Monday, October 20, 2014

The Village: Opening Doors for Those in Need

Chrystal Arzola and Stephanie Morabe, assistant
director of Village West.

By Katrina Gay, NAMI Director of Communications

High rates of homelessness and the revolving door of jails for many who live with serious mental illness are challenges many communities face. Nearly 25 percent have mental illness and an even higher percentage have substance abuse disorders. The Twin Towers Jail, part of the Los Angeles County jail system, is the world's largest jail, and the nation's largest mental health treatment facility.

Recognizing that the lack of continuity of care was a huge barrier to helping those in most need, MHA Village (“the Village”) stepped to the plate in 1990 to offer a solution. This nationally-recognized program helps close the gap and encourage the reality of recovery through an approach that aims to provide consistent treatment. Key components of the program include:

  • Focusing services on those who need them most, including those who access emergency rooms, inpatient treatment for psychosis, have not responded to traditional service systems and who often cycle in and out of jails.
  • Providing coordinated care, housing and employment assistance, rehab support and other services.
  • Connecting with three businesses that are staffed by members of the Village to increase competence and confidence.

The Village is one of four exemplary programs heralded by Connect4MentalHealth, a partnership that aims to promote innovative community solutions to our national mental health crisis. The Village is especially recognized for the success in providing integrated health care for those who live with serious mental illness.

Once homeless and struggling with drug addiction, Chrystal Arzola came to the program because she was “tired of being tired.” Encouraged by her sister, her first experience with the program was group housing which provided her a sober living environment and jumpstarted her recovery journey.

”I came in angry, not able to get along with anyone. I wasn’t even aware of how I was part of the problem—living on the streets like I had been doing before I came to the Village, I became defensive, angry and ready to fight,” said Chrystal.

The staff at the Village and the integrated program helped Chrystal learn how to control her anger. “They would hear me out. They really listened and did not push me. They understood, and through that, I began to understand, too,” Chrystal shared. “Now I know how to cope better, how to communicate. I have a job [as a staff member at the program facility], I am healthier and I go to church with my sister.”

The Village aims to build a community by focusing intensely on each individual person. By providing coordinated care, including integrating mental and physical health needs, peer support, connections with the larger community, the Village helps each person gain independence and achieve wellness and meaning.

Happier and healthier, Chrystal serves as a mentor to others at the program. “Now, I have my family back. The Village helped me learn how to better myself. I can actually say that now, I am happy. All doors are open now.”

Together with the National Council for Behavioral Health (National Council) and Otsuka America Pharmaceutical, Inc. and Lundbeck, NAMI affirms the need for localized, innovative, effective and sustainable approaches to address serious mental illness. Through Connect 4 Mental Health (C4MH),a nationwide initiative, we have joined together to call for communities to prioritize serious mental illness and encourage promising practices that help people, like Chrystal, live healthier, fuller lives. 

Thursday, October 2, 2014

Refusing to Leave Borderline on the Sidelines

By Courtney Reyers, NAMI Director of Publications

“I’ve been trapped all my life not by man or by cages but by my own emotions. Where I’ve been, what I’ve seen while traveling inside myself can be summed up by one word: damn.”

Brandon Marshall is one of the NFL’s best wide receivers. He’s a 5-time Pro Bowler and has the NFL record for catches in game. His nickname is the Beast. But Marshall’s career hasn’t always been smooth. The Chicago Bears star was the subject of A Football Life, a documentary series produced by the NFL Network, on Sept. 19. This inside look at the NFL player offers a deeper look at his life and career—and his journey of living with borderline personality disorder (BPD).

The NFL is Marshall’s platform, but awareness is his purpose. BPD is frequently viewed as a disorder that affects females and means that you’re “weak,” but Marshall embraces who he is, owns up to his mistakes and takes full responsibility for his recovery. Before Marshall was diagnosed, though, it was a pretty bumpy ride.

“There would be times where a switch would just flip and you’d be like ‘I don’t know this guy,’” Bears quarterback Jay Cutler says in the documentary. Cutler and Marshall started their careers together on the Denver Broncos and have found themselves back together on the Bears.
Marshall acted up in practice and during games, disobeyed his coaches, sabotaged plays and received penalties that jeopardized his team—and career. Two NFL teams dropped him due to his antics. He also racked up two domestic abuse charges. He suffered injuries to himself too—even punching through the screen of a TV.

Brandon’s mother says she noticed “outbursts and hissy fits” during his time with the Broncos. His mom and teammates approached him asking him to “grow up,” to “control” his behavior. His mother says “We still weren’t thinking something was clinically wrong—we were under the impression that Brandon could control this.”

Finally after years of ups and downs, Marshall was diagnosed with BPD and was able to take control of his life.

Marshall voluntarily joined a 3-month outpatient program at McLean Hospital in Belmont, Mass., where he used treatments like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) under the guidance of Dr. John Gunderson. Psychotherapy is the cornerstone of treating BPD and there is no medicine approved by the FDA for treating the illness, though some people will take medicines to control symptoms such as anxiety.

After educating himself on his illness and continuing to engage himself in therapy, Marshall became a heavy-hitting advocate for mental health awareness. In 2013 he was hit with a $10,000 fine by the NFL for rocking green cleats (green is the color for mental health), spoke at the NAMI National Convention in 2012 and started the Brandon Marshall Foundation in 2013. He and his wife Michi have a strong connection to NAMI Chicago and NAMI Cook County North Suburban in Illinois. Michi is an avid NAMIWalk participant, and attended the NAMI Chicago walk last weekend and will be walking at the NAMI CCNS Walk on Oct. 18.

By speaking out and proudly owning Brandon’s recovery, the Marshalls are becoming powerful advocates. Brandon’s willingness to use his public status to create understanding around mental illness is a quality I wish all public figures and celebrities tapped into.

Speaking out is a choice and I can respect that, but every time we get to hear about somebody who overcame a mental health condition, it creates hope. It lets us know that even if you feel like the world is against you, you’re not alone if we’re dealing with something similar. It shows us how mental illness can touch anybody. And it can even save a life.

During Mental Illness Awareness Week and the rest of Oct., the National Education Alliance on Borderline Personality Disorder is sponsoring a social media campaign to fight stigma: #BeyondBPD.

Wednesday, September 24, 2014

“Why Do Y’all Have Tattoos?”

By Simone McKitterick, NAMI Intern

The 2014 NAMI National Convention was an amazing, surreal experience. For four days, people from all over the country came together to educate and learn about mental illness. The entire conference was a smorgasbord of options; from panels on the latest updates in schizophrenia research to exhibits with titles like “Bipolar Girl Rules the World!” Yet, as fascinating as many of the lectures were, the thing that really intrigued me was the conversations people were having with each other. Ordinary people were coming together to communicate for many reasons: education, concern and curiosity.

One of the most profound experiences I had was completely unexpected. I was looking at a booth on borderline personality disorder, when a man came up to me and started talking. He was there because his daughter has borderline and he wanted more information. I told him I had borderline and I’d be happy to answer any questions I could. He had one:

“I don’t meant to be rude, but why do y’all have tattoos? I’m what you might call “old-school,” and I don’t really get them. My daughter has a bunch of them all over her. Is it a Borderline thing?”

Very few things faze me, especially in regards to people asking questions about myself. They’ve run the gamut from polite to slightly tactless to downright insulting, and I’ve fielded them all as best I can. I should also mention that I have six tattoos, some of which are very visible when I wear a short-sleeved shirt. I listen to Goth and heavy metal music, and I wear a lot of black. I’m noticeably “different,” and I accept that people are going to have questions. But I never had anyone ask me if tattoos were “a borderline thing.” This was new, and somewhat refreshing. I liked this guy.

He must have realized how awkward his phrasing was, because he started backpedaling. I just smiled and told him that people with tattoos get them for different, often personal reasons, and that the same applied to people with borderline who have tattoos. I told him a little bit about why I had them: that, for a long time, I lived in a body that gave me a great deal of suffering. This was my way of taking back control. Each tattoo symbolized a time and place in my life. I also explained that many people who have borderline self-harm, and that I saw this as a positive alternative. Perhaps his daughter did too.

He smiled. “Yeah, you might be right. And considering what else she’s dealt with, tattoos aren’t so bad. It could be worse.”

Our conversation switched to several other topics surrounding this notoriously maligned illness, but the initial question remained with me long after the conference was over.

I shared with him how I had been diagnosed with borderline personality disorder 12 years ago and was told I would never get better. How I was informed that there was no cure, and that I shouldn’t ask too many questions about my diagnosis, because then I would become “fixated.”

Meeting other people with borderline wasn’t much better. I don’t know if it’s me, or the fact that this illness tends to emotionally cripple us to the point where we simply cannot interact with others because of the amount of psychic pain we’re in.

But here was a guy who was not a doctor, not a therapist, not a person who had dated someone with borderline and written us off as “psychopaths,” but a father concerned for his daughter. A father who lived through the chaos that ruled over his child’s life, who couldn’t totally understand why she was the way she was, but who nevertheless knew it was an illness, not a character flaw. And who loved her anyway.

When he looked at me, it was clear he didn’t see a lab specimen or an emotional leper, but a person who just so happened to have the same illness as his kid. The fact that she has tattoos or wore Edgar Allen Poe earrings? Feh. It could be worse.

Wednesday, September 10, 2014

Change Starts with Us

By Darcy Gruttadaro, NAMI Director of the Child and Adolescent Action Center

As college students begin the new academic year, there is one subject that all of them should be focused on, regardless of their major. Suicide is a subject that most people don’t talk about until a tragedy happens, yet it remains the second leading cause of death among college students. Campuses need to provide more education to stem the tide.

It is National Suicide Prevention Month so there is no time like now to start. Suicides have devastated families and college communities across the country. The overwhelming majority of people who die by suicide live with a mental health condition. They need access to effective mental health services and supports as early as possible.   

How do we address this public health crisis? So often after a suicide, the community is left wondering, how did this happen and what went wrong? There is certainly more we can do. We can start with educating and informing college communities about the warning signs of mental health conditions, suicide and how to help a friend.

In 2012, NAMI released College Students Speak: A Survey Report on Mental Health, documenting the experiences of college students living with mental health conditions. Students who responded to NAMI’s national survey called for far more education and information about mental illnesses on campuses. They expressed the critical need to educate students, administrators, faculty and staff about mental illness.

With this in mind, NAMI developed a toolkit to educate and inform. It includes:

  • An engaging presentation covering the warning signs and how to help a friend.
  • A step-by-step guide on how to present the material, complete with discussion questions.
  • Fact sheets to reinforce information presented.
  • Customizable flyers and social media posts as an easy way to get the word out.
  • A customizable template on the mental health resources and information on campus.
  • Videos to share through social media to increase conversations about mental health.

There is great hope in the rapid expansion of NAMI on Campus clubs across the country. These clubs raise awareness and advocate for better and more accessible mental health services and supports on college campuses. They make it OK to talk about mental health issues, decrease stigma and bring hope.

People experiencing a mental health condition often feel isolated and alone. This can be especially difficult for college students who are away from home and under tremendous academic and social pressure. The more we can reach students, resident advisors, faculty and staff with information, the better equipped they will be to help. We can all play a part in lifting the shame and stigma that all too often hold people down.

Together we can stem the tide. Change starts with us.

If you or someone you know are experiencing thoughts of suicide please call 1-800-273-TALK (8255), the National Suicide Prevention Lifeline.

Tuesday, September 9, 2014

How is Your Health Insurance Treating You?

By Everly Groves, NAMI Policy Intern and Sita Diehl, NAMI Director of State Policy and Advocacy

Dramatic changes now taking place in our nation’s health care system should mean that people living with mental illnesses will have better access to mental health services. But will they? NAMI created a brief online Coverage for Care Survey to answer this very question. We need your help to find out how recent changes in federal law affect you and your family.

Over 11 million people with mental illness were uninsured as of 2010. Most are now eligible for mental health and substance use care because of changes to health coverage under the Affordable Care Act (ACA). The ACA requires Medicaid expansion and individual and small group private health plans to cover mental health and substance use services as one of the 10 Essential Health Benefits. This change will mean that millions of people will be getting access to private health coverage or Medicaid for the first time.

Even more changes to mental health and substance use coverage came July 1. Provisions to the Mental Health Parity and Addiction Equity Act of 2008 were put in place to ensure parity for mental health and substance use care. But what exactly is parity? Parity ensures that all plans cover mental health and substance use treatment on par with other types of care. That means fair and equal terms for what types of services are covered, the procedures necessary to get care and how much you pay out of pocket.

Coverage for Care Survey
Because these changes are so important, NAMI wants to understand how the ACA and the new parity rules affect you and your ability to get the care you need. We created the Coverage for Care Survey to learn from you.

We want to hear from everyone in need of mental health or substance use care. So if you or your family member uses these services, complete this survey! It doesn’t matter if you have private health insurance, Medicare, Medicaid, TRICARE, VA health benefits, student health, any other type of coverage or don’t have coverage at all.

Take this survey on behalf of you or your loved ones in need of mental health and/or substance use care. Spread the word to your friends, family, co-workers, and colleagues. It should only take 15-20 minutes. Post the link on your Facebook or Twitter! The more responses we get, the stronger our findings will be.

The deadline to complete the survey is 12 p.m. EST on Sept. 30, 2014.

Friday, August 29, 2014

Technology as a Tool for Recovery—A Promising Practice

Millions of Americans face the day-to-day reality of living with a mental illness. Mental illness affects everyone—our communities, our families and ourselves. Access to help, treatment and services for those in need can be a challenge, and the impact of systems and treatment failures—homelessness, cycles of hospitalization, jail, failed relationships—affect many.

And yet, amid the failures are stories of success. In many communities, we see innovative solutions emerging that offer hope while providing effective approaches that truly improve lives.

Many people with mental illness do not have access to integrated primary health care. Despite the fact that people with mental illness often have other health challenges, including heart disease and diabetes, too often health care providers are not equipped to address all of their health care needs. And, if left untreated, this may result in additional struggles for the individuals, too often resulting in the use of other more expensive, downstream services including emergency departments and crisis services.

In Massachusetts, one local approach to solving this challenge stands as a pillar, as a promising practice. Through the creative use of technology, community health care provider Vinfen, along with Dartmouth Medical School and other community health providers, embarked on an effort to study the use of a small personal technology device, The Health Buddy, to help individuals manage their physical and mental health needs on a daily basis.

"Although it does not fix everything for me, I am walking more than I used to, I am more active and it has helped me get through my day better."

“The Health Buddy helps me and my case manager stay connected,” said John, a gentleman with a mental illness who has been using the personal technology device to help him manage his mental and physical health care. “It helps monitor health and feeling and helps me manage my medications. It also helps me manage how to eat and when to eat to be healthier.”

A small hand-held device with four buttons and a display screen, the Health Buddy, along with a related systems study, aims to teach individuals with serious mental illness, like John, how to help manage their chronic medical conditions and access care sooner while avoiding more severe complications.

In John’s case, the technology helps him keep track of his health experiences and also alerts his treatment team. If he records information that alerts a concern, they are notified sooner and can reach out to check in to address any problems before they may escalate. If John needs something special, he can also alert his case management team ahead of time so they can talk about it, a relief to John who previously may have had to wait for an appointment to register an issue.

“I think this technology is a good idea,” John shared. “I get to communicate every day, not just when I have an appointment. It serves as a reminder about my diabetes and mental health condition by asking me ‘How do you feel today?’ and then also gives me new information that is helpful for me in understanding how to be healthier.”

In addition to helping John better manage his various health conditions, it has helped him stay connected, personally, and has helped him be more independent. He visits to the emergency department have rapidly decreased as he has learned to become his own health care advocate, and his relationships with his wife and sister have improved.

“I think this is a good idea” John said. “Although it does not fix everything for me, I am walking more than I used to, I am more active and it has helped me get through my day better.” A promising practice indeed.



Together with the National Council for Behavioral Health (National Council) and Otsuka America Pharmaceutical, Inc. and Lundbeck, NAMI affirms the need for localized, innovative, effective and sustainable approaches to address serious mental illness. Through Connect 4 Mental Health® (C4MH),a nationwide initiative, we have joined together to call for communities to prioritize serious mental illness and encourage promising practices that help people, like John, live healthier, fuller lives. 

Learn more about the C4MH initiative and the Community Innovation Awards program which, through four $10,000 awards, will strive to recognize additional organizations across the country that are exhibiting innovative approaches to serious mental illness in their communities.

Wednesday, August 27, 2014

Criminalization of Mental Illness: It’s a Crime

By Mary Giliberti, NAMI Executive Director

Today, 1 in 5 people in jails and prisons in this country live with a mental illness. About 70 percent of youth in the juvenile justice system have a mental health condition. This criminalization of mental illness is tragic and it’s wrong.

Instead of getting people with mental illness the treatment and support they need, our society too often puts them in jails or prisons, which are the worst places for recovery.

News reports almost routinely revealed cases that should shock the conscience of Americans. In California, the state was forced to adopt detailed regulations after videotapes became public showing prison inmates with mentally illness being doused with pepper spray and violently removed from cells.

Solitary Watch, an advocacy group that focuses on solitary confinement issues in general has begun to circulate videos to document the brutal treatment of inmates with mental illness.

Two years ago, NAMI warned the U.S. Senate that putting people with severe psychiatric symptoms in solitary confinement is like pouring gasoline on a fire. It only intensifies symptoms. Today, a NAMI fact sheet on solitary confinement is being used to influence policymakers as part of the reform movement.

NAMI has worked for years to expand Crisis Intervention Teams (CIT) training for police for compassionate responses to people experiencing psychiatric crises. At a Senate hearing this year, NAMI called on the federal government to vigorously promote CIT nationwide.

At NAMI’s National Convention, Sept. 4-7, in Washington, D.C., NAMI will honor Cook County Sheriff Tom Dart of Chicago, a national champion for CIT and other criminal justice reforms.  His staff recently gave me a tour of the Cook County Jail— which, sadly, is considered one of the largest “psychiatric hospitals” in the country.  

Although Sheriff Dart works tirelessly to provide treatment in the jail, it still was sickening to see such a large number of individuals with mental illness confined because they did not get the help they needed. I also had the privilege to visit a community-based center for individuals with mental illness in the same city that provided extensive peer support and a place for people to feel part of a community.  I was struck by the different outcomes for people with mental illness and how much rests on access to good services and supports and diversionary programs.

Besides honoring Sheriff Dart, NAMI’s convention will focus on a range of criminal justice issues. The convention program includes:

  • An “Ask a Cop” workshop.
  • A networking session on “Families and the Criminal Justice System.”
  • A major topic session is entitled “Treatment, Not Jail: Diverting Veterans from Incarceration into Mental Health and Substance Abuse Treatment.”

But criminalization is more than a policy topic. For many people, it can be an immediate, urgent crisis. Every month, NAMI’s national Helpline gets hundreds of telephone calls for legal help:

  • Individuals want to know whether it is safe to call 911 if they or someone they love is in crisis.
  • Families want to know what to do if a loved one has been taken away by police.
  • Families struggle to cope with having loved ones in prison, sometimes for years, and worry about whether they are getting the help they need.

What can you do to help? Send a message to Congress to pass the Mentally Ill Offender Treatment and Crime Reduction Act this year to support alternatives to incarceration for youth and adults with mental illness.

Click here to take action

If you need more information, please feel free to also contact the NAMI Helpline at 1-800-950-NAMI (6264). NAMI stands for help and hope. We welcome your support.