Notes from meeting on 8/26/14 How can we both reduce the stigma and address
the unmet mental health needs of so many among us?
 |
| http://metro.co.uk/2014/02/06/time-to-talk-day-shaking-off-the-stigma-of-mental-health-4265834/ |
First, some statistics:
One in five children birth to 18 has a diagnosable mental disorder.
One in 10 youth has serious mental health problems that are severe
enough to impair how they function at home, in school, or in the community.
About 18 percent of children and adults — more than 1 million people in Massachusetts — suffer from
behavior problems, depression, bipolar disorder, schizophrenia, or other
psychiatric illnesses, and about 9 percent have substance abuse disorders,
according to a report last month from the state Department of Public Health.
Untreated
population with schizophrenia: 37,284
Untreated population with severe bipolar disorder: 58,486
Estimated number of homeless
with with severe mental illness: 4,999 (30% of 16,664 )
Prisons:
7.26% of the male inmate
population identified as having serious mental illness
24% of men in prison have open
mental health cases; 18% on psychotropic medication
24.9% of the female inmate
population identified as having serious mental
59% of women in prison have open
mental health cases; 49% on psychotropic predication
http://www.bostonglobe.com/lifestyle/health-wellness/2014/06/26/change-proposed-inmates-health-coverage/xfY7PeWbX1U0gzCtMwUlBN/story.html
Forty
percent of inmates in [Middlesex County Sherriff] Koutoujian’s charge suffer
from a mental illness, and 80 to 90 percent report drug or alcohol addiction,
he said, making it urgent for them to connect with caregivers shortly after
release.
We had 7 people show up at the Waltham Public Library for
this discussion. These are my somewhat
cryptic notes, in order of how they came up in the discussions and to the best
of my recollection.
·
Waverly Place in Belmont is a day program that
helps adults work on their goals.
It is run by McLean Hospital and
grant funded.
·
Mental health issues and substance use is common
and can have undesirable consequences.
As hard as it is for most to avoid using substances, it is even more difficult for kids
with MH needs.
·
It is sometimes difficult to differentiate
between MH issues and issues related to substance use, and sometimes they are
so intertwined there is no difference
·
Stigma gets in the way of admitting there is an issue
or a need
·
Not necessarily the same level of stigma
associated with MH issues in other countries as there is here in the US. All cultures are diffrent, here in the US we
tend to hide our family members with MH issues.
Parents often feel as though their children are shunned and sometimes
the family is shunned by the community
·
MH issues need to be identified early on in
families, noticing and dealing with issues, differentiating between typical
behavior and non-typical. Hard to know
what to look for and then know what to do.
Parents are not trained MH experts
·
‘Back in the day’, people lived with their
extended families and there was a place for an uncle with MH issues or an aunt
that could not go out on her own. They
were accepted as part of the family.
·
Two different people heard someone with MH
issues speak at their places of worship.
Very brave act and helpful for the community to understand that this is
just one facet of the person and to understand how it impacts the person’s life
and that they can still be productive contributing citizens
·
We in the US are getting a little better but we
do not know how to talk about MH, about race, about oppression
·
We do have the freedom in the US to explore new
ideas and try to implement them
·
Education system needs attention
o
Need to put more effort into helping our
educators identify, understand and help our children
o
Need more alternative educational options to
help our children be succcssful
o
Massachusetts implementation of No Child Left
Behind by the requirement to pass MCAS is in fact leaving many children behind.
o
Students that need MH services often do well
academically so they are not identified as children in need. The law requires that they make adequate
progress not just academically but also socially and emotionally. Educators and parents are often not aware of
this requirement and the only recourse for families is to hire a Special
Education lawyer of an educational advocate.
Costs lots of money to get the students their legal right
o
It can be difficult to measure social emotional
growth but there are tests just for this
o
There is much more awareness now and some of the
stigma is going away in the schools. One
person said his daughter is not at all afraid to say she is going to the
Disability Office at her college
·
Mental Health Parity -
http://www.healthlawadvocates.org/priority-areas?id=0016 Adults
and children who need mental health treatment or substance abuse treatment
should have access to the care they need. Both Massachusetts law and
federal law require health plans to cover diagnosis and treatment of these
conditions at equal levels to coverage for medical and surgical services.
The federal Paul Wellstone and Pete
Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) prevents health plans from placing
higher costs or stricter treatment limitations on consumers who need mental health
and substance abuse services. Under the Massachusetts Mental Health
Parity Law, insurers may not establish dollar or service amount limits that are
more restrictive for biologically-based mental health conditions than for other
types of medical conditions and requires a minimum level of coverage for
non-biologically based conditions.
o
Yet we continue to have to re-qualify for
services
o
Very difficult to find quality providers and
then to find quality providers that will take your insurance is another battle
·
What are we doing as a community?
o
Roz Rubin, Director of GWarc in Waltham is an
advocate for change at the legislative level – would be a good contact
o
Need a community center or some place for people
to connect, find support and resources
o
Need educational advocacy
o
Need housing.
There is some limited housing through the Department of Mental Health
but there is not nearly enough housing and many people fall through the cracks
o
People with MH issues are not always their own
best advocates
o
After a person turns 18 parents often cannot
gain access to information because their child is now considered an adult
We all have responsibility for MH
·
De-institutionalization
http://en.wikipedia.org/wiki/Deinstitutionalisation According to psychiatrist
and author Thomas Szasz, deinstitutionalisation is the policy and practice of
transferring homeless, involuntarily hospitalised mental patients from state
mental hospitals into many different kinds of de facto psychiatric
institutions funded largely by the federal government. These federally
subsidised institutions began in the United States and were quickly adopted by
most Western governments. The plan was set in motion by the Community Mental Health Act as a part of John F.
Kennedy's legislation [clarification needed] and passed by the U.S.
Congress in 1963, mandating the appointment of a commission to make
recommendations for "combating mental illness in the United States".[4]
Although deinstitutionalisation has been positive for the
majority of patients, it also has severe shortcomings.[22] Expectations that
community care would lead to fuller social integration have not been achieved;
many remain without work, have limited social contacts, and often live in
sheltered environments.[23]
o
‘We’ have a moral obligation, and some might argue a legal
obligation to take care of these citizens.
o
There is little lobbying done on behalf of people with MH
issues. NAMI (http://www.namimass.org) does good work but not
nearly enough
o
Police are often the first line of defense in communities and
they are not trained mental health providers
o
We need to find a way to stimulate the community to take an
interest in this important topic
§
Maybe something like the ‘ice bucket challenge’, or the Pink for
Breast Cancer awareness, we need to find our own ‘thing’
§
NAMI has a mental heath walk and the OCD community has a fund
raiser walk - we need more than these to raise awareness
·
What can
we do?
o
Look
at other countries for models of MH care
o
Consider
implementing a local community mental health center modeled on the Council on
Aging
o
Advocate
for more and better community based services
o
More
advocacy
·
Why
should me/we/you care?
o
Health
care industry is a big job generator
o
Massachusetts
could and should be the mental health care innovation center
o
Look
at all the mass shootings and suicides.
Many could be prevented with better health care services
o
Impact
on community of under-educating or under-serving our children has financial
repercussions for all of us
Next up, the Story of Oscar.
We have a smoke extinguisher in our house and I have never given it a thought. It sits in the corner of the kitchen, I pass it several times a day and I barely know it is there. It came with the house two years ago.
