Just a reminder that in recognition of Mental Illness Awareness Week, MHAM is hosting the Celebrating Recovery education event on Tuesday, October 5 at the Ramada Plaza in Minneapolis. The event will begin at 9:30 a.m. and conclude at 3 p.m. We would love to see you there! If you register before October 5, admission is $15. At the door admission is $20. Your admission includes presentations, a Wellness Fair, a Steps To Wellness self-care kit, and lunch.

This will be a great event for individuals living with mental illnesses, their family members and friends, and mental health providers. Michael Trangle, MD will speak about holistic care and staying healthy and Minnesota 10 x 10 and the DIAMOND program. Kim Lutes will share her experiences with the mental health system and the importance of self-advocacy. Brain Doran will discuss ways in which family members and friends can support a loved one who is living with a mental illness. Brett Dumke will provide an overview of the brand new Steps to Wellness self-care kits. Ed Eide will give examples of how individuals can share their stories to influence public policy.

The Steps to Wellness kits have been developed with support from an educational grant from Lilly USA, LLC, a charitable contribution from Janssen, Division of Ortho-McNeil-Janssen Pharmaceutical, Inc., a grant from Park Nicollet Foundation Healthy Community, and a grant from Pfizer Healthcare. The kits contain tools to help individuals manage their health and learn skills to advocate for themselves when working with medical professionals and social service providers. After the event, the kits will be available for order from the MHAM website.

Tickets to this event are still available. Please see the Celebrating Recovery page on our website to register online. Scholarships are available. To arrange for a scholarship, please contact Ed Eide at 612-843-4868, ext. 1 or edeide at mentalhealthmn.org.

In the United States alone, nearly 15 million adults suffer from a major depressive disorder. Though there are several treatment options, many of the medications that are prescribed to patients with depression have a delay in their onset of action. During this time, the patients’ condition may even deteriorate to dangerous levels.  Despite this, there are signs that research by pharmaceutical companies on depression medications has slowed.

This creates a strong need to find a drug that will begin to work soon after beginning therapy.  One possibility has come through drug studies on Ketamine by the National Institute of Mental Health.  This research has shown a possible route to more quickly treat patients who suffer from depression and bipolar disorder.  Previous NIMH studies have learned more about the receptors that are acted on by this drug.  Now, they have focused on predicting which patients will see the benefit of this kind of treatment.

In this recent study, researchers found that activity in the pregenual anterior cingulate cortex (pgACC), the area of the brain that has connections to both emotional and cognitive brain centers, provided indicators that patients would respond to therapy using Ketamine.  For patients with certain activity patterns, the drug worked quickly and effectively to relieve symptoms of depression.  The authors noted that areas of the brain normally associated with emotional control were at work for these patients, even when given a task with no emotional content.

Unfortunately, Ketamine has far too many side effects to be used widely.  In fact, it can be abused as a recreational drug.   Side effects can include hallucinations and euphoria when the drug is given in high doses.  Ketamine is a most often used as an anesthetic during minor surgery and is approved by the Food and Drug Administration at much higher doses. Nonetheless, its use is limited because there have been cases where patients have hallucinated while recovering from anesthesia.

While this particular drug may never be used to specifically treat depression, this research has revealed a great deal about how this drug works, and the function of brain receptors in the treatment of depression.  Hopefully, this will lead the way to developing a new generation of faster-acting medications. However, until more research has been done, it is important to be patient with trying new medications.  Working with your doctor by discussing improvements or side effects of certain medications is a good start to creating a treatment plan that works for you.

This post comes from our guest blogger, Margo Tell.

Federal Health Care Reform was signed into law this spring.  But how that law will be enacted remains a hotly contested issue.  Many of the provisions do not go into full effect until 2014.  In the mean time, states are being offered a variety of grants to study, plan, and implement these changes.

Last week, Gov. Pawlenty ordered state agencies to halt applications for these grants unless given specific permission by his office.  There is some question concerning his authority to do so, because the Legislature had specifically directed that some of these grants be sought in a bill that Pawlenty signed into law.

Sadly, this appears to be a case in which potential avenues of compromise have been shut off.  The idea of insurance exchanges is not new.  Versions of the concept have been promoted by members of the House Republican Caucus as a potential solution to health care access.  Pawlenty, in fact, supported a similar concept a few years ago.

A wide range of groups has called on Pawlenty to reconsider this decision, including the Minnesota Budget Project (an initiative of the Minnesota Council of Non-Profits), the Minnesota Council of Health Plans, the Minnesota Hospital Association and the Minnesota Medical Association, as well as the Minnesota Chamber of Commerce.

We know that many Minnesota counties are doing what they can to help those without health insurance, trying to move as many people as possible on to other programs if they are eligible.  Some counties have paid premiums so that former GAMC patients can participate in Minnesota Care.  But these are stopgap measures.  Eventually, we will need to expand the MA system to cover more low-income single adults.  Eventually, we will need to set up an insurance exchange for individuals and small businesses buying their own coverage.

The question is: how much control will we take over the shape of things to come?  One of these grants in particular would have given the state greater control over how our insurance exchange would operate.  Delaying these programs hurts Minnesotans who lack health care coverage, and we know that many of those individuals have significant mental health concerns.

Meanwhile, the “compromise” GAMC program is straining to meet the needs of the metro area, and has let down individuals across the state that cannot travel to seek medical care.

As Minnesotans decide how to address these issue, we will continue to call for long-term solutions that provide equitable access to care.  Right now, there are two great opportunities for shaping that future.  You can contact Gov. Pawlenty’s office to let him know why health care access is important to you.  You can also participate in the Federal rulemaking process that helps determine how specific parts of the new law will take effect.  You can submit your comments at www.regulations.gov, by searching for “health care” and looking for rules that might impact you.

We think that it is vital for people with mental illnesses to be a part of creating new systems of care.  We know what services are missing from our communities, where the barriers have been, and what we need to do.  Please make it a priority to speak out and be heard.

We have two upcoming events to announce!

The first is MHAM’s education event Celebrating Recovery on October 5, 2010. This education event in recognition of Mental Illness Awareness week will provide you with information about self-care and advocacy and offer tips on how you can become a partner in your own care. We are also very excited to unveil our brand new Steps to Wellness kits. All attendees will receive a free kit. Lunch will be served and is included in the registration fee. Cost is $15 per person in advance, $20 per person at the door, and $40 to exhibit at the Wellness Fair (includes admission to the event and lunch). Location: Ramada Plaza Hotel, 1330 Industrial Boulevard NE, Minneapolis, MN.Click on the link for more information and to register online.

The second event is Proof by David Auburn, produced by the Phoenix Theater Project. After the death of her father, Catherine is left to pull together her own life; a life that was set aside to care for her ailing father, a famous mathematician. She must deal with his legacy; hundreds of notebooks that most likely hold the ramblings of a man slowly losing his genius, but may reveal the last great work of a brilliant mind.  Now she is forced to face her own life and can no longer avoid her possible inheritance; genius or insanity. Proof will be playing weekends beginning Friday, September 10 and running through Saturday, September 25 at the People Center’s Theater, 425 20th Avenue South, Minneapolis. Tickets are $16. MHAM is working closely with Phoenix Theater Project to offer feedback on the portrayal of family relationships where a mental illness is involved, and we will be participating in a talk back session after the show on Sunday, September 12. Visit Phoenix Theater Project for more information on this Pulitzer Prize-winning play or to purchase tickets.

Minnesota will hold primary elections on August 10th.

MHAM and our partners in the Mental Health Legislative Network sent out some questions to candidates who are running for Governor.  We don’t support or oppose any candidate, and we don’t grade their answers.  But we’ve presented their replies here for your information.

Gubernatorial Candidate Questionnaire Responses

Several candidates responded and shared their views on some of the key issues that are important for mental health.  If you don’t see your preferred candidate represented here, or simply want more information on where candidates stand: please contact their campaigns to ask your questions.  We strongly encourage everyone to get involved.

You can go to The Secretary of State’s Office or call 1-877-600-VOTE (8683) to get more information on finding your polling place, registration and eligibility and more.

It’s been very hot in Minnesota, and we’ve heard from some people who have had concerns regarding staying safe.

Individuals on certain medications may be more vulnerable to heat stress. Persons taking regular medication should consult with their physician.  Some medications cause an adverse reaction in hot weather, such as reducing a person’s ability to sweat. If you are on such a medication, or if you know someone who is, please take a look at these strategies for managing heat stress.

To avoid heat-related illness:

• Avoid, as much as possible, working or playing in the hot sun or other hot areas.  If you must be out in the sun, wear a head covering and sunscreen.  A wide brimmed hat or visor will not only protect your head from intense rays of the sun; it will also provide a shield for your eyes.
• Shut blinds and open windows slightly during the day to release trapped hot air.  Use air conditioners if you have them.
• Wear lightweight clothing.
• Drink plenty of water and fruit juices; avoid alcohol, carbonated or caffeinated drinks.  Because the body loses fluids in the heat, drinking lots of liquids helps to avoid dehydration.
• Eat frequent, small meals; avoid high-protein foods
• Take cool baths or showers—cold water can lower body temperatures 25 times faster than sitting in an air-conditioned room
• Spend time (even 2 hours will reduce the risk of heat-related illness) in an air-conditioned environment or basement; cover windows to block direct sunlight; turn lights on low or off; use fans to blow hot air outside.  Public libraries, community centers or other similar locations may be a good option for spending some time away from the heat.
• Do NOT direct fans to blow in at you.  Fans can actually increase heat stress.
• Do not leave older people, children, or pets, alone in cars.

Non-emergency questions about how to stay cool—call 2-1-1 or visit the heat information at the Office of the Ombudsman for Mental Health and Developmental Disabilities.

For emergency heat-related health problems—please call 9-1-1

Since mental disorders are the leading cause of disability in the United States, it is vitally important that people of all ages be aware of the signs, symptoms, and proper treatment options for mental disease.  As explained by the National Institute of Mental Health, nearly half of all lifetime cases of mental illness begin by age 14, and three quarters have begun by age 24. In Minnesota alone, approximately 56,000 children suffer from some mental disorder.  These statistics support the proposition that mental illness is, unfortunately, a major problem for the youth of our country and for the state of Minnesota.

Mental illness is uncovered in many young people at the point in their lives when they are searching for independence from others.  Because of this pursuit for independence it makes it hard for adolescents and young adults to seek help, and it makes it difficult for their friends and family to know if their irregular behavior is something serious, or perhaps just a passing phase.

It is particularly unfortunate that many lifelong afflictions go undiagnosed because they first manifest themselves during adolescence when so many changes in personality can mask underlying pathology.  For example, the onset of bipolar disorder usually occurs during the late teen years or early adult years. Schizophrenia, although rare in children under 12, begins to increase dramatically in frequency in adolescence, with an average age of onset between 20 and 25.

Though there are effective treatments for youth suffering from a mental disorder, all to often there are long delays between the onset of symptoms and the beginning of treatment.

As outlined by the National Institute of Health, there are several signs seen in teenagers and adolescents that may suggest referral to a medical or mental health professional.  Some of these signs are listed below:

• Feelings of anger or worry
• Feeling grief for a long time after a loss or death
• Thinking your mind is controlled or out of control
• Using alcohol or drugs
• Exercising, dieting and/or binge eating obsessively
• Hurting others or destroying property
• Participating in reckless activity that may harm you or others

Part of the goal of the Mental Health Association of Minnesota as well as public health systems and services is to provide people with the adequate resources and information needed to maintain a positive mental health throughout their lifespan.  Several mental health promotion projects promote help-seeking behavior and also help to reduce the current stigma associated with mental illness.

Most importantly, learning strategies for self-care can help people suffering from mental illness overcome their disease on a day-to-day basis.  Setting short term goals, staying in touch with friends, and seeking out resources in schools, faith communities, support groups and health centers can help provide people with the tools they need to work towards wellness.

This post comes from volunteer blogger Margo Tell.

According to a 2008 study conducted by the RAND Corporation, many returning veterans that had been deployed to Iraq or Afghanistan as part of Operations Enduring Freedom and Iraqi Freedom had significant mental health issues. Of the 1,945 that were surveyed, 14% met the criteria for post-traumatic stress disorder (PTSD), 14% met the criteria for major depression, and 19% had a probable traumatic brain injury (TBI).  About one-third of these returning veterans had at least one of these conditions.

Last year, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) launched the Real Warriors Campaign directed towards service members, veterans, their families, and health professionals. The goal of the campaign is to reduce stigma associated with psychological health problems and traumatic brain injury. The campaign encourages and supports service members to seek help through the many resources that are available to them and their families. Along with helpful resources and a 24/7 information and help line, the Real Warriors campaign’s website draws upon the courageous stories of service members and veterans that found the strength to seek help and how it made a positive difference in their lives.

We recently saw an interesting article from Dr. Hyde, the administrator of SAMHSA (Substance Abuse and Mental Health Services Administration).  She talks about some of the various different terms that people use for talking about mental health issues and chemical dependency:

Is a person who uses mental health services a patient? a consumer? A survivor?  Is recovery something you can define?  Is it a process?  Or should we be talking about wellness instead?

That article is found here, and the accompanying Q & A on language is found here.

We’d like to hear your thoughts on language and terms.  How important is it to you?  Is there a term you really prefer?  One that you can’t stand?  This is an on-going process, and we want to learn more about what people in Minnesota are thinking and feeling around these issues.  What we’ve heard so far is that the language we use around mental health has a big impact on if people feel respected and empowered.

We’re planning on using your feedback to help write an article that we’ll publish in our newsletter.  If you would not like your response to be used, or if you prefer to stay anonymous, just let us know, and we’ll honor those requests.  Please send any feedback to Ben, who will be compiling your answers.  We’ve already heard from some of our volunteers, and we look forward to getting responses from around the state.

CVS CarePlus conducted many of the blood draws required when a person is taking clozapine.  On June 1, 2010 the company ended this service and those individuals using CVS CarePlus must find an alternative for the required blood draw.

There are several options available that can result in connecting with a provider that can conduct the necessary blood draws:

• Speak with your psychiatrist or prescriber and make sure that they are aware that the blood draw is no longer available through CVS CarePlus.  Your prescriber should be able to direct you to an alternative provider.
• Contact your primary care clinic and set up appointments for the necessary blood draws.
• An appointment could be made with an independent lab in your area.
• Contact a home care agency that has the capacity to do in-home blood draws.
• Contact a pharmacy that has the capacity to do the blood draws.

Without the blood draws, people will not be able to obtain refills on clozapine, so the blood draws are critical.  If a person is not able to find an alternative provider for the blood draws, the advocacy program at the Mental Health Association of MN would assist the person in finding a workable solution.