Take Control and Build Your Future with Ticket to Work

By Bob Williams, Associate Commissioner
Office of Employment Support Programs, Social Security Administration

Next week is Mental Illness Awareness Week. Designated by the U.S. Congress in 1990, activities and efforts to raise awareness about mental illness are planned for national and local communities, including efforts to promote awareness about the importance of work for all Americans, including employment for those living with mental illness.

The numbers are striking. According to the National Institute of Mental Health (NIMH), one in four adults in this country experiences mental illness in a given year. This figure translates to 57 million Americans. Serious mental illnessis the leading cause of disability in the U.S. for people aged 15-44. My agency provides support to approximately 2.3 million people who have been diagnosed with a mental illness; they are the largest and most rapidly expanding subgroup of program beneficiaries. In 2010, nearly one out of every five working-age adults who were awarded benefits qualified because of a mental illness. In addition to their monthly cash benefit, all are eligible to participate in a Social Security-sponsored program, called Ticket to Work.

Why Work?

Choosing to work means earning money and, eventually, becoming financially independent. Having more money enables people to make choices and to pursue goals that simply aren’t possible living on disability benefits. The Ticket to Work program is here to help people with disabilities find good jobs, good careers and better self-supporting futures! As a secondary advantage, for many people, work means boosting self-esteem, meeting new people, and giving back to their community. The path to employment leads to success, and that success builds, allowing individuals to gain confidence and transform their lives. The Ticket to Work program, along with other Work Incentives, offers a number of features that can help individuals with mental illness choose to work. For example, features such as continuation of Medicare/Medicaid coverage and expedited reinstatement (for those who qualify) can ease the concerns of people who may be considering entry or re-entry into the workforce.

How It Works

All Social Security beneficiaries with disabilities who are between the ages 18-64 qualify for these free and voluntary programs. Social Security works with more than 1,200 rehabilitation and employment service providers across the country.These organizations provide support to beneficiaries with career counseling, job search assistance, vocational rehabilitation and training. Many of these organizations offer services especially for individuals living with mental illness. For example, some service providers offer peer-to-peer support, crisis intervention and a focus on employable skills-building. According to NAMI, more than 70 percent of employers who have hired individuals with serious mental illness are willing to continue working with rehabilitation programs that place and support those people.

What You Can Do

For more information on Ticket to Work and Work Incentives, to find a service provider near you, or to learn about people who used the program to find work, visit www.socialsecurity.gov/work or email us at support@chooseworkttw.net or call (866) 968-7842 or (866) 833-2967 (TTY/TDD).

Scientific Research: In the News

By Bob Carolla, NAMI Director of Media Relations

Medical science usually advances slowly and incrementally. What seems logical or reasonable at one point in time may be built upon or overturned by an advance of knowledge in the next decade—or even 20 years later..

Thomas Insel, M.D., director of the National Institute of Mental Health (NIMH) has noted that “Diagnosis for mental illnesses is totally by observation and the causes are unknown. Treatment is based off trial and error along with the facts that there is no cure.” He pointed to three insights: mental illnesses are brain disorders, they are developmental disorder and they result from complex genetic risks plus environment factors.

In launching the One Mind for Research campaign, former U.S. Representative Patrick Kennedy has called for a broad, aggressive research agenda that would not be “disease specific.” Instead, research should reach across traditional disciplines that involve brain disorders— neurodevelopmental conditions like intellectual disability and autism, neurodegenerative illnesses like Alzheimer’s and Parkinson’s disease and neuropsychiatric illnesses like schizophrenia.

Both Insel’s and Kennedy’s views are covered in the current issue of NAMI’s print magazine, theAdvocate. Two news stories broke this week that reflect their approach.

Science Daily reported that scientists from more than 20 countries conducted collaborative studies involving more than 50,000 people to identify genetic variants that put people at risk of developing mental illness.

They discovered that common genetic variants exist for both schizophrenia and bipolar disorder, involving 11 regions of the genome, including six that were not previously known. The results represent a significant advance in understanding the causes of both illnesses. NIMH funded international coordination of the study.

Meanwhile,Health Daily News reported on a Taiwanese study that found that people living with epilepsy are nearly eight times more likely than those without it to develop schizophrenia. In turn, people living with schizophrenia are also six times more likely to have epilepsy.

The “two-way relationship” between the two conditions may be the result of genetic, neurobiological or environmental causes. While the cause is still uncertain, the study provides new perspective for research.

Every study is a building block of knowledge. Unfortunately, for anyone who lives with mental illness, breakthroughs in scientific research can’t come fast enough.

The NAMI Advocate: Read All About It

The Advocate magazine is starting to arrive in the mail boxes of NAMI members this week. It is NAMI's flagship publication, printed three times a year.

Only NAMI members receive it. That's one more reason to join NAMI -- if you haven't already -- above and beyond the support that you already give our mission in helping millions of Americans affected by mental illness.

Besides the print magazine, NAMI offers many diverse electronic publications for free through the Internet. To subscribe to them, all that is required is registering on the NAMI website and checking boxes that fit your interests.

Selections include general or topical updates whenever something new is added to the site, our monthly e-Advocate, our NAMI Faithnet newsletter, Avanzamos in Spanish, and NAMI's Policy E-News and Alerts to name only a few. They all are a good way to follow what's happening in the mental health community.

For example, the current issue of the print Advocate includes articles on

• Mental Illness in the Workplace: Rights Under the ADA
• Patrick Kennedy's new "One Mind for Research" Campaign
• Off to College: Living with Mental Illness
• NAMIWalks -- growing in leaps and bounds
• The Latest in Schizophrenia Research
• Updated "PORT" Guidelines for Treating Schizophrenia
• The U.S. Military and Mental Illness
• Mother and Son Share Stories at NAMI Convention: Jesse Close and Calen Pick of BringChange2Mind
• Improving Cognition in Schizophrenia
• Only in Your Dreams: Revising Nightmares Can Help PTSD Symptoms
• Book and Film Reviews

Again. these print Advocate articles are only available to NAMI members.

However, other lively, informative articles appear each month in NAMI's e-Advocate newsletter.

The next issue of the e-Advocate will be coming out in two weeks, just in time for Mental Illness Awareness Week (Oct.2-8). Make sure to read it. We hope you'll like it. If you aren't a NAMI member already, we also hope you'll consider joining us as a member and start reading the print Advocate as well.

Youth Shouldn’t Struggle in Silence

By Dana C. Markey, Child and Adolescent Action Center Program Manager

A recent article, “Mental health screening and follow-up care in public high schools,” in the September 2011 issue of the Journal Academy of Child and Adolescent Psychiatry recognizes screening is as a practical strategy for schools to identify and connect youth to services and supports—when they otherwise may never receive help for mental health needs.

It summarizes a study that examined 2,500 students at six public high schools who participated in mental health screening between 2005 and 2009. Nearly 20 percent were identified at risk—with 73.6 percent of that group not receiving mental health services and supports at the time of the screening.

In other words, without screening, those students most likely would have continued to struggle in silence well into adulthood where fewer than half of adults with mental health needs get help.

As an advocate, and especially, as a young adult who struggled in high school, it comes to no surprise to me that such an alarming number of youth with mental health needs are not receiving treatment.

When I began my freshman year of high school, I was struggling to overcome a traumatic childhood. Often I was plagued with feelings of guilt, shame, self-hatred and sadness, which often triggered debilitating bouts of depression. In order to cope, I turned to self-injury as a way to handle the overwhelming emotions. Even so, I was extremely successful in school. My perfectionism super exceeded my desire to admit “failure” and get help. I didn’t raise any red flags and thus, didn’t get connected to any services or supports. I eventually found my own way out of my depression and self-injury. However, it came at a high cost—I lost critical developmental years of my life and had to deal with the aftermath of my destructive behaviors.

Looking back, I believe sheer luck and a fortunate amount of resiliency prevented me from becoming one of the more than 4,000 youth who die by suicide a year.

All it would have taken to help me was for one person to ask about my mental health. I would have opened up like a book. It never crossed my mind to proactively share this information, that it was okay to do so and that help was available.

Youth should not have to find their way through a difficult time alone.

As the article indicates, voluntary screening, along with a continuum of services and supports, offers schools and communities the valuable chance to catch youth who may otherwise fall through the cracks. It also provides youth with a safe zone to share concerns and the opportunity to get help if needed.

Routine, voluntary screening also sends the critical message that mental health and well-being is just as important as other major public health concerns and should be treated no differently.

If we can identify youth who need help early they can be connected to school- and community-based services and supports when they first need it—before they fail or drop out of school and before they develop more difficult-to-treat, chronic conditions and before they experience other tragic consequences of untreated mental health issues.

NAMI’s Child and Adolescent Action Center has made the early identification and intervention of youth living with mental health needs a top priority. We stand ready to support schools and communities with this important and life-saving undertaking. Together we can ensure youth going through a difficult time can get the support they need when they need it.

Believe me, I know.

NAMI's News Desk: People Watching

By Bob Carolla, NAMI Director of Media Relations

Running NAMI's news desk is a challenge, but a satisfying one. I get to monitor where and how NAMI is making a difference, especially at the grassroots level. It provides reminders of why we are here.

NAMI's bottom line is its mission: helping people affected by serious mental illness. Every day, we're proud of the work NAMI members are doing in every state and in hundreds of communities nationwide and proud when it is recognized in local or national media.

Here are two examples.

New York City's 24-hour news channel, NY1, recently aired a story about NAMI's NYC Metro affiliate and its back to-school launch of NAMI Basics classes for parents of children and adolescents experiencing mental illness.

The story profiles the family of Erin Mercado, now 17, who has lived with depression since age 12. NAMI Basics helped Erin's parents develop knowledge and skills needed to problem-solve, listen and communicate in helping their daughter.

It also was satisfying to read the article "Schizophrenia Tactics: How to Stay Out of the Hospital" on Health Central's www.schizophreniaconnection.com website, which recommends NAMI's Peer-to-Peer education program for people living with mental illness as an important means of learning to manage their conditions and identify triggers before relapses occur. Like NAMI Basics, Peer-to-Peer is one of many education and support programs NAMI offers.

The author of the Health Central story is Christina Bruni, who herself lives with schizophrenia. She once dropped by the press room at one of NAMI's national conventions as part of her research. I remember her. She is one of the many people I've been privileged to meet in my work.

Inside or outside NAMI, we're all part of a common cause. It's all about our mission. It's all about people. And that includes you.