OCTOBER   2016
From the desk of Mary Zdanowicz
If elected on November 8th, how would Cape & Islands candidates for the Massachusetts Senate and House support adequate access to Mental Health Care?

Candidates for the Massachusetts were Senate and House were asked to respond to survey questions, one of which addressed mental health. Responses to that question from Cape & Islands candidates are listed in the table below.

QUESTION:  How can the legislature best support adequate access  to mental health care in  Massachusetts?
Senate Candidates
Julian Andre Cyr
We must address scarce services and inconsistent coverage through proposals such as improving reimbursement rates to incentive providers to offer high quality services in areas such as behavioral health. We must provide community-based services where appropriate, rather than using the criminal justice system as a default mental health provider. I support training for police, partnerships between law enforcement & mental health providers, & resources for programs serving high-risk populations.
Anthony E. Schiavi
Creation of more beds equitably distributed across the commonwealth. Ensure more access to beds for women which the Gov has started so that they are not sent to the prison in Framingham and get proper care for MH issues. That effort needs to continue...as well as more options closer to or on Cape Cod/Islands. These options need to be accessible to all and not based on economic circumstances.
House Candidates
2nd District Barnstable
William L. Crocker Jr.
The problem of access to mental health care in Massachusetts comes down to treatment beds. There are not enough treatment beds on Cape Cod, plain and simple. An effective State Representative would work to obtain more funding in that area. Many of our addiction and homeless problems have direct links to mental illness. Long term rehabilitation beds are critical to tackling the mental health issues affecting Cape Cod.
Aaron S. Kanzer
The legislature should ensure that healthcare plans provide proper coverage for all forms of mental illness. It would also be conducive that the legislature promote an awareness campaign in order to educate the public as to how to recognize those struggling with mental illness, how to reach out to such people, and how to remove the stigma associated with mental illness that prohibits many from seeking the treatment that they need.
3rd District Barnstable
Matthew C. Patrick
The legislature should dedicate more resources to Department of Mental Health. We can do that by passing the Fair Share income tax that will dedicate the revenue to rebuilding our infrastructure, education and mass transportation. We can then take some of the revenue currently dedicated in those areas to provide DMH with adequate resources.
Barnstable, Nantucket & Dukes District
Dylan A. Fernandes
We must provide funding for mental health facilities and require parity for mental health treatment in our health insurance plans. This is particularly important given the strong mental health component of the current heroin and opioid crisis. My stepfather founded the first sober house in Nantucket and I understand very personally how important it is to address the mental health needs of our community.
Tobias B. Glidden
Having lost my father to mental illness, and having sisters and friends who suffer from mental illness, this is a very personal issue from me. I want to propose a far-reaching solution to this devastating and intimate problem: universal health care. We cannot continue to expect those who are in a state of mental crisis to put up the money to get the help they need.
   Source: Vote 411 Voter Guide

From the desk of Mary Zdanowicz, Esq.

                      Cape Cod Healthcare Community Needs Report


     On October 3, 2016, Cape Cod Healthcare released the Community Needs Health Assessment Report and Implementation Plan 2017-2019. The report describes major health findings based upon a comprehensive needs assessment for Barnstable County. A Joint Implementation Plan for Falmouth and Cape Cod Hospitals describes the goals, objectives and initiatives associated with four health priorities identified in the report.
Barnstable County Behavioral Health Findings and Priorities  (Report pp.14-15)
     One of the major health findings is well known to NAMI Cape Cod & The Islands. "Mental health and substance use disorders have a profound impact on individuals, families and the entire community."
     Behavioral Health is one of the four health priorities addressed in the Implementation Plan. As described in the report, Behavioral Health is an "overarching priority" that encompasses both mental health and substance use and "recognizes the co-occurrence and comorbidities that exist for many individuals with substance use and mental health disorders."
Behavioral Health Goals, Objectives and Outcomes  (Implementation Plan pp. 3-4)
     The goal for Behavioral Health is to "strengthen regional health services and community resources for individuals with mental health, substance use, co-occurring disorders, and comorbidities."

     The objectives include: expanding hospital-based services and collaborations to assess and address mental health, substance use disorders and co-occurring disorders in various care settings; and strengthening the regional network of care for individuals with mental health and substance use disorders.
     Expected outcomes include: Community Benefits grants to fund efforts to expand access and navigation of behavioral health services; and telemedicine to expand access to behavioral health services in the region.
Overview - Behavioral Health  (Report pp. 21-26 & Appendix D) 
     Behavioral health statistics gathered during in the needs assessment are sobering.
     The rate of hospital emergency department discharges for mental health disorders in Barnstable County was statistically higher than the state overall. Barnstable County had a significantly lower rate of hospitalizations for mental disorders than the state overall, which validates the concern that it is difficult to achieve hospitalization for individuals with mental illnesses. 
     The emergency room discharge and inpatient data for alcohol/substance-related hospitalizations and emergency department discharges showed the same results.
      In 2012, Barnstable County's rate of suicides was significantly higher than the rest of the state. Barnstable County's number suicide deaths increased from 26 in 2009 to 32 in 2012.
Additional Information of Interest
  •  Extensive Demographic Information for Barnstable County.  (Report pp. 13-17, Appendix C)
           Needs not addressed: transportation, housing and homelessness, and employment.  (Report pp. 36)
           Resources and service providers.  (Report pp. 37-38)
                                                    Monitoring Patient Care
     In a recent article about incidents of patient harm in psychiatric hospitals, the authors called for more attention towards the monitoring and safety of such care at private psychiatric hospitals, noting problems at Universal Health Services (UHS) facilities in particular [1]. UHS is a nationwide chain of private, free standing psychiatric hospitals. There are seven UHS hospitals in Massachusetts. One is in Pembroke, MA, and frequently admits patients from Cape Cod and the Islands. Pembroke Hospital, with 78 adult, 19 geriatric, and 18 adolescent beds, has a 90% occupancy rate [2].
     Department of Mental Health (DMH) inpatient facilities are subject to extensive operational regulations, monitoring and reporting. [3] These requirements are also applicable to licensed private facilities. However, a legislative committee noted in 2014 that DMH has few resources for monitoring licensed private hospitals and because DMH is not the payer for these services, it has little leverage to control how units actually function within the overall system. [4]
     Despite these limitations, the state conducted surprise inspections earlier this year that uncovered significant issues at four of seven UHS psychiatric hospitals in Massachusetts, one of which was Pembroke Hospital. Patient care problems were prevalent and DHS Commissioner J oan Mikula appointed a "clinical monitor'' to be a "consistent presence" and oversee improvements. [5]
     Since that time, there have been media reports of additional issues and concerns about Pembroke Hospital, which is the largest private hospital in Southeast Massachusetts. [6]
     M any of our members are unable to get information about family or friends who are admitted to hospitals, such as Pembroke, due to privacy concerns. For that reason, NAMI CC&I will try to monitor the situation. We have reached out to DMH to inquire about the status of the monitoring and corrective action measures that are in place.

     Nonetheless, it is important to note that some families have reported good experiences with the Pembroke Hospital, some recently.

[1] Is Anybody Paying Attention? Harm And Death Within Inpatient Psychiatric Facilities, Huffington Post, 10/19/16 http://huff.to/2eKfcOd
[2] Mental Health Advisory Committee Report Phase I and Phase II Final , June 30, 2014, pp. 13-14. http://bit.ly/2eKdLQ3
[3] e.g., 1 04 CMR 27.00, et seq.
[4] Mental Health Advisory Committee Report, see [2] above.
[5] State assigns monitor to oversee hospitals - Surprise inspections revealed multiple deficiencies, Boston Globe, May 5, 2016 http://bit.ly/2dPSxym


The NAMI CC&I ADVOCACY NETWORK is focusing on the needs of adults with serious mental illnesses (SMI) and their families.

The Network will:
  • identify priority topics to form the foundation of the advocacy program;
  • monitor legislation, regulations, and policy developments; and
  • develop a strategy for effective communication with NAMI CC&I members, stakeholders, policymakers and the public.
Send an email to  advocacy@namicapecod.org  to join.


Register for the 
2016 NAMI Mass Annual Convention!

 Saturday, October 29, 2016, 8:00 am - 4:00 pm

Journey of Hope and Recovery

K eynote Speaker: Dr. Ken Duckworth, NAMI Medical Director
"First Episode Psychosis, New Technologies for Mental Health Recovery; and Smoking Cessation"
Breakfast buffet will be available
Registration: 8:00 - 11:00 am
Welcome: 9:00 am
2-Minute Speeches by Board Candidates: 9:15 am
Morning workshops: 10:00 - 11:30 am
Luncheon, Awards & Keynote Speaker 12 - 2pm
                            Afternoon workshops: 2:30 - 4:00 pm
For more information or to register:   www.namimass.org 


Recognizing Mental Health Awareness Month on Nantucket: A Movie and the Book

On October 19th, I attended a screening of the popular movie Silver Linings Playbook, based on the novel of the same title by Massachusetts author, Matthew Quick. The film, featuring Bradley Cooper and Jennifer Lawrence, focuses on the situations and family dynamics which develop when Pat, the main character, is released from a mental institution into his mother's custody.
The movie is well done in a "Hollywood" way and has a really sweet tear jerker ending. That being said, the movie does manage to demonstrate many of the fissures in the relationships within the family, leading one to imagine why Pat had anger issues and mental health issues which brought him to the place he is at when we, the viewers, meet him. In this sense, the film is thought provoking, if one is tuned into the broad spectrum of mental health issues that prevail in today's society. 
Several mental health professionals were in attendance and an interesting discussion ensued.
I had not seen the movie and in preparation for the event, I read the book. If one wants to get the full impact of the story and message that Matthew Quick is relaying, reading the book adds another and much more impactful layer of understanding. The characters in the book are fully developed and the relationships are sharper and rawer and, in my opinion,  much closer to the reality that we at NAMI CC&I see in our Family 2 Family classes, our support groups, and our many support calls. I would love to see a book discussion group!
I would recommend both the movie and the book although I maintain that the book, a quick read, will render a deeper understanding of the reality of mental illness and its effects on family relationships.
A special thank you to the Silver Light Theater of Nantucket for sponsoring this screening at no cost to the non profits.

We are pleased to announce that Ruth Blount of Nantucket has joined our staff as our Nantucket liaison.  Ruth has been a long time NAMI CC&I volunteer and is a former member of the Board of Directors of NAMI CC&I. As a trained NAMI CC&I Family 2 Family teacher and a NAMI Basics teacher, Ruth has taught several times on the Island impacting the lives of many in need of help in dealing with the family dynamics associated with mental illness. She has also been unofficially serving as our "point person" on the Island for quite some time.
We feel that Ruth is a perfect fit for this position since as a longtime resident of Nantucket, she is familiar the unique issues of the island and its people. This knowledge, along with her caring and giving nature, make Ruth the ideal "go to" person for island families. We are looking forward to this opportunity to further meet and better serve the needs of Nantucket.
Ruth can be reached at NAMIonNantucket@gmail.com
Strategic Planning for Nantucket
On Tuesday, October 16, I met with several of our Nantucket members for a four hour strategic planning session. Due to the great success of Kate Kling's Dragonfly On Nantucket event held in September, there are additional monetary resources dedicated to building our services on the island.
In addition to hiring Ruth Blount as the official Nantucket point person, the group made plans to establish a therapist facilitated support group for adults ages 18-45, to hold a Family 2 Family class led by Sandy Kendall and Connie Voges this winter, to reinstate the NAMI Basics program, and to collaborate with other island agencies to sponsor Think:Kids as an in service training for the Nantucket schools staffs.
Additional marketing and publicity will also be developed in order to spread the word about our ever expanding island services.
Ruth, and we at NAMI CC&I, welcome your input on how we can better serve the needs of this important constituency.

Jackie Lane, Executive Director, NAMI Cape Cod & The Islands

                               Crisis Intervention Training (CIT) on Nantucket
I was pleased to represent NAMI CC&I at the CIT training presented by Kevin Marshall at the Nantucket Police Station the week of October 17th. It was a wonderful opportunity to explain our multifaceted mission of Education, Support, and Advocacy and how we as an organization can help those in the community who are dealing with the ramifications of having a mentally ill family member or friend.
The program consists of presentations by many community service organizations and also teaches the police how to recognize and deal with people experiencing a mental health crisis. This type of training has proven effective in preventing violence and even fatalities in community policing efforts.
As we as a society have come to understand that incarceration is not the answer when dealing with the mentally ill and that jail diversion and treatment are not only necessary for the individual, but make sense on a societal level.
Thank you, Kevin for making this program available. 


Nami Collaborates...
On Monday, October 24, Kim Lemmon and Jackie Lane met with several students at Falmouth High School to discuss and plan a student driven Mental Wellness Club. The format of the club, requested by a student who had suffered from anxiety and stress leading to a bout of severe depression and who wanted to share this experience in an effort to help others, has been collaboratively developed by the students, school officials, and NAMI CC&I. Dr. James McGuire, a Cape Cod child psychiatrist and a member of the NAMI CC&I Board of Directors, is helping as an advisor.

The club will meet twice a month, with the first meeting of the month being dedicated to thought and discussion provoking programming, targeting the issues of anxiety, stress, and depression and the second meeting of the month is planned to be an opportunity for the students to participate together in a "stress busting" activity, either physical or mental.
The goal of the programming is to help students recognize and understand anxiety, stress, and depression in themselves and their classmates, to know when and where to get help, and to understand that they are not alone in their struggles and feelings. Hopefully these issues can be more openly discussed in the high school setting leading to a reduction in the stigma attached to mental health issues.

We are finding that more and more schools, public and private, are seriously concerned with the mental health of their students and the stress levels that students are experiencing. These schools are responding with a variety of programming which is a positive sign that mental health is being treated as a "real" health issue.
We are hopeful that working with the FHS students and staff will help us at NAMI CC&I to develop a model Mental Wellness Club format that we can present to other schools in our service area. 
Thank You, students and staff of FHS for this opportunity to work together.


The second Workshop with Dr. Stuart Ablon was held on   Saturday, October 22, 2016  9:30 am - 3:00 pm
 at the Nauset High School in Eastham.

A group of parents, educators and mental health professionals learned the major tenets of Collaborative Problem Solving:  "Children will do well if they can", challenging children lack necessary skills--Skills NOT Will

Through case studies, personal experiences of the participants and anecdotes, Dr. Ablon  taught a rapt audience that the evidence-based collaborative problem solving strategies are the key to handling not just challenging children but all relationships.

For more information, visit the Think:Kids website.

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.

                         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.

The meeting WILL CHANGE to the third Tuesday of the Month.   The next meeting is: 
          Tuesday evening January 17 from 6:30pm to 7:30pm
        There will be no meetings in November and December

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.


NAMI Ask The Doctor: 

Helping a Loved One Understand the Need for                                        Treatment -  with 
Dr. Xavier Amador
Learn why some people living with mental illness believe they don't need help or see obvious symptoms, and how this can become an obstacle to helping them get help.

Dr. Amador will share information on overcoming this common obstacle using LEAP-Listen, Empathize, Agree and Partner. With LEAP, a person can quickly gain trust, lower anger and tension, develop genuine understanding and empathy making it possible to partner with a loved one and help them receive treatment.

Dr. Xavier Amador is an internationally renowned clinical psychologist and leader in his field. He is the author of many popular books include I Am Not Sick, I Don't Need Help about the LEAP method to overcome lack of insight into mental illness. It has been helping families help loved ones for years.

Ask the Doctor will be presented on November 3rd from 5:00 - 6:00 p.m., ET. Invitations to register in advance will be send to NAMI members in October. Limited registration, if possible will be offered to the public the day of the webinar and unlimited access to the recorded webinar after November 4th.

New Family to Family Course 
The next Family to Family classes will begin in January in Nantucket and in Barnstable at the YMCA.  If you are interested, call the office or email:   klemmon@namicapecod.org

New Support Group to Begin in Mashpee.  
A new support group, led by Hope Freeman and Terri Huff,  is forming on the 2nd Wednesday of the month beginning November 9 at the Mashpee Chamber of Commerce, 5 Market Street (next to Capeway Cleaners), 7:00 - 8:30 pm.

Grandparents Raising Grandchildren
Meets the third Friday of the month at 12:00 at the Barnstable Senior Center.
Call Kerry Bickford at 508-771-4336 for more information.

My Choice Matters:  Parenting To Prevent Substance Abuse
First Annual Parent Summit
Sunday, November 20, 12:00 - 3:30 pm at the Cape Codder Hotel in Hyannis
For more information, contact Kim Slade at kim.slade@barnstablecounty.org or 508-375-6845
  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.