Thursday, February 3, 2011
Free Depression or Bipolar Disorder Monitoring Program Available to Consumers
Consumers with depression or bipolar disorder, being treated by a primary care physician, may benefit from additional monitoring by a trained pharmacist.
The program is seeking participation by consumers with depression or bipolar disorder. The program is funded by a grant funded by the Montana Department of Health and Human Services and is free to consumers. Patients receive a complete review of all of their medications, education brochures, and monitoring for the effects of their illness. All information collected is sent back to the primary care physician for review and interpretation.
To qualify, consumers must be on four or more medications, which can include over the counter or herbal medicines. Medications are not provided. Trained pharmacists are currently available in Billings, Roundup, Kalispell, and Lewistown or by Skype.
For more information please call Carla Cobb at 406-670-3722 or Dee Holley at 406-896-8805.
Friday, January 28, 2011
Innovative ways to move forward during budget cuts
At least 46 states have now cut budgets that help vulnerable low income people, especially those of us with mental illness. In times of struggle, it’s easy to hunker down and try to keep doing the same things we have always been doing, just with less money. I personally think we need to do more than just stick out our hands out and say, “Please don’t cut us… Please.” However, another way out of our difficulty is to find radically new ways of doing things that cost significantly less money while providing even higher quality results. Here are a couple of key suggestions for how we can keep high quality community health care even during budget cuts.
* Recognize the community mental health centers as sources of innovation and progress. In Kansas and Missouri, the states in which I work, they are the only providers of medicaid billable peer support, assertive community outreach, case management, and employment services. Although many people think that private health care is preferable, in the mental health system it might not be. The public care is the only place possible to get these evidence based treatments that help move people towards recovery. Innovation should be our primary response to economic difficulties, not stagnation.
* Recognize that the alternative to community based care is often hospitalization or jail, at up to 40 times the cost. It would be a significant cost savings to keep people treated in the community rather than re-institutionalizing us.
* For every dollar spent on rehabilitating a disabled person to be able to go back to work, $10 is returned to the economy. U.S. Census Bureau, 1986
* Increasing the amount of peer support would reduce overall mental health costs by increasing people’s recovery, helping people to get more involved in their community, and decreasing reliance on the mental health system. Peer support is an evidence based practice and often peer supporters can work at lower expense than professional with a higher educational requirement.
* Respite care centers cost 1/5 as much as psychiatric hospitalization and shift funding from large institutions to small community based mental health center or local consumer run organizations. Providing people in crisis with peer run centers would save large amounts of public funding. This would also increase people’s ability to stay closer to their local communities and keep their family and native supports involved. Respite care does less to delay peoples’ recovery than does institutionalization. There are quite a few existing models in the U.S.
* Trauma-informed care involves dealing with people’s primary experiences of loss of choice, voice, and control. Increasing the use of trauma informed care in the community mental health centers will greatly decrease costs by helping people to end the revolving cycle of becoming so strongly influenced by emotions brought on by past overwhelming experiences.
* Treat sex offenders in the criminal justice system instead of leaving them indefinitely in more expensive hospital situations that take away beds from people in crisis.
* Consumer run organizations promote well-being and recovery and are very cost-effective. One study found that the more people used these programs, the greater their increase in well-being.
* Some psychiatric medications may be less effective that previously reported and may in fact worsen long term outcomes. Keeping non-medication options like peer support, employment services, and respite care available is crucial to helping people who don’t respond to meds. For depression, this may be the majority of people according to a re-review of the data from the STAR-D trial, the biggest ever government funded clinical trial of antidepressants. This data shows that only 7.7% of participants did not relapse or drop out the end of the one year trial. If we were simply to admit the existence of a large percentage of people that aren’t helped by meds, then we could as a society make other treatments the primary option for up to 40% who have negative medication effects and not the positive benefits. This would drastically reduce medication expenditures and then we wouldn’t have to resort to using preferred drug lists that limit medication choice for the people that ARE being helped by their medications. This would free up vast amounts of funding for more recovery oriented approaches to mental health treatment.
In conclusion, although budgets are very lean in almost every state, now would be the time to radically rethink our approach to funding. We could fund approaches like the ones above that have been consistently shown to be effective while have significant cost savings. Many of in the consumer movement have appreciated the move towards recovery approaches, because we know recovery is possible. We are the evidence. We would love to help bring innovation into our states to help relieve the budget shortfall.
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Thursday, January 20, 2011
Baucus working to reduce Guard, Reserve suicides
Montana's senior U.S. Senator Max Baucus expressed deep concern about military suicides after the Army released new data today showing suicides of Army Reserve and National Guard soldiers increased significantly to 145 in 2010, including two members of the Montana Army National Guard. Baucus is working with the Pentagon to implement the law he passed in 2009 to make sure troops get the care they need and deserve by requiring the military to conduct improved assessments to help identify signs of Post Traumatic Stress Disorder (PTSD) and suicidal tendencies.
“Montana is proud to have more brave men and women volunteering for service than almost any other state in the country – many of them as citizen soldiers in the Guard and Reserves. The news of increased suicides among our citizen soldiers is deeply troubling. This issue hits home in the worst way because we have already lost too many Montana heroes to suicide. We owe it to our troops, their families and their communities to tackle this problem head on,” Baucus said. “I will continue working with military leaders at the Pentagon until I am confident every Guard and Reserve unit across the country has the tools and resources it needs to keep our troops safe while deployed and here at home.”
In 2009, Baucus wrote and passed a law to establish a new assessment program to identify post-traumatic stress disorder, suicidal tendencies, and other behavioral health conditions both before troops deploy and after they come home – including troops serving in the Guard and Reserve. Baucus is working with the Pentagon to confirm that it is in full compliance with the law and identify any additional resources that would help implement it.
Baucus modeled the law after an innovative program used by the Montana National Guard. The law requires the military to provide mental health assessments for every soldier, Marine, airman, and sailor during the 60 day period before a deployment and six, twelve, and twenty-four months after they’ve returned home. The assessments are to be provided in a private, clinical setting by licensed mental-health professionals or troops trained and certified to perform the assessments.
A recent study released in the American Journal of Psychiatry found pre-screening, like that required by Baucus’ law, to be a very effective tool in reducing mental health problems in the military. The report said pre-deployment screening helped decrease the need for clinical care for combat stress, psychiatric and behavioral disorders, and suicidal tendencies.
Baucus also plans to reintroduce his VET Act this Congress to help veterans find good-paying jobs when they come home by making it easier for businesses to get tax credits for hiring troops returning home from service.
Monday, January 17, 2011
Health Care Reform Contains Major Expansion Of Access To Mental Health Services
WASHINGTON -- The health care law that Republicans are targeting for repeal provides significant assistance and options for people with mental illness, an issue that has received increased attention as details emerge about the alleged shooter in Arizona on Saturday.
"The shooter was a very disturbed individual and it appears there were so many warning signs that he was going to do something horrible," Rep. Allen West (R-Fla.) wrote on his Facebook page. "We should be focusing on the mental health crisis in our country, not politics."
As Igor Volsky of ThinkProgress points out, Rep. Mike Rogers (R-Mich.) similarly told MSNBC Tuesday, "A bad guy is going to get a gun. What we have to do is "intervene earlier in that cycle of violence when they have this kind of mental disability."
Lawmakers looking for a way to boost mental health services might want to start by checking out last year's Patient Protection and Affordable Care Act, which both West and Rogers support repealing. Mental health advocates have hailed the law for its expansion of access.
In 2008, President George W. Bush signed landmark "parity" legislation requiring employers to provide mental health insurance benefits comparable to traditional medical coverage. It also barred insurance companies from setting higher co-pays or deductibles for mental health services.
That law, however, applied only to people who already have insurance. Chris Koyanagi, policy director at the Judge David L. Bazelon Center for Mental Health Law, told The Huffington Post that the Obama administration's signature health care law is at least as key.
"While the 2008 law was very important in terms of people who have insurance through their employer, the great thing about the Affordable Care is that it's everybody," said Koyanagi, whose organization has produced a report on the 2010 law's impact. "If you have a serious mental illness, you have trouble staying employed. There's a whole group of people for whom parity would never have applied without this statute. We've had a lot of people just falling right through the cracks because they don't come with any way to pay, and they're the folks with the most serious problems."
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Koyanagi highlighted two major elements of reform: More Americans are projected to be enrolled in private insurance under the 2010 law, which is required to provide coverage for mental health and substance abuse services, and it is also expected to significantly increase Medicaid availability.
"The expansion of Medicaid to people with incomes under 133 percent of poverty who would not otherwise have been able to get on the Medicaid program is going to include a lot of people with mental health needs," she said.
Before the Affordable Care Act, low-income childless adults with severe mental illnesses were not able to get Medicaid assistance, and therefore had no way to pay for mental health services. "Certainly the repeal of ACA would drastically hurt a lot of childless adults with serious mental illness who need treatment," Koyanagi said.
Acquaintances of Jared Lee Loughner, the man charged in Saturday's Arizona shootings, have described him as a troubled individual with worrisome behavior. One of his community college classmates wrote in an email about Loughner, "We have a mentally unstable person in the class that scares the living crap out of me. He is one of those whose picture you see on the news after he has come in to class with an automatic weapon."
Dr. Anthony Lehman, a professor at the University of Maryland School of Medicine, said that early reports on Loughner seem to follow a familiar pattern (with an atypical outcome) of the "failures of mental health systems to respond to young people with serious mental illness."
"As I understand, he began having problems as early as high school, dropped out of high school and was identified as someone who was having problems, and then proceeded in some of the history that we just heard about with involvement with the police and problems in college, but never received, I guess as best we know, any mental health treatment," Lehman said on PBS's "Newshour."
Despite the recent attempts to expand access and services, mental health is still woefully undertreated. In the past year, Arizona's Pima County, where Rep. Gabrielle Giffords (R-Ariz.) and 19 others were shot Saturday, has seen more than 45 percent of its mental health services recipients forced off the public rolls.
In response to the shooting, House Republican leadership postponed its vote on the Repealing the Job-Killing Health Care Law Act, which was supposed to take place Wednesday. The House is expected to pick it back up next week.
Neither West nor Rogers returned calls seeking comment.
Monday, January 10, 2011
Statement of Mental Health America on theTragedy in Arizona
It will likely take many days to understand the reasons and motivations behind this national tragedy. Many have pointed to mental health as an issue.
It must first be emphasized that people with mental health conditions are no more likely to be violent than the rest of the population. And we have science-based methods to successfully treat persons with even the most severe mental illnesses. A very small group of individuals with a specific type of mental health symptoms are at greater risk for violence if their symptoms are untreated.
At the same time, we must recognize that the nation’s mental health system is drastically under-funded and fails to provide Americans living with mental health conditions with the effective community-based mental health services they need. Sadly, in the current environment of strained state budgets, mental health services have been cut drastically just as demand for these critical services has risen dramatically.
It is also important that, as a community, we assist persons with signs and symptoms of mental illnesses to seek treatment. Although rare, when a person becomes so ill that he/she is a danger to themselves or others state laws provide a way to get them help even if they don’t believe that they need it. The best strategy, however, is to have an accessible system of care that is easy to use.
Science has not developed tools to predict reliably individuals at risk for violence. But we can reduce the small risk of violence in those with certain mental health conditions by investing in proven intensive, coordinated community-based mental health services and making certain that they can access these services.
We do not know if the mental health system failed in this situation or if there were missed opportunities or if effective treatment might have averted this tragedy.
We do hope that we can find answers and create solutions that prevent this from ever happening again.
Mental Health America (www.mentalhealthamerica.net) is the country's leading nonprofit dedicated to helping all people live mentally healthier lives. With our century of service to America and our more than 300 affiliates nationwide, we represent a national movement that promotes mental wellness for the health and well-being of the nation— everyday and in times of crisis.
Tuesday, December 28, 2010
Families worry mental health cuts will send kids spiraling
A week before Christmas, Judy Powelson was awaiting her son's first visit home in nine months with a mix of excitement and trepidation.
Earlier in the year, the 17-year-old's mental illness had spiraled out of control to the point that he attacked her, kicked a teacher in the groin and was hospitalized for psychiatric treatment. But since he entered residential treatment funded in part by the state, she'd seen him go through marked improvements — getting a 3.11 GPA and being voted MVP in soccer.
Now Powelson's son, identified in court papers as T.G., is one of 20,000 students across California whose mental health services may be in jeopardy in the new year because of a line-item veto by the governor. In October, Gov. Arnold Schwarzenegger slashed $133 million in funding for what are known as AB 3632 services, a 25-year-old program that requires state and local education and mental health agencies to jointly provide education-related mental health services.
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Families with children who suffer from mental illnesses ranging from depression to schizophrenia and who depend on these services have been thrown into chaos, parents and advocates say. Several counties, including Orange and Alameda, have sent out notices indicating that the services will be discontinued in January, attorneys representing the parents said.
"If my son loses this treatment, I will lose my son," Powelson said, her voice quivering. "I will lose him to mental illness, I will lose him to the criminal justice system, to drug abuse, to suicide."
She has filed a declaration about her son's situation as part of a federal class-action lawsuit seeking to block cutbacks to or discontinuation of the services. This month, a federal judge in Los Angeles heard arguments from attorneys representing the families and various state and local agencies but said he would wait until the new year before considering whether to issue an injunction.
U.S. District Judge George Wu said it wasn't immediately clear what would happen come Jan. 14, when a temporary order restoring the funding for the services is due to expire. He said he also wanted to wait for the outcome of a separate state court case in Sacramento challenging the governor's veto, which is scheduled to be heard in early January.
"I understand that the state agencies are pointing the finger and saying, 'It's your problem, it's your problem, it's your problem,' " Wu said at the hearing, adding that each agency was "waiting for somebody to blink." But he said it wasn't the right time for him to issue an order because "it's a complicated situation.... Bad things have not happened, but may happen in the future based on how these agencies act."
Attorneys representing various state and county agencies said they were trying to determine where the funds would come from, not dodging their responsibilities. They also said the four named plaintiffs in the case were currently receiving the necessary treatment and had not been notified that it would be taken away.
"They're here prematurely," said Supervising Deputy Atty. Gen. Jennifer M. Kim, representing the governor's office and the California Department of Mental Health.
Attorneys for the plaintiffs contended that a statewide court order was immediately necessary because vulnerable children were at risk of being harmed while the case was being litigated.
"Every day, a new county is saying they can't provide the services," said Laura Faer, an attorney for Public Counsel, which filed the class-action lawsuit along with Disability Rights California and the law firm Gibson Dunn & Crutcher.
David Campos, whose son is the lead plaintiff, said he felt his child was being left behind while government agencies passed the blame.
"Everybody's waiting for somebody else to take the first step," said Campos, whose son, identified as A.C. in court papers, has been receiving counseling since kindergarten. Campos and his wife, Gail, have been trying to get help for their son ever since they adopted him at age 4 knowing he suffered the effects of fetal alcohol syndrome and had been neglected and abused.
This summer, their son twice attempted suicide — swallowing half a bottle of Tylenol and trying to hang himself — and landed in juvenile hall. Through AB 3632 funding, he is receiving residential treatment for oppositional defiant disorder and attention deficit hyperactive disorder in Texas.
"When I heard the news [of the cut], I felt like I had been punched in the stomach," Gail Campos wrote in a declaration submitted with the court. "My son so desperately needs these services to get better, and I don't want him to end up in the criminal system or homeless."
Powelson said the treatment for her son, who has been diagnosed with oppositional defiant disorder and intermittent explosive disorder, had been like the "light at the end of the tunnel" for her family.
"The bad days before turned into bad weeks and bad months. My husband used to say it was like a piano falling from a tall building," she said. "Now, in treatment, he has a safe place to fall."
Friday, December 17, 2010
Troop Discharges High for 'Pre-Existing' Psychiatric Disorders
The numbers suggest the military, under pressure to find recruits for two wars over the better part of the last decade, may not be catching the signs of mental illness during the enlistment process. While ailments ranging from asthma to hearing problems to orthopedic conditions accounted for a large percentage of discharges, mental health issues were the most common cause.
The military's Medical Surveillance Monthly Report and its Accession Medical Standards Analysis & Research Activity Report both confirmed this trend -- the statistics varied drastically depending on the branch.
Among Marines, 44 percent of discharges between 2004 and 2009 for pre-existing conditions were for psychiatric complications. That percentage was 24 in the Army and 18 in the Navy. It was less than 1 percent in the Air Force. The disorders ranged from depression to ADD to bipolar disorder.
The studies tracked recruits who were discharged for conditions that surfaced within six months of joining the military -- meaning many were probably discharged during training and did not see combat.
Paul Sullivan, director of veterans advocacy group Veterans for Common Sense, said the numbers reflect the "recruiting shortfall" the military has had to deal with. He said sloppier vetting opens the door for problems to surface after new member are enlisted.
In total, 3,636 Marines were discharged for psychiatric reasons between 2004 and 2009. In the Army, 4,359 were discharged. The Pentagon did not respond to a request for comment.
However, the startlingly high number of psychiatric-based discharges for recruits comes as the Pentagon faces complaints that it may be discharging combat troops on spurious mental-health grounds. Though the military has moved to recognize more cases of post-traumatic stress disorder -- as opposed to classifying them simply as "personality disorders" -- lawmakers have complained that the military is finding other psychiatric reasons to discharge troops.
The distinction is critical in determining what kind of benefits packages the discharged service member receives -- PTSD discharges get a 50 percent disability payment and health care benefits, while others do not receive that level of help after leaving the military.
Four lawmakers wrote to Defense Secretary Robert Gates in October complaining that the military was discharging members for "other physical or mental conditions not amounting to disability."
"While it is a good thing that the Pentagon has moved away from unfairly discharging combat troops by erroneously claiming a service member had a (personality disorder) rather than addressing the harmful effects of combat stress, we need to ensure a new method is not being used to deny combat veterans the care and benefits they deserve," they wrote. The letter was signed by Sens. Kit Bond, R-Mo.; Chuck Grassley, R-Iowa; Sam Brownback, R-Kansas, and Patrick Leahy, D-Vt.
They cited Pentagon data showing that while personal disorder discharges were down dramatically over the past few years, discharges for other "physical or mental" conditions rose from 1,453 to 3,844 between fiscal 2006 and 2009. Many of those conditions were labeled as "adjustment disorder," they wrote.
"We are particularly concerned that troops who display symptoms of combat stress are being expeditiously chaptered out of the military by the medical bureaucracy prior to their condition meeting formal diagnostic criteria for PTSD or other conditions that would constitute disability," the senators wrote.
Sullivan described this "patient dumping" as a serious problem in the military.
"The military finds it more expedient ... to improperly kick out tens of thousands of troops," he said.
In a response to the senators' letter, the Army assured them that it would continue to review the circumstances for such discharges.
Thomas Lamont, assistant secretary of the Army, wrote in a memo that the Army made sure soldiers discharged due to various disorders were "appropriately screened" for PTSD and traumatic brain injury.
"The Army is dedicated to ensuring that all soldiers with physical and mental conditions caused by wartime service receive the care they deserve," he wrote.
Source: Fox News