AUGUST  2018 
                 New Bay Cove Crisis Line Phone #
                        As of July 1, 2018, the 24-hr Bay Cove Crisis Line will be changed to:
                                                        833 BAY-COVE (229-2683)
 


 


The 2018 Siobhan Leigh Kinlin Memorial Golf Tournament will be held on Monday, September 10, 2018 at the Oyster Harbors Club.  There are opportunities to join us for dinner and an exciting auction, become a Sponsor or have a Tee & Green sign for your company.  Visit our website for more information or to register.  

This tournament supports NAMI Cape Cod & the Islands free programs for the coming year.
 
From the desk of Jackie Lane, Executive Director  NAMI CC&I 



As we go into Labor Day Weekend, the last of the official summer season, we look back on a very hectic summer here at NAMI CC&I. During the past few tropical, energy-draining weeks, we have held a highly successful Dragonfly on Nantucket fundraiser, put the pieces in place for our ninth Memorial Golf Tournament to be held at Oyster Harbors on September 10th, and have planned our first Vineyard friend/fund raiser on September 14th as well as written grants and met with major donors to ensure funding for our 2019 ambitious programming goals. Our support line has been extremely busy throughout this summer and we have worked as a staff to connect people in need with the services available as they deal with mental health issues in their families.
The remainder of the year will remain very busy as we present two Think:Kids introductory programs (Monomoy and Mashpee), Home Front facilitator training (a new program for military families), our second Mental Health First Aid instructor training, our Fall session of Brazilian programs, 2 Family-to-Family programs, and finally a five day CCIT police training.
In the midst of all this diverse activity, it is important for us to try to maintain balanced lives and to pursue family time and personal interests. My own personal therapy or "grounding" lies in the art/science of horticulture or gardening. I have always found being outside in the natural world, being close to the earth, and nurturing growing things helps me to put the many components of my life in perspective. The art of designing with living material (plants) appeals to and challenges the creativity in my nature.
It was with great interest that I read an article (see below) sent to me by one of our
B oard members, a psychiatrist. Perhaps my obsession with landscape design and horticulture as a hobby has some benefits that I have never thought about. Anyhow, it works for me! Regardless of your interests and passions, take time to balance your life and be kind to yourself. It makes one stronger. Fall in New England, and especially on the Cape and Islands, is a beautiful time of year.
My favorite of our garden pictures

To read The Curious Case of the Antidepressant, Anti Anxiety Backyard Garden:
 
ADVOCACY NEWS...

From the desk of Mary Zdanowicz, Esq.

 
     It is estimated that more than 9,000 people living on Cape Cod suffer from a serious mental illness. While it may not sound like a substantial number, it is important because these individuals are most likely to be homeless, addicted to substances, suicidal and/or involved in the criminal justice system. As a result, not only are these individuals likely to suffer in some way, but there is also a measurable cost to the community at large.
 
     Serious mental illness is not a particular diagnosis; people who experience any diagnosable mental illness, such as depression, anxiety, PTSD and mood disorders may have a serious mental illness. Rather it is based upon the impact the illness has on one's ability to function. A serious mental illness causes a "substantial interference" with "one of more major life activities."
 
     Nearly half of individuals who suffer from a serious mental illness do not receive treatment. There are many factors that impact an individual's ability to engage in treatment, such as lack of treatment resources, transportation, insurance, or family support. On the other hand, about half of individuals are untreated because they do not believe that they have a problem requiring treatment, which may be a symptom of the illness itself. It is a condition called "anosognosia" which is an "inability or refusal to recognize a defect or disorder that is clinically evident," also known as "lack of insight."
 
     Anosognosia occurs frequently in other brain diseases, such as dementia, Alzheimer's disease or Parkinson disease. In fact, it is not uncommon for dementia patients to fail to recognize that their lives have changed and refuse medical evaluations, treatments and medication. There is generally no controversy about intervening to protect a dementia patient whose lack of insight places them at risk of harm. Seeking legal guardianship is a common means of gaining authorization to intervene and protect a dementia patient. For those whose ability to care for themselves is seriously impaired, resources are available to provide 24-hour care for dementia patients.
 
     But this is not always true for people with serious mental illnesses. Other than short-term acute care hospitalization, there is little that can be done to protect seriously mentally ill individuals who lack insight into their illness. For example, police and social service agencies can attest to the fact that there are some seriously mentally ill individuals on the Cape who, because of their illness, refuse to take shelter in blizzard conditions. This may be due to paranoia or a delusion that they are immune to the effects of harsh weather conditions. On the other hand, a dementia patient would not be allowed to wander in the snow, wind and freezing temperatures.
 
     The problem is that people do not understand serious mental illnesses and there are few advocates for the seriously mentally ill, except on the Cape. NAMI Cape Cod & the Islands is working with police, social service agencies, medical providers and the courts to develop strategies to address the needs of individuals with untreated serious mental illnesses who suffer the consequences of non-treatment, such as homelessness.
 
   NAMI CAPE & ISLANDS EDUCATION PROGRAMS

Family-to-Family :     Begins September 5th in Barnstable 6 - 8:30 p.m.
                                   Begins September 20th in Falmouth 6 - 8:30 p.m.

Homefront Facilitator Training is being offered in Hyannis on September 29th and 30th.  
Homefront is a six-week course similar to Family-to-Family for military families. NAMI Homefront Teacher trainee MUST meet one or more of the following criteria:
  • Have a relative who is a Service Member or Veteran with symptoms of a mental illness/mental health condition (includes PTSD & TBI).
  • Be a Service Member or Veteran AND have a relative with a mental health condition (the relative with a mental illness need not be a Service Member or Veteran but the NAMI Homefront teacher MUST have a personal connection to the military).
  • Have a relative who is a Service Member or Veteran AND have a relative with a mental health condition (the relative with a mental illness need not be a Service Member or Veteran but all NAMI Homefront teachers MUST have a personal connection to the military).
NAMI Basics Facilitator Training:   The date for this training has not been determined. The training will take place in the Acton-Concord MA area .
      
NAMI Basics is a free, 6-week education program for parents and family caregivers of children and teens who are experiencing symptoms of a mental illness or who have already been diagnosed. NAMI Basics is offered in a group setting so that participants can connect with other people face-to-face.
It includes facts about mental health conditions and how best to support your child at home, at school and when they're 
getting medical care. Last year, 99% of participants told us they would recommend the program to other parents. The course is taught by a trained team with lived experience-they know what you're going through because they've been there. The 6-session program provides critical strategies for taking care of your child and learning the ropes of recovery.
 
Facilitator training will teach participants how to lead a Basics program.
 
People interested in participating in any of these education programs can call Kim Lemmon at 508-778-4277 or email klemmon@namicapecod.org for information and registration.

            OTHER EDUCATIONAL OPPORTUNITIES

Although DBT (Dialectic Behavior Therapy) is one of the key treatments for people with Borderline Personality Disorder, there are a limited number of therapists on Cape Cod and the Islands who are able to teach these skills.  An alternative is to learn DBT skills online:
 
Learn DBT skills online in our live (real-time) DBT informed psychoeducational classes. Online DBT Course led by Debbie DeMarco Bennett (Corso) B.Sc., Life Coach and DBT Skills Educator in recovery from BPD, and Kathryn C. Holt, LCSW, DBT trained psychotherapist.

Open enrollment every three months. Next session begins on October 15, 2018 - Distress Tolerance.
Emotional Regulation and Interpersonal Effectiveness follow the Distress Tolerance module.


                                      **************************************

In September, Jud Phelps and Kim Lemmon will be teaching a 6-week course for ALL (Academy of Life Long Learning) on "Understanding & Managing Loved Ones with Mental Illness." It covers the full array of mental illnesses, treatments & resources and will feature the NAMI 'Primer' as the text.  The course will be held at Cape Cod Community College and is open to ALL members.

  The Challenge of 'Two' or 'Dual' or 'Co-' or Both

There is a close correlation between mental illness and addiction (to any ingested mood-altering substance). While I have never encountered a formal research study, from my 28 years of treating addicts and the mentally ill, I guestimate that nearly 75% of this population is dual diagnosed or co-morbid, that they have both a mental illness and an addiction.
At a minimum addicts are depressed just by the drugs they ingest. The substances ultimately induce some level of central nervous system depression (pot, alcohol, opiates, or Benzodiazapines) because they are all CNS depressants. While stimulants (speed, coke/crack, Ecstasy) initially pump an individual up, when their uplifting affects wear off, depression sets in.

 

Addiction can begin in the early years of adolescence (13-14). It most often starts with booze and/or pot, then escalates to other more potent substances. These substances give the teen a sense of mood elation and exaggerated confidence, reduced anxiety, and risk-taking courage. They can easily mask an underlying mental health issue such as depression, anxiety or more serious diagnoses like Bi-Polar, Schizophrenia, or Obsessive-Compulsive Disorder.

 
Early adolescence is a period of experimentation and risk taking. It is also a time when a teen's pre-frontal cortex is evolving (the brain's executive function determines judgement and reason; the pre-frontal cortex is generally not fully developed until the early 20's. The result is that an adolescent's thinking is not cohesive and impulse control can be dangerously flawed.
 
Concurrently, teens' moods can often vary and fluctuate. This can be scary because they feel so foreign. Alcohol and/or illicit drug use can relieve these uncomfortable feelings. Used often enough and in mood altering quantities, these substances can become chronically abused and lead to addiction--the inability to decline or manage their ingestion.
 
In one case, a mood disorder develops because of the presence of excessive anxieties and depressed moods, or other more serious mental illnesses. On the other hand, the addiction can develop because of excessive drug use to cope with and overcome these same anxieties, depression, other mood/thinking disorders.
 
It requires extensive counseling to assess the underlying source of the problem and provide the individual with the treatment tools to abstain and change.
 

Once a dual diagnosis has been made, how are these joint mental illnesses addressed? If the primary diagnosis is a mental illness and substances are involved, the mental illness issues usually cannot be addressed until the individual has been stabilized off alcohol or other drugs. The clinician can't assess what is 'real' and what is substance induced. If patients are still impacted by the influence of illicit drugs, they cannot address mood/thought disorder issues until the drugs are long gone from their system.

 

Some exceptional treatment programs do approach both elements of a dual diagnosis simultaneously, but most typically they start with getting the patient 'sober' and into recovery before a psychiatrist can begin to prescribe medications to address a mood/thinking disorder.

There is hope. Recovery stages that seem to be most effective require insurance (private or state) or self-pay. They are as follows: (A). Detox, if necessary; (B). Entering into a licensed treatment program, either Residential or Intensive Outpatient that requires complete abstinence, that also addresses their lack of insight into their problem, i.e. denial, receiving support--realizing they are not alone, and education, having a formal clinical assessment and diagnosis, and a long-term (many months) treatment effort. Recovery succeeds best with sustained abstinence. Patients makes major changes to their life that embrace 'recovery' and makes it the cornerstone of a new life.

 

Once the patient is fully stabilized, and recovery is sustained, then the mental health issues can be most effectively dealt with. They, too, require continued and ongoing treatment-- with psychiatry for medications to treat mood/thinking disorders. The right fit medication can take trial and error plus time, a licensed individual or group therapist to help change their thinking and process and to deal with old, painful guilt and hurt feelings, regular attendance @ AA or NA (Narcotics Anonymous), even using an AA sponsor to guide/coach.

 
Following a well-defined treatment protocol holds the promise of long-term abstinence and stabilized mood/thinking.
 
On or near Cape Cod there are many mental health and/or drug addiction accredited facilities, both inpatient, residential and outpatient with multiple levels of treatment intensity.
 
To identify and locate any such facilities go to: https://findtreatment.samhsa.gov.
 
    By Judson Phelps, MS, LADC I, Director of Client Services, NAMI CCI



                                         The 3rd annual Dragonfly Fundraiser,
an event to inspire change with mental illness &
raise funds for NAMI CC&I on Nantucket was held on Friday, August 10
at Great Harbor Yacht Club.  Guests enjoyed drinks & 
hors d'oeuvres, music by Jeff Ross, 
& bid at the silent auction.
 
Over 250 guests attended this wonderful event and  gave generously to support mental health on Nantucket.  Kudos to Kate Kling, her Committee, Sponsors, Donors, Guests and Volunteers.
     




 

                                                                        
Suzanne Fronzuto
NAMI on Nantucket Program Coordinator
                              August 10th, under a warm summer sky, Great Harbor Yacht Club hosted the annual Dragonfly fundraiser for NAMIonNantucket. Office Administrator Arlene Hoxie and volunteer Alyssa Hoxie from NAMI Cape Cod & The Islands greeted and registered guests while Executive Director, Jackie Lane spoke to the crowd on the importance of treating mental health like any other disease ("Mental Illness Is An Illness") and the importance of reducing the stigma so that people will seek and accept help. 

Silent auction items lined the walls creating multiple areas for conversation and camaraderie. The food and signature drink were delicious, and the music was a delightful background. The evening was a huge success. A great round of applause and a huge thank you to Kate Kling and her committee for making this happen!

August 15th, I attended A Caring Connection, offered by the Samaritans of Cape Cod & The Islands to train volunteers to form connections via telephone with individuals who have been admitted to the emergency room or to a psychiatric facility for suicidal ideation or attempt. Research supports that suicide risk is highest in the first week after discharge from an inpatient setting (Qin & Nordentoft).

Students are back to school next week, and I will be reaching out to guidance counselors, school social workers, etc. with information on Family-2-Family and Basics classes as well as our monthly support group.

In September a Mental Health First Aid Community Training will be taught by Sgt. Kevin Marshall of the Nantucket Police and Rachel Day, Director of Human Services, Town of Nantucket, with Crisis Intervention Training proposed for October.

     
 And From NAMI on Martha's Vineyard 




Summer is winding down here! It flew by but we are ready for the quiet and gorgeous Fall weather.
 
NAMI on MV is holding its first Fundraiser on September 14. We are excited to see where this will lead us. A special thanks to Tammy Silva and Kristie Mayhew for their tireless efforts in securing wonderful donations and having the vision to organize our first fundraising event.
 

We welcome Lisa BelCastro as our part time coordinator. Lisa will assist with   marketing NAMI to the island as well as involvement in coordinating fundraising events and assisting with F2F organization. Lisa has lived on island for years and has both administrative and fundraising experience. She feels a personal connection to NAMI.
 


We held our first meeting of our second support group in early August.

Cecilia Brennan
NAMI CC&I   
MV Representative
201-981-5123
ckbrennan@yahoo.com

   
Managing Chronic Conditions for Individuals with Serious Mental Illness

Individuals with serious mental illness have chronic physical conditions at rates significantly higher than the general population, such as cardiovascular disease and diabetes, and are less likely to receive standard levels of care for these conditions. This disparity contributes to the extreme lower life expectancy of individuals with serious mental illness, causing them to die up to 32-years sooner than those without mental illness, according to most recent estimates.

An increased effort to integrate physical health care into community mental health clinics is aimed at addressing this concern. In January 2013, Kitsap Mental Health Services, a community mental health center in Kitsap County, Washington, received a Centers for Medicare and Medicaid Innovation Award to implement a program called Race for Health! The program utilizes a whole health model that addresses all an individual's health needs, including psychiatric and physical health conditions.

Kitsap Mental Health Services restructured their staff into multidisciplinary care teams, each including a psychiatrist, psychiatric nurse, therapists, case managers and co-occurring disorder specialists. These teams worked together to address the patient's whole health and develop a treatment plan. In addition, well-being interventions were developed, aimed at helping patients reduce tobacco use and increase physical activity.

In a newly-published article in Psychiatric Services this week, Ellen Bouchery and her co-authors analyze the effects of the whole health model, Race for Health! on reducing Medicare expenditures and health care utilization among individuals with mental illness.

Integrated care reduces costs

The authors found that the integrated care model reduces Medicare expenditures by $266 per month per enrollee in the program, compared to participants in another community mental health center. The cost savings were due to a decrease in hospitalizations, emergency department visits and outpatient office appointments among the individuals enrolled.

The program's success is attributable to the mental health treatment staff having greater awareness for their patient's general medical needs and their coordination with their patient's primary care physicians, the authors report.

Although the study did not allow for an analysis of the whole health model on improving long-term outcomes, the results suggest that integrating physical health care into community mental health centers may improve care access to individuals with serious mental illness with co-occurring conditions. These innovative models will hopefully improve outcomes and longevity, addressing the extreme disparity in mortality among individuals from this vulnerable population.
References

Bouchery, E. et al. (2018, August). Implementing a whole health model in a community mental health center: Impact on service utilization and expenditures. Psychiatric Services.

DATAPOINT of the Month
  • 701,169 sworn law enforcement officers in the United States      According to a new report released today by the Bureau of Justice Statistics, in 2016 there were only a little more than 700,000 sworn law enforcement officers in the United States, or 2.2 officers per 100,000 population. More than two-thirds of these officers are local police officers, 25% are sheriff officers and less than 10% are state police officers. There was a 4% decrease in the number of sworn officers from 2013 to 2016, according to the report, despite an increase in the US population over that period.     Failures in the mental health treatment laws have made law enforcement officers the de facto front line of the country's mental health crisis -- a medical task that they are not necessarily well suited for. This statistic suggests that this front is also not particularly deep.
Also from TAC:

Poor insight is identified as top reason for treatment nonadherence among individuals with serious mental illness  

Poor insight, or anosognosia, was found to be the top reason for nonadherence to antipsychotic medications, according to research published last year. Authors from the Department of Psychiatry University of Texas conducted a systematic review that included 36 peer-reviewed articles. They found that poor insight was the reason why, in more than half of the identified studies, the subjects did not adhere to their medical treatment regimens. Co-occurring substance abuse was the next most prevalent reason.


The Miracle of Clozapine, A Personal Story

 
This week's Research Weekly is written by Bethany Yeiser, author, mental health advocate and founder of Comprehensive Understanding via Research and Education into Schizophrenia (CURESZ) Foundation, an organization dedicated to increasing public education and awareness to schizophrenia and addressing the severe under-utilization of the antipsychotic medication, clozapine.

Hers is a valuable first-person perspective with relevant statistics on the use of this drug treatment. Here is Bethany's testimonial:

On March 3, 2007, I was picked up by police and taken to an emergency room for psychiatric evaluation.

Paranoia had driven me to sleep outside, alone, for over a year. At the time, my former life as a biochemistry student and violinist had faded into a distant memory. Within 24-hours of being picked up by police, a doctor prescribed antipsychotic medication.

Risperidone greatly helped with my psychosis, including my delusions, voices and hallucinations, but I was unable to perceive that anything had changed.

Prior to being involuntarily admitted to a psychiatric ward, I spent six-months following command hallucinations which compelled me to act strangely. Suddenly, I would walk to the right and then abruptly to the left or look up and scream at the sky. The voices in my mind insisted that I sleep outside.

The antipsychotic medication risperidone eliminated the command hallucinations. But the voices in my mind continued to be louder than ever, screaming and swearing at me, making irritating noises like a painful stimulus. The voices prevented me from reading normally.

Then, I began to suffer from the medication's severe side effects, including restlessness, weight gain, excessive salivation, and anhedonia, or the inability to feel pleasure. Risperidone left me in a sedated state, like a zombie. I slept 16-18 hours a night.

For many people, risperidone and other newer antipsychotic medications work wonders to address the symptoms of schizophrenia and bipolar disorder. I met a full time pre-medical undergraduate student who took risperidone, which enabled him to thrive in his degree program. His experience was very different from mine.

After less than a month on risperidone, I discontinued it. I believed I did not need it and was suffering from intolerable side effects.

My second psychotic episode occurred a few weeks later. This time, I broke a valuable violin. 911 was called, and I was readmitted into a psychiatric hospital.

During my second hospitalization, I gained insight into how schizophrenia was affecting my life, and I developed a vision to regain a quiet mind. But though the risperidone was helping, it was clearly not the drug for me.

I tried paliperidone, aripiprazole, ziprasidone, and olanzapine, but with little symptom relief. The voices broke through. My psychiatrist referred to my symptoms as "residual voices." It seemed as though nothing would take them away.

I became desperate for a treatment or medication that would restore my personality, my happiness, my ability to read, and my future.

After twelve months of failed medication trials, my new psychiatrist introduced me to an older medication called clozapine, which some people refer to as a "wonder drug." He cautioned that the drug could cause me to gain 50 or even 100 pounds. But despite that risk, I knew I had to try it.

Over the next few weeks, as my physician gradually increased my dosage of clozapine, the residual voices became quieter. Once again, I was able to read, study, and retain the information I read. My mind became clearer than it had been in years.

Clozapine was the "miracle" I had been waiting for.

My recovery was not like a light switch. It progressed over a period of weeks and months. At six months, I was going out into the community and making friends. At one year, I made plans to return to college.

After 18- months, I enrolled in a university class, genetics, earned an A grade, and went on to graduate. Two years later in 2014, my memoir "Mind Estranged" was published.

Today, I have been in full recovery without relapse for over ten years, thanks to clozapine. I would compare myself to a person with diabetes taking insulin, enjoying a productive and normal life. I feel slightly sedated at times and I sleep a few more hours every night, but I have left the symptoms of schizophrenia in my past.

I only wish I had tried clozapine sooner.

Unfortunately, clozapine is underutilized in the United States. It is estimated that while 20-30% of persons with schizophrenia qualify for a clozapine trial, only 5% are prescribed the medication. Because of rare side effects and frequent mandatory blood tests, many clinicians do not prescribe it at all.

Today, in addition to the one million individuals who are untreated, there are half of a million people in the United States with schizophrenia who are taking medications but still doing very poorly, as I did before clozapine. Many of them suffer severe side effects on medications that do not fully take away their voices or hallucinations and leave them in a state of partial recovery. Many of these people have never even heard of clozapine-- this affordable, generic, older medication which has potential to bring even the sickest people into full recovery.

In partnership with my psychiatrist, Henry Nasrallah, MD, who prescribed clozapine for me, I established the CURESZ Foundation in 2016. One of the highest goals of CURESZ is to promote the use of clozapine, especially in treatment resistant patients like me.

The CURESZ Foundation has assembled a panel of psychiatrists from across the United States and in 12 countries that have experience prescribing clozapine. We hope that people struggling with schizophrenia will access our online Clozapine Experts map, to locate a physician in their area who can determine if a clozapine trial is appropriate for them.

It is essential that every person diagnosed with schizophrenia be made aware of all available treatments, including clozapine. Typically, clozapine is an option for individuals who are not experiencing recovery, despite trials of at least two different antipsychotic medications. I wish I had been told on day one that clozapine was an option if other medications did not effectively address my symptoms.

When I look back on March 3 of 2007, the day I was first committed to a psychiatric hospital, I remember the confusion, the fear and the pain. It was one of the most difficult days I have ever experienced. But it was also the best day, a turning point, when I took my first steps to recovery. It is the day I am most grateful for.




Elizabeth Sinclair
Director of Research
Treatment Advocacy Center


Dance In The Rain 

Dance in the Rain Whole Person Approach is a non-profit organization that supports peers who struggle with mental illness. Located in the heart of Hyannis, we provide this population with an opportunity to expand their lives, despite their condition, to grow, engage and heal. The staff, from executive director to volunteers, live with a history of mental illness as well. Our staff is well vetted to work with other peers who wish grow and seek to define themselves beyond mental illness. We are the only program in New England to have an organization that is conceived, developed and designed by peers for peers. Daily programs are offered to enhance self-esteem and positive identity.

For more information, contact:
Mary E. Munsell
Founder/Executive Director/Peer
Dance in the Rain Whole Person Approach
Peer to Peer Mental Health Center
501 c 3 Non Profit Public Charity
508-364-4045


   Transportation Services....

  The Cape Cod Regional Transit Authority provides a daily general public demand service called Dial-A-Ride Transportation (DART) that is a door-to-door ride by appointment transportation service.  It is available to all 15 Cape towns, runs from 7:00 am to 7:00 pm on weekdays and more limited hours on weekends.  It is easy to access and use.  

For more information, call them at 800-352-7155 or visit their website at:

http://www.capecodtransit.org/b-bus.htm



The Primer on Mental Health
WE'RE PUBLISHED!! You Are Not Alone: A Primer on Mental Illness, which has been in development for the past 18 months, is now available. (Call or email the office to make arrangements for your personal copy or copies for your organization.)  The Primer has been hugely popular--we published 2,000 copies
and have only 100 left!

The Primer is also online on our NAMI CC&I web site. The production and publication of this 88-page booklet was made possible by generous support from the Cape Cod Healthcare Community Benefits Fund, The Kelley Foundation, Inc. and The Cape Cod Five Foundation.


Tidbits...
                        Suicide Loss Survivors

The Samaritans of Cape Cod are piloting a new support group for suicide loss survivors lasting 8 weeks in Sandwich.
                             BeginsTuesday, September 4, 2018 | 6:30-8:00 PM 

For more info or to register, call 508-548-7999 or email
 
                                 *************************
       
Families for Depression Awareness Presents Free Teen Depression Webinar
                                            Thursday, October 11 at 7:00 PM  
Presenter Amy Saltzman, M.D. will discuss how caring adults can encourage teens to manage stress. The program is designed for parents, caregivers, school educators and personnel, youth workers, and anyone interested in teen mental health. 
Register  here  to join us for a live webinar discussion.


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GRANDPARENTS RAISING GRANDCHILDREN
                              

Grandparents Raising Grandchildren:  Legal Advice
Grandparents with questions about guardianship/options can visit the Probate Court on the 3rd Thursday of the month between 8:30 AM-1:00 PM.
They can also call the Bar Association (508-362-2121) or Susan at the courthouse (508-375-6730) for an appointment with Kathleen Snow on  Mondays between 10:00 AM-1:00 PM.
There is no fee for either of these consultations.

 
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.
 
 
I nclusions 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.

 
 

 
When  shopping on Amazon, think NAMI CC&I and Amazon Smile.
 Every dollar you give to NAMI CC&I goes to help support, educate and advocate for the residents of Cape Cod, Nantucket and Martha's Vineyard.  



AmazonSmile is a simple way to give when you are shopping on Amazon

Amazon donates 0.5% of your eligible purchases. 
It's so easy, you can still use your Amazon Prime and you still collect points.  All you need to do is:  When you are going to make a purchase on Amazon, first enter
in your internet browser. On your first visit to AmazonSmile, you will be prompted to select a charitable organization .  
Select NAMI Cape Cod Inc.
Thank You!