FEBRUARY 2020
PARENT GROUP in FALMOUTH CANCELLED THURSDAY
the next meeting to be sure it is going to be held
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From the desk of Jackie Lane, Executive Director NAMI CC&I
As the days get longer and spring bulbs start popping up, we at NAMI CC&I are making plans for May, Mental Health Awareness Month. A few weeks ago, I was approached by Dr. Kim Meade-Walters from the Outer Cape, who is the founder of Sharing Kindness, a group that promotes kindness and caring for those who are grieving after a loss. The suicide of her son, a junior at Nauset High School, was the driving force behind the idea when she discovered that people did not know how to respond to someone in her situation as she tried work through her devastating loss. Dr. Meade-Walters, with a small group of dedicated and enthusiastic workers, established a Suicide Awareness Walk which has been successfully held in Orleans for the past few years. The Samaritans of Cape Cod & the Islands and the Cape & Islands Suicide Prevention Coalition joined the effort.
This year Dr. Meade-Walters approached NAMI CC&I about becoming the fourth collaborative partner as she brings the walk to Hyannis. We gladly accepted and are dedicated to helping to build and grow this event drawing attention to suicide, a significant mental health issue this country, and especially its youth, is facing.
The 3-mile walk will be held on Saturday, May 16
th
, 10:00 am starting at Veteran’s Park Beach, moving up to Main Street, and back down Ocean Street. Opening remarks will be given by notables and agency resource tables will furnish information. We will have more details as the event draws nearer.
We are hoping to attract many new walkers, including school groups, as the suicide rate among high school and college aged kids is significant. Anyone can walk for free; however, we are suggesting a minimum of $25.00 in sponsorship. Tee shirts will be available. We are hoping to increase event sponsors, previously limited to the Orleans area, and to grow the number of walkers as it is an opportunity for all of us to draw attention to the seriousness of mental health issues in our community. Net proceeds will be divided among the four collaborative partners.
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SUICIDE: End the Silence-Educate/Advocate/Parent
Saturday, May 16, 2020 10 am
Veterans Park Beach, Hyannis
NAMI Cape Cod & the Islands is collaborating with the organizations shown below:
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Spotlight On the Brain
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And how early experiences affect its development
James P.D.
McGuire, MD
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One of NAMI Cape Cod & the Islands' visions for 2020 is to share information with the community about how the human brain is built and and the risk and protective factors involved in development.
How we attend to our relationships with children early in their life has a profound developmental effect on the health of their brains and our shared future. Life experiences and developmental trajectories of children are shaped very early in life. Brain health and development is shaped by many factors but none more important than the relationships with the significant adults in their lives.
If you plan for one year plant rice
If you plan for ten years plant a tree
If you plan for 100 years educate a child
In the last newsletter I wrote about the importance of nurturing relationships in the building of the brain architecture of our children and also how the brain is built hierarchically. Brain development nurtured early in life has a foundational importance on how the structures of brain and its capacities are built, connected, and used.
See the brain game exercise on you tube
The science of Early Childhood &Brain Architecture Game
O
ne of the most helpful graphic descriptions of the structure of the brain and its hierarchical organization has been developed by Bruce Perry MD and his colleagues at the Child Trauma Academy in Texas. Bruce has a Seven slide series on YouTube which is listed below in which he presents his model and describes with clear graphics the hierarchical nature of the brain and the functions of each of the levels of that architecture.
Seven slide series: the Human Brain
I have also included one of Bruce’s recent talks for a review of his work.
Social & Emotional Development in Early Childhood
Over the past four years Cape Cod NAMI has sponsored and introduced to Stewart Ablon’s program of “THINK KIDS” and the model of ”Collaborative Problem Solving “ to our community.
Stuart and Bruce have been working together for over a decade and have integrated Collaborative Problem Solving with the neurobiological underpinnings of the Neurosequential Model of Treatment (NMT) developed at the Child Trauma Academy.
A Chapter of a book outlining this collaboration is listed below. The chapter may require several readings but is well worth the investment of time and effort.
A key concept of the Neurosequential Treatment Model is that the emergent properties of the developing brain and their hierarchical arrangement can be divided into areas whose principal functions are to REGULATE, RELATE AND REASON. REGULATION is what goes on with the unconscious maintenance of the bodies’ homeostasis attending to the metabolism, sleep and wake cycles and the human stress response. These regulatory functions are embedded in Social RELATEDNESS.
The second rung in the Brain’s hierarchy of function lies in the Limbic structures of the brain.
The strength, capacity and flexibility to RELATE lie in this area of the brain which in turn becomes the foundation of our ability to REASON.
We hope you view some of these and let us know what you think!
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From the Desk of Mary Zdanowicz, Esq.
ADVOCACY
Note: This is the second in a series of articles that will explore a variety of guardianship topics.
What is an “incapacitated person”?
The threshold question in any guardianship proceeding is whether the person has “capacity,” which requires both a clinical and legal determination. The three basic components of the legal definition of an “incapacitated person” under Massachusetts law are:
·
a clinically diagnosed condition;
·
an inability to receive and evaluate information or make or communicate decision; and
·
an inability to meet essential requirements for physical health, safety, or self- care.
To complete the Medical Certificate, a clinician determines whether the person has a
clinically diagnosed condition
and then evaluates the following factors to assess the person’s ability to
receive and evaluate information or make or communicate decisions:
·
alertness & level of consciousness;
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memory and cognitive functioning (e.g., memory, comprehension, reasoning, judgment, planning, insight); and
·
emotional and psychiatric functioning (e.g., mood, anxiety, psychosis, substance use and other disorder).
A clinician also assesses the person’s ability to meet the
essential requirements for physical health, safety, and self-care
. That is, the person’s ability to manage Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), such as: health, hygiene, home, communication, driving, leisure, and social activities. Additionally, the person’s functioning in the community, ability to express treatment choices and make medical decisions, and ability to complete any or some legal transactions are evaluated.
There are myriad reasons why a person might become incapacitated and benefit from guardianship. Individuals diagnosed with neurological disorders and serious mental illnesses may experience neurocognitive deficits that affect memory, attention, executive function, and insight. Lack of insight may be the most challenging issue for people with serious mental illnesses. As noted by experts:
“If, after months and years of evidence, the person still does not believe she or he is ill, what we are often dealing with a cognitive deficit: anosognosia (AH-no-sog-NO-sia). The term anosognosia was coined by the Hungarian-born neurologist Babinski who, when working in Paris at the turn of the last century, described patients with neurological deficits such as hemiparesis, who were completely unaware of the deficits. And perhaps more importantly, most studies of nonadherence and partial adherence to treatment find that the best predictor is unawareness of illness or poor insight.”
Celso Arango & Xavier Amador,
Lessons Learned About Poor Insight,
37 Schizophrenia Bulletin (2011)
What does this mean in practice? Perhaps it is helpful to consider a population that would benefit from the protections of guardianship but is often overlooked. For homeless individuals suffering from a serious mental illness, it would be important to evaluate skills that are important to their daily functioning, such as taking medications as prescribed by a physician, filling out an application for benefits such as food stamps, keeping track of or budgeting their money, using city buses to get where they want to go, setting up job interviews by telephone, and finding an attorney to help them with a legal problem.
Answering the inquiry about a person’s capacity for purposes of guardianship requires a detailed clinical and legal analysis that is specific to the person’s individual needs and abilities.
In future articles in this series, these topics will be covered in greater detail. If there is a specific topic of interest that is not listed above, please send an email to [email protected].
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NEW NAMI ON NANTUCKET PHONE #:
508-280-8777
The little gray lady is unusually quiet this week. It’s school vacation and many island families and businesses are taking advantage of the hope for warmer climes and a brief respite before the busy summer season. But mental health and wellness, homelessness, food insecurity and the need for medical services don’t get to pack their bags and sit in the sun or on a snowy ski slope; these are our friends and neighbors and people we know by sight if not by name. While I’ve been guilty of bemoaning how expensive it is to live here and how hard it is to travel off island, my commitment to this community runs deeper than a family history. I see that dedication and commitment in others too, especially as I sit at the table for the monthly Behavioral Health Advisory Group meeting. Every person at the table whether working as part of an organization or individually, provides much needed services to the community while collaboratively working to identify and remediate the gaps. Mental Health Awareness Month is in May and a calendar of events is being organized for distribution to the island community.
Fairwinds is sponsoring an all-day training for clinicians on March 6
th
on suicide prevention and assessment.
NAMI on Nantucket and the Behavioral Health Advisory Group will have an information table at Nantucket Cottage Hospital’s annual Pediatric Health Fair March 22
nd 12:30-3:30
. A key speaker for this event will be a physiatrist from Spaulding Cape Cod talking about youth concussions and sports.
The Nantucket Historical Association is sponsoring a multicultural day on March 21
st
. Come out and meet your neighbors!
March 28
th
is Woman’s Gathering sponsored by several island health organizations including NAMI on Nantucket. Keynote speaker is Dr. Maria Sirois, licensed clinical psychologist speaking on the resilience of the human spirit under pressure.
Efforts to address homelessness and food insecurity are ongoing.
Although I look out my window today and see gray skies, yesterday was filled with sunshine and the promise of spring. We are indeed fortunate to live here amongst so many dedicated individuals and organizations and I thank every one of you for showing up every day to make life on Nantucket better for us all.
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SAVE THE DATE
DRAGONFLY 2020 will be held on Thursday,
July 23, 2020
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February was a great month for NAMI MV!
We are thrilled and honored to announce that Michael Blanchard, Island photographer, counselor, and addiction/recovery spokesman has selected NAMI MV as the non-profit recipient of his yearly calendar sales. NAMI MV will receive $5 for every calendar sold, which normally is around $10,000 total to the non-profit.
The Peer Outreach Group at the High School continues to grow and reach out. During the first two weeks of February we ran a self-love give on Instagram. The winner, Trip Harding, was drawn on Valentine’s Day. He won a basket filled with goodies: chocolates, Mocha Motts gift card, Scottish Bakehouse gift card, candles, tea, lotion, facemasks, tote bag, and more.
The Peer Outreach Group is going to host three tabling events, one each month this spring, during lunch. We will select a topic every month and have materials to distribute to the high school students at our table, as well as Hershey kisses or Tootsie Rolls.
Stay tuned for news on a NAMI Walk on Saturday, May 16. The Peer Outreach Group is working hard to secure a location and get permitting.
NAMI MV, the Island Wide Youth Collaborative, and the Youth Task Force are joining forces to rent Edgartown Cinemas and offer a free showing of the movie “Like” on Sunday, March 29. We will show “Like” in the main theatre, then offer free childcare and G-rated movie in the second cinema.
Our Family-to-Family class begins on March 5. We will be teaching the new 8-week course. We have 23 enrolled to date, with five spaces still open.
Warm wishes to all,
Lisa
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Education and Support News
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NAMI Homefront is a 6 session, peer-delivered course designed for families or support persons of Veterans and service members with mental health conditions. You will learn how to:
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Manage crises, solve problems, communicate effectively
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Care for yourself; manage stress
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Develop confidence to support your loved one with compassion
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Identify and access federal, state and local services
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Be informed on the latest research on mental health
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Understand current treatments, therapies and medications
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Navigate the challenges and impact of mental health on the family
Most importantly, be with others who face similar challenges. You are not alone!
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FAMILY-TO-FAMILY
A free, comprehensive 8-week course designed
specifically for families and friends of persons managing a mental health issue. Family to Family offers education, support, and resources.
Classes start Tuesday, March 10, 2020 from 6:00 – 8:30 pm
IN HARWICH
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Family Connections NEA-BPD
This 12-week, research-based program for family members of individuals who have difficulty managing their emotions, provides current information, teaches communication skills, and creates the opportunity to develop a support network.
Is This Program For You?
•
I am a family member, partner/spouse, caregiver or close friend of someone struggling with symptoms or a diagnosis of Borderline Personality Disorder. (A mental health disorder characterized by unstable moods, behavior, and relationships.)
• I want to improve my relationships.
• I am willing to consider how my own behavior impacts the relationship.
• I am willing to try out new skills even though they may be uncomfortable at first.
• I am willing to attend all classes.
• I am willing to participate and practice new skills.
• I want to have the knowledge and tools to create better relationships.
Family Connections is being planned for the Spring 2020 in Barnstable.
To register for the upcoming classes in Harwich and Barnstable, or to be notified about another offering in the future, call or email Kim Lemmon, Director of Family Programs. 508-778-4277 or
[email protected]
To register for the upcoming class on Martha’s Vineyard, contact Lisa Belcastro at
[email protected]
or 508-776-3746.
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NAMI Basics On Demand is a free education program available to parents and other family caregivers who provide care for children age 22 or younger who are
experiencing mental health symptoms
Highlights include:
- Solving problems & communicating effectively
- Accepting that mental health conditions are no one's fault
- Gaining an overview of the public mental health care, school & juvenile justice systems and different types of mental health care professionals and treatment options
- Preparing for and responding to crisis
- Brain biology and getting a diagnosis
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Difficult-to-Treat Depression: A New Approach to Treatment-Resistant Depression
By Scott T. Aaronson, M.D.
Dr. Aaronson is Director of Clinical Research and a psychiatrist at the Retreat at Sheppard Pratt Health System and a clinical associate professor of psychiatry at the University of Maryland School of Medicine. In 2018, Dr. Aaronson and colleagues published
an article
* proposing a reframing of depression treatment and discontinuing use of the term “treatment-resistant depression.” Here, he provides an overview.
How would you describe the current approach to depression treatment?
Currently, treatment is viewed as three phases: acute, continuation, and maintenance. Acute treatment is meant to bring the person with depression into remission, with their depression symptoms alleviated. Continuation treatment is meant to prevent relapse into the just-treated depression. Maintenance treatment is meant to prevent a recurrent (new) depression episode.
This three-phase approach has limitations. I am especially struck by the disconnect between the treatment goal of full remission and the reality that many people cannot achieve, or sustain, that remission. For some people, a focus on functioning and controlling symptoms may be more appropriate. We need to acknowledge that not everyone will get fully well.
In addition, there’s not good evidence to support the sequence of treatments, whether individually or in combination. Researchers have not fully explored the range of treatments available, particularly neurostimulation interventions, in the progression of treatment.
What are the problems with our current understanding of treatment-resistant depression?
The main problem is that it lumps all patients who have not been effectively treated by a certain number of medication trials into one group. We know that the brain involves both chemical and electrical processes, so it is not necessarily accurate that someone is “treatment resistant” if they have only tried medications. We also don’t distinguish between people who have not responded from people who have not been able to maintain their response (i.e., relapse). Not all depressions are the same, so why do we call them all the same and think they should be treated in the same way?
What is your proposal to reconceptualize treatment-resistant depression?
The current three-phase structure of depression treatment presumes that people will achieve remission and be able to sustain it, similar to treatment for cancer. Unlike cancer treatment, however, people with depression don’t necessarily become free of the condition or all of its symptoms. In one study, only about 1 in 10 patients with depression in remission were entirely symptom-free after two courses of treatment.
Instead, for a good number of people living with depression, it makes sense to take our cues from the field of cardiology. With chronic heart disease, “full recovery” is not feasible, so treatment is oriented to support the person in achieving their best health and best quality of life despite their heart condition. The treatment goals are to reduce the impact of symptoms and side effects on the person’s life and to encourage behaviors that support good heart health, such as quitting smoking, losing weight if appropriate, exercising, following a balanced diet, and managing stress. In other words, cardiac patients aim to manage their heart disease in a way that controls symptoms and supports daily functions and a good quality of life.
With depression, when treatment to date indicates that becoming symptom-free is not likely, it makes sense to aim treatment toward managing the depression, its symptoms, and the treatment side effects in a way that affords the best level of function and mental wellness under the circumstances.
Practically speaking, what is the difference for people living with depression?
We need to change how we think of what constitutes a meaningful outcome of treatment. Having people return to their pre-depressive episode lives without significant negative side effects, functioning as well as they did then, is generally the goal of depression treatment. But we know that this goal is realistically not achievable for everyone.
Just as people who experience a cardiac event cannot reasonably expect to have their heart be the same as it was before the heart attack, clinicians, people living with depression, and families must align their expectations to the reality that people living with depression are not always able to regain their full functioning, despite otherwise effective treatment that alleviates some but not all symptoms. For some, managing the depression with all available interventions, trying appropriate new treatments as they become available, and developing strategies to cope with remaining symptoms (generally through psychotherapy) may be the best outcomes they are able to achieve. Though short of the ideal outcome, using the difficult-to-treat model can be enough to support people in reclaiming their work lives, overcoming suicidal ideation, and being able to engage as parents and partners.
I believe that this approach has a psychological benefit. I am sure that some people may consider this aiming too low for defining successful treatment. However, for people who have unrelenting depression, the implicit (if not explicit) pressure to achieve nonrealistic goals can add to their sense of worthlessness and despair, thus exacerbating their depression. We should accept that acknowledging their progress and maintaining those gains – even if not a return to full functioning, but reflective of their personal values – is, for some, the very best that they can do.
How does this approach to unremitting depression affect families and their role in supporting their loved one?
I believe it is a positive change. Chasing unattainable goals creates unnecessary stress and depletes resources, including the capacity of caregivers. Setting – and achieving – more realistic treatment goals can restore a level of predictability to their lives as expectations align better with the person’s abilities. Being a caregiver to a person with ongoing depression presents a variety of challenges, including physical, emotional, logistical, interpersonal, and more. Using the difficult-to-treat framework facilitates the re-imagining of relationships, re-distribution of responsibilities, and reconciliation with their new reality. It also allows for celebration of being “well enough” to work on rebuilding their lives.
*
Rush, A.J., Aaronson, S.T., and Demyttenaere, K., “Difficult-to-treat depression: A clinical and research roadmap for when remission is elusive,” Aus & NZ J. Psychiatry 53:2, pp. 109-118 (Online Oct. 31, 2018; print Feb. 1, 2019).
20%
20% of Americans will experience depression sometime in their lifetime.
65%
65% of teens with depression don't receive treatment from a mental health provider.
80%
80% of people treated for depression get better within four to six weeks.
90%
90% of people who die by suicide have a diagnosable mental health condition.
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Free Webinar
Teen Self Injury: Working Toward Healthy Coping Skills
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My teen is self-injuring. What do I do?
Your first reaction may be to panic, but we know that isn't the most helpful response. We'll share strategies and resources so you can learn how to respond calmly and support your teen in getting the help they need.
Join us on
Tuesday, March 24, 2020 at 7-8:15pm
ET
for our free live webinar
This webinar features
Jason J. Washburn
, PhD, ABPP, a board-certified clinical child and adolescent psychologist.
You can submit questions when you
register
and during the live webinar. We'll answer as many as we can, so don't worry if you will be watching on demand rather than live.
This webinar is designed for any adults interested in teen mental health. Although clinicians are welcome to register, the program is intended for a general audience.
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Dialectic Behavior Therapy (DBT)
Skills Groups for Adults & Adolescents on Cape Cod:
ONGOING ADOLSCENTS GROUP*
Monday (Ongoing) 6:30pm – 7:45 pm 1.5 hrs.
3180 Main Street , Barnstable, Ma 02630
ONGOING ADULT GROUP*
Wednesdays 6:30pm-7:45pm 1.5 hrs.
3180 Main Street, Barnstable, Ma 02630
Learn Skills to become more effective.
*Mindfulness *
Distress Tolerance
*Interpersonal Skills *Emotional Regulation
*Fee: $30.00 Private Pay, No Insurance Accepted
Aimee T. Facchini, LICSW
3180 Main Street, Barnstable, MA 02675 508-360-8578
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RESEARCH WEEKLY: February Roundup
R
esearch 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
Suicide is the leading cause of death in jail, accounting for 31% of inmate deaths in 2016.
Suicide has been the leading cause of death in jail for many years, and 2016 is no exception, according to
data
released this month by the Bureau of Justice Statistics at the U.S. Department of Justice. More than 31% of all deaths of individuals incarcerated in state and local jails in 2016 were due to suicide. Approximately 40% of all deaths in jail during that year occurred during the first week of incarceration. More than one in five (21%) of all suicide deaths that occurred in a jail between 2000-2016 happened while the individual was in solitary confinement.
RESEARCH of the month
Veteran’s Health Administration successful in providing equitable care.
Too often does the research show how people with serious mental illness are disproportionately affected by a particular condition or have less access to quality care compared to people without. However, new research published this month in Psychiatric Services shows the success of the Veteran’s Health Administration to eliminate this disparity.
There are approximately 2.4 million adults living in the United States with chronic Hepatitis C virus (HCV), and veterans with serious mental illness are three to four times more likely to have HCV than those without mental illness. Importantly, people with serious mental illness have been shown to be less likely to have been screened, tested or treated for the virus.
Utilizing administrative health data, researchers analyzed data from more than 4,000 people with HCV, of which approximately 31% had received an evidence-based treatment for the virus. The researchers found no difference of treatment access for people with serious mental illness to those without. The authors conclude that “the VA should continue to provide equitable access to HCV treatments and support medication adherence.”
Gene and environment interactions in risk for developing schizophrenia.
As the Treatment Advocacy Center has called attention to previously, research studies on the interaction between genetics and environmental factors are needed to better understand risk factors to developing severe mental illness. Utilizing computing power and large population datasets on genome sequencing as well as environmental factors, such as exposure to different agents or where an individual lives, researchers can develop computer models that weigh all of the different risk factors and test what combination is able to best differentiate between people with or without a psychotic disorder.
In this study, researchers created an environmental risk score that included an individual’s ethnic group, urbanicity, paternal age, birth weight, cannabis exposure, and childhood adversity. They combined this data with a genetic risk score based on the individual’s genome sequence. Researchers then created algorithms that tested the interactions between people’s genetics and environmental factors and whether or not they had a diagnosis of first-episode psychosis. The algorithm allowed researchers to differentiate between people with a psychotic disorder compared to those without, based on these gene and environmental interactions. In addition, the algorithm shows that the higher the risk score, the more severe symptoms the individual experienced. The authors argue their results provide further evidence of the role of gene and environmental interactions in the development of psychosis.
Gut microbiota and psychiatric symptom severity.
Research has shown that the gut microbiome, the natural microbes found in all people’s digestive tract, is involved in psychiatric symptoms due to its influence on inflammation and neurotransmission. Researchers examined this relationship in a sample of more than one hundred individuals with serious mental illness who were hospitalized. The authors found that the diversity of organisms found in an individual’s gut is associated with psychiatric symptom severity. Specifically, the more richness and diversity found in an individual’s gut correlated with better treatment outcomes after release from the hospital, with greater depression remission rates.
Elizabeth Sinclair Hancq, Research Director
Treatment Advocacy Center
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Time to Start KNITTING FOR NAMI
We are again partnering with A Great Yarn in Chatham to knit panels for blankets to be donated to the Housing Assistance Corp (HAC) for the homeless and the newly homed. Knit-A-Thon continues through April.
All you need to do is knit 50 stitches across and 72 inches long, any washable worsted weight yarn, any colors, on size 8 needles.
From A Great Yarn: "This is our fifth annual Knit-a-Thon, and last year you guys produced 215 blankets for the Cape’s homeless. Amazing! This year our goal is to make 250 blankets. We know that’s an ambitious target, but we also know that the demand for the blankets keeps growing. Last year the HAC ran out of our blankets even before the really cold weather set in."
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Feb 15, Mar 21, Apr 18
Healing Arts Collective
47 Main St, Orleans
Register at
www.sueandersenyoga.com
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POSTVENTION:
Helping After A Suicide Loss:
Community Dialogue with Early Responders
Wednesday, April 29, 2020 10:30 am - 1:30 pm
Martha's Vineyard
This program was developed for early responders (police, firefighters, EMT, clergy, funeral directors) to better understand the impact of suicide and the effect on suicide loss survivors. Goals include:
- Promote healthy grieving
- Restore equilibrium and functioning
- Commemorate the decease
- Provide comfort to those distressed
- Reduce the risk of contagion
- Minimize adverse personal outcomes such as PTSD, depression, complicated grief
- Use the experience as a "teachable" moment
- Increase empowerment & mutual support for multiple disciplines and the community
- Find ways to work together to better support those impacted by suicide
Sponsored by: Samaritans Hope, the Samaritans on Cape Cod and the Islands and NAMI Cape Cod & the Islands
Future sessions are planned for Hyannis and Nantucket
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TIDBITS
The next Community Crisis Intervention Team Training will take place April 7,8,9, 14, 15, 2020. There is limited space available for non police or first responders. If you are interested in taking this 5-day course, please call the office at 508-778-4277.
NAMI Cape Cod & the Islands will hold its Annual Meeting on Thursday, April 16 at 4:00 pm. It is open to the public; however, only active members can vote.
Important Dates
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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
http://smile.amazon.com
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. It costs you nothing, but provides funds for NAMI CC&I.
Thank You!
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