From the desk of Jackie Lane, Executive Director NAMI CC&I
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As I sit here in my office on a day that may reach record setting low temperatures with adjustment for wind chill factor, I am thinking about the plight of the multitude of homeless people in our country, our state, and our own community of Cape Cod and the islands of Nantucket and Martha’s Vineyard. Homelessness has become a major issue and a part of life in metropolitan cities such as San Francisco, Chicago, Boston, and New York City. However, it has also become a part of the normal landscape in our small cities and villages including Hyannis, Falmouth, and other Cape Cod towns. It is an issue that we, as a hopefully civilized society, need to address. It is not going to go away, and we cannot hide it and forget about it.
From my experiences, homelessness happens for a variety of reasons, many of which are purely economic. Statistics tell us that the majority of people in this country do not have the means to comfortably absorb an unexpected $1000 expense in a given month. Stagnant wages and rising housing costs make home ownership or even rental a challenge for more and more families. An unexpected medical issue can wipe out savings and make monthly bill paying impossible. In other words, bad luck can push a family or individual over the edge in a society where so many are living from pay check to pay check. We do have many agencies such as HAC that work hard to transition these families and individuals into our limited supply of affordable housing.
However, as the Executive Director of NAMI CC&I, I am especially concerned about the chronically homeless, those who live in the woods in camps and those we see on the streets. Most of these people suffer from addiction or serious mental illness or both. These are the people that we see camping out on the village green, sometimes approaching strangers, and sometimes putting their own lives in danger as they are unable to make the necessary decisions to keep themselves safe. They are viewed as undesirables at best and as criminals at worst. Where did these people come from and why are there so many of them? I personally feel that the answer lies in the changes in our mental health system over the past few decades. State mental hospitals got a bad reputation, and it was decided that these people should and would do better if they were released into the mainstream population. However, in order for this to be workable, there is a dire need for a wide range of readily available and affordable community support systems to be in place. The appropriate funding for these services never happened and thus we have a group of people that desperately need help.
We now see this as a local issue that reaches crisis status during the bitterly cold winter weather like today and the Martin Luther King holiday weekend. The Barnstable Police Department’s Community Impact Unit has taken the responsibility of attempting to manage this population, trying to find a balance between their needs and those of the community. Meetings take place weekly between the police and other agencies in an effort to work together to keep these people safe and get them help when needed. A Community Crisis Intervention Team (CCIT) meets monthly and includes representatives from healthcare, housing, mental health, and the judicial system to review issues and work for solutions for individuals.
Based on the extreme weather of last March, the CCIT group decided that a plan needed to be in place in order to house the “potentially problem hard core” who were unable to be sheltered in conventional ways. In a joint effort between the Barnstable Police Department, VinFen and NAMI CC&I, we applied for and received $45,000 through working with Senator Cyr’s office. For this year, the Barnstable Police Department is collaborating with Duffy Health Center’s
“In From the Streets”
program with this funding, and there is a plan in place to shelter these people on nights like last night. This has been a collaborative effort of many agencies with the police department and town government. That being said, this is only a temporary solution. What happens next year? When do we accept the homeless issue as a community responsibility and one that needs to be addressed with services and funding? This is not going to go away and cannot be hidden. Perhaps one should think of a community as being only as good as its treatment of its most fragile members?
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by Larry DeAngelo on 12/16/18
Dear Family Caregiver,
I am addressing those caregivers that have a loved one with a diagnosis of bipolar illness, schizophrenia, and/or clinical depression. These ill-defined illnesses are spectrum disorders. Patients with these diagnoses have a range of symptoms: some experience single episodes of depression, psychosis, and mania and others chronic, multiple, and severe symptoms. This document addresses the latter, families dealing with serious and persistent mental illness. Most of the ill family members have had multiple hospitalizations and half of them are abusing substances. Although most people with mental illness are not violent, violence and/or the threat of violence is present in these families, (I include the threat of suicide). Some peers have cognitive deficiencies. Having mental illness in your family has a terrible financial, emotional, and structural impact on your entire family.
Your Situation
Your goals for your ill family member are different from their goals. Your focus is on the well-being and safety of your ill family member. You see medications and hospitalization as good things. You live in a constant state of despair worrying about the possible suicide of your family member. You worry that they will be homeless, destitute, or incarcerated. You feel that your ill family member’s life will improve if they accept their illness and accept treatment. You live with constant guilt that you caused this illness and you do not have a clue on how to end this nightmare. Many of you are depressed, anxious, and in need of therapy.
Your ill family member’s situation.
Your family member with major mental health issues wants a life not a pathology: a job, relationships, housing, financial independence. Frequent hospitalizations and current treatments can be traumatic and disabling. Your family member’s world is a world of stigma and the resulting discrimination. Their life is on permanent hold. Their peers are married, have a job, in school and/or, have a family. While your loved one is trapped in your house with no job and no future. They want and deserve a better life. They cannot get there because they are ill.
The Mental Health System
Your mental health system is underfunded, the clinicians are well meaning, overworked and underpaid. Clinicians place huge barriers between you and your ill family member. Many clinicians feel you are part of the problem and refuse to make you part of the solution.
Given that the above description is your situation, what can you do about it?
- Educate yourself on all aspects of mental illness and the mental health system. Education gives you personal power and the confidence to communicate with professionals. NAMI’s Family-to-Family education course saved our family. In Family-to-Family, you learn to develop a variety of coping skills, problem-solving techniques, hone communication skills, share the burden with others, and learn acceptance. You learn that you cannot fix mental illness, and to forgive yourself for mistakes that you have made. You learn what treatments are effective, and where to find mental health resources, and to understand disability benefits. You will need all the knowledge you can acquire. This is a lifelong assignment!
- Take Care of Yourself. Your wellbeing is important to yourself and your family. Your mental health system forces you to be a case manager, health plan coordinator, and advocate. You cannot do an effective job without knowledge of mental illness and the mental health system. NAMI’s Family Caregiver Support Group offers a safe, supported environment allowing you to share your innermost fears and learn from the wisdom of a group of people in your same situation. The level of your compassion and effectiveness in helping your ill family member is directly related to your energy and physical and mental health. Stress, poor health, exhaustion make you a combative, angry, guilt ridden person. Depression and anxiety are rampant among caregivers. I know I have been there.
- You have to learn to let go
- Understand that letting go does not mean abandonment
- Accept the reality of your situation (Reality-based hope)
- Reset your expectations
- Know that you have done your very best
- Understand that you have an obligation to yourself, your partner, and other family members.
- Understand that YOU cannot fix it
- Understand that YOU cannot control the behavior of others but can control YOUR behavior
- Share the responsibility with others
- Collaborate with your ill family member and STOP enabling. Listen, Empathize, Agree, and Collaborate.
- Learn to set limits and mean it
- Communicate don’t engage
- Understand that to let go is not to care for, but to care about
Larry DeAngelo is a NAMI Massachusetts Affiliate President, NAMI Basics and Family-to-Family teacher, State Family-to-Family Trainer, and Support Group Facilitator.
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A Book Review by the Author
SERIOUS MENTAL ILLNESS REFORM BOOK
When hospitals release seriously mentally ill patients too soon without outpatient follow-up, the patients can end up homeless, jailed, harming others, or even dead. When patients are deemed suitable for inpatient care, they can languish for weeks in hospital emergency departments before placements become available. Meanwhile, patients who fake the need for care are smoothly and swiftly moved to inpatient settings.
Breakdown
opens a dialogue with anyone interested in improving the system of care for the seriously mentally ill population. This book helps to answer questions such as:
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Is inpatient care too inaccessible to those who need it most?
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Do mental health professionals discriminate against mentally ill patients?
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Are more stringent measures needed to ensure that patients take their medication?
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Is borderline personality disorder too serious to be classified as just a personality disorder?
Using vignettes based on real interactions with patients, their families, police officers, and other mental health providers, Lynn Nanos shares her passion for helping this population. With more than twenty years of professional experience in the mental health field, her deep interest in helping people who don’t know how to request help is evident to readers.
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A woman travels from Maine to Massachusetts because she was ordered by her voice, a spirit called "Crystal," to make the trip.
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A foul-smelling and oddly dressed man strolls barefooted into the office, unable to stop talking.
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A man delivers insects to his neighbors' homes to minimize the effects of poisonous toxins that he says exist in their homes.
Breakdown
uses objective and dramatic accounts from the psychiatric trenches to appeal for simple and common-sense solutions to reform our dysfunctional system. This book will benefit anyone interested in seeing a glimpse of the broken mental health system way beyond the classroom. It can guide legislative officials, family members, mental health professionals, and law enforcement officers toward a better understanding of the system.
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People tend to make resolutions at the beginning of a new year; a promise to lose weight, eat healthier, change destructive patterns of behavior, etc. and look for ways to both help and be helped. In January, NAMI Cape Cod & The Islands and NAMIonnantucket launched the next phase of the behavioral health marketing campaign
Mental Health Matters, You Matter
with posters highlighting the Nantucket Interface Helpline, a confidential resource manned by professionals that provides information and referral matches for a variety of mental health services. The posters are displayed in providers’ offices, the local supermarkets, transportation facilities and the public schools with new venues added weekly.
We are also advertising for a Family to Family Class to begin mid-March. I received several calls this past month from individuals looking for information and supports for family members with new diagnoses which has developed into Tuesday morning coffee at one of our local cafes. The initial phone contact and conversation helps me be better prepared with relevant resources for our face to face meeting – and coffee or tea makes it more intimate and less intimidating.
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Looking for a good book to read? Scheduled for release on February 5
th
is
The Collected Schizophrenias
essays by Esme Weijun Wang. It begins with the author’s journey toward a diagnosis of schizoaffective disorder compounded by PTSD and Lyme Disease, dealing with schizophrenia in her own life and the medical community’s difficulty agreeing on labels and procedures for diagnosing mental illness
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January has already been a busy month for NAMI on Martha’s Vineyard. We paired up with Darkness into Vineyard Light, a local suicide prevention and awareness group, to host a free community bowling afternoon at The Barn Bowl & Bistro. We had a ton of fun, and pray our infectious laughter (perhaps because of the numerous gutter balls, but who’s counting!), smiling faces, and glowing candles shed lights of hope during these dark winter months.
We are planning another event with Darkness into Vineyard Light in February. We are finalizing the dates for a free pizza and family game night. We’re talking of the third gathering in March.
On Thursday, January 31, NAMI MV will host our first Dine-to-Donate event at Offshore Ale in Oak Bluffs. Offshore Ale is donating up to 20 percent of all meal proceeds, both lunch and dinner, to NAMI MV. We are busy emailing and passing out coupons to those on Island.
On Sunday, February 3, if you're not watching the Super Bowl, please join us for the First Sunday Support Group at 6:00 pm at the Island Wide Youth Collaborative building on MVCS campus. Katharine Neadow will be facilitating. Please call Katharine if you have any questions: 774-563-1247 or by email:
[email protected]
Our next Family-to-Family class begins on Thursday, March 7. Megan Grennan and Katharine Neadow are going to facilitate again. We held our first planning session on Sunday, January 20. Megan and Katharine are full of light and positive energy, and eager to help others through Family-to-Family as they were helped.
Our final bit of exciting news is an upcoming in-house library. We’ve been collecting books on mental health over the years, and they’re currently piled up in boxes. Recently, one of our local librarians offered to catalogue the books and create a spread sheet and lending library program. Just in time for our next Family-to-Family class!
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Serious Mental Illness and Re-Hospitalization, An Update
People with serious mental illness are two-times more likely to be readmitted within 30-days of discharge for a hospitalization for medical or surgical reasons compared to individuals without a mental illness, according to new research published earlier this month.
As has been previously
reported
, people suffering from the most severe psychiatric disorders have significantly higher rates of co-occurring physical health conditions, including hypertension, diabetes, and chronic kidney conditions - a fact that contributes to the 25-year difference in life expectancy for individuals suffering from severe mental illness compared to others. In addition to dealing with the barriers to treatment for one's schizophrenia, bipolar disorder, or major depression, people with serious mental illness also have significant medical and surgical treatment needs due to their chronic physical conditions. To make matters worse, research has shown that individuals with serious mental illness receive lower quality medical care compared to other individuals.
In new research published this month in JAMA Psychiatry, Dr. Hayley Germack and colleagues utilized the Nationwide Readmissions Database housed within the Department of Health and Human Services to study this phenomenon and determine how readmission rates differ among a nationally-represented sample of individuals with serious mental illness as compared to the general populations. The results have implications for hospital payments as the Centers for Medicare & Medicaid Services move towards service reimbursements for that are based on performance measures. The 30-day readmission rate is a quality of care indicator that is used for such payments.
The authors found that the 30-day medical readmission rate was 23.1% for individuals with serious mental illness, almost two-times greater than the 13.8% readmission rate for people without serious mental illness. For surgical hospitalizations, the 30-day readmission rate was 19.3% versus 9.4% for individuals with serious mental illness and those without, respectively. Even when statistically controlling for hospital characteristics and demographics, the odds of readmission for individuals with serious mental illness were significantly higher compared to those who had a medical or surgical hospitalization without a co-occurring serious mental illness.
The authors argue that these findings highlight a gap in care quality for individuals with serious mental illness that should be addressed by the Centers for Medicare & Medicaid Services Hospital Readmissions Reduction Program. More research is needed to identify programs to prevent readmissions for patients with serious mental illness, as typical transitional care programs may not address the specific needs of this population.
For a previous analysis of hospital readmissions for individuals with schizophrenia, see our November 2017 Research Weekly
blog post
. The Treatment Advocacy Center also conducted our own analysis of readmission rates and length of stay for psychiatric hospitalizations, published in our November 2016 report
Released, Relapsed, Rehospitalized
.
Elizabeth Sinclair. Research Director
Treatment Advocacy Center
References:
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NAMI EDUCATION
Family to Family
A new session of Family to Family will be offered this Spring in Yarmouth.
This will be an afternoon class for individuals who prefer a daytime meeting.
If you have a loved one who is struggling with a mental health issue,
and wish to learn more about how you can effectively support them, this free course will support you.
For information and registration call Kim Lemmon 508-778-4277 or email
[email protected]
Borderline Personality Disorder
12-week class will be offered this spring
Call Kim to be notified of the starting date
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Knitting for NAMI to Benefit the Homeless
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The 2019 Knit-a-Thon is About to Start
Once again,
A Great Yarn of Chatham -- in partnership with the Housing Assistance Corporation of Cape Cod –
will lead an effort to knit blankets for the Cape’s homeless population. Our goal this year is to prepare 250 blankets. We know that’s an ambitious target, but we also know that the demand for the blankets keeps growing. Even though we prepared 192 blankets last year, the number was still not sufficient to meet the demand.
Remember, panels should be 50 stitches across and 72 inches long, washable wool, any colors or combinations.
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Dance in the Rain
Peer to Peer Mental Heath Center
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“
Dance in the Rain Peer to Peer Mental Health Center” is a safe place for people with mental illness, and or dual diagnosis to build healing, wholeness, self-empowerment, and accountability. “Dance…” is a drop-in style center offering multiple support groups, workshops, and meetings for people ages 14 years and older with mental health challenges living on Cape Cod. It’s a place where wholeness and a person’s potential will be nurtured and allowed to grow. “Dance…” with its various programs challenges an individual to face his/her mental illness and healing. It’s also a place that strives to engage the Cape and Islands communities in a concerted effort to end stigma and help promote the much-needed changes within the mental health system.
Created and built by people with mental health challenges for people with mental health challenges. "Dance..." offers unique lived experience perspectives to offer support to our peers. We believe that a strong personal support system and peer engagement are some of the greatest assets a person with mental health challenges can possess in his/her journey of healing. We work hard to help individuals recognize who their supports are and to help them build strong support systems.
Dance in the Rain offers all of our services free to all of our peers because we understand the damaging toll isolation takes on the individual and in turn costs the community.
We have a new calendar at Dance in the Rain with new groups and workshops plus increased hours on Wednesday and Thursday!
Everyone at Dance in the Rain has been working hard to make "Dance..." a place of healing through our programming and through our venue.
Checkout our programing and what's coming-up at the "Dance..."
website
.
The next Moondance Coffeehouse will be Friday February 15th 6:00PM - 8:00PM. No RSVP required. Bring a dessert to share and come as your are. Everyone is welcome; peers, family, providers and the community. It's about celebrating healing and building community around mental health.
Come share your talent or just come to listen and socialize.
Hours:
Monday - Thursday 10AM - 4PM
Wednesday & Thursday open to 6PM
We directly engage with on a average of 12.8 peers daily.
On a monthly basis we directly engage with over 260 peers.
Through our social media and newsletter we engage with over 1,630 individuals every month.
Located in Downtown Hyannis Minutes from the Bus Station and Main Street. Upstairs 145 Barnstable Rd. Hyannis
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A New NAMI Course for Military Families Facilitated by Veterans
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Orleans Saturday Support Group for Peers:
Note that the time has changed to 2:00 pm - 3:30 pm,
effective immediately.
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Thank You
Anne Keifer of Hidden Gems
47 Main Street in Orleans
f
or your ongoing support for NAMI Cape Cod & Islands!
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Award-winning mental health drama 'Antelope' released online
Following a successful run on the film festival circuit, ‘
Antelope
’ a mental health themed short film by Southampton based writer/director Ben Grace has been publicly released online.
It follows Maddie (Becky Mills) who is released into the care of her brother Rupert (Wesley Budd) and sister-in-law April (Joanna Russel) following a stay in hospital after a failed suicide attempt. This hopeful drama sensitively explores how families can readjust their relationships following a mental health crisis.
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Families for Depression Awareness
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Depression Awareness is in the final stages of producing a new publication and we'd love to share it with you!
Introducing the
Helping Someone Living with Depression or Bipolar Disorder: A Handbook for Families and Caregivers.
This resource takes the reader through everything they need to know from diagnosis to helping someone maintain wellness. An essential read for all caregivers.
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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.
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
i
n 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!
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