Government Estimates 754,000 Homeless People - AP

By STEPHEN OHLEMACHER

WASHINGTON — The nation has three-quarters of a million homeless people, filling emergency shelters through the year and spilling into special seasonal shelters in the coldest months, the government said Wednesday.

The Department of Housing and Urban Development estimated there were 754,000 homeless people in 2005, including those living in shelters, transitional housing and on the street. That's about 300,000 more people than available beds in shelters and transitional housing.

The report is the government's latest attempt to count people who are notoriously difficult to track. The estimate is similar to one by an advocacy group in January.

The 2000 Census pegged the number of homeless people at 170,700, but it was widely considered an undercount. In 1996, the Urban Institute used data collected by the Census Bureau to estimate there were between 640,000 and 840,000.

Housing officials hope the new report will serve as a starting point to more accurately measure changes in the homeless population.

"Understanding homelessness is a necessary step to ending it, especially for those persons living with a chronic condition such as mental illness, an addiction, or a physical disability," HUD Secretary Alphonso Jackson wrote in the report.

HUD developed the estimate using data collected by local agencies that serve the homeless. Agencies across the country tried to count the number of people living on the street one night in January 2005. The agencies also collected information about race, gender, and disability status from people staying in emergency shelters and transitional housing from February to April 2005.

Among the findings for people in shelters and transitional housing:

_Nearly half were single adult men.

_Nearly a quarter were minors.

_Less than 2 percent were older than 65.

_About 59 percent were members of minority groups.

_About 45 percent were black.

_About a quarter had a disability, though experts said the percentage is probably much higher.

The Urban Institute recently did a study on homeless people in Santa Monica, Calif., and found only 6 percent of those using services for the homeless did not have a mental illness or a substance abuse problem, said Martha Burt, a researcher at the institute.

Emergency shelters are more than 90 percent full on average nights, the report said. They would be over capacity if not for seasonal shelters.

By comparison, less than three-quarters of transitional housing units for families are occupied on an average night.

HUD has been shifting resources from emergency shelters to transitional and permanent housing for years. The number of emergency shelter beds dropped by 35 percent from 1996 to 2005, to 217,900.

Meanwhile, the number of transitional housing beds increased by 38 percent during the same period, to 220,400. The number of beds in permanent supported housing increased by 83 percent, to 208,700.

"We ought to be looking for ways to move people from shelters into permanent housing," said Nan Roman, president of the National Alliance to End Homelessness.

"Building shelter beds doesn't result in these people being housed," Roman said. "But clearly, short of housing, everybody should have a roof over their head. This points out that we are not there, either."

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On The Net:

Department of Housing and Urban Development: http://www.hud.gov/

National Alliance to End Homelessness: http://www.endhomelessness.org/

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Mental-health falls short, survey says - Winston-Salem Journal

By M. Paul Jackson

Less than half of the region's mental-health patients said that they are pleased with the state's mental-health system since it was overhauled in 2001, according to a report released yesterday.

The report was released by the Mental Health Association in Forsyth County Inc., a local advocacy group. The association held a meeting at Fellowship Hall at Highland Presbyterian Church in Winston-Salem to release the report.

The group surveyed about 220 mental-health patients and 80 mental-health providers from April to May of last year.

"We still have a ways to go, as far as satisfaction of services and consumers feeling that they're not getting what they need" said Andy Hagler, the association's executive director.

The survey was conducted to examine how the mental-health system has changed and how it has affected patients since it was overhauled.

The Winston-Salem Journal published a series of articles last year showing how the state's 2001 plan to shift care from mental hospitals to smaller community agencies was based on false assumptions about payments for mental-health services.

In addition, many smaller agencies were unable to provide adequate care and were forced to shut down, including HopeRidge Centers for Behavioral Health, a Winston-Salem agency that closed in 2005.

According to the association's report, about 48 percent of mental-health patients said that they were pleased with the changes to the state's system.

Mental-health providers, including staff members at agencies, were less satisfied with the system.

About 7 percent of the providers said that they were pleased with the state's changes. Many cited problems dealing with the government and planning for services for their disapproval.

The report also included statistics on the numbers of consumers who felt that they received all the care they believe they needed. For example, about 65 percent of the consumers surveyed said that they received enough mental-health services.

According to Liz Arnold, a board member for the association, about 90 percent of consumers should be satisfied with the amount of their care.

"I think that speaks to the level of turmoil in our system," she said.

The region's mental-health services are managed primarily by CenterPoint Human Services, a mental-health agency in Winston-Salem.

Association members said they planned to create support programs for mental-health providers under stress, as well as develop programs for the region's mentally ill homeless residents.

"It's an extremely underserved population in our community," Arnold said.

• M. Paul Jackson can be reached at 727-7473 or at mjackson@wsjournal.com. Read more!

The cost of reform - Raleigh News & Observer

Editorial:

State investigators are right to delve into the finances of a new Charlotte-area mental health program that serves more clients, by a relatively small percentage, than the program it replaced, but that costs $20 million more per month. The program understandably has raised the eyebrows of state Rep. Verla Insko of Orange County, who is one of the legislature's best informed members on the subject of mental health treatment.

The aim of Mecklenburg County's new program, run mostly by private firms, is to help clients toward self-sufficiency. That is an objective at the heart of what has been North Carolina's fits-and-starts attempt at mental health care reform. For nearly a decade, the state has been -- or was supposed to have been -- moving in the direction of getting the mentally ill out of long stints in big, centralized hospitals and into smaller programs closer to their communities.

The implicit goal, of course, is faster healing for hurting North Carolinians. They would be closer to supportive family and friends. Patients who get better sooner would be in a better position to get jobs and live independently.

But this change in treatment approach has proved neither easy nor cheap. Existing programs must be shut down and new local programs built, often from the ground up. They may have to go through periods of testing for effectiveness. State hospitals need to be reconfigured in keeping with their evolving mission.

The hoped-for payoff is that in the long run, money will be saved. Expensive hospital care, while it can't be eliminated, will give way to less costly local programming. Patients will be better off.

Critics of the Charlotte program say that companies are extending services -- personal aides who help clients build skills such as grocery shopping, house-hunting and searching for jobs -- to pad their invoices. The claims should be aggressively investigated. But state policy-makers should recognize that to make reform of the mental health system succeed, a large investment may need to be made in the short term to save money -- and help the mentally ill advance -- in years to come. Read more!

Easley wants HHS complex on part of Dix - WRAL Radio Raleigh

(Originally published Feb. 27)

Raleigh — There’s been plenty of debate, but no official decision on what to do with a prize piece of Raleigh real estate, the Dorothea Dix Hospital campus. The governor has made a move that speed up the process, however.

The 2008 budget that Gov. Mike Easley submitted last week includes $173 million in bond money to develop 25 of the 306 acres of the state property just outside downtown Raleigh. The city is hoping the state will sell it the land.

The 150-year-old state hospital is set to close late this year or in early 2008. What happens to that land will impact the capital city for generations, which led city officials to bring in planning advisers from the nationally known Urban Land Institute.

Easley wants to build a state-of-the-art, energy-efficient office complex for more than 3,400 Department of Health and Human Services employees.

“We need that. That is long overdue. We need that complex, and it will be the greenest building in the state,” North Carolina’s Democratic governor told WRAL.

The complex would be built on the edge of the Dix campus, along Lake Wheeler Road. DHHS employees who already work at Dix and thousands from downtown offices would fill the facility.

Politicians and planners have spent months talking about a putting a park, a mixed-used development or both on the site. A final decision hasn’t been made, which is why the budget item stunned some leaders.

“My reaction was a little bit surprised that it would be in this year's budget. It would have been great if everyone could have been on the same page,” Sen. Vernon Malone, D-Wake County, said. Malone co-chairs the committee studying the future of Dix.

The group hasn't yet found consensus, so, the senator and other lawmakers were surprised to learn the governor earmarked millions for the office complex.

“It is getting the cart before the horse in the governor's budget. What we need to do is determine what we're going to do with the Dix property first,” said Rep. Nelson Dollar, R-Wake County.

The governor says the jury is still out over what to do with Dix. He hopes the historic site can be preserved for public use.

Wake County leaders see the governor’s budget as an executive message.

“I know ultimately a decision has to be made on the Dix property. This may force us to move forward,” Malone told WRAL.

Easley’s chief economic adviser says that putting a new state building on the Dix campus makes sense.

“I believe this is the state's property first and foremost, and there's a lot of discussion that needs to take place on this,” said Dan Gerlach.

It now appears the governor is leading that discussion. The future of the Dix property will now become part of legislators’ budget negotiations. Read more!

Deadline to Meet Goals Extended as District Promises Better Foster Care - Washington Post

By Sue Anne Pressley Montes

The District's foster care system continues to shortchange children in its care by failing to provide full medical and mental health services and sufficient caseworker visits, a children's advocate said yesterday in U.S. District Court.

Officials from the new administration of Mayor Adrian M. Fenty, promising reform, negotiated an extension of a deadline for improving the child-welfare agency. The city has until Dec. 31, 2008, to make changes that should have been in place by the end of last year or earlier.

"It is troubling to us that, although the District has made progress, they are still as far off as they are," said Marcia Robinson Lowry, executive director of Children's Rights, a New York-based nonprofit advocacy group leading the long-running suit against the city. "The agency has still failed to address some significant problems affecting the well-being of these children."

The new timetable marks the latest development in the case now known as LaShawn A. v. Fenty. Filed in 1989, the federal class-action suit has outlasted several mayoral administrations and now represents about 2,400 D.C. children under the care of the Child and Family Services Agency. The suit was named for a 4-year-old who had been in emergency foster care for 2 1/2 years, significantly longer than the 90 days allowed by D.C. law.

Both sides in the case agreed to extend the deadline after lengthy negotiations. The District promised to improve investigations of alleged child abuse and neglect. The city also said it will seek better placement of children in family-like settings and provide more rigorous health and dental care.

Peter Nickles, general counsel for Fenty (D), told Chief U.S. District Judge Thomas F. Hogan that the new administration is "committed to the necessary funding."

"The issue is the quality of care, the outcomes for this vulnerable population," he said.

When the suit was filed, the District's child welfare system was described as chaotic. Hogan wrote about "the indifference" of the administration of then-Mayor Marion Barry (D) and "the resultant tragedies for District children relegated to entire childhoods spent in foster care drift." In 1995, the system was placed in court receivership because of the lack of progress, a condition that was lifted in 2001.

But improvements have come too slowly for child advocates involved in the case.

Lowry told the judge that the agency did not meet 60 of its 105 goals during the last three years. Among other problems, only 56 percent of children in foster care are receiving the prescribed twice-monthly visits by caseworkers, she said. Only 29 percent receive medical exams within 90 days of their placement in the system, although the District earlier had agreed to provide timely screenings for 90 percent of the children in its care by the end of 2005.

"Children are still being damaged on a day-to-day basis by this system," she said.

Richard S. Love, senior assistant D.C. attorney general, told the court that the agency has gone through "dramatic, measurable and, indeed, remarkable" reform. "But it is long recognized that there are things yet to be accomplished," he said.

Hogan acknowledged "the commitment of the new administration" and called the new deadline "logical and enforceable." He set a hearing for June 7 to gauge progress. Read more!

Please Check Mid-Afternoon for Further Updates

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Mental health building sold - Overland Park (KS) KC Community News

Miami County and Osawatomie officials concerned about how the loss of Family Services Center will affect delivery of care

By: Jennifer McDaniel, jmcdaniel@miconews.com

Despite the impending sale of the Miami County Family Services Center near Osawatomie, the county’s mental health provider is assuring local officials that mental health services designed for children still will be available.

But Osawatomie and county officials are working with Elizabeth Layton Center representatives to determine how to best solve the center’s dilemma of finding a new location without affecting services provided to children.

When it opened nearly seven years ago, the center served as a means for the former Miami County Mental Health Center to broaden its scope to help the county’s children struggling with severe behavioral disorders. Services originally were provided in the former Families First offices along Osawatomie’s Sixth Street. But with quarters so tight and a growing need to serve more Miami County families, officials began to look for an alternative site.

A little more than 12 acres of free state land just off U.S. Highway 169 near Osawatomie State Hospital would give officials a location, but it would take money to build the structure. Little by little, officials found the funding necessary to build the 6,700-square-foot structure where children could play, work on improving their own behavioral skills through therapy and seek help. Funding came from various sources, including a Community Development Block Grant, local charitable foundations, assistance from residents and utilities from the city of Osawatomie. In all, more than $1 million was donated.

But last year when Sunflower Centers, formerly Miami County Mental Health Center, experienced financial problems, the center was replaced in September by the Elizabeth Layton Center of Ottawa as the county’s mental health care provider. From the beginning, Diane Drake, executive director of the Franklin County clinic, said the center was informed the family services center building was for sale and was only available to rent on a monthly basis, a problem officials also struggled with as they worked through the initial transition.

“It was always the intentions of Sunflower to sell those buildings,” Drake said. “Since early September, they made it clear they would be selling. Through time, there had been a consistent message that their properties could be sold.”

On Nov. 29, she was told by a Sunflower employee that the group had an interested buyer and center officials had 30 days to vacate and find another location.

“That’s when we decided we had to get serious about looking for a place to relocate to,” she said.

Bob Nicholson, a Paola attorney representing Sunflower, confirmed Monday that officials have all four of its locations for sale, with contract negotiations nearly complete on three of the four buildings. Elizabeth Layton officials are close to working out agreements with potential owners of the East Street and Hospital Drive locations, but not the Osawatomie site, he said.

“Sunflower is having to sell off its assets to pay off debts,” Nicholson said.

Drake said the center does not have the resources to buy the building. Though she would not comment on the structure, Drake said the building has some inherent problems, including a lack of expandability and utilities that cost five times more than the center’s other facilities.

Despite the continuing negotiations between Sunflower, the building’s potential buyer and Elizabeth Layton representatives, both county and Osawatomie city officials thought they were in the dark. Both said they didn’t learn of the potential closing of the Osawatomie location until a Miami County Commission work session nearly two weeks ago, as Elizabeth Layton representatives and county officials worked to complete an agreement through the end of the year.

The county pays more than $200,000 to the center each year to subsidize cost of treatment for county residents. It also has involvement in the family services center. County officials offered $495,000 in certificates of participation to help construct the building. Though Sunflower has continued to make its payments, County Administrator Shane Krull said the county would have to cover the additional amount if Sunflower could no longer do so.

After learning of the issue, Commissioner George Pretz, Osawatomie Mayor Tom Speck and Norma Stephens, former Osawatomie State Hospital superintendent, scheduled a meeting with the center’s board of directors Thursday to convince officials not to close the location.

“We were caught by surprise,” Speck said. “We told them of our disappointment that they hadn’t come to us before, and why they waited until February.

“Obviously, we don’t want to lose those services, but now we understand their efficiency issues from a business standpoint,” he said. “We’re willing to work with them.”

Pretz said he thought the meeting was a positive first step.

“We had a chance to hear the other side of the story,” he said. “I think it was good. We made the whole board aware of the Osawatomie community’s concern, and by setting up this committee, I hope we can get down to the hard facts and see what we can accomplish.”

Drake said she doesn’t think the center itself delayed contacting city and county officials about the problems. She added that she did notify two individuals last fall, but said caring for clients had to be dealt with before facility issues.

“The first priority has always been client care,” she said. “Buildings are an issue, but No. 1, we want people to know those receiving care are not falling through the cracks. The same care is being provided.”

“We took on Sunflower without any resources given to us, meaning there wasn’t a stack of money,” she said. “We did it for the sake of client care, and that was the reason why we did it.”

Drake said the Family Services Center continues to operate and is planning for additional services and programs coming within the next year. The Layton Center has served nearly 860 clients in Miami County since Sept. 3, and 273 of those clients are children, she told commissioners earlier this month. The Family Services Center averages a quarterly caseload of about 62 children. Of those children, 20 live in Osawatomie.

As officials plan to meet in the coming week, Drake said she is more than willing to work with local officials and come up with a plan both can live with.

“We’re not wanting to make any rash decisions and will work cooperatively with the group named,” she said. “This isn’t an attempt to take away from Osawatomie; we don’t have control of building. It’s Sunflower’s choice to sell the building.

“It’s been a process ... I don’t know what we could’ve done better,” Drake said. “I feel our priorities were in the right place.” Read more!

Hearing focuses on mental health coverage - Deleware County (PA) Times

By PATTI MENGERS , pmengers@delcotimes.com

MIDDLETOWN -- In 1995, when U.S. Rep. Patrick Kennedy, D-R.I., was 27 years old and a new member of Congress, he became the major sponsor of a bill that would compel insurance companies to cover mental illnesses as fairly as they cover physical illnesses.

"I was the youngest member of Congress from the smallest state from the minority party sponsoring a bill with a large stigma against it," said Kennedy. "It was not popular."

Twelve years later, with Democrats in the majority and a promise of support from George W. Bush, the 39-year-old congressman is hoping to finally see his dream of mental health parity become a reality.

Next week, along with U.S. Rep. Jim Ramsted, R-Minn., Kennedy expects to introduce the Paul Wellstone Mental Health and Addiction Equity Act, named for the Minnesota Democrat who championed mental health parity in the U.S. Senate until his death in a plane crash in 2002.

To help fuel the cause, Kennedy, hosted by U.S. Rep. Joe Sestak, D-7, of Edgmont and the Mental Health Association of Southeastern Pennsylvania, conducted a forum Tuesday at the corporate headquarters of Elwyn, a nonprofit provider of services for special needs individuals including those suffering from mental illness and emotional and behavioral disorders.

"This is an issue of civil rights at its core," said Kennedy.

If enacted his bill would expand the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as other diseases. It would close loopholes that allow insurers to charge high co-payments, co-insurance, deductibles and maximum out-of-pocket limits and impose lower day and visit limits on mental health addiction care.

Kennedy, who told the audience he is a recovering alcoholic and addict with bipolar disorder, underwent treatment for cocaine addiction as a teenager and, last year, sought treatment for prescription pain medication addiction after an automobile accident on Capitol Hill. He said he has been criticized by members of the 12-step community for not maintaining anonymity in his recovery.

"People should be more wild and worked-up by the fact that 175,000 fellow alcoholics die because 300,000 insurance companies deny them treatment," said Kennedy.

The son of U.S. Sen. Edward "Ted" Kennedy and Joan Kennedy, who have both been connected with alcohol-related incidents,his cousin, David A. Kennedy, died of a drug overdose in 1984 at the age of 28.

"I faced it in my own family and in my own personal life. I lost a cousin to this illness. I’ve personally seen the effects of recovery in having access to the best treatment in the country as a member of Congress. What’s good enough for federal employees is good enough for the American people," Kennedy said after the hearing.

Elwyn President Sandra Cornelius testified one in five Americans suffer from mental illnesses but only one third receive treatment in part because of the constraints of health insurance coverage.

"Knowing that only a limited number of visits are covered, or that associated costs are prohibitive, forces patients to self-treat or minimize the effects of the illnesses. The impact of this can last a lifetime," said Cornelius.

She maintained the increased costs to employers and employees of mental health parity in insurance premiums would be outweighed by the increased productivity resulting from people obtaining the treatment they need.

Sestak estimated the indirect costs of untreated mental illness are three times what it would cost if Americans directly invested in mental health treatment.

According to the Mental Health Association of Southeastern Pennsylvania, equal coverage of mental illnesses with physical illnesses would ultimately save the nation about $2.2 billion because of the high success rates of proper treatment.

Pennsylvania Psychiatric Society President-Elect Kimberly Best testified research has shown an increasing number of mental illnesses to have genetic or biological bases.

A retired Navy admiral, Sestak noted of the approximately 17 percent of Iraqi war veterans who need care for such illnesses as anxiety, depression or post traumatic stress disorder, about 40 percent go untreated.

A Collingdale mother of three detailed how, while working two jobs, she was forced to drop her son from her private health insurance and enroll him in Medical Assistance to get him adequate care for manic-depression and behavioral disorders. During her quest for his care he became suicidal.

"I compare all of this with the fact that, if my son had been diagnosed with cancer, although this would have caused us enormous anguish, I would not have had to go through all the trauma of figuring out how we would pay for it and he would have had access to all the care he needed," she said.
Read more!

Mental health in new court - Crystal Lake (IL) Northwest Herald

Mental illness often is misunderstood in society.

It is not uncommon for employers, family members, and friends to fail to recognize that someone they care about needs help. One of the places where this failure to understand is magnified is the criminal justice system.

McHenry County is attempting to deal with this issue by creating a special court. The mental-health court will provide treatment resources for people with mental disorders, such as bipolar disorder or schizophrenia. The program will only be made available to those charged with minor crimes.

The National Institute of Mental Health estimates that about one in four Americans over the age of 18 suffer from a mental disorder. That translates to about 57.7 million people.

The court is recognition that it does no one any good to simply cycle those who suffer from mental illnesses through the criminal justice system. A better avenue is treatment. When it comes to minor, nonviolent crimes, one goal should be that offenders do not commit a crime again. The mental-health court could go a long way to help people to stay out of the criminal justice system.

“I think that mental-health issues are the most overlooked, ignored and misunderstood in our society,” McHenry County State’s Attorney Louis Bianchi said in a Saturday Northwest Herald story.

A program such as this one has the potential to be controversial. There is the fear among some of the public that someone will be able to cheat the system or avoid punishment by feigning mental illness. But, it is important to note that the court will not deal with violent crimes.

Also, cases will be funneled to the mental-health court through recommendations most likely made by police, attorneys or social workers. And victims will be consulted as to their opinion of the mental-health court option.

If the accused completes an intensive treatment program, criminal charges will be dropped.

It appears that McHenry County has gone about creating the court the right way. Hopefully, it will provide help to people who need it. Read more!

Facing Mental Health Issues: Looking Out for Each Other - Cornell Daily Sun

By David J. Skorton, Cornell University President

I am concerned about the level of stress and about mental health issues that affect our campus. We have many services available to students and also to faculty and staff members, but I want to be sure that everyone on campus knows what is available and how to access the help they may need. And I want to stress how important it is that we take better care of ourselves and also look out for each other as members of a campus community.

Mental health issues, including but not limited to the prevention of suicides, are receiving increased attention on college campuses — especially those like Cornell where many students report high levels of stress. Cornell has already established an extensive support network of mental health professionals and specially trained faculty, staff and students, but there is a growing recognition that we need to do more to watch out for each other and to support each other when cognitive and emotional challenges arise. This responsibility includes the entire Cornell community: faculty, students and staff.

There is debate regarding claims that mental health problems among college students are on the rise, but there is no question that the demand for mental health services has risen dramatically. The rate of referrals and self-referrals for mental health services at Cornell has risen briskly, with mental health visits to Gannett Health Services increasing 128 percent over the past eleven years. Such increases are due partly to advances in the treatment of mental illness in childhood and adolescence, which enable more individuals to function successfully, with appropriate support. Partly they are due to the decreasing stigma that our society attaches to mental illness.

Gannett Health Services has doubled its counseling staff over the last decade. In addition, the academic advising offices have become the first points of contact for many students in distress and also for faculty members who become aware of students in need of help. We also have a Dean of Students-based Alert Team for early intervention plus crisis managers and community support teams to provide organizational support for students in need.

Cornell’s Council on Mental Health and Welfare, which includes faculty, staff and students, guides our efforts to address mental health at the university, and we are continually evaluating our policies and practices to build a stronger safety net for students and provide a supportive environment. Our efforts have earned us recognition from the Jed Foundation as a leading campus in the area of student mental health.

We are part of a multi-campus project developing and evaluating best practices in mental health promotion and suicide prevention. Our staff and faculty are also conducting research to learn more about the sources of stress among our students and how their experiences compare with those from other colleges and universities.

We know, for example, that the rate of suicide among Cornell students is consistent with campuses nationwide. Of course, whatever the overall statistics, even one suicide on our campus is too many, and the steady rate of such problems requires our attention and action.

Gannett’s Counseling and Psychological Services offers extensive counseling services to students at the health center and at nine other locations around campus, as well as on-line depression screening and other resources and services. We’re also building a network of staff, faculty and students trained to recognize students in distress and reach out to them and who are also available to educate their colleagues about signs of distress and where they can steer students for help.

For Cornell faculty and staff and their dependents, the Employee Assistance Program offers free, confidential, professional counseling and consultation services by telephone or in person. EAP can help address personal and workplace difficulties ranging from stress-related emotional issues, to domestic violence, to interpersonal difficulties and financial concerns. I urge faculty and staff members to utilize its services when a problem is affecting their well-being, daily life or job performance.

We also need to preserve and enhance the physical environment of the campus so that people can find opportunities to reduce the stress in their lives, whether by taking a walk or a run through the Cornell Plantations, exercising at a fitness center, spending time in a practice room playing a musical instrument or curling up in a comfortable chair in the library. We must ensure that Cornell continues to provide a beautiful, nurturing environment that promotes good mental and physical health. And given such an environment, we need to discipline ourselves to slow down occasionally and take care of our own needs.

We have enormous leadership by professionals on our campus regarding mental health issues. However, we need to do more to support those of us who are struggling with mental health issues, but who have not yet received help. And we need to remember, as individuals, our role in identifying colleagues and friends under unusual stress.

• All of us must acknowledge our interdependence and share responsibility for our own and others’ health and well-being. The importance of such recognition and of an offer of help cannot be overemphasized. It is a sign of strength, not weakness.

• When we are aware of someone who is in distress, we demonstrate compassion when we extend ourselves to that person, rather than ignoring the need.

• And when we care for ourselves and allow others to help us when we are in trouble, we ease our own burdens and enable each other to express compassion.

Please join me in addressing the challenges of stress and good mental health at Cornell in a positive and supportive way.

David J. Skorton is the President of Cornell University. He can be reached at david.skorton@cornell.edu. From David will appear every month.
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The Ten Work-Happiness Secrets of People with Mental Retardation - Beverly Hills (CA) American Chronicle

More on the author, CSS Executive Director, is at the bottom of this article

Tom Swanston (originally published Feb. 27)

Is your workplace making you crazy? Do your co-workers get on your last nerve? There is no question that work can be a place that tests your patience by lifting you up, tearing you down or sometimes completely ignoring your contributions. It can be a place of passion and drive or a place of frustrated and burnt out clock-watchers. At Chesapeake Service Systems (CSS), hundreds of people with mental retardation and other severe disabilities have a refreshingly honest point of view about work and how attitudes on the job can greatly affect happiness and work satisfaction. We can all learn a lot from how they choose to see the world.

1. Be grateful that you have a job to go to every morning. 20.3 million people with severe developmental disabilities are unemployed in this country. People with severe disabilities who are out of work often suffer mentally, physically, and developmentally digress. Those who have a job, come into work with big smiles on their faces. They want to come to work on the weekends, holidays and even during inclement weather because they know how it dramatically affects their life for the better. Regardless of whom you are, having a job and a purpose in life is essential to self-esteem, independence, and overall well-being. It might be difficult to drag yourself out of bed on Monday morning, but without a job to go to; your quality of life would suffer immensely.

2. Every job (no matter how small it may appear) is important. Whether you have difficulty communicating, moving, hearing, seeing, or comprehending, every job for a person with a severe disability is important. To someone without a disability, putting a cable into a bag could seem monotonous and boring. It could appear to be just a very minute part of a larger contractual obligation with an outside company, but to that one individual performing the task; it is their one chance to be like everyone else. When they are on the job, they are not a person with mental retardation; they are a co-worker and an essential part of a team with a goals and objectives. Status and titles have no meaning here because everyone is an essential part of the companies’ success.

3. Greet your co-workers with a kind word or smile when you pass them in the hallway or when they enter your workspace. In a world that is increasingly cut off from people and emotions, simple gestures that display kindness and openness are harder and harder to find. Walking onto out work floor is an instant mood-lifter. Everyone who visits is welcomed with open arms and greeted in a positive manner, regardless of who you are or how much money you make. Everyone wants to know how your day is going, to shake your hand and to tell you how excited they are to be on the job. Think of how differently your day would go if you treated your co-workers in that manner.

4. Look for ways to encourage your co-workers to perform better on the job and you will all reap the rewards. It is not uncommon to see people on the work floor assisting others with their daily tasks or giving an encouraging word. No one is viewed as competition or as someone to fear, but rather as people who are all in the same boat, trying to make the best of some very challenging situations. When someone accomplishes a personal or professional goal, their achievements are championed by all. There is a deeper understanding that when one person wins, everyone wins.

5. Take breaks and have fun, even if it’s just for a few minutes. Understand the value of balance in your life. Due to physical, mental, and emotional limitations, breaks throughout the day are mandatory for our clients. Because of the unique circumstances, becoming stressed and overwhelmed not only affects one person, but can quickly permeate the entire work force and wreak havoc for everyone. Knowing when to stop, to give your mind and body a break, is essential to maintaining a happy and healthy work environment for people with and without disabilities.

6. Take pride in what you do, regardless of the pay or recognition. We all want to be known for being the best at what we do. It’s human nature to crave recognition and monetary compensation for hard work and dedication. Many of the jobs here are assembly-line, labor intensive or entry level positions that most people would dread. However, every single person is proud of the work they do and they are eager to tell everyone they know about it. The work is not glamorous. It’s not all that creative or dynamic. Unfortunately it will probably never be seen as something deserving of high wages or praise, but it serves a very important function in our society. These are jobs that give incredible meaning and value to countless lives.

7. Life is too short to gossip, back-stab or criticize. People, who have the most compelling reasons to complain about difficult life circumstances, choose not to. Life is challenging for everyone. We all deal with the daily frustrations of having to work with people who are different from us. Some people communicate differently, some are slower or faster than us, and some don’t share our same enthusiasm, but we all are required to work together. Conflicts arise on the work floor, but they never last long or become spiteful, catty, or mean. Being focused and grateful on the job leaves little time or energy for negative interactions with co-workers. Positive attitudes give-way to positive interactions.

8. Focus on what you have, instead of what you don’t have. It’s easy to get caught up in keeping up with the Jones’. In a society where it’s all about the nicest car, clothes, and house we miss out on enjoying what we have in the constant search for something bigger and better. Many of the clients with mental retardation, autism and other severe disabilities have very little in life. Almost all cannot drive, don’t own a home, and wear the same clothes year after year. However, that doesn’t change how happy and fulfilled they are in life. The one thing they want is to feel normal in the here and now. Working gives them that feeling and as long as they are provided that opportunity, they feel like millionaires.

9. Enjoy the little things in life. Some of the clients get paid $2.00 every two weeks, but to them, it’s like getting $2,000. It’s not about the monetary value of the check, but the paycheck alone that gives them pride in themselves and what they do. Going to the mall and buying something with their own hard-earned money is an indescribable joy that most people take for granted. The next time you buy something for yourself, remember how hard you worked to get it. It will make your purchase even more rewarding.

10. Get excited about going to work. Even if it’s raining outside, you are stuck in traffic or are running late, you were hired because of your unique abilities and talents. You were specifically chosen because someone was impressed by what only you can bring to the table. Someone had faith in you and believed in you. Celebrate and enjoy that fact!

So many people with severe developmental disabilities are never even considered for employment. They are all too often perceived as not being useful to society, much less on the job. Imagine how it would feel knowing you have a lot to contribute to the world, but no one will give you a chance. As a result you spend your entire life hoping that someone will come along who will see you for who you really are and give you that opportunity to shine.

People with mental retardation and other severe disabilities are elated to be at work. They are often the first to arrive and most days dread having to leave. Their work ethic is something beyond compare because they know how it feels to be isolated and segregated away from normal life. They appreciate the opportunities they are given and show their gratitude by excelling on the job.

Our motto is: “It’s not about the work they produce, but what the work produces in them.” That is true for all people in all work environments. In many ways your work defines who you are and brings to the surface your core values and character. It can make your life enjoyable or completely miserable. It’s all in how you choose look at it and how you choose to let it affect you. Take some time to see life from someone else’s perspective and learn the important lessons that they are trying to teach you. It is often in the most unexpected places where we find the greatest gifts.

----------------------------------------
Tom Swanston

As a successful Executive Director and a person with a severe disability (Meniere’s Disease), Tom Swanston brings insight, enthusiasm, and compassion to his work at Chesapeake Service Systems. Tom has a unique perspective in that he is an enthusiastic disability advocate, as well as experiencing a severe disability of his own.

With experience as a financial analyst, Tom has increasing CSS workshop sales from approximately $15,000.00 to over $4.8 million during the past twelve years. In 2004 Tom lead CSS into a capital campaign to expand client services with the goal to raise $3 million. Through superb grant writing techniques and marketing tactics Mr. Swanston single handedly raised over $1.3 million in less than 18 months.

Mr. Swanston currently serves on the Endependence Center Board of Directors. He is a past Board Member of the Chesapeake Economic Development Board and has participated in fundraising activities with the Chesapeake Foundation for the Mentally Disabled.

Tom is a dedicated advocate with remarkable vision regarding the employment of people with severe disabilities and a conviction that all people with a disability can and should have a job.
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Family turns to petitions to keep son in mental hospital - Janesville (WI) Gazette

By Carla McCann (Originally published Feb. 27)

MILTON-Melly and Redgie Staskal want the community's help to keep their son, Mark, in a mental hospital, where he's lived since he murdered their daughter 22 years ago.

They are collecting signatures on petitions, asking people to sign in support of keeping Mark at Mendota Mental Health Institute.

"We're not against our son," Melly said. "Our concerns are about keeping the community safe so that other people don't become victims."

The Staskals also paid to have about 5,800 purple fliers showing their daughter Marcy's picture and asking people to "Help Us Keep Mark Staskal at The Mendota Mental Health Institute" inserted into The Janesville Gazette on Saturday.


A petitions to keep former Milton resident Mark Staskal in a mental institution sits near the cash register at Janesville's Kealy Pharmacy. Mark Staskal killed his sister, Marcy, in 1984 and has been confined to Mendota Mental Health Institute ever since. His parents are concerned that he is not cured and could kill again.
Bill Olmsted/Gazette Staff

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Mark has been confined to Mendota since the 1984 stabbing murder of his 16-year-old sister. He now wants to rejoin society and has petitioned for release from the hospital.

The Staskals are unsure how they will present the petitions to the court.

"God is leading us," Melly said. "We have a lawyer and may put the petitions in his hands."

She agreed that the petitions may not make a difference, but she said the issue is bigger than her son's case.

"We are giving the public the opportunity to say, 'We don't want people who are dangerous and violent free to hurt people,'" Melly said.

The Staskals have not counted signatures on the petitions, which they plan to collect March 6.

At Dave's Ace Hardware Store in Milton, Carla Herbst, a buyer, has heard customers express concern about signing the petition.

"Some are a little worried that if Mark does get out and has access to the petitions, he may come looking for them," Herbst said. "They would love to sign the petitions but are concerned about putting themselves and family in jeopardy."

Susan Frederick, customer service manager at Piggly Wiggly, said she's seen many people sign the petitions. She was unsure how many signatures the store has gathered, however, because some of the sheets were filled and removed.


Redgie Staskal


Melly Staskal
Although Mark has regularly asked for release without success, this time may be different.

At a hearing Jan. 5, Judge Michael Byron ordered the first step toward the 43-year-old being released to a halfway house by telling the Wisconsin Department of Health and Family Services to prepare a community-based treatment plan for the man.

The next court date is scheduled for Friday, March 9, but assistant district attorney Raymond Jablonski said it probably will be postponed. The state has requested more time to find a facility where Mark could live, Jablonski said.

Byron then would have to decide if it's an appropriate place, he said.

Mark suffers from paranoid schizophrenia, his parents said.

"The last I read, this disease has a very low cure rate," Melly said. "Mark is a victim of the disease."

The Staskals fear their son isn't well enough to live outside of the mental hospital's restrictive and structured environment. They believe Mark's unpredictable illness is smoldering beneath the surface and that he still is capable of murder. Read more!

Governor proposes two new state hospitals - Bend (OR) Weekly News

SALEM, Ore. – Today Governor Ted Kulongoski delivered to the Oregon Legislature recommendations for the location of two new state mental health facilities – a 620-bed hospital on the existing site in Salem and a 360-bed hospital in Junction City – to replace the outdated Oregon State Hospital and improve the lives of Oregonians with mental illness.

“This initiative represents the most significant opportunity in more than 120 years to improve the quality of mental health care Oregonians receive at our state hospitals,” said Governor Kulongoski. “As we move forward this critical initiative focused on construction of new state psychiatric hospitals, we must also remained focused on a vision of a truly transformed Oregon mental health system.”

In selecting the sites, the state used criteria developed by a 10-member committee named in June 2006 by the Governor, Senate President and Speaker of the House. Those criteria focused on three themes: 1) the opportunity to deliver high quality services to patients closest to their home communities; 2) the ability to retain and recruit the best professionals available to care for patients and deliver those high quality services; and 3) cost, focusing on estimated construction costs and the value of the investment to the state.

“I look forward to working with the Legislature to advance the recommendations in this report this session because this issue cannot wait another two years for action,” the Governor said. “Resolution on the location for these two new facilities before the legislature adjourns this summer is critical both to the state’s community mental health system planning efforts and, most importantly, to the state’s ability to better serve Oregonians with mental health needs in our state-owned hospital facilities.”

Construction of these facilities is critical to moving forward Phase III of a multi-phase process the Governor launched in 2004 to redesign Oregon’s mental health system, including a new State Hospital system.

That intensive planning process, detailed in the “Master Plan Phase I Report” and the “Oregon State Hospital Framework Master Plan Phase II Report” – was led by KMD Architects of San Francisco. The Phase I Report identified the structural and systemic challenges facing the Oregon State Hospital’s Salem Campus and concluded that Oregon should proceed with both the replacement of the Hospital facility and a redesign of the entire public mental health system.

Building on those findings, the Phase II Report recommended enhancing Oregon’s delivery of mental health care to its citizens at the community level and clarified the role that the Oregon State Hospital system should have within an improved and enhanced community-based system.

The Governor’s recommended budget takes significant steps to advance the mission of the next phase, namely, to create an integrated, culturally competent continuum of mental health treatment and support services designed to help individuals avoid disruptive and costly hospitalization in the first place, offer the highest quality community and state hospital-level services, and help individuals transition back into their communities when hospitalization is unavoidable.

Community services in the Governor’s budget include: improved access to phone counseling and “crisis” services; more out-patient and residential treatment; and more employment and housing supports for individuals with mental illness. The Governor’s budget also includes the necessary funding to perform a more detailed assessment (‘due diligence”) of both the Salem and Junction City properties, and to design and begin construction on the 620-bed hospital facility, with completion of that facility scheduled for 2011. The 360-bed facility would be completed by 2013.

The focus of today’s report is on the two larger facilities west of the Cascades recommended in the Phase II report. Separate efforts are underway to address the unique needs of central and eastern Oregon. Another separate effort detailing recommendations about community-based mental health service needs is also ongoing. Both of those efforts will produce additional reports at a later date.
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Stigmas of mental illness remain - Hackensack (NJ) Herald News

By TOM DAVIS
RECORD COLUMNIST

Five times he called her a "loon" or "lunatic." Each time, the peace activist reacted to Bill O'Reilly's name-calling with a shrug or smirk. But this encounter on "The O'Reilly Factor" raised the question: Who was more outrageous?

Was it O'Reilly for using words that some might interpret as slurs? Or was it the activist for not taking him to task?

For a long time, words and images that define mental illness have been used to describe a person who holds a differing opinion as out of line or evil.

Mental health professionals recoil when they hear such talk or see such pictures. Now they're speaking out to stop the use of words and images that stigmatize people who suffer from schizophrenia, bipolar disorder, obsessive- compulsive disorder and depression.

Stereotypes sell

Otto Wahl, a psychology professor at the University of Hartford, says that despite years of advances in mental health awareness, the media still rely on stereotypes to sell books, magazines, news-papers, movies and TV shows.

In his book, "Media Madness," Wahl displays movie posters that make light of mental illness.

One for "Crazy People," for instance, shows a cracked egg that appears to be sticking its tongue at people.

"The stereotypes of people with mental illnesses have just these qualities -- they are extremely dangerous, outstandingly different, and/or excessively ridiculous," Wahl writes in his book. "They are, in other words, entertaining and profitable."

The media have even created myths, Wahl and others say. The so-called "psycho killer," for example, has become a mystery-novel slasher-movie trademark. It even is the title of a hit song by the Talking Heads.

Not only does the term stigmatize people with mental illness, mental health professionals say the labeling is incorrect. They point to studies that show only 4 percent of people who commit murder are mentally ill.

But the media are making some progress, mental health professionals say.

Star power helps

Hollywood has achieved some measure of critical and commercial success by using likable or sympathetic characters to portray mental illness.

Gary Morris, a lecturer at the University of Leeds in the United Kingdom and author of the textbook "Mental Health Issues and the Media," cited Russell Crowe in "A Beautiful Mind" as an example of a box-office star taking on a sensitive role of a mentally ill professor.

Even Jack Nicholson's cranky Melvin Udall in "As Good as It Gets," Morris says, could be considered a favorable portrayal.

"It is helped to some degree because we, as an audience, largely admire the actor Jack Nicholson, and his character's warm side begins to emerge, enabling a more positive attraction to be formed," Morris writes.

The Coping column appears every other Tuesday. To suggest topics, write to Tom Davis, The Record, 150 River St., Hackensack, NJ 07601 or e-mail davist@northjersey.com. Please include your phone number with all correspondence. Read more!

The right reforms can lead to preventative care, cost controls - San Jose (CA) Mercury News

Mercury News Editorial

For decades the medical community has known that mental illnesses are biologically based brain disorders. Yet society, to its great detriment, still wrongly insists on attaching stigmas to those suffering from mental problems.

Mental health coverage must now be part of America's health care debate.

It's past time that we started treating the mentally ill as medically ill and began looking for ways to aggressively ramp up preventive treatment to bring down future costs.

Reps. Patrick Kennedy, D-R.I., and Jim Ramstad, D-Minn., plan in March to reintroduce legislation in Congress that would bring further parity to coverage of mental illness, requiring insurers to reimburse treatment for mental health problems as they would for other common medical problems, such as cancer or heart problems.

The logic is inescapable.

If a patient has a brain tumor, there are lots of resources. Many resources are covered by insurance and made available for long periods of time as alternatives are explored. But if a person has a chemical imbalance in the brain and is diagnosed as schizophrenic, they are commonly greeted with disdain or disgust, and hospital stays and treatments are limited. Many alternatives and long-term care are not fully covered by insurance.

The costs to society are staggering. Substance abuse. Homelessness. Disability. Incarceration. Estimates are that the impact is close to $100 billion every year. A stunning Department of Justice survey released in September revealed that the total number of prison inmates with mental health problems is two to three times greater than previously believed.

The study showed that 64 percent of local jail inmates, 56 percent of state prisoners and 45 percent of federal prisoners have symptoms of serious mental illnesses. It's an accepted medical fact that between 70 and 90 percent of people with serious mental illnesses can be treated so that the symptoms are severely reduced.

Opponents argue that health care costs are already escalating at an unsustainable rate, and that the nation cannot afford to add the costs of treatment for the mentally ill to an already over-burdened system.

But a study published in 2006 by the New England Journal of Medicine indicates that elimination of caps on mental health coverage might not lead to increased spending. The study of 20,000 federal employees who were given access to increased coverage failed to show an increase in spending, after inflation was taken into account.

Congress will want to take a prudent approach to the issue. But beyond the moral obligation to humanely treat the mentally ill's conditions as medical problems, attacking mental illness earlier and more aggressively could ultimately result in a reduction of costs to American taxpayers. Read more!

NJ child welfare reform finally on track, federal monitor says - AP

GEOFF MULVIHILL

New Jersey is finally taking the necessary steps to fix its long-troubled child welfare system, according a federal monitor assigned to track the system's progress.

A report released Monday by the Washington-based Center for the Study of Social Policy found that between July and December 2006, New Jersey accomplished everything it said it would to improve the protection of children. In several areas, it exceeded goals.

"New Jersey is finally on a positive path toward reforming the way it delivers child welfare services to children and families," the report's authors wrote.

Susan Lambiase, associate director of Children's Rights Inc., a New York-based advocacy group that sued New Jersey to force changes in the child-welfare system, said she's encouraged by the new report.

"This is the baby step. It is the first step in getting this fixed, but they're doing it so far," she said. "It's tremendous progress for a system who really couldn't get the job done in any area."

That sunny assessment reflects major changes in the Division of Youth and Family Services and changes in the way its progress is measured.

The state's child welfare system has been under federal monitors since 2003, when the New Jersey settled a lawsuit with Children's Rights, which claimed the system was placing children in peril.

Though critics said that the state had failed to protect the abused and neglected children in its care for years, the issue gained widespread public attention in 2003 when a boy was found dead in a Newark basement and then four severely malnourished boys were discovered in a Collingswood foster home.

The first monitor's reports found major problems in reform efforts. In 2005, Children's Rights asked a judge to intervene.

That request was dropped, though, when the state agreed to make big changes.

DYFS was taken out of the Department of Human Services and placed into a newly created Department of Children and Families, with former state child advocate Kevin Ryan put in charge.

After that, the state and Children's Rights reworked their settlement, giving the state more time to make changes.

The first steps would deal largely with improving the setup of the agency as well as meeting some other goals, such as stopping the practice of warehousing children who need mental health treatment in youth detention facilities and increasing the number of adoptions.

The state placed 1,387 children into adoptions in 2006 - far exceeding the goal of 1,100. In 2007, the agency is committed to place 1,400 children.

Under the new standards, the state is to be held eventually to other specific goals, such as reducing the number of children abused by foster families.

"We have a very long walk home," Ryan said. Read more!

Mentally ill make case for coverage - Bridgewater (NJ) Courier Post

By TOM BALDWIN
Gannett State Bureau

TRENTON -- A parade of witnesses telling stories of heartbreak and frustration appeared Monday before a congressional forum about insurance coverage for mental and emotional issues not routinely covered by insurers.

"There certainly is room for improvement. . . . We are at a critical point of both opportunity and challenge," said U.S. Rep. Frank Pallone, D-Long Branch.

Pallone and Rep. Patrick Kennedy, D-R.I., headed the subcommittee hearing that included state Sen. Joseph Vitale, D-Middlesex, chairman of the state Senate Committee on Health, Human Services and Senior Citizens.

"Mental-health and addiction-services parity has to happen," said Vitale. "Studies have long illustrated that mental health and substance-abuse are diseases."

Kennedy, who entered a treatment center after he had crashed a car near the U.S. Capitol and later blamed his incoherence on a mix of alcohol and medicines in 2006, told the room that people with mental disorders won't get what they seek "because we don't speak out enough," inspiring applause.

"When I get worse, or sick, my coverage gets worse, and when I am healthy, the coverage gets better," said Sekhar Subramani of Old Bridge of the Depression-Bipolar Support Alliance.

"We have been working on this, getting the coverage," said Bill Buther of Ocean Grove, speaking for the Care Center of Neptune City, which offers support for the mentally frail.

Asked how much the idea would cost, Pallone said, "If we have proper coverage, it means preventative care. It can save the state money."

"In this budget year?" asked a dubious Public Advocate Ronald Chen after he had testified for the need of such coverage. "I am thinking long-term." Read more!

Long waits, delays the norm for psychiatric patients - Newsday

Busy mental health centers are passing off patients to other institutions that face the same problems.

BY LAUREN E. TERRAZZANO
lauren.terrazzano@newsday.com

A Suffolk hospital that serves as a mental health hub to evaluate emergency psychiatric cases has been increasingly diverting patients to other centers as the demand far outweighs its resources, state and local health officials say. The Stony Brook University Medical Center was on "diversion" for nearly half of January, and for 12 days so far in February, according to records and interviews.

As a result of high patient loads, the mentally ill who are escorted by police for emergency care have been subject to long waits and delays in evaluation and treatment, or have been taken elsewhere, where they face similar waiting lags, officials say. And the county's already fragile mental health network has gotten increasingly backed up as people are delayed from entering long term treatment, local officials said.

"It's an issue we have to be very concerned about," said Thomas MacGilvray, the county's director of community mental hygiene. Those being diverted are specifically in the custody of Suffolk County police and sheriffs, MacGilvray said. The waits can be as long as seven or eight hours, and police are required to wait with them. As of Monday, the hospital was not on diversion, and was accepting patients to its 18 observation or extended-stay beds.

He said the problem has been exacerbated by the county's overall lack of hospital beds, the lack of community mental health day programs and the temporary closing of 25 beds at Bay Shore's Southside Hospital mental health unit because of renovations.

At Stony Brook, the Comprehensive Psychiatric Emergency Program serves mentally ill children, adolescents or adults. Officials there said they are working to make things better and reduce waiting time.

Calling it a statewide issue, Dr. Mark Sedler, Stony Brook's chairman of psychiatry, attributed the diversions to a decline in statewide psychiatric beds overall, "and are a symptom of the inadequacy of the whole system."

He said when the unit was designed in 1990, officials expected that it would need only four extended beds to observe patients. As Long Island's state-run psychiatric hospitals shut their doors and the number of outpatient programs didn't keep pace, the backups started to increase, he and others said.

"Our field office is working closely with the county mental health department to address the issue that is involved," said Jill Daniels, a spokeswoman for the state's Office of Mental Health.

Sedler said Stony Brook houses from seven to 18 unit patients. "We have a limited physical capacity. It's a locked unit, a very defined physical space," he said.

Part of the problem, he said, is that some patients are intoxicated and may require eight or more hours before evaluation, or the hospital may have trouble reaching a family member or getting medical test results. And some patients are homeless.

According to records, the state's Office of Mental Health last reviewed the unit in 2004, and found that 400 individuals waited at least six hours to see a physician. There are about 6,000 visits to the unit annually. It is due for another review in April, when it reapplies for its new operating certificate.

"For me, it's like waiting for the other shoe to drop," MacGilvray said. "People in need of acute psychiatric care aren't getting it, and I'm concerned about what happens while they're waiting."
Copyright 2007 Newsday Inc. Read more!

Rare No More - The Washington Post

With Research Up and Stigma Down, Autism Sheds More of Its Mystery

By Roy Richard Grinker
Special to The Washington Post

When my daughter Isabel's autism was diagnosed in 1994, when she was 2 1/2 , I knew little about the condition. Autism was a strange word to most people. "You mean like Dustin Hoffman in 'Rain Man'?" people would ask. "You mean she's artistic?"

Back then, autism was considered a rare disorder, occurring in only about three in every 10,000 live births.

Little more than a decade later, autism has become a "major public health concern," according to Marshalyn Yeargin-Allsopp, chief of the developmental disabilities branch of the Centers for Disease Control and Prevention. The results of a CDC survey released this month suggest that about one in every 150 children in the United States has some form of autism.

Those numbers don't reflect an epidemic, as some reports have suggested, or even mean that the incidence of autism has necessarily increased. Instead, we are defining autism and measuring its prevalence differently than we did in the past. Isabel's story illustrates that evolution.

The years since Isabel's diagnosis show a rapid change in our awareness of the disorder. In 1993, the state of Maryland (where we live) told the U.S. Department of Education that the state's public schools had provided special education services during the 1992-93 academic year to just 28 children between the ages of 6 and 21 with autism.

By the time Isabel was diagnosed, Maryland's public schools claimed to have served 300 people in the same age group with autism in 1993-94 (still a small number, but an enormous increase over the previous year).

And by 2003 there were more than 4,084 children ages 3 to 22 who had been given the official coding for autism in the Maryland public school systems, a rate of 1 in 183 children.

Isabel was no longer alone.

Shifting Definitions
Like most of the illnesses psychiatrists treat, you cannot see autism under a microscope or discover it through a lab test. The only evidence we have is the individual's behavior. And until 1980, when the criteria we're familiar with today were first standardized in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), there was little agreement about what was and was not autism. Even now, there is an element of subjectivity in each diagnosis.

What's more, many psychiatric diagnoses come and go -- and hence rates of diagnoses go up and down and change rapidly. Several million Americans have been diagnosed with depression, for example. But many of them would not have received that diagnosis just 50 years ago. The increase does not mean that depression is more common today than in the past, but only that our way of defining depression has changed. Half a century ago, the term was used to describe only debilitating depressions that required long-term hospitalization.

The shift in how we view autism is also part of a set of broader shifts taking place in society. The growth of child psychiatry after World War II, the rise of advocacy organizations, greater public sensitivity to children's educational problems and changes in public policies (the establishment, for example, of autism as a special-education code after the 1991 Individuals with Disabilities Education Act, or IDEA) have together changed the way autism is diagnosed and defined.

As a society, we have also become more aware of children's behavioral and learning differences at earlier and earlier ages and more comfortable with diagnosis, medication and psychiatric labels. Under the rubric of autism we now find a multitude of emotional and cognitive problems -- problems that used to be given other diagnostic labels or were even considered within the range of the normal.

And these days, researchers use reliable diagnostic tools to provide more accurate statistical counts of disease rates in a community, rather than basing their counts on reports of already known cases.

As a result, there are more people with a diagnosis of autism now than at any time in history.

And it's a better time than ever to be autistic.

More Awareness, Research
What was our school supposed to do in the early '90s with Isabel, who was just one of a few hundred kids in the whole state labeled with autism?

The key word here is "labeled," because there were certainly thousands of people in Maryland with autism at the time. So where were they? The answer is that many of the kids were in school; they just didn't have the label. That category had been introduced only in the 1991-92 academic year -- and then as an optional category.

A diagnostic label really does influence the way we view someone. If Isabel's condition had been diagnosed as schizophrenia, as might have happened in the 1950s and '60s, a psychologist might have recommended that she be sent to a mental institution or assigned her to a class or school for mentally disturbed children. If she had been diagnosed as mentally retarded, as so many autistic people were and still are, she would have been placed in classes for cognitively challenged kids.

Today, pediatricians, mental health-care practitioners, speech and occupational therapists and educators are providing therapy to children with autism at earlier ages than ever, and they are discovering how to use safe and effective medicines to ameliorate some of their symptoms.

Federal, state and local agencies have mobilized to manage the heavy public health burden of autism. Special-education programs are expanding; new money is pouring out of the National Institutes of Health into autism research; and donors are contributing millions of dollars to advocacy organizations, private schools and research foundations. Between 2003 and 2004, the number of grant applications to the National Alliance for Autism Research, which was then the leading private foundation for autism research, doubled.

The increased awareness, and the new, higher, more accurate rates, mean that a newly diagnosed child is no longer a mystery. And this is true no matter where you are -- in a suburb of Washington or in Seoul, Cape Town or New Delhi. Parents all over the world are beginning to break through the walls of stigma that had made them hide their children from public view. They are asking for the public assistance they deserve, and where it is absent they are demanding it.

Plenty of Progress
I trace the beginning of my knowledge about autism and Isabel's identity back to that beautiful spring day in 1994 when a short, slightly overweight, affable child psychiatrist at Johns Hopkins told my wife and me that "Isabel has enough features of autism to be called PDD-NOS, Pervasive Developmental Disorder Not Otherwise Specified. It means that she's not severely autistic." By that time we had already been worried about Isabel for more than six months. The discussion of her diagnosis was really just having someone we could trust tell us what we knew all along, even if we hadn't admitted it to ourselves.

Isabel was our first child, and so we didn't really have a standard for comparison. In her first two years, she had seemed like any other child, and at 12 months she had begun to make some of the sounds that seemed like the beginnings of words. We thought she was fine. But when I look at our home movies today, I see that she never tried to communicate with us; in none of the videos of Isabel between 18 and 24 months does she say a single word. At 25 months old, she made only fleeting eye contact.

She began flapping her hands and arms occasionally and didn't respond to her name consistently. She spoke little and couldn't even tell us if she was hungry. We were at a point where we demanded clarity from doctors. A valid diagnosis of what was wrong with Isabel was more satisfying than devastating. It gave us a framework for understanding Isabel and a road map for the future.

Today, my teenage daughter is mainstreamed into a high school classroom for part of the day. Numerous tests have shown that she has above-average intelligence. She plays cello in the school orchestra.

Just last week, I showed her two magazine articles about my new book on autism, in which I talk about how far she has come -- farther than my wife and I, or our doctors, ever expected. "What do these articles say?" I asked. "They say I'm doing great," Isabel replied. Indeed, she is. ·

Roy Richard Grinker, a professor of anthropology at George Washington University, is the author of "Unstrange Minds: Remapping the World of Autism" (Basic), from which this article is excerpted. Comments:health@washpost.com.
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Man kills disabled children, wife, self - AP

HARTFORD, Conn. (AP) -- An 81-year-old man killed his wife and disabled adult children before fatally shooting himself because he was ill and worried the family might become a burden to others, police said Monday.

Officers who discovered the bodies late Saturday in a condominium north of Hartford found a detailed note from Richard C. Brown, saying his wife's health was also failing and his children had experienced health problems throughout their lives.

''He said he didn't want the family to be a burden,'' Enfield Police Chief Carl Sferrazza said Monday. ''It wasn't something he wrote down in five minutes. It was a pretty detailed note, and not an impulsive act.''

Police found Brown's three-page letter on the dining room table when they discovered the bodies of Brown, his 80-year-old wife, Martha, and their children, 49-year-old Janice and 53-year-old Kenneth.

Brown called a family friend on Saturday night, and that person called 911, police said. Officers discovered that Brown killed himself after making that call.

Martha Brown had been shot in the head while reading on the living room couch, and the children -- both of whom were mentally retarded and had physical disabilities -- were killed in their beds in separate bedrooms, police said.

Brown's note was straightforward and gave directions on how to reach out-of-state family members to report the deaths, Sferrazza said. It gave no indication that his wife was aware of his plans.

Friends and associates said Brown was a strong advocate for people with mental retardation. He was recovering from recent back surgery. Read more!

Discussing Mental Illness On The Airwaves - Chester (PA) Daily

By Tracy Behringer

It took guts for John Aberlee to tell his story, but once he started talking, it seemed his courage had no bounds.

I first met this Chester County sales and marketing consultant, and former Air Force security specialist, almost two years ago. He visited my office at COAD, Mental Health Services, in Exton, after hearing our department head, Rachelle Weiss, on a radio program. She had been interviewed about her depression and bipolar disorder.

John felt moved to tell us about his own struggles with the same mental illnesses. But this 6-foot-3-inch tall bodybuilder is an imposing figure — and perhaps that‘s why his story is so compelling. When John tells you that depression kicked his butt, you realize that depression must be mighty powerful.

Fortunately, John has had few major depressive episodes; the first when he was an injured jock in his senior year of high school, and the most recent a couple years ago when his doctor made some medication changes.

While the first depression was awful, the last was even more difficult for the 37-year-old husband and father. John‘s family had never seen him so incapacitated. And his family depends on him.

Since that first meeting, John has stared down stigma and has volunteered to speak publicly about his illness. He‘s addressed high school health classes and was the keynote speaker at a local mental health event. But he has taken his natural public speaking talents and his passion for this subject even further. He‘s become a spokesman for the national Depression and Bipolar Support Alliance (DBSA), and has spoken at such places as Brown University.

Most recently, John was interviewed by Newsweek Magazine for a cover story on ”Men and Depression,“ and he has added ”radio talk show host“ to his resume.

In addition to a two-hour live sports show he has been hosting on WCOJ (1420 AM) every Saturday from 4 to 6 p.m., he is beginning a weekly Saturday morning radio program on mental health issues. John‘s Mental Health in Chester County will air the first segment at 8 a.m. on Saturday, March 3.

Rachelle and I have already taped the first show with John, and he plans on having guests from the local mental health community each week. If you want to hear a dynamic speaker, tune in!

If hanging out with ”radio celebrities“ wasn‘t enough excitement for someone who doesn‘t get out of Chester County much, I also had a phone call from Congressman Joe Sestak‘s (D-PA) office last week. Seems the congressman is holding a forum on one of my favorite subjects: mental health parity.

Mental health parity is the term used to describe a health insurance system that would cover mental illnesses in the same way it covers physical illnesses. I‘ve complained about the lack of mental health parity in this column, but it seems as though some people are listening. Congressman Sestak, along with Patrick Kennedy (D-RI) and Jim Ramstad (R-N) will be at the Elwyn Media Campus in Elwyn, Tuesday, Feb. 27 from 8:30 a.m. until 10:30 a.m. And we‘re all invited.

If you‘d like more information about this forum, call 610-594-9740.
Tracy Behringer is a Daily Local News columnist. She can be reached at tracy.behringer@gmail.com. Read more!

Ridding Mental Illness of Its Stigma - Washington Post

Letter to the editor:

The Feb. 18 Business article "Should You Tell?; For People With a Mental Illness, There's No Easy Answer" got it right on an issue that should be part of society's mainstream consciousness. Mental illness must not be stigmatized.

As the article noted, one in four people has depression or some other mental illness. Two other facets of mental illness are particularly profound:

First, suicide is the third-leading cause of death among people ages 15 to 24, with depression the leading cause of suicide.

Second, studies have shown that 50 percent of all cases of mental disorders begin by age 14, and three-quarters begin by 24.

Mental disorders impose enormous burdens and can have intergenerational consequences. They reduce the quality of children's lives and diminish their productivity later in life. But mental illnesses can occur at any stage of life. No community is unaffected, no school or workplace untouched.

Stigma is the most formidable obstacle to treatment and progress. New research tells us that the average delay between diagnosis and treatment is seven years. That is unacceptable.

When we think of a person with cancer, it evokes compassion and empathy. But when we think of a person with a mental illness, do we feel compassion and empathy? Or is it reproach, maybe even fear?

It's 2007. Let's resolve that no disease deserves to be stigmatized.

ALAN EZAGUI
Director, Potomac Ridge
Behavioral Health Foundation
Rockville Read more!

Groups send open letter to advertising community

WASHINGTON, Feb. 26 /PRNewswire-USNewswire/ -- The following is an open
letter from mental health groups to advertisers and a list of signatories:

In the last several weeks, television advertisements from two major
automotive companies have made light of suicide to sell consumers their
products. These ads were both insensitive and potentially dangerous. In
response to outrage expressed by our organizations and others, these
corporations reevaluated their new ads, determined them inappropriate and
pulled them off the air.

We thank General Motors and Volkswagen for this show of sensitivity and
responsibility. We urge other corporations and advertisers to follow their
leadership and avoid exploiting mental illness and/or suicide in their
advertisements.

Each year, suicide claims the life of more than 30,000 people in the
United States. That is twice as many people lost to homicide. Ninety
percent of suicides are attributable to untreated or mistreated mental
health conditions.

Mental illnesses can happen to anyone. In fact, over 60 million
Americans live with these illnesses each year -- with more than half going
without the treatment and care they need. We know that without treatment,
these people are at risk of many other serious problems -- including
suicide.

We feel that the children, adults and families living with a mental
illness in this country deserve compassion. They deserve to live a life
without shame. They deserve access to treatment and support. Without these,
we cannot begin to prevent the 30,000 tragic suicides each year, and we
cannot ensure people more productive, healthier lives.

Suicide and mental illnesses are no laughing matters. As our nation's
leading mental health organizations dedicated to reducing the stigma and
shame associated with mental illnesses and preventing suicide, we challenge
advertisers to appreciate the seriousness of mental illnesses and treat
them as you would any other major illness.

We ask you for sensitivity and compassion and we welcome the
opportunity to work with advertisers toward this goal.

American Foundation for Suicide Prevention -- http://www.afsp.org
American Psychiatric Association -- http://www.psych.org
Mental Health America -- http://www.mentalhealthamerica.net
National Alliance on Mental Illness -- http://www.nami.org

Contact: Heather Cobb, Mental Health America, 703-797-2588
Wylie Tene, AFSP, 888-333-AFSP Ext. 24
Jessica Mikulski, APA, 703-907-8640
Alexis O'Brien, NAMI, 703-312-7893 Read more!

GM rewrites suicide ad - Brandweek

Genral Motors has re-write the Robot Suicide Ad. They have eliminated the suicide scene that drew protests from mental health and suicide prevention groups and put a happy ending.

The original ad portrayed a robot on the assembly line who was fired for dropping a bolt. The anguished robot toiled through a series of low-end jobs, including holding a sign hawking condo units before pondering a bridge jump. As he jumps he awakes from what was a bad dream.

The amended 30-second spot, premiered today during the Academy Awards, removes the jump and substitutes as a bad dream a shot of a car being compacted in a scrap yard, and shows the robot in additional menial jobs, including work as a shelf-stocker and holding the security gate in a parking ramp. Read more!

Unpopular, Painful Choices Await on Budget - Portland Press Herald

Mental Health Services for the Poor Are Important, but Something's Got to Give.

Editorial:

With all the attention lavished on Gov. Baldacci's plan to force consolidation on local school districts, scant attention has been given to his other big budget initiative: cutting social service costs.

The governor's two-year, $6.4 billion budget has slightly more money being spent through the massive Department of Health and Human Services over the next two fiscal years than during this biennium. But that increase masks an aggressive attempt to bring spending on social services under control.

Without program cuts, the DHHS budget, which includes the state/ federal Medicaid program for low- and moderate-income Mainers, would grow by $75 million more than the governor has budgeted.

One of the budget-cutting targets is mental health services provided through the Medicaid program. For poor people who suffer severe mental illness, these services are vital. Many agencies serving this population use Medicaid reimbursements to provide mental health care to some of our most vulnerable citizens.

Those points were driven home by advocates for the mentally ill at a hearing last week. While supportive of better case management, providers were unhappy with plans to cap payments for some mental health services.

Chris Copeland, president of the Maine Association of Mental Health Services, complained that the "rate standardization" proposals in the budget were merely cuts. "Bringing down the maximum rate paid to providers without raising the minimum doesn't standardize rates," he said.

Actually, however, there's no reason why standardization can't mean capping rates only on the top end. It's that kind of standardization that's going to produce real savings. Cutting one rate while raising another may, in fact, increase overall payments, and it's reasonable to assume that is not the purpose of an exercise in budget-cutting.

This is not to say that the proposed rate cuts won't affect the level of service given to the state's mentally ill. But if Maine is to get state spending under control and lower its unreasonable tax burden, hard choices are going to have to be made. The trick is to provide the maximum level of service for the available dollars.

If reimbursement rates for mental health care appear to be too generous at the top end, that's a good place to start the budget- cutting discussion.

Social service advocates may not like it, but the state cannot make a budget by determining need first and then spending whatever is required to fill it. Needs are endless. Revenues are not.

(c) 2007 Portland Press Herald. Provided by ProQuest Information and Learning. All rights Reserved. Read more!

Man’s mental status keeps case in limbo - Fayetteville Observer

By Paul Woolverton

Nearly six years ago, deputies arrested Jamal Delvon Gurley and charged him with setting fire to his father and repeatedly stabbing his teenage cousin. Both died.

Gurley has been locked up for 2,161 days, longer than any other defendant awaiting trial for murder in Cumberland County. He is charged with two counts of first-degree murder and one count of first-degree arson.

Gurley, 27, may never get a trial, said Paul Herzog, one of his lawyers. “He’s severely mentally ill,” Herzog said, describing Gurley as delusional.

“It’s just one of these cases that’s in limbo because of the nature of the defendant,” he said.

The case began around 10:30 p.m. March 27, 2001, in the Gurley home at 1112 Hodhat Drive. The home is off Hoke Loop Road in western Cumberland County. Gurley lived there with his father, 53-year-old Bobby Glenn Gurley, and his cousin, 17-year-old Shakiya Taylor. Taylor had recently moved from Paterson, N.J., and wanted to get her high school diploma.

A neighbor saw Taylor run from the house. She wore only a shirt and a bra and was bleeding from stab wounds. She collapsed in the yard and died.

Inside the house, Bobby Gurley lay in his bed, set on fire with gasoline.

Jamal Gurley was arrested about two hours later at a convenience store at Cliffdale and Rim roads, according to deputies’ affidavits. He had blood on him and torn clothing, and he smelled of gasoline. A bloody knife was found in the trash can of the store’s restroom.

Gurley admitted to and described the killings, an affidavit says.

Gurley’s court file is fat with sealed records — it’s typical for a defendant’s mental health reports to be blocked from public view.

Suicide watch
The records that are public show that Gurley was put on suicide watch at the county jail soon after he was arrested. A few days later, he was sent to Central Prison in Raleigh, which has a mental health section, for safekeeping and evaluation.

In August 2004, Gurley was sent to Dorothea Dix mental hospital in Raleigh and found incompetent to stand trial. He was given treatment.

In June 2005, Gurley was found to be competent for trial. Doctors recommended keeping him at Dix to prevent him from deteriorating back to incompetence.

Further records show that Gurley moved back and forth between the Cumberland County Jail, Dix Hospital and Central Prison. At Dix, a court order says, he threatened the staff, tried to incite a riot to foster an escape and had to be kept in restraints.

In an affidavit dated Oct. 3, psychiatrist George Corvin said Gurley is a paranoid schizophrenic. He said Gurley believes he killed his cousin and father in self-defense and that his lawyers were conspiring against him. Further, Gurley did not believe he is mentally ill, Corvin said.

In fall 2006, Gurley attacked one of his lawyers, Herzog said. So those lawyers dropped out of his case. Herzog and Jim Parish were appointed in November to replace them.

They await a judge’s ruling on whether Gurley is incompetent to stand trial.

Gurley remains at Central Prison’s mental health facility, according to a letter he wrote on Feb. 8 to Cumberland County Superior Court.

In that letter, which starts, “Dear Judge,” Gurley complains that Herzog and Parish have not contacted him. He says he wants to see them before he is evaluated again because he doesn’t want an evaluation.

“I want you to try to speed things up so I can come back to the county and address my legal situation. Sincerely, Jamal Gurley.”

Staff writer Paul Woolverton can be reached at woolvertonp@fayobserver.com or 486-3512. Read more!

Agency that filled void is now gone - Wilmington Star-News

Generosity, integrity, dedication, community service - powerful words for a vital agency that had an impact on our community in remarkable and lasting ways. When a human service organization as important as Family Services of the Lower Cape Fear closes its doors after 60 years, it is worth noting.

Started in 1946 by visionary community leaders who documented the need for psychological and mental health services for families, Family Services assisted thousands of our citizens in times of trouble and has been a leader in developing new services as gaps in resources have been identified.

The loss of Family Services, which closed in December, is hard to measure. The legacy of role models like Alice Sisson endures, despite the agency's demise. Alice, whose memory is indelibly etched in this community, will always stand for self-sacrifice, grace, strength, and compassion.

These are tough times for mental health as the latest "reform" has been brutal in the cuts and closings of other human service agencies in the area.

Family Services served people from all socioeconomic backgrounds and operated on a sliding-scale fee system. Its closing creates a chasm where a large segment of people in our community needing mental health services and other resources will inevitably fall through the cracks.

As we grieve the losses, we must consider how much we value healthy families and communities and whether there are still visionaries willing to commit to strengthening all types of families, individuals, and communities as well as training future mental health professionals.

Making public mental health services available to everyone was the cornerstone on which Family Services' board of directors pushed forward with its mission. The agency engaged volunteers from organizations such as Junior League, men's service organizations, churches, synagogues. It accepted referrals from schools, public welfare and others serving families in need.

The United Way began providing funding for Family Services soon after it was established. The agency's staff and board believed in and supported the broad range of services needed for our community's citizens to get through times. It was truly a community agency.

Providing quality staff, offering student training, and developing new ways of dealing with family problems were hallmarks of this agency.

The agency developed many programs to meet community needs. Travelers Aid services, created in the 1960s, served hundreds of stranded and/or destitute travelers. In the 1970s, a neighborhood center was adopted as a special project (which eventually became the After School Enrichment Program) by student intern Alice Sisson. This program provided opportunities for engaging various groups of community and parent volunteers and students-in-training.

Consumer Credit Counseling, a service geared specifically to those needing help with debt or learning budget management, was developed in the 1970s. By the 1990s, it served large numbers of clients and was mainly supported by donations from the business community.

The Big Buddy program, also created in the 1970s, took its name from the decision by Family Services to serve both boys and girls rather than have the traditional Big Brother/Big Sister programs. Big Buddy matched countless children with mentors who believed in the resiliency of children and forged lasting bonds.

The core service of the agency - individual, couple, and family counseling - filled a gap left for those who could not afford the full cost of counseling. Family Counseling was staffed, for most of its history, by graduate-level clinical social workers.

It served as a rich and vital training ground for hundreds of students from various universities. Linking with these universities allowed Family Services to serve more clients while providing the kind of close supervision necessary for optimal learning experiences.

It is a tragedy to lose such a significant community institution. It is now our challenge to embrace a new vision to help bridge the gap in the wake of Family Services' closing.

Sid Bradsher is retired executive director of Family Services, and Melissa Bass is a former student intern and family therapist.
Read more!

Un-stalling parity - Raleigh News & Observer

Letter to the Editor

My fourth-grade math teacher always said that laziness, not hard work, is the mother of invention. To think that mental health advocates have been laboring, scraping and fighting over every dollar they can get for community-based mental health services!

As the mental health reform machine marches forward with the closing of Dorothea Dix Hospital, it is abundantly clear that without reimbursing mental health services at the same rate as other health care services (so called parity), few providers will step forward and our most vulnerable population will continue inappropriate, hard landings in our jails, rest-homes and our streets.

Who knew that the real solution was so quick, so easy, and so cheap? All we need is $29,000, a men's restroom and another corrupt legislator like Jim Black. Finally, real doctors might be reimbursed like other real doctors and chiropractors.

Our governor's silence on mental health reform leadership has been deafening. Here is his chance at redemption. During this difficult budget season, if Gov. Mike Easley is having trouble getting his hands on the cash, perhaps he could try his luck with the lottery. Do the math!

Seth E. Tabb, M.D.

Cary Read more!