s active involvement.  Philosophically it affirmed Pres. John F. Kennedy’s Community Mental Health Centers, an attempt to thwart hospitalizations. It fit into the safety-net values championed by Pres. Lyndon B. Johnson with the passage of Medicaid and Medicare.

Still, by 1980 the nation needed more for those with a chronic illness. Many failures accompanied the attempts to close the miserable hospitals, often little more than warehouses, to help patients succeed in the community. The neglect of government support conspired to form a patchwork system with notable gaping holes. A 1977 GAO report said, “Government needs to do more.”  Congressional hearings in 1979 re-affirmed the need to strengthen impoverished services and the failed policies.

Although not perfect, the Mental Health Systems Act responded to these problems. For the first time since the National Institute of Mental Health became part of NIH in 1949, mental health was front and center in federal policy.

Then came Ronald Reagan. Within a month, the Office of Management Budget announced it would curtail the budget of the National Institute of Mental Health (NIMH), phase out training of clinicians, interrupt research, and eliminate services.  Cutbacks to staff followed; chaos ensued. Experienced people left, others remained in government service but were forced into menial jobs. Trained professionals were reassigned to labs to dissect dead rats; science writers were reassigned to typing pools. The Mental Health Systems Act would disappear. Instead, the Omnibus Budget Reconciliation Act (1982) would merge money for mental health programs into block grants, and with fewer dollars going to the states.  They had the discretion to use them however they saw fit, often to perpetuate programs already deemed problematic. The pretense for all this was the president’s concept of a “new federalism.”

“Many of our dreams were gone,” wrote Rosalynn Carter in Helping Someone with Mental Illness. “It was a bitter loss.”

This could have been enough, but it was not. Pres. Reagan attempted to restrict criteria for determining eligibility for SSI, thought to be a safety-net. Nearly 2.6 million people were receiving insurance because their disability prevented them from working. New evaluations for eligibility led to widespread terminations. Of those who were terminated, about half appealed, and in two-thirds of the cases, administrative law judges reversed the decision. The process took nearly a year, during which time they, and their families, were deprived of promised help.

About 340,000 people would lose their insurance before public outcry and courts halted the process. Sen. John Heinz, a liberal Republican from Pennsylvania, told the New York Times the policy was a “meat grinder.” Sen. Carl Levin, Michigan Democrat, said the reviews caused “unconscionable suffering.” In June 1983 HHS Secretary Margaret Heckler announced she would halt suspending about 135,000 people until the government could improve standards for “functional psychotic disorders.”

By then, however, the nation was doubting the president’s kindness. A1982 Louis Harris survey found nearly three-quarters of the respondents said the president was hard-hearted toward the poor.

These are the facts. And they add up to a roll-back of opportunities for people already struggling with a psychiatric illness.  Whatever spin accompanies the birthday celebrations for Ronald Reagan, we should not create yet another mythic figure, larger than life, more pure than Ivory soap, or with qualities he did not have.  He may have portrayed himself as everybody’s lifeguard, but he seemed willing to let people with a psychiatric illness sink.

Originally appeared in MIWatch.org

According the the University of Arizona Press, “The poignant, but ultimately empowering memoir tells the story of Peter Likins, his wife Patricia, and the six children they adopted in the 1960′s, building a family beset by challenges that ultimately strengthened all bonds.  With issues such as inter-racial adopton, mental illness, drug addition, unwed pregnancy, and homosexuality entwined in their lives, the tale isn’t just a famlly memoir-it’s a story of the American experience, a memoir with a message.  With circumstances of race, age, and health making all their children vitually unadoptable by 1960′s standards, Pat and Pete never strayed from the belief that loyalty and love could build a strong family.

Both Pete and Pat have served as teachers, and Pete’s long academic career-holding positions as a professor, dean, provost and then president illuminates more than just his personal success.  Pete’s professisonal attainments produce a context for  his family story, wherein high achievments in education, athletic, and financial terms coexist with the joys and sorrows of this exceptional family.

A frank, open account of the difficulties his family faced, this is a brave story, told with unflinching honesty and remarkable compassion.  The New American Family is a wonderful narrative of the genesis of a family and a journey to the deepest parts of a father’s heart.”

The University of Arizona Press will publish the book in March 2011 and you can order copies by contacting them at 1-800-426-3797 or by visiting the website at:  www.uapress.arizona.edu

In response to this public discussion and request for education, Community Partnership of Southern Arizona (CPSA) has partnered with the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the National Council for Community Behavioral Healthcare (National Council) to launch a statewide, extensive training campaign in Mental Health First Aid.

“People in our community want to take positive action after this tragedy,” said Neal Cash, President and CEO of CPSA. “Learning more about mental health and how to recognize and respond to possible problems is one way of doing that, one that could be of long term benefit to everyone in our community.”

Mental Health First Aid is a novel, evidence-based public education program. The program teaches average people a five-step process to assess a situation, select and implement appropriate interventions, and help a person in crisis or who may be developing the signs and symptoms of mental illness. The groundbreaking training equips people to provide initial help until appropriate professional, peer or family support can be engaged. Participants also learn about risk factors and warning signs of specific illnesses such as anxiety, depression, psychosis and addiction.

“None of us should underestimate the importance of early identification and intervention with an emerging mental health or substance abuse problem,” said Laura Nelson, M.D., Deputy Director at ADHS/DBHS. “Just as with diabetes or high blood pressure, the earlier the problem is recognized and addressed, the better the outcomes can be. It is also true that people who know the individual best can recognize the early signs and symptoms and can help that person get the treatment and support they may need.”

CPSA has been involved with Mental Health First Aid since 2009 and is now working to expand program offerings in the state.

CPSA will host an Instructor Training, conducted by the National Council, to increase the number of certified instructors who can offer the program throughout Arizona. The Instructor Training takes place the week of February 28-March 4, 2011. CPSA and the other Tribal and Regional Behavioral Health Authorities from around the state will identify thirty (30) future instructors to participate in this event.

The National Council has worked closely with CPSA and ADHS/DBHS to quickly mobilize its nationwide resources to support the Arizona trainings.

”People in the family or community often don’t connect a person with mental illness to care because they don’t know how,” said Linda Rosenberg, President and CEO of the National

Council. “Mental Health First Aid teaches people how to offer concrete help. This early intervention can prevent tragic consequences and save lives.”

CPSA will offer a Mental Health First Aid training in early March for organizations and individuals most affected by the events of January 8. CPSA and the National Council will provide instructors for these sessions.

CPSA also will schedule trainings that will be open to the general public. For information, see the CPSA Web site at www.cpsa-rbha.org, call (520) 618-8860 or e-mail Prevention@cpsa-rbha.org.

CPSA, founded and based in Tucson, has overseen publicly funded behavioral health services in Pima County since 1995 and currently serves close to 30,000 members. CPSA receives funding from ADHS/DBHS, the Arizona Health Care Cost Containment System (AHCCCS), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Resources for mental health and trauma issues
following the January 8 shootings

• Tucson Tragedy Support Line: (520) 284-3517, available at no cost to anyone in Pima County who is struggling to deal with these events, or who wants information on how to help themselves or others cope. Staff at this number also will provide referrals to community behavioral healthcare providers and other services such as help coping with trauma and help talking with children and teens about tragedy.
• CPSA Web site (www.cpsa-rbha.org), including links to information from trusted sources on how to talk with children and teens about a tragedy, self-care in the wake of trauma and related topics.
• Community-Wide Crisis Line: (520) 520-622-6000 or 1-800-796-6762. Available 24/7 for anyone having a behavioral health crisis. Hearing impaired individuals may call the Crisis TTY Line at 520-284-3500 or 1-888-248-5998.
• Walk-in behavioral health crisis services: SAMHC, 2502 N. Dodge Blvd. (enter from Flower Street, which is parallel with and just north of Grant Road). If possible, please call the Community-Wide Crisis Line before going to SAMHC.

ADHS/DBHS and Magellan Health Services of Arizona have established a hotline for people outside of Pima County who need help in dealing with this tragedy: 1-800-203-CARES (1-800-203-2273).

An additional resource for people who are concerned about their own or someone else’s mental health is the “Mental Health Checklist” on ADHS/DBHS’ Web site, www.azdhs.gov

As I did back in 2005 after my son died, I am trying to refocus my energy on healing, positive thoughts.  We all agree that negative rhetoric and threats of violence have increased over the last several years and I think we all can agree it’s not the direction we want to go in.  Like previous National tragedies, there is a collective sadness in our country today and I  hope that we can embrace this united energy to refocus and march forward into a more compassionate, tolerant society that appreciates each other’s differences and has empathy for those that are our most vulnerable.

As I watch President Obama speak this evening, I will be thinking of the beautiful lives lost and the potential for a new beginning for our country.  Learning about the “Angels” that will be present at the funerals give me hope.  See more information on them at:  http://www.tucsonmemorial.org/help.html

There is an excellent article on healthy grieving that I think can help at

http://health.msn.com/health-topics/depression/articlepage.aspx?cp-documentid=100268947&GT1=31009

A listing of online resources to assist in dealing with the tragedy in Tucson has been posted on the CPSA website and is on the SAMHSA website.

According to recent press releases, Brewer’s involvement in state politics started with her activism pushing better treatment and care for our state’s seriously mentally ill population.  Her son is diagnosed with a serious mental illness and has spent time in-patient at the Arizona State Mental Hospital.  As a Mom with a son who had a serious mental illness, I certainly can understand her motivation to try and make a difference.  Stigma continues to be pervasive and some still believe it’s the Mother’s fault when a mental illness presents itself.  Character flaws, laziness, and violent behavior automatically get labeled as mental illnesses when medical science knows that these illnesses are actual biological brain disorders that are treatable.  With proper medical treatment and support people have and do live in recovery.

Given all the positive news about the potential for recovery, why in the world has Govenor Brewer decided to not only distance herself from the issues, but supported drastic slashes to budgets that assist people with mental illness?  I understand that we need to cut our spending, but why cut spending for our state’s most vulnerable?  In the long run, as Gov. Brewer knows, we will end up spending more for emergency room visits, hospitalizations and incarcerations for ignored people living with a treatable mental illness.  With all the publicity and nation wide visability she has created over the last several months, it seems a shame to me that she hasn’t used the opportunity to advance anti-stigma and the value of  proper treatment to some of our states most vulnerable…….including her son.  Is the illegal immigraton bandwagon the only issue she can focus on now?

The law included a six month extension of higher Medicaid federal matching funds for states – a major contribution towards some of the drastic slashes in mental health coverage in Arizona.

Recent budget slashes (I prefer that term over cuts as I feel it’s much more descriptive) in the state’s healthcare system for the poor have forced many people to search for alternatives to afford their medications. Some are going to Canada, while some have been fortunate to be able to get discounts directly from the pharmaceutical companies. I applaud the efforts of some of the drug companies to help and I wish they would all step up.

While illegal immigration and calls to enforce the border by sending in troops occupies the headlines, our state’s most vulnerable citizens are doing the best they can just to survive.  In my world they take priority over someone who has illegally crossed our borders to look for a better way of life.  Helping disabled and seriously mentally ill people is not only money well spent, it’s the “right” thing to do!

How Did Your Member Vote?

View the House roll call vote on final passage of HR 1586

Both McCain and Kyle voted no when the bill went through the senate.

Read further details on the provisions in HR 1586 designed to support state Medicaid programs into 2011.

The new test is not really new. The EEG (electroencephalography) has been around for years. It measures brainwaves and researchers have found that a certain type of brain wave is slightly different in people whose siblings have schizophrenia. Researchers believe it could be used to identify people at risk so treatment can be introduced pre-emptivley.  The test could possibly be used to see how the treatment is working as well.

The research showed that a certain activity, called the P300 marker,  was reduced in people that had siblings with schizophrenia.  That marker is thought to represent attentional and inhibitory control aspects of brain processing.  But, the diminished activity of the marker may be a sign of increased risk for the illness, not a sign of the illness itself.

Researchers are also investigating P300 in people with ADHD (Attention Deficit Hyperactivity Disorder).

Separate studies have linked brain disorders to malfunctions in genes involved in making synapses between brain cells.

These are all positives signs in the slow progress to diagnose and treat mental illnesses.  It is difficult enough to accept a mental illness for a loved one, or for the patient himself. A specific test will help that process and make treatment more accurate as well.

Staying out of the heat can be difficult for our homeless population, many of whom also live with mental illness. I have seen a homeless person on more than one occasion totally overdressed during our 100 degree plus days because he either doesn’t realize how hot it is, or he’s afraid to leave his few possessions, including his clothing, behind.

Stay Safe

Educate yourself about the symptoms of heat stroke , such as:

* An extremely high body temperature (above 103 degrees Fahrenheit)
* Red, hot and dry skin (no sweating)
* Rapid, strong pulse
* Throbbing headache
* Dizziness
* Nausea
* Confusion

Individuals living with mental illness may be more prone to heat stroke because some medications alter the body’s response to heat. In addition, people taking specific medications may be at a higher risk of developing Neuroleptic Malignant Syndrome (NMS) , a serious condition that may be connected to high temperatures and the dehydration that can result from heat stroke. NMS and heat stroke have similar symptoms, so it is especially important that people with mental illness inform their doctors of all medications they are currently taking.

Stay Informed

The National Weather Service is the hub of information about heat alerts. The Weather Channel offers a free service that will send updates about heat advisories to your phone.

Stay Inside

On extremely hot days, limit your exposure to the heat and sun, especially during the hottest part of the day. Don’t walk long distances if you don’t have to. Some public transportation systems offer free bus service on days with a dangerous heat index.

Stay Cool

If you do have an air conditioner, change the filter and perform other maintenance that will keep the unit working at peak capacity. If you don’t have an air conditioner, try to spend a few hours a day in an air-conditioned public place like a library or mall. Look into area programs that may provide air conditioners for people with disabilities for free or at a reduced cost. In the past, some local United Way chapters have collected donated units and redistributed them to people with the most need.

Here’s a list of some of Tucson’s Homeless Shelters.  I don’t know if any of them have room, but hopefully they can provide a respite from the heat for our city’s people on the streets.

An email came in from Linked in  today from a “certified mental health recovery educator” asking for input.  I signed on to Linked-in and this is what I found…

“If you were interviewing a mental health professional to see if their beliefs are congruent with those of the “Recovery Model” of mental health care, what top 3-5 questions would you ask?

I have a client who wants to locate someone in my area that is recovery-oriented, and I found myself explaining the Recovery Model as I know it today to the very first psychiatrist I called. I don’t have time to talk to everyone like that, so I am trying to narrow my interviews down to just a few questions. Recovery IS possible. People DO recover and can live long and product lives. Yeah peer support and boo institutions, people know what’s best for themselves and all of that. What would your top 3-5 questions be?”

Imagine my shock when I read the first response:

“I suspect you are thinking about Substance Abuse rather than mental illness or psychothopathology. There is no such concept as recovery. Treatment or cure may be possible but not recovery.”

WHAT? I’m not printing his name because I don’t want him to be overwhelmed with angry phone calls, but how can it be that a person who is currently involved in the mental health community hasn’t even heard about mental health recovery?  As one responder who is currently living a life in mental health recovery said, ” it’s heartbreaking to read the response……”

I have talked about recovery in previous posts, but I think it needs to be stressed again.  Recovery is possible and very real! I have met dozens of people over the last several years who are in mental health recovery……..one girl I remember had been told while in the throes of a particularly intense psychotic episode that she would remain institutionalized all of her life!  I am here to say, she is not only living independently, but she has a great job and a happy life!  And, her story is NOT unusual!

My family and I recognize people in our community every year that are in recovery with the Daniel Moreno Recovery Award.  It is named after my son who died by suicide after being diagnosed with schizophrenia five years prior. Recovery does not come easy, but it is a reality and is probable with the correct medication if needed, support and treatment. The big problem – only half of those with mental illness receive treatment, yet estimates as high as 80% of those that do get proper treatment do recover.

If you or someone you know is seeking treatment for a mental health issue, I suggest the first question you ask the provider is:  “Do you believe in mental health recovery?” I wouldn’t want you to work with someone that didn’t.