Montana Mental Health Bulletin

From the desk of the Executive Director
Charlie McCarthy

The election is behind us. Now we know who we will be working with during the next couple of years. Faced with budget problems of monumental proportions, we will have our work cut out for us. The number of calls received on the MHA/Montana 1-800 line has increased dramatically since DPHHS announced future cuts in the state Mental Health Services Plan. As they are currently proposed, the cuts are unacceptable and will inevitably lead to increased costs to the state mental health budget through emergency services and commitments to Montana State Hospital.

We are confronted daily with the effects of the cuts on consumers, which makes it easy to forget the effects of the cuts on the state economy. In recent phone calls to three children’s mental health services providers in Montana, I learned that 79 people have lost their jobs in these programs as a direct result of recent cutbacks in children’s mental health services: 17 at one program, 40 at another, 22 at the third. Many of the 79 people are heads of households with young children.

When layoffs take place at Stone Container, Touch America, or a local lumber mill, it is newsworthy because these are “good jobs,” but layoffs in the mental health services industry are also “good jobs.” Without arguing the merits of one over the other, all jobs are needed in Montana.

To help turn our economy around, Montana should be dedicating more money to health-related services for children and families. For each dollar spent in the Medicaid program, the state receives nearly three dollars in Federal matching funds. For every dollar state government spends on the Children’s Health Insurance Program, Montana receives four dollars in Federal matching funds. The loss of these matching funds contributes to the state deficit. No matter how they come into the state, these are real dollars that circulate in our communities. Employees in the health care industry buy groceries, cars, goods and services. These dollars create additional jobs that are not directly associated with health care.

In their report, Competing for Quality Care, the Governor’s Task Force said, “The Governor should ensure that Montana pursues, and when possible takes advantage of, all public and private sources of additional funding or resources to help attract, train, and retain health care and human services workers.”

The state should not cut its mental health services to adults, children, and families. It should be doing all that can be done to meet the demand for additional mental health services. This is not only the right moral choice, but the right economic choice for Montana.

DAVIS TO LOBBY

Al Davis of Helena will once again serve as the MHAM registered lobbyist for the 2003 session. He is a former Juvenile Corrections Division Administrator for the State Department of Family Services and brings to the lobbying position a wealth of knowledge about state financing and service delivery systems. Al is a co-founder of Connections Consulting Group where he currently serves as lead consultant. He can be reached by phone at:(406) 449-9851, cell phone at (406) 439-6061 or email at: connectionsconsult@msn.com.

Patient Assistance Programs

Many pharmaceutical manufacturers have patient assistance programs to help consumers with the cost of prescriptions and a number of companies have started new programs in 2002 to assist the senior population with the cost of drugs. However, the ability to obtain assistance is many times limited to specific criteria that may be hard to meet. There is a web site called www.needymeds.com that will provide you with information on many drug assistance programs. If you find a company program that you think you may qualify for, it may be worth asking your physician if he/she feels that it may be a help to you.

James Willie Brown to Die for His Mental Illness

NMHA News Release, November 18, 2002

ALEXANDRIA, VA. — The National Mental Health Association vehemently opposes the Nov. 19 execution of James Willie Brown who had been diagnosed with paranoid schizophrenia 17 separate times by at least 10 different doctors. Brown, who suffered mental and physical abuse from an alcoholic father throughout his childhood, was first diagnosed with schizophrenia in 1975.

At the time of his crime, Brown had been progressing more deeply into psychosis and was floridly psychotic when he was admitted to Central State following his arrest. The jury that sentenced him to death was told that he did not suffer from a mental illness but flashbacks stemming from LSD use in the 1970s. They were told nothing of his previous 17 diagnoses of schizophrenia or his abusive past.

”Our justice system inadequately addresses the complexity of cases involving criminal defendants with mental illness,” said Michael Faenza, President and CEO of the National Mental Health Association. “As a result, over the past 30 years, the number of people with mental illness and other mental disabilities on death row has steadily increased.”

Although precise statistics are unavailable, it is estimated that 5-10 percent of people on death row have a serious mental illness. NMHA has called on lawmakers to suspend use of the death penalty until they can develop more just, accurate and systematic ways of determining and considering a defendant’s mental status.

In a Nov. 13 letter sent to the Georgia Board of Pardons and Parole, Faenza wrote “In this case there is reason to believe that an individual with a severe mental illness might be executed without the court’s knowledge of the existence of that illness, and, therefore, without the requisite consideration of that mental illness as a mitigating factor. James Willie Brown’s mental illness clearly constitutes a circumstance mitigating his culpability for the capital charge. Mr. Brown’s execution would be contrary to American standards of justice, fairness, and decency. For these reasons, we urge you and other members of the Georgia Board of Pardons and Parole to commute the death sentence of James Willie Brown to life in prison.”

The National Mental Health Association is the country’s oldest and largest nonprofit organization addressing all aspects of mental health and mental illness. With more than 340 affiliates nationwide, NMHA works to improve the mental health of all Americans through advocacy, education, research and service.

If you or a friend would like to receive future NMHA alerts, news releases and other updates please sign up online at NMHA e-Alerts.

Stigma

Mental illness can strike anyone! It knows no age limit, economic status, race, creed, or color. During the course of a year, more than 51 million Americans are affected by one or more mental disorders. Medical science has made incredible progress over the last century in understanding, curing and eliminating the causes of many diseases including mental illnesses. While doctors continue to solve some of the mysteries of the brain, many of its functions remain a puzzle. However, researchers have determined that many mental illnesses are probably the result of chemical imbalances in the brain. These imbalances may be inherited or may develop because of excessive stress or substance abuse. It is sometimes easy to forget that our brain, like all of our other organs, is vulnerable to disease. People with mental illnesses often exhibit many types of behaviors such as extreme sadness and irritability, and in more severe cases, they may also suffer from hallucinations and total withdrawal. Instead of receiving compassion and acceptance, people with mental illness may experience hostility, discrimination and stigma.

Why does stigma still exist?

Unfortunately, the media is responsible for many of the misconceptions which persist about people with mental illnesses. Newspapers, in particular, often stress a history of mental illness in the backgrounds of people who commit crimes of violence. Television news programs frequently sensationalize crimes where persons with mental illnesses are involved, Comedians make fun of people with mental illnesses, using their disabilities as a source of humor. Also, national advertisers use stigmatizing images as promotional gimmicks to sell products. Ironically, the media also offers our best hope for eradicating stigma because of its power to educate and influence public opinion.

What is mental illness?

A mental illness causes mild to severe disturbance in a person’s thinking, perception, and behavior. If these disturbances significantly impair a person’s ability to cope with life’s ordinary demands and routines, then he or she should immediately seek proper treatment with a mental health professional. Depending on the type and severity of the mental illness, with the proper care and treatment, a person can recover and resume normal activities. Many mental illnesses are believed to have biological causes, just like cancer, diabetes, and heart disease, but some mental illnesses are caused by a person’s environment and experiences. Mental illnesses should not be confused with temporary psychological or emotional disturbances in a person’s life which may also be caused by life situations such as death, divorce, or a serious illness. These disturbances may also be treated with psychotherapy and/or medication, but are usually short term.

The five major categories of mental illness:

Anxiety Disorders
Anxiety disorders are the most common mental illness. The three main types are: phobias (extreme fear or dread of a particular object or situation), panic disorders (sudden, intense feelings of terror for no apparent reason, often accompanied by heart attack-like symptoms), and obsessive-compulsive disorders (anxious impulses to repeat words or phrases or engage in repetitive, ritualistic behavior, such as constant hand washing).

Mood Disorders
Mood disorders include depression and bipolar disorder. Symptoms may include mood swings such as extreme sadness or elation, sleep and eating disturbances, and changes in activity and energy levels. Suicide may be a risk with these disorders.

Schizophrenia
Schizophrenia is a serious brain disorder which affects how a person thinks, feels, and acts. Schizophrenia is believed to be caused by a chemical imbalance in the brain that causes a variety of symptoms including hallucinations, delusions, withdrawal, incoherent speech, and impaired reasoning.

Dementias
This group of brain disorders includes diseases such as Alzheimer’s, which leads to loss of mental functions, including memory loss and declining of intellectual and physical skills.

Eating Disorders
Anorexia nervosa and bulimia are serious, potentially life-threatening illnesses. Symptoms include a preoccupation with food and an irrational fear of being fat. Specifically, anorexia is self-starvation, while bulimia is cycles of bingeing (consuming large quantities of food) and purging (self-induced vomiting or abusing laxatives).

Penny Wise and Pound Foolish

by Charlie McCarthy

Effective December 1st, the Department of Public Health and Human Services will be reducing pharmacy benefits to people on the Mental Health Services Plan to a maximum of $250 per month. In its announcement, the Department indicated that one-third of those currently receiving pharmacy benefits have monthly drug expenses that exceed $250 per month, and these people “will have to pay anywhere from a few dollars to several hundred to have their MHSP prescriptions filled.”

Persons eligible for MHSP have incomes of less than 150% of poverty. Where will they come up with “anywhere from a few dollars to several hundred” a month? The Department says they have met with mental health centers and, “We are confident that the centers will do what they can to help consumers who are affected.”

The Mental Health Association also is confident that the centers will do what they can to help, but we are likewise confident that many consumers will not be helped. Those with very high monthly expenses for medications will be left behind. Those people who suffer greatly without their medication, and who have to be hospitalized at anywhere from $350 to $800 a day, will more than make up for any hoped for budget “savings”. Reductions in pharmacy benefits are surely, “Penny wise, and pound foolish.”

Thank You To Our Supporters!

Our sincere appreciation is extended to all who continue to give so generously. Following are new or renewed supporters from August, 2002 through October, 2002. If we have missed your contribution, please accept our apologies, and notify us, so we can make the correction.

Pacesetter

Astra Zeneca Pharmaceuticals

Professional

Elaine Barrett, Miles City
Judy Birch, Helena
Laura Bryant, Clancy
Mary Jane Fox, Kalispell
Fred Griffin, M.D., Missoula
Stuart Klein, Helena
Jani McCall, Billings
Archie McPhail, Deer Lodge
Marla North, Lewistown
Kristine Olsen, Billings
Molly Protheroe, Helena
Debra Sanchez, Helena
Peg Smith, Joliet
Candace Wimmer, Helena

Corporate

Genesis House, Stevensville
Shodair Hospital, Helena

And a special thanks to...

Big Sky Counseling, Adult and Child Counseling, and The Rocky Mountain Developmental Council for participating in and promotion of the Depression Screening Day, October 10th in Helena, MT.

Affiliate Highlight

Sweet Grass / Stillwater Chapter
by: Karen Herman, President

Our Chapter is made up of two communities, Big Timber and Columbus. Started in 1978 through the efforts of citizens from each community, we still have two of the original board members, Nora Hanson and Grace Leuthold. We try to meet twice a year, once in the Spring and then in the Fall. Our yearly membership drive is during the Fall time. Presently we have 40 active members. We alternate locations of the meetings between the communities.

Through the years, Nora, Grace, and the rest of us have witnessed many changes in the mental health care field. But our group has a fundamental purpose: working to reduce the stigma of mental illness, and educating people about those illnesses and about good mental health. To help educate the public, our chapter sponsors different workshops on topics such as parenting, suicide, and depression. In recent years our efforts have been centered on educating the public on the impact of the legislative issues. Our Board has members on the County Board for the Southwest Health Care Providers. This allows us to keep current on the regional issues and communicate the issues by writing letters and becoming vocal advocates when necessary. Often this is what it takes to make changes in our mental health delivery system. In December, we gather presents for the Montana State Hospital’s “Gifts with a Lift” along with a check for $50 and Nora Hanson makes sure poinsettias along with presents are delivered to the HUB in Billings.

The Rainbow House was one of our projects up until it closed. We not only delivered poinsettias and presents to the residents, we had an annual summer picnic where 20-30 residents plus counselors were bussed to Big Timber for a picnic in the mountains. The residents often enjoyed fishing before returning home. With the changes in mental health delivery, this became a thing of the past. This year has brought changes for all: providers, consumers and patients alike. We all are aware of the financial cuts that have occurred. One of our roles as Mental Health Advocates is to help keep the public and policy makers informed on mental health issues that may effect us locally, regionally and state wide and help minimize negative outcomes.
Let’s all work together!

Voice of the Consumer

by Yvon Remark

School is dismissed for the day.

I pick up my jacket from a narrow, long room lined by coat hooks, and wander outside to the swings. There I spend time until the dinner whistle blows at six o’clock.

No point in going home promptly after school.

Time hangs heavy on me. No point to it. No connection to being a viable person, to viable persons. With the detachment of perspective, I can say ‘My mother is schizophrenic; my father is an alcoholic.’ Neither is there for me at home. I am like a disconnected feather drifting in the breeze. To delay going home I play alone on the swings or on the merry-go-round; I huddle on the fire escape or in a corner behind the storage shed. Sometimes I stay indoors, creating random sounds on the school piano, self-soothing until the janitor tells me he is closing the building for the night.

Then there is nowhere to go except home.

If mother is up and moving around the house, I know it is best to pick up a slice of bread or a handful of crackers, go upstairs and lock myself into my room. She is inclined to attack me on sight when she is active. I don’t question whether I deserve this: mother must know what is appropriate, and is there any other way for a family to be? On other days she will be sitting in her rocking chair weeping; all my fault for being such a worthless, unwanted child. Mother is talking with angels again, but she has nothing to say to me.

Now I know that mental illnesses are part of everyday life experiences. When someone can no longer cope realistically with life, it’s time to consider the possibility of a mental illness.

• Mental illnesses are disorders of brain chemistry and/or function.
• Most mental illnesses are treatable, chronic health conditions.
• Don’t try to cope alone.
• Seek professional counseling or medical help.
• Silence about mental Illness is no treatment.