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

Undiagnosed depression is the number one cause of suicide, yet few people know what the symtoms are and even fewer seek treatment.  Each year nearly 26,400 teens in Arizona attempt suicide…….and that number reflects only the attempts that end up in an emergency rooms and/or require treatment by a professional! Many times the family is able to do something to treat the effects of the attempt (induce vomiting, CPR, etc.) without anyone outside the home ever being notified.

Education and awareness is crucial and O.P.T.I.O.N.S. (Offering Parents and Teens Information on Needless Suicide) is a free depression education and suicide prevention program offered to Arizona high schools by Mental Health America of Arizona. The successful educational program has been operating in the Phoenix area for several years and it is now available in Southern Arizona. When evaluated, 85%  of the students said the program provided helpful information on clinical depression and were able to identify at least 5 of the symptoms, and 90% felt that schools need a program like this.

Mental Health America of Arizona (MHAAZ) is a 501(c)3 non-profit organization providing leadership to address the full range of mental health, illness and wellness issues in Arizona. We are dedicated to improving care, treatment and recovery for people with all types of mental illness through support services, education and advocacy.

For more information or to schedule presentations in your child’s school, please contact Susan Moreno at:  smoreno@mhaarizona.org

Recent articles on teen depression and suicide:

http://health.usnews.com/health-news/family-health/childrens-health/articles/2010/10/04/adhd-depression-and-suicide-how-parents-can-keep-children-safe.html

http://www.huffingtonpost.com/dr-harold-koplewicz/gay-teen-suicide_b_760093.html

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?

But when a person suffers from a psychotic break in the earlier stages of serious mental illness and needs to be hospitalized or even when a person who has been living successfully in mental health recovery and experiences a set back, the support system vanishes and the person can be left to climb out of the hole on their own.  No cards and flowers are sent.  No help with day to day chores  is offered.  Rarely are there concerned phone calls asking how the family is holding up.

Why is that?  Is it because mental illness is so frightening to some people that they don’t want to discuss it?  Is it because they still think mental illness and/or a mental health crisis is not as devastating as a chronic physical illness or physical health crisis?

When my son was diagnosed with schizophrenia, many of my “friends” seem to disappear.  While my daughter and I were dealing with the most intense period of our lives, many seemed to look the other way.  As a parent I experienced unbearable grief and pain.  Gone was the brilliant young man who had plans of attending Harvard.  Left in his place was a person that had delusional thoughts that kept him incapable of caring for himself.  His first hospitalization was a rude awakening for all of us.  Psychiatric care at the hospital was not effective and when he was discharged after a few weeks the only advise I got was to “buy him some earphones so he could listen to music and drown out the voices.”  He was literally drooling from being over-medicated and started experiencing tremors that continually ebbed and flowed over the next years.

Fortunately, after several weeks a medication “cocktail” was created to give him some balance and give us some optimism that he would get better.

He did get better and although he never went to Harvard, he began a new life as a forever changed young man.  His old friends never came back around……perhaps they were too scared, and all of my support system was there again for me.  Unfortunately my son died by suicide five years later.  My friends and family were there for us then and continue to lovingly support us today.

The moral of this blog?  When someone with a psychiatric illness needs to be  hospitalized, they need your care and support the same as they would if they had pneumonia or were injured in an accident.  Trauma is trauma, whether it be mental or physical and loving care and support are essential in the healing process.

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.

Some have struggled for years to find the right medication “cocktail” and now the rug is being pulled out from under them. They won’t be able to afford the newer, more effective drugs that can cost thousands of dollars a month and they won’t have a therapist or case manager monitoring their changes.  Many are the “working poor” who make just a few too many dollars to qualify for the the state’s medicaid system, AHCCCS;  also  in jeopardy of loosing millions.

Yes, it looks like it could get even worse since  Congress may not extend the states Medicaid assistance. Medicaid assistance from the federal government was voted against by the U.S. Senate last week.  Without it, Arizona’s health care budget falls further into the red.  In a letter to Arizona members of Congress, Governor Brewer complained that “(I)t has become clear that Congress does not have the will to assist states in addressing the very problem that it created.” Based on her combative attitude displayed recently all over the media, I will be surprised if any “Fed” will pay attention.

I guess you can tell I’m angry, but instead of complaining, I wish she would use the same “take charge” attitude towards our state’s health care system as she does toward our illegal immigration issues where no expense spared is the mantra.  We’re soon to be using our local city and state law enforcement officers to enforce federal immigration laws.  Plus, there always seems to be more money to build more prisons to house the additional “illegal immigrants.”  What about using money to house and treat some of our state’s most vulnerable citizens?

The Obama administration launched a new health care reform website yesterday that provides information to the public on “the full range of public and private health insurance plans” that fits their specific circumstances. Mandated by the health reform law, the site will show users how their options “will change in coming years” as the law takes effect. – The Progress Report, July 1, 2010

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.