Update on Legislative Study of Montana's Public Institutions

NAMI Montana friends:

I wanted to give you a quick update on the legislative study of Montana’s public institutions. The Children, Families and Health and Human Services Interim Committee met yesterday. This was the first public testimony on the study that NAMI Montana worked with Representative Jenny Eck to create.  I’m more than a little biased but it was a really promising start. There are great legislators from both parties on this Committee and they are already well-versed in mental illness policy making issues.  The heads of DPHHS and the Department of Corrections both said that the study was going to be essential in reviewing current practices and designing for the future.

We’ve got a lot way to go with this process.  (See the rough study plan here - http://leg.mt.gov/content/Committees/Interim/2013-2014/Children-Family/Committee-Topics/HJR16/hjr16-draft-study-plan-june2013.pdf).  It’s going to be a lot of work, but there is a big potential pay off in creating a more compassionate and effective treatment system for Montana’s future.  Special thanks to Representative Jenny Eck  who carried the study bill. Patty Jacques and John Wilkinson whose incredible testimony yesterday about their families helped put the issue in extremely real and tangible terms. 

Click on this link, http://leg.mt.gov/css/Lyris/email_logon.asp, to receive email updates about this Committee to see how you can stay involved.

Thanks,

matt

Matt Kuntz

Executive Director

NAMI Montana

Suicide Motivation and Neural Circuits: Connecting the Studies

by Matt Kuntz

Executive Director
NAMI Montana

Note: I've underlined certain sections of this article to clearly link similar analyses in various research. All of this underlining is my own and a should not be ascribed to the quoted individual.


A University of British Columbia research team just completed a systematic analysis to help understand the motivations to commit suicide. The study, led by UBC PhD candidate Alexis May, was published by Suicide and Life-Threatening Behavior – the official journal of the American Association of Suicidology. (Read the study's official press release here.) The study was based on 120 participants who recently attempted suicide. The results suggest many motivations believed to play important roles in suicide are relatively uncommon. For example, the researchers found that suicide attempts were rarely the result of impulsivity, a cry for help, or an effort to solve a financial or practical problem. Of all motivations for suicide, the two found to be universal in all participants were hopelessness and overwhelming emotional pain.

This study's participants were Canadian outpatients and undergraduate students, but it is important to note that the motivations behind the participants' suicide attempts mirror the findings in a similar study of United States’ soldiers. In that analysis, researchers from the the University of Utah questioned soldiers who had attempted suicide. Out of the 33 reasons the soldiers could use to describe their motivation to committed suicide; all of the soldiers included one in particular — a desire to end intense emotional distress. (Read more about that study here.)

According Dr. Craig Bryan, the coauthor of that study, the soldiers tried "to kill themselves is because they have this intense psychological suffering and pain."

Beyond college students and soldiers, the New York Task Force on Life and the Law (New York Task Force) issued a report in May of 1994 stated that "the common stimulus to suicide is intolerable psychological pain." That report cited Dr. Edwin Shneidman's book, Some Essentials for Suicide and Some Implications for Response, which was published in 1986.

The accumulation of multiple decades of research into populations as varied as college students, soldiers, and people with terminal illnesses seem to generally agree that suicidal thinking and actions are a response to intense psychological pain. As someone with a brain wired to occasionally do battle with that demon, I agree with that analysis.

The unavoidable follow-on question is "What causes psychological pain so intense that suicide appears to be the only option." The New York Task Force provides that, "Contrary to popular opinion, suicide is not usually a reaction to an acute problem or crisis in one's life or even to a terminal illness. Single events do not cause someone to commit suicide."

The Task Force further specified that "Studies that examine the psychological background of individuals who kill themselves show that 95 percent have a diagnosable mental disorder at the time of death" Since serious mental disorders can generally be defined as disruptions in neural circuits, the logical conclusion is that there is something within the neural circuitry of a suicidal person's brain that causes them to experience extremely high levels of emotional pain - beyond the scope of any environmental stressors occurring in their life.

Neuroscientists are working to develop a better understanding of the process behind these deadly neural circuitry disruptions. After examining eighteen different studies, researchers from the University of California San Francisco proposed a tentative neural network for psychological pain that involves the following sections of the brain: the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. (See the abstract of their article in Brain Imaging and Behavior from March 2013 here). The proposed network has significant overlap with the neural network utilized when we experience traditional physical pain.

Take a minute to process that information. The neural circuits that transmit the feeling of physical pain such as a person's hand being on fire are similar to the circuits that transmit feeling of emotional pain. It's not surprising that a disruption in that powerful of a system in the brain would lead to the number one cause of disability in the world, depression, and potentially suicide.

It is hard to pinpoint what causes these neural disruptions and those causes may be different for different people. Genetic susceptibility, emotional trauma, brain injuries, and substance abuse are all potential contributing factors; especially when combined together.

There is no miracle cure for these devastating neural conditions, but recovery is possible through effective treatment and lifestyle changes. Life doesn't have to be a fight for survival.

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If you're experiencing suicidal thoughts and deep psychological pain, please call 1-800-273-8255. If you're worried about a loved one, call that number to learn about what you can do to get them help.

A Written Letter: An Undervalued But Essential Advocacy Tool

Navigating through the mental illness treatment system can be difficult. It can be especially troubling when trying to find care for a loved one who so deeply enmeshed in symptoms that they cannot care for themselves.

With privacy laws and everything else, it’s hard to know who you can even talk to.

Outside of a crisis situation where someone’s life is immediately at risk, the most effective tool to express your about your or your loved ones treatment is also the simplest. Write a letter.

Write the treating clinician a letter describing what you’re worried about, why you’re worried and what you think should be done. If you don’t feel comfortable making specific recommendations, just tell them that you’re worried and ask if the treatment team can review the situation to make sure it’s being handled properly. It’s that simple.

If you don’t receive a response, wait a week or two and then send them another one. And then another one. Make sure to always keep a copy for your records.

Be polite, yet be specific about what you’re worried about and why. Don’t forget to put your name and contact information on the letter.

The same technique also works with city and county attorneys if the situation has become so dire that a 

commitment might be necessary. Or, with institution administrators if your or your loved one is not receiving effective treatment in their facility.

A written letter serves two purposes. The first is to let the person know about the issue. The second to build up a record in case something bad happens. Both of these purposes are important tools to utilize to help you or your loved one get effective care.

To find out more about mental illness, advocacy, and recovery go to www.namimt.org.

p.s. Please share this video with your friends and family to help them understand the power of writing letters in mental illness advocacy.