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Needed: A New Stigma Battle Plan

Who knew? Seems people in general don't buy the "disease like any other disease" argument used prominently by health care providers and advocates to reduce the stigma of mental illness. That's the conclusion of study results released by Indiana University and Columbia University in mid-September and published in the American Journal of Psychiatry. The researcher found that "prejudice and discrimination in the U.S. aren't moving...In fact, in some cases, it may be increasing..."

Stigma is a big problem. It produces discrimination. It negatively impacts quality of life. And most of all, it perpetuates the devaluation of persons afflicted by the illnesses and the services they need. This, in turn, pushes mental health services further to the edge of the plate of public support and funding.

The study suggests that stigma reduction efforts would do better to focus on the person rather than the disease - emphasizing the abilities and competencies of people with mental illness. The authors also suggest that the hymns need to move well beyond the choir.

If you think about it, isn't that the model of cancer fighting advocates? They focus on the victory, the recovery, the triumph - not on the disease.

These findings give us all a challenge - to re-think our thoughts, re-think our expressions and re-focus our attention where they always should have been - on the people, not the disease.

Shades of the Cleaver Family

TV family shows of the 50s, 60s and even the 70s regularly featured scenes around the family dinner table. Remarkably, the entire family was normally present! Try finding that on a family TV show today. OK, maybe the Thanksgiving or Christmas episodes, at best. It's a struggle for families to come together on a regular basis for a shared meal. But it's a struggle that well worth winning.

A study performed by Columbia University revealed that children who eat dinner with their families each night at least 3 times a week are less likely to use drugs, smoke or drink.

What a great prevention measure - dinner with the family!

Monday, September 27th is Family Day - a day to bring your family together for dinner. It's a great day to start a very worthwhile and healthy family tradition.

New National Drug Use Stats Don't Look Healthy

From today's press release by the Substance Abuse and Mental Health Services Administration:

The use of illicit drugs among Americans increased between 2008 and 2009 according to a national survey conducted by SAMHSA. The National Survey on Drug Use and Health (NSDUH) shows that the overall rate of current illicit drug use in the United States rose from 8.0 percent of the population age 12 and older in 2008 to 8.7 percent in 2009. This rise in overall drug use was driven in large part by increases in marijuana use.

The annual NSDUH survey, released by SAMHSA at the kickoff of the 21st annual National Alcohol and Drug Addiction Recovery Month, also shows that the nonmedical use of prescription drugs rose from 2.5 percent of the population in 2008 to 2.8 percent in 2009. Additionally, the estimated number of past-month Ecstasy users rose from 555,000 in 2008 to 760,000 in 2009, and the number of methamphetamine users rose from 314,000 to 502,000 during that period.
"These results are a wake up call to the Nation," said SAMHSA Administrator Pamela S. Hyde, J.D. "Our strategies of the past appear to have stalled out with 'Generation Next.' Parents and caregivers, teachers, coaches, faith and community leaders, must find credible new ways to communicate with our youth about the dangers of substance abuse."

"Today's findings are disappointing, but not surprising, because eroding attitudes and perceptions of harm about drug use over the past 2 years have served as warning signs for exactly what we see today," said Director of the Office of National Drug Control Policy, Gil Kerlikowske. "

Blah Blah Health Care Reform Blah Blah

By Dean L. Johnson, Vice President

Community Relations

Seems to me there's plenty of nonsense reporting and self-interested revelations surrounding the health insurance reform act passed earlier this year. If the mass media is your only source of information about what the act does and how it might affect you, your family, your business or your employer, then you've been shortchanged. 2 column articles and 30 second sound bites can't do it justice. Mostly, they do an injustice. Your most likely to find out somebody's beef with the bill. You're leastly likely to find out how it will affect you.

There is another way. An industry selling manuals, articles and slideshows centered on "what's in the bill" instantly materialized and continues to grow. I've had no less than four documents explaining the reform package in my briefcase at any one time for the past two months. I've read health insurance reform papers on planes, on trains, on buses and in automobiles.Most of them are large. Many of them are barely comprehensible. Nearly all are focused on how the bill affects a particular segment of the health care industry.

There's not a lot out there that delivers comprehensive, easy to understand and unbiased information to Joe and Jane Public, who need to understand what this bill does for and to them.

Fortunately, in Kentucky, we have a resource that fits the need. It's a ten page, easy-to-follow piece created by a coalition of organizations called Kentucky Voices for Health. It's simply titled: "The New Health Reform Law: What it Means to Kentuckians." Want to know if you'll be eligible for a subsidy to pay your insurance? It's in there. Wondering if your employer will have to provide you with insurance coverage? It's in there. Looking for small business assistance? It's in there. Worried about how the law affects Medicare recipients? The answers are in there.

Want to know how you can get one? It's in here: http://www.kyvoicesforhealth.com/.

Happy Birthday, Seven Counties!

Seven Counties Services celebrated its 32nd birthday on August 1…but celebrate may be the wrong word. In fact, I didn’t hear any of my colleagues mention it, even once! In years past, Seven Counties’ birthday was a big deal to many of us…it meant another year of growth, another year in the business and health communities, another year of providing community residents with high quality behavioral health, developmental and intellectual, and substance abuse services.

There’s nothing different about this year; Seven Counties is still providing services – now to more than 32,000 people every year. The organization is solid financially, has good name-recognition in the community and a national reputation for excellence, innovation and quality. It’s a great place to work, and staff (according to a recently completed independently-conducted staff survey) feel personally satisfied about the work they do in helping Seven Counties achieve its mission.

Our President/Chief Executive Office Dr. Howard Bracco was recently named the recipient of the Center for Non-Profit Excellence’s Lifetime Achievement Award, marking his 32 years of serving this community through his leadership of Seven Counties. Last year, our Vice President of Finance and Administration, Vicki Knable, was named the Business First Non-Profit CFO of the Year. Seven Counties routinely tops the Business First’s list of top non-profit organizations in the region. A number of our programs have won recognitions recently for quality and excellence. While Seven Counties will certainly continue to seek excellence in all areas of operations and staffing, I’d say we’ve done pretty well thus far.

So, with all these successes, why didn’t we celebrate our birthday this year? Perhaps, like a lot of people, it gets to the point where the actual number doesn’t seem important – it’s the quality that matters. Perhaps staff no longer feel we must prove ourselves within the community. Again, we don’t want to rest on our laurels – far from it; we want to keep pushing the envelope to identify better ways of helping people achieve recovery, but perhaps we don’t feel that we have quite as much to prove, considering our great track record for…uhmm… 32 years.

So, just in case you missed it (and I believe nearly everyone did), Happy Birthday, Seven Counties.

A Vacation Full of Brain Food

By Dean Johnson, VP Community Relations

I took a vacation last week - sort of. Technically, it was five days of vacation. In reality, it was five days of very hard labor.

I spent a week in Vermont on a "Volunteer Vacation" helping to build the Cross-Vermont Trail, a four-season, multi-use trail that will eventually run from one side of the state to the other.

Trail building in southeast Vermont involves three basic activities - digging ditches, moving boulders and crushing granite. Since I was working with an organization dedicated to low-impact trail building techniques, that meant doing all three with hand tools - shovels, rock bars (picture a six foot crowbar on steroids), picks and sledge hammers. No machines - just human bodies at work.

I got more exercise in the course of two hours than I normally get in two days - and I exercise regularly. By the end of the week, I was about as "bone weary" as I can ever remember being.

But I was also happy. I felt very accomplished. I felt satisfied. And I felt like I had done something worthwhile for a bunch of folks I'll never meet. My mind and mood seemed to be at their zenith, while my body was in the depths of despair.

Maybe I did more than I should have, but all that exercise had a positive effect on my brain. Not a big surprise. Years ago, Duke University researchers discovered that exercise has antidepressant properties. Others revealed the benefit of exercise to brain functioning and its ability to ward off dimentia. Theories on the science behind these effects vary, but the conclusion is undeniable.

Exercise is brain food. In Vermont, it's nearly as good as the seafood.

Six - An Unlucky Number for KY

Maybe it’s only a coincidence, but yesterday I ran across two seemingly unrelated items that grouped Kentucky as one of six states with a certain distinction – and, now don’t be surprised - neither are positive recognitions.

First, my inbox contained an e-mail forwarded from a colleague that, among of things, recounted the results of the National Alliance on Mental Illness (NAMI) project called Grading of the States. Each year, NAMI looks at states’ efforts in promoting and supporting effective programs and treatments for individuals with mental illnesses. I imagine few were surprised to find that, in 2009, Kentucky received the same mark it has received nearly every year the grades have been awarded - we were one of six states to receive an “F.”

Next, I was catching up on my periodical reading on the bus ride home and discovered, thanks to a LEO investigative reporter, that our commonwealth ranks sixth (from the bottom, not the top) in the percentage of women serving in the state legislature. We share a dismal rate of female representation in our General Assembly with Pennsylvania (surprise), Alabama, South Carolina, Oklahoma and “thank God for” Mississippi.

Think there’s a connection? I can tell you that research overwhelmingly supports the contention that women are the primary health care decision makers in every family. Whether it’s a concern over an earache or a suspicion of addiction, it’s the women who speak up and take action. Interestingly, it’s also women who are the first to read their children’s school report cards.

Would more women in the legislature (there are 21 females and 117 males in the KY General Assembly) make a difference? Would an “F” still be acceptable, as it has been for many years?

I wonder.

Dean L. Johnson, VP, Community Relations

The Unspoken Truth

By Dean L. Johnson, V.P. Community Relations

Healing travels many roads and by way of many modes. Art and performance are two of the more powerful vehicles that drive recovery for those who have survived the pain and trauma of personal violence, abuse, incest.

This past weekend, Seven Counties was honored to be the presenting sponsor of an exhibition of art and performance that was both powerful and groundbreaking. More than 300 individuals in our community experienced (and created) visual arts, performance arts, films, music, lectures and discussions all centered on one goal - to end personal violence against persons everywhere. Granted, it's a lofty goal - but oh what a start 18 contributing artists, nine dancers, poets, musicians and others made.

In the words of the world's best known anthropologist, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. "

Due to the success of Unspoken Truth (the title refers to the silence within families that is too often the response to violence and abuse), the visual arts will remain at the Huff Gallery at the Spalding University Library in downtown Louisville until August 10th. Take a few moments in one of your days and experience what one attendee described as "the most powerful hour of my life."

You can find more information at http://unspokentruthexhibit.wordpress.com/

Tax Reform is Desperately Needed in Kentucky !

The Commonwealth of Kentucky approved its budget for FY ’11, and it leaves a lot to be desired. I’m not criticizing the legislators, since they have only so much to work with. Let’s face it. There just aren’t sufficient dollars to pay for everything the state needs. Now is the time for state tax reform to increase revenues; currently, the tax burden falls on the middle class and working poor. Folks who earn between $15,000 and $47,000 pay nearly 11% in state and local taxes – while the wealthiest citizens pay only 6.1% of their income in state and local taxes!

Desperately needing some of that additional funding are community mental health centers in Kentucky, which are struggling to meet the demand for services.

Did you know that Kentucky was ranked 42nd in the country in funding mental health services in 2006? In its report, Grading the States 2006, the National Alliance for Mental Illness (NAMI) ranked Kentucky 42nd in per capita spending on mental health ($51.27), with total mental health spending at $210,000,000. By comparison, Indiana’s ranking in 2006 was 28th in per capita spending on mental health ($72.37); its total mental health spending was $448,000,000.

In NAMI’s 2009 Grading the States Report, it’s noted that little progress has been made in Kentucky. It reports, “The community mental health centers haven’t received a cost-of-living increase in their state contracts in 12 years.”

Without greater funding, more stress is put on other areas. Without outpatient treatment, folks end up in hospitals, where costs are greater. Seven Counties’ costs per day, including outpatient and medication services, are about $204 a day; the average cost for one day of treatment in a psychiatric hospital is $700 per day.

Without outpatient treatment, jails fill up with individuals whose major crime is that they have a mental illness. Between July 1, 2009 and April 30, 2010, Seven Counties – using a $183,000 grant – saved Metro Corrections $1,726,289 (figuring the cost of one day in jail is $68.00) by keeping individuals out of jail. Think how many people could be diverted from jail if more funding were available!

Until the state makes a committed investment to bolster its community mental health centers, everyone will be paying a higher price in emergency, inpatient and corrections services. Contact your state legislators and let them know that tax reform is needed now – not only for mental health but for all the other areas where Kentucky is coming up short.

Let's Talk About It! by Dean Johnson, Vice President - Community Relations

Mental health can be a tough subject to talk about. Admittedly, it’s not usually in the top ten on the water cooler or cocktail party conversation menus. But it needs to be. Mental illness issues affect us all in some way, shape or form. National statistics say that about one in four adults suffer from a diagnosable mental disorder in a given year. Look around you – right now. See three other people? Get the picture?

Human experience tells us that when we don’t talk about something, we generally get it all wrong.

Misconceptions about mental illnesses are abundant. No, they are not character flaws. No, you can’t just make yourself feel better. Contrary to popular opinion, it’s not “just a mood thing.” And all the will power in the world isn’t going to make you better without professional help to go with it.

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. They do to the mind what diabetes, heart disease and cancers can do to the body.

Remember a few years back when Tom Cruise said on national television that Brooke Shields – who had just gone public about her battle with post partum depression – should just take some vitamins and “get over it”? He claimed there was no such thing as depression. He was wrong.

Fortunately, Brooke sought treatment (and she did, actually, “get over it”, but not by her own will alone).

Not talking about something has another negative consequence – stigma. Research shows that the stigma associated with mental illnesses is the number one reason people don’t seek treatment. People are afraid – of judgment, of misunderstanding, of loss of friendships and loss of love. Just imagine the health of our country today if the same stigma and reluctance to seek treatment was associated with cancer or heart disease? What a tragedy we’ve created – because we do not talk about it.

Glenn Close, who has a sister with bi-polar disorder, has become an active stigma fighter lately. The actress says, “There is nothing to hide…We are all connected, and none of us should ever feel marginalized, stigmatized and alone.”

Mental illness is just an illness, although a serious one. It can be treated with therapy and, when needed, medication. So, let’s talk about it. Let’s be open about it. Let’s make it not just OK, but the expectation – that people with mental illnesses will be treated and they will recover.

Guest Blog by Dean Johnson, Vice President - Community Relations, Seven Counties Services

“Oh Behave!” - Certainly one of Austin Power’s more famous lines. In case you don’t know Austin, he’s the swinging English bachelor created by comedian Mike Myers. If you’ve seen any of the movies, you can probably hear his inflection and picture his facial expression just at the thought of the words. You also know that “Oh Behave!” was his admonition to others to control their flirtations.


I recently participated in a round table discussion with other behavioral healthcare professionals, advocates, parents and consumers from our community. One of the parents, who has been active in advocacy for many years, asked a question that left most in the room looking to one another for the definitive answer: “What exactly is behavioral healthcare and why do we call it that?” She’d heard the term and references to it throughout the years, but even someone so deeply involved in the field wasn’t sure she knew exactly what to think of when she heard those words. She wasn’t – and isn’t – alone.

There seemed to be a general agreement that behavioral healthcare has two components: treatment of mental illnesses and treatment of addictions. Individually, the two components enjoy a fairly widespread, if superficial, understanding by John and Joan Q. Public. But the term coined to identify the two together - behavioral healthcare -is not widely understood. Ask 10 people on the street what it means and I’d bet you an instant lottery ticket that the majority wouldn’t even come close.

One of the consumers in attendance said she didn’t like the term. An individual active and successful in recovery, she said she thought the term conveys the idea that people can control these illnesses through their own determination: they just have to “behave.”

The word “behave” has its origin in 15th Century Middle English (probably one of Austin’s distant relatives). Merriam-Webster says its primary meanings are “to manage actions of oneself in a particular way” or “to conduct oneself in a proper manner.” The first definition might find a home in the recovery models of both the mental health and addictions fields. The second definition is a bit more open to interpretation.

The common understanding does imply a level of management and control that exceeds the comfort of many. So what do we mean? More importantly, what are we conveying to the public when we use the term “behavioral healthcare”? We know what Austin would say. What do you say?

TV Show Highlights that Treatment Works

Did you see the TV show America’s Got Talent on Tuesday night? If you didn’t, you missed, as host Nick Cannon said, the most emotional moment in the program’s history.

A dozen or so adults took the stage to perform. The choir, calling itself New Direction, was entirely comprised of veterans – sailors, marines, soldiers. All of them had been homeless at some point after their discharge. One man told the audience that he had been homeless for 25 years, but, one day, he loaded up his shopping cart and walked several miles to a treatment facility. It was, he said, the beginning of his life.

Let me paraphrase what the spokesman of the group said: “In the past, you might not have wanted to see us, but our being here shows that people can change.”

People can change – with the right kind of help. Too many vets are afraid to ask for help – they were in the military, for heaven’s sake, you think, and nothing should scare them! – but they’re afraid to ask for help. More and more vets are returning from horrific conditions in the Middle East, and many of them, for one reason or another, will end up on the streets.

If you know a vet, let him or her know that you’re there for them. If they appear to be struggling, encourage them to seek help and let them know that asking for help isn’t a sign of weakness. If you see a homeless individual on the street, you can be relatively certain that he or she has a mental illness (in the case of veterans, possibly post traumatic stress) and is likely abusing alcohol or drugs. Many homeless individuals were in the military; they helped protect our country. They were there when we needed them. They deserve better than this.

There needs to be more money available for treatment. But more than that, there’s a bias against the homeless. You see someone who is tattered, talking to himself, weaving along the sidewalk or asleep on a park bench, and you think “homeless bum”. You don’t think about what brought him to this point, to this place. You don’t wonder if he’s a veteran of this country. You just think about him being a bum.

And the group New Direction? How’d they do last night in their audition? They got a standing ovation from the audience. They deserved it. They were good.

People can change. Treatment works.

Mental Illness Impacts Entire Families

My father-in-law had a bipolar disorder, which, I’m sorry to say, he seemed to enjoy. His disorder manifested itself into grandiosity – he was important, he knew important people, he knew best, he was always right. I remember a sister-in-law telling me that, one night at the dinner table when she was small, her mother told him that one of the children desperately needed to go to the dentist. My father-in-law didn’t even hesitate. “No,” he said, “I need new shoes. Her teeth will have to wait.”

My father-in-law wasn’t unfeeling or uncaring, but his illness got in the way. In fact, when he was finally diagnosed (years after his children were grown) and began taking Lithium, his entire demeanor changed. He was more thoughtful, more affectionate and empathetic, much less likely to dominate conversations and actions, and more understanding.

It was his children who paid. Being raised by a loving mother and a dictatorial father who was prone – during their childhood – to periods of anger or depression or hyperactivity was very confusing to them, and profoundly affected them into their adult years. Well into middle age, one son reacted angrily to just about everything. The other son employed adult temper tantrums (which his father had so successfully used his entire life) to get his way. One daughter will, to this day, leave the room if anyone raises a voice. Another daughter has bipolar disorder too, and she has decided that she doesn’t need medication, continuing the sad cycle through another generation. All four married very young just to get out of the house and away from their dad.

If you have an untreated mental illness, it is impacting your interactions with the people you love, and you’re impacting them in ways you can’t foresee. Particularly, I think, in the case of children, you’re altering their personalities and views of themselves just as readily as though you were deliberately cruel or abusive.

If you have been diagnosed with any mental illness, please seek treatment from a qualified mental health professional. The road to recovery may not be easy; it’s full of potholes and temptations to just say, “Forget it.” But it’s not just your health and well being that could be at stake; there are others who love you who will be forever impacted by your negative symptoms. By taking the steps to recovery, you’re helping those you love move forward, too.

For more information about services for behavioral health issues, go to sevencounties.com.

Fetal Alcohol Syndrome is Preventable

I’m sure you’ve heard of the woman in Tennessee who adopted a child from Russia, then recently sent him back, saying that the Russian adoption agency failed to tell her he had fetal alcohol syndrome. Her argument was that he was too difficult to manage and posed a threat to other members of her family.

I don’t want to speculate on this particular case, but it does raise a good opportunity to provide information on fetal alcohol syndrome (FAS). FAS is a condition that results from a woman drinking alcohol during her pregnancy. Any woman who drinks during pregnancy places her baby at risk of fetal alcohol syndrome.

When you drink alcohol, it enters your bloodstream and reaches your developing fetus. Because a fetus metabolizes alcohol slower than an adult, your baby's blood alcohol concentrations are higher than those in your body. Alcohol also interferes with the delivery of oxygen and optimal nutrition to your baby's developing tissues, organs and brain.

FAS isn't a single birth defect. It's a cluster of problems: facial impairment; developmental disabilities or delayed development; heart defects; deformities of joints, limbs and fingers; slow physical growth; vision and hearing problems; learning disorders; hyperactivity; poor impulse control; extreme nervousness and anxiety.

As many as 40,000 babies are born with some type of alcohol-related damage each year in the United States.

There is no cure or specific treatment for fetal alcohol syndrome. The physical defects and mental deficiencies last a lifetime. Heart abnormalities may require surgery. Learning problems may be helped by special services in school. Parents often benefit from counseling to help the family with a child's behavior problems.

The more you drink when you’re pregnant, the greater the risk to your unborn baby. The risk is present throughout pregnancy, but impairment of facial features, the heart and other organs, bones, and the central nervous system may occur as a result of drinking alcohol during the first trimester. Alcohol may affect the brain of the fetus at any time during pregnancy.

The most important thing to remember is this: if you are trying to get pregnant or are already pregnant and you can’t/won’t stop drinking, you need help. You are putting your child’s health and future happiness at severe risk.

Guest Blog by Joel Bowman, MSW, CSW

Our youngest daughter recently turned 18 months. On May 4th, Katie was particularly defiant. So, my wife, Nannette, put her in time-out. She complied for a few seconds, but got up before instructed. Finally, Nannette placed Katie in her bed, and closed the door.

We then heard a loud knocking noise . . . BAM! BAM! BAM! Perhaps, it was the UPS man, knocking at the front door. But we were not expecting any packages. I thought, that sound is coming from the girls’ bedroom. We hurried to the bedroom, opened the door to discover . . . Katie knocking at the door, trying to get out of the bedroom. Talk about "a strong-willed child."

But wait, how did she . . . huh?! I thought to myself, her state-of-the-art baby bed has been specifically designed by some of the world's greatest engineers, so as to keep her contained in "the time-out position." Nannette had the ingenious idea, let's put her back into the bed, so we can see how she got from the bed to the door. Within 60 seconds, Katie hoisted one of her exceedingly short legs all the way over the railing. Then, the second leg . . . while at the same time holding on with both hands, as she backed her way down to the floor. It was as though she were Lebron James returning to earth from a tomahawk dunk. The amazement with which we gazed upon this scary scene was as though we were going down the hill of the world's tallest roller coaster. We then began a laugh so robust, we almost burst into tears of hilarity.

Lessons Learned:

1. Be careful where you put your child for a time-out.

2. Toddlers have a determination that is unequaled, and they're not afraid to take risks, no matter who's watching.

3. The mind of a toddler is replete with creativity. They think outside the bed . . . I mean, box.

4. If the aforementioned determination and creativity can be properly channeled and developed, our children will grow into adults who will change this world, for the better.

Remember, the same is true of the youth we serve here at Seven Counties. We simply need to have ears to listen for the BAM! BAM! BAM! of their hearts.

Check out Seven Counties' web page at sevencounties.org, and learn more about services for children!

Salute to People Who Have Made a Difference

Quick! What do you think of when you think of Abraham Lincoln? Sixteenth President of the United States? The man who stopped slavery? His humble beginnings? The Gettysburg Address?

You probably don’t think of this: He suffered from depression – depression so severe and incapacitating that he occasionally thought of suicide.

What do you think of when you think of Winston Churchill? That he was one of Britain’s greatest prime ministers? That his stirring leadership and inspiring speeches helped Britain through the terror and fear of WWII?

Did you know he had bi-polar disorder (manic depression) – what he called his ‘black dog’? "Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgment might well have concluded that we were finished," wrote author Anthony Storr.

May is National Mental Health Month and a great time to recognize all the talented, creative people who have overcome their illnesses to become our leaders, our entertainers, our inspiration.

George Fredrick Handel, Gustav Mahler, Robert Schumann and Ludwig van Beethoven – all superbly talented musicians and composers – had bi-polar disorders, but their masterpieces will never die.

Charles Dickens, Ernest Hemingway, Eugene O’Neill, Leo Tolstoy, and Tennessee Williams were brilliant authors who have given us images and characters that will remain classics for eternity - and all had clinical depression.

Comedians Drew Carey and Roseanne Barr (they have had depression) and Tracy Ullman (bipolar disorder) manage their illnesses – and very successful careers. And they make us laugh.

Former news icons Mike Wallace (depression) and Jane Pauley (depression and bipolar disorder) didn’t let their illnesses get in the way of the news.

Vivian Leigh of Gone with the Wind fame…bipolar disorder. Linda Hamilton of the Terminator movies…bipolar disorder. Ron Steiger, star of In the Heat of the Night…depression. They’ve brought to life movie characters we’ll never forget.

Ted Turner, businessman and entrepreneur….bipolar disorder.

Teddy Roosevelt, President of the United States…bipolar disorder.

Vincent van Gogh, artist…bipolar disorder.

So let’s give thanks that, despite what you may think, mental illness does not deprive a person of intelligence, creativity, determination or ambition. Our world would be a grayer place without the insight and talent of people with mental illness.

And if you know someone struggling with a mental illness, you can help them realize their potential. Begin by encouraging them to seek treatment. It’s a well-established fact: treatment works.

Debilitating Forces in Families

For Tina and Susan life as a child was everything but normal. Their mother suffered from Schizophrenia, resulting in violent behavior towards her children. Susan eventually moved out to escape her mother’s abusive ways. Tina attempted suicide.

Gene’s mother tried to take her life 10 times. Her struggle with her illness led to her inability to properly raise Gene. When Gene was 14, he was sent to live with his brother and sister-in law.



For such parents, daily tasks are hard to remember, can be emotionally taxing and are thus neglected. The debilitating forces of mental illness can cause children to take on abnormal levels of responsibility in caring for themselves and in managing the household. This, in turn, makes it tough on the children to have a healthy and stable childhood and produces higher probability of the children developing a mental illness.

The stigma associated with mental illness keeps parents from seeking the help they need. When these parents do seek help, as in Gene’s story, their children are removed from the home. Seventy percent of parents who seek treatment have lost custody of their children and find themselves in an unending cycle of loss.

Addressing the needs of these families requires not only personal treatment for the effected parent, but family care as well. One in four American families is affected by mental illness and as a result is more likely to be broken by divorce. Changes are needed to lower the rates of divorce and child mental illness. This is why communities should strive to improve care for these vulnerable families by creating programs that help cope with mental illness within the family, while keeping the family unit intact.

Kotulski, Tina. "Book Review." SavingMillie. N.p., n.d. Web. 29 Mar. 2010."Living in Chaos: Survival: Family history... The legacy of mental illness...." Schizophrenia.com, Indepth Schizophrenia Information and Support. N.p., n.d. Web. 29 Mar. 2010."Mental Health America: When a Parent Has a Mental Illness: Issues and Challenges." Mental Health America: Welcome to Mental Health America. N.p., n.d. Web. 12 Mar. 2010.

Homeless and Mental Illness

I bet you don’t know this. Mental illness, drug abuse, homelessness and not enough being done to address any of them are four things that are prominent in today’s world. When this situation arises in our own area we are faced with a problem that hits closer to home.

People who are homeless in the community are in need of our help. Prior to the 1960’s people with mental illness were involuntarily admitted to state psychiatric hospitals. Eventually unnecessary hospitalization ceased with the development of medication to control symptoms. Today’s standard is no involuntary admission unless the individual posed a threat to themselves or others. Gradually people were being discharged from the hospitals but were not provided with the follow-up community-based programs they needed. These people ended up living on the streets.



According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 20-25% of the homeless population in the United States suffers from some form of mental illness. In 2008, mental illness was the third largest cause of homelessness in adults. Research has shown that homeless individuals with a mental illness suffer mostly from severe chronic depression, bipolar disorder, schizophrenia, schizoaffective disorders, and severe personality disorders.

Forty percent of the homeless population is families with children; most of these are run by a single woman. Research has shown that 84% of these mothers have been severely assaulted at some point in their lives resulting in a higher probability their children will have mental health problems. These mental illnesses disrupt peoples’ ability to carry out essential daily tasks such as personal hygiene, household management, and creating and maintaining stable interpersonal relationships.

In addition to having a mental illness, some of these people have substance abuse problems. They self medicate with street drugs which can lead to disease from intravenous injections. This combination of mental illness, poor physical health, and substance abuse makes it very hard for people to obtain employment and a stable residence.

Studies show that continual treatment and services improve the probability that homeless persons will maintain stable housing. Supported housing programs were created to provide the care needed. Services include mental health treatment, physical health care, education and employment opportunities, peer support, daily living and money management skills trainings.

In order to reduce the numbers of homeless people with mental illnesses we need to have more continual treatment available. Seven Counties Services, Inc has a homeless outreach team that does just that. The Center for Rehabilitation and Recovery also offers a Supported Housing Program for residents that are ready to learn how to live in the community.



"Library Index." Library Index. N.p., n.d. Web. 24 Feb. 2010. http://www.libraryindex.com/pages/2321/Health-Homeless-MENTAL-HEALTH-HOMELESS.

"National Coalition for the Homeless." National Coalition for the Homeless. N.p., n.d. Web. 24 Feb. 2010. .

Thoughts on Hope from Dr. Bracco

Too often nowadays when I watch newscasts I am overwhelmed by the negativity, cynicism, mean-spiritedness and pessimism reflected in the content. As I flip from channel to channel I am amazed that the same stories are being broadcast almost at the same exact moments. The stories would have you believe that the glass is not even half empty, it is virtually drained. I find myself caught in a vise of negative emotions feeling anxious and full of despair. I wonder how these myopic presentations affect others.

How often are we bombarded with warning signs that tell us the world is a dangerous place? Frequently, even the weather report is made to sound ominous and foreboding. We are in a constant state of storm warnings that have turned the cleansing rain of a thunderstorm into a deluge of fear.

What are the cumulative effects of the onslaught of continuous stress on us as people? I can only imagine the constant flow of adrenaline we are exposed to which leads us to states of hypersensitivity or numbness. Karen Horney, a contemporary of Freud, defined anxiety as a "feeling of being lost and alone in a potentially hostile environment." We must be experiencing states of super anxiety since we are exposed to messages that tell us we are in a constantly hostile environment. I can feel the rush of adrenaline and the pressure building within me and then I force myself to pull back from the brink recognizing that what I am reacting to is the myopic characterizations that are being placed before me.

I become mindful once again of the words of FDR "The only thing we have to fear is fear itself." and mindful of the wisdom of Howard Zinn, a social activist and historian who recently passed away on January 27th 2010. In his book "A Power Governments Cannot Suppress" Zinn wrote:

"If we see only the worst, it destroys our capacity to do something. If we remember those times and places-and there are so many-where people have behaved magnificently, it energizes us to act, and raises at least the possibility of sending this spinning top of a world in a different direction. And if we do act, in however small a way, we don't have to wait for some grand utopian future. The future is an infinite succession of presents, and to live now as we think human beings should live, in defiance of all that is bad around us, is itself a marvelous victory."

I open my eyes more fully and I can see the resilience of the people of Haiti following the devastation caused by an earthquake. I can see the coming together of others with their outpouring of help. I can see courage, strength, generosity, hope. While the world may have its dangers I recognize that we as human beings have the competence to cope with them and the ability to fashion the world as we would like it. So in spite of the economy, weather, violence, political corruption, and the empty glass there is hope.

Adolescence: The Forgotten Age

"Are you lying to me?" "Don't EVER let me catch you doing that again." "And don't ask me WHY, the answer is NO." These are a few of the things that adolescents hear from their parents on a regular basis. Teens are often perceived as troubled kids or trouble makers and their problems are largely ignored.

Research shows that even good students from wealthy backgrounds go off track when they reach junior high. "They desperately want the approval of their friends, to be perceived as 'cool,' and they will do dangerous and just plain dumb things to gain that status" says Phyllis Ellickson, a senior RAND analyst. In high school, dangerous temptations arise from peers to use drugs, alcohol, and to engage in unsafe sex practices. These behaviors contribute to violence and emotional problems. Children between 12 and 18 are extremely vulnerable and have not developed the skills to cope with temptations that arise by this age.

Some of these temptations result in serious consequences, including death. Seventy-five percent of adolescent deaths are primarily caused by three things: automobile accidents, homicide and suicide. These are directly linked with risky behaviors, such as drug use (alcohol and other drugs). Twenty percent of high school seniors smoke and about 30% are binge drinkers. Such things often go together: drug usage increases the risk of unsafe behavior; teens with mental health problems often use drugs.

The problem is compounded by the limited ability to get help. About one-third of poor and near-poor teens have no medical coverage, and a surprisingly large portion of middle-income teens also lack coverage.

So, how do we prevent adolescents from potentially life threatening behaviors? Studys by Ellickson and others discovered that school-based prevention programs can curb drug use. These programs work best at delaying or reducing cigarette and marijuana use. These programs are most effective when continued throughout high school.

We can do better. Treatment plans need to be developed for adolescence that involve families, schools, and health professionals. "We need to promote community-based or school-linked systems of care that recognize the interrelatedness of many adolescent problems" says Ellickson. Better training in adolescent medicine would go a long way to helping health professionals identify with mental disorders and drug abuse in teens.

"Adolescence: Forgotten Age, Forgotten Problems." RAND Corporation Provides Objective Research Services and Public Policy Analysis. RAND, n.d. Web. 25 Jan. 2010. . www.dicts.info/img/ud/alcohol.jpg

Kentuckians and Increased Health Access

Thirty-eight percent of adults from 18-65 went without health insurance at some time during this past year, said a study done by the Foundation for a Healthy Kentucky. This year the foundation joined with the Health Foundation of Greater Cincinnati to conduct an extensive Kentucky Health Issues Poll.

There were over 1600 interviewed and the study had a margin of error less than 2.5 percent, according to Eric Rademacher of the Institute for Policy Research. Despite the economy, 81% of Kentuckians still favor “providing access to affordable, quality healthcare for all Americans,” noted Foundation Executive Director Susan Zepeda. This percentage is down 10 percentage points from the prior year. Of those favoring, 64% supported increased access “even if it means raising taxes.”


The support for access to healthcare may be a reflection of another finding from their study. Thirty-seven percent of white and 55% of African American Kentuckians 18-65 reported going without coverage now or some time in the past year. And, 47% of younger adults (18-29) and 49% of those with family incomes below the federal poverty level are currently uninsured. This contributed to the support of affordable quality healthcare for all Americans.

There were some insured Kentuckians who reported going without needed healthcare in 2009 “because of the cost.” For more information go to www.health-ky.org

Foundation for a Health Kentucky. Despite Economy, Kentuckians Still Favor Increased health Access. Jan 13, 2010.

Vision

I believe that there is one characteristic that differentiates homo sapiens from all other life species and that attribute is the capacity for vision. All other living creature's behaviors are dominated by their conditioning, their history, their past. Human beings have the additional option of visualizing a future that is yet to be and they can utilize it to determine how they will act.

A rat consistently reinforced for turning left at a choice point in a maze becomes conditioned to always turn left at that choice. A human being confronted with the same choice point can chose to turn right regardless of prior conditioning. We have the choice of repeating the past or innovating change in ourselves based upon where we wish to go rather than where we have been.

Vision provides us with direction. It allows us to gauge our progress and examine the effectiveness of our behaviors. If you know where you want to go you can begin to develop strategies to get there. When I counsel others invariably my first question is "What is your vision of how you would like your life to be?" Beginning with the end in mind allows us to evaluate the effectiveness of our choices in getting us there.

Conditioned behavior takes place at a level that generally is outside of our consciousness. I often recall the story of a friend of mine who found himself driving into his office parking lot to discover that his child was in the back seat because he was to have dropped him off at day care.
He mindlessly drove his usual route since he was conditioned by many repetitions to drive to work each morning. On this day he had a new destination but he did not keep his end in mind and so he repeated his old behaviors. Being mindful is the key.

How often have you experienced people coming from virtually identical backgrounds behaving in very different ways from one another. Consider a family of origin in which there is alcoholism and abuse. Too often such dysfunction appears to perpetuate itself but there are certainly instances of offspring who have created lives of sober living and family nurturance.

Breaking the tyranny of our past involves three components : 1) Developing a vision, 2) Evaluating the effectiveness of our behaviors in terms of moving us closer or further away from that vision and 3) Mindfulness of both our vision and behaviors.
It is these elements that make recovery, achievement and the shaping of our future, possible.

Howard F. Bracco, Ph.D.