OCTOBER 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)
From the desk of Jackie Lane, Executive Director  NAMI CC&I 



Yesterday I attended the 22nd Annual Cape Cod Philanthropy Day, presented by the Philanthropy Partners of Cape Cod and the Islands. In addition to speakers and educational break- out sessions and the usual networking opportunities, this day gives all of us in the not-for-profit world an opportunity to recognize and honor the philanthropists and the volunteers who make our community a much better place for all our citizens. It was an especially poignant day as I had just learned of the passing of one of our notable philanthropists who also happened to be a special friend.
 
Roger Ludwig, a noted Cape Cod philanthropist and a generous friend of NAMI Cape Cod and the Islands, passed away early this week at his home in Naples, Florida. As Trustee of the Weny Charitable Trust, Roger was responsible for several million dollars of donations to our local institutions, focusing his giving on health and education. He was very generous to NAMI CC&I, sponsoring our highly successful CCIT police training programs and also taking on the lead sponsorship of the Siobhan Leigh Kinlin Memorial Golf Tournament for the past three years. In addition to his significant NAMI CC&I contributions, over the past few years, he donated generously to Cape Cod Healthcare, YMCA Cape Cod, Harwich Junior Theater, The Cape Cod Museum of Art, Heritage Museums & Gardens, The Thornton W. Burgess Society, The Community Health Center of Cape Cod, The Cape Conservatory, and most recently the Yarmouth Police Department. His giving extended to his winter community of Naples where he supported the Naples YMCA and the Naples Hospital.
 
Having had first-hand experience with one of his own children, he was especially interested in providing education and support for those afflicted with diabetes and their families or caretakers. He founded the Diabetes Education Center of Cape Cod which later merged with the Cape Cod YMCA resulting in the building and establishment of the Diabetes Resource Center, a resource room within the YMCA which is open to the public.
 
I had the interesting opportunity to work closely with Roger as he determined his giving, and I will always remember some unique aspects of his distribution of funds. So many foundations and trusts are interested in funding programs as they feel that that insures a direct benefit to those in need. Roger, being a "numbers guy," appreciated the need for operational money in order to support the implementation of programs. He knew that we had to pay the rent, the heat, the electricity, etc. He also loved to build and was very generous with "bricks and mortar" money.  Again, it is difficult to implement programming if the roof is falling in!  In other words,  
he was a realist, and honest and straight forward conversations with him brought results. He also believed in collaboration between the organizations that he supported and helped forge relationships between many of us. A large part of the appeal for the CCIT program for him was that it brings the police together with many other social service agencies.
 
Although this is a tribute to one special donor, we always need to remember that NAMI CC&I exists and is able to offer all our services free of charge solely because of the many volunteer hours and private donor dollars that have been given. The growth of our signature fundraising events, the SLK Golf Tournament and Dragonfly on Nantucket, and the development of our grant funded community programming demonstrate philanthropy and volunteerism at its best. Roger Ludwig, although very special, is only one of many who through the years, have been responsible for the continuing growth of NAMI CC&I. In this seemingly often harsh environment in which we are living, let's take a moment to thank those in our community who bring people together and try to make the world a better place for all.

    From the desk of Mary Zdanowicz
    
Ballot Question 1:
 Psychiatric Patient-to-Nurse Limits & the Impact on Acute Psychiatric Beds on Cape Cod

 
Question 1 on the 2018 ballot in Massachusetts proposes a law that would limit the number of patients that could be assigned to registered nurses in certain types of health care units. NAMI Cape Cod & The Islands supports the work of our dedicated nurses throughout the Commonwealth. But the measure, if passed, could negatively impact the limited resources available for psychiatric patients on the Cape and Islands.
 
A unique aspects of behavioral health care is the multi-disciplinary approach that focuses on monitoring daily activities, counseling, group therapy and programs support recovery, and peer support. In addition to nursing, care team members also include psychiatrists, social workers, case managers, occupational therapists, counselors and mental health technicians. The proposed law would increase the ratio of nurses in behavioral health care facilities by mandating that each nurse have no more than five psychiatric patients, thereby reducing the availability of other critical professional services that are required to successfully prepare a patient for discharge to the community.
 
Behavioral health care is already seriously underfunded and hiring sufficient staff is difficult. The Massachusetts Department of Mental Health calculated that the cost of implementing mandated nurse staffing ratios in state psychiatric facilities alone would be an estimated $46 million annually, bringing the statewide total implementation cost on the behavioral health inpatient system to $226 million per year. That is twenty times more than the increase to the Department of Mental Health budget in 2018.
 
California is the only state that currently has a law mandating specific nurse staffing ratios in hospitals and has ratios that are specific to psychiatric units within acute care hospitals. Research has shown that the ratio legislation in California may have led to hospitals downsizing mental health services.
 
Cape Cod already has fewer acute psychiatric beds than any other area of the state. There are 20 beds at Cape Cod Behavioral Health Center (Cape Cod Hospital) and 16 beds at Pocasset Mental Health Center (DMH).) This is less than half the statewide average number of psychiatric beds per person. The proposed law would likely result in a reduction in the already limited number of beds on the Cape.
 
Fewer psychiatric beds means that patients would have to wait longer to be hospitalized. Emergency Department (ED) boarding occurs when a patient must wait in an ED until an appropriate inpatient bed is available. Patients going to an ED in need of inpatient psychiatric or substance use disorder services, who already make up a disproportionately large percentage of patients that board in the ED, would be forced to board there even longer.
 
For these reason, NAMI CC&I cannot support the mandatory staffing ratios for units with psychiatric patients, as proposed by Question 1.
 
Note: The Massachusetts Association of Behavioral Health Systems prepared an analysis of Question 1 as it pertains to behavioral health facilities, which can be found here:
 
  

NAMI CC&I Honored



NAMI Cape Cod & the Islands was honored to be the recipient of the 2018 John F. Kennedy Jr. Community Service award from the Greater Hyannis Chamber of Commerce.  Jackie Lane received the award at the Chamber of Commerce Award Dinner in October.
   
NAMI Education & Support Opportunities:
 
Family-to-Family is a program for family and friends of people with a mental health challenge.  The course meets weekly for 12 weeks and teaches people about the various mental health conditions, medications commonly used, communication skills, self-care, and problem management.

New sessions to begin on Nantucket and in Wellfleet - Winter 2019
 
Homefront is a six-week course similar to Family-to-Family for military families.  This is a pilot program in Massachusetts, and currently will only be available on Cape Cod.  The first offering for Homefront will begin in Barnstable on January 9, 2019 6 - 8:30 p.m.

For more information, or to register for these upcoming courses, call Kim Lemmon at 508-778-4277 or email klemmon@namicapecod.org
 
 
NAMI Support Group-  
NAMI Cape & Islands has been discussing the idea of starting a new Support Group for the families and friends dealing with a mentally ill loved one to meet in Hyannis in the afternoon.  We recognize that some individuals have difficulty traveling at night, and as the days grow shorter and colder, we think this may be a good time to start a  daytime group. 

 Please reach out and let us know if this is a group you would be interested in attending.  We want to be sure that this group would be attended prior to implementing it.

Email Kim at    klemmon@namicapecod.org  or call the office at 508-778-4277.




Mental Health First Aid

Mental Health First Aid training was facilitated by NAMI's Kim Lemmon and Beverly Costa-Ciavola, Director of Cape Cod Neighborhood Support Coalition, at the Centerville Library.  One person who became a Mental Health First Aider said:
 
"I use it daily when I interact with people because the key thing is to recognize when people may be suffering and to offer them assistance. So, when I'm working with a coworker and see that something is 'off' in their attitude or something is different in the way they're interacting with me, I know I need to say, 'Are you okay? I'm here to talk if you need help.'" -Sarah Scoular, Cerner
 
We would like to thank the staff at Centerville Library for their hospitality and support over the two days we were there!  
 
If you would like to learn more about the Mental Health First Aid training, and find a course that works for your schedule, please call Kim Lemmon at 508-778-4277.



A very special little book...
Quiet Places
by
  Dr. James McGuire

I t was with great pleasure that we in the NAMI CC&I offices were able to share with a member of our Board, Psychiatrist Dr. James McGuire, the final editing and the publication of Quiet Places, his delightful and insightful story of little Timmy bear as he searches his world for a quiet and peaceful place. As Timmy travels through his forest, he explores and tries out the quiet places of the friends that he meets. It is a charming and amusing adventure attractively illustrated by Nancy Nicol; an adventure provoking thought and ending on a wise and comforting note.
 
Although the book is written as a children's book, its message is universal. We all need to find our quiet places in a world full of noise, positive noise and negative noise, but so much noise! Share this book with a young friend, and together discover the value of quiet places and quiet time.
 
                            We hope that Dr. McGuire has more stories to tell!






Written by Jackie Lane

Book Review


Imagine Me Gone
by
Adam Haslett

If there was ever any doubt that mental illness is a family affair, this book shows in painful detail how all family members are affected.

Margaret is about to marry John when she discovers that he has been hospitalized for serious depression.  She decides to marry him anyway, and they have three children.  John's depression is the 'elephant in the room' even when he plays games with the children to make them more resilient when he is gone.  Margaret feels somewhat annoyed and dissatisfied with the effects of John's depression, but never discusses it or possible treatment with him.  John names his depression "the Beast" and sees it coming, but is helpless to cope with it.  Eventually, he goes into the woods and kills himself.

The book deals primarily with the aftermath of his suicide.  Margaret, in an effort to keep the family together, rarely mentions it, and the children never discuss it except for a brief foray into family therapy when they are much older; yet, it is the theme that runs through their lives.    Celia and Alec have difficulty committing to relationships for fear of loss.   
Michael, the oldest, struggles with mental illness.  There is never a  clear diagnosis, but terms such as anxiety, depression and psychosis are in the background.  The family never understands the severity of his illness, although they all feel the need to rescue him.  Michael thinks about his illness with both anxiety and humor and takes many different psychotropic medications over the years, but with little success.  He is eager to be 'normal' to please his family, but has no idea how.  Margaret wants to protect him, but chooses to have very little knowledge of his illness or treatment.

It comes to a head when Alec, desperate for Michael to be "his old self", decides that the cause of Michael's symptoms is the medications he is taking, and believes that if he could wean Michael off these medications, he would be normal again.  He convinces a dubious Celia that this is the right path.  He then persuades Michael to go along with the plan, although Michael, more aware of his illness than his siblings, is worried about the effects of suddenly stopping his medications.  Needless to say, disastrous consequences ensue.

The tragedy of this story is twofold.  First, the stigma of mental illness, keeps Margaret and John from dealing with his depression--  Margaret with her head in the sand, and John who feels helpless and alone.  Because of Margaret's silence, the children do not understand or discuss first their father's suicide and then Michael's illness, although there is always the sense of fear and dread in their dealings with Michael.  Second, in their lack of knowledge about mental illness, lies the hubris of trying to cure him simply by stopping all of his medications.  Alec is adamant about it without discussing it with Michael's doctors, and the others go along.

Haslett has written a beautiful and tragic book.  He takes you into the minds of each of the characters, and you feel their unspoken pain with elegant prose.  It is a book you will think about long after you have read the last page.

Review by Arlene Goldberg Hoxie
                                                                        
Suzanne Fronzuto
NAMI on Nantucket Program Coordinator
                              
 
The cool winds and gusty breezes of October make me think of finding that box of winter sweaters and putting a nice pot of soup to simmer on the back burner, but rather than hunkering down, these cooler temperatures have me looking forward to new initiatives for mental health on Nantucket. At the October meeting of the Nantucket Behavioral Task Force, the Nantucket Data Platform presented a plan to address the cadence of crisis on Nantucket; what is the ebb and flow for mental health needs on Nantucket? The Nantucket Data Platform (NDP) is a "collaboration between data scientists, demographers, data visualizers and writers, supported by local leaders from business, nonprofit groups, and government. Nantucket Data Platform's long-term goal is to assemble actionable information and place it in the hands of local decision-makers and citizens, so they can replace guesswork with evidence-based decisions".

By creating a behavioral health test case, NDP will build a team, get data, aggregate and analyze the data with the goal of doing something with the data to identify target-rich areas in order to create a co-location plan that can provide a continuum of behavioral health care services for clients on the island. NAMIonNantucket will be a part of this test case through our collaboration with Margaret Hannah and the William James College "warm line" referral service.

Ads will appear next week for NAMI Basics and Family to Family classes beginning in January. I will continue to look for ways to boost our Facebook presence as we spread the message- mental health matters; you matter.
   
  NAMI on the Vineyard 




                


 
We are so excited to announce that NAMI Martha's Vineyard has a Facebook page! Here is the link: 

Please like our page and follow us as we grow awareness of NAMI on Martha's Vineyard, and offer support to those in need. The more followers (likes) we have, the greater our impact can be.

The first Darkness into Vineyard Light Suicide Prevention and Awareness Walk was held Saturday, September 29. The walk began at 5:30 AM and people walked through the early dawn hours into the sunrise, where we gathered on State Beach as the sun rose.  The response to this event was phenomenal! Darkness into Vineyard Light set out to raise awareness, hoping for 50 to 75 people to show up, and approximately 200 people were there. Many NAMI members were there! Through the event, $11,743 was raised to support the Island Intervention Center, which is an organization that helps those who are experiencing a mental health crisis.

Plans are in the works for a joint winter-time venture between NAMI MV and Darkness into Vineyard Light. The winter months on Island show an increase in mental illness, drug and alcohol related problems, and suicide attempts. We hope to increase our presence and spread the word that there is hope and there is support.
       
                                      

Thank you,
Lisa Belcastro
NAMI - MV Coordinator

   



Violence in Emergency Departments and the Role of Serious Mental Illness  
 
(October 17, 2018) Emergency departments are our country's health care safety-net. They are a place where the lives of the sickest individuals with the most urgent needs are saved, including for individuals with serious mental illness. In 2014, there were more than 2.2 million emergency department visits in the United States for which serious mental illness was the primary diagnosis.
 
However, emergency departments may also see levels of violence that threaten both the safety of physicians and the treatment of their patients, according to a recent survey from the American College of Emergency Physicians.   
 
Of 3,500 emergency physicians surveyed in the poll released this month, almost half have been assaulted on the job. A staggering 90% of emergency physicians have either personally experienced an assault or witnessed the assault of a colleague. Nearly 70% of those surveyed believe violence has increased in just the last five years-one-quarter say violence has increased "greatly" in that time.  
 
The data beg the question: what has caused the uptick in cases of emergency room violence? Important considerations are numerous and varied, but the results indicate that mental illness could play a significant role. Of the 1,643 physicians who have experienced an assault, more than 40% believed more than half of the attacks were committed by psychiatric patients. Nearly one-third of physicians surveyed also cite "behavioral health patients" as a main contributing factor to emergency department violence.
 
Even though emergency departments are the place where individuals in psychiatric crisis when in need of treatment, a common response to the sometimes-violent behavior expressed by these individuals while there is arrest by law enforcement - a reality that the Treatment Advocacy Center represented in an info-graphic on emergency department outcomes for those experiencing a mental health crisis, available here. Of physicians who had been assaulted and whose hospital responded to the incident, 21% said the hospital had the patient arrested. Arrest was the second most-common response, following a mark on the patient's medical chart for violent behavior.
 
When discussing violence on the part of those with the most severe psychiatric diseases, it should be noted that the vast majority of individuals with severe mental illness are not violent. However, the data generated from surveys such as that of the American College of Emergency Physicians emphasize the need to address existing treatment gaps for the most severe cases of mental illness to prevent violent encounters. In the case of one recent attack on a physician in a New England hospital, a patient became violent when told he would be held indefinitely in the emergency department simply because no psychiatric beds were available elsewhere.
 
For more information on serious mental illness and violence or the United States' psychiatric bed shortage crisis, please visit the Treatment Advocacy Center's key issue pages below:
 
 Je ssica Walthall   
Research Assistant
Treatment Advocacy Center

   
                                  


  NAMI CC&I held two introductory Think:Kids sessions on October 5, 2018 as an inservice for educators in the Mashpee, Wareham and Monomoy school systems.  There were also educators from the Vineyard.

Two packed auditoriums held rapt audiences as they listened to the ways in which Collaborative Problem Solving can change the way that educators can more effectively deal with the challenging children in their classrooms.  Their mantra:  "Kids will do well if they can.  It is skills not will" has proven to be a major paradigm change in how we understand and deal with these children, helping them to acquire the skills they need to be successful.

The next step in this model will be Tier I training which will be scheduled at a later date.

 


NAMI's Support Call Service


  One of the major objectives of NAMI CCI is to connect callers with needed resources including mental health clinics, substance abuse detox and facilities, support groups, housing agencies, employment counselors, primary care doctors, lawyers, crisis intervention, etc.
 
An example of a typical call: A 60-year old mother with a 40-year old daughter who is experiencing a manic state for the first time. The daughter is bouncing off the walls with uncontrollable energy, can't sleep and won't eat, talking a mile a minute incoherently, making grandiose and threatening statements, egotistical and self-centered.  She has been demanding and spending money in a flourish. The mother is terrified and has no idea where to turn.
 
We advise the mother to call 911 and ask for police with CCIT training (Community Crisis Intervention Team training); they have been taught ways to approach a mentally ill individual with calmness, patience and a soft voice, rather than if that individual were a dangerous criminal. The police can then deescalate the crisis and calm the individual down. They may take him to the Cape Cod Hospital Emergency Room for evaluation or they may call Bay Cove Emergency Services.
 
We advise the mother that her daughter probably has a mental illness which she cannot control and for which she is not to blame. The daughter likely needs to be hospitalized in a specialized psychiatric unit for several days or more where she can be medicated and stabilized. We explain the HIPAA laws.
 
We then recommend that the mother take the FREE NAMI 12-week Family-to-Family course (held throughout the year at different locations on Cape Cod and the islands) to learn about the types of mental illness and treatments, communication and self-care and then join one of NAMI's monthly support groups with other suffering parents, spouses and friends. Most important, she will no longer feel alone.
 
NAMI support calls are received during the hours of, 9 AM to 5 PM Monday-Friday, and by the answering machine on off-hours and weekends. Calls on the machine are always responded to promptly.
 
During the first one-half of 2018 NAMI CCI received and responded to almost 200 calls.

By Jud Phelps, MS, LADC I, Director of Client Services
Dance In The Rain 

Dance in the Rain Peer to Peer Mental Health Center
"Where Healing Begins"
 
Dance in the Rain Office: Upstairs at 145 Barnstable Rd. Hyannis.
Hours are:

Monday 10:00am - 4:00pm
 
Tuesday 10:00am - 4:00pm
 
Wednesday 10:00am - 6:00pm
 
Thursday 10:00am - 4:00pm
Drop in for a chat and check us out. No need to attend the programming being offered . Just stop on by and find out more about Dance in the Rain. I bet it's not what you think it is. Peer engagement is one of the foundations of healing.
All meetings, workshops and groups are held at the Dance in the Rain Office Upstairs 145 Barnstable Rd. Hyannis. Unless otherwise noted.
Pick a day to come every week and become part of something really unique and healing.in the Rain is looking for donations of art materials for our open art studio.  Canvases, acrylic paints, brushes, drawing paper, frames, and collage materials.
 
Dance in the Rain Peer to Peer Mental Health Center is open Monday through Thursday 10:00AM to 4:00PM. "Dance..." offers a variety of daily workshops and meetings.  We are drop-in style and all of our services are free of charge.  Come check us out and experience the healing power of peer engagement.
 
Please visit our website at: www.danceintherain-wpa.org

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 about to be reprinted. (Call or email the office to make arrangements for your personal copy or copies for your organization.)   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.

h
Tidbits...
       
For NAMI members:      
 
NAMI's Ask the Expert Webinar: 
                Caregiving for Adults with Mental Illness
               Thursday, November 8, 2018 - 4:00 p.m. - 5:30 pm 
 

As a member of NAMI, you have the opportunity to register in advance for NAMI's Ask the Expert Webinar! Advance registration is open ONLY to NAMI members and leaders, as a way to show thanks for your support and involvement.
The program is an overview of the challenges faced by more than 8 million Americans who care for adult relatives with mental health conditions. Families struggle to help relatives while navigating health care systems, mental health providers and community supports. Presenters will discuss barriers families encounter, review a guidebook for mental health caregivers and recommend public policy changes. Participants will learn:
  • Challenges faced by unpaid caregivers in accessing mental health care for an adult relative
  • Effects of caregiving on the caregivers themselves
  • Tips and resources for caregivers
  • Policy solutions and recommendations to improve support for caregivers
Registration space is limited and expected to fill quickly! To register:   
View past recordings of Ask the Expert  at NAMI's website
For questions or more information, contact us at info@nami.org or 703-524-7600
           
                        
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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!