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From the desk of Mary Zdanowicz, Esq.
Legislative Update
The 189th formal session of the Massachusetts legislature (2015-2016) ended July 31, 2016. The House and Senate will attend to business in an informal session until the end of the year. The 190th session (2017-2018) will convene on January 3, 2017. This interim period is a good time to review bills that may be reintroduced next year.
Thousands of bills are filed each session. The bills that are of interest to NAMI CC&I are typically assigned to the Joint Committee on Mental Health and Substance Abuse.
There are two factors to consider in evaluating the potential success of bills that may be reintroduced next year. One factor is the number of bill sponsors. The second is how far the bill moved in the current session.
Bills that are passed by the Joint Committee on Mental Health and Substance Abuse are usually referred to the Joint Committee on Health Care Financing. Bills that do not pass in Committee may be "sent to study" in a study bill, which suggests that although the bill did not pass, the Committee found it was worth further consideration. The bills that have the best chance of success are those referred to the second committee (Health Care Financing) and sent to study.
The bills that may be of interest to NAMI CC&I are grouped in categories below based upon the progress the bills made during the session.
What you can do:
- If you would like to see the bill text and sponsors, use Bill Search at https://malegislature.gov
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If there is a bill that you support, you may ask your state representative or senator to co-sponsor the bill. Find a Legislator at
https://malegislature.gov
- Send comments or questions to [email protected]
Each session, several reports are filed on various topics. Two reports of interest to NAMI CC&I are described following the list of bills:
Bills Sent to Study by the Joint Committee on Health Care Financing
S. 359
An Act relative to protecting the health and safety of elders with hoarding disorder (5 sponsors)
Expands the definition of "abuse," for the purposes of adult protective services to include compulsive hoarding.
S. 578 An Act relative to mental health certified peer specialists (7 sponsors)
Requires that MassHealth pay for services provided by certified mental health certified peers specialists
S. 588 An Act relative to behavioral health services (3 sponsors)
Requires that MassHealth pay for services provided to a "boarder patient," which is defined as a patient being held in a hospital emergency department for at least two hours after a physician has made the decision to admit or transfer the patient
S. 1027/H. 787 An Act to require health care coverage for the emergency psychiatric services (11 sponsors)
Requires private insurers to cover "emergency services programs"(ESPs) that are provided by private entities under contract with the Mass Behavioral Health Partnership. Currently, only individuals who have public insurance (Medicaid, MassHealth, etc.) or are uninsured are entitled to ESP services. As written, the bill does not apply to the Cape Cod ESP, which is still run by DMH, nor the Nantucket and Martha's Vineyard ESPs, which are under contract with DMH. The proposed privatization of DMH services on the Cape and Islands is still being litigated.
S. 1051 An Act relative to creating a pilot program to transfer high acuity behavioral health and dual diagnosis patients away from overcrowded emergency departments (7 sponsors)
Establishes a 2-year pilot program on the campus of Taunton State Hospital for medically stable, high acuity patients that cannot be transferred to an available psychiatric inpatient bed within four hours of admission to the emergency department.
Bills sent to study by the Joint Committee and Mental Health and Substance
S. 1030
189th (Current)An Act to provide critical community health services (3 sponsors)
Establishes a program to provide "critical community services" for individuals with mental illnesses who are gravely disabled and have a history of non-compliance with treatment that has been a significant factor in prior hospitalizations or serious violent behavior. Further, based upon treatment history and current behavior, the individual must be need of "critical community health services" and be likely to benefit from those services.
S. 1031 An Act relative to improved medication adherence (3 sponsors)
Allows a pharmacist, in collaboration with a supervising physician, to administer injectable drugs and biological products that have been ordered by the supervising physician
H. 1792 An Act relative to creating a difficult to manage unit within the Department of Mental Health (18 sponsors)
Establishes special psychiatric hospital units to address and consider issues relative to difficult to manage patients within the Department of Mental Health(DMH)
H.1800 An Act relative to improving access to emergency treatment plans (6 sponsors)
Establishes an oversight program for "treatment monitors" who are appointed by the court to oversee treatment plans for individuals who lack the capacity for decision-making with respect to the administration of anti-psychotic medications (Rogers Orders). Establishes a process for treatment monitors to petition the court when an incapacitated person has refused to comply with any condition of the treatment plan or when the treatment monitor determines that the service provider is not delivering treatment in accordance with the treatment plan.
Bills Referred to the Committee on Health Care Financing, But Not Sent to Study
H. 1805 An Act providing equitable access to behavioral health services for MassHealth consumers
H. 1817 An Act relative to the civil commitment of mentally ill persons to Bridgewater State Hospital
H. 1818 An Act relative to applications for temporary involuntary hospitalization
H. 1821 An Act to provide services for medically ill and mentally ill persons
H. 1822 An Act relative to providing appropriate medical care for persons in mental health facilities
Special Reports
Report of the Special Commission on Substance Addiction Treatment in the Criminal
Justice System, December 31, 2015
Specialty courts are examined in the report. The following excerpt describes Mental Health Courts and Veterans' Treatment Courts in MA
Mental Health Courts
Since 2009, the Springfield District Court has had a mental health session designed for individuals who are competent to stand trial, have disposed of their criminal cases by admission to sufficient facts or guilty plea, and have been placed on probation. In 2011, the Plymouth District Court established a mental health session as the first mental health court whose clinical services were funded by DMH, which now funds the service agencies supporting both specialty sessions. The mental health court sessions include a court-imposed condition of probation for defendants who have serious mental illness or co-occurring mental health or alcohol/substance abuse issues. The sessions are designed to provide an alternative to incarceration through case management, and by linking to community-based services with probation. The probationers are required to participate in community-based treatment for a minimum of 3 months in conjunction with regular reviews by the mental health court team.
There are 3 mental health courts within the Boston Municipal Court Dept. Participation in the mental health court is for individuals who have been placed on pre-trial probation or post- disposition probation, and have serious mental health issues or co-occurring mental health and alcohol/substance abuse issues. When competency is an issue, after consultation with an attorney, participation may be available as a term of release.
The first mental health session began in 2007 in the Central Division through the financial assistance of the Sidney Baer Fndn. and the efforts of Judge Maurice Richardson (ret.). Since 2014, DMH has provided additional financial support and resources, which has enabled the expansion of the mental health sessions to the West Roxbury Division and Roxbury Division. Working with a mental health clinician from Boston Medical Center, the probation officer assigned to the mental health session identifies the particular mental health and social needs of each participant, and creates a service plan which includes referrals to mental health treatment, substance abuse treatment when appropriate, as well as housing, educational and employment opportunities. The length of participation in a mental health session is usually between 3 to 12 months. The Court monitors progress and compliance of the service plan through regular in-court reviews with the Judge, mental health clinician, and probation officer.
The Trial Court now has 6 mental health court sessions, having opened another session in Quincy in 2015.
Veterans' Treatment Courts
Veterans' treatment courts are designed to handle criminal cases involving defendants who have a history of military service through a coordinated effort among the veterans' services delivery system, community-based providers, and the court, thereby improving public safety while dealing with the underlying issues of posttraumatic stress disorder, traumatic brain injury, etc. Not using drugs and alcohol, mandated treatment, swift accountability, and weekly interaction with the court are requirements of the Veterans Treatment Court.
Currently, there are 5 veterans' treatment courts in Massachusetts: Norfolk County Veterans Treatment Court, located at the Dedham District Court, Boston Veterans Court, located in the Central Division of the Boston Municipal Court, Essex County Veterans Treatment Court at the Lawrence District Court, Middlesex County Veterans Treatment Court at the Framingham District Court, and Western Mass Veterans Treatment Court at the Holyoke District Court.
Elder Economic Security Commission Report to the Mass State Legislature, April 2016
The Report includes recommendation for greater access to mental health/behavioral interventions and promotion of mental health awareness and prevention. Following is an except from the report:
Untreated mental health or behavioral conditions among the state's 65+ population are
costly to families, individuals and the Commonwealth. Depression, anxiety, impaired cognition, substance abuse, and other conditions have been identified as both a result of and a contributor to chronic economic insecurity among older adults. Untreated depression, anxiety and other conditions bring functional impairments that become barriers to accessing public benefits (SNAP, LIHEAP, SSI as examples) and social support opportunities and lead to inefficient use of health care resources (i.e. Emergency Rooms and nursing facilities). Prevalence is estimated to range from10% among seniors living independently in the community to 25% of older adults living in the community with another chronic illness. Rates are higher among hospitalized seniors with onset of serious medical conditions 35% - 60% (cancer, heart attacks, arthritis, and severe back pain). MA Aging Service Access Points have reported that up to 50% of seniors receiving their services require some type of mental health intervention.
Barriers to treatment include: 1) lack of provider capacity; 2) inadequate understanding of treatment benefits; 3) perceptions of mental illness; and 4) absence of coordination among providers of various services. MA created and operated partnerships between ASAP's and mental health entities do exist as models to begin to address these issues throughout MA.
Implementation:
a) Create a new line item in the Dept. of Elder Affairs annual fiscal year budget restoring funding for the development and support of a geriatric mental health partnership program in MA communities
b) Create a new line item in the Dept. of Elder Affairs annual fiscal year budget for the development and support of a program of public education to increase awareness of MA seniors to include the promotion of mental health and wellness, prevention of the onset of behavioral health conditions during later life, information on the importance of integrated physical and behavioral health care, and available evidence-based interventions that support emotional wellness.
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Mental Health...And Where Our Presidential Candidates Stand
At the last NAMI Members' Meeting, it was suggested that we inform members of where our politicians stand regarding mental health.
Democratic candidate Hillary Clinton has presented her statement. We will print statements from other presidential candidates as they become public.
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The following statement was released today by Paul Gionfriddo, President & CEO, Mental Health America following Secretary Clinton's announcement of her mental health platform:
"Secretary Hillary Clinton today released her mental health policy platform. MHA has eagerly awaited this day, because we know that it reflects months of thoughtful deliberation about her vision for the future of mental health services in America.
"It is a solid, comprehensive plan, consistent with MHA's century-long advocacy for mental health, including prevention for all, early identification and intervention for those at risk, integrated services for those who need them, and recovery as the goal.
"The plan treats mental health as a part of overall health - just as it should be treated. In that respect, it doesn't just focus on what some have called "serious mental illness," limiting our policy attention to deep-end, post-crisis services only. Instead, it takes the same approach that MHA does - treating all mental health concerns seriously, and focusing on earlier interventions and integrated services that promote recovery at the lowest expense of dollars, resources, and lives - in other words, it promotes action before Stage 4.
"Much of the plan is in line with MHA's top federal policy priorities. The plan provides more than $50 million for early identification and services for children with mental health needs; calls for a major investment of Medicaid dollars into community behavioral health clinics; supports the expansion of the peer specialist workforce, through efforts (such as those underway at MHA) that will train peers to work as valued members of clinical care teams and provide for Medicaid reimbursement for peer support services in every state; calls for the diversion of nonviolent offenders with mental illnesses away from jails and prisons and into treatment and services; supports the expansion of housing, employment, and advocacy services for people with mental health conditions; and offers new initiatives that ensure that the provisions of the Mental Health Parity Act will be enforced.
"MHA also strongly supports the training of more mental health professionals and expansion of the mental health workforce; the promotion collaborative care; improvements to mental health services to returning veterans; the promotion of brain research, improvement of training of law enforcement officers; and a commitment to help end suicide in America. MHA believes that this plan will build on the bipartisan foundation for mental health that has been laid in Congress this year.
"While we all may find certain things missing in the plan - most notably how people might get to services in the future and for what beds and services Medicaid will pay in the long run - we believe the debates about these issues will continue and we welcome the evaluations of them that have been underway. It should be noted that this plan does not choose one approach or another.
"But what it does do is more important - it recognizes that without a comprehensive set of integrated services, discussions about payment mechanisms and consumer choice don't mean much. So its greatest strength may well be in its investments in creating more of those choices. In fact, this is all a matter of choice, and most importantly the policy choices we make. Together, we can change the trajectory of mental health policy in America. And this in turn will change the trajectories of lives.
"There is an emerging bipartisan consensus toward action today. This plan rests solidly within that consensus and adds to it. We applaud Secretary Clinton for offering it, and look forward to the day that mental health is truly seen as an essential part of overall health, and the brain as a most essential part of the body."
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Boston Globe Spotlight Team
The Desperate and the Dead
In late June, the Boston Globe Spotlight
Team launched the first of a series of articles about the Commonwealth's neglect of the seriously mentally ill. The third part, published on August 28, 2016 was a scathing indictment of money over mental health with devestating results:
"Massachusetts was once in the vanguard in mental health care, but budget cutting and policy failures put an end to that...Governors from Frank Sargent to Deval Patrick, House speakers, Senate presidents and other legislative leaders and federal officials together cut hundreds of millions of dollars in mental health spending over the last 50 years. They closed psychiatric hospitals but funneled comparatively little of the savings into community treatment programs--once successfully defying a federal court order requiring that they spend millions more. They stood by as community service provicers withered and shrank, and as counseling, psychiatric prescribing, and other services grew harder to access. They allowed state oversight to erode to dangerous levels."
A landmark court decision requiring states to treat the mentally ill in the least restrictive enviornment, along with civil rights activists pushing for allowing mentally ill patients to refuse treatment or medication, gave Massachusetts the opportunity to close facilities and dump people out in the street without providing any of the promised community services, thus saving the state "tons of money." Included in this exodus were many people who desperately needed their medication and the attendant clinical services, to curtail the voices pushing them towards violence. In addition, Massachusetts is one of the few states that does not have an Assisted Outpatient Treatment (AOT) program to add a layer of support and oversight to those who need it.
The critical point is this:
With the philosophy of money over mental health, and the naiivete of state officials about mental illness and its effects on people, everyone is a victim--the mentally ill who suffer needlessly without adequate treatment, their families who are frustrated about the lack of services, and the innocent bystanders who bear the brunt of untreated psychotic anger.
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NAMI COLLABORATES...
New Program at
Cape Cod Behavioral Health Inpatient Unit
 We are delighted to announce that Jud Phelps will be a familiar figure in the visiting room on Monday evenings. He and Pat Durgin, Director of the partial hospitalization program in the unit, have created an opportunity for visitors to have their questions and concerns addressed. Families, especially those for whom the current hospitalization is a new experience, are often overwhelmed, feeling bewildered by what is happening to their loved one. As well, they will be introduced to NAMI and the ways in which NAMI can help them.
NAMI CC&I has been approached by a parent and student at Falmouth High School, with the support of school administration, to help develop an ongoing educational mental health program for students. Anxiety, stress and depression are unfortunately prevalent in high school students who often feel confused and alone. This program will give them an opportunity to express their feelings and to address their concerns. We are looking forward to developing a model that can be used in other schools.
Community Crisis Intervention Team
NAMI CC&I has been invited to participate in a community case management group at the Dennis Police Department to try to find solutions to deal with mentally ill persons in their community for whom they receive repeated calls for help and intervention. Other Cape Cod police departments are also interested in this kind of discussion.
- Jud met with Sheriff Cummings in Barnstable to discuss jail diversion
- Jackie & Jud met with Judge John Julian of Barnstable District Court to discuss the benefits of NAMI programming for people who end up in his court. Also discussed was the idea of setting up a mental health court on Cape Cod similar to the drug courts
- Jackie met with the RCC to discuss joint programming
- Jackie met with the Director of Cape Cod Child Development to explore collaborating on the Basics program
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Coping With
BPD
:
DBT
and
CBT
Skills to Soothe the Symptoms of Borderline Personality Disorder
by Blaise Aguirre, MD and Gillian Galen, PsyD
People struggling with Borderline Personality Disorder face many emotional challenges that often interfere with their relationships. These challenges may lead to everything from conflicts that are resolved quickly, to resolution over a period of time, to long term estrangement. This guide will help people who suffer from BPD, as well as anybody who is feeling depressed, angry, anxious or worried.
The authors, who are clinicians at McLean Hospital, use
DBT
(a form of behavioral therapy) to teach skills that help a person react more effectively to overwhelming emotions. This guide addresses over 50 of the most common struggles people with
BPD
face, and offer evidence-based solutions to resolving the challenges.
The format is straightforward and easy to use. For each scenario there is a Problem Statement (an overview of a situation); What it looks like (an illustration of the problem based on real-world examples); The Practice (specific skills and techniques to that can be applied to solving the situation); Checklist (a list of questions to keep the reader on track with a solution).
Although this book was written for people diagnosed with Borderline Personality Disorder, the message and coaching skills communicated in Coping with
BPD
, are helpful to the common challenges humans face.
Kim Lemmon, Outreach Coordinator
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Look At Us Now, Mother
Award-Winning Film &
Panel Discussion
Co-sponsored by NAMI Cape Cod & Islands
Held August 17 at the Cultural Center of Cape Cod, a group of 60 watched a screening of Gayle Kirschenbaum's humorous, moving, intimate and courageous documentary about the transformation of her abusive mother and tumultuous mother-daughter relationship to one of acceptance and love.
Following the film there was a panel discussion featuring Emmy award-winning filmmaker Gayle Kirschenbaum, psychiatrist Tom Penders, MD and Pat Durgin, Director of Cape Cod Behavioral Healthcare's partial hospitalization program regarding the effects of an abusive mother/daughter relationship on daughters as well as ideas about forgiveness.
Audiences wanted to know how Kirschenbaum handled her highly critical mother and also shared their own stories.
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Mark Your Calendars--
There are several important events coming up and we would hate for you to miss them!
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MEMBERSHIP HAS ITS REWARDS:
Attention NAMI members:
The benefits of Yoga are numerous. This low impact exercise will decrease physical pain while increasing mental focus. It will help to "quiet your mind"! No Special Training Necessary!
On
Thursday, September 8t
h
@ 5:00 pm
Sasha's Yoga and Massage Studio, located at 23 MA 134, South Dennis,
is offering a free yoga class with Tina to NAMI members only.
Space is limited & registration is required.
Plan to arrive about 15 minutes early to sign a
healthy-to- exercise
waiver and set up your mat. Yoga mats & other props are available at the studio or bring your own.
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MGH Department of Psychiatry Fall Symposium: Managing Your Kid's Behavioral Health
Saturday, September 24, 2016
9:45 am - 3:30 pm
Check-in from 9:00-9:45 am
At: MGH
The Starr Center Auditorium
Charles River Plaza, 185 Cambridge Street, 2nd floor, Boston 02114
This free educational program is designed exclusively for patients, families and friends.
Topics:
- OCD/PANDAS
- Mood Disorders
- Disruptive Disorders
- Parenting Inflexible Kids
- Parenting Children with Eating Disorders
- Parent Panel
This event will also include "Lunch Table Talks" featuring expert faculty during the lunch break.
Seating is limited and pre-registration is required.
To learn more about the program and register, call 866-644-7792.
Complimentary coffee, tea, and lunch will be served.
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IF YOU DON'T PLAY GOLF, JOIN US FOR DINNER FOLLOWING THE GOLF PLAY
(Registration Required)
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We are thrilled to announce our 1st fundraiser in Nantucket--
Thanks to Kate Kling for her hard work and her inspiration to make this happen.
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You are invited to Dragonfly, the first annual
event to raise funds for NAMI CC&I on Nantucket
Wednesday, September 21st, 2016
5:30 - 8:00 pm
The Nantucket Hotel & Resort
77 Easton Street, Nantucket
Please join us for an evening to support the important cause of mental
illness on Nantucket. Enjoy complimentary beer, wine, and hors d'oeuvres, music by Jeff Ross, and bid at the silent auction.
To purchase tickets for $150, or if you cannot attend, but would
like to donate to NAMI CC&I on Nantucket,
click here
Net proceeds from Dragonfly will be donated to NAMI CC&I on Nantucket, an organization that serves individuals and their families who are affected by the broad spectrum of mental illnesses and neurological disorders through support, education and advocacy, and promotes wellness for all. For more information, visit
www.namicapecod.org.
NAMI CC&I on Nantucket is a 501(c)(3) non-profit organization.
Your donation is tax-deductible.
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A special thank you to our sponsors:
GOLD SPONSOR
The Wilson Foundation
SILVER SPONSOR
Hanley Development
BRONZE SPONSORS
Cape Cod Five Cents Savings Bank Charitable Foundation Trust
Clean Lines Construction
Eric & Patrick Dorton
Diane Firsten
Don Allen Chrysler Jeep Dodge Ram
J Pepper Frazier Real Estate
Nantucket Bank
Nantucket Golf Club Foundation
Vaughan, Dale, Hunter
and Beaudette, P.C.
IN KIND SPONSORS
Jeff Ross
La Rock Events
Marquis Creative
Nantucket Blackbook
Nantucket Hotel & Resort
N Magazine
97-7-ACK-FM True Island Radio
The many people who donated auction items
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Dance in the Rain
Whole Person Approach
Peer to Peer Services
Individuals with mental health challenges helping and supporting one another and the families that support them.
Dance in the Rain is presenting it's 3rd Annual coffeehouse fundraising event 'Underground Asylum' Tuesday evening November 15, 2016 at the Doubletree Inn Vine Room.
We are looking for people willing to donate their time and talent for our 'open mike'. Singers, musicians, digital art displays, comedians, expressive readings, expressive storytellers, poetry or any other coffee house open mike performance. Please go to our webpage: http://www.danceintherain-wpa.org/underground-asylum-2016.html to see how you can become involved in Underground Asylum 2016.
Mary E Munsell, founder and executive director and peer of Dance in the Rain, is presenting a 6-week workshop beginning Wednesday September 7, 2016. The workshop will run every Wednesday from 12:30pm to 2:00pm at the Dance in the Rain Office 145 Barnstable Rd.
The workshop is call: 'Building Wholeness Healing Fractured Lives'. It's a program of healing and moving forward for people with mental health challenges. The program is a culmination of over 37 years of Mary's experience living with mental illness. This program will challenge how you view mental illness and the possibilities of healing.
The program consists of five Building Blocks that build upon each other and link together to form a whole program. There are worksheets that will be done 'group style' to elicit the participants to look deeply inside themselves to answer each question posed. Included are evaluations for each block and daily journals.
Come build and create the life you are meant to live upon a new foundation of understanding and accountability. See the front page of our website to read more and sign up for this opportunity to kick start your healing process among people who understand http://www.danceintherain-wpa.org
The workshop is free, all materials supplied and it is limited to 6-8 participants. Spaces are filling up so check out our website and see if this program is a fit for you.
Bridging the Gap Peer/Family Program
Helping to bridge the gaps in family relationships that develop when there is a mental health challenge within the family unit.
Come as a family or come alone. Learn from persons' with mental illness at all stages of healing and learn from families at all levels of experience.
Begin learning how to open dialogue within the family to promote healing and understanding.
I
n coalition with NAMI Cape Cod & The Islands, Dance in the Rain is offering this program to help family and mentally challenged individuals (peers) learn to understand each other. Ask questions, bring up concerns, thought and emotions in an anonymous way. Hear both sides of the story to gain better understanding of the family dynamics and sometimes dysfunctional family dynamics that develop.
The meeting is always the second Tuesday of the Month.
The next meeting is:
Tuesday evening September 13 from 6:30pm to 7:30pm
Location: Dance in the rain Office - Upstairs at 145 Barnstable Road last office down the hall on the left.
Bring a dessert to share and let the healing and understanding of living as a family with a mental health challenge within the family unit.
www.danceintherain-wpa.org
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Tidbits...
The next Workshop with Dr. Stuart Ablon will be
Saturday, October 22, 2016
Nauset High School
Support Groups
NAMI Cape & Islands would like to extend appreciation and congratulations to the following members of the organization for participating in training to become Support Group Facilitators. Hope Freeman, Carolann
Gillard
, John Holman, Betty Anne Holman, Kim Lemmon, and Katharine Neadow. Jud Phelps, Director of Client Services, and long time Support Group Facilitator in Barnstable, and more recently
Harwich
, also participated with the group. Trainers were Betty
MacIntyre
and Kathleen
Considine
.
Support Groups are an important component of NAMI. These regularly scheduled meetings offer hope, emotional support, and camaraderie with others who can relate to similar challenges. It is our goal to offer more support groups in more locations. The lower and outer cape particularly would benefit by increased leaders facilitating in more locations.
Anyone interested in learning more about training to become a Support Group Facilitator or a Family-to-Family teacher, please contact the office at 508-778-4277. You may also contact Kim Lemmon by email: [email protected]
Lawyer For A Day--Free Legal Advice
Held daily at the Barnstable Probate Court. It is advisable to arrive promptly when it opens at 9:00 am as it is first come, first served and fills up quickly.
Inclusions in the Newsletter
We have recently been asked for last minute inclusions of events in our newsletter. We have instituted a new policy: It is at the discretion of the Executive Director to determine whether content being submitted for distribution to the membership is aligned with our mission. If the content is determined to be appropriate, it may be included in the monthly e-newsletter if it is submitted prior to the first of the month.
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