Help a Veteran neighbor this July 4th weekend: Silence the fireworks bombs

The other night I was sitting on my deck when a loud explosion shocked me in its suddenness and intensity.

The evening before, I was at an event where my friend, Patrick Donohue, was performing as a comic. Patrick is a combat Veteran who founded Project 9 Line, a non-profit that helps Veterans reintegrate back into civilian life. As part of his routine, Patrick made a joke about the “benefits” of PTSD, like scanning rapidly for danger while driving.

Patrick has been very open about his PTSD. In fact, last year he was interviewed by News 12 about how he used to find cnews 12.jpgomfort in the quietness of the basement of his house when the July 4th “explosions” would begin.

Our Veterans won’t be vocal about this issue – except, perhaps, when asked. Better to suck it up and deal with it…or make jokes about it like Patrick and his “Comedy Assault” brethren. That’s more the military way.

But PTSD is no laughing matter. It’s the signature injury of the post-9/11 wars and treatment for it is all about building coping strategies and resilience for the discomfort, the anxiety, and the depression.

In this week’s Stars and Stripes, writer Elizabeth DePompei related the experiences of one Veteran:

The first time he heard the crack of fireworks around July 4th the following year, he realized how wrong he was. Thomason, a 28-year-old Louisville native…remembers being at that first Independence Day party when a flashback was suddenly triggered. He was either playing a game or in a conversation with his wife — he can’t remember which — when someone behind him set off fireworks without warning. “When that happened, I physically just jumped and didn’t really know where I was for a minute,” he said. “I had a flashback and we had to leave, and that started to be a trend.”

Dr. Frank Dowling of Long Island Behavioral Medicine notes, “Many sights, sounds, and smells may trigger anxiety, panic attacks, or flashbacks to traumatic events from their service-related experiences.  This includes the sights, sounds, and smells – even vibrations – caused by fireworks.”

Combat Veterans have sought out “safe spaces” to avoid fireworks during the Fourth of July season, according to Marcelle Leis, Program Director of the Joseph P. Dwyer Veterans Peer Support Project. Programs like the Dwyer Project are working this holiday season to find alternative solutions, such as movie theaters, to find solitude while Americans patriotically celebrate Independence Day.

It’s a sad irony that many Veterans feel the need to relocate and isolate themselves while their family and friends enjoy a weekend that’s all about the freedoms they fought to protect.

We live in a region where there are many opportunities to enjoy professional fireworks events. Veterans with PTSD will tell you that these planned, supervised fireworks shows are less apt to trigger PTSD symptoms.

This season, can’t we spread some patriotic and neighborly goodwill and bag the loud boomers at least in our neighborhoods?

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Posted in PTSD, Veterans

Words Can Kill

StoltzAnd then there’s the guns.

Our nation grieves again for the victims of yet another mass shooting, this one the largest, most horrific scale we have experienced with guns.

As has become requisite now for these assaults on people and sensibilities, terms of terror, disaffected rage, association with hate groups, emotional disturbance, and mental illness become the focal points for public debate.

I have little professional understanding of hate; I have personal and professional understanding of mental health disorders. Here’s the connection:

Denial.

When someone we care about descends into mental confusion — which often is accompanied by addiction — our attempts to engage and intervene with someone are rebuffed by the person specifically because holding onto one’s beliefs carries its own reward, despite the loss of love, caring, employment, or status. Damaging and hateful words of others are candy for denial.

True psychiatric disabilities are always preceded by episodes of decline of varying lengths. The idea that someone “suddenly snapped” is for all intents and purposes a myth. Movies and headlines embrace the “he snapped” concept because it carries more drama than the true descent associated with mental and emotional despair.

It is this period of time — before the act — that provides an enormous window of opportunity for good public policy. Waiting periods, references, reviews of police reports including for domestic violence (in this Orlando case), review of other law enforcement investigation (the FBI in this case, too), all offer opportunity at crime prevention and a sustained, multi-pronged mental health intervention.

It is awful to watch the horror of the event . . . of those who were in that nightclub followed by the grief of victims’ families.

It is even worse for people in recovery, their families, and mental health professionals because we all know that a little real education about mental distress coupled with some sensible interventions can prevent tragedy.

Denial does not close discussion. It’s the very point where education can happen.

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Posted in Gun Violence, Guns

Remembering Patty Duke (1946-2016)

IMG_0168Anna Patty Duke Pearce connected with 1,200 new friends on Mental Illness Awareness Day in 2006 — that’s what we at Clubhouse of Suffolk called our annual event back then.

Now, thanks to Anna and many of her courageous peers, we discuss “health” and “recovery” far more than we focus on illness and disability.

To this day, some of the attendees from that event tell me about their own warm, personal conversation with Anna that day and the deep meaning and inspiration they gained from her message about her own IMG_0169recovery from childhood trauma and consequent emotional and mental distress.

Anna refused to focus on illness, medication, and diagnosis; she acknowledged these but told the audience — comprised of people in recovery, their family members, advocates, and clinicians — that these did not define her. She said that stories of others similarly affected had inspired her to find her own path and her own voice and that she was now on a journey to share her story so others might also find theirs.

My wife and I got to spend a little behind-the-scenes time the evening before with Anna and her w20160329_153948onderful husband, Mike. Despite being under-the-weather, she was extremely gracious and kind. Unbelievably, she thanked me for the path I chose in my life.

The picture of her with her personal note to me has been on my desk facing me for the past 10 years.

So many others whom she spoke with that day — and thousands more in other venues — are grateful to have shared a similar, personal gift from Anna.

Message to Mike

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Posted in Bipolar Disorder, Depression, Mental Illness Awareness Day, Stigma

Be a Mental Health “First Responder”

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A Mental Health First Aid training class at the Westbury School District.  (Photo Credit: Barry Sloan, Newsday)

On March 19, 2016, Newsday‘s Laura Figueroa wrote a great story about the impact of Mental Health First Aid training for first responders.  MHAW trainers have been providing Mental Health First Aid certified courses to teachers, care managers, youth and forensic workers, health and hospital “front line” staff, librarians, and more who have first-contact situations with people who may be experiencing mental and emotional distress.

As noted on its website, www.mentalhealthfirstaid.org, Mental Health First Aid teaches participants:

  • The signs of addictions and mental illnesses
  • A 5-step action plan to assess a situation and help
  • The impact of mental and substance use disorders
  • Local resources and where to turn for help

Like its physical health First Aid counterpart, Mental Health First Aid is for everyone: non-professionals and professionals alike. It is a safety-driven process but, along the way – as participants have noted – it takes the stigma and tension out of these encounters.

The feedback has been phenomenal from attendees. MHAW and our partners at Nassau MHA are available wherever an audience of up to 30 can convene. Unfortunately, until more grant funding is available, there is a modest fee (just as there is for Certified First Aid courses), but that shouldn’t get in the way.

Join the movement. Contact Alexis Rodgers, Coordinator for Community Outreach & Education, at arodgers@mhaw.org or call 631-471-7242 x1315 to find out more, get information about upcoming training opportunities, or to schedule a course with your organization or company.

Posted in Uncategorized

Zeldin Calls for Expanded Vets Peer Support

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Rep. Lee Zeldin

Congratulations and thank you, Congressman Lee Zeldin!

In an election year where there is often a lot of political posturing and little policy substance, New York’s freshman Congressman from the First District here in Suffolk County made a strong statement about the power of peer support as a key ingredient in enhancing the care of our Veterans who have struggled with post-service transitions.

A few comments are warranted here to make clear exactly what peer support is:

  • Peer support is delivered by trained and supported peer specialists. Too often, people perceive it as just about “one person talking to another who has also ‘been there’.” Peer specialists have ‘been there’ but also receive specialized training in how to engage and coach people to navigate through health, social, emotional challenges, and more.
  • Peer support is an “evidence-based practice” under the Federal government’s Substance Abuse and Mental Health Services Administration, a division of the Department of Health and Human Services. What that means is that there is evidence that shows trained peers help to reduce hospitalizations and emergency room visits and enhance treatment compliance. Just like when we seek a treatment for cancer, diabetes, Parkinson’s, and other serious impairments and diseases, we want to choose among treatments that are supported by valid and reliable, research. This is also the case for good mental health care.
  • Peer support complements mental and physical health care. A central tenet, and high value, of trained peers is the privacy of the relationship and the confidentiality of the conversations. However, a common outcome of these relationships is more effective use of treatment options, primarily because people often become at ease with their peers to discuss their fears or confusion about treatment approaches.
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PFC. Joseph P. Dwyer

Congressman Zeldin, himself a Veteran, knows the value of peer support. Veterans and their families (yes, families get peer support too!) will benefit in their own formal

processes and outcomes with an increase across the country of a phalanx of peers who work just to the side of this system.

It’s not just an emotional argument for peer support. The Congressman is “spot on” with expanding the Joseph P. Dwyer Veterans Peer Support Project across the country. To that end, our organization will be reaching out to our national mental health and peer organizations to help promote this excellent piece of legislation.


Update
Newsday: Lee Zeldin proposes $25M veterans counseling program, February 14, 2016. Learn more.

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Posted in Dwyer Project, Joseph P. Dwyer Veterans Peer Support Project, Peer Support, Veterans

Brandon Marshall: “The Way People Talk About Mental Health Is Crazy”

I was so moved by this column by NFL All-Pro wide receiver Brandon Marshall, that I wanted to share it with you. He speaks very frankly and eloquently about his own personal struggles, as well as how media reports too often incorrectly link violent behavior with mental illness when we know that just the opposite is true.

Mike


THE WAY PEOPLE TALK ABOUT MENTAL HEALTH IS CRAZY
by Brandon Marshall
Published in The Huffington Post, October 12, 2015

A gunman bursts into a classroom – or a movie theater, or a community center – and begins shooting. Victims are rushed to the hospital, some to the morgue. We know the scenario all too well. Media and politicians alike immediately condemn the gunman’s actions.

And just as automatically, the actions are attributed to mental illness.

Whether they occur in a private setting such as Roseburg, Oregon, or on live television as a few weeks ago near Roanoke, Virginia, these high-profile acts of violence provoke outrage and confusion. Why? we ask. What sane person would do this?

We struggle to understand, to comfort ourselves with an obvious explanation. So we point to mental illness. Except in most cases, it’s not true.

Between 2001-10, there were close to 120,000 gun-related homicides. The facts surrounding these tragedies are clear: mental illness is not the cause. According to the National Institute of Mental Health, only about 4 percent of violence in the U.S. can be attributed to people with a mental disorder. In a recent study, the American Psychological Association concluded that the vast majority of people who are violent do not suffer from mental illnesses; conversely, the vast majority of people with mental illness are not violent. People with severe conditions – schizophrenia, bipolar disorder, and psychosis – are far more likely to be victims than perpetrators of violent crime.

We decry racial profiling and religious stereotyping. What about those with mental illness?

The fact is, one-fourth of all U.S. adults, approximately 62 million people, have some type of diagnosable mental illness. This ranges from periodic mood disorders to chronic conditions like schizophrenia and serious anxiety disorders. Common mental illnesses can be successfully treated most of the time, including a 70-80 percent success rate for depression. But most Americans don’t know this. Most don’t know if they personally suffer from a diagnosable illness.

I didn’t.

It’s no secret that, in the years before my diagnosis of Borderline Personality Disorder in 2011, I was making some bad decisions. I had little idea why. I struggled to control my emotions or manage my life and relationships. As a longtime athlete in the NFL – a testosterone-driven, tough-it-up, egocentric profession – there’s not a lot of room for “How do you feel today?”

The tipping point arrived when I became extremely isolated and depressed. I stopped speaking to my wife and family. As the downward spiral continued, it just felt like the new normal. People told me I needed help. Finally, I went to McLean Hospital near Boston and got evaluated in a supportive environment where I felt people actually understood me. Just getting the diagnosis made me feel 50 percent better. And getting the right treatment plan transformed my life.

Why did it take so long to get help? The biggest factor was the stigma surrounding mental illness. I saw how ashamed others felt. This was what motivated me and my wife Michi to launch Project 375, a foundation to raise awareness, erase the stigma, and help people to get diagnosed and treated. Nearly a third of adults say they wouldn’t seek treatment for mental illness because they fear what others may think. According to the Mayo Clinic, this stigma can lead to low self-esteem, bullying, discrimination and decreased opportunities.

False beliefs about mental disorders get stoked every time a tragic shooting occurs. We need to stop equating violence with mental illness. The fact is, 88 million people in the U.S. who suffer some kind of condition aren’t shooting up schools or movie theaters. They’re struggling to live normal lives. And when violence does rarely occur, it’s because a system overshadowed by stigma was unable to help those in need.

As a society, we may feel safer by believing the threat of violence can be ascribed to one group of people. Like human nature, however, the truth is more complicated. Chronic anger, obsession with revenge, cravings for celebrity… these can all motivate people toward violence.

We need to accept that mental illness is a disease – and like any other disease, it needs stronger research, early screening and treatment, especially for young people. We need better recognition of new therapeutic treatments scientifically proven to work. We need more robust education in schools, the enlightened support of news and entertainment media, and the advocacy of high-profile figures, like myself, willing to step forward.

Because, as I know from my own life, the hardest step to take is the first.

Brandon Marshall is a professional football player and co-founder of Project 375, a national nonprofit that seeks to end the stigma of mental illness. Follow him at @project375, join mycounterpane.com/mentalhealth and subscribe to The Chatter.

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Posted in Adversity, Gun Violence, Sports, Stigma

King v. Parity

This blog post appeared last week on the National Council for Behavioral Health website and was written by NCBH President and CEO Linda Rosenberg.  While the Supreme Court ultimately upheld Affordable Care Act subsidies, Linda’s message is still very relevant as it reminds us how important it is continue advocating for parity and resources so Americans can access needed mental health and addiction care.

Michael Stoltz, LCSW


KING v. PARITY

by Linda Rosenberg, President and CEO, National Council for Behavioral Health

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Sometime between Thursday and next Monday, the U.S. Supreme Court will issue its decision in what could be the final legal challenge to the Affordable Care Act. Pundits, politicians and legal scholars are holding their collective breath as we wait to find out if the Court will strike down the federal subsidies that help millions of Americans purchase health insurance from healthcare.gov.

But I’m on the edge of my seat for a different reason. Because there’s something else at stake in King v. Burwell, something no one is talking about.

Health policy experts have covered at length why the loss of subsidies could result in 6.4 million Americans losing access to affordable coverage. If the Court rules against the ACA, I have no doubt that Congress and the states will figure out how to address their constituents’ loss of coverage in some way, shape or form. With an election year fast approaching, not to act would be politically disastrous.

The question weighing on my mind is: what will that coverage look like? And will it include the mental health and addiction parity protections that were embedded throughout the ACA?

Prior to the ACA, consumers with pre-existing conditions could be denied insurance, or offered coverage that excluded the key services they needed to manage their health. This was especially problematic for Americans living with addiction or mental health conditions because so many plans either didn’t cover those services or imposed such burdensome restrictions that it was nearly impossible for consumers to access needed care. This lack of access to adequate health insurance contributes to the average seven-year lag time between first onset of symptoms and initiation of treatment. Without access to comprehensive, affordable care, people living with serious mental health and addiction conditions may experience major deterioration of their health, irreversible cognitive declines (often leading to disability), loss of employment, incarceration, homelessness, and more. Many of these could be prevented with timely, comprehensive treatment – something that has traditionally not been available through most commercial insurance products.

Our nation’s long march toward parity began with the passage of a limited Mental Health Parity Act in 1996, dealing with lifetime and annual benefit caps under employer-sponsored plans. It continued in 2008, when the Mental Health Parity and Addictions Equity Act imposed broader parity requirements on most large group health plans and Medicaid managed care plans. With the passage of the Affordable Care Act in 2010 (and the subsequent implementing regulations), comprehensive parity protections now extend to Americans insured through group plans, individual plans, Medicaid managed care and the Medicaid expansion.

Parity has ushered in a new era for behavioral health care. The vision of parity is a simple one: that all individuals will be able to access the services they need, when they need them. But all of this could be at risk if the Supreme Court decides in favor of the plaintiffs in King v. Burwell this month.

Among the options on the table if the federal exchange falls are a number of proposals that would permit states to launch and regulate their own ACA-like marketplaces – without the consumer protections embodied in the health law. Without the ACA’s parity protections, millions of Americans could suddenly find themselves subject to a patchwork of widely variable state parity laws. These laws differ substantially in terms of what types of benefits they cover, which types of plans are affected, and what coverage standards are required. Before the advent of national parity standards, depending on where you lived, you might find that parity applied only if you had a certain type of condition, or only if you were enrolled in the state employee benefit plan. Some states’ concept of “parity” is so limited, it hardly merits the name. And two states had no parity laws on the books at all.

Consumers should not be at the mercy of geographic happenstance when it comes to their ability to access needed mental health and addiction care. King v. Burwell is a turning point in the evolution of our nation’s health care system not just because of the massive loss of coverage that could result, but because it could set us back years on our path towards ensuring that all Americans have equal access to mental health and addiction care. For their sake – and for their families, friends, neighbors and communities – I hope the Court will rule to uphold the federal exchange subsidies.

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Posted in Affordable Care Act, Parity
Association for Mental Health and Wellness
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