By Derrick Keith, Band Member, The Last Gold Leaf

When I was sixteen my parents bought be my first guitar as an Easter present. I never thought of myself as a musician. I was the kind of kid that spent endless hours locked away in my room, pencil in hand, drawing feverishly, seeking desperately to express the fanciful worlds in my head into images on a page. In fact, even as I began writing songs I never imagined I would seek to make a career out of music.

Picking up that guitar unlocked an urgency in me. I found that others could identify with the loneliness and depression that informed my music. And that made us all a little less lonely, the days seem just a little bit brighter. I was hooked and there was no looking back. I set out to find that connection on a larger and larger scale.

If I were to try to sum up my goal as a songwriter in one word I think it would be “fearless.” I believe my role as an artist is to bring light to those dark places in our psyche that we become afraid to talk about. The unpretty things: addiction, poverty, hunger, betrayal. It seems as if our culture is almost engineered to isolate ourselves from one another. But it’s in recognizing our griefs, our failures, in forgiving that we can tear down the walls we built originally to protect us. The walls we found cut us off from our lifelines.

I have seen friends, family members, lovers, strangers in deep hurt. In need of help. Become helpless. But I believe in the power of music to heal. To foster community. To open up wounds to draw the infection out. I seek to bring to the surface the ugliness so we can accept one another.

That’s why I reached out to the Mental Health Association of Minnesota (MHAM). Music can raise the questions, but MHAM has the resources to help heal the wounds. None of us can do it alone. According to the National Institute on Mental Health’s website, In 2012 18.6 percent of adults ages 18 and above were diagnosed with mental illnesses. That’s almost 2 out of every 10 people. And that’s just the people seeking help.

If you or a loved one you know have questions, seek help.

The Mental Health Association of Minnesota is proud to support the band The Last Gold Leaf in their upcoming EP release party for their new album Opaque. Through this release party for the EP Opaque, The Last Gold Leaf hopes to generate awareness of mental health and point people in the right direction to find treatment and services for mental illnesses.  Staff from MHAM will be at the party to share information about mental health and our services. A portion of the proceeds from this event will benefit the Mental Health Association of Minnesota.

Guests include: Parachute Empire, The Lost Wheels, and Kara Doten

Featuring photography by Haythem Lafaj

Location
The Stu
77 13th Ave NE
MInneapolis, MN

Cost: $11

Purchase tickets here.

By Jennifer Ilse, Co-Artistic Director, Off-Leash Area

I have sweet memories of my brother Craig, 11 years my elder. Accompanying him to Boy Scout meetings, camping, swimming, pine cone fights, building snowmen… Though at times he staked out his rightful place as older tormenting brother, he clearly adored me, loved to teach me and show me the world and the things he loved in it. At age 19 he developed acute paranoid schizophrenia, and that was the end of that chapter of our lives together. I was confused, terribly embarrassed by his behavior in front of my friends, and I missed my old Craig dearly.

I watched our parents’ frustration and grief as they struggled with understanding what to say, what to do, what to feel. And I kept my own emotions well constructed in front of them and everyone else.

As the director of a dance and theater company, art is my most comfortable form of expression of the deepest places in my soul. And hence was born Maggie’s Brain from my memories of this period of intense struggle. This was in a small town in the mid-70’s – a time and place where most people didn’t know what schizophrenia was; it was still believed that “cold” mothers were the cause, and nobody ever talked about mental illness except in hushed and generally misinformed whispers. Thankfully my parents were able to find significant emotional and practical support through the local chapter of NAMI, and as a result Craig was able to get into a network of support that enabled him to have a safe and fruitful life.

Though Maggie’s Brain is not a replica of my family’s story with mental illness, it is born from those intense memories of confusion, guilt, anxiety, love, and grief. I researched and talked with many people who have experienced mental illness personally and professionally, and from all of our experiences created a version of this journey. The social and political environment for mental illness has also improved significantly since that period of time. But the struggle, the frighteningly intense emotions, the desire for communication and understanding, are part of everyone’s journey whose lives are touched by mental illness. Maggie’s Brain is my artistic expression of that journey.

You can see Maggie’s Brain at The Cowles Center in Minneapolis, January 24-26, 2014. I hope you can come.

DATES/TIMES/TICKETS
At the Cowles Center for Performing Arts
January 24/25/26, Fri/Sat 8pm & Sun 7pm
FULL DETAILS at www.thecowlescenter.org
Tickets: Adults $25, Students/Seniors $23/ Under 21 $19
Group rates available
Reservations: Reserve online at www.thecowlescenter.org or call the box office at 612-206-3600.

There will be a discussion with the artists, mental health professionals, and those directly affected by mental illness after the show on Friday, January 24 and Saturday, January 25 as part of The Cowles Center’s Meet the Company Talk-Back Series.

You can find out more about Off-Leash Area’s work at their website.

Last night I had the opportunity to attend ‘Other Desert Cities’ at the Guthrie Theater. ‘Other Desert Cities’ takes place over the course of Christmas Eve. Brooke, who has recently been hospitalized for depression, and her brother have come to stay with their parents for the holiday. The play is premised on the notion that Brooke’s brother, Henry, committed suicide after assisting a radical leftist organization with a bombing. This loss, and the story of the circumstances around it, has profoundly influenced Brooke’s life and recovery from depression, and inspired her to write a memoir.  When she returns home for Christmas, Brooke informs her family the memoir will be published in the New Yorker. This public voicing of the family secret creates chaos and sparks discussions about mental illness, the nature of silence, the nature of change, and the importance of truth.

Henry’s suicide, and the fact of his existence, has been erased from the family memory. Very few pictures of Henry can be found in the house, and it is clearly off-limits for discussion. Brooke has grown up within the silence around Henry, longing for her beloved brother but unable to discuss the experience of loss with anyone in her family.

However, Brooke’s parents have wealth and status within their community and believe her memoir will ruin their reputation. They have an interest in and benefit from maintaining silence, and the family system is dependent upon this silence. For the family system in its current iteration to continue, silence must be maintained.

Much of the play is consumed with the question of truth. What is truth? What does Brooke have to gain from speaking the truth of her experience? What purpose does it serve? Who does telling the truth harm or heal, and is it worth it? Is it possible for divergent truths to exist within a family? And do these divergent truths make it impossible to relate or love?

There was promise for deep examination of what it means to have divergent truths within a family, the stigma of mental illness and suicide, and how to maintain mental health in hostile territory, but the writing got weak towards the end. Rather than coming to a conclusion about the issues raised by suicide and mental illness, an unexpected revelation turns the play in a completely different direction.

While the first two-thirds of the play did an excellent job of depicting a family dealing with the fallout from suicide, depression, and chemical dependency, the last third seemed to negate the entire premise. A lot of thoughtful material is brought up, and then nothing is done with it. This does not mean the play is not worth seeing—it is fascinating to watch the complex family dynamics unfold. However, be aware that very little is done with this unfolding. While this play brings to light the very types of conversations people with mental illnesses might have with their families in a way that is emotionally real, it collapses on itself and refuses to play them out to their conclusion.

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

From the Substance Abuse and Mental Health Services Administration (SAMHSA)

Excessive Heat Exposure Can Pose Higher Risks for Those on Psychotropic Medication or Other Substances

During this period when parts of the Nation are experiencing record high temperatures, SAMHSA is reminding everyone that these conditions can pose certain health risks to everyone—including people with mental and substance use disorders.

Exposure to excessive heat is dangerous and can lead to heatstroke, which is considered a medical emergency. Heatstroke occurs when an abnormally elevated body temperature is unable to cool itself. Internal body temperatures can rise to levels that may cause irreversible brain damage and death.

Individuals with behavioral health conditions who are taking psychotropic medications, or using certain substances such as illicit drugs and alcohol, may be at a higher risk for heatstroke and heat-related illnesses. These medications and substances can interfere with the body’s ability to regulate heat and an individual’s awareness that his or her body temperature is rising.

Visit the CDC’s Extreme Heat: A Prevention Guide To Promote Your Personal Health and Safety for information on how to prevent, recognize, and treat heat-related illnesses.

When it comes to services for people with disabilities, how well do you think current public policies and practices in Minnesota meet your needs? What’s working for you? What isn’t? These are all questions the Minnesota Olmstead Committee would like to ask.

By October 2012, this committee must develop goals, recommendations, and a timeline that will become Minnesota’s Olmstead Plan. This Plan will be submitted to the State of Minnesota through the Minnesota Department of Human Services. The Minnesota Department of Human Services will begin to implement recommended changes in 2013.

You can help shape this plan by going to the Minnesota Olmstead Planning Committee’s website. The committee wants to hear from individuals living with disabilities, their families, service providers, and concerned community members.

The site is still being developed, but check back often for more information about the Olmstead Decision and ways that you can be a part of the conversation.

Which of these treatments is most effective?  This is a question that doesn’t always have a clear answer.  Antidepressants have become the most frequently prescribed drug in doctor’s offices and outpatient clinics today.  In fact, between 1996 and 2005 the number of people in the United States taking antidepressants has doubled in size.

In a recent study, “Psychotherapy Versus Second-Generation Antidepressants in the Treatment of Depression”, researchers attempted to find a more clear answer to this frequently asked question.  This study when compared to past research focused more on comparing the “newest” drugs (i.e. Paxil, Zoloft, and Prozac) to psychotherapy administered by a “qualified” provider.  A majority of previous studies were comparing older drugs to psychotherapy which left an incomplete picture of the comparative effectiveness.

This study was a meta-analysis, meaning they looked at data from 15 studies of similar topics.  In the process of choosing these 15 they had to eliminate studies that were using inadequate treatment methods. This would include studies that included untrained psychotherapists or variables that affected treatment quality such as:  switching of treatments, changing of dosages of medication and/or changing frequency of psychotherapy.  Another factor taken into consideration was the level of depression of the participants.  Depending on severity of depression (mild, moderate, or severe) outcomes and effectiveness of medication and psychotherapy may vary and treatment recommendations may differ.  To improve accuracy this study focused only on participants that were diagnosed with major depressive disorder.

The result of this study found that psychotherapy can be just as effective in the treatment of depression when compared to the newest of antidepressant medications. It was also noted that in the long run psychotherapy showed slightly better results.

So the question is; did they come up with a clear answer?  When comparing risks, benefits, and cost the course of treatment is ultimately up to the individual and their providers.  Some questions to discuss with your doctor might include:

• How severe are my symptoms? How long have I experienced these symptoms?  In what ways do they impair my goals for my health?  Other research has indicated that anti-depressants are most effective for depression that is severe and/or chronic.
• Are their side effects that are more concerning to me?
• What are barriers to me following a treatment?  Can I remember to take medications as directed?  How will I get to appointments for therapy?  Do I have a plan for what to do if I relapse?

We still need more research to be completed that focuses on the effectiveness of these treatments.  Depression today is the fourth leading cause of disability in the United States and it is predicted to be the second by 2020.  It is essential for people with mental illnesses to understand the facts so they can make educated decisions with their doctors about which treatments are most suitable to their specific needs.

This post was written by MHAM Intern Jahna Sandkamp.

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.

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.

By Ben Ashley-Wurtmann, MHAM Policy and Outreach Associate

In the wake of the tragic shooting in Arizona, many people have been asking questions about the mental health system and how it responds to individuals who may be capable of violence.  We believe that a strong health system is better able to handle individuals in crisis when it focuses on providing a strong continuum of care.  When every case is an emergency, few people will get the kind of care they require.  However, some of the discussion around the nation has been focused on the perceived danger presented by “the mentally ill.”

The truth is that people with mental illnesses vary greatly in terms of the symptoms they experience, the personalities they have, the experiences they have lived through, and the extent to which their illnesses affect their daily life.  Simply put, there is no one experience of mental illness, or even a particular condition, such as schizophrenia.

An interesting article was posted by the Wall Street Journal, questioning the validity of link of violence and mental illness caught our attention.

But another, more recent study showed that people with schizophrenia are no more likely to commit violence than those without mental illness. That research did find an increased risk of violence among those with schizophrenia who are also using drugs or alcohol.

Complicating things is that even if someone with schizophrenia commits a violent act, the illness isn’t necessary[sic] the reason for the behavior, say experts. With regard to Loughner, “my concern is that people immediately leap to the explanation that [the mental illness is] the master answer to why he committed this crime,” says Swanson. “It’s much more complicated than that.”

These are both important points to keep in mind.  Mental illnesses do not automatically make people violent, nor do they explain everything there is to know about a person.  More than ever, the public understands that mental illnesses are biological and treatable.  Unfortunately, this has not led to a reduction in stigma. This is an ongoing conversation at MHAM as we pursue our vision of improved lives for people with mental illnesses.  You can find more about how stigma works and how we are changing our struggle against it in our recent newsletter (page 4), on our blog, in the news, or by contacting us at [email protected].