by Anna Raudenbush, Client Advocate

There has long been a gap in mental health services for folks who don’t need emergency room level care, but cannot wait a couple weeks to see a provider.  Now St. Paul has a new service to fill that gap, the Urgent Care for Adult Mental Health center.  Located at 402 University Avenue East, the center is meant for anyone in Ramsey, Dakota, and Washington Counties who need immediate non-emergency mental health support.

The center is operated by the Mental Health Crisis Alliance, formerly EMACs, and managed by Ramsey County.  While they offer on-site support and walk-ins, they also operate a mobile crisis team for Ramsey County.

Going to a new place for mental health care can be nerve-wracking; it’s hard to feel comfortable when you don’t know what to expect.  Fortunately, the Urgent Care center is hosting monthly open houses on the first Friday of each month at 1PM.  These open houses are free and anyone can come, no RSVP required.  At the open house visitors will get to tour the new center.  This is a great way to get familiar with mental health services in Ramsey County and to learn how Urgent Care can be a resource for you.

You can find more information about Urgent Care for Adult Mental Health here.   For more information about the monthly open houses, you can call their front desk at 651-266-4008.

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.

Although the health care bill has recently passed, many of the new provisions will not take effect for some time.  For recent college graduates, staying on their parents’ coverage may be a good option since many insurance companies have already expanded their coverage to the children of dependents until they are 26.  As of last fall, health plans must offer this.  However, this might not be an option for everyone.

One important thing during this time of transition is to be consistent with a medication plan. In order to do so, it is a good idea to talk to your doctors before your coverage changes in order to develop strategies so that you guarantee continued coverage of your medication.  This will insure that you stay healthy both physically and mentally.  Getting a prescription for a 90 day supply is one potential option.

If you plan to buy your own health insurance, learning about the different options and plans is crucial.  First, it is a good idea to figure out how long you may be under or uninsured.  This would help you to decide if you should look at short-term health insurance plans or more long term plans.  Healthcare.gov has information on eligibility for public and private health insurance plans.  EHealthInsurance.com is a for-profit website, but can offer a useful comparison of different private plans.

Many insurance companies that provide short term insurance, offer plans where you can buy insurance a month at a time, usually for up to 6-12 months.  However, it is important to understand that short-term plans only provide coverage in the event of an emergency or a catastrophic event.  Many short-term plans don’t cover regular check-ups, pre-existing conditions, prescription medications, or other preventative care needs.

When considering a health insurance plan, learning about the limits and constraints of high deductibles vs. low deductibles, as well as the premiums is vital.  When considering an insurance plan, the annual deductible is the amount of money you have to pay out of pocket before your health insurance kicks in.  Normally, the higher the deductive, the lower the premium, or monthly payment.

Along with the security of health insurance, there are also several clinics that offer sliding fees. Depending on your income and other expenses, certain clinics can adjust the price of their services and other health care needs.  You can find more resources on our website or by calling one of our individual advocates.

Though graduation is accompanied by celebration and excitement, there are also lots of things to start thinking about.  It is especially important for people with mental illnesses to plan ahead when thinking about health insurance.  This summer in particular may leave many people not only jobless but also without the medical coverage they need.

Speaking with health care professionals and advocates can help.  They possess the tools and resources that can help in alleviating possible long-term stress or more serious illnesses.  Taking the time to learn about your options and coming up with a strategy now will certainly help you avoid the pain and anxiety of being in need of medical care later, and not having the coverage to afford it.

This post comes from volunteer blogger Margo Tell.

The Food and Drug Administration (FDA) notified health care professionals and the public of medication error reports in which patients were given risperidone (Risperdal) instead of ropinirole (Requip) and vice versa. In some cases, individuals who took the wrong medication needed to be hospitalized. The FDA determined that the factors contributing to the confusion between the two products include: 1) similarities of both the brand (proprietary) and generic (established) names; 2) similarities of the container labels and carton packaging; 3) illegible handwriting on prescriptions; and 4) overlapping product characteristics, such as the drug strengths, dosage forms, and dosing intervals.

Individuals who take Requip, Risperdal, or their generic equivalents are reminded to take note of the name and appearance of their medication, know why they are taking it, and to ask questions when the medication appears different than what they expect. Healthcare professionals are reminded to clearly print or spell out the medication name on prescriptions and make certain their patients know the name of their prescribed medication and their reason for taking it.

For additional information on this FDA drug safety alert, please link to: http://www.fda.gov/Drugs/DrugSafety/ucm258805.htm

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.

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).