News

Not Done Yet

The session is over, but there is no signed budget.

Gridlock.          Deadlock.        Principled.      But where is Compromise?

These are all words that have been bandied about in the past few weeks. As we hear about how principled everyone is, Minnesotan’s lose critical services that keep them independent.

You will hear me use that term “independent” frequently as we discuss the legislature. In the 2007 mental health bi-partisan reform, independence was at the core of that action. People with mental illnesses previously were hospitalized frequently with their illness. After the reform, hospitalizations lessened and prevention was the emphasis.

Now it appears we are returning to more of a crisis response, except crisis services are also being cut. So I guess we return to uncompensated hospitalizations and loss of independence.

If your legislator holds meetings in your community ask him or her why they didn’t compromise on the budget. Ask them if they are going to take the per diem for the special session and where that money is in the budget. Ask them about a government shut down.

Ask them what’s next.

HHS Budget Moves Again

The HHS budget is approved by conference and the full Senate, moving to the House.  The cuts it contains are truly devastating for people with mental illnesses, and we continue to oppose them.  While Gov. Dayton has pledged not to agree to such cuts, we know that we need to change the conversation at the capitol.  Please keep raising your voice, with your legislators, to the Governor, and in your community to let people know why an all-cuts budget won’t work.

It’s very sad to see the dedicated grants for mental health services being targeted for cuts at the same time that counties will be released from any obligation to spend a consistent amount on services.  What are small amounts of funding compared to the entire budget make a world of difference for Minnesotans with mental illnesses.

For full details, visit our legislative update on the website.

No Movement

There’s little sign of progress at the legislature.  Conference committees are still debating the final form of major budget bills.  With less than a month left, the only complete and balanced budget proposal on the table is the Governor’s.

For full details, including policy bills that we are watching, visit our website.

Bad Process

This week’s update focuses on some of the problems we still face as the session heads to the end.  Instead of bills that are passed and signed by the governor, the Legislature is heading straight to amending the Minnesota constitution.  Several of these propose amendments could have harmful effects on our community.

We’re still waiting on the SF 760 conference committee, which convenes again on Friday. This is the major omnibus bill that would fund health and human services.

More details are coming out on the MN Choice proposal, the block grant that the GOP is seeking instead of participating in Medicaid.  There is still a large gap between what the House and Senate leadership claim it will save.  Gov. Dayton remains opposed.

For full details, visit our update page on the website.  Keep writing, calling, and being heard.  Our friends at NAMI MN have put together several protests this week at the capital, that’s another opportunity to get involved.

Anti-inflammatory drugs may decrease the effectiveness of SSRI antidepressants

A study published online in the Proceedings of the National Academy of Sciences, suggests that anti-inflammatory drugs may decrease the effectiveness of SSRI antidepressants. Researchers at the Fisher Center for Alzheimer’s Disease Research at The Rockefeller University found that mice that were treated concurrently with SSRI antidepressants and anti-inflammatory drugs had diminished behavioral responses compared to mice treated with SSRI antidepressants alone.  To see if this finding had the same effect on humans, the researchers examined data extracted from the completed National Institute of Mental Health funded STAR*D study. The findings from the STAR*D data showed that individuals that were depressed and taking an SSRI antidepressant and an anti-inflammatory drug were less likely to have their symptoms relieved (40%), compared with individuals that were depressed and taking an SSRI depressant, but not taking an anti-inflammatory (54%).

Experts caution that this is a preliminary study and further studies need to be done. Individuals should not change their medication regimen based upon these recent findings, but should follow the advice of their prescribing physician.

Conference Committee Moves Forward

The House and Senate Health and Human Services Conference Committee have completed their side-by-side comparison walk through.  They have heard initial statements from the Commissioners of both the Health Department and the Human Services Department.

The next step, next week, is to look at where they are in agreement and where they differ and then come to some understanding.  Rep. Abeler said on Monday that the spreadsheets have been amended to make changes on a couple of items based upon new financial information.

There are items that are as good and as bad as can be.  Find out more at our legislative update page.

An Ounce of Crisis Intervention is Worth…

This week’s legislative update features several Letters to the Editor that are designed to get the facts out around mental health services in Minnesota.  Since 2007, Minnesota has taken real steps towards a system that believes in recovery.  More resources were put into crisis intervention, community services, and creating levels of care that would allow more people to transition out from or avoid hospitalization.  However, it seems that ever since these reforms passed with bipartisan acclaim, they have been under fire as the budget situation tightened.  This year, we are trying our best to focus the discussion on what Minnesota stands to lose when it turns away from recovery.

We hope that people can send these letters in to local papers, so that we can build support for these services as cost-saving and outcome improving.  Mental health matters to Minnesota.

Check them out at our website and send your letter today!

Is your medical care working for you?

Care Manager vs. Primary Care Provider…does it matter who you are seeing in regards to your health?  In some cases it may.  NIMH supported research has shown benefits for people with multiple medical conditions who use primary care plus case-managed care.

According to CMSA, the term “case management” is defined as “collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes.”

To evaluate the effectiveness of this combined approach, Wayne Katon, M.D., of the University of Washington, and other colleagues conducted a study that zeroed in on methods of care for patients with diabetes or heart disease and depression.  Patients such as these, on average, tend to practice poorer self-care methods and experience more complications due to treatment.

To aid in decreasing these detrimental issues researchers developed a model in which a nurse care manager and primary care provider coordinated care.  This approach was used to ease depression symptoms and improve medical conditions.  Of the 214 patients that participated in this study, half experienced a 12-month trial with the additional case management. In this trial the nurse care manager’s role was to act as an advocate for the patients by informing them about their medical condition and by motivating them to take a more proactive role in their treatment.  The remaining half of the patients were treated with usual care, solely by a primary care provider.

The two groups were compared and the result of this study showed that patients experiencing the case management found it to be a successful approach.  More  of these patients reported a decrease in depressive symptoms, improved blood glucose levels, and improved blood pressure when compared to patients that only received the primary care.   The recipients of the additional resources also reported better overall wellness and felt their care had improved.

Currently in action, The Diamond Program and MN 10 by 10 have been implemented in Minnesota to promote  holistic approaches to mental illness.  The Diamond program includes primary care physicians, consulting psychiatrists, care managers, and other mental health specialists working together to provide the best care for patients.  The care manager plays an important role in this process in that they manage the components of the program for the patient.  The patient is responsible for taking an active part in their own care. MN 10 by 10 aims to reduce early mortality of the persons with mental illnesses by 10 years in 10 years. Similarly, this program focuses on improving primary care by educating health care professionals (social workers , case managers, primary care physicians, counselors etc…).  They also provide information such as health check lists are available to patients so they can learn how to get the most for their doctor visits.

At the end of the day it is important for these programs to continue educating health care professionals on how to built the best possible care for individuals faced with multiple medical conditions.  This will hopefully generate more satisfied patients who then become motivated to take better care of themselves.

At MHAM we offer Steps to Wellness that can be use as a helpful guide in learning how to motivate yourself in terms of improving your own wellness. To order the Steps to Wellness kits, please call us at 651-493-6634 or kits can also be ordered online. Individual items from these kits can be downloaded from our website as well. Providers that need multiple copies, please contact Brett Dumke, Education Coordinator, at [email protected].

This post was written by Jahna Sandkamp, who is interning with MHAM this Spring.

On the Lookout

Budget targets have gone out to committee chairs, and they are now assembling the bills that will help them make their targets. We’ve made this week’s update a focus on some of those bills.

Now is a great time to be in contact with your legislator.  The more they hear on these bills, the better chance we have of improved outcomes.

Fight for Parity

Sadly, the fight for parity seems like it never really ended.  This week’s update talks about the problems with HF8/SF32, a proposal to change the Minnesota Care Program.

By pushing state program recipients out on to the individual market, people would lose access to the model mental health benefit set, a proven package of treatment options for better mental health, and instead be pressured to buy plans that exclude any mental health or chemical treatment coverage.

We think it’s wrong, and we’re asking for your help in turning this proposal around.  Read more on our legislative update page this week.