Thursday, May 26, 2011

Calling All Legal Beagles

By Bob Carolla, NAMI Director of Media Relations

It’s been a long time since I practiced law, but two things got my legal instincts stirring this week. They suggest strategies that might help advance the cause of mental health care.

The sheriff of Cook County, the greater Chicago, Ill. area, threatened to sue the state for turning the county jail into a “dumping ground” for people living with mental illness. Approximately 20 percent of the jail’s population receives psychiatric care. Many have committed relatively minor crimes such as shoplifting or trespass.

Then, the U.S. Supreme Court announced a 5-4 decision holding that conditions in California’s overcrowded prisons are so bad they violate the U.S. Constitution’s ban on cruel and unusual punishment. The state will need to release more than 30,000 inmates. Even so, California prisons will remain almost 140 percent over capacity.

The New York Times noted that the court’s majority opinion went so far as to include photographs of prison conditions. But in a dissenting opinion, Justice Antonin Scalia argued that most prisoners released probably will not be those with medical conditions or mental illness, but rather “physical specimens who have developed intimidating muscles pumping iron in the prison gym.”

Along with the Cook County sheriff’s threat, Scalia’s comment points to more fundamental issues.

Can states develop mental health care systems to keeps people with serious mental illness out of prisons in the first place?

Will prisoners with mental health problems who are released be able to find help in communities “on the outside?”

Will states at least improve conditions for those who remain imprisoned? In 2003, Human Rights Watch released Ill-Equipped: U.S. Prisons and Offenders with Mental Illness, a report NAMI called “the equivalent of a five alarm fire.” Prisons are probably the worst environments for treating individuals with mental illness. Conditions can push a person “over the edge” into acute psychosis.

I haven’t finished reading the court’s 50 page opinion (plus dissenting opinions), so I don’t know whether any of the Justices read or cited the Humans Rights Watch report. If they didn’t, they should have.

Legal opinions aren’t always fun to read. I once took my 10-year-old daughter to visit the law school I attended. She looked at thick volumes of case reporters on endless dusty shelves in the library. “This is the most boring place I’ve ever seen,” she said. “No way am I ever going to be a lawyer.” Part of me agrees with the sentiment. But then I remember that sometimes it’s often only legal strategies that can protect human rights against the failings of legislatures and other institutions.

Thursday, May 19, 2011

Courage and my Triathlon Effort

By Janet Ohlsen

I Love triathlons. I love to swim, bike and run.

In high school I struggled with negative thoughts as well as to be happy and get great grades. I was very good in art and sports. My art took me to college and I received a degree in Communication Design in 1979. I faired better in college but I partied and drank which made me feel good and tame my feelings-so I thought.

If you were to tell me I would lose interest in my favorite activities I would have said, "No way, not ME," but that is what happened slowly and painfully. I have been diagnosed with a bipolar mood disorder, heavy on major depression and as a topping, alcoholism- resulting in a wonderful compilation called dual diagnosis. These are all things I could not see or admit I had. For years I was slowly sinking into a depression that I used to fight to hide and deny. My focus, concentration, unexplained physical aliments and suicidal thoughts were building up along with anxiety. Then, sometimes, it diminished for short periods of time so I thought I was fine. But. It would not take long until I would be back to a sense of hopelessness, self loathing and not being able to "come out of it!"

It was frustrating not to be able to control my moods, deal with emotions or have the energy to reach out for help. It took three trips to the ER, for complications due to self-medicating, before I started getting help. It has been a long process involving general practitioner visits, rehab and then visits to a psychiatrist and psychotherapy.

Recently, NAMI asked me to be part of a National Public Radio (NPR) Morning Edition story about my experience with getting help and psychotherapy. The topic was "Shop for a Psychotherapist: Avoid the Lemons" as reported by Nancy Shute who is very attuned to the area of mental health. I had a very good experience with the whole process, being able to talk openly, and as it turned out it was a greatly therapeutic way of dealing will my illness. I talked about how important finding the right therapist is. Fortunately I got mine from a friend's referral. It took several visits to understand how it would help, but counseling is the biggest part of my recovery; finding someone you trust and "click" with. I have been working a lot with my therapist on negative thinking, which is a hallmark of depression.

I enjoy books about athletes with health issues who overcome incredible odds to become inspirational sources of courage for others. Courage has become my favorite word. It takes courage to go forth to get help and do what you love to do. After I was feeling better, I got certified as a triathlon coach.

The Project Athena Foundation picked me to pursue my athletic dream of competing in the upcoming IRONMAN triathlon, following my story submission a year ago. They are helping support me with some funds (the entrance fee is $650.00!!) and encouragement as well as coaching advice. In return, will be a "Goddess" to help raise money for the next recipient, which I feel strongly about. "Pay it forward" feels so good.

Thursday, May 12, 2011

Are Recovery and Wellness Less Likely for GLBTQ Ethnic Minorities?

By Philip Qualo, STAR Center Program Manager

I am a Black man who happens to be gay. In my mid-20s I revealed my sexual orientation to friends and family who in turn expressed both support and concern. The common perception was that facing prejudice and homophobia would make it twice as hard to achieve my life goals.

The Centers for Disease Control and Prevention (CDC) notes that the quality of life for Americans who are from minority communities continues to be substantially diminished compared to their majority counterparts-especially in terms of housing, education, income, obesity, homicides, HIV infection, health care access and preventative health services as well as potentially preventable hospitalizations. In recent years, the Gay Lesbian Bisexual Transgender and Questioning (GLBTQ) community has similarly fought against discrimination and oppression and has earned public recognition of its status as a disadvantaged minority group. However, the GLBTQ community is inherently diverse in and of itself since sexual orientation is not based on skin color, ethnicity or religion.

The STAR Center is a Substance Abuse and Mental Health Services Administration (SAMHSA) funded technical assistance center assigned the task of enhancing cultural competency and diversity in the mental health field. In my role as program manager, I could not help but wonder whether individuals living with mental illness who are GLBTQ and members of a racial or cultural minority face twice as many obstacles when it comes to recovery compared to other people. In other words, are they less likely to achieve recovery and mental health wellness than their majority counterparts?

According to a study conducted at Columbia University's Mailman School of Public Health that included lesbian, gay and bisexual populations, racial and cultural minorities do not experience more "mental disorders" than whites. Surprisingly, the most underserved individuals in the study, Black GLBTQ individuals, had the least number of mental health challenges in comparison.

Based on the theory that prejudice-related stress would increase risk for mental disorders, researchers typically expect that Black lesbians, gay men and bisexuals face prejudice related to both racism and homophobia and therefore would have more disorders than their white counterparts. "These findings suggest that black lesbians, gay men and bisexuals have effective ways to cope with prejudice related to racism and homophobia," noted Ilan H. Meyer, Ph.D., associate professor of clinical Sociomedical Sciences at the Mailman School of Public Health and principal investigator of the study. It is impossible to cite any definitive reason for these findings because of the inherent individual diversity among study participants. However, it has been noted that gays and lesbians are more likely to seek mental health services than their straight counterparts, and so are more likely to address any mental health challenges early on.

What can be gleaned from this information? Belonging to multiple underserved groups, or even just one, does not necessarily guarantee the likelihood of mental illness or failed recovery. At the same time, culture matters, and mental health maintenance that acknowledges and integrates cultural or sexual identity experiences can and needs to be a priority for all individuals. Although minority groups continue to experience substantial disparities in terms of access to treatment, every individual and community has the power to develop effective coping skills, supports and programs, particularly with the wealth of tools, tips and guides that are available through the National Alliance on Mental Illness (NAMI), the NAMI STAR Center, SAMHSA, providers and numerous other organizations and resources.

Philip Qualo, J.D. is a program manager at the NAMI STAR Center, which is a SAMHSA-funded technical assistance center dedicated to meeting the recovery needs of underserved communities by increasing cultural competency, diversity and social inclusion and promoting self-help and empowerment tools and messages for mental health and community wellness. Please visit us at www.consumerstar.org.

Thursday, May 5, 2011

National Children's Mental Health Awareness Day

By Mike Fitzpatrick, NAMI Executive Director

NAMI joined with others this week on Tuesday, May 3, to celebrate National Children's Mental Health Awareness Day. This day is dedicated to all the young lives that have been impacted by mental, emotional or behavioral health challenges. It provides the perfect opportunity to come together to rally behind these youth and to advocate for a full array of effective services and supports that give hope to our youngest citizens.

Mental health issues impact large numbers of youth but fortunately, with early identification and intervention, they are treatable. We all play a role in ensuring this happens-whether by providing information, support, guidance or simply, hope.

National Children's Mental Health Awareness Day is an important reminder of what we can do to improve the health and well-being of the next generation. This year, numerous events and activities were undertaken to raise awareness, including:
  • A briefing on Capitol Hill that focused on the importance of early identification and intervention for children living with mental illness. The briefing also focused on two pieces of federal legislation that provide support to schools to better address the needs of students living with mental illness- theMental Health in Schools Act (HR 751), which would provide federal funding to increase and improve school-based mental health services and supports and the Achievement Through Prevention Act (S. 541), which would increase the implementation of school-wide positive behavioral interventions and supports to improve student academic achievement.
  • NAMI state organizations and local affiliates around the country took advantage of the tools NAMI developed for National Children's Mental Health Awareness Day by securing proclamations from state and local officials to honor the day and by engaging in a variety of other local activities to help educate and inform the public about children's mental health.
  • The National Institute of Mental Health joined in the celebration with a Research Panel Videocast and with a series of resources on their website related to children.
  • The Substance Abuse and Mental Health Administration organized a touching evening event that opened with a youth art exhibit at the Shakespeare Theatre and continued with a tribute to youth who have experienced trauma in their childhood. The event focused on building resilience in young children dealing with trauma.

Although we honor Children's Mental Health Awareness Day the first week of May every year, the resources NAMI developed can be used any day of the year to educate and inform the public about children's mental health.

Research shows that 50 percent of mental illness begins by age 14 and 75 percent by age 24, so we now know that mental illness strikes early in life. The more we raise awareness about mental health, the more that we can eradicate stigma and link children living with mental illness with effective services and supports. The more that we can do this, the more we can change the course of young lives for the better.