In Minnesota, individuals with serious mental illnesses lose 24 years of life expectancy compared to those without these disorders. Cardiovascular disease, diabetes, high blood pressure and cholesterol, and obesity contribute to this early mortality. However, many of these health risks can be prevented or managed by early detection, treatment, and healthy lifestyle changes. An integrated healthcare approach can effectively address these issues and improve the health outcomes for people with mental illnesses.

The following infographic from SAMHSA-HRSA Center for Integrated Health Solutions explores the problem and illustrates the impact on communities and individuals. Click on the image below to see the full infographic.

Incorporating healthy lifestyle changes into our daily lives can be challenge, but the long-term benefits it has toward our health and wellbeing can make a big difference. Even simple changes like reducing the amount of time we sit or reducing the amount of salt we eat can have a significant impact on our health. MHAM’s Take Charge booklet provides a few ideas on how to improve your overall health by eating healthy, getting active, managing your stress, and getting a good night’s sleep. Along with these tips, the booklet provides some ideas on how to set a few goals and to track your progress.

The Take Charge booklet can be downloaded from the MHAM website or ordered online. If you are a service provider and looking for multiple copies, please contact Brett Dumke, Education Coordinator, at [email protected] or 651-756-8584, ext. 6.

Every month I participate in the Regions Hospital Patient and Family Advisory Council. At our monthly meetings we discuss issues specific to the experience of mental health patients at the hospital, but we also spend time addressing broader issues related to mental health. The advisory council gives feedback not only on the construction and organization of Regions’ new mental health building, but also on patient policy and staff trainings. As part of this, the council got an advance preview of Healthpartners’ Make It Ok campaign last year.

You may have seen some of the Make It Ok campaign posters in bus shelters and on billboards. They typically feature two people facing each other with a blank dialogue bubble creating a barrier between them. The message is that people’s unwillingness to talk about mental health furthers stigma. At the bottom of the poster is a website: www.makeitok.org

Talking about mental health is complicated. Because so much cultural baggage is tied up in our notion of mental health, folks are resistant to identify with the concept or to even bring it up. When I am contacted by friends or family members who are concerned about someone they know, much of our conversation revolves around how to respectfully communicate with someone who may be experiencing a mental illness. When I am contacted by individuals with mental illnesses, much of our conversation revolves around how to be a good self-advocate in a stigmatizing environment. Frequently I’m asked if I know of resources the individual can pass on to family members who know little about mental illness.

The Make It OK website is a great starting point for friends and family. At the website you can browse through different phrases family and friends can use to bring up mental health respectfully. It contains basic information about mental illnesses and tips for how to engage with folks who may be experiencing a crisis.

If you live with a mental illness and want your family, friends and community to learn more about mental health and stigma, check out www.makeitok.org. It may be a useful resource for you. But if you need more information than the website offers, or if you have questions that are more complex, you can also contact an individual advocate for support by calling MHAM at 651-493-6634.

70% of adults in the U.S. have experienced some type of traumatic event at least once in their lifetime. Of those about 20% will develop post-traumatic stress disorder (PTSD). In any given year, about 7.7 million U.S. adults are affected by PTSD. PTSD can occur after being involved in a traumatic event and can affect both children and adults. PTSD may develop after a person has been harmed or witnessed a loved one or others being harmed. A traumatic event can include combat exposure, violent crime, natural disasters, a serious illness or death, and accidents.

For those who do develop PTSD, the symptoms can begin shortly after or can occur months or sometimes even years after the event. Common symptoms of adults with PTSD include:

> Nightmares
> Flashbacks or feeling that the traumatic event is occurring again
> Scary thoughts that a person can’t control
> Avoidance of places and things that remind you of the event
> Guilt, worry, and sadness
> Trouble sleeping
> Angry outbursts
> Thoughts of harming yourself or others

There are several options for treating PTSD. Treatment for PTSD will vary from person to person and may include therapy, medication, or combination of both.

For more information on PTSD, visit the National Institute of Mental Health. Take an anonymous and free online PTSD self-assessment.

Additional Resources:
U.S. Department of Veterans Affairs – National Center for PTSD
PTSD Alliance

For people with serious mental illness (SMI) the risk for being overweight or obese is significant. Four out of five people with SMI are overweight or obese in the United States. According to the Centers for Disease Control and Prevention (CDC), being overweight or obese can increase your risk for coronary heart disease, type 2 diabetes, some cancers, hypertension, dyslipidemia, stroke, and other health conditions. A recent study, published in the New England Journal of Medicine, shows that tailored lifestyle programs for people with serious mental health conditions can be effective in achieving healthy weight loss.  

The study consisted of 291 participants from 10 outpatient psychiatric rehabilitation programs that were randomly assigned to an intervention group or control group. The study found that the intervention group that received regular weekly group exercise classes and individual/group weight management classes had significant weight loss compared to the control group that had basic information on nutrition and exercise at the beginning of the study.

After 18 months the participants in the intervention group:

• on average, lost 7 pounds more than the control group.
• 38% lost 5% or more of their initial weight, as compared to 23% for the control group.
•  nearly 1 in 5 participants lost 10% or more of their initial weight, as compared to 1 in 14 participants in the control group.

The study also found that the participants from the intervention group who were taking certain psychotropic medications known to cause weight gain still had significant weight loss as well. This study shows that when effective resources are provided, people with SMI can implement healthy lifestyle changes with good results, despite the many challenges that they face.

For more information on this study, please visit the National Institute of Mental Health website:  http://www.nimh.nih.gov/science-news/2013/nih-study-shows-people-with-serious-mental-illnesses-can-lose-weight.shtml

Also, please check out our wellness and recovery resources.

With nearly two weeks of spring behind us, the hope of warm weather and getting outside to soak up some sunshine will eventually come. In Minnesota, we are fortunate to have so many city, county, and state parks that offer a variety of recreational activities, such as biking, hiking, walking and swimming, just to name a few. Not only do many of these activities can impact your overall health, but can also provide a place to connect with friends, family, and people from your community. Below are just a few resources to help plan a visit to your local or state parks.

Listings of Minnesota state parks
http://www.dnr.state.mn.us/state_parks

Listings of Minnesota county websites
http://mn.gov/portal/government/local/Counties

Also, check out our Take Charge booklet for more ideas to improve your health and wellbeing, tips on setting some wellness goals, and to track your progress.

Check out two new video series from the Depression and Bipolar Support Alliance (DBSA) on their YouTube channel this month.

Out of the Blue: The Many Faces of Depression

Depression doesn’t just look one way. Major depressive disorder affects more than 14 million adult Americans each year, and many don’t attribute the range of symptoms they encounter to depression. In this series of videos, six individuals share their experiences with depression, including some of its less identifiable manifestations, which range from anger and irritability to feeling overwhelmed by a lack of focus and difficulty making decisions. DBSA thanks the Takeda-Lundbeck Alliance for its unrestricted support for the production of the Out of the Blue video series.

Bipolar Disorder Education Video Library

The DBSA Bipolar Disorder Education Video Library addresses common questions and concerns that people living with bipolar disorder and their loved ones often have. In each video, a peer shares their experience with issues such as dealing with stigma, identifying triggers, and working with clinicians. Speakers include individuals living with bipolar disorder, their loved ones, and professionals in the mental health field.

Recently, SMCPros featured the work of individuals and organizations in the community.  We had an entry posted there, but we wanted to share it here as well.

Every day of the week, I find a call for help in my inbox.  The people who write are unflinchingly honest about emotional breakdowns, job losses, and medical nightmares.  They found a form on our website or our general email address, and sent something in the hopes that there is some help on the other end.  Even though they have no idea they are writing to me, they are honest and candid to a degree that awes me.  Because I forward these emails directly to our client advocates, Anna and Tom, almost none of them ever hear from me at all.
But nonetheless, they have come to the right place.  In a system that still tends to treat people as less than, and with an illness that can make even the smallest obstacle too much to handle, they have run into a group of people who are dedicated to understanding their needs and helping them find their way.  I work for a small non-profit, Mental Health Association of Minnesota.  For over 70 years, we have helped people with mental illness be heard.

We don’t focus on what we think is important, we ask them what their goals are.  For one client, it was making copies of correspondence without feeling like the hospital staff were looking over her shoulder.  For Amanda, it was just sorting through the paperwork that meant the difference between a stable home and living on the street.  For Kevin, it was trusting group home staff enough to tell them about his nutritional goals.  It all matters because the person behind it matters.

Believing that we’re important and that we can take a concrete step towards recovery is absolutely necessary.  Time becomes a real enemy when I feel depressed or anxious.  I lose my sense of what things are like without that cloud hanging over me, much the same way that you might forget how good a full, deep breath feels after a long bout of the flu.  Without hope and help, everything is too much, and every set back feels like the end of the world.

More than a decade ago, I was a patient at Abbot Northwestern, hospitalized a handful of times for suicidal behavior and thoughts.  I was not responding well to medication, and every change in my prescription added another 15 or 20 pounds to my frame, until I could barely recognize myself in the mirror.  In a matter of months, I had gone from zero involvement in the system to a head-first dive.  It was frightening and lonely, full of people who didn’t believe me or listen to what I thought might help.  I was on a unit with all kids, but many went days or even entire stays without seeing family.

I got daily visits from family.  There were cards from my friends waiting for me when I got home.  My internship supervisor came to the unit to make up for a lunch we were supposed to have.  She even arranged a get-well call from her boss’s boss, a guy named Paul Wellstone.  And from working in his office, I knew that it took phone calls all the way up the chain of command, and a scheduling effort.  Far from taking away from the impact, it doubled it.  You see, the point is that it’s not about one person who cares, it’s about entire families, communities, workplaces that do.

Mental illness is often chronic.  It can be extremely painful and damaging.  It is also true that people recover, leading wonderful and meaningful lives.  They do so every day, but they almost never do it without support. MHAM takes phone calls and emails from anyone who is living in Minnesota or is concerned about a Minnesota resident who is having a hard time navigating the mental health system.  We connect people with needed services, teach skills for self-advocacy and wellness, helping them live into their recovery.

I wanted to share this story with you so that you know two things.  First.  If you have a mental illness, and you don’t know where to turn, there is help. If it’s 2 AM when you’re reading this, and you’re in crisis, please call 800-273-TALK. It’s a different organization, but they are ready to connect with you, and believe me that it is worth it.  But the next morning, I hope you email us at [email protected], or give us a call at 651-493-6634/800-862-1799.

Second.  Whether or not you are living with a mental illness, do you agree with me that recovery shouldn’t be luck? There are plenty of ways for you to help.  Drop us a line to find out more about volunteer opportunities, how to contact your legislators about life changing community mental health services, or our wellness education program. And yes, consider a donation.  Our services may not be the easiest to fund in today’s economy, but that voice of hope is worth something.  Personally, I think it’s worth quite a lot.

Ben Ashley-Wurtmann

Policy and Outreach Associate

Recovery is a journey and often involves several components. One essential component is support from others. Support from family and friends and can play an integral role. Connecting with others that are experiencing a similar health condition can be important too. Support groups can provide a positive environment to share these experiences. Support groups are not group therapy or a substitute for medical treatment, but a place where people can connect with others and to find mutual support.

The Minnesota Chapter of the Depression Bipolar Support Alliance (DBSA) – a program of MHAM since 2004 – has provided a platform for people to share experiences, personal feelings, information, and strategies for living successfully with mood disorders. DBSA support groups can:

> give you the opportunity to reach out to others and benefit from the experience of those who have been there.
> motivate you to follow your treatment plan.
> help you understand that a mood disorder does not define who you are.
> help you rediscover strengths and humor you may have thought you had lost.
> provide a forum for mutual acceptance, understanding, and self-discovery.

DBSA support groups are free and open to individuals who have depression or bipolar disorder, or for their loved ones. Meetings are facilitated by trained volunteers and meet at several locations within the Twin Cities area and parts of Greater Minnesota.

Check the current listing of DBSA meeting locations and times on the MHAM website. At some meetings, there are specific support groups for depression, bipolar disorder, and family issues. Please contact the facilitator directly for more information. If there is not a meeting location in your area or you are looking to attend a different type of support group, please check our listing of other sponsored support groups on our website. If you are interested in starting and facilitating a DBSA group in your area, please contact Tom Johnson at [email protected] or 651-493-6634 / 800-862-1799.

For general information about DBSA support groups, please visit the DBSA website. Also, check out DBSA on the Not Alone radio program, airing on KKMS-AM (990), August 4 at 1pm and August 5 at 11:30 am. DBSA leadership will be talking about peer support through DBSA.

From most recent estimates, one in two Americans used at least one prescription medication in the past month and one in five Americans used 3 or more prescriptions in the past month. While prescription use is increasing, so are adverse drug events (ADE). Approximately 4.5 million ambulatory visits related to ADEs occur each year. The Institute of Medicine (IOM) estimates that at least 1.5 million preventable adverse drug events occur within the healthcare system each year. All medications have inherent risks, but both healthcare providers and consumers can often manage or reduce many ADEs from occurring. So what can you do?

The following questions from the Federal Drug Administration (FDA) can help you talk with your healthcare team so that you can gain a better understanding of your medications and to safely use them. You may want to ask your healthcare professional…

> What are the brand and generic names of the medicine? Can I use a generic form?
> What is the medicine for and what effect should I expect? Does this drug replace any other medicine I have been using?
> How and when will I use it, what amount will I use, and for how long? What do I do if I miss a dose?
> Should I avoid any other medicines, (prescription or over-the-counter), dietary supplements, drinks, foods or activities while using this drug?
> When should I notice a difference or improvement? When should I report back to my healthcare team? Will I need to have any testing to monitor this drug’s effects?
> Can this medicine be used safely with all my other medications and therapies? Could there be interactions?
> What are the possible side effects? What do I do if a side effect occurs?
> What other medicines or therapies could be used to treat this condition? How do the risks and benefits compare?
> How and where do I store this medicine?
> Where and how can I get written information about this medicine? What other sources of information can I use to make my decision?

For other information and resources, check out the following:
www.consumermedsafety.org
www.fda.gov
www.mentalhealthmn.org/be-informed/steps-to-wellness (Downloadable Medication Form)