MAY 2019

From the desk of Jackie Lane, Executive Director NAMI CC&I
Jackie Lane is on a well deserved vacation and madly doing garden therapy! 

From the desk of Mary Zdanowicz, Esq
State Senator Julian Cyr, who represents the Cape & Islands, holds a position that is very important in determining mental health policy and law. He is chair of the Joint Committee on Mental Health, Substance Use and Recovery. He is also a member of an informal mental health working group seeking to launch an extensive change in how mental health care is accessed and viewed in Massachusetts.
He shares his own frustrations over the past two years trying to get his outpatient therapist covered by his insurance provider:

I imagine someone who is in a similar situation being on different insurers, not having that consistency and not having the tools I would have,” Cyr said. “I haven’t been able to figure it out. Right now I’m paying out of pocket … If I can’t navigate this system, something is really wrong.”

There are two issues that are identified for consideration as part of a new initiative to transform the mental health system. The first is an investment of at least $500,000 to the Department of Public Health for a public awareness campaign to promote available behavioral health services. A second investment would be at least $2 million on a loan forgiveness program for workers employed in mental health professions.

Sen.  Cindy Friedman , the chair of the Joint Committee on Health Care Financing, explains that loan program is trying to solve job shortages driven by low reimbursement to certain providers.

“Historically the rates for behavioral health providers are significantly lower than they are for most medical/surgical,” said Friedman, an Arlington Democrat. “This is causing a huge issue with workforce, and getting people to actually work in this field. They can’t afford to work in it. Either the rates are so low and the administrative burden is so high they stop taking insurance, or they leave the field altogether.”

In addition, the proposed state budget would significantly increase spending for community mental health services for both children and adults.

May has been a busy month for NAMI CC&I disseminating information about mental health. Jackie Lane spoke on both Nantucket and Martha's Vineyard, and Kim Lemmon spoke at the YMCA. In addition, we had half-page, 4 color ads in the Cape Cod Times as well as the local community newspapers. Jackie did a radio interview with Matt Pitta from Cape Cod Media WQRC as well as Why Care radio spots. In addition, Jackie Lane was able to secure the use of a vacant storefront in the most highly trafficked area of the Cape Cod Mall for a display on Mental Health Month--Why Care .
In Portuguese

Appalachian Trail stabbing highlights challenge of intervening on behalf of the mentally ill
By Vernal Coleman and Laura Crimaldi |  Globe Staff

Odie Norman, a so-called trail angel, heard disturbing reports about a man threatening hikers on the Appalachian Trail, and decided to seek him out.
Norman tracked James Jordan down earlier this month and bought him a hamburger at Bob’s Dairyland in Roan Mountain, Tenn.
Almost immediately, he saw that Jordan, 30, of Yarmouth, was deeply troubled and needed help. But what to do? “Do you call 911 and say: ‘Don’t call the cops, send a psychiatrist?’ ” Norman said in an interview. Norman’s dilemma encapsulates the challenge of getting troubled people help, while weighing their rights against the possibility they could harm themselves or others.
“You’re having to find that balance, and predicting violence isn’t an exact science,” said Martin Cohen, board member of the Massachusetts Health Policy Commission. One in five adults in America experiences a mental illness in any given year, and half of chronic cases start by 14 years of age, according to the National Alliance on Mental Illness.
Advocates say those with mental illness are more likely to be victimized by violence than commit it. Nonetheless, from 2005 through 2015, 10 percent of all homicides in Massachusetts in which a suspect is known were allegedly committed by people with a history of mental illness or clear symptoms,   according to a 2016 Spotlight Team investigation .
In Massachusetts, a person can be detained at a hospital or treatment facility for up to 72 hours if an examining physician believes they could hurt themselves or someone else if left free.
Once the person is admitted, medical authorities can petition for a court order to commit the person to a mental health treatment facility. Under state law, a person facing an involuntary commitment for the first time can be forcibly hospitalized for up to six months, and subsequent commitments can last for at least one year.
There were 3,084 petitions for involuntary commitment filed in 2017, according to the most recent state data available. That’s a 22 percent increase over 2012, when 2,518 petitions for involuntary commitment were sought.
Commitments are a drastic step, said Phil Kassel, executive director of the Mental Health Legal Advisors Committee. He and other advocates say Massachusetts should expand the availability of treatment options as another potential solution.
Cohen agreed preventative care is paramount. “We have got to make mental health care more accessible to people before they need crisis services.”
Jordan is currently in jail in Virginia, charged with killing hiker Ronald Sanchez Jr. on the Appalachian Trail. Friends in New England had previously steered Jordan, 30, to mental health facilities, but he allegedly signed himself out and refused medication. Meanwhile, he accrued a record of minor crimes, none of which kept him locked up for long.
Fifty years ago, Jordan might have landed in a public psychiatric hospital. Today, in Massachusetts, most of those facilities are shuttered, and a patchwork of community services and private care providers operate with strained budgets.
There are 2,892 inpatient beds available for both voluntary and involuntary hospital admissions, as well as involuntary commitments. Still, patients can wait days in Massachusetts hospital emergency rooms before receiving needed psychiatric treatment, according to a recent study published in the Annals of Emergency Medicine.
Danna Mauch, Massachusetts Association for Mental Health CEO, said one of the keys to dealing with a person with mental illness is intervening “before the situation reaches emergency proportions.” She would like to see a broader menu of treatment options that are more accessible to people across the state.
By April, hikers reported Jordan appeared to be troubled. He allegedly brandished a knife and hissed at passersby. Norman, founder of  The Hiker Yearbook , chose to steer Jordan off the trail earlier this month and away from others. Norman told the Globe he bought Jordan a one-way ticket to see his family. Norman even confirmed that Jordan got on the bus. But not long after, Jordan was back on the trail.
The system, Norman said, isn’t equipped to keep people like Jordan safe from themselves and others. “There should be a social worker or psychiatrist we can call, not someone who only has the power to put people in handcuffs and have them spend the night in jail.”
Vernal Coleman can be reached at . Laura Crimaldi can be reached at
The Biology, The Misconceptions and The Complexity of Mental Illness

This learning event was presented on May 21st at the Cape Codder Resort. The event, sponsored by DMH, NAMI Cape & Islands and DMH Citizens Advisory Board, was well attended by professionals and the general public. The program, from McLean Hospital's Neurobiology of Fear Laboratory, is designed to engage people in conversations about the biological basis of mental illness as a means to alleviate mental health stigma.

There were speakers, including Charity Bell who presented "It is all in your mind...Interacting in Escalated Moments" where she discussed what is happening in the brains of humans whose responses confuse and frustrate us, as well as an "Unmasking Stigma" expressive arts therapy project display from Fellowship Health Resources.

Sean Shinnock, speaker at Brain Matters, presented his story of growing up struggling with his own mental health challenges and the treatment he received.

The Collected Schizophrenias :

By Esme Weijun Wang

There are many books written about the complex disorders of schizophrenia and schizoaffective illness, both first person accounts as well as clinical texts. What makes this book unique is that it is a collection of essays about mental illness rather than a straight narrative. Although it details Wang's experience, it also highlights the complexity of illness and provides insights into the disagreements in the psychiatric field regarding diagnosis and treatment as well as the stigma that otherwise intelligent and sensitive people unknowingly harbor against mental illness in general and the schizophrenias specifically. She shares her experience at Yale as one of these examples.
I recommend this very well-written and moving book to anyone who wants to understand how the schizophrenias can affect the lives of previously high functioning individuals during the acute phase as well as throughout the course of their lives. Winner of the Graywolf Press Nonfiction Award.

Book Review by Arlene Hoxie
NAMIonNantucket continued the mission of outreach and collaboration as NAMI CC&I Executive Director, Jacqueline Lane was invited to be part of a continuing community forum “Let’s Talk” sponsored by A.S.A.P. ,the Alliance for Substance Abuse Prevention. The panel of mental health professionals, wellness practitioners and community members with lived experience addressed coping skills, warning signs and what’s “normal” in exploring the range of human emotions.

This interagency collaboration emphasizes the message that “we are stronger together” and NAMIonNantucket looks forward to being part of this continuing conversation.

Wow! I can’t believe May is over. What an incredible month we had on Martha’s Vineyard celebrating Mental Health Awareness Month!

We started off on May 1 with NAMI CCI Executive Director Jackie Lane visiting the Island and speaking at the Chilmark Library. We held two ‘Dinner and a Movie’ nights. On May 7 we featured As Good As It Gets . Chef Gavin Smith created an amazing meal for us, and retired therapist Betty Robie spoke after the movie about the three main characters and their mental illnesses. We were maxed out at 20 people, and everyone had an incredible evening.

Our second movie night offered The Soloist . As the movie was set in California, chef Tanya Chipperfield created a menu that would outdo any fancy LA restaurant. Personally, the orange chocolate mousse for dessert was my favorite. J Dr. Charles Silberstein spoke after the show and answered numerous questions. Once again, we were full with 20 attendees and a waitlist of folks who wished they’d signed up sooner.

We also offered two afternoons at local libraries showing Disney’s Inside Out . We not only watched the movie, but we talked about feelings and emotions, ate themed based snacks, and played a few games.

On May 18, attorney Debra Rahmin Silberstein of Burns & Levinson LLP came down from Boston to speak on: Estate Planning to Leverage Treatment and Improve Mental Health Outcomes. Debra’s knowledge and advice were greatly appreciated by all in attendance.

Our Family-to-Family Class wrapped up on May 23. The last class was filled with hugs, laughter, tears, and much gratitude for all that was learned and shared. Huge THANK YOUs to Megan Grennan and Katharine Neadow for all their hard work, love, and compassion.

We finished out the month on May 30 with a visit from author, activist, and suicide attempt survivor Craig Miller. Craig spoke to all the students at the Martha’s Vineyard Regional High School early in the morning for an hour and a half. Then we visited the Dukes County House of Corrections. Craig spoke with the fifteen inmates, and we gave each person a copy of Craig’s book, This is How it Feels: Attempting Suicide and Finding Life. On Thursday evening, Craig gave a fantastic presentation at the Katharine Cornell Theatre.

May was incredibly busy month, but a deeply rewarding one. The Martha’s Vineyard Times did a cover story on Mental Health Awareness Month, and both Island papers, The Times and The Gazette, featured NAMI MV events each week in the calendar sections. As we do more and become more visible, under the wonderful leadership of Cecilia Brennan, it is our hope that day by day, person by person we can cure stigma.

Blessings and hope,
Lisa Belcastro

RESEARCH WEEKLY: May Research Roundup
Research Roundup is a monthly public service of the Office of Research and Public Affairs. Each edition describes a striking new data point about severe mental illness and summarizes recently published research reports or developments.

DATAPOINT of the month
  • One-third of individuals with serious mental illness live in remission.
Research indicates that approximately one-third of individuals diagnosed with a serious mental illness, including schizophrenia, severe bipolar disorder or major depression, live in complete remission of their symptoms for a full-year. Devoid of impairments associated with these disorders that limit daily life, remission and recovery is possible with appropriate treatment and supports for some individuals with severe psychiatric illnesses.

RESEARCH of the month
  • Effects of polypharmacy on reducing rehospitalization among individuals with schizophrenia.
Although antipsychotic medications are the first-line of treatment for individuals with schizophrenia, sometimes these alone are not sufficient in reducing all of the symptoms associated with the disorder. Therefore, physicians may add another medication to an individual's pharmacological treatment, including another antipsychotic medication or other psychotropic medications such as antidepressants, mood stabilizers, or benzodiazepines, a practice known as polypharmacy.
Utilizing Medicaid data from 2001 to 2010, new research published this month indicates that when compared to adding another antipsychotic medication, the addition of an antidepressant medication was associated with a lower risk of subsequent psychiatric hospitalizations or emergency department visits for individuals with schizophrenia. The addition of benzodiazepines resulted in an increased risk of these negative outcomes, according to the study results. The authors conclude that adjunctive antidepressant medications should be used as needed in combination with antipsychotic medications for individuals with schizophrenia to reduce the symptom burden.

  • Antipsychotic polypharmacy and associated outcomes for people with serious mental illness.
Another study published this month examined the outcomes associated with polypharmacy for individuals with serious mental illness, analyzing administrative data from 17,255 individuals with serious mental illness in the United Kingdom. The authors compared treatment utilizing multiple antipsychotic medications with treatment using only one medication on outcomes such as psychiatric hospitalizations, emergency department visits and death.

The authors found that antipsychotic polypharmacy had no negative effects on increasing risk of hospitalizations or mortality among individuals with serious mental illness. In addition, compared to individuals who were not taking any antipsychotic medications, pharmacological treatment was associated with a reduction in hospitalizations or emergency department visits and had no negative effects on mortality risk. The authors conclude that although treatment guidelines discourage polypharmacy for individuals with serious mental illness, when clinicians deem it necessary, polypharmacy has limited negative effects on patient outcomes.

  • Cannabis use in adolescence increases suicidality in young adulthood.
Cannabis is the most commonly abused drug for adolescents, and its use has been increasing among this population in the United States in recent years. In addition to the association of cannabis abuse in adolescence with an increased risk of  later developing psychotic disorders, new research indicates that cannabis use in adolescence may also be associated with suicidality in young adulthood.
Published this month in JAMA Psychiatry, researchers conducted a systematic review and meta-analysis to examine the effects of cannabis use in adolescence on developing mental illness and suicide. Based on 11 published studies with 23,317 individuals, the authors found a significant increased risk of suicidal ideation and suicide attempts in cannabis users in people 18 to 25-years old. The authors conclude that although the individual risk is low, because of the high prevalence of young adults using cannabis, the link presents a considerable public health concern. Responsible health policy should seek to further examine and address the risk of severe mental illness and suicidality associated with cannabis use among adolescents.

Elizabeth Sinclair 
Director of Research
Treatment Advocacy Cente r

Spotlight on Manny Marrero, MOT,OTR/L,FCE
A recent addition to the Board of Directors of NAMI CCI, Manny Marrero is an impressive individual by both his life experience and professional training. He was raised by a single mother with two older sisters. He began his journey on 117 th Street in Harlem, New York City, a very tough and dangerous neighborhood. Fortunately, his mother and new step-father were able to move to Western Massachusetts (Pittsfield) before Manny became a teenager. He graduated from Pittsfield High School and immediately enlisted in the U. S. Marine Corps. He survived two tours to Iraq, battle-tested, returning to the U.S. as a Corporal with PTSD.

Following his Marine active duty, he completed college and masters degree programs to become a licensed Occupational Therapist (MOT), a profession devoted to helping people with physical and/or mental disabilities develop everyday living skills. For the past few years Manny has practiced his profession as a MOT at the Cape Cod Healthcare Center for Behavioral Health Partial Hospitalization Program. There he exhibits his passion, commitment and caring to make a difference in the lives of his patients.

Manny’s interests span both his professional and vocational activities. With his own PTSD and his mother’s Bi-Polar Disorder, he is attracted to individuals with their own mental health issues. He sees the OT field as a merger of nursing and social work. Manny has expanded his trainings to encompass a Certification as a Meditation and Mindfulness leader and he runs a monthly support group to teach others in these areas.

In his free time, Manny plays league basketball, lifts weights, practices Yoga and is in training to run the Falmouth Road Race and raise $1,000 for charity. He is 36 years young, married and hoping to have kids one day. NAMI CCI is very grateful to have Manny Marrero on our team. 

Every month we will feature a person or agency in our area

Newly Trained Family to Family Facilitators
NAMI Cape & Islands would like to congratulate and welcome our new Family to Family facilitator team, Julie Greenspon and Dianne Jackson. Julie and Dianne participated in the Boston teacher training on May 4th & 5th and will be teaching the next Cape Cod Family to Family session in Barnstable beginning soon.  

If you know anybody who would benefit from attending Family to Family, please have them call Kim Lemmon at 508-778-4277 to register.

Orleans Support Group
NAMI Cape & Islands and Carolyn Witt of the Orleans Support Group, would like to express gratitude to Linda Burnham for her dedication to the Orleans Support group. Linda covers the Orleans group during the winter months.  Linda celebrated a birthday recently and we wish her all the best for a year of good health!  The Orleans Support group has been meeting since 2004!  The group meets at The Federated Church of Orleans, 162 Main Street on Saturday mornings 10:00 - 11:30 a.m. during the summer months and 2:00 - 3:30 during the winter months. 

For more information about the Orleans Support Group, call the NAMI office at 508-778-4277 or email Carolyn directly

NAMI Support Group Notes:
Ø  New Support Group: For family members, caregivers, and friends of those with a mental health issue. Meeting on the second Thursday of each month at St. Mary's Episcopal Church on Route 6A in Barnstable from 2:00 - 3:30 p.m. 
Ø New Support Group: For family members, caregivers and friends of those with a dual diagnosis. Dual diagnosis refers to individuals who have a mental health issue and a substance use disorder. Substance abuse is a barrier for treating mental health. NAMI will have a support group facilitated by a retired alcohol/drug counselor-family therapist on the second and fourth Thursday of each month at the NAMI office located at 5 Mark Lane, Hyannis (Brick building located behind New England Pizza on W. Main St. 2 nd  floor)   1:00 – 2:30 p.m. (June 11 and 25)
*All NAMI Support Groups are free, open for drop in, and confidential. Please call the NAMI office with questions or for more information at 508-778-4277.
Upcoming Classes:
Homefront: New to the state of Massachusetts and only offered on Cape Cod; Homefront is the “Family to Family” for military families. This 6-week course facilitated by peers is an opportunity for veterans and military family members to understand and respond effectively to a family member who may be suffering from a mental health issue. The first Homefront course on Cape Cod is scheduled to meet on Monday evenings, 5:30 - 8:00 p.m., July 15th - August 19th in Hyannis. 

Family to Family: The next session of Family to Family will begin on Wednesday, July 10th, 6:00 - 8:30 p.m. in Barnstable (easy access from Route 6).  
*All NAMI educational programs are free and confidential. However, registration is limited and required. Please contact Kim Lemmon, Director of Family Programs for registration and information at 508-778-4277.

A New NAMI Course for Military Families Facilitated by Veterans

A Great Yarn of Chatham thanks all NAMI knitters who contributed to their annual project of knitting strips for blankets for the homeless and newly homed.
Dance In the Rain
Mary Munsell wishes to announce that Dance in The Rain will no longer meet at 145 Barnstable Road, Hyannis.  During this time of transition and restructuring, program information will be available on their website at  and on their Facebook page. Specific questions can be directed to Mary at her email address -    
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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