The Social Security Administration (SSA) is looking at making some very important changes to the mechanisms by which disability is determined for people with mental illness. The proposed changes would probably be expected to make it much more difficult to be found disabled by the SSA if the primary basis of disability is a mental illness.

The Bazelon Center for Mental Health Law has studied and provided a recap of the proposed rule changes Major concerns revolve about the proposed implementation of standardized tests and eligibility determinations hinging on the number of standard deviations from the mean on the new standardized tests. Bazelon projects that only one to two percent of the nation’s population will qualify as disabled as a result of a mental illness under the rule change if adopted. This is far below the most conservative of the estimates of the people with mental illness that are thought to be unable to work.

There are no standardized tests that have a body of evidence that suggest the tests will be able to predict an individuals ability to work Adoption of the proposed rules can be expected to result in many people being turned down by Social Security, but who will not, due to their mental illness, be able to work.

You may express your concerns and/or objections to the proposed rule changes to the Social Security Administration, but you must do so by November 17, 2010. Address your comments to the SSA by one of the following methods:

Go to the http://www.regulations.gov/search/Regs/home.html#home website and search for docket number SSA-2007-0101 and follow directions.

or Fax the SSA at 410-966-2830

or mail the Office of Regulations, Social Security Administration, 137 Altmeyer Bldg., 6401 Security Boulevard, Baltimore, MD 21235-6401

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.

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.

Research suggests that peer support for persons with serious mental illnesses can improve psychological outcomes, such as empowerment, and can also improve clinical outcomes, such as reduced hospitalization. As of last year, Minnesota is now 1 of 26 states that cover peer support services. With a focus on recovery, the Certified Peer Specialist (CPS) is a compensated and trained member of a mental health services team. According to the Minnesota Department of Human Services website, the role of a certified peer specialist is to:

• Inspire hope that recovery from mental illness is not only possible, but probable
• Provide opportunities for people using mental health services to practice self-efficacy through activities that emphasize the acquisition, development and enhancement of skills needed to move forward in mental health recovery.
• Promote empowerment and self-determination
• Build relationships based on mutuality and shared-perspective
• Deepen the treatment teams’ understanding of the experience of being a mental health consumer.

CPS Training is provided through the the Minnesota Department of Human Services for individuals that work within an Assertive Community Treatment, Intensive Residential Treatment, Crisis Response and/or Adult Mental Health Rehabilitative program.

The Facing Us Clubhouse, a program of the Depression and Bipolar Support Alliance (DBSA), is a free online wellness tool for individuals living with mood disorders. The website offers a variety of tools and resources to help support and maintain a person’s health and well-being. These include:

• Personal online journal where you can write down your daily reflections, do some creative writing or gratitude practice, or other forms of expression.
• A step-by-step individualized wellness plan that helps you take control of your health and well-being.
• Personal wellness book where you can collect and write down tips and advice that work for you, read tips from others, and if you like, share them with family and friends.
• Media room that includes audio and video material to uplift your spirit.
• Creativity center that has online workshops and podcasts to help you be inspired and find your creative outlet.
• DBSA Wellness tracker can help you chart your daily life by spotting trends related to your mood, symptoms, life style and physical health.
• You can even send an e-postcard to somebody you care about!

Incorporating wellness into your life is just a click away!

May is Mental Health Month and we wanted to highlight some important initiatives regarding wellness and recovery. The Substance Abuse & Mental Health Services Administration (SAMHSA) earlier this year started the SAMHSA 10×10 Wellness Campaign. The campaign’s goal is to address all aspects of a person’s health and wellbeing in hopes of increasing life expectancy for people with serious mental illness by 10 years over the next 10 years.

The rates of diseases such as diabetes, cardiovascular disease, and respiratory disease and the early mortality rate from these types of diseases are often significantly higher for persons with serious mental illness. By addressing modifiable risk factors like smoking, obesity and inadequate medical care, can help reduce the progression or the risk of developing these diseases. The campaign provides a variety of resources, online issues of “Wellness Wisdom” and frequent teleconferences for providers, family members, and consumers.

To date, more than 2000 organizations and individuals have shown their support in promoting wellness to reduce morbidity and mortality for persons with SMI. The Minnesota Department of Human Services, along with other members of the community have developed a statewide initiative, Minnesota 10×10, which also promotes the importance of taking care of your physical health for living a healthier, longer life.

MHAM has joined this quest for wellness and we hope you will pledge your support for wellness too!

For over 60 years, Mental Health America – who began this tradition in 1949 – and other national and state mental health organizations have been celebrating “Mental Health Month.” In recognition of Mental Health Month, MHAM will be informing you about several important mental health initiatives involving both national and state led efforts. The central focus of these initiatives involves wellness and recovery for persons with mental illnesses. The importance of self-care and personal wellness not only can improve our mental health, but can also improve our overall health and well-being. So revisit our blog throughout this month and learn more about how these initiatives will help promote wellness and recovery for persons with mental illnesses.

Also, please check out our calendar of events that are occurring around the state for the month of May. If your organization is having an event and you would like it to appear on our calendar, please email details to Nancy at [email protected].