Mental Health Bulletin

Published by the
Montana Mental Health Association
An Affiliate of the National Mental Health Association
with contributions from the Piper Family and Ely Lilly Company

EXECUTIVE DIRECTOR'S UPDATE

The office has been a busy place this fall.  In September, the Association sponsored a conference in Helena on Mental Illness in Our Criminal Justice System that was followed by an NMHA sponsored training for consumers and advocates.  Both the conference and the training were well attended and the evaluations positive.  The training provided a springboard from which additional MMHA advocacy efforts in criminal justice are being implemented.  The first effort will be five regional youth forums on mental illness in our juvenile justice system to be held this winter in Glendive, Billings, Helena, Great Falls, and Missoula.  The first Forums to be scheduled are December 6 at the Glendive Medical Center and December 7, 2000 at the Alice Fortin Center in Billings.  In September we also participated in the Twelfth Annual Conference on Seriously Emotionally Disturbed Children.  It was an excellent conference that was well attended.

In mid October, I attended the National Healthcare Reform Policy Training in Arlington, Virginia and returned to the Helena office with a lot of material on parity, substance abuse treatment integration, access to medications, employment issues, Olmstead implementation, involuntary commitment laws, new Federal legislation, and more.  I was able to tour the offices of the National Mental Health Association and get a better perspective on available technical assistance, consultation, and grants from the NMHA.

On October 18 in Glendive, MMHA co-sponsored a workshop with the Pintler Institute.  The workshop provided  the opportunity to hear Dr. Bill Doctor of the Pharmacy Department at the University of Montana talk about psychotropic medications and children, to listen to Barb Ayres from MSU Billings describe methods for changing behaviors of children with emotional disorders, and to Juanita Hooper Addy present the trans-parenting curriculum for divorcing families.

The annual mental health conference was held in Missoula in October and was, no doubt, the best mental health conference I have ever attended. With over 400 persons registered, the general sessions and workshops were filled to capacity.  The presenters and topics were too numerous to mention here.  Congratulations to NAMI Montana and especially Sandy Mihelish for a job well done. 

On October 21, I met with the MHA of Sweetgrass/Stillwater Counties and was treated royally. That Association has been advocating for better treatment for persons with a mental illness for a long time, and I really enjoyed meeting with John and Grace Leuthold, Nora Hanson, President Karen Herman, Jean Duffy, and all of the other members who were present.

The MMHA Public Policy Committee is completing its work on the Platform for the 2001 session, and we have scheduled the Legislative Buffet for January 11, 2001.  More information is included elsewhere in this newsletter.  

The Public Education Committee has been busy with planning and initiating conferences.  A conference on "Bridging the Generations: Surviving Our Loss After Suicide" will be held February 22 in Missoula, and a May 2-4, 2001 conference will be held in Butte, Montana on experiential education, wilderness and adventure therapy, equine therapy, and more.

I am pleased to announce that our membership campaign "1000 in 2000" is working, and we are continuing to grow.  We have gone from 700 members in April of this year to 894 members on November 15.  I am confident with the help of each of you, we can still reach 1000 members by the end of the year. 

Schizophrenics Anonymous

In the last issue of the Mental Health Bulletin, we announced that MMHA is seeking persons who are interested in starting local SA groups.  We have received a response and are moving to the next step of applying for a training grant through Partners in Care at the National Mental Health Association.  The grant will partially cover training for local sponsors.  So, if you or some one you know is in recovery from schizophrenia and interested in starting a local self-help support group, please call the Association to enroll in training for sponsors.  No date has been set, but the training will likely take place in Billings in late January or early February.  See www.sanonymous.org for more information.

MENTAL HEALTH CAUCUS

The "Caucus" is made up of representatives from the Office of Mental Health Ombudsman, the Board of Visitors, the Montana Advocacy Program, the National Alliance for Mentally Ill Montana Chapter, the Mental Health Center Director's Association, the MMHA and others.  We have been meeting in anticipation of the upcoming legislative session.  The group made a list of important issues that were distilled to eight issues that we all agreed were very important.  The issues were then presented to the participants at the Annual Mental Health Conference in Missoula in October.  The Caucus' most important issue for the coming session will be to support the supplemental budget request by the Department of Public Health and Human Services.  The additional issues include:  support the creation of a line item in the mental health system budget for community-based services, support elimination of co-payment for psychotropic medication, support elimination of the Mental Health Services Plan "cap" and develop an alternative, support a rational increase in provider reimbursement rates, support a more flexible system for reimbursing providers (for examples, a "capitated" system or a local community referenced system), and support the use of tobacco fund money to augment the mental health system.

Xanthopoulos Building Controversial

The Xanthopoulos Building was constructed on the campus at Montana State Hospital in 1988 at a cost in excess of $6,000,000.  It is a locked, secure facility designed for forensics patients, that is, those persons with a mental illness who are involved in the criminal justice system.  Because the Addictive and Mental Disorders Division saw no further need for the building for its purposes, the building was transferred by the legislature to the Montana Department of Corrections in 1995.  Officials from the Department of Corrections now state they do not need the building, and they recommended that the state transfer the building to Anaconda/Deer Lodge County for purposes of establishing a "regional correctional facility." 

Because the transfer of the building requires action by the State Land Board, a hearing was held in Helena on November 20, 2000.  On three occasions this fall, members of the MMHA Board toured the new hospital facility at Warm Springs.  On the last tour, they also visited the Xanthopoulos Building.  While at the campus they learned that the new hospital is not fully operational.  The forensics unit cannot be occupied until omissions in the unit's construction are rectified.  Board Members also learned that the State Hospital's daily population has been running in excess of 190 patients, and the rate of admissions is two to three times greater than a few years ago.  In other words, the hospital has more patients than anticipated when the new hospital building was constructed, admissions are on the upswing, and the new building is not operating at capacity.  At the November 20 Land Board meeting, the Association found itself in the unusual position of advocating for the possible need for additional beds at Montana State Hospital.  Other advocacy groups, including NAMI and the Office of Mental Health Ombudsman, voiced their support for the continued use of the Xanthopoulos Building for care and treatment of persons with a mental illness.  We all opposed, at this time, the proposal of a "regional correctional facility" at Montana State Hospital.

Representatives from Butte/Silver Bow County and Anaconda/Deer Lodge County explained the problems they are facing with no jail facility in either community.  Anaconda/Deer Lodge has passed a bond issue and will be constructing a jail.  Butte/Silver Bow County passed a referendum to construct a jail, but there is no appropriation.  One resident from Butte testified that the voters will Butte will fight any attempt to site their jail anyplace other than Butte.  Representatives from both Butte and Anaconda voiced their concern that the Xanthopoulos Building would be "mothballed".  Dan Anderson, Administrator of the Addictive and Mental Disorders Division of DPHHS, said they "have enough beds, now, to serve the patients at Montana State Hospital who are appropriately committed to that facility."  Sally Johnson, Attorney for the Department of Corrections and spokesperson for DOC at the hearing, stated that DOC no longer has need for the Xanthopoulos Building.  So, what will happen?

It was a very difficult decision for the Land Board.  Greg Petesh, Attorney for Legislative Services, spoke with the Board about the law that transferred the Xanthopoulos Building to the Department of Corrections.  The law identifies that the building is to be used by the Department of Corrections.  Senator Mignon Waterman pointed out during her testimony that, if the building was not going to be used by the Department of Corrections and was not needed by the State Hospital, the decision for the appropriate disposal of the building "should go back to the legislature".  A motion made by Land Board Member Mark O'Keefe was approved by the Board to transfer the Xanthopoulos Building to Anaconda/Deer Lodge County on April 2, 2001, unless other action is taken by the Montana state legislature prior to that date.  Senator Bob Keenan has submitted a bill draft request that will lead to a full discussion by the State Legislature of the transfer of the building.

Articles and Letters to the Bulletin

The Association encourages readers to send articles and letters to the editor for inclusion in the newsletter.  Until the articles and letters exceed the available space, we will continue to print all items received. 

Our thanks are given to Pat Brown and Leita Cook for their articles in this issue that were submitted in response to our appeal to readers.  Suicide is a critical mental health issue in Montana.  Pat's article is timely.  In February, the Association will be sponsoring a regional conference on suicide. For information about the conference, see the "Mental Health Calendar" below.

Fetal Alcohol Syndrome (FAS) is also a critical mental health issue.  Because of the nature of the illness, persons with FAS in the public health system often get shuffled between services for the developmentally disabled and services for persons with a mental illness.  The patient/client is often "in transition" between such services.  While the agencies negotiate over who should be responsible for providing services, the patient/client goes unserved or underserved.  Leita Cook volunteers many hours for the Association in our Helena office.  She wants to share her story in the hope that it might help each of us gain some understanding of FAS and its affects.

Montana State Suicide Prevention Plan Development

Pat Brown, Nurse Consultant,
DPHHS/Family and Community Health Bureau

In the spring of 1998, following the National SPAN conference in Reno, Nevada, a meeting of key stake holders concerned with the burden of suicide in Montana was held at the Burns Telecommunication Center in Bozeman to strategize regarding development of suicide prevention activities to reduce the incidence of suicidal activity in Montana.

As a result of the identified need for action and in response to the Surgeon General's Call to Action to Prevent Suicide, a Montana State Suicide Prevention Planning Committee was formed. Members of the Steering committee are key stakeholders from around the state including, policy makers, public and private care and service providers, representatives of the judicial and law enforcement system, members of the faith community, and suicide survivors.

The Montana State Suicide Prevention Steering Committee with the assistance of Suicide Prevention Specialists Bryan Tanney, MD and Morton Silverman and strategic planning consultants Tom Kean and Karen Hohman have in a series of three working meetings developed a draft Montana Suicide Prevention Five Year Plan.   Our first meeting on May 5, 2000 was an education and information program for Suicide Prevention Steering Committee Members facilitated by Bryan Tanney.  The second of three meetings was held on July 18-19.  At this meeting Bryan Tanney, Tom Kean and Karen Hohman, facilitated a strategic planning process at which a draft suicide prevention plan was completed.  On September 28, the steering committee reviewed comments from outside reviewers.  It was decided at that meeting to appoint a subcommittee to edit the plan.  The edit committee meeting was held on September 28 at the Fort Belknap Indian Agency Offices. 

Fort Belknap has established a local community wide suicide prevention/ crisis response program.  The program is being coordinated through the Safe Futures program on the Fort Belknap.  It has been embraced by members of the mental health and substance abuse community, local school staff, the "First Nations Youth Council", by policy makers and by tribal spiritual leaders on that reservation.

Members of the Fort Belknap suicide/crisis intervention support group participated at the Suicide Prevention Steering Committee meeting to edit the Plan.  Their input was very useful in defining a plan that speaks to all Montana residents including members of Native American/ First Nations Culture.

The draft plan is currently available on-line, and, following the complete edit of the draft plan, the final plan will be posted on the website: www.montanasuicide.org which has been donated for our use by Nels Sanddal and the Critical Illness and Trauma Foundation in Bozeman, Montana. 

In reviewing the Montana Suicide Prevention Draft Five Year Plan at the Montana Public Health Association annual meeting and other related meetings, the following needs are most frequently mentioned:  education of key stakeholders and care providers in suicide prevention, identification and intervention, a suicide crisis line available across the state, and an education resource library.

            Following completion of the edit process, the suicide prevention steering committee will reconvene to adopt the plan, to outline action plans for implementation of the plan and to establish goals and outcomes for the first year of the plans use. 

FAS & How I Live With It

By Leita Deanna Cook

My name is Leita and I have FAS; my mother drank while she carried me. I was born without hip sockets, and I have gone under 18 hip surgeries.  I have had 6 hip replacements and finally they had to take them out so now I live in a wheel chair. I have physical and mental disabilities. I was taken from my parents when I was 1 year old. I was in and out of foster homes and hospital, due to starvation and neglect. Then along came a couple to take a look at me; once they saw me they said they would take me and my brother. I was a mess. I was a snot nosed dirty pants kid. They took me and my brother and cleaned us up. When my new mom put me in my dad's arms the first thing I said was "Oh, I am a happy baby."

In Dec 15, 1959 they adopted me. And I started to have my surgeries at the age of 4. I was so little that the clothes for a four year old were too big. I literally swam in them. I only weighed 4 ½ lbs when I was born. I was the runt of the litter of 11 children. Growing up was very difficult. I had a hard time in school. I have a learning problem. Math and money I can't do. I was teased when I was in school because of my disability, so I didn't have very many friends. My attention span is very short. I can only do one thing at a time, so when you tell me directions you have to let me do it first hand and tell and show me what to do. You will have to do it several times before I understand. I get frustrated real easy, especially if there is more than one person talking to me and telling me what they want me to do.

I have difficulty following through with things. I have lack of understanding of what is right and what isn't. I get distracted really easy. I have had jobs but couldn't keep them because lack of speed and keeping my mind on what I was doing.

I have been molested and raped several times in my life. But there are things that I can do, for instance, I am a good speller. I like to put model ships together. I know how to work a computer, I paint, I can figure out how to make things run. Like computers. The more difficult the problem, the more I like it. There are some things that work on us, when a child is tapping his/her fingers on the desk or wiggling in their seat, have a place for them in the back of the room for them to sit and listen to some quiet music with headphones. I find it very soothing. Also bright light or even day light makes me irritable. So I find it soothing to be in the dark. I was always in my closet where it was dark and quiet with just a nightlight on or a light with a 15-watt light bulb. On thing I say to mothers or expecting mothers, please be good to your baby and don't drink.

MENTAL HEALTH SYSTEM UPDATE

Since our last issue, Diane White has become the new Child and Adolescent Services Specialist, replacing former Adolescent Specialist and MMHA Board Member, Dave Bennetts.  Diane is working closely with MMHA and a group of youth services specialist from other state agencies on a series of Youth Forums on Mental Illness and the Juvenile Justice System.  Barb Kriskovich has been hired in the newly established position at DPHHS/AMDD of employment services specialist.  Formerly with the Rural Institute on Disabilities and the Board of Visitors, Barb will be working on Ticket to Work and other employment issues affecting persons with a mental illness.

The two persons who have led important legislative committees on mental health during the interim will be in new key positions.  Senator Chuck Swysgood of Dillon has accepted the position of budget director in the administration of Governor Judy Martz, and Senator Bob Keenan is the new Chairman of the Senate Finance Committee.  Swysgood has been Chairman of the HJR interim committee on managed care in mental health, which completes its work this month.  Senator Keenan remains the Chair of the Mental Health Oversight Advisory Committee.  The MHOAC is an ongoing advisory body to the DPHHS Addictive and Mental Disorders Division (AMDD).

On November 20, 2000 Technical Assistance Collaborative, Inc. (TAC) delivered to DPHHS/AMDD its Final Report on Outcome and Performance Measurement and a Draft Report for Public Discussion on Findings and System Recommendations.  TAC is under contract to the Division to conduct an analysis of the mental health system in Montana and make recommendations for improvements.

The First Health Services of Montana Provider Manual for enrolled providers in the Mental Health Services Plan is available "on line" at the AMDD/DPHHS web site, www.dphhs.state.mt.us.

MENTAL HEALTH CALENDAR

December 1, 2000 through March 31, 2001 - A series of five regional Forums on "Closing the Gap: Mental Illness and Juvenile Justice" will be held this winter. A team of youth mental health specialists from state agencies will be hearing from local and regional participants. State agencies participating include: Montana Department of Corrections, Department of Public Health and Human Services, the Office of Public Instruction, the Montana Board of Crime Control, the Montana Advocacy Program and the MMHA. Jointly sponsored by the Montana Mental Health Association and the Youth Justice Council of the Montana Board of Crime Control.  The Forums are a follow-up to the fall conference on Mental Illness in Our Criminal Justice System and will be held in Glendive, Billings, Missoula, Helena and Great Falls.  Forum dates and other information will be posted on the MMHA website. The public is invited and encouraged to attend, and there is no charge for the Forums.

December 11-12, 2000 - The Mental Health Oversight Advisory Council is conducting an important two-day meeting in the Ross Sierra Room at Carroll College.  This is a meeting dedicated to MHOAC planning for 2001.  Observers are welcome to attend, but no time is planned for public comment or general public discussion.

February 22, 2001 - MMHA is sponsoring a conference at the Holiday Inn-Parkside in Missoula. "Bridging the Generations: Surviving Our Loss After Suicide." The conference will feature Michael Marks, Ph.D. from the Missoula Psychological Medicine Group speaking on adolescent suicide; Paul Quinnett, Ph.D. Director of Greentree Behavioral Health in Spokane, WA on adult suicide and QPR (CPR for suicide prevention), and; Mark Johnston, M.D., Medical Director of Pathways Treatment Center in Kalispell, Montana speaking on Eldercide.  The conference will also include a panel of relatives and friends who are "Surviving Loss After Suicide," a panel on gay and lesbian suicide issues, a panel of professionals, and a panel of staff and members of the Montana State Council on Suicide Prevention who will discuss the State of Montana's Five Year Plan. Participants will be able to attend two of the four panels in the afternoon. Question and answer time will be available at the end of each panel.

May 2-4, 2001 - Mark your calendars for the Spring Rendezvous: Beyond the Walls to be sponsored by MMHA and Alternative Youth Adventures at the Copper King Inn in Butte, Montana. This Northwest Regional Conference will feature nationally recognized experts and authors on experiential education, adventure therapy, wilderness therapy, equine therapy, character education and The Virtues Project.  For more information visit the MMHA website at www.MMHAontana.org or call the MMHA office.

1000 in 2000 Campaign
How You Can Help

In May of this year the Board of Directors of the Mental Health Association adopted a Five Year Strategic Plan. One of our most ambitious objectives in the Plan is to raise membership in the Association from 700 members in May to 1000 members by December 31, 2000.  We find ourselves at December 1, 2000 with a membership of 908 with less than thirty days to go, so the Board is appealing to its members to help us achieve the objective.

There are several ways a member can be of assistance:

            If your membership has lapsed, please renew.

If you know a former member whose membership has lapsed, please encourage him or her to renew membership in the Association now.

If you would be willing to make phone calls or write letters on behalf of the Association to recruit new members, please call Betty DeYoung at the MMHA office - 1-800-823-6426.

If you know persons who might be interested in joining the Association and you prefer to have the staff or a board member contact them, please complete the form below and mail it to our office, or send the names and addresses by email to info@montanamentalhealth.org