Important Meeting–Long Beach, March 30, 5.p.m

City of Long Beach
Planning Commission Meeting
to Discuss a Proposed Behavioral Health Urgent Care Center

Please come and support the Behavioral Health Urgent Care Center.

These services are urgently needed to assist people with mental health disorders and reduce the long waiting times in emergency rooms.

The meeting will be
Thursday at 5 p.m., March 30, 2017
at 333 W. Ocean Blvd. 4th Floor
Long Beach, 90802

Approximately 1 in 5 adults experience mental illness in a given year. Even if someone doesn’t experience this themselves, they likely know someone dealing with depression, anxiety, obsessive-compulsive disorder or suicidal tendencies. Sometimes those with a mental health condition experience a crisis and need help right away.

Because of the shortage of psychiatric mobile response teams, police and sheriff departments in Long Beach and surrounding cities have the difficult task of responding to mental health-related calls. The Behavioral Health Urgent Care Center (BHUCC or “Buck”) is a facility that will save law enforcement time in the field, will decrease the burden on hospital emergency rooms, and will help prevent unnecessary incarceration by providing medical treatment instead.

What is a BHUCC?

BHUCC will be a place where people with mental illness can go to be stabilized (instead of going to the hospital ER). It can be compared to an Urgent Care Center (where people often go for a medical emergency instead of going to the hospital ER).

The BHUCC provides:

  • Crisis stabilization service
  • Up to 12 adults and 6 adolescents (estimate about 30 clients a day)
  • Doctors, nurses, therapists, peer counselors
  • 24/7 Outpatient Program
  • Patients may stay up to 24 hours
  • Average stay is 4 to 6 hours
  • Round the clock security staff
  • Discharged patients leave the area and return to their home and community services

Learn more at


Making a Difference with Schizophrenia

According to a recent article by Lloyd I. Sederer, M.D., medical editor, mental health for The Huffington Post, and author of The Family Guide to Mental Health Care (Forward by Glenn Close), after an intensive, series of sessions involving 25 scientists, clinicians, researchers, patients, family advocates and government prepresentatives, the following were identified as important answers to the question: “What really makes a difference in the lives of people with schizophrenia?”

  1. Keep the natural environment when possible, keep family closely involved, and work toward a return to school or work.
  2. Measurement-based care with clear goals.
  3. Use technology effectively to reach home-bound and rural patients.
  4. Increase peer services, which are critical in engaging and retaining people with schizophrenia in care.
  5. Combine treatments, using reliable treatments, but permitting innovation; use skill building in social and work areas, cognitive techniques to manage paranoia, effective medications, family education/support, all combined with outreach to help people stay engaged.
  6. Recruit people and grounds that will go byond the call of “champion” and zealously pursue improvement over the status quo
  7. Insist on goals–for patients, families and clinicians.
  8. Maintain hope and a belief in human resilience.

Dr. Sederer is the Medical Director of the New York State Office of Mental Health (OMH), the nation’s largest state mental health system. As New York’s “chief psychiatrist”, he provides medical leadership for a $3.6 billion per year mental health system which annually serves over 700,000 people and includes 24 hospitals, 90 clinics, two research institutes, and community services throughout a state of ~ 19 million people. He is also an Adjunct Professor at the Columbia/Mailman School of Public Health. Previously, Dr. Sederer served as the Executive Deputy Commissioner for Mental Hygiene Services in NYC, the City’s “chief psychiatrist”. He also has been Medical Director and Executive Vice President of McLean Hospital in Belmont, MA, a Harvard teaching hospital, and Director of the Division of Clinical Services for the American Psychiatric Association.

Follow Lloyd I. Sederer, MD on Twitter: @askdrlloyd

His website is


Study Finds Depression Subtype May Not Be Relevant in Selecting Treatment

From Psychiatric News Alert: There may be no preferential antidepressant pharmacotherapy for treating subtypes of major depressive disorder (MDD), according to a study published online in AJP in Advance, “Depression Subtypes in Predicting Antidepressant Response: A Report From the iSPOT-D Trial.

oweirieoeA. John Rush, M.D., a professor of psychiatry and behavioral sciences at Duke University School of Medicine, and colleagues conducted a study with 1,008 individuals with MDD to assess the proportions of participants who met at least one criteria for MDD subtype—melancholic, atypical, and anxious depression—and compared subtype profiles on remission and change in depressive symptoms after eight weeks of treatment with escitalopram, sertraline, or extended-release venlafaxine. Improvement of symptoms and likelihood of remission were quantified by the 16-item Quick Inventory of Depressive Symptomology-Self Report.

The researchers found that 39 percent of the studied individuals exhibited at least one pure form of a depressive subtype, with atypical subtype being the most prevalent at 15 percent. Approximately 36 percent of the participants met criteria for more than one subtype. As it relates to antidepressant treatment, the results showed that participants in all subtype groups exhibited a similar statistically significant reduction in symptoms and did not differ in the likelihood to remit.

“Whether pure or mixed, subtypes were not differentially predictive of overall acute treatment outcomes or differentially predictive of efficacy among the three antidepressant medications,” the researchers concluded. “If replicated, these findings would suggest that the clinical utility of these subtypes in treatment selection is minimal.”

The iSPOT-D trial (International Study to Predict Optimized Treatment – in Depression) is the largest personalized medicine research study in mental health.

To read more about treatments for major depressive disorder, see the Manual of Clinical Psychopharmacology, Eighth Edition, by Alan Schatzberg, M.D., and Charles DeBattista, M.D., D.M.H., from American Psychiatric Publishing.

Image Credit: MorgueFile

Conference Presenters: Deadline for Proposals Extended to February 13th

0cb9926c-3944-4165-a01f-ea4e881410c0NAMI California’s 2015 Annual Conference will be returning to Newport Beach on August 21st through the 22nd.

NAMI California is seeking proposals for presentations for our upcoming conference. NAMI California highly encourages workshop applications that incorporate and address diverse communities through dynamic strategies and programs including:

  • Multimedia
  • Education/Training
  • Personal Stories
  • Advocacy
  • Diversity.

Below you will find a brief description of each of the categories. Applications can be found HERE.

You can send your completed proposal to


This year NAMI California is excited to announce that its program will include 6 tracks for its attendees to choose from.

Transitional Aged Youth (T.A.Y.)

Workshops will focus on strategies and best practices for educators, early identification and intervention, and reducing stigma and discrimination for ages 18-24.

Criminal Justice

Workshops will focus on strategies around incorporating and partnering with the law enforcement, the Justice system, and other criminal justice sectors.

Strengthening NAMI

Workshops will focus on best practices in Board development, organizational financial management, and expanding access to NAMI education programs through technology.

Consumer and Family Engagement/Recovery practices

Workshops will focus on strengthening our voice as a unified organization of lived experiences, increase visibility and impact, and promote mental health wellness and recovery.


Workshops will focus on new and innovative ways to advocate, current policies and their impact on all levels (local, state and nation wide), and training tools to effectively utilize grassroots advocacy efforts.


Workshops will be focused on strength-based approaches and best practices to engage diverse communities, increase access to programs and services, and reduce the stigma and discrimination among diverse populations.

Study Finds Treatment-Resistant BPD Responds Better to ECT Than Medication

Bipolar Disorder. Image Credit: xpixel | shutterstock

Bipolar Disorder. Image Credit: xpixel | shutterstock

From Psychiatric News Alert: Electroconvulsive therapy (ECT) for treatment-resistant bipolar disorder appears to be more effective than an algorithm-based pharmacologic treatment in terms of symptom improvement, says the report “Treatment-Resistant Bipolar Depression: A Randomized Controlled Trial of Electroconvulsive Therapy Versus Algorithm-Based Pharmacological Treatment” in the January American Journal of Psychiatry. But remission rates did not differ between the two groups and remained modest regardless of treatment choice for this challenging clinical condition.

According to the research, ECT treatment was significantly more effective than the pharmacological treatment. For more details of the research, see the Psychiatric News article. There were possible limitations noted by Mauricio Tohen, M.D., Dr.P.H., and Christopher Abbott, M.D., M.S., additionally stating:

“In spite of the above limitations, this report adds major value to the evidence-based data on the use of ECT as a treatment option for bipolar depression.”

For more research on the use of ECT in depressive disorders, see the Psychiatric News article, “Ketamine Outperforms ECT in Depression Study.”

People with Mental Illness in the Criminal Justice System: A Cry for Help

By Jackie Feldman, M.D.

Several years ago, in partnership with Dear Abby, a request was sent out in her newspaper column asking those with mental illness or family members with mental illness who had “interfaced” with the criminal justice system.  I was part of a committee called Psychiatry and the Community, with the Group for the Advancement of Psychiatry, and received almost 3,000 letters.

Each one was read and we decided a practical response was to develop a monograph entitled: “People with Mental Illness in the Criminal Justice System: A Cry for Help,” hopefully to be published soon with the help of the American Psychiatric Foundation (and available to the public, providers, and purveyors of care in the criminal justice system).

The demographics of the criminal justice system are devastating. In a year’s time:

  • 2 million arrests in the U.S. involve persons with serious mental illness
  • 550,000 people with serious mental illness are in jails and prisons
  • 900,000 are in some kind of community control

The system is woefully understaffed and often poorly educated about the needs of those with mental illness.

However, a few things about the criminal justice system became apparent as I read the letters.

  1. It can be ignorant and insensitive, usually not because providers are evil, but because they are tired and lack resources like time, money, training, space and manpower.
  2. It often lacks innovation in response to crises and focuses on safety and boundary setting via restraint and seclusion.
  3. It uses short-term fixes and “efficiencies” to save money, but lacks a commitment to assessing long-term consequences of these fixes.
  4. And importantly, it can and will respond to advice and training.

The document that was developed after reading this letters will hopefully offer guidance to mental health care providers on how to interact with the criminal justice system to advocate for skills development, provide training opportunities, develop partnerships and enhance care.

In addition, the final product will provide practical advice for individuals with serious mental illness and their families on how to be prepared for an interaction with the criminal justice system.

  • Carry the name and contact information of your psychiatrist/mental health care provider (they can be contacted to advocate and educate law enforcement, jail and court personnel). Sign and carry a pre-emptive release form allowing communication with your mental health provider and law enforcement.
  • Carry a sheet with your diagnosis and list of medicines (some of my patients have taken to wearing medical alert bracelets).
  • Keep the lines of communication open.  Family members should ask to speak with local leadership such as a police chief, sheriff or patient advocate if care isn’t being provided in a timely fashion. Insist on treatment, but also understand that jails and prisons have very limited formularies that often contain the cheapest medications. You will need to lobby hard to get formularies to expand, or more practically, negotiate with the jail to use your family member’s own medication supply (there may be barriers to this tactic). Require adequate transition/discharge planning (a call at 11 p.m. telling you that your son is being discharged at midnight with no medication and no follow-up is basically a guarantee for failure).
  • If law enforcement has been trained, develop and share your WRAP (Wellness Recovery Action Plan) in advance.
  • Advocate for crisis intervention training of local law enforcement. Make sure to participate and offer your viewpoint as an individual with mental illness or as a family member.  Personal stories carry incredible weight, especially if delivered face-to-face.
  • Support/advocate/demand the development of mental health courts and drug courts.

I’d be interested in hearing how y’all deal with these challenges and if these suggestions have been helpful.

This is Jackie Feldman’s inaugural blog since starting her volunteer position as Associate Medical Director. She is a family member of near and dear relatives who have experienced depression and psychosis, and the consequences of the stigma of hospitalization, side effects to medicine, and memory loss from ECT. 

She is also a psychiatrist. When she retired in mid-2014, she had spent the last 24 years in community psychiatry, running a public mental health center at the University of Alabama at Birmingham. In this position, she was privileged to work with thousands of individuals with serious mental illness and their family members.  She was a member of the NAMI state board, a federal court monitor for the Alabama women’s prison system, and helped the Department of Justice investigate state hospitals in Georgia.

Primary Care Provider Training May Improve Prescribing for Children

Researchers compared an intervention group of 176 PCPs who volunteered for PT training with a stratified random sample of 200 PCPs who did not receive PT training; Photo: Syda Productions | DPC

Researchers compared 176 PCPs volunteers for PT training with random sample of 200 PCPs; Photo: Syda Productions | DPC

FROM Psychiatric News Alert: A New York state initiative to provide psychiatric consultation to pediatric primary care providers about prescribing psychotropic medication shows promise for enhancing providers’ comfort with prescribing, according to the report “Detection and Treatment of Mental Health Issues by Pediatric PCPs in New York State: An Evaluation of Project TEACH” published online in Psychiatric Services in Advance.

Researchers in the Department of Child and Adolescent Psychiatry at New York University School of Medicine and colleagues at other institutions evaluated Project TEACH (PT), a statewide training and consultation program for pediatric primary care providers (PCPs) on identification and treatment of mental health conditions. The project is part of a collaboration between the REACH Institute (Resource for Advancing Children’s Health) and five academic departments of psychiatry. The curriculum consists of 15 hours of in-person training, a tool kit, and Web-based learning tools, along with a six-month distance learning program that includes 12 one-hour consultation calls with child psychiatrists.

“Our findings suggest potential benefits of training PCPs to identify and treat children’s mental health conditions. Provider training and consultation may be a meaningful way to help reduce the number of children who do not receive treatment for mental health conditions, but further research is necessary to determine whether this type of model will be useful as the responsibility for mental health care and outcomes shifts under health care reform.”

For more about this program, see the Psychiatric News article, “New York Child Psychiatry Divisions Fill Gap in Collaborative Care Model.”