When the national mental health parity law went into effect last year, many of us were relieved our health insurance companies could no longer treat the mental health coverage they offered any differently from traditional coverage.  While this was a big step for health insurance companies, the law did not apply to other types of insurance, such as long-term disability insurance.

Long-term disability insurance is usually offered through work, though you can purchase it individually.  It is intended to provide income to employees who develop a disability that prevents them from working.  The type of disability covered varies from company to company, and from plan to plan.  Not all disability insurance offers coverage for mental health.

When an employer purchases disability insurance coverage for their employees, they may choose to purchase a plan that has limited coverage.  Perhaps the plan offers only two years of disability payments for mental health disabilities but offers unlimited coverage for physical disabilities.  Employees don’t always know what their policy covers, or for how long.  Be sure to read your insurance plan’s policy.  What is covered?  How long can you expect to be covered?  Under which circumstances will your coverage end?

If you are currently receiving private disability benefits and have a limited coverage plan, it is good to start planning as soon as possible for when it will end.  Will you need to move somewhere more affordable?  If so, now is a good time to contact your local public housing authority and get on the subsidized housing waiting list, if it is open. Have you applied for social security disability?  The application process can take a few weeks, so apply before your insurance runs out. If you have applied and been rejected, do you think it is possible you may be able to work?  If so, there are a number of programs specifically for people who have mental illnesses geared towards getting into the workforce again.

If you need help finding resources or planning for when your insurance coverage ends, contact an MHAM advocate at 612-334-6840 between 9 and 4:30, Monday through Friday

By Brett Dumke, MHAM Education Coordinator

Who will develop the next generation of medications for mental illness? That was the question posed by the Director of the National Institute of Mental Health (NIMH), Dr. Thomas Insel, on a recent NIMH blog posting. Dr. Insel commented on the recent decision of two major pharmaceutical companies to terminate their psychiatric medication development programs and the likelihood of others to do so as well. If new drug innovation comes to a screeching halt, it will have a profound impact for individuals who have not responded well to medications that are currently available. In order to fill this void, the National Institutes of Health (NIH) and NIMH may have to play a key part in all phases of drug development in the coming years.  MHAM will continue to monitor this alarming trend and will provide updates when they develop.

With spring’s arrival the gardeners come out of hibernation, the birds return, the leaves unfold…and the college acceptance letters arrive.  As students across Minnesota discover where they’ll be going this fall, it is a great time to begin planning for the transition to college.

The first year of college can be challenging.  Not only do new students have intense academic pressure to cope with, but they are adjusting to a new location, new people, and separation from family.  Adapting to these changes is difficult for most people, but for a person with a mental illness, it can be even more complicated.  On top of everything else, they have to arrange for academic accommodations, continued treatment, and sufficient emotional support.  For students facing college with the added challenge of a mental illness, planning ahead can save a lot of stress down the road.

Many students with mental illnesses aren’t aware they have the right under the Americans with Disabilities Act (ADA) to request accommodations from public and non-religiously affiliated private colleges and universities.  An accommodation is an adjustment in how things are done that allows a student with a disability equal access to academic programs.  Each college may have it’s own standard for what is considered reasonable.  Generally, an accommodation can’t change the nature of the program or give select students an unfair advantage.

To find out if an accommodation would be useful to you, take a moment to think about your experience as a student so far.  What have you struggled with? What types of support helped? Did the support come from outside resources (family, friends, therapist) or from within the school (teachers, students, tutors)?  What helped you be successful?

There are many types of accommodations commonly requested by students.  Some find it helpful to record lectures, others request extra time for exams or a modified course schedule.  Some accommodations are personal, and can be made independent of the college (taking evening courses, adjusting your medication regime, getting a private tutor).

Before you request an accommodation, take a moment to consider your need for privacy.  What information are you comfortable sharing with professors, administrators, or your fellow students? Be aware your college may require you provide medical documentation before they provide an accommodation.  The disability support services office at your college should be able to assist you in making an accommodations request.

In some cases, you may need to leave college for an extended period of time for your mental health.  Take time to review the medical leave policy at your college.  If you take medical leave, they should allow you to return to college without a penalty or disciplinary actions.

It’s important to take a look at your insurance coverage before you attend college.  Will you be covered by your parent’s plan? Will your plan cover out-of-state providers?  Can you get prescriptions filled at the pharmacies in your new town?  If you will not be covered by health insurance, does your college offer free or low-cost mental health services to students?  If not, will you qualify for any state health insurance plans?

Whether you are covered or not, emotional support can be extremely valuable during transitions.  Before you go, check in with your friends.  What’s the best way to stay in touch?  Even one email a week can make a difference.

A little advanced planning can make a big life change a lot less stressful.  If you need help planning your transition, contact an advocate from MHAM at 612-331-6840.  Advocates are available Monday-Friday, 9-4:30.

You can find more information about accommodations and attending college with a disability at: Minnesota State Colleges and Universities, Parent Advocacy Coalition for Educational Rights (PACER) , and the Association of Higher Education and Disability (AHEAD).

By Brett Dumke, Education Coordinator

In a recent article in the journal of Preventing Chronic Disease, published by the Centers for Disease Control and Prevention (CDC), the authors stressed the critical role of primary care providers (PCPs) in “bridging mental health and public health.”   With the shift of care from mental health specialists to primary care, mental health delivery within these settings can provide a central focus on prevention from early detection, and effective continuation of care. But as the article suggests, time constraints and financial disincentives to treat mental disorders limit the ability for PCPs to provide high-quality care for these types of health conditions.  Implementing an integrated or collaborative approach for PCPs can help ensure that high standards of care can be achieved.

One such approach has been implemented right here in Minnesota and is receiving national recognition. Leading the way for improving depression care in the primary care setting is the DIAMOND (Depression Improvement Across Minnesota, Offering a New Direction) program. Based upon the “IMPACT” study, the program was developed by the Institute for Clinical Systems Improvement (ICSI) and supported by members representing area heath plans, medical groups, patients, employer groups, and purchasers. The program involves a collaborative effort involving the primary care physician, consulting psychiatrist, care manager, and other mental health specialists.  The care manager plays a pivotal role in managing the essential components of the program for each patient, while the patient has an active part in determining his or her care.

So far, the success of the program is encouraging. According to the ICSI website, of the participants that have been active in the program for six months, “43% are in remission, and an additional 17% have seen at least a 50% reduction in the severity of their depression. These results are 5-10 times better than for patients with depression treated under  ‘usual’ primary care.”  Along with effective treatment results, the initial cost of treatment under programs like this can expect to be offset by substantial long-term cost savings. To track the effectiveness of this program the National Institute of Mental Health (NIMH) has provided a five-year grant to HealthPartners Research Foundation.

For more information on who is eligible for this program and what clinics are participating in this program, visit the ICSI website.

By Ed Eide

As I have traveled around the state visiting with Local Advisory Councils (LAC’s) I have heard comments about reducing the stigma of mental illness. While we can pretend that stigma is lessening, in smaller towns in greater Minnesota it is not. People are often identified by their mental illness, not their accomplishments.

As we work on goals to getting more people involved in their community, an understanding of what mental illness is becomes critical. Along those lines, a group of major mental health organizations are supporting BringChange2Mind.org.

From the BringChange2Mind Website:

BringChange2Mind.org is a not-for-profit organization created by Glenn Close, the Child and Adolescent Bipolar Foundation (CABF), Fountain House, and Garen and Shari Staglin of IMHRO (International Mental Health Research Organization).

The idea of a national anti-stigma campaign was born of a partnership between Glenn Close and Fountain House, where Glenn volunteered in order to learn about mental illness, which both her sister and nephew suffer from.

This is the first effort of this magnitude in U.S. history. Ron Howard generously donated his time in directing our first PSA that features Glenn Close and her sister, Jessie Close. John Mayer generously donated his song, Say, which serves as an anthem for this movement.

The campaign has the support of major mental health organizations, including Active Minds, the American Foundation for Suicide Prevention (AFSP), International Mental Health Research Organization (IMHRO), the Jed Foundation, Mental Health America (MHA), National Alliance on Mental Illness (NAMI), NARSAD, National Institute of Mental Health (NIMH), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

View this video and more at BringChange2Mind.org and then share the videos with others. These could make a difference in someone’s life.

By Brett Dumke

A recent pilot study, funded by the National Institute of Mental Health (NIMH), shows a promising new intervention for depressed teens that have previously attempted suicide. Along with medication, this intervention uses a psychotherapy called cognitive behavioral therapy for suicide prevention (CBT-SP).  CBT-SP was developed to prevent or reduce the risk of suicide reattempts.  The study found that the rate of recurrence of either suicidal thoughts or attempts were lower than previous comparable studies, which suggests that this type of intervention might be an effective new approach in helping to reduce suicide among this most susceptible group of teens.

For more information, go to the NIMH study. Also, check out our youth education section on our website for information and resources pertaining to depression and suicide prevention.

By Brett Dumke

Thursday, October 8^th is National Depression Screening Day, a program sponsored by Screening for Mental Health, Inc. Last year, nearly 300,000 people were screened nationally at in-person events. Several Minnesota hospitals, health centers, and social service organizations are participating in this free event, which is available to the public. Many of these statewide screenings offer:

• An anonymous mental health self-assessment
• Educational resources for you to take home

• A confidential interview with a mental health professional to discuss the results of your screening
• In primary/specialty care offices

• A list of local referral resources where you can receive treatment

To contact an onsite screening location in your area, or to access an anonymous online self-assessment, please click on: http://register.mentalhealthscreening.org/Locator1.aspx?MPEID=14

By Alida Purmalietis

There are several ways to become active in your communities.  For those interested in issues related to mental health services, understanding the current system can seem like a daunting task.  Most people understand that a good way to voice concerns is to contact their elected officials.   However, an option that is sometimes overlooked is to attend a Mental Health Local Advisory Council (LAC) meeting.  It was recently announced that the Hennepin LAC is looking for additional consumers to join the council.  For information about where the meetings take place and who to contact.

By Brett Dumke

September 6^th through September 12^th is Suicide Prevention Week.  This national campaign draws attention to this public health crisis and how we can take action.  There are many things that individuals, local communities, and places of employment can do to help in this effort.  Several local and national organizations can assist those who would like to get involved, here are just a few:

Suicide Awareness Voices of Education (SAVE), based here in Minnesota, offers a variety of educational materials and resources via their website.

Check out the Suicide Prevention Resource Center (SPRC), which provides an abundance of information and is a good starting point on how to create an effective approach for preventing suicide.  In addition, SPRC has compiled a list of ideas and activities that may also be helpful.

The National Institute of Mental Health (NIMH), an outreach partner of MHAM, has an updated suicide prevention page for this campaign as well.

The Greater Twin Cities United Way has informed MHAM that an extreme heat alert is in effect from today, Thursday, August 13 through tomorrow, Friday, August 14, 2009.

Temperatures are to reach the 90s with high heat index and humidity.  Today it will be warm and muggy with few thunder storms possible early this evening.  Friday is predicted to be hot and muggy, few clouds and isolated thunder storms are possible.  High temperatures at 87 to 92 and winds at 10-20mph are expected.

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. 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, metro residents of all ages should:

• 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.
• 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 Minnesota Department of Health for further information.

Emergency heat-related health problems—call 9-1-1