FOR MOMS WITH POSTPARTUM DEPRESSION

The Tucson Postpartum Depression Coalition (TPDC) and CODAC Behavioral Health Services will host the Grand Opening of Mother’s Oasis: Center for Emotional Wellness on Thursday, August 18, 2011 from 4:30-6:30at 1067 E Silverlake Drive (85713).

Senator Linda Lopez, Elizabeth Jiminez (State Director for Healthy Families), and mothers who have experienced severe postpartum depression are scheduled to speak about the importance of a center dedicated to the emotional wellness of mothers.

“This is the first center of its kind in the entire country,” says founder Carole Sheehan, President of the Tucson Postpartum Depression Coalition. “Mother’s Oasis is now open to meet the special needs of women who are experiencing the troubling effects of pregnancy- and postpartum anxiety and depression.”

Maternal Depression is the number one predictor of future behavioral and cognitive problems in children. Therefore, a mother’s mental and emotional wellness are key to family health and survival. Unfortunately, however, each year around 4,000 women in Pima County suffer with anxiety and depression around childbirth. Many are not identified or treated, leading to chronic depression for the mother and challenges for the child(ren) as well.

Mother’s Oasis will offer support groups, therapy, doula services, yoga and zumba classes and connections to other community resources, such as parenting classes and behavioral health services. Services are offered at no cost.

CODAC is providing physical space to TPDC for the Mother’s Oasis free of charge, which compliments CODAC’s Healthy Families, Mother’s Caring About Self (intensive outpatient) and Las Amigas (residential treatment) programs.

All media are invited to attend the grand opening to learn of this first-of-its-kind center. For more information, please contact Kristine Welter at kwelter@codac.org or 260-2771.

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

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.

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

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.

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.

But, this catastrophic Gulf oil spill has gotten me down.  I can’t imagine what it must be like for people who live in the area affected. And that area is growing day by day.  If you listen to some doomsday “sayers” this is just the beginning of a global crisis that could change the world as we know it. One can’t help but get nostalgic thinking about the days most of us have spent frolicking on white sand and splashing in the ocean. Some of my favorite childhood memories are from family vacations spent on the beach.  Many times it was on a Gulf of Mexico beach.  Same is true for my daughter, except that it was usually the Sea of Cortez.

What I can say for a fact is that the Gulf of Mexico is experiencing the biggest threat to it’s environment in history and it makes me want to cry.  When I first heard of the oil spill, I had this sinking feeling in my stomach.  Some how I knew intuitively this wasn’t just another oil spill. Now, almost two months later most of the world knows it’s the worst environmental disaster in history.  Scary part is, we still don’t know how to stop it.

A few facts we do know:

• 11 people lost their lives in the initial explosion
• Efforts to cap it or plug it have been unsuccessful
• Relief well may or may not work
• Dispersant’s being used are toxic
• Skimming works in a very small area
• Small portion of the oil is being recaptured
• Thousands of people’s livelihoods have been disrupted

No one really knows how this will end. President Obama said in his speech on Tuesday that we should all pray.  Some made fun of that suggestion.  It reminded me of the bumper stickers that say “Visualize Peace,”  or the adage “the power of positive thinking.”  So,  I think we should all visualize a clean Gulf – it can’t hurt! Thinking about a clean beach and aqua blue seas can definitely lighten my mood!!

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.