I had a great trip yesterday to see the folks in Le Center for their LAC meeting. I’m headed back that way today for the LAC meeting in St. Peter. There’s lots to talk about with the upcoming session, but primarily, I enjoy getting a better picture of what people are doing around the state for their own recovery.

One member yesterday talked about how she had educated a physician on resources in the community, including the Resource Center where we met. I think that’s just such a testimony to the capability we all have to make improvements to the system, and why it’s so vital that the person stay at the center of all we do. And the refrain is common: the connections and networks of caring that are formed at resource centers, drop-ins, and community groups are a big factor for people. Breaking isolation and finding a place to belong is something we all strive for, and despite all the budget cuts we have faced, I am heartened to see how much effort is put into keeping those places alive.

Day on the Hill Bus Routes

We have a few more routes from last week, so please check and see if there is one near your community. If you are driving, please consider offering space to others in the community who could use some help getting there.

All buses are expected to arrive at Christ Lutheran Church by 9:45 am and will depart St. Paul around 3:00 pm.  Registration is required since space is limited.

The routes are:

• Baxter/Little Falls/St. Cloud (Matt Burdick at 651-645-2948 x107)
• Duluth/Cloquet/Pine City/North Branch/Wyoming (Matt Burdick at 651-645-2948 x107)
• Winona/Rochester (Matt Burdick at 651-645-2948 x107)
• Kerkhoven/Willmar/Atwater/Litchfield/Cokato.  Contact Teresa Emmen at (320) 894-7336
• Marshall/Redwood Falls/Fairfax/Gaylord.  Contact Teri Herder-Blahnik at 877-537-0831 for this route.  A 1$ donation is requested for this bus.
• Moorhead/Fergus Falls/Alexandria. Contact Maureen King at 218-385-3689.

If you can’t make it, please consider sending a mental health valentine to arrive that day. Our friends at NAMI spent some time coming up with some very witty ones to hand out, so we’d love to hear your contributions as well.  You have all felt some impact from the budget cuts already: let them know what it has meant for you and ask what they plan to do.

Rep. Greiling Set to Retire

Rep. Mindy Greiling has just announced that she will not seek re-election.  She has been an amazing advocate for Minnesotans with mental illnesses at the Capitol and will be sorely missed. She has served her district and state since 1993, and we recognized her many contributions with the Gloria Segal Award in 2009.

She has been a critical part of the push to make community mental health a priority and was the chief author of the 2007 mental health funding/reform bill.  This legislation set the high water mark of our state’s commitment to mental health care, and promised progress towards more care in the community and support for meaningful recovery.

We hear that she plans to stay involved with the mental health community, and I’m grateful that her voice will still be on our side.  Please consider sending a note of thanks to her office, and let her know how much her advocacy is appreciated.  Her contact information can be found here.

SOS Redesign

Last week, the Mental Health Legislative Network heard from Assistant Commissioner Maureen O’Connell on a variety of issues, including SOS redesign.  She stressed her continued involvement in and attention to the SOS system, including St. Peter.  The group sincerely thanked her for her candor and efforts to reach out to advocates, even if we still have some concerns about the redesign process.

“Redesign” has been a recurring headline, and I am anxious to see more details about how DHS proposes to change SOS.  Bottlenecks at intake and discharge are still major issues, and we need to make sure the resources dedicated to the CBHH facilities are being wisely used.  The state needs to ensure access to regional options for clients who require secure hospitalization, but that does not necessarily mean that the state must directly provide those beds.  I am encouraged by their solicitation of feedback from regional stakeholders, and hope we will have better answers this time around.

Hospitals Report Community Contributions

The MN Hospital Association has put out their data on community contributions they have made in the past year.  These numbers will likely see hot debate, as the squeeze on the health care system continues.  Including under-compensated care, notably the difference between the payment given by MA and the cost of the treatment, the hospitals recorded $2.28 Billion in contributions to the community.

More reliance on emergency care and uncompensated care is certainly an expensive way to deliver health care, but it does not appear to be directly affecting the health of the hospitals.  With hospitals in the Twin Cities seeing record profits, it appears that they have found ways to pass those costs on.  It is ultimately the public that pays, in longer wait times and higher insurance/medical costs.  Lawrence Massa, CEO of the Minnesota Hospital Association, is quoted as saying that Accountable Care Organizations (ACOs) and payment for outcome, not procedure, will continue to change this equation.

As a state, we will need to decide whether ACOs and the like will simply be tools of cost containment, or if they will be leverage to get better health care to more people. Perhaps part of the question ought to be about what a health care outcome is, and if our needs will be reflected in this new math.  It might be easy to see if a diabetic patient has had better control over their blood sugar, but we will need to make the idea of recovery more visible so our outcomes can be counted too.

In the coming weeks, college students will be returning home for the holidays. For many, this break provides a time to catch up and relax with old friends and spend some quality time with family; yet for some, deep sadness and emptiness prevents them.

A recent national study conducted by the American College Health Association-National College Health Assessment (ACHA-NCHA) reported that 31 percent of college students reported feeling “so depressed that it was difficult to function” at some time in the past year. In 2009, 8 percent of 18-25 year olds had a major depressive episode, but less than half received treatment according to a national survey.

Everyone feels sad or down from one time to another, but for individuals affected by depression, the symptoms are serious and long lasting. A person with depression may feel: sad, anxious, empty, hopeless, guilty, worthless, helpless, irritable, and/or restless. They may also experience one or more of the following:

• Loss of interest in activities
• Lack of energy
• Problems concentrating, remembering information, or making decisions
• Problems falling sleep, staying asleep, or sleeping too much
• Loss of appetite or eating too much
• Thoughts of suicide or suicide attempts
• Aches, pains, headaches, cramps, or digestive problems that do not go away

Depression is common and for most people, depression can be treated successfully. If you feel that you may have depression, try to be seen by a health professional as soon as possible. If you are a friend or relative encourage your loved one to seek help. It may be necessary to make an appointment and to go with them. If you have no insurance, having trouble finding a health professional, or need additional resources accessing treatment, please contact MHAM at 651-493-6634 or 800-862-1799 to talk with an advocate.

If you or someone you know is in crisis, get help quickly.
• Call your doctor.
• Call 911 for emergency services or go to the nearest hospital emergency room.
• Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

For more information and resources on depression, visit the National Institute of Mental Health (NIMH) website or click on the selected NIMH publications below:

Depression
Depression in Women
Men and Depression
Depression and College Students: Answers to college students’ frequently asked questions about depression

Our recent newsletter included a Q and A on SNBC enrollment that incorrectly described the opt-out procedure.  To remain on Fee for Service Medical Assistance (Traditional MA), you must return an opt-out form.  Doing nothing will result in being placed in a managed care plan.

We apologize for the confusion, we based our report on information provided by the Department of Human Services. Please note that that “Guide to Special Needs BasicCare Enrollment” found on the SNBC main page of the DHS site describes benefits/regulations as they are now, but does not apply to the new expansion.

For more information, visit the “Expansion Outline” found here.  The Disability Linkage Line is a great resources for asking questions about this transition: 866-333-2466.

How can you help MHAM improve the lives of people with mental illnesses? On November 16th, Give to the Max Day, you can! Go to MHAM’s page on GiveMN.org anytime on Wednesday, November 16th to make your donation. Your dollars will go a long way to help us in our mission to enhance mental health, promote individual empowerment, and increase access to treatment and services for persons with mental illnesses. Thank you for your support!

MHAM relies on individual donations from people like you to support our mission to enhance mental health, promote individual empowerment, and increase access to treatment and services for people with mental illnesses. Since 1939, MHAM has made a difference in improving the lives of people with mental illnesses. On November 16th, you can make a difference too!

Last year, more than 42,000 donors logged on to GiveMN.org and gave over $10 million to Minnesota charities in 24 hours during Give to the Max Day. This year, GiveMN’s annual Give to the Max Day amplifies your giving impact in a number of ways:

> The MHAM Board of Directors is providing a $10,000 matching grant. (Please note that this match applies only to funds raised for MHAM through GiveMN.org on November 16.)

> A $1,000 “Golden Ticket” will be given to a random donor’s charity every hour. Are you a night owl? Early bird? Donate anytime during the 24 hours on November 16 and you could be that donor!

> $15,000, $10,000 and $5,000 prize grants will be awarded to the top three small nonprofit organizations – with budgets under $750,000 – which receive the most dollars on Give to the Max Day. Help MHAM get “on the board!”

Please show your support for MHAM by making a donation on Wednesday, November 16th through MHAM’s GiveMN webpage.

A study by the Substance Abuse and Mental Health Services Administration, found that one in five adults experienced mental illness in 2009. Yet, the majority of individuals that have these types of health conditions do not seek treatment because of cost, fear of stigma, and lack of knowledge of the treatments that exist.  By educating the workforce on mental health issues, an organization can create a supportive climate that can break down the barriers of stigma and lead to steps that promote better health. The following are ideas on implementing mental health into existing health promotion and communications efforts at work.

Partner with community mental health agencies and existing benefit providers: These agencies often provide training and educational materials to community members, including area businesses.

•  Training can include formal presentations on common mental health problems such as depression, anxiety, and stress in the workplace. If you have an employee assistance program (EAP), training or educational seminars may be part of your contracted service or may be available for an additional fee.
•  Educational materials can include brochures, booklets, and training and resource manuals that can approach a variety of topics relating to mental health. These services are often provided at a low cost or, in some cases, free of charge.
•  Incorporate mental health into your company’s health or wellness fair. EAPs and community agencies often provide information for employees at these events.

Add mental health information to your existing communications: Newsletters, payroll stuffers, post cards, e-mail blasts, and other communications can all help initiate your organization’s commitment to mental health.

•  An internal newsletter can provide a great opportunity to talk about health issues. Your EAP, health care provider, or local community mental health agency may be able to provide material or assist you with the article.
•  Payroll stuffers and post cards provide another option for reaching out to employees and their family members.
•  Placing literature in inconspicuous areas of the workplace is also important. Instead of placing brochures in a break room or busy hallway, provide these materials in a subtle and inconspicuous place for employees, such as restrooms.
•  Make sure that toll-free numbers and websites for the company’s EAP and health care provider, and/or the community mental health agency, are included in all mental health educational materials. Also, be sure that information about mental health benefits available from your EAP and health insurer is easily accessible on your company’s website. Promoting your benefits will create awareness and utilization.

*This information was adapted from “Mental Health at Work: A Resource Manual for Minnesota Employers.” To obtain a copy of this manual and other MHAM workplace publications, please visit the Workplace Publications Page.

According to findings from the 2007 National Health Interview Survey (NHIS), approximately 38% of American adults used some form of complementary or alternative medicine (CAM) and spent about $33.9 billion on CAM services and products. The increased use of CAM shows that individuals are seeking ways to enhance their health and wellness; however, the effectiveness and safety of many CAM therapies are relatively unknown.

To gain a better understanding of the effectiveness and safety of CAM, the National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health, sponsors and conducts research using scientific methods and advanced technologies to study CAM practices. On the NCCAM website, there are several health topics and studies that address CAM practices, including mental health. This information can help guide informed decision-making among individuals and healthcare professionals.

It’s important to talk to your doctor if you decide to use CAM practices, especially if you have existing health conditions, using prescription medications, or over-the-counter medications. The following tips, provided by NCCAM, can help you talk to your health care providers about CAM.

> When completing patient history forms, be sure to include all therapies and treatments you use. Make a list in advance.
> Tell your health care providers about all therapies or treatments—including over-the-counter and prescription medicines, as well as dietary and herbal supplements.
> Don’t wait for your providers to ask about your CAM use. Be proactive.
> If you are considering a new CAM therapy, ask your health care providers about its safety, effectiveness, and possible interactions with medications, both prescription and nonprescription. (Download the Steps to Wellness Medication Form to keep track of your medications, including dietary and herbal supplements)

For more information, please visit the NCCAM website at www.nccam.nih.gov

All session long, we’ve been talking about connecting with your legislators and telling them what matters to Minnesotans with mental illnesses.  We always need to try to stay visible when so many different things are competing for their attention.  But the “off season” is a great time to connect and really lay the groundwork that helps them understand why mental health matters.

This fall and winter, the Mental Health Legislative Network will be hosting or facilitating meetings where we can tell our stories, explain what really helps, and why service cuts have been so devastating.

To be connected with a town hall or house meeting in your area, contact us.  If there isn’t one scheduled, maybe you’d think about helping us get one started?  We have materials and support; but we need a constituent to call up their legislators to say, “This is important, and I think you should come hear more about it!”

To find out more, visit our legislative update this week.

As Minnesota continues to digest just what the budget deal will mean for us, we have gotten a few new pieces of news.

Moody’s has downgraded the state, stating that our reliance on one time cuts and borrowing meant that investors should be more worried about our ability to repay bonds.

American Crystal Sugar has locked out workers over increased health care costs.

Austin, MN has just released their property tax levy: they will have to seek 15% more than last year.

We were all told by legislative leaders this year that if we could avoid increases to income and state taxes, that job creators would be freed up to increase prosperity.  But it just seems so clear to us that not only is a lack of new revenue hurting people around the state who have lost services, it isn’t even preventing tax hikes or job losses.

As Moody’s told us, we face a structural deficit.  We can cut spending such as LGA or the grants to counties that fund mental health services.  But those choices have costs.  In good times, we lowered taxes instead of saving for a rainy day.  Now, the bank is empty, and we face difficult choices.  But we think that it is increasingly apparent: we can’t cut our way out of this mess.

As always, please see our website for full details, or to sign up to get our updates via email.

The legislature has spoken for this biennium: setting the priorities and policies that will shape mental health services in our state.  So now is a good time to think about talking back.  What would you say?  What do these cuts mean for you?

This week’s update has more details on the budget as well as information on a couple of community events designed to connect you with your legislators.  Hopefully, there will be more announced soon.  Are you interested?  Let us know, and then have your say!