Monthly Archives: June 2014

NAMI Affiliates Play A Key Role in the Success of CIT

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By Laura Usher

In 1988, two advocates from NAMI Memphis were the driving force behind the first crisis intervention team (CIT) program. Ann Dino and Helen Adamo were driven by outrage at the way their families were treated by police. But their advocacy was persistent and thoughtful; ultimately, the city of Memphis and the police chief worked with them because they presented a solution that would help both individuals and families affected by mental illness and police.

As NAMI members have followed in the footsteps of NAMI Memphis to help start hundreds of CIT programs in communities nationwide, they have learned a lot about what makes a successful CIT program, and the role NAMI Affiliates can play.

Building the Partnership

CIT programs are only successful in the long term if they are built on strong partnerships between mental health advocates, mental health providers and police. A training-only approach to CIT will be only somewhat effective, and only in the short-term. The goal of CIT is to change hearts and transform the community, and that can only be accomplished with genuine relationships. NAMI Affiliates can contribute to this challenging process by:

  • Bringing the potential partners to the same table. By identifying shared challenges, and asking representatives from law enforcement and mental health provider agencies to work together, NAMI Affiliates can help build the foundation for a strong partnership.
  • Serving a resource to law enforcement agencies.  Often the way to convince a potential partner to work with you is to offer them help with a problem. Before demanding that police department adopt CIT, NAMI Affiliates can offer to help law enforcement with basic mental health information and training. Often a one hour NAMI In Our Own Voice presentation can open the door for future partnership and training. NAMI Affiliates can educate law enforcement agencies about NAMI education and support programs, and suggest that NAMI programs could be resource to the families that officers encounter in a crisis.
  • Responding to tragedy with an offer of a solution that could help prevent future tragedies.   It’s natural to be outraged when a person with mental illness is injured or killed when interacting with police. The best way to make something positive out of a tragedy is to offer a solution, like CIT, that could help prevent future tragedies and offer to help with implementing the solution.
  • Identifying champions. Sometimes selling CIT is easier if the message comes from a trusted leader or high-profile individual. NAMI Affiliates can identify a community leader such as a law enforcement leader, government official, judge, business leader or a member of the media with a personal connection to mental illness and interest in championing CIT.

Represent the Needs of Individuals and Families

CIT programs should be guided by a steering committee of all the agencies involved, including the NAMI Affiliate, mental health provider agency and law enforcement agency.   As part of this committee, NAMI Affiliates have a unique role: to make sure that the needs of individuals and families affected by mental illness are heard at every step. These committees help to identify resources and challenges in the community, plan how to coordinate services, organize CIT training, problem-solve and sustain the program over the long-term. At every step, the need of individuals and families should be included and a representative from your NAMI Affiliate should be a permanent member of this committee.

Support Training

CIT training takes a lot of planning. Any one of the partner agencies may designate a CIT coordinator whose responsibility is to coordinate training and promotes smooth communication between the partners. Sometimes the NAMI Affiliate plays this role, but not always.  NAMI members can pitch in, with other partners, to make sure training manuals are copied, chairs are set up, lunch is served and the week goes smoothly.

NAMI Affiliate leaders should carefully select presenters to participate in the CIT training who can be honest, positive and constructive. Sometimes NAMI members feel anger and frustration with past behavior by police.  If possible, it’s best to resolve this privately with the sheriff or chief. It’s never appropriate to use the CIT training to air grievances or accuse officers of wrongdoing.

NAMI members present during the training on the following topics:

  • NAMI’s mission and programs. CIT officers need to know what NAMI is, who we represent and how we can help them. It’s helpful to describe NAMI’s education and support programs, and provide a card or brochure that officers can give to families in crisis to help them easily connect with NAMI. Officers also appreciate hearing how important CIT is to NAMI members and that the community is grateful that they volunteered for CIT training.
  • The individual experience of mental illness. An individual with lived experience should tell their story and give officers a chance to ask questions. Police officers respond to mental health crisis situations all the time; this presentation may be the first time they talk with a person in recovery. It’s important for officers to get a perspective that recovery is possible and that their help could make a difference for an individual in crisis. This presentation can be a NAMI In Our Own Voice presentation.
  • The family perspective of a mental health crisis. A NAMI presenter should explain why families call police to help their loved ones, what they are hoping for and how officers can help them in a crisis.
  • Group meetings with individuals living with mental illness. Many CIT programs schedule informal face-to-face meetings between a group of officers and a group of individuals living with mental illness. This gives officers another opportunity to really develop empathy and relationships with individuals. These conversations don’t necessarily center on mental illness; rather, the group can talk about relationships, hobbies, sports, jobs, kids or other common interests.

Support and Honor CIT Officers

Officers usually volunteer for CIT training because of a personal connection with mental illness or a desire to help others in their community. Responding to crisis calls is challenging, and most CIT officers get no extra pay or perks. NAMI Affiliate can help keep CIT officers motivated and dedicated to their jobs by spreading the word about CIT and thanking officers for good service. Here are some ways to do that:

  • A NAMI leader can present at the CIT graduation and express NAMI’s appreciation.
  • NAMI Affiliates should take the lead on planning an annual awards ceremony to honor outstanding CIT officers.
  • When an individual or family receives excellent service from a CIT officer, they can write a letter of thanks to the officer and his or her supervisor. This shows the chief or sheriff that the program is important to the community, and provides the officer a morale boost.
  • NAMI Affiliates can work with local media to publicize CIT trainings and CIT success stories.
  • CIT officers should be invited to attend NAMI meetings, NAMI Walks and other events.
  • Finally, NAMI Affiliates can spread the word about CIT among NAMI members and the broader community, so that people know to ask for a CIT officer in a crisis.

For more ideas on how to keep your CIT program strong in the long-term, read chapter five of NAMI’s CIT for Youth implementation manual.

Advocating for a CIT program in your community takes patience and a real willingness to work in partnership with the police.  NAMI members have always been willing to work hard for worthwhile change.   If you need help or advice along the way, ask your fellow NAMI Affiliate leaders or contact NAMI’s CIT Center.

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Reaching Out to Those with Mental Illness

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By Karen Ranus

When I am giving community presentations, I often invite people to close their eyes and imagine the “face” of mental illness. “What does that face look like?” I ask. More often than not, the images people share are the faces of people who are confused, disheveled, unclean and sometimes frightening. Like the misshapen faces of lepers from Biblical times, the faces of mental illness scare us, repulse us and shame us.

Rarely has someone raised a hand and said, “The face I imagine looks just like my son (or daughter, husband, mother, brother, neighbor, co-worker or friend).” And, yet, the National Institute of Mental Health (NIMH) estimates that one in four Americans have a mental illness.

If the numbers are one in four, the reality is this: the face of mental illness looks a lot like each of us. We don’t always recognize the face because many who struggle with mental illness (and the families who love and care for them) do so in isolation. They wear masks, unwilling to reveal the pain and anguish, fearful of the rejection and embarrassment. Families and individuals living with mental illness feel like outcast lepers and our communities of faith often fail to reach out to them, fearful of what they don’t know and understand.

Three years ago, I looked into the beautiful brown eyes of my precious 18-year old daughter and came face-to-face with mental illness. You can imagine my shock and disbelief as we sat in a mental health hospital waiting for my daughter to be admitted. Just shy of 19, she was a 4.0 student on an academic scholarship and had been accepted into an elite leadership program on campus. On the surface, she looked like she had it all together, but she had been struggling since high school. We’d noticed the changes in her senior year and sought help for her. Therapy seemed to help and the summer before college, she seemed healthier and excited for the future.

But, it was only a mask. She didn’t want anyone to see the depth of her depression nor the tight grip of the eating disorder. She was much too ashamed of the darkness that enveloped her and the fear of disappointing her family and friends was overwhelming. She pushed forward determined to stay busy and keep the depression at bay, but it only tightened its grip until she broke.

Mental Health Awareness Ribbon

Mental Health Awareness Ribbon (Photo credit: Wikipedia)

The day of her admission to the hospital, the day I came so close to losing her, I called the associate pastor at our parish. He quickly came and visited her, anointed her and offered words of hope and comfort. He knew little about the resources available, and in retrospect, I wish he had encouraged us to be more open with our parish community. I didn’t ask for her name to be put on the prayer list. I didn’t order her a prayer blanket. I did what so many family members do in similar situations, I simply retreated in shame. I’d fallen prey to the same misconception about mental illness that so many of us do—that somehow we are to blame when mental illness strikes because it is a flaw in character and a reflection of bad parenting or upbringing.

Six months later, I discovered the National Alliance on Mental Illness (NAMI). The local NAMI Affiliate offers a free 12-week class called NAMI Family-to-Family for family members who have a loved one with a mental illness. During those 12 weeks I learned about the full spectrum of mental illnesses, their signs and symptoms and the various treatment options. I learned how best to communicate with my daughter and advocate for her.

But, the most important thing I learned is that no one is to blame. Mental illnesses are like physical illnesses. Just like diabetes is a disease of the pancreas, mental illnesses affect the mind and change the way people think, act and behave. Like physical illnesses, they require ongoing treatment which may include medication and therapy, exercise, healthy eating and a support system. Severe and persistent mental illnesses require the same level of attention and care as any serious physical illness, and like all illnesses it can be exhausting for the families caring for them.

With numbers like one in four, we know our pews are brimming with people suffering in isolation, shamed by illnesses for which they are not to blame. May is Mental Health Awareness Month and it is an opportune time for church communities to begin having conversations about mental health. Our parish staff and clergy need to be armed with information and resources so they can better serve those who have become like lepers in our midst. We need to talk openly and positively about mental health, pray for those suffering from mental illness in our prayers of the faithful and create environments where people feel comfortable sharing their struggles with mental illness.

Karen Ranus is a parishioner of St. Austin Catholic Parish and the Executive Director of NAMI Austin. For more information about NAMI classes and support groups, visit the website at http://www.namiaustin.org. Her daughter, Sara, is in remission from her depression and eating disorder, has returned to school and is now trained to provide mental health presentations to high school teens.

Short Stay Behind Bars Before Diversion Does Not Affect Mental Health Outcomes, Study Finds

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Criminal offenders who went to jail before being diverted into mental health treatment fared no better in the long run than those who go straight into diversion programs, according to a study of Connecticut defendants.

“Short stays in jail before diversion did not appear to be associated with improved mental health and reoffending outcomes, even though they appeared to improve receipt of psychotropic medication,” said Allison Robertson, Ph.D., M.P.H., an assistant professor of psychiatry and behavioral sciences at Duke University, and colleagues online this week in Psychiatric Services in Advance. The researchers compared 102 diversion participants who first went to jail with 102 who went directly into diversion.

The “jail first” strategy did lead to a greater chance that the prisoner would receive psychotropic medications, but all other indicators—use of outpatient services, psychiatric hospitalizations, jail days, emergency visits, or rearrest—demonstrated similar outcomes whether the person was sent to jail or diversion first.

These findings may indicate that the participant’s risk may be influenced not only by mental health treatment but also by criminogenic factors like unstable housing, unemployment, or lack of social services, said Robertson. “These analyses offer an early but important indication that a brief incarceration before diversion to the community does not ultimately achieve the goals of the courts—reduced recidivism and improved public safety,” the researchers said.

To read more about diversion programs for offenders with mental illness, see the Psychiatric News articles, “Program Prepares Defendants for Return to the Community” and “Combined Effort Needed to Prevent Incarceration of Mentally Ill People.”

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ACTION ALERT For “Keeping All Students Safe National Call-In Day”!

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Thursday, June 12, 2014, is our national call-in day so advocates all over the country can call their Senators and Representatives and ask them to co-sponsor the Keeping All Students Safe Act (S. 2036 and H.R. 1893).

These bills greatly restrict the use of restraint and seclusion in our nation’s schools to protect children from harm. There are currently no federal laws regulating the use of restraint and seclusion in schools.

Numerous media stories and various reports have documented the harm, trauma and even death that have occurred from the use of restraint and seclusion in schools. Restraint is being used in alarmingly high numbers on students with disabilities, including those living with mental illness.

Effective alternatives exist to reduce and eliminate the unnecessary use of restraints and seclusions and protect students and staff. These bills support alternatives that provide students with a safe and positive learning environment.

 For more information from NAMI National, click Call Today!
 
Please call your Congressional members and urge them to co-sponsor the Keeping All Students Safe Act. 

Thank you for your dedication to mental health advocacy!

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Article by Jim Beall – (D) Each Mind Matters in a Healthy Economy

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The need for mental health treatment in California should be an overriding concern for all of us. About 1 in 5 adults in California need mental health support.

A national effort now underway draws attention to the role mental health plays in our overall wellness as individuals and communities. In California, a growing community is working hard to end the stigma surrounding mental health and to increase access to treatment and services.

Delivering treatment hinges on enforcing mental health parity laws that require health insurers to provide services for mental illnesses and addictions that are equivalent to coverage for physical medical care.

In other words, equal co-pays, equal deductibles, no caps on visits and no limits on treatment benefits.

Parity laws, however, are only as effective as the compliance of health insurers. Last year, the state Department of Managed Health Care levied a $4 million fine against Kaiser, accusing the health care provider of limiting access to mental health care. Kaiser is appealing the fine.

In the meantime, I am pushing budget legislation at the state Capitol to reform parity enforcement in California. The existing enforcement system is based on patient-initiated complaints filed with health insurers. I am calling for health insurers instead to reach out and conduct surveys with consumers and providers to measure their compliance.

The state would collect the information and post it on the Internet to help consumers shopping for a new insurance carrier.

By affirming mental health and physical health are equal in importance and response to treatment, we commit a powerful act with a broad benefit to our state.

Just consider the workplace, California’s role in the global economy and how mental wellness affects innovation.

Left misunderstood and untreated, the overall impact of mental or emotional health problems drains our economy and hurts businesses. Untreated mental health challenges cost America at least $105 billion annually in lost productivity.

But we can cut that cost by ensuring a workplace that supports wellness and eliminating prejudice toward people with mental health conditions.

When employees have access to effective mental health treatment, employers see higher productivity, fewer unexcused absences, and both lower turnover and health care costs, according to Wellness Works, an organization that promotes mental health awareness in the workplace.

In the public realm, we can channel our precious police and fire resources for public safety emergencies instead of responding to people in crises caused by untreated mental health problems.

Moreover, Californians have voiced their support for mental health treatment at the ballot box. In 2004, voters passed Proposition 63 to create a fair funding mechanism — independent of the state’s general fund — to expand resources for people with serious mental health needs.

However, much work remains. To build momentum, Mental Health Matters Day — part of May as Mental Health Month — will be observed by hundreds today (May 13th)  in Sacramento.  The event is sponsored by the California Mental Health Services Authority, which implements prevention and early intervention initiatives to expand resources for mental health, and reduce stigma and discrimination related to mental illness.

Partnering with the authority is Each Mind Matters, an organization bringing Californians together to increase mental health wellness through dialogue and early intervention.

Mental health awareness is a 365-day proposition that requires all of us to act and to recognize when ourselves or others need help.

Let us unite today and renew our efforts to overcome mental illness with understanding, compassion and accessible treatment.

Originally printed in the Sacramento Bee.

NAMI California’s Statement about The Santa Barbara Tragedy: What Communities and Families Can Do

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Sacramento, CA, May 28, 2014 / Jessica Cruz, Executive Director of the National Alliance on Mental Illness, California (NAMI CA) has issued the following statement:

NAMI California shares in the sadness over Friday’s tragedy in Isla Vista, California. NAMI California is an organization of individuals and families, whose lives are deeply affected by mental illness. We extend our sympathies to the families of those who lost their lives or were wounded. We are also sorry for the pain experienced by the family of the person responsible.

When tragedies occur, clear facts emerge slowly.  However, the immediate focus on mental illness often adds to the stigma that surrounds them. NAMI California has repeatedly called for action to erase the stigma of seeking help for mental illness.

Acts of violence are exceptional.  The likelihood of violence by people with mental illness is low.  In fact, the U.S. Surgeon General has reported that “the overall contribution of mental disorders to the total level of violence in society is exceptionally small.”

Families and communities must work together to ensure adequate and culturally competent services are available to everyone, free of stigma and discrimination. NAMI California praises Senate President pro Tem Darrel Steinberg for addressing key issues today in his press conference. His suggestions to improve the mental health system by reforming sentencing, providing meaningful mental health treatment through the training of prison personnel and law enforcement; and promoting humane releases through Parole Out-Patient Clinics are taking the important next steps in ensuring an adequate response to the mental health crisis in our state.

NAMI California is also taking steps to combat these challenges, our innovative programs such as Provider Education work to reduce stigma and discrimination and better train frontline responders by helping them understand the perspectives of families and individuals living with a mental illness.

NAMI California, its 67 local affiliates and over 19,000 members look forward to being an active part of these solutions. In nearly every community in our state, NAMI members work every day to ensure Californians have access to mental health services and support. We will not rest until that work is complete.

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Sonoma County MST & NAMI!

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By Lauren Peterson, NAMI Sonoma County

I am Lauren Petersen from NAMI Sonoma County. In our coun ty, NAMI is fortunate to partner with a group of dedicated professionals to deliver a very remarkable crisis resource that works.  It is called our Mobile Support Team, or MST.

After many requests and strong public support, the County of Sonoma’s Behavioral Health Division partnered with police departments and sheriff’s organization to form the Mobile Support Team. And NAMI is part of it! This team, made up of licensed mental health clinicians and certified substance abuse specialists, provides field-based support to law enforcement. This means that when law enforcement encounters a mental health crisis, or even a situation that might have evolved from mental health challenges, they can call MST to the scene for help in making the right assessments and coming to the best outcome for everyone involved.

There’s something else about MST that distinguishes it from all other similar programs… peer and family support! In my work as a NAMI staff member, part of my job is as the Family Support role with the Mobile Support Team. After MST meets a family out in the field, I will follow up with them and provide a direct link to NAMI’s family programs as well as any other resource they might need as they takes steps away from this crisis.

That family can know that I understand what they are going through, as I am a family member of someone with mental health issues and an individual with a couple mental health diagnoses myself. I continue MST’s goals of promoting safety and emotional stability, minimizing negative outcomes, helping community members obtain sufficient support and treatment, and prevent overly intrusive intervention.

But I can also help fill in the gaps. At NAMI, we all know that family members are often the first to recognize the signs of a disorder and the first to offer support, but also the first to feel “in the dark”.  By referring folks over, MST gives families the benefit of finding out right away that they are not alone, they can find support, and they can find answers. It’s my honor to continue working with this fantastic team and providing that direct link for families. And recently, I was so proud to present a NAMI presentation beside an individual whose family I met through MST, while she talked about her lived experience with mental health!

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