Premiering tonight at the Loft Theater for  one night only is the awarding winning documentary “Of Two Minds.”  The director will be available after the showing for questions and answers as well as a panel consisting of a local psychiatrist, a person living with Bipolar and a family member.  Sponsored in part by The Aurora Foundation of Southern Arizona.  The film begins at 7pm with Q and A afterwards.  A DVD of the film will also be available.  I’ll provide my “review” tomorrow.

 

OF TWO MINDS puts an authentic human face on bipolar, providing an intimate and stigma-busting look at those who live in its shadows – our parents and children, our friends and lovers… and ourselves ONE SHOW ONLY MAY 14TH AT 7 PM! LIVE PANEL Q&A AFTER THE FILM! Tickets & Info at: www.loftcinema.com/film/of-two-minds/

 

Mental Illnesses are not curable at this point, but they are recoverable and people can live healthy productive lives while managing their illness.  The Pima County Peer and Family Support Coalition is sponsoring a “Town Hall Meeting” to promote a bright future for our youth currently receiving behavioral health services. “Journeys of Peers and Families,”  an event to enlighten our community about the realities of mental health recovery, will engage attendees with real life stories from a panel of adults and youth currently in recovery.  Since recovery also depends on a support system,  family members of those with mental illnesses will also share their compelling  standpoint.

The evening begins at 6:00 pm and will be held at C.P.S.A, at 2502 N. Dodge, Suite 130 in Tucson. Light refreshments will be served  Reservations are requested to (520) 770-1197 and child care will be provided if required, so please request upon confirmation.

The event is supported by local non-profits, MiKid, HOPE, Inc., and CFSS.

(Below is the Proclamation making May Mental Health Awareness Month)

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

Today, tens of millions of Americans are living with the burden of a mental health problem. They shoulder conditions like depression and anxiety, post-traumatic stress and bipolar disorder — debilitating illnesses that can strain every part of a person’s life. And even though help is out there, less than half of children and adults with diagnosable mental health problems receive treatment. During National Mental Health Awareness Month, we shine a light on these issues, stand with men and women in need, and redouble our efforts to address mental health problems in America.

For many, getting help starts with a conversation. People who believe they may be suffering from a mental health condition should talk about it with someone they trust and consult a health care provider. As a Nation, it is up to all of us to know the signs of mental health issues and lend a hand to those who are struggling. Shame and stigma too often leave people feeling like there is no place to turn. We need to make sure they know that asking for help is not a sign of weakness — it is a sign of strength. To find treatment services nearby, call 1-800-662-HELP. The National Suicide Prevention Lifeline offers immediate assistance for all Americans, including service members and veterans, at 1-800-273-TALK.

Our commitment cannot end there. We must ensure people have access to the care they need — which is why the Affordable Care Act will expand mental health and substance use disorder benefits and Federal parity protections for 62 million Americans. For the first time, the health care law will prevent insurers from denying coverage because of a pre-existing condition. The Act already requires new health plans to cover recommended preventive services like depression screening and behavioral assessments for children at no extra cost to patients.

My Administration will keep building on those achievements. Earlier this year, I was proud to launch the BRAIN Initiative — a new partnership between government, scientists, and leaders in the private sector to invest in research that could unlock new treatments for mental illness and drive growth throughout our economy. We have made unprecedented commitments to improving mental health care for veterans suffering from traumatic brain injury and post-traumatic stress disorder. And we have proposed new funding for mental health programs that will help teachers and other adults recognize the signs of mental illness in children, improve mental health outcomes for young people, and train 5,000 more mental health professionals to serve our youth.

Mental health problems remain a serious public health concern, but together, our Nation is making progress. This month, I encourage all Americans to advance this important work by raising awareness about mental health and lending strength to all who need it.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 2013 as National Mental Health Awareness Month. I call upon citizens, government agencies, organizations, health care providers, and research institutions to raise mental health awareness and continue helping Americans live longer, healthier lives.

IN WITNESS WHEREOF, I have hereunto set my hand this thirtieth day of April, in the year of our Lord two thousand thirteen, and of the Independence of the United States of America the two hundred and thirty-seventh.

BARACK OBAMA

The recent suggestion from the NRA to have armed guards in our schools as an answer to increasing gun violence is beyond ridiculous.  “Fight fire with fire” seems to be their mantra.  Well, I have a better one.  “An eye for an eye makes the whole world blind,” – Gandhi.

It makes about as much sense as the law in Arizona that allows people to carry firearms in bars!  Great, “let’s get all liquored up” and and start playing with guns!  Ugh!  Am I the only one that doesn’t understand this mentality?  Don’t get me wrong, I totally support the second amendment, except when it comes to ballistic missiles, 30 round magazines, and other weapons of mass destruction. I understand wanting to protect yourself, but really?  What has happened to common sense? What about fences and security gates like most of the high schools have?

Devastating shootings like the one that occurred in Newtown last month or the one that occurred here on January 8th two years ago need to stop.  There has to be an answer other than putting more guns out there.  As a mental health advocate, I want more education in schools, community groups, businesses, and organizations about the realities of mental illness.  Everyone aggrees that a person who literally mowes down innocents with a high capacity gun needs to have his “head examined.”

Let the conversation start here……One in four families are effected by mental illness.  Treatment success rates for depression go as high as 90%.  One in eight teens experience depression, yet only 20% of them seek treatment. Even treatment success rates for schizophrenia are very high! Should people with a mental illness diagnosis be restricted from gun use?  Not necessarily, but let’s talk about it!

These are the topics of discussion we should be having.  Answers may not come as quickly as the “solution” from the NRA, but increasing arms in our schools is preposterous. The last thing our babies need is an increase in violence and an “eye for an eye” mentality.

Last Saturday I had the opportunity to participate in a panel that fielded questions and discussed the challenges of mental illness.  During the hour, struggles faced by a person living with mental illness  as well as the difficulties a care giver confronts while trying to support a person with a diagnosis were addressed.  Unlike many of the panel discussions I have participated in where we have spoken mostly to people currently involved in the mental health community, this group was much more diverse and consequently less informed about the illnesses, treatments, stigma and recovery.  It was a fascinating discussion and hopefully enlightening to those in attendance.

Afterwards, I was able to watch the Broadway Musical now playing at the Arizona Theater Company, “Next to Normal.”  The play exquisitely tells the story of a family’s struggle with mental illness.  In this case, the Mother is struggling with Bipolar Disorder and the rest of the family is  doing the best they can to cope with the unpredictable scenarios that are faced on a daily basis.  When Mom is feeling hypo-manic everything is great.  But, inevitably either the bottom falls out and Mom becomes horribly depressed or just as awful, Mom becomes manic and repercussions can be just as devastating. The Dad misses the exuberant young woman he first fell in love with. The teenage daughter feels un-noticed and at times unloved by an overwhelmed Dad and an ill Mom. As for the son, well……I’ll leave his story out of this blog as I wouldn’t want to spoil it for anyone going to see this play.

Suffice it to say that this dramatic musical tells a complicated, absorbing tale of life in a family with mental illness.  After all, when someone in the family have a serious illness, everyone is effected, no matter if it’s a physical illness or a mental illness.  The narrative, told almost exclusively with song, is compelling and realistic.  Having experienced mental illness in my family, it touched me as if  my best friend was sharing her family life with me.  The author has great insight  and the actors were amazing.

The first steps in changing attitudes about mental illness are awareness  and education. This production does an excellent job in demystifying the reality of mental illness.  One in four families are effected by mental illness and mainstream media, even  Broadway musicals, can have a huge impact on advancing that goal.

In addition to the silent auction and dinner, the evening will include a presentation ceremony and keynote speech from Dr. Jose Apud, Clinical Director of the Schizophrenia Research Program at the National Institutes of Mental Health.  Dr. Nicholas Breitborde will also provide an update on the new Epicenter (Early Psychosis Intervention Center) at the UPH South Campus.

The event was founded in 2007 in an effort by the Daniel Moreno Family to increase awareness about mental health recovery and reduce the stigma surrounding mental illness.  Ten local individuals have previously been selected to receive the Daniel Moreno Recovery Award.  The 2012 Recovery Award will be presented to Sarah Martin, the Advocate Award will be presented to Neal Cash, CPSA CEO/President, the Educator Award to Peter Likins, President Emeritus of the University of Arizona and Adreinne Sainz, LMSW, Clinician at La Frontera will receive the Direct Service Provider. More information about the recipients will be provided over the next month on this blog.

Proceeds from the event will benefit the Aurora Foundation, a local non-profit dedicated to advancing disability justice and the newly formed Southern Arizona Suicide Prevention Coalition.  For more information or to purchase tickets, please visit the website at: www.planetaurora.org

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.

Today doctors understand that mental illness involves biology, genetics and environmental factors, but the myth that bad parenting is the cause still exists.

It was some of these wrongly accused parents that started the advocacy movement in the 1970′s that eventually turned into the largest grassroots organization of it’s kind (NAMI)  advocating for, supporting and educating people with mental illness AND their families.

May is Mental Health Awareness Month and for Mother’s Day  some PBS stations are airing a documentary, “When Medicine Got it Wrong” about the so-called “Schizophrenic Mother.”  Unfortunately, it isn’t scheduled to be aired locally,  but the video is available at: www.whenmedicine.org

I hope you all are able to celebrate with your Mother this weekend.  Being a Mom can be difficult at times, but it’s benefits are incalculable.  Happy Mother’s Day to my Mom!

Extension of the 2009 Poverty Guidelines Until at Least May 31, 2010

[ Federal Register Notice, January 22, 2010, (initial extension of guidelines until March 1) — Full text ]
[ Prior Poverty Guidelines and Federal Register References Since 1982 ]
[ Frequently Asked Questions (FAQs) ]
[ Further Resources on Poverty Measurement, Poverty Lines, and Their History ]

Congress has taken action to keep the 2009 poverty guidelines in effect until at least May 31, 2010.

Congressional actions on this matter have been in response to a decrease in the annual average Consumer Price Index (CPI-U) for 2009, projected during 2009 and announced on January 15, 2010 (see http://www.bls.gov/news.release/archives/cpi_01152010.pdf, Table 1A).  In the absence of legislative change, this decrease — the first since the poverty guidelines began to be issued in 1965 — would have required HHS to issue 2010 poverty guidelines that were lower than the 2009 poverty guidelines; that would have led to the “reduction in eligibility” referred to in the Congressional explanatory language quoted below.  Congress took several actions on this matter:

1.  On December 19, 2009, the Congress enacted and the President signed the Department of Defense Appropriations Act, 2010 (Pub. L. 111-118), which included a provision affecting the poverty guidelines.  Section 1012 of this law (as originally enacted, before subsequent amendment) stated that:

Notwithstanding any other provision of law, the Secretary of Health and Human Services shall not publish updated poverty guidelines for 2010 under section 673(2) of the Omnibus Budget Reconciliation Act of 1981 (42 U.S.C. 9902(2)) before March 1, 2010, and the poverty guidelines published under such section on January 23, 2009, shall remain in effect until updated poverty guidelines are published.

The Congressional Record (House) (December 16, 2009, p. H15370) provided the following explanation of this Congressional action in Pub. L. 111-118:

Section 1012 includes a provision to freeze the Department of Health and Human Services poverty guidelines at 2009 levels in order to prevent a reduction in eligibility for certain means-tested programs, including Medicaid, Supplemental Nutrition Assistance Program (SNAP), and child nutrition, through March 1, 2010.

A Federal Register notice about this initial extension of the 2009 poverty guidelines was published on January 22, 2010. (See Federal Register, Vol. 75, No. 14, January 22, 2010, pp. 3734-3735.)

2.  On March 2, 2010, the Congress enacted and the President signed the Temporary Extension Act of 2010 (Pub. L. 111-144), which included a provision affecting the poverty guidelines.  Section 7 of this law amended Section 1012 of the Department of Defense Appropriations Act, 2010, by replacing “March 1, 2010” with “March 31, 2010”.  The effect of this was to extend the 2009 poverty guidelines until at least March 31, 2010.

3.  On April 15, 2010, the Congress enacted and the President signed the Continuing Extension Act of 2010 (Pub. L. 111-157), which included a provision affecting the poverty guidelines.  Section 6 of this law amended Section 1012 of the Department of Defense Appropriations Act, 2010 (as amended by Pub. L. 111-144), by replacing “March 31, 2010” with “May 31, 2010”.  The effect of this was to extend the 2009 poverty guidelines until at least May 31, 2010.

We will provide updated information about the post-May-31 period when it becomes available.

The 2009 poverty guidelines figures that will remain in effect are given below.

NOTE:  The poverty guideline figures below are NOT the figures the Census Bureau uses to calculate the number of poor persons.
The figures that the Census Bureau uses are the poverty thresholds.

The 2009 Poverty Guidelines for the 48 Contiguous States and the District of Columbia
Persons in family	Poverty guideline
1	$10,830
2	14,570
3	18,310
4	22,050
5	25,790
6	29,530
7	33,270
8	37,010
For families with more than 8 persons, add $3,740 for each additional person.

2009 Poverty Guidelines for Alaska
Persons in family	Poverty guideline
1	$13,530
2	18,210
3	22,890
4	27,570
5	32,250
6	36,930
7	41,610
8	46,290
For families with more than 8 persons, add $4,680 for each additional person.

2009 Poverty Guidelines for Hawaii
Persons in family	Poverty guideline
1	$12,460
2	16,760
3	21,060
4	25,360
5	29,660
6	33,960
7	38,260
8	42,560
For families with more than 8 persons, add $4,300 for each additional person.

SOURCE: Federal Register, Vol. 74, No. 14, January 23, 2009, pp. 4199–4201

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Go to Further Resources on Poverty Measurement, Poverty Lines, and Their History

Go to Frequently Asked Questions (FAQs).

Return to the main Poverty Guidelines, Research, and Measurement page.

Last Revised:  04/19/10

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“Thinking outside the box” was a phrase heard repeatedly and for many attending that answer was not enough to calm their fears. For a population accustomed to difficulties  finding appropriate mental health care that particular phrase has become a mantra.

One question about how the non-title XIX residents will be covered if they are currently in the Arizona State Hospital was never answered.

Of major concern to me is the misguided thought by some in Phoenix that people that are currently taking some of the more expensive, newer anti-psychotics, mood stabilizers and anti-depressants  can now be administered some of the older, less expensive drugs to save money.  What he forgot to say when talking about the older, less expensive medications is that they don’t work for some people.  Hence the reason for being prescribed the newer, more effective medications. Plus, the newer medications don’t have some of the debilitating side effects  that the older medications cause.  (Although, I must admit all of these medications do have some sort of negative side effect)

Even when a certain medication is successfully treating some of the symptoms today,  next week, next month or next year it may loose it’s efficacy and a new medication will need to be introduced; most likely a newer drug.

The state’s crisis system which had up until recently seen some positive advances is now experiencing limited funding as well.   It was suggested at the meeting that family members “step up” to the plate and do what they can to cover the shortages like manning all night crisis phone lines, etc.  on a volunteer basis.  Hum…….I guess that might work if their loved one isn’t in a crisis because their newly prescribed medication is working!