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)

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.

MHAM is accepting nominations for the 2012 Gloria Segal Award for excellence in improving the lives of Minnesotans with mental illnesses. This award is given to honor the memory of Representative Gloria Segal. Representative Segal served in the Minnesota House of Representatives from 1983 until her untimely death in 1993. In her 10 years in the legislature, she worked tirelessly to change how people with mental illnesses are treated in Minnesota. She led the way in the passage of groundbreaking legislation such as mandating coverage of mental health treatment in group health insurance plans and the creation of the mental health division at the Department of Health and Human Services, the State Ombudsman’s Office for Mental Health, and the State Advisory Council.

The Gloria Segal Award is given to an individual who has improved the lives of a great number of Minnesotans with mental illnesses. Accomplishments may include:

• Empowering people with mental illnesses
• Clinically treating people with mental illnesses
• Championing key legislation
• Increasing resources for people with mental illnesses
• Creating or improving systems of care for people with mental illnesses
• Performing key research in the area of mental health
• Creating a popular book/movie/play or other work of art that significantly decreases stigma

The Gloria Segal Award has been received by Representative Mindy Greiling in 2009 and Robin Wold and Hope House in Bemidji in 2011.

Do you know someone who has significantly improved the lives of Minnesotans with mental illnesses? We invite you to let us know! Please provide a short narrative including:

• Name and phone number of the person you are nominating
• Your name, phone number, and email
• Nominee’s relationship to the mental health community
• Activities which improve the lives of people with mental illnesses
• Accomplishments in those activities

Nominations will be accepted May 15 through June 30, 2012. The award will be presented at the 3rd Annual Celebrating Recovery event on September 27, 2012.

Submit your nomination to edeide @ mentalhealthmn.org or via mail to:

Mental Health Association of Minnesota
Attn: Gloria Segal Award Nomination Committee
475 Cleveland Avenue N, Suite 222
Saint Paul, MN 55104

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.

As January comes to an end, so do a lot of New Year’s resolutions. The University of Southern California School of Social Work recently posted a blog about some stats and tips on self-care resolutions. Of those who make a resolution, about 60% have kept their resolution after 1 month and 40% have kept their resolution after 6 months. Depending on the resolution, several factors may determine if a goal is successful or not. Self-care goals such as increasing physical activity, eating healthy foods, or setting time for one’s self can be difficult when life becomes busy and stressful.

Goal setting can be done anytime in the year, but its important to prepare. When setting a new goal, there are a few helpful tips to remember:

> Be realistic about your goals. Is this goal achievable? It’s important to challenge yourself, but setting a goal that is too complex can lead to frustration and be impossible to carry out. Goals should be simple and clear.

> Start with short-term goals rather than long-term goals. Achieving short-term goals can provide much needed confidence before setting a long-term goal.

> Track your goals. Write down your goal and keep track of how that goal is progressing. Ask yourself: What is working and what needs to be done differently?

> Don’t feel discouraged if you are unable to carry out a goal. Issues come up and things happen that you may have no control of. Revisit that goal when things become better.

Below are some resources on goal setting:

Depression and Bipolar Support Alliance – Setting goals for recovery

Mayo Clinic – Stress blog

Brought to you by MSW@USC: Masters in Social Work

A study by the Substance Abuse and Mental Health Services Administration, found that one in five adults experienced mental illness in 2009. Yet, the majority of individuals that have these types of health conditions do not seek treatment because of cost, fear of stigma, and lack of knowledge of the treatments that exist.  By educating the workforce on mental health issues, an organization can create a supportive climate that can break down the barriers of stigma and lead to steps that promote better health. The following are ideas on implementing mental health into existing health promotion and communications efforts at work.

Partner with community mental health agencies and existing benefit providers: These agencies often provide training and educational materials to community members, including area businesses.

•  Training can include formal presentations on common mental health problems such as depression, anxiety, and stress in the workplace. If you have an employee assistance program (EAP), training or educational seminars may be part of your contracted service or may be available for an additional fee.
•  Educational materials can include brochures, booklets, and training and resource manuals that can approach a variety of topics relating to mental health. These services are often provided at a low cost or, in some cases, free of charge.
•  Incorporate mental health into your company’s health or wellness fair. EAPs and community agencies often provide information for employees at these events.

Add mental health information to your existing communications: Newsletters, payroll stuffers, post cards, e-mail blasts, and other communications can all help initiate your organization’s commitment to mental health.

•  An internal newsletter can provide a great opportunity to talk about health issues. Your EAP, health care provider, or local community mental health agency may be able to provide material or assist you with the article.
•  Payroll stuffers and post cards provide another option for reaching out to employees and their family members.
•  Placing literature in inconspicuous areas of the workplace is also important. Instead of placing brochures in a break room or busy hallway, provide these materials in a subtle and inconspicuous place for employees, such as restrooms.
•  Make sure that toll-free numbers and websites for the company’s EAP and health care provider, and/or the community mental health agency, are included in all mental health educational materials. Also, be sure that information about mental health benefits available from your EAP and health insurer is easily accessible on your company’s website. Promoting your benefits will create awareness and utilization.

*This information was adapted from “Mental Health at Work: A Resource Manual for Minnesota Employers.” To obtain a copy of this manual and other MHAM workplace publications, please visit the Workplace Publications Page.

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].

In October, we unveiled the Steps to Wellness kits at MHAM’s Celebrating Recovery education event. Since the event, we’ve had a tremendous response for these kits from individuals, providers and other community organizations. The kits offer several personal wellness tools that can be used to develop a plan for self-care, address a crisis should it arise, and tips on how to advocate for oneself. Because each person’s health and wellness varies and often changes throughout a lifetime, the resources contained in the kit can be used in conjunction with one another or separately. MHAM is inspired by the response and will continue to promote and encourage individuals and providers to take steps to incorporate personal wellness.

To order the Steps to Wellness kits, please call us at 612-331-6840 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].

Steps to Wellness is Supported By:
• An educational grant from Lilly USA, LLC
• Janssen, Division of Ortho-McNeil-Janssen Pharmaceutical, Inc.
• Park Nicollet Foundation Healthy Community
• Pfizer Healthcare

Speaking of wellness… In a past blog, we highlighted a campaign developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). The SAMHSA 10X10 Wellness Campaign provides resources and free educational events surrounding the latest research and information on programs that address health and wellness issues for individuals with mental illnesses. On December 7, 2010, from 2pm-3:30 pm, the SAMSHA 10×10 Wellness Campaign will be hosting a free teleconference on Prevention and Holistic Approaches to Wellness.