SAMHSA’s Wellness Initiative: Why Wellness Matters for People with Mental Health and Substance Use Conditions

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People with mental health and substance use conditions die decades earlier than the general population, mostly due to preventable medical conditions. Risk factors for people with mental health and substance use disorders: poverty, social isolation, trauma, tobacco, obesity, medication side-effects, alcohol and drugs, and lack of access to quality healthcare.

SAMHSA organized “National Wellness Week” for the 3rd week in September, with events around the country. Find events or organize your own: More Info

Infographic shows why individuals with mental illnesses die earlier than the general population 

When It Comes to Involuntary Treatment, I Have Mixed Feelings

A part of me believes that people living with mental illness should be free to live their lives just as normal people do. The problem is, when some people with mental illness try to get by without treatment, they can’t live their lives just as normal people do. It would be great if everyone with a mental illness could hold jobs, pay rent, feed themselves and stay out of trouble. There would be no need for involuntary treatment if this was the case. But it’s not.

Without treatment, many people with mental illness will either end up homeless, in jail or – like Joel Reuter, who was shot and killed in a confrontation with Seattle police last month – dead (“Joel Reuter’s family pushes for change in mental illness laws,” Capitol Hill Seattle Blog, Aug. 11).

I live with bipolar, and Joel Reuter was like me in many respects. We are fine if we’re on our meds. We both graduated college, can hold a job and live successful lives . . .  on our meds. I have been hospitalized three times, and I agree with Joels’ father Doug Reuter when he said, “[For] most people with mental illness, it takes two or three hospitalizations before it clicks.”

For me, it took me a third hospitalization (after going off my meds) and two near-death experiences to figure out that when I am not on my meds, I hear voices. These voices are not nice. These voices want me dead and are convincing enough to make me want to die. If I want to live, I have to take the meds that keep them away.

For Reuter, his paranoia and delusions made him a danger to others, but the problem to me seems that he was smart enough to get released without being ready. If he hadn’t been, he may still be alive today.

As a person living with bipolar, I am thankful for involuntary treatment. It was very hard at times, especially when I thought there was nothing wrong with me and everyone else was crazy, not me. But I know without involuntary treatment, I would be dead, too. Civil commitment laws save lives. They provide people with a way to get medication that allows them to live normal, successful lives, like how Reuter’s was before he went off his medication.

If people with mental illness didn’t need help sometimes to get and stay in treatment, these laws wouldn’t exist. I know that the meds can be crummy at times, but they are better than the alternative . . . homelessness, jail or death.

by Natalie, Treatment Advocacy Center

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The Importance Of Getting Help For Your Fears And Anxieties

Getting professional help for dealing with your persistent fears and anxieties is the single most important step in your recovery. Many people are reluctant to get the help they need. Making excuses for not getting the treatment for your anxiety problems will not solve the problem. Here are a few reasons that getting help is important.
Getting professional help can lead to additional insights and suggestions for your stress and anxiety problems. A professional counselor can give you many ideas on how you can manage your fears and anxieties.

Most counselors and psychologists know of ways to get rid of your fears. They can recommend certain treatments that will make you feel a lot better. The only way you will get access to these treatments is to talk to a counselor. Ask your primary care physician if he or she knows anyone that can help you.

You can not manage your fears all by yourself. Anxieties and fears can be extremely difficult to manage and more than likely you will need some help. Remember when your boss or your coworkers showed you how to do your job? You needed help from someone to learn the ins and outs of doing your current job. This concept applies to managing your fears. Do not feel ashamed that you are getting help. We all learn new things from others on a regular basis.

As you work with a professional, you will improve your skill sets in managing your stress. You will become better in time, which will benefit you later on in your life.

Do not be ashamed to ask for help. We all have to learn new things in life and learning how to manage your fears is no different.

BIOGRAPHY:
 Stan Popovich is the author of “A Layman’s Guide to Managing Fear Using Psychology, Christianity and Non Resistant Methods” – an easy to read book that presents a general overview of techniques that are effective in managing persistent fears and anxieties. For additional information go to: http://www.managingfear.com/

One Third of States Score D or F for Jail Diversion

Fewer than half the U.S. population lives in communities where the most basic methods of diverting people with severe mental illness from the criminal justice system are being used, according to a new study by the Treatment Advocacy Center.

A full one-third of the nation’s states get a D or F grade for using mental health courts and crisis intervention teams (CIT) – diversion programs proven to reduce the criminalization of mental illness, the study found.

“People with untreated psychiatric disease should be getting the treatment they need before law enforcement shows up at their door because of behaviors caused by their illness,” said Doris A. Fuller, executive director.

“Assisted outpatient treatment (AOT) is a proven best practice to keep high-risk individuals from encountering police in the first place. Until more jurisdictions start actively using AOT to reduce criminal justice involvement, mental health courts and CIT are the best available options to reduce the criminalization of mental illness. The failure to use these basic tactics is a disservice to both the individuals who would benefit and to their communities.”   

Mental health courts divert qualifying non-violent criminal defendants from jail into community-based mental health treatment. Crisis intervention teams consist of specially trained officers who respond to service calls involving mental illness. Both programs have consistently been found to reduce the arrest and incarceration of individuals with severe mental illness.

Nationwide, less than 40% of the U.S. population lives in jurisdictions with mental health courts, and only 49% lives where police departments are using CIT, according to “Prevalence of Mental Health Diversion Practices: A Survey of the States.”

At the top of the class, Utah and Arizona were the only states serving at least 75% of their populations with both mental health courts and CIT. At the bottom, receiving Fs, were 10 states where less than 20% of the population has access to these diversionary practices.

SEE WHERE YOUR STATE RANKS: Read “Prevalence of Mental Health Diversion Practices: A Survey of States

–Treatment Advocacy Center

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Chronic Alcohol Use Shifts Brain’s Control of Behavior

Chronic alcohol exposure leads to brain adaptations that shift behavior control away from an area of the brain involved in complex decision-making and toward a region associated with habit formation, according to a new study conducted in mice by scientists at the National Institutes of Health.

The finding provides a biological mechanism that helps to explain compulsive alcohol use and the progression to alcohol dependence. A report appears online in the Proceedings of the National Academy of Sciences (PNAS).

The brain’s prefrontal cortex is involved in decision-making and controlling emotion, while the dorsal striatum is thought to play a key role in motivation and habit formation. Past studies have shown that alcohol dependent individuals show problems with skills mediated by the prefrontal cortex such as impulse control. These same individuals often show exaggerated neural response in the dorsal striatum to alcohol-related cues.

To investigate whether changes in the dorsal striatum might account for these observations, researchers led by Andrew Holmes, Ph.D., in the Laboratory of Laboratory of Behavioral and Genomic Neuroscience at NIAAA, measured changes in the brains of mice that were chronically exposed to alcohol vapors.

He and his colleagues found profound changes in the dorsal striatum of these mice, including the expansion of neuronal dendrites, the branching projections of the nerve cell that conduct signals. Such changes are also seen with chronic exposure to drugs such as amphetamine. These structural changes were associated with changes in synaptic plasticity, the brain’s ability to change in response to experience, and reduced activity of endocannabinoid receptors, which are part of a signaling system that may play a role in sensation, mood, and memory.

“These findings give important insight into how excessive drinking affects learning and behavioral control at the neural level,” said Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). “The shift to increased striatal control over behavior may be a critical step in the progression of alcoholism.”

“The changes we observed suggest that the manner in which the dorsal striatum signaled and adapted to environmental information has been altered by alcohol,” said senior author Dr. Andrew Holmes. “The findings imply that chronic drinking may set up a concerted set of adaptions in this key brain region that produce a bias for striatal control over behavior.”

Such changes could contribute to the emergence of habitual and compulsive patterns of behavior in alcohol abuse, and suggest that treatments designed to normalize striatal function may be an important approach for alcohol treatment.

Dr. Holmes and his colleagues add that their findings suggest that drug abuse doesn’t simply impair brain functions, but instead produces a complex set of adaptations that tamp down the function of some brain regions while dialing up the function of others.

Indeed, the researchers found that chronic alcohol actually improved the ability of mice to learn to make choices on a touchscreen.

“Improved performance on learning tasks that we know depend on the dorsolateral striatum is particularly interesting because it suggests that alcohol could prime the brain to favor other dorsal striatal behaviors – including things like habit formation, which may foster addictive patterns of behavior,” said Dr. Holmes.

–National Institutes of Health

Full Article

7 Surprising Things About the Affordable Care Act

Oct. 1 isn’t a deadline for you, but it is for the government.

You may have heard that everyone is scrambling to meet the law’s Oct. 1 deadline. Breathe easy. You don’t have to do anything by Oct. 1. But the federal government — or your state — is on the hook, and your employer probably is, too.

Oct. 1 is the day the new insurance Marketplaces are set to open in every state. The Marketplaces have web sites that offer one-stop shopping for new health insurance. Fill out a three-page form, and you can find out if you qualify for financial assistance and see what policies you can buy. Open enrollment runs from October 2013 through March 2014. Some states chose to operate their own Marketplaces. Others left it up to the federal government. There also will be trained “navigators” in your community to help you understand and sign up for insurance.

By Brenda Goodman, MA
Reviewed by Sarah Goodell
WebMD Health News

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Prescription Pain Med Abuse Can Lead to Heroin Use

A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that people aged 12 to 49 who had used prescription pain relievers nonmedically were 19 times more likely to have initiated heroin use recently (within the past 12 months of being interviewed) than others in that age group (0.39 percent  versus 0.02 percent). The report also shows that four out of five recent heroin initiates (79.5 percent) had previously used prescription pain relievers nonmedically.

While the report shows that people using prescription pain relievers nonmedically were at greater risk of later starting heroin, it also shows that the vast majority of people using prescription pain relievers nonmedically did not start using heroin. In fact, only 3.6 percent of the people who initiated the nonmedical use pain relievers went on to use heroin within five years.

“Prescription pain relievers when used properly for their intended purpose can be of enormous benefit to patients, but their nonmedical use can lead to addiction, serious physical harm and even death,” said Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “This report shows that it can also greatly increase an individual’s risk of turning to heroin use – thus adding a new dimension of potential harm.”

The report’s examination of the association between the nonmedical use of prescription pain relievers and the initiation of heroin use is part of SAMHSA’s efforts to identify some of the factors which may explain the rise in the rates of heroin use, dependence and initiation that have occurred in the past few years.

The number of people reporting that they have used heroin in the past 12 months rose from 373,000 people in 2007 to 620,000 people in 2011. Similarly, the number of people dependent on heroin in the past 12 months climbed from 179,000 people in 2007 to 369,000 people in 2011. The number of people starting to use heroin the first time in the past 12 months also increased from 106,000 people to 178,000 people during the same period.

The report also found significant shift between 2008 and 2011 in heroin initiation levels and patterns. For example, although overall heroin initiation rose among all 12 to 49 year olds, these increases were only seen among adults aged 18 to 25 and 26 to 49, with no change in the rate among youths aged 12 to 17.  Heroin initiation among people with annual incomes less than $20,000 or $20,000-$49,999 also increased during this time period.

Past-year heroin initiation rates went up sharply in all regions of the nation during this period except the South where the rate stayed lowest in country. Heroin initiation rates were also lower among Blacks than among other racial and ethnic groups.

–Substance Abuse and Mental Health Services Administration (SAMHSA)

Full Article

Aftermath of the Navy Yard Tragedy: Call for Early Intervention in Serious Emotional Illness

HOUSTON, TX (September 19, 2013) – Schizophrenia and Related Disorders Alliance of America mourns the loss of those killed during the horrendous tragedy on Monday in the Navy Yard.  We extend our deepest sympathy to families, loved ones, friends and all who are affected by this dreadful catastrophe.  Our thoughts, prayers and best wishes are with all those injured for a full recovery.  We are all deeply saddened by this extraordinarily horrific event.

The tragedy is another wakeup call for everyone. Details are emerging that Aaron Alexis clearly had serious psychiatric difficulties for some time. While several media reports suggest that he may have had a major mental disorder, the precise nature of what he might have had is still unclear. As details surrounding the tragedy continue to emerge, there are many potential lessons to be learned from this highly tragic event.

If Aaron had been experiencing a heart attack, he would have received immediate care, even if he denied he was having a heart attack (a common occurrence).  Aaron was experiencing an acute brain crisis.  Although the brain is the most important organ of the body, the individual in psychiatric crisis is not treated equitably as the person in cardiac crisis.  Yet, the outcome can be much more tragic.

It is important to dispel several myths that exist in public perceptions of mental illnesses. Anyone can develop a mental illness. Mental illnesses are extremely common. About half of all Americans will meet the criteria for some type of mental disorder sometime in their lifetime, with first onset usually in childhood or adolescence.  Mental illnesses such as schizophrenia, depression and bipolar disorders are not a sign of weakness, but are real diseases of the brain. Delays in their treatment lead to a snowballing of suffering and decline in function. People cannot just “snap” out of mental illness; symptoms cannot be just wished away or controlled at will. Like in other medical illnesses, effective treatments are now available, both psychological and medical. Treatments can lead to recovery, facilitating productive lives. Timely assessment and adequate services for early symptoms go a long way toward preventing later, more serious problems.

Unfortunately, efforts to get Aaron Alexis help had been made but were not successful; the reasons perhaps will become clearer with time. It is time to take a serious look at the lack of public understanding of serious psychiatric illness in youth, glaring inadequacies in mental health care, as well as delays in care, often for many years. Most people with mental disorders in the United States remain either untreated or poorly treated. The mental health system in the U.S  is dangerously underfinanced and its infrastructure is crumbling  Many students with emotional difficulties on college campuses tend to not seek mental health services because of stigma attached to being diagnosed with a mental illness.

Negative portrayals of mental illness in the media are one major cause of stigma. Seriously mentally ill individuals can often put themselves or others in danger when they are acutely ill, and not in treatment. However, studies in general show that violence is actually no more prevalent overall among individuals with treated mental illness than the general public;  the mentally ill are in fact more likely to be victims of violence.

The emotional toll for the survivors of the massacre and the families of the victims is huge, and the loss is incalculable. The immediate response to provide prompt grief counseling is laudable.  Counseling to deal with the grief is critically needed in order to minimize long term negative consequences of the trauma.

In the aftermath of the Navy Yard tragedy, it is vital we emphasize the need for improving mental health services and early intervention for school and college campuses. There is no better antidote to stigma than education. Our high schools, colleges and universities need to be better educated about the signs of, and early detection for emotional disturbances, which can be nipped in the bud before they escalate into serious disasters. Proactive steps include disseminating mental health information at school orientation as well as training programs for staff, faculty, athletes, resident assistants, counseling services, faith-based organizations, sororities and fraternities and businesses. Mental Health centers need to be better staffed, and networked with state of the art capabilities of psychiatric diagnosis, preventive and therapeutic services. Improved access to treatment and civil commitment are necessary to provide relief of the individual suffering with a brain disorder and to decrease the risk of future tragedies.

 

Matcheri S. Keshavan M.D., Stanley Cobb Professor Psychiatry, Harvard Medical School

 

Linda Stalters, MSN., Executive Director, Schizophrenia and Related Disorders Alliance of America

Contact (240) 423-9432

APA Resources:

Disaster Psychiatry Resources:
1. “What to do Before, During, and After Disaster”
2. Psychological First Aid Field Operations Guide
3. Skills for Psychological Recovery Field Operations Guide
4. “Grief Leadership”
5. “Restoring a Sense of Well-Being in Children After a Traumatic Event”
6. “Restoring a Sense of Safety in the Aftermath of a Mass Shooting”
7. “Fear Management”
8. “Coping with Anxiety During High-Risk Terrorist Alerts”

Other Resources:
Disaster Mental Health Resources from Other Organizations
Links to Disaster Mental Health Organizations, both US and International

Submit Your Story: A Compilation of Uncensored Real Life Experiences with Mental Illness

dark red tulipSubmit your story by 26th of September. (Submissions are welcomed on an ongoing basis, with updates being scheduled for distribution approximately every 3 months.)

 Glimpses – A compilation of uncensored real life experiences with Mental Illness

I compile this manuscript of personal experiences with mental illness for free distribution to Carers, Consumers, Educators and Clinicians, in hope of increasing awareness, understanding and reducing stigma surrounding mental illness and would benefit greatly from your story. Most contributors indicate it was a very therapeutic exercise writing about their experiences with mental illness.

The manuscript is called Glimpses and a free updated version is distributed electronically quarterly (if new stories have been received). Several Universities use this manuscript as a course resource, it is posted on websites nationally and internationally. So only submit your story if you are happy for it to be distributed and forwarded freely.

If you haven’t already done so, I am inviting you to submit your Consumer or Carer story on your personal experiences with: – Anxiety Disorder, Borderline Personality Disorder, Depression, Obsessive Compulsive Disorder, PTSD, Bipolar, Schizophrenia, Anorexia, Post Natal Depression, Hearing Voices, Any other MI I have overlooked.

The average length of stories are 6 to 15 pages. However I do have those that are 4 pages, (minimum accepted, narrow margins, size 12 Arial font, single line spacing)

People have told of the lead up to diagnosis, dealing with MH Services, medication issues, identifying triggers, working towards recovery and coping strategies. What and how much you want to share is up to you. Use your whole name, first name or a pseudonym, the choice is yours; but please know that your story, however you present it, could make a difference in how the world sees us. See below for my contact details.

Glimpses & Minds Unleashed are distributed free of charge and encouraged to be printed, forwarded, added to websites, used as a training resource, as long as excerpts and content of the stories are not changed. If you are not happy for this to happen, I will not be able to include your submission.

I also compile a collection of poetry for distribution in pdf format. So if you have always wanted to share your talent, now is the time to do so.

Minds Unleashed is distributed for free to Carers, Consumers, Educators and Clinicians, in hope of increasing awareness and reducing stigma surrounding mental illness and it would benefit greatly from your poetry.

Several Uni’s/training organisations use this manuscript as a course resource. Minds Unleashed reaches people all over Australia and some other countries. So only submit your poetry if you are happy for it to be distributed and forwarded freely.

Email or post your submission to:-

Nicci Wall

Mental Health Advocate

c/o 43 Browallia Drive

Rose Park Vic 3214

forwalls@xi.com.au        email submissions preferred

Cheers, Nicci Wall

Setting NAMI Priorities: Serious Mental Illnesses? Trauma? Poverty? The “Worried Well?”

Pete Earley’s Response to an email criticizing NAMI:
When I look at NAMI, I see an organization that is doing too many things, and probably duplicating the work of other non-profits.  Just by their website alone, I see articles on bullying, “fighting stigma” through a bike ride (really? is it a magic bike?), veterans with PTSD, and parenting an ADHD child.
 I thought NAMI was there to help the severely mentally ill (SMI), which I define as illnesses such as bipolar disorder and schizophrenia, and their families.  Am I mistaken?  Should I be looking to another organization instead?  Why doesn’t NAMI consider leaving the veterans and children’ issues to the other strong non-profits who are already addressing those important issues?   Then they could focus solely on the needs of the SMI and their families.
by Pete Earley