JULY  2016

From the desk of Mary Zdanowicz, Esq.

Families Helping Families
On July 6, 2016, H.R. 2646 - Helping Families in Mental Health Crisis Act of 2016 - passed the House of Representatives by a vote of 422 - 2. Representative Tim Murphy sponsored the bill and garnered bipartisan support to pass this important legislation. His powers of persuasion are no doubt due to the passion derived from his experience as a family member (see his testimony below).

It is worth taking a look at the transcript of the House debate and vote, not only because the bill is so important to families, but because it provides a rare glimpse of Congress working in a bipartisan manner to help people in need. A transcript of the floor debate and vote can be found at this link. 

       Excerpts from the floor:
Representative Bernice Johnson (D-TX) was Chief Psychiatric Nurse at the Dallas Veterans Administration Hospital and is a dedicated advocate for people with serious mental illnesses and their families. She was one of the first sponsors of the bill:

"Mr. Speaker, I rise today in support of H.R. 2646, the Helping Families in Mental Health Crisis Act. As the original Democratic cosponsor of this piece of legislation and the one that preceded it, I am proud to see it come to the floor today. 

The end result is a bill that remains focused on enabling the most severely and mentally ill to access the treatment they desperately deserve, while allowing their families and caregivers to help them along the way.

This piece of legislation contains several necessary provisions, including the establishment of an Assistant Secretary 
for Mental Health and Substance Use Disorder, easing our Nation's chronic shortage of psychiatric beds, requiring the Secretary of Health and Human Services to clarify confusing HIPAA rules surrounding mental health patients, and increasing grant programs with results proven to help individuals with serious mental health illness gain access to treatment like Assisted Outpatient Treatment and Assertive Community Treatment."

Representative Tim Murphy (R-PA) is the chief sponsor of the bill and provided the most powerful testimony. It should c
ome as no surprise that he is a family member. 

"I ask my colleagues now ... this is one of those moments to put aside any political differences. In the 40 years that I have worked as a psychologist, I have never once asked any of my patients what party they belonged to. We were there to help them. This is our opportunity to speak up for those who have no voice, as I said at the onset, the last, the lost, the least, and the lonely. They depend on us.

I know that Members from both sides of the aisle have told me many times of the stories that they have suffered themselves of their own families and friends.  But now let me take a moment to set aside my title as Congressman or as doctor but to talk as a family member.

I think I was in college at the time when I heard a soft voice call in my house just saying ''help.'' It was my father. I went into the bathroom where he was. He had cut the arteries in his arms and he was bleeding out. I called an ambulance and asked them to come get help for him. He eventually recovered and made peace. But it was that soft voice calling for help that I responded to.
It is decades later and he is long gone. But it is that soft voice that millions of Americans are also calling out for help.  We have a chance here with this bill to make a huge difference. Unlike any other bills we may pass in Congress, this 
is one where I think Members can really go back and say: Today I voted to save lives.
Let's have treatment before tragedy, because where there is help, there is hope."
H.R. 2646 was referred to Committee in the Senate. Congress leaves Washington for the
month of August, but the Senate is scheduled to return on September 6th.
Ask our Senators to support H.R. 2646!
Senator Edward Markey
(202) 224-2742
Senator Elizabeth Warren
(202) 224-4543
       Massachusetts Department of Mental Health   
                              FY 2017 Budget
Governor Baker signed the FY 2017 budget on July 8th. In most categories, the increases are higher than the projected rate of inflation (1.5%).
Adult Mental Health and Support Services  - $ 5.5 million increase (1.5%)
Adult Community-Based Placements - $1.1 million increase (37.9%)
Inpatient Facilities and Community Based Mental Health - $14.9 million increase (7.8%)
Homeless Services - $ 1.5 million increase (7.1%)
Emergency Services - $ 0.1 million increase (0.4%)
Forensic Services - $0.5 million increase  (5.5%)
The Governor did not strike earmarks for the programs that we have been following:
    State Hospitals


DMH shall not take action in fiscal year 2017 to reduce the number of state-        operated  continuing care inpatient beds.


   DMH shall maintain not less than 676 inpatient beds in its system in fiscal year 2017

  • Not less than 50 beds shall be continuing care inpatient beds on the campus of Taunton State Hospital

                              Assisted Outpatient Treatment
Funding will continue for the assisted outpatient treatment pilot program at Elliot Community Human Services to treat residents who suffer from serious and persistent mental illness and experience repeated interaction with law enforcement or have a high rate of recurring hospitalization due to their mental illness, either through a voluntary agreement with the resident, or by court order mandating that the resident receive the treatment described in this program.
DMH, in conjunction with Elliot Community Human Services, shall produce an Assisted Outpatient Treatment Pilot Analysis Report that includes baseline and current metrics related to clients served including, but not limited to:
(i)     behavioral and physical medical diagnosis;
(ii)    status of activities of daily living, including food, shelter, and employment;
(iii)   psychiatric hospitalizations;
(iv)   treatment history; and
(v)    insurance status;
The report shall define the factors that proved successful in treating pilot participants including practices used and type of staff functions necessary for success in treating pilot participants; provided further that the report shall identify issues and practices that present barriers to successful treatment; and provided further that the report shall include a cost analysis of treatment. The report shall also include a plan for creating a sustainable program based on information from the analysis report and shall include a proposal for a sustainable course of funding to implement the program.



    Mental Health...And Where They Stand

At the last NAMI Members' Meeting, it was suggested that we inform members of where our politicians stand regarding mental health.  

N YAPRS Note: Here're some excerpts from both parties' recently released policy platforms as regards the needs of those with mental health and addiction related issues.
2016 Democratic Party Platform (NYAPRS Excerpts) 
We will tackle the problems that remain in our health care system, including cracking down on runaway prescription drug prices and addressing mental health with the same seriousness that we treat physical health. 
Community Health/MH Centers: Double the Funding, Workforce Training and Support
We must renew and expand our commitment to Community Health Centers, as well as community mental health centers and family planning centers. These health centers provide critically important, community-based prevention and treatment in underserved communities, prevent unnecessary and expensive trips to emergency rooms, and are essential to the successful implementation of the ACA. 
We will fight for a comprehensive system of primary health care, including dental, mental health care, and low-cost prescription drugs by doubling of funding for federally qualified community health centers over the next decade, which currently serve 25 million people.
Democrats also know that one of the key ingredients to the success of these health centers is a well-supported and qualified workforce in community-based settings. We will fight to train and support this workforce, encourage providers to work with underserved populations through the National Health Service Corps, and create a comprehensive strategy to increase the pool of primary health care professionals.
Combating Drug and Alcohol Addiction: Parity Enforcement, Education, Prevention, Peer Mentorships
We must confront the epidemic of drug and alcohol addiction, specifically the opioid crisis and other drugs plaguing our communities, by vastly expanding access to prevention and treatment, supporting recovery, helping community organizations, and promoting better practices by prescribers. The Democratic Party is committed to assisting the estimated 20 million people struggling with addiction in this country to find and sustain healthy lives by encouraging full recovery and integration into society and working to remove common barriers to gainful employment, housing, and education.

We will continue to fight to expand access to care for addiction services, and ensure that insurance coverage is equal to that for any other health conditions. We think it is time for the Department of Health and Human Services (HHS), the Department of Labor, and state regulatory agencies to fully implement the protections of the Mental Health Parity and Addictions Equity Act of 2008-which means that American medical insurers, including the federal government, will need to disclose how they make their medical management decisions.

We should also do more to educate our youth, as well as their families, teachers, coaches, mentors, and friends, to intervene early to prevent drug and alcohol abuse and addiction. We should help state and local leaders establish evidence-based, age-appropriate, and locally-tailored prevention programs. These programs include school-based drug education programs that have been shown to have meaningful effects on risky behavior; community-based peer mentorship and leadership programs; and after-school activities that deter drug use and encourage life skills.
Treating Mental Health Issues: Increase Access, Enforce Parity, Prevent Suicide
We must treat mental health issues with the same care and seriousness that we treat issues of physical health, support a robust mental health workforce, and promote better integration of the behavioral and general health care systems. Recognizing that maintaining good mental health is critical to all people, including young people's health and development, we will work with health professionals to ensure that all children have access to mental health care. We must also expand community-based treatment for substance abuse disorders and mental health conditions and fully enforce our parity law. And we should create a national initiative around suicide prevention across the lifespan-to move toward the HHS-promoted Zero Suicide commitment.
Veteran's Mental Health Needs: Service Expansion, PTSD Treatment
We will fight for every veteran to have timely access to high-quality health care and timely processing of claims and appeals. We must also look for more ways to make certain the VA provides veteran-centric care, such as providing women with full and equal treatment, including reproductive health services; expanding mental health programs; continuing efforts to identify and treat invisible, latent, and toxic wounds of war; treating post-traumatic stress; and expanding the post-9/11 veteran's caregiver program to include all veterans. We reject attempts by Republicans to sell out the needs of veterans by privatizing the VA. We believe that the VA must be fully resourced so that every veteran gets the care that he or she has earned and deserves, including those suffering from sexual assault, mental illness and other injuries or ailments.
Preventing Gun Violence: Ensure Those with 'Severe Mental Health Issues' Don't Have Guns
....We will fight back against attempts to make it harder for the Bureau of Alcohol, Tobacco, Firearms, and Explosives to revoke federal licenses from law breaking gun dealers, and ensure guns do not fall into the hands of terrorists, intimate partner abusers, other violent criminals, and those with severe mental health issues.
There is insufficient research on effective gun prevention policies, which is why the U.S. Centers for Disease Control and Prevention must have the resources it needs to study gun violence as a public health issue.
2016 Republican Party Platform (NYAPRS Excerpts)
Block Grant Medicaid to Promote State Solutions to Helping Individuals and Families w MH Needs
Medicaid presents related, but somewhat different challenges. As the dominant force in the health market with regard to long-term care, births, and persons with mental illness, it is the next frontier of welfare reform. It is simply too big and too flawed to be administered from Washington.

...Block granting Medicaid is particularly needed to address mental health care. Mental illness affects people from all walks of life, but there has been little success in developing effective system-wide medical models for addressing mental health. For a variety of unique reasons, government is often the first frontier for people experiencing mental health problems - from first responders who deal with crises to publicly funded mental health facilities and prisons where large numbers of inmates suffer from mental illnesses. 
Using block grants would allow states to experiment with different systems to address mental health and develop successful models to be replicated in states across the nation. The current federally dictated mental health care regime is wasteful and ineffective, and moving to a block grant approach would allow for state and local governments to create solutions for individuals and families in desperate need of help in addressing mental illness.
Combatting Drug Abuse: Reduce Over-prescription of Opioids, CARA Agreement
The misuse of prescription painkillers -opioids - is a related problem. Heroin and opioid abuse touches our communities, our homes, and our families in ways that have grave effects on Americans in every community. With a quadrupling of both their sales and their overdose deaths, the opioid crisis is ravaging communities all over the
country, often hitting rural areas harder than urban.

Because over-prescription of drugs is such a large part of the problem, Republican legislation now allows Medicare Part D and Medicare Advantage plans to limit patients to a single pharmacy.

Congressional Republicans have also called upon the Centers for Medicare and Medicaid Services to ensure that no physician will be penalized for limiting opioid prescriptions. We look for expeditious agreement between the House and Senate on the Comprehensive Addiction and Recovery Act, which addresses the opioid epidemic from both the
demand and supply sides of the problem.
Oppose Mandatory MH, Psychiatric, Socio-Emotional Screening Programs
We oppose school-based clinics that provide referral or counseling for abortion and contraception and believe that federal funds should not be used in mandatory or universal mental health, psychiatric, or socio-emotional screening programs. The federal government has pushed states to collect and share vast amounts of personal student and  family data, including the collection of social and emotional data. Much of this data is collected without parental
consent or notice. This is wholly incompatible with the American Experiment and our inalienable rights. 
Modifications to Mandatory Minimum Sentencing for Nonviolent Offenders w BH Issues
In the past, judicial discretion about sentences led to serious mistakes concerning dangerous criminals. Mandatory minimum sentencing became an important tool for keeping them off the streets. Modifications to it should be targeted toward particular categories, especially nonviolent offenders and persons with drug, alcohol, or mental health issues,and should require disclosure by the courts of any judicial departure from the state's sentencing requirements. 
More Focus on Faith-based Aid to Vets
The burden of our country's extended military involvement in the Middle East has taken a toll on our service personnel. Suicides among our military -active duty troops, reservists, National Guardsmen, and veterans - are at shocking levels, while postservice medical conditions, including addiction and mental illness, require more and more assistance. More than ever, our government must work with the private sector to advance opportunities and provide  assistance to those wounded in spirit as well as in body, whether through experimental efforts like the PAWS (Puppies Assisting Wounded Servicemen) program for service dogs or through the faith-based institutions that have traditionally been providers of counseling and aid.

Over-prescription of opioids has become a nationwide problem hindering the treatment of veterans suffering from mental health issues. We therefore support the need to explore new and broader ranges of options, including faithbased programs, that will better serve the veteran and reduce the need to rely on drugs as the sole treatment.

                             Boston Globe Spotlight Team

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. Their investigations into the mental health care "system" in Massachusetts revealed:
"threadbare policies, broken promises, short-sighted decisions, and persistent underfunding over decades."
"As a result, the seriously mentally ill, including those at greatest risk of harming others or themselves, are far too often left in the care of parents, police, prison guards, judges, shelter workers, and emergency room personnel - almost anyone, in fact, but professionals trained to deal with their needs."
The writers deal with the issue of untreated mental illness and violence, which is something that cannot be ignored because, as they recognized:
"few have paid a higher price for the dismantling of the mental health care system than the loved ones of people with a serious mental illness."
The critical point is this:
"Studies show that people with a serious mental illness are no more prone to violence than anyone else - when 
they get the help they need. But when they do not, drifting away from therapy and medications, often into the grip of alcohol or drugs, the risk of violence sharply escalates."
Ensuring that people receive treatment when they need it is the only way to end the violence.
The Desperate and the Dead: Families in Fear , Boston Globe, June 26, 2016.
Boston Globe Editorials
In early July, the Boston Globe Editorial Board weighed in with two important editorials.

Massachusetts "is one of only four states without a law that gives the courts a clear path to compel mentally ill patients with a history of noncompliance to undergo medical treatment. Adopting such a law in Massachusetts would be far from a comprehensive response to the problems detailed in the Spotlight report, but it would make it far harder for the state to blow off any responsibility - at least before troubled patients are arrested or readmitted to a limited number of inpatient psychiatric facilities."

 "The thinking behind deinstitutionalization may have been rooted in sincere intentions, but the result has ruptured the most basic tenants of health care, leaving the most vulnerable people - and their families- with little recourse. Freeing patients from hospitals wasn't enough. We also have to provide the ongoing care that allows them to stay out."
Facing the aftermath of psychiatric hospitals (July 7, 2016)
You can follow the moderated discussion about the Boston Globe Spotlight Series on Facebook: 

The mental health care system in Massachusetts is broken. It's stretched thin, deeply fragmented, and severely underfunded. This summer, the Boston Globe's Spotlight team looks at where and how care for the mentally ill is failing and how those failures are making life more dangerous. This moderated group is open to those wishing to discuss these problems, personal experiences, and possible solutions. Members are requested to be respectful and appropriate. Comments that are not respectful or include foul language will be deleted and members may be barred.



Barnstable County Department of Human Services reports that Barnstable County has the oldest population in New England, and it has one of the oldest populations on the East Coast.
Depression in this population is often overlooked and underdiagnosed.  People age 65 and older are less likely than any other age group to report their symptoms to their doctor and are more likely to "handle it themselves."
Risk factors for depression in this population include, but are not limited to:  loss of a spouse; lack of a social network; living in an institutional setting; chronic pain and/or medical conditions; side effects from medication(s); family history of a major depressive disorder.

Recognizing clinical depression vs. a case of the "blues" can be challenging.  Generally, if a person is exhibiting symptoms for more than a two-week period, a visit to the doctor is recommended.  What to look for:  lack of energy; ongoing sadness and anxiety; loss of interest in regular activities; sleep problems (too little or too much sleep); eating more or less than usual; difficulty focusing, remembering, or making decisions; physical pain that doesn't go away when treated; irritable mood; thoughts of death or suicide.

Often the first person to notice depression is a family member or caregiver.  Depression is not a normal part of aging. Depression is treatable and can change a senior's life.  Different treatments work for different people.  Antidepressant medications can improve mood, sleep, appetite, and concentration.  There are different methods of talk therapies that work over time to help a person think differently about their life.  Studies show that 80% of seniors recover well from depression.

If you are concerned that somebody you know is suffering from depression, encourage a visit to the primary care physician.  It is  important to have a medical evaluation to identify any medical condition that may be a contributing factor.
  By Kim Lemmon


Furiously Happy:  A Funny Book       About Horrible Things

In Furiously Happy,  Jenny Lawson explores her lifelong battle with mental illness. A hysterical, ridiculous book about crippling depression and anxiety? That sounds like a terrible idea.
But terrible ideas are what Jenny does best.

As Jenny says:
"Some people might think that being 'furiously happy' is just an excuse to be stupid and irresponsible and invite a herd of kangaroos over to your house without telling your husband first because you suspect he would say no since he's never particularly liked kangaroos. And that would be ridiculous because no one would invite a herd of kangaroos into their house. Two is the limit. I speak from personal experience. My husband says that none is the new limit. I say he should have been clearer about that before I rented all those kangaroos.

Like John Hughes wrote in The Breakfast Club, 'We're all pretty bizarre. Some of us are just better at hiding it.' Except go back and cross out the word 'hiding.'"

Furiously Happy  is about "taking those moments when things are fine and making them amazing, because those moments are what make us who we are, and they're the same moments we take into battle with us when our brains declare war on our very existence. It's the difference between "surviving life" and "living life". It's the difference between "taking a shower" and "teaching your monkey butler how to shampoo your hair." It's the difference between being "sane" and being "furiously happy."

This is a book about embracing everything that makes us who we are - the beautiful and the flawed - and then using it to find joy in fantastic and outrageous ways. 

Because as Jenny's mom says, "Maybe 'crazy' isn't so bad after all." Sometimes crazy is just right.

Mark Your Calendars--
        There are several important events coming up and we would           hate for you to miss them!
Borderline--Feature Documentary
July 31, 2016 at 5:00
T he first time Regina tried to kill herself, she was 5 years old.  Now she's 45 and hell-bent on trying to live. People say having a Borderline Personality Disorder (BPD) diagnosis is equivalent to walking through life with a Do Not Resuscitate order. To the extent that it is portrayed in popular culture, the disorder is often caricatured, turned into something cartoonish and pathetic: shrieking outbursts, bleeding eyeliner, dark mascara and slashed wrists. This film does not do that. 

BORDERLINE is the first documentary film to capture the lived experience of Borderline Personality Disorder. The film follows one person with the borderline diagnosis who gives us access to her internal world. Regina is a 45-year old woman - outta work and outta love. Witty and self-aware, she makes observations that are uncomfortable but astute, reacts on impulse, attacks, distracts, meditates, trips over herself, laughs, burns bridges, makes social gaffes, apologizes, loses her cool, philosophizes and remains dogged in her search for recovery.
      Look At Us Now, Mother
Award-Winning Film &
Panel Discussion 
Wednesday, Aug 17
Cultural Center of Cape Cod
7:30 pm

Join us for 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. Kirschenbaum writes, "Some years ago, I made a short funny film called MY NOSE about my mother's relentless campaign to get me to have a nose job. The reaction was overwhelming from audiences and the media.

Audiences wanted to know how Kirschenbaum handled her highly critical mother. "After screenings, audience members shared their stories. Unexpectedly, she found herself teaching people how she did it by using her 'Seven Healing Tools' on how to transform abusive relationships. "I soon realized, that it was my mission to tell my whole story. That's why I made this deeply personal feature documentary,  LOOK AT US NOW, MOTHER!"

Co-sponsored by NAMI Cape Cod & Islands (National Alliance of Mental Health).

Following the film there will be a panel featuring Emmy award-winning filmmaker Gayle Kirschenbaum and mental health professionals to discuss abusive mother/daughter relationships and Borderline Personality Disorder. 

Please join us for this very special event. 

NAMI CC&I Members receive a discounted rate of $10.00  (Non members pay $12.00)

                       (Registration Required)

  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.

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, 

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.

A special thank you to our sponsors:
The Wilson Foundation
Hanley Development
Cape Cod Five Cents Savings Bank Charitable Foundation Trust
Clean Lines Construction
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.
Jeff Ross
La Rock Events
Marquis Creative
Nantucket Blackbook
Nantucket Hotel & Resort
N Magazine
The many people who donated auction items

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.
           Bridging the Gap Peer/Family Program

Helping to bridge the gaps in family relationships that develop when there is a mental health challenge with in 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 Island Dance in the Rain is offering this program to help family and mentally challenged individuals learn to understand each other.  Ask questions, bring up concerns, thought and emotions in a completely anonymous way.  Hear both sides of the story to gain better understanding of the family dynamics ans sometimes dysfunctions family dynamics that develop.

The meeting is always the second Tuesday of the Month.
The next meeting is: 
          Tuesday evening August 9 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.

Save The Date
The next Workshop with Dr. Stuart Ablon will be 
                Saturday, October 22, 2016
                           Nauset High School

Support Groups

NAMI CC&I has just completed Support Group Facilitator training and has certified 6 new Faciliators.  We will be having another training in the fall for additional facilitators.  Our goal is to increase the areas in which support groups will be offered. If you feel a particular area needs a support group, please let us know.
  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.