Our New Health Policy in 140 Characters or Less

I was listening to a radio talk show early Friday morning after the Republican House and President celebrated the rapid passage of their version of repeal of the ACA. While the radio hosts missed the irony, the program cut to an advertisement for a genetic testing company that was promoting its product, touting that it could tell us with a simple biological test the extent of risk we possessed for all types of cancers.

I recalled hearing testimony as part of the Welfare to Work Commission’s 2012 report on Suffolk County poverty where many people spoke of losing everything owned because they were denied treatment by insurers for a relapse in a health condition like breast cancer. The ACA, of course, subsequently eliminated this line of inconsideration by insurance companies.

Tests that might predict such risk weren’t really in significant use pre-ACA. But its potential repeal now re-opens this question – and many more – of what will constitute a “pre-existing condition.” I have personal and family health histories that amount to a WebMD volume of conditions, encompassing both physical and mental health. I know I’m already screwed with respect to possible excising of coverage for a host of conditions I’ve actually experienced, including two types of cancer. I know my risks of worsening or relapse of my conditions, so I do what I can to maintain a healthy lifestyle in order to minimize my risks.

But, what if I take a test and learn that I also have a 10 percent chance of Alzheimer’s or other conditions I have not yet experienced? Will this new information preclude me from coverage or care by a commercial insurer? If I don’t take the test, and nobody knows my pre-disposition, am I still eligible for coverage for that and related conditions? Or, will my insurer get really “progressive” and require diagnostic tests before telling me how much my insurance will cost?

How about new data from the population health world that indicates that even more than our genetic code, it’s our zip code that is often a strong determinant of our health and our healthcare needs? Just like homeowners and auto insurance, will our access to health insurance vary by the neighborhood we choose? (One gnarly congressman was quoted Thursday, “well you will always have the right to move.”).

I told the financial planners in my Rotary Club that they are in a great place under Trumpcare because we will all have to put off retirement pretty much until death so we can put away more dollars just in case any of our loved ones gets sick or disabled…or worse.

This issue will require a lot of public information at a time when fewer people consider information that comes in a form containing more than 140 characters. Some can endure a Facebook post (especially if there’s a funny video) and a few enlightened people will dig deeper and read a one-page blog or two. Recall how the brief non-fact of “Obamacare death panels” impacted public opinion during the ACA debate.

Another House Member admitted Thursday that he didn’t even read the bill, brief as it was, before voting on it. That’s the new stylistic challenge for the President: To issue a profound Tweet that will make good public policy, be it health care, taxes, immigration, or launching a missile attack.

It sure seems unfair that the people who are making the rules and are responsible for thinking through the all their implications are themselves exempt from the impact of the new rules.

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Posted in Affordable Care Act, health, mental health, Politics, wellness

Salve for the Sensibilities

I am a recovering news junkie…one who is struggling to stay on course in the current storm of political wrangling about social, economic, environmental, and overall  leadership issues.

For many years, my home lifestyle included watching cable news and TV newsmagazines early in the morning and in the evening.  The greatest “high” was Sunday mornings with coffee (after a run-through of the Sunday e-NY Times “Top News” and “Opinion” sections) – Fareed Zakaria, Meet The Press, etc. While driving, it would be NPR and maybe a little (mostly mindless) sportstalk radio. At the gym, a favorite hideout of mine for nearly 40 years, I’d often listen to podcasts of my favorite “talking heads,” at least until my daughter added a few health-related shows about brain and behavior science stuff (Invisibilia and many TED Talks).

Around the time of the two national political conventions, the sense of tension throughout my brain and body peaked. The verbal adrenaline that I could unleash when someone raised a political topic would, more often than not, leave others shrugging their shoulders and rolling their eyes with frustration of the topic – or maybe with me. Some new news, or more often political spin on critical events and issues, would make me lose sleep and affect my focus at work and in my relationships.

I knew I had a problem, and I admit that I still do. But, a new substance has fallen into my path in the form of e-books through my local library.

I have listened to well over a dozen books since the election. These include biographies (loved The Wright Brothers), fiction (okay, one was based on current Middle East conflicts), leadership, brain science, history, and a smattering of old political stuff (JFK, Patton, Lincoln).

A most recent “listen” was real salve for my sensibilities, Born to Run, Bruce Springsteen’s autobiography.  Stories “The Boss” told of his journey awoke my memories of college days. I first heard Springsteen in concert in 1975 in my school’s dining hall, an incredibly visceral event in my late adolescence that led me to follow his music and career. Listening to his book – recorded in his own voice – was moving, compelling, and reaffirmed for me that there are caring, moderate, humble, and sensible people who walk among those we today label as stars and celebrities.

Springsteen mixes his stories with an oft-painful self-awareness that brings the listener into his world of chronic perfectionism, which is the source of his brilliance yet also the fuel for his depression. He artfully describes, in impoverished and yet hopeful language, his lifelong journey with depression that spanned his early struggles to find himself musically as well as his rise to fame and acclaim. Springsteen also discloses how years of therapy and the use of meds allowed him to find freedom from his harsh self-criticism. His relationship with his father, diagnosed late in life with schizophrenia, adds dynamism to this journey.

A really engaging part of his ride to inspiration was his relationship with Veterans, achieved through a fortuitous meeting with Ron Kovacs, author of the best-selling autobiography and Academy Award winning movie Born on the Fourth of July. Springsteen, who has enjoyed a lifelong friendship with Kovacs, shares his guilt for not having served in the military and the pain of losing close high school friends to Vietnam combat. He beautifully weaves his sincere admiration for wartime and post-wartime courage and convictions, which resulted in Born in the USA and thousands of reprisals of Woody Guthrie’s This Land is Your Land.

I must admit that this new e-book addiction of mine is every bit as engrossing as my political news affliction, but somehow feels healthier in its breadth and depth. It is often said that overcoming addiction is a journey of replacing the bad, damaging, “drugs of choice” with healthier compulsions.

Unfortunately, an avalanche of new issues in our political environment has threatened to retrigger me:  Rapid-fire proposals of health insurance reform, huge transitions in Federal spending priorities toward defense and away from social and environmental needs, and international instability — all engrossing and also extremely important to me on many personal and professional levels.

Now my challenge is finding new balance. I hold out hope that as I enter my senior years, I’m at least on the right path toward learning how to re-generate other parts of my brain that may be being wrecked by my obsession with political news.

Of course, with spring looming, I’ll also need time for golf . . .

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Posted in Addiction, Politics, Tension, Veterans

Amazed by Strength Through Adversity: What it Means to be Homeless

Please welcome Ruth McDade, Director of Development at the Association for Mental Health and Wellness, as a returning guest blogger. Her story below motivates us to continue the important work we do every day. We are grateful to her team that included Joanne Massimo, Greg Dutcher, and Scott Bradley. ~ Michael Stoltz


From left: Ruth McDade, Director of Development; Scott Bradley, Board Member; Joanne Massimo, Director of Programs, SCUV, and; Greg Dutcher, Sr., volunteer.

Recently, a team of four representatives from the Association for Mental Health and Wellness/Suffolk County United Veterans (SCUV) – volunteer Greg Dutcher, board member Scott Bradley, and staffers Joanne Massimo and Ruth McDade – participated in the 2017 “Point-in-Time Homeless Count.” Each year, the Long Island Coalition for the Homeless (LICH) conducts the count to estimate the sheltered and unsheltered homeless population and project service needs and resources.

Our team was assigned to Suffolk’s East End. Like other teams across Long Island, our charge was to locate, count, and engage homeless people about their living situation and their needs and – if they agreed – accept assistance locating shelter for the night. LICH provided us with waterproof blankets, clothing, personal care items, food, and a list of housing resources.

We began our search at 6:00pm driving along the Tanger Outlet, Wal-Mart, and going into the McDonald’s and Starbuck’s at the Tanger food court. Team members engaged store managers, providing them with our cell numbers if they saw someone needing assistance.

A 20-year Veteran, “Dutch” is highly driven for the task as he himself was homeless 15 years ago when health problems led him to lose nearly everything he owned. From his service with the Helping Hands of the East End Food Pantry at Synergy Center, Dutch is very familiar with the Riverhead area homeless “hangouts.” That evening, he led our team to a laundromat, the back halls of a library, and streets where Maureen’s Haven just completed its nightly homeless outreach.

For a while, other than one woman sitting alone with a number of possessions alongside her, it seemed that the warm winter night would leave us with few engagements. That changed when we entered the local McDonald’s.

Sitting among a group was Vernon, who warmly greeted us. I met Vernon – at the time homeless and living in his car – at last year’s Kick Stands Up event where he was a volunteer food prep/server. Since then, we helped him find permanent housing and secure employment. Vernon happily introduced us to the remaining people while Scott Bradley purchased hot meals for each person who accepted his generous offer.

We met some other incredible people that day who were deeply grateful for our outreach:

  • Frank, 22, lives in his car despite working full-time. He is estranged from his family but is with his friend, Sam, 23, also homeless. They met while receiving shelter services at Maureen’s Haven. Sam is undocumented and has been homeless for over a year and is working with an attorney to gain citizenship. Sadly, Sam declined our offer and said he would sleep in the car with Frank but would be open to assistance from LICH to help him find permanent housing. They would have to connect with him at McDonald’s as he has no other means of contact.
  • Tom and Lisa are a couple who occasionally sleep in the waiting room of a local hospital where she receives treatment for chronic illnesses. Lisa shared some intimate and traumatic events she had experienced; Tom provided very compassionate support and spoke of his mental health and substance abuse struggles over the past few years. With the help of DSS, we convinced them to return to a shelter with the goal for them to be placed together in the near future.
  • Sylvia, 52, struggles with alcohol abuse. She had been sleeping on a porch in an abandoned building for 9 months after separating from her husband. Her alcohol abuse compromised the continuity of benefits she critically needs to better manage her life. She refused DSS assistance since the only opportunity available was 45-miles away. However, Sylvia accepted help from our Health Home Care Management program to get assistance for her drinking and other healthcare and social service needs. Like the others, she accepted our offer of clothing, food, personal care items, and a waterproof blanket. I felt helpless as I watched her walk out of McDonald’s and into the night all alone.
  • Larry, 50, has mental health challenges and has been homeless for the past year and a half since the house where he lived went into foreclosure. Since becoming homeless he has lost all benefits and is without needed medication. Larry worked as a mason in his youth, then went into the military, but was not able to complete his service though he did receive an honorable discharge. Larry heartily accepted a referral to our SCUV Vets Place shelter with help from Suffolk DSS. Bill Doane, the shelter’s night manager, welcomed Larry, who not only got a clean bed, food, clothing, and lots of peer and professional support, but will also receive mental health services and care management.

I would be remiss if I didn’t give a huge “shout out” to Nora, a kind and patient DSS Emergency Services staff member, who made multiple calls over two hours for housing and transportation for our new clients; and to our own Bill Doane, who was well-prepared to receive any homeless Veteran we brought him that evening.

I look forward to doing “The Count” each year as it reminds me why I do this work. I feel honored to work alongside such a committed team who, like me, were amazed by the strength of people who are going through such an intensely difficult time in their lives. Their profound and sincere gratitude, for me – some with tears – was best reflected by Joanne: “I meet homeless folks all the time. What I learn is that each person deeply appreciates the help. It never gets old. They appreciate that someone looks at them and listens. I also feel the torture they go through and can understand why they sometimes self-medicate.”

Our terrific team shared fist bumps at night’s end for a sense of accomplishment that evening. Said Scott Bradley, “We had to complete the mission.” Spoken like the true Veteran that he is.

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Posted in Homeless, Veterans

5,000 Miles Away . . . or From Another Planet?

globe-handsI was teasing friends, families, and colleagues over the past two weeks that I couldn’t join them for any of the post-inaugural marches organized by our courageous and determined sister leaders as I had to be in Hawaii.

While my trip certainly included some vacation, it came about because of an award my daughter received for developing Curvy Girls, a foundation that facilitates peer support, leadership, and medical advocacy by girls with scoliosis. This blog post isn’t to brag even more (honest!)…though I am happy to talk about my daughter and this great organization at any time! Rather, I want to share about the incredible experience we had with the awards program which was hosted by the Medtronics Corporation’s foundation.

Recognized along with my daughter were people of all ages and from all corners of the globe who were stricken by a range of diseases, some life-threatening and others disfiguring, only to find relief from major advances in medical technologies. As a result, each awardee has been able to devote “their extra life” to helping others with the same afflictions. Some of the inspiring stories included:

  • Natalia of the Ukraine, stricken as a child with a rare neuro-muscular dystonia disease now saved by a device that allows her to be able to move – and to become a strong advocate for treatment and rights of similarly afflicted in eastern Europe. She also, through her interpreter, gave me a real first-hand perspective on the Ukraine-Russian issues.
  • Advanced cardiac disease and cancer care devices transformed the lives of an advocate in South Africa (who is also a breast cancer survivor) to fight for the health rights of indigent Africans . . . it helped an 82-year-old who now promoted senior singing groups . . . and the former Minneapolis three-term mayor R. T. Rybak – stricken by a near-fatal heart attack just days after leaving office – now devotes his “extra life” to closing achievement gaps among children of different ethnicities.
  • Several young adults with Type 1 Diabetes saved by insulin pumps now engage and educate children and young adults similarly diagnosed in India, Brazil, China, and Sweden to lead long and healthy lives despite their disease.
  • A survivor of severe obesity in Spain uses her new life gleaned from bariatric surgery to provide patient support and education about obesity to others similarly afflicted.
  • Lucia of Italy suffered from severe bladder disease but was saved by new therapies that now allow her to promote awareness in the medical and political communities.
  • Yonkuan of China – his life saved by Deep Brain Stimulation – now works with the Chinese Red Cross to reach out to others suffering with Parkinson’s disease in that country.
  • In North Carolina, opera singer Eric’s career was cut short by a near-fatal stroke. A revascularization device now allows him to extend the community reach of the music therapy program at his local university.

And if there wasn’t already an ocean of tears sprung by these inspiring tales, there was also the story of 92-year-old Fran Heitzman who danced and sang through the weekend thanks to his new pacemaker. It has allowed him to grow the charity he started when he was a church custodian, accepting and distributing furniture through 150 Minneapolis charities to people in need. It began with one crib 30 years ago to what is now a fleet of 11 semi-trucks that move household goods to thousands of people in need.

It was clear to me that most all award recipients were of modest means who were gracious and humble for the recognition and the long weekend retreat sponsored by Medtronics. Thanks to the medical technology most often made accessible to them by policies of their national government, these inspiring people have chosen to become productive citizens and work to ensure that others can be afforded the same care they received.

If our new President really wants America to be “first,” why can’t America pledge to be first in advancing health, mental health, and drug addiction care?  We have come so far in innovation in these fields with so much promise in the pipeline – along with armies of people ready to help promote their effective use. Do we really want to achieve “America First” by building a “great wall,” by reviving coal mines or other fossil fuel industries, or by squeezing other countries for increased tariffs in trade deals?  Instead, let’s leverage the economic and social impact that advancing our health and rehabilitation industries can inspire here and around the world!

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Posted in Adversity, health, mental health, wellness

A Simple Step to Help Prevent Tragedies


MHAW’s Emily Sussman speaks to Suffolk County Police Department recruits. Seated to her left is Alexis Rodgers.

Seattle Seahawk Wide Receiver Doug Baldwin, son of a Florida police officer, spoke recently to Sports Illustrated in response to the actions of Colin Kaepernick.  Kaepernick, you might recall, is the 49ers quarterback who has been widely chastised for choosing to not stand for the national anthem before NFL games as a call for action to address the rash of tragic incidents involving police and African Americans. Baldwin noted, “…training for law enforcement is not universal across the country . . . there’s 18,000 [law enforcement agencies] in the country, and they all have their own specific training regimen, their own policies.” For example, he added, “…there are a lot of different definitions of ‘de-escalation,’ and I think that’s where the root of the problem is.”

Law enforcement personnel and people with psychiatric disabilities know all too well about the precarious nature of these interactions. On October 17, 2016, a rank-and-file NYPD officer fatally shot 66-year-old Deborah Danner, a woman with schizophrenia, who swung a baseball bat at him.  Unfortunately, the officer never had the benefit of the Crisis Intervention Team (CIT), an evidence-based training model that NYPD recruits now receive.  The incident brought memories of other such death-by-cop tragedies that trace back to the 1984 death of Eleanor Bumpers in the Bronx (see On the Tragic Death of Deborah Danner).

Police Officer Ray Sitler, who coordinates the mental health training for the Recruit Training Center for the Suffolk County Police Department, invited Association for Mental Health and Wellness (MHAW) advocates to augment the department’s mental health curriculum with their own personal, lived experience with psychiatric disabilities, including their interactions with law enforcement.  P.O. Sitler shared that he was inspired by his own experience as a father of a young man with autism and the vast gaps of misunderstanding that surrounds that disability.

Facilitated by Alexis Rodgers, MHAW’s Coordinator for Community Education, four advocates poignantly told their stories and gave critical guidance to nearly 200 police recruits. Emily Sussman, an MHAW staff member open about her own recovery, was impressed that, despite the formality of the recruits wearing their dress grays and sidearms, “they were a warm and interested group.  They asked interested and invested questions about how to approach someone, the kind of language to use, and demonstrated interest in us as individuals.”

Alysha, another advocate, shared a difficult interaction she had with an officer who stopped her for a minor motor vehicle issue while she was experiencing a lot of personal distress. She told recruits that the officer was cold and off-putting, and didn’t recognize her distress, which made her feel like verbally lashing out at him.

The speakers discussed a range of issues that officers might encounter such as responding to suicide threats, harassment by neighbors, distressing behaviors, roommate and community disputes, medication side effects, and substance abuse.  The recruits asked thoughtful and sensitive questions: “What would an officer have better said to you in that situation?” “What does the medication do?” “What helped you to get to where you are today?” “What about your family?” “What’s your understanding of why you have that illness?” “What happens if you drink or use drugs while you’re not well?” and dozens more.

Raymond, another advocate, said that myths that too often accompany people with mental illness, such as violence, and how myth alone can make a situation worse. Andrea, the fourth advocate, passionately explained the difference of how she appears to others in times of depression and in times of high-energy mania. The officers were transfixed and applauded the speakers loudly, including a couple of standing ovations.

Police recruit Dario Perito, who was previously an NYPD officer, said that the session reminded him of interactions he had with homeless people at train stations. While many fellow officers advised him otherwise, Dario made it a point to get to know the homeless people there more personally. “They told me a lot about why they avoided shelters and outreach workers as well as mental health and drug treatment facilities.” Recruit Luis Cabrera said he loved hearing the personal stories from MHAW advocates as they helped confirm for him that “people are people” and need to be treated with kindness when they are not in a good place.

Another recruit, Michael Smith, approached me after the meeting and asked whether, once he was assigned to a precinct, it would be a good idea to introduce himself to programs and community residences on his beat. I told him about the great relationship our clients in Ronkonkoma have – at our Pollack Center as well as at our local residences – with P.O. John Seppi of the Fourth Precinct and how his warm and confident involvement alone has frequently eliminated tension in distressful episodes.

Advocates know that too often it takes tragic events to move institutions to self-examination and action.   However, progressive police departments like Suffolk demonstrated in this training that meaningful discourse can bring powerful sensitivity and set an atmosphere where conflict can be resolved safely. And Doug Baldwin, along with other athletes, are now helping to lead these community conversations.

As Emily Sussman noted, “I think we really brought home the message that we are just people like their friends, family, and colleagues.  It was a wonderful afternoon well spent.”

Such a simple concept.

Our gratitude to Police Officer Ray Sitler and the Suffolk County Police Department.

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Posted in Law Enforcement

Thanking Those Who Have Gone the Extra Mile

veterans-day-imageOn this Veterans Day, we recognize all Vets for their service to protecting our country in peacetime and in conflict. I want to especially recognize those Veterans — such as those who work or volunteer as part of our agency’s staff and board — who have extended themselves beyond their service experiences to help others and our communities.

At the Statewide Dwyer Project conference last month, the keynoter was young Army Veteran, Andrew O’Brien, of Texas, who shared that his volunteering for service was not about patriotism but about finding a sense of purpose for himself following a childhood of horrid abuse and neglect. However, after a challenging combat experience in Iraq, while still in the service, his journey included an attempt to take his own life.

After returning to, and completing, a distinguished service career, Andrew later founded the Wysh Project (www.wyshproject.org) not only to help end Veterans suicide, but building on his own experiences, to help everyone who has past experience from trauma from any source move “from trauma to triumph.”

Responding to Andrew’s talk, one recovering Dwyer Vet asserted: “We are not broken. We are strong. We saw and participated in stuff we expected but weren’t fully prepared for. We are injured, but because of our strength we can take ownership of a helping role in helping others overcome injuries and help build community.”

As we thank our Vets today for their service in uniform, let’s also thank so many who have gone the extra mile to help enrich our communities as places of caring, hope, and opportunity for all people who face adversities.

Posted in Dwyer Project, Healing, Joseph P. Dwyer Veterans Peer Support Project, PTSD, Suicide

Why we do Mental Health Awareness Week?

mha-week-2016-revised-logoThere are a myriad of health education weeks and months for so many different diseases, each with campaigns and events to promote vital information that can engender personal, social, political, and health profession activation.

Mental health awareness encompasses a huge umbrella that embraces the impact and challenges of all these diseases – plus mental illnesses, psychiatric disabilities, stress, trauma, and comorbidities with substance use and developmental disabilities – and the inevitable family distress that comes with all of these. Left without intervention – such as education, peer and family supports, rehabilitation, and medical and psychological care in any combination – any and all of these mental health challenges are associated with the social consequences of employment and income instability, poverty and dependency, family strife, homelessness, incarceration, marginalization, and suicide.

The Centers for Disease Control (CDC) states that “published studies report that about 25% of all U.S. adults have a mental illness and that nearly 50% of U.S. adults will develop at least one mental illness during their lifetime.” There are a few other disturbing facts that we need to accept and bring to personal and public health discussion and debate:

  • Mental health problems are associated with increased occurrence of chronic diseases such as cardiovascular disease, diabetes, obesity, asthma, epilepsy, and cancer. Similarly, mental illness is associated with lower use of medical care, reduced adherence to treatment therapies for chronic diseases, and higher risks of adverse health outcomes.
  • The largest psychiatric facilities in our country, and right here on Long Island, are our municipal jails and State prisons whose inmates are disproportionately comprised of minorities who rarely have access to culturally-relevant community mental health information or services.
  • The national suicide rate among Veterans is still nearly 22 per day – despite public awareness of this national tragedy. Furthermore, the rate among Veterans who served during, or after, Vietnam (the term “peacetime” Veteran is a frequent distortion of their real experiences) is rising. This pattern also aligns with that of middle-aged men in general.
  • Around 20% of the world’s children and adolescents have mental health problems, about half of which begin before the age of 14.
  • Nearly 75% of people who access public mental health services have reported being victims of violence and/or trauma of some kind in their lifetime. People with mental health conditions are far more frequently victims rather than perpetrators of crimes.
  • 22% of people who become homeless have serious mental health problems.
  • Mental and substance use disorders are the leading cause of disability worldwide and are the second most impactful conditions affecting workplace productivity.

The more than forty events being held during Mental Health Awareness Week (www.MHAWeek.org), October 2nd through the 8th, are as broad as the umbrella itself and include films, conferences, walks, yoga, seminars, open houses, and more.  Attend any one activity or event and you will be sure to gain new insights that can enlighten and inspire you, your family, a friend, or a neighbor,  and perhaps enrich or even save a life of someone you care.

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Posted in CDC, Centers for Disease Control, Mental Health Awareness Week, Suicide, Veterans
Association for Mental Health and Wellness

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