Major Bipartisan Effort At Montana Legislature to Improve Montana's Mental Illness Treatment System

The Interim Children, Families, Health and Human Services Committee of the Montana Legislature finished up its work yesterday.  One of their main efforts was a study of Montana’s public institutions and how they care for people with serious mental illnesses.  Representative Jenny Eck developed the study proposal based on a NAMI Montana request. 

The Interim Legislative Committee and staff tackled this massive, complex and unavoidable problem.  It was really contentious; but they were able to come up with strong bipartisan solutions to challenges which include a State Hospital that is well over capacity. limited options for transitioning forensic patients back the community, and a dramatic rise in children placed in residential treatment facilities.

Some of the highlights of the bills they developed are:

• Significant investment in community mental health crisis services to help people get treatment in their community and avoid stays at Montana State Hospital and correctional facilities.
• Significant investment in transitioning forensic patients out of Montana State Hospital/Montana State Prison and back in the community.
• Significant investment in developing community crisis services for youth to reduce suicide and reduce the number of children placed in residential treatment facilities.
• The expansion of mobile crisis teams to care for people with co-occurring mental illness and developmental disabilities before they require hospitalization.

These bills offer tangible methods to help Montana families access effective care in their communities to minimize expensive stays at state institutions and residential treatment facilities. They were developed with input from a large number of organizations including: mental health providers, the Resident Council at MSH, Disability Rights Montana, the ACLU, law enforcement, Montana’s County Attorney Association, the Montana Association of Counties, developmental disability advocates, and others.   The specifics of the Committee’s efforts are available at the Committee website.

The members of this committee are: Senator Dave Wanzenried (D) (Chairman), Rep. Ron Ehli (R) (Vice-Chairman), Rep. Carolyn Pease-Lopez (D), Rep. Scott Reichner (R), Rep. Casey Schreiner (D), Senator Terry Murphy (R),  Senator Roger Web  (R), and Senator Jonathan Windy Boy (D).  They each played a critical role in finding ways to improve Montana’s mental illness treatment system. If you’d like to thank them, their contact information is available at this link.

If you’d like to support the Committee’s work, please take few minutes and ask Governor Steve Bullock to support the Interim Children and Family Committee’s efforts to improve Montana’s mental illness treatment system.  You can call the Governor’s office at (406) 444-3111 or send him a message through this link.

Thank you,

Matt

Matt Kuntz

Executive Director

NAMI Montana

www.namimt.org

(406) 443-7871

Please support the fight against mental illness by donating to Montana’s NAMIWalk. You can make a donation at my Walk page. Thanks for supporting this critical cause!

NAMIWalk Team Captain Duties

Are you looking to make a big difference in the fight against mental illness in Montana? Sign up to the be a Team Captain at the 2014 Montana NAMIWalk! It's a great way to take a leadership role in this critical effort.

NAMIWalk Team Captain Duties

• Register to be a Team Captain. You can either register online at www.namimt.org or call 443-7871.  Registering online will allow you to participate in Team Captain contests that award team fundraising and online recruitment.
• Pick a Team Name.
• Set Participation and Fundraising Goals for Your Team.  Each Team should consist of at least five Walkers and each Walker should have a minimum fundraising goal of $100.  Encourage each Walker to set a fundraising goal. 

      GOAL
     – My team will have _____ Walkers
     -  We ill raise $_________  

• Recruit Walkers to your Team.  Recruit as many Walkers as possible to your Walk Team.  Ask them to register and fundraise online as well at www.namimt.org.
• Register all Walkers.  Use the Team Captain & Walker Registration Form to list all Walkers, their contact information, and the amount of checks and cash that they collected. [Do not list online donations on the Team Captain & Walker Registration Form.]
• Raise funds for the Walk.  The most effective way to raise money is through an email or letter writing campaign.  Encourage your Walkers to send out messages or letters to their friends, family, colleagues, etc.  If you would like you may have incentive contests to encourage your Walkers to go the extra mile in their fundraising.
• Team T-Shirt. Team T-Shirts are optional, but they are a great way to build team spirit and let the other teams know who you are. 
• Team Sign. Team signs are optional, but are a fun way to provide visibility on Walk Day. 
• Kick Off Luncheon. Attend the Mary McCue NAMIWalk Kick Off Luncheon at noon on Thursday, August 14th in the basement of St. Mary’s Catholic Church, 1700 Missoula Ave. in Helena.
• Bring Your Team to the Walk. The NAMIWalk will be held on Sunday, September 28th at Memorial Park in Helena, Montana.  Registration begins at 11:00 a.m and the program starts at 12:30 p.m.  Team Captains must be there by noon.
• Turn in Your Donations.  Turn the large NAMIWalks envelope into the Registration Desk.  Each large envelope should include: (1) a completed Team Captain & Walker Registration Form, (2) a Walker Donation Form for each Walker (including yourself), and (3) each Walker’s small envelopes containing all checks and cash that they collected.  Please contact NAMI Montana at (406) 443-7871 or info@namimt.org if you need additional forms or envelopes.
• Have Fun.  The NAMIWalk is a great chance for you and your Walkers to have a great time while raising funds for NAMI Montana’s critical mission of supporting, educating, and advocating for Montanans suffering from severe mental illness and their family members.

Neuroscience in the Courtroom: Daubert, Frye, General Acceptance, and Replication Studies

by Matt Kuntz, JD - NAMI Montana's Executive Director

I was fortunate enough to spend a few days with some of the nation's most innovative neuroscientists, psychiatrists, psychologist, and medical researchers as part of the founding of the new Center for Mental Health Research and Recovery at Montana State University. It was a powerful event that left me with a pragmatic hope for long-term improvements in the process of mental illness diagnostic and treatment. While the field is not changing fast enough for some of us, it is changing.

One of the avenues to that change will likely be the effective use of biological indicators of brain conditions in the courtroom. However, this avenue has had a rough start as court's have struggled to evolve their usual evidentiary standards to the dynamic, yet still developing world of brain scans, genetics and blood tests. It's hard for anyone, much less someone outside of the medical profession, to determine what kind of neuroscience evidence should be admitted and what kind of evidence is not ready for prime time.

According the researchers I met with and the general opinion of other in the field, most of that evidence is not ready to be introduced into court. (Brain Scans, Blood Tests). However, we are moving in that direction and approaching the kind of quandary that the discussed in Frye v. United States, 293 F. 1013 (D.C. Cir. 1923):

              Just when a scientific principle or discovery crosses the line

              between the experimental and demonstrable stages is 

              difficult to define. Somewhere in this twilight zone the 

              evidential force of the principle must be recognized, and 

              while the courts will go a long way in admitting experimental 

              testimony deduced from a well-recognized scientific principle 

              or discovery, the thing from which the deduction is made must

              be sufficiently established to have gained general acceptance

              in the particular field in which it belongs. [emphasis added]

Frye's strong "general acceptance" test has given way in many courts to the standard described in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993). Under this standard, the factors that may be considered in determining whether the methodology should be admissable valid are: (1) whether the theory or technique in question can be and has been tested; (2) whether it has been subjected to peer review and publication; (3) its known or potential error rate; (4) the existence and maintenance of standards controlling its operation; and (5) whether it has attracted widespread acceptance within a relevant scientific community.

It's understandable that courts are getting lost when applying this standard to the rapidly evolving field of neuroscience and combining prongs (2) and (5). However, publication in a peer-reviewed journal does not equate to widespread acceptance within a relevant scientific community. Further, evidence of low statistical significance in many neuroscience studies suggests that prong (5) is as important as ever to ascertaining scientific validity. 

I poised the question to these leading researchers about what could act as a concrete factor to demonstrate widespread acceptance within the neuroscience/psychological/psychiatric community and the answer was immediate - an independent replication study published in a peer-reviewed journal.

This answer is supported by a staff article in the American Psychological Association Monitor which stated, 

"In psychology, as in other sciences, replication is the gold standard. In theory, new knowledge doesn't make it into the canon until the studies that produced it have been verified, independently, by more than one researcher. But in practice, critics say the field rarely lives up to that ideal — and the result is a psychological literature rife with findings that may or may not be true, yet are generally accepted as valid."

The adoption of this "gold standard" to Daubert's "widespread acceptance" prong would allow courts to utilize a clear standard to determine when brain biomarkers should be admitted into court. This standard is based upon the actual findings of the relevant scientific community, not the judge's estimate of the acceptance of the scientific community.

A Modified Daubert Standard for the Introduction of Brain Biomarker Evidence in the Courtroom

Under this standard, the factors that may be considered in determining whether the methodology should be admissable valid are: (1) whether the theory or technique in question can be and has been tested; (2) whether it has been subjected to peer review and publication; (3) its known or potential error rate; (4) the existence and maintenance of standards controlling its operation; and (5) whether it has been replicated by an independent research team with their results subjected to peer review and publication.

As an attorney who advocates for people who live with serious mental illness and their families, I'm convinced that the addition of valid neuroscience evidence in the courtroom will be a major addition to both the justice system and the overall fight to effectively diagnose/treat these conditions. However, the science has to be proven and accepted by the field.

Unproven brain scans and and genetic tests do not serve either the interests of justice or the people that depend on the mental illness treatment system.

Angry and Tired

I am angry and I am tired. In a four day span this week in Helena this week, two of our young citizens (Ages 50 & 52) lost their lives due to the consequences of serious mental illnesses. One was a Son and a Father whose family will wonder every day for the rest of their lives what they could have done to prevent to prevent this tragedy. The other was a former neighbor, who in his teenage years, was a babysitter for my two sons. Many people do not realize that people living with serious mental illnesses have a life span 25 years shorter than those of us who are diagnosed as “normal.” Premature death can be due to accidents and suicides, but the adverse effects of psychiatric medications, while lifesaving, can result in obesity, diabetes and heart disease. It is a little known fact that people living with serious mental illnesses use tobacco to alleviate the symptoms of their illnesses. In fact, 44% of the people who use tobacco are the 6% of the population who suffer from serious mental illnesses.

Mental illnesses cannot be cured at this time. They are however very treatable if people can access appropriate treatment. Many people do not know that appropriate therapy and medication can alleviate the symptoms, but no treatment eliminates the symptoms. Mary Giliberti, J.D., Executive Director for the National Alliance on Mental Illness has said, “The reality is that the current treatments available for serious mental illnesses such as schizophrenia and bipolar disorder are palliative interventions, not curative. At their most optimal and effective use, they are able to improve functioning and allow some to experience recovery and community integration. For major mental illnesses, we are still waiting for discreet novel interventions that genuinely change the course on the illness and avoid lifelong disability and impairment. This includes the development of a new third generation of antipsychotic medications to treat psychotic disorders.”

I am angry that I live in a world that does not recognize serious illness as a legitimate disease. I am angry that people in a psychiatric crisis cannot access respectful, thoughtful, compassionate and caring treatment. I am angry that our jails and prisons are overwhelmed with people suffering from serious mental illnesses. I am angry that there are more offenders in the Montana State Prison receiving psychiatric medications than there are patients in the Montana State Hospital. I am angry at our elected officials, public health servants and mental health professionals who tell me that they understand, but very little changes or improves. I am angry at families who, because of stigma, shame and discrimination do not recognize mental illness or advocate for their family members. I am angry at people who live with serious mental illnesses who, because of stigma, shame and discrimination do not access available treatment.

Finally, I am tired of attending funerals for the children of families who have been lost due to serious mental illnesses. Remember, the enemy is the illness.

Dr. Gary Mihelish

President

NAMI Helena
618 Edgerton Road
Helena, MT 59602

Sticking With Your Treatment Plan

Part Seven of Debra Hoppe's Recovery Series

The question of whether a person needs medication to help control their mental illness and what kind of medication should be used is extremely complicated. It’s important to work with a psychiatrist or psychiatric nurse that you trust to help you through this difficult process. Don’t expect results right away. Every person is different, so it will probably take a little while to fight out what works for you.

I can’t stress how important it is to stick to your treatment plan. I have bipolar disorder and have a hard time functioning if I don’t stick with my treatment plan. For instance, I once wound up in an inpatient behavioral health unit during an episode that began when I forgot to take my evening medication.

It’s also important to stick to your treatment plan, because it helps your psychiatrist to know how to treat your symptoms and helps you to know what to tell the doctor when they do examine you. All medications need to be monitored for their effectiveness and for side effects as well as the dosage and cycling of your disorder.

It’s also important to work with a licensed therapist to help you with daily skills and determining symptom cycles or patterns. Since I have been taking my meds properly I haven’t cycled in a month which is an improvement for me.

I take my medication the correct way and work with my therapist. I get the rest I need and watch what I eat. I also exercise on a regular basis. All these add up to a healthier me.

Thank you for continuing on with your treatment plan and next time we’ll be discussing how to keep busy. Take care and may God bless you richly.

Don't Give Up

By Debra Hoppe

Part Six

Giving up is a normal instinct that a person has so it is a struggle to do. I know that I am a strong person and have a will that is solid. I try to think of the positive aspect of life and carry on. I have lived through two comas and have been able to tell people about them so I can say I haven’t given up.

A person has to set goals in their life and stick to them. Goals are hard to accomplish but that is one of the reasons you don’t want to give up. Another reason is that it only hurts you and the people around you. I know it is hard but when the chips are down I just pick myself up and dust myself off and get with the program. It will be beneficial for all concerned if a person sticks it out and completes the goal at hand.

Another reason to not give up is your self esteem. Your self esteem is one of the main things a person has that carries them through in life. If a person is having a bad day with their self esteem try looking at yourself through the eyes of another person and see what you come up with. You might be surprised with what you see.

Self esteem is important to all concerned because it affects not only you but the people around you. I have a high opinion of myself. I guess that is why I haven’t given up. I have a family that is proud of me and a boss that is happy with what I am doing. That is all that matters right now so I manage to make the best out of every situation that comes my way.

I want to thank you for taking the time to read what I have to say and I hope that I have been an inspiration to you. Take care of yourself and please don’t give up. It is important to stick with it and you will be a better person for it. Next time I will be talking about sticking to treatment.

Gary Mihelish Receives NAMI's National "Distinguished Service" Award and is Elected to the National Board

NAMI Montana is incredibly happy to announce that Dr. Gary Mihelish received NAMI's national "Distinguished Service Award" for 2013. This is NAMI's highest award. Past recipients of the Distinguished Service Award include Congressman Patrick Kennedy and Dr. Joyce Burland. Dr. Mihelish is a longtime leader of both NAMI Helena and NAMI Montana. He helped lead the charge for mental health parity in the Montana legislature and has been a teacher of Family-to-Family with his wife Sandra for over a decade. Dr. Mihelish has also been a means of support and information for desperate families across Montana that didn't have anywhere else to turn.

Dr. Mihelish was also elected to NAMI's national Board of Directors. This will allow him to bring his passionate service for people who live with mental illness and their families to a nationwide platform. This is a critical time for mental illness advocacy in America and we are extremely happy that Dr. Mihelish will be helping lead the fight.

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.

***   ***

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.

Joining a Support Group

By Debra Hoppe

This is part five of the recovery plan. To join a group means that you are serious about your recovery plan. You are willing to take that step toward a better you. I myself have been in groups since I was 14 years old. In and out of psychiatric hospitals since that time so I know a few things about group settings.

The one that helped me the most was the one in Amarillo, Texas when I was just a kid. I learned that I could accomplish anything I set my mind toward without anyone laughing at me or pointing a finger at me. I have since learned that people are cruel and do laugh at you but that is because they don’t understand what you are going through and don’t take into consideration the feelings you may be experiencing. Remember, people with mental illnesses are people too and deserve to be treated the same way as people that don’t suffer from a mental illness. The stigma that is so prevalent out there needs to be broken and we are the only ones that can do that. That is why a group setting is so important. It will teach you how to overcome stigma and join in the fight against people that want to look at you as disabled.

I have a certification to mentor a gathering called Peer to Peer. It is a nine week course that teaches a person how to deal with their disorders be it bipolar disorder, schizophrenia or major depression. It is a peer run course that is a very comfortable setting and I enjoyed mentoring a group of 7 people. It taught me how to not be only an inspiration to myself but to others as well. I learned a great deal about myself and the whole group. If you ever have the opportunity to experience a Peer to Peer course then please don’t hesitate. You will find the experience to be utterly refreshing.

I also have a certification in In Our Own Voice which gives me the opportunity to tell my personal story. It is an hour and a half long group that deals with my feelings all the way back to when I was a child to present day. I tell about how I was put into a mental facility and how I survived two comas all in the 52 years I have lived. I can tell you some happy and sad times of my life but the main thing is that I am not letting my disorder pull me down. I am making a difference in people’s lives as well as people making a difference in mine. I hope I have made a difference in yours.

Until next time when we will be studying how not to give up in your everyday life and how to keep fighting for what you believe in. Thank you for your time and I will see you next time. Take care and God bless.

"Of Two Minds" will be Making Its Montana Premiere on April 24th

On April 24th, the movie "Of Two Minds" will be making its Montana premiere at 7:00 pm in the Carroll College Cube at 7:00 pm. The movie examines the experiences of bipolar disorder through firsthand testimony from people living and coping with it.

Lisa Klien, the co-director, writer, and producer will present the film and be available for questions after the showing. Don't miss it

Watch the movie's trailer now!

 



OF TWO MINDS Official Trailer from Douglas Blush on Vimeo.

Please Take Five Minutes to Help Insure Montana's Working Poor

NAMI Montana friends and supporters,

After a lot of back and forth, the Montana Senate passed a bipartisan compromise bill (House Bill 623) to provide a private health insurance option for the working poor who cannot afford health insurance. It was an amendment onto Representative Liz Bangerter’s earlier bill. Republican Senator Ed Buttrey of Great Falls says the proposal the proposal does not expand Medicaid, but rather simply would use the expanded federal Medicaid money starting next year to buy health insurance for thousands of Montanans earning less than 138 percent of the federal poverty level — about $15,400 for a single person.

Here's an article that describes the compromise bill in-depth.

This bipartisan bill will allow Montanans to take advantage of the federal government’s investment in healthcare for the working poor without increasing the state’s long-term investment in Medicaid. Please take a moment to contact Representative Bangerter asking her to approve the amendment to House Bill 623.

Representative Bangerter is in an interesting spot because this was not her original intention for the bill. She is going to need to hear from her constituents and people from across Montana about why this is a good idea. Representative Bangerter is a great person with a huge heart. She’ll really appreciate hearing your thoughts.


Thank you,

matt

UPDATE: Representative Bangerter voted for the bill, but unfortunately it still died on the House floor. Here is a link to an article about the vote.  It's a sad day for Montanans who cannot afford health insurance, but we're truly thankful to legislators like Representative Liz Bangerter who are willing to cross party lines to do the right thing.




Matt Kuntz
Executive Director
NAMI Montana
www.namimt.org

(406) 443-7871

Please “Like” our NAMI Montana facebook page, www.facebook.com/namimontana, to stay involved with the fight against mental illness in Montana.

Please Support SB 11: Mental Illness and Criminal Justice System

Senator Mary Caferro’s Senate Bill 11 to make Montana’s criminal justice system deal more effectively with offenders with mental illness is in front of the Senate Public Health, Welfare and Safety Committee on Friday, January 11^th at 3:00 PM in Room 317 at the Capitol.  Please contact the Committee and individual legislators either online or by telephone before that meeting to let them know you support Senate Bill 11.  (I’ve included a description of what the bill does below my signature.)

Here is a link to the bill, but we did pull out Sections 5-7 in order to gain the support of the LCPCs and Social Workers. There will also be an amendment to make it clear that Guilty But Mentally Ill parolees who have their parole revoked will be directed into the exact same process of being committed to the head of DPHHS as when they were convicted without any additional placement requirements.

 Here are the legislators on that Committee: Jason Priest, Terry Murphy, Mary Caferro, Greg Jergeson, Fred Thomas, Dave Wanzenried, and Art Wittich.

Online: You can leave a message for the Committee or individual legislators with the online message form at this link. http://leg.mt.gov/css/Sessions/63rd/legwebmessage.asp

By telephone: The Legislative Information Desk’s regular office hours during the session are 7:30 a.m. to 5 p.m. weekdays and 8 a.m. to adjournment on Saturdays. Callers may leave messages for legislators or acquire general legislative information by calling the Information Desk at (406) 444-4800. Callers may leave messages for up to 5 individual legislators or 1 legislative committee per call.

Please share this email message with anyone who you think might be interested in helping reform Montana’s criminal justice system.

Thank you,

Matt Kuntz

Executive Director

NAMI Montana

www.namimt.org

(406) 443-7871

Please Support Senate Bill 11

Senate Bill 11 is sponsored by Senator Mary Caferro. The bill revises the parole and probation system to work more effectively for offenders that have a serious mental illness. The bill’s main focus is on prisoners who have been convicted as Guilty but Mentally Ill and sentenced to the custody of the Department of Public Health and Human Services. This is only roughly 1% of the Correction population, but the reason for their unlawful actions are different than other prisoners, so their release dates and the supervision requirements should reflect that difference. It is critically important make this system as effective as possible for public safety, the impact on the offender’s lives, and the significant costs to the State of Montana of both keeping offenders in institutions longer than necessary and having them repeatedly return to the institution.

The Bill also provides for overall training and Parole Board requirements that will help the Corrections system deal with all prisoners with mental illness.

·         The main function of the bill will be to make it clear that offenders committed to the Department of Public Health and Human Services can utilize supervised mental health treatment programs in order to help them qualify for parole. MCA 46-23-101(6)

·         The bill will help get offenders who are deemed ready of the of the expensive institutions and back in the communities in supervised programs that will ensure the offenders continue treating the mental illness symptoms that made them dangerous. MCA 46-23-101(6). The current system of paroling these inmates has a 60% recidivism rate.

·         This bill will make the parole standard for offenders who are deemed Guilty But Mentally Ill solely depend on their ability to be safe in the community through participation in a supervised mental illness treatment system, by excluding them from the broad requirement that offenders must serve a quarter of their sentence before being eligible for parole.

·         This bill will mandate mental illness training for the Parole Board, probation, and parole officers. It will also require two members of the Parole Board to be mental health providers.

·         This bill will make it clear that an offender may have a mental illness and another co-occurring brain conditions such as developmental disabilities and substance abuse conditions. 

Beyond Firing Rates and Magazine Sizes

America is in horror again over another mass shooting.  The twenty-four hour news channels know the drill. This time it was Newtown, Connecticut; before that, tragedy struck Aurora, Colorado; before that, Tucson and Virginia Tech. Examples go back to the University of Texas sniper in 1966 and beyond. With each event, our nation ponders why did this happen and what could we do to prevent future attacks.

This tragedy has sparked a strong conversation about gun control, but it is important to note that any proposed regulation would likely focus on limiting how fast guns can legally fire and how many bullets can be held in a magazine. If successful, these restrictions would decrease the number of casualties in mass shootings; not prevent the shootings from happening. Gun rights proponents recommend the converse – arm more people to fire back at shooters. Security is important and it is worth considering more school resource officers and other options. But again, this is a reactive strategy meant to limit the scope of the violence.


As someone who works with people who live with mental illness and their families, I hope that our nation can look at the broader solution – not the politically easy answer. People who live with mental illness are more likely to be victims of violence than to commit violent acts, but it is also a reality that serious mental illness is linked to some of the nation’s worst acts of violence. The tragedy does not stop there. Untreated mental illness also leads to suicide, homelessness, broken families, and a variety of other criminal acts. Dr. Thomas Insel of the National Institute of Mental Health conservatively estimates that total direct and indirect annual costs of mental illness at well over $300 billion.


The only way to truly prevent these tragedies, not just to the scope of the tragedies, is to focus on the mental illnesses at their root. The current process of diagnosing these brain conditions based upon subjective tests and symptom clusters is simply not good enough. It is common practice for a person exhibiting signs of serious mental illness to receive different diagnoses and treatment recommendations from different treatment professionals.  


Our society knows that this is a problem. We blame doctors, psychologists, drug companies, individuals affected by these conditions and their families. But in reality this is a medical technology problem that our country must solve. We must develop methods of diagnosing these brain conditions that are specific and precise. Methods based upon the actual biology and circuitry of the brain – not just clusters of symptoms.  Methods capable of detecting brain conditions well before the person begins experiencing potentially dangerous delusions and hallucinations. Methods capable of guiding treatment decisions.


White House spokesman Jay Carney correctly stated that “no single piece of legislation, no single action will fully address the problem” of mass violence. But the federal government can and must focus resources on the task of developing effective biologically-based diagnostic procedures for serious mental illnesses. There is promising research in blood testing, brain scans, and other screening technology; but our nation does not have a concerted and well-funded effort to move this research beyond the lab and into the hands of clinicians and the desperate families they serve.


America cannot afford to wait for someone else to solve this medical technology problem. As we were reminded again in Newtown, there is simply too much at stake. It’s time for the President and Congress to step up to the challenge. The results will not be quick or easily implemented. It might take five or ten years, but eventually it will lead to a safer America.


Please sign this online petition to tell the White House that it is time to find a better way to identify and treat serious mental illnesses. 
https://petitions.whitehouse.gov/petition/launch-coordinated-national-effort-identify-biological-markers-serious-mental-illness-fight-these/6z4w0zvV


Thank you,


Matt Kuntz
Executive Director
NAMI Montana

Using Online Recovery Resources

By Debra Hoppe

Online resources can be incredibly valuable for your recovery.  There are many websites to look at one being www.namimt.org.  There are several ideas and links that instruct you on how to succeed with your recovery plan.  That is what this series is all about recovery.

Another site is DBT Self Help.  There you will find a vast amount of information that shows you how to use your coping skills and interpret your mindfulness exercises both which are helpful tools in ones recovery plan.

My coping skills happen to be deep breathing and taking a walk.  Also reading and exercising.  They get the endorphins going and that makes me happy which is a stress reducer.  Also listening to music and watching my favorite symphony band play in the park.  They both calm me down and help me to function better.

Since I have bipolar disorder, I access www.bipolar2.com.  It brings up several sites about bipolar and what to expect from having this disorder.  I find that the more you know the better you can deal with the problem at hand.  That is why I stress so much on the recovery plan and what to do to help a person overcome their struggles.  I am struggling with my disorder so I figure I am not alone in this matter.  I just hope that I can help one person and that person helps one person and so on.  I am not an expert, but I do know that I have to tell my story to someone and what better way to do that is by directing them to the things that work for me.

Another site that I have found helpful is www.brainyquotes.com.  There you will find the quote of the day that helps a person with depression.  I find that it helps just about everyone.  It helps me to go hmmmm.  I think about the meaning of them and come up with my own conclusion.  It makes me think about how wonderful this society is to make such a simple website as this that has such an impact on my life.  What a great way to spend just a few moments of your time.

Once again, thank you for your time and I hope you are enjoying this series as much as I am enjoying writing it.  If I can help you in anyway then my goal in life has been a success.  I do have many other goals so my mission is not complete but at least I can say I have done my best at least once in my life.  Thanks again and stay tuned for the 5^th part of the series on joining a group.  

What online resources do you take advantage of in your recovery.

A Peek at the Future: Mental Illness Early Detection and Prevention

by Matt Kuntz

Note: This story is a fun look at what mental illness detection and prevention might be like in the future. None of the screening methods described in the story are up and running yet, but they are all based on actual research in the field. Check the links at the end to find out more.

Timmy dribbled the basketball down the court, ten steps behind another dribbling student. The student did a right handed layup into the basketball hoop. A few seconds later, Timmy’s ball bounced off the rim and fell through the net.

It was basketball week at sixth grade gym class. The P.E. teacher drilled them on the fundamentals for the first three days before the next two days of games.

“Timmy Johnson!” a female voice hollered from a door on the other side of the gym.

A female student ran away from the school nurse and Jimmy ran towards her.

“Hi Mrs. Woolridge,” Timmy said.

“Hi Timmy,” she replied. “I’ve just got a few quick tests for you. All of our students have to take them during their sixth grade year.”

“Mr. Cory told us all about it.”

“Great, it’ll just take a few minutes. Start by sitting down and putting on a headset and glasses.”

Timmy took a seat then slipped on the Electroencephalography (EEG) headset and the dark glasses.

Mrs. Woolridge looked at the screen in front of her to make sure the EEG sensors on the headset had a clear read of Timmy’s brain waves.  She turned the system on. “Do you see the blue dot?”

“Yes.”

“Good. All you have to do follow that dot with your eyes.  When it moves left, you look left. Got it.”

“Yes.”

After completing the eye movement test, Timmy stood in front of a screen and copied the movements of a little cartoon boy. The cartoon boy raised his left foot. Timmy raised his left foot.  The cartoon boy rotated his arms in circles. Timmy rotated his arms in circles. A motion sensor instantly recorded and analyzed Timmy’s gross motor skills.

Then Timmy moved over to the table in front of a small black computer that measured fine motor skills.  The computer timed Timmy while he rotated a round sensor between each of his fingers. After finishing that test, Timmy had to trace a line through a circular maze on the computer as fast as possible without touching the borders of the maze. Finally, he tapped the screen each time a purple frog appeared. The purple frogs started appearing slow, then they sped up. Timmy’s hand moved across the screen tapping frogs wherever they appeared.

After running through the frog test three times, Mrs. Woolridge let Timmy go back to class.

One week later, Timmy and his parents sat in chairs in Mrs. Woolridge’s office.

“First of all, I want to let you know that this isn’t something that should scare you. Timmy did come up on one of our health screening tests as vulnerable to serious mental illness, but there’s no reason to be frightened.

Timmy’s mother put her hand on Timmy’s father’s knee. “Stan’s mother had schizophrenia. He died from suicide when Stan was just a boy.”

Mrs. Woolridge nodded, “We have a lot of families with mental illness susceptibility. With a little prevention, there’s no reason to worry.”

Mrs. Woolridge handed each of them a piece of paper. “I screened Timmy’s eye movements, skin conductance, gross motor skills, and fine motor skills last week.  His eye movement and gross motor skills were fine, but Timmy’s skin conductance was a little low and had some difficulty with his fine motor skills.”

“Stupid frogs,” Timmy grumbled.

“Stupid frogs,” Mrs. Woolridge agree with a wink.

Mrs. Woolridge continued, “Mental illnesses are basically disruptions in neural circuits in the brain. If you think of the brain as a big set of wires with information passing through them, sometimes things go wrong with the wires. Those disruptions affect how people, think, feel and act. They also affect overall nervous system through the basal ganglia and other areas.”

“The basal what?” Timmy’s father asked.

“The basal ganglia. It’s a group of nerves in the center of the brain. You’ll see that it’s highlighted in red on your picture. When something affects the basal ganglia, it can impact a person’s ability to control their muscles. So basically we test the students eye movements, galvanic skin response, major body movements and delicate finger movements as a way of checking the function of the basal ganglia.

“So problems with fine motor skills mean somethings wrong with the basal ganglia?” Timmy’s mother asked.

“Not for sure,” Mrs. Woolridge responded, “But it is an indicator that something may be going on. Same thing with the galvanic skin conductance. After Timmy’s failed the fine motor portion of that exam, we ran some of his blood that you deposited with the school health center at the beginning of the year through a genetic scan for mental illness susceptibility.

“Not surprising that it turned something up,” Timmy’s mother said.  “I’ve also got depression and anxiety issues on my side.”

“So I have mental illness?” Timmy asked.

“Not full blown mental illness, but maybe the beginning stages. We can’t say that for sure Timmy without a full brain scan. You could run one of those, but it’s not necessary. The medical field is pretty hesitant in scanning young brains.  There’s a lot of radiation in a scan so we try to avoid them if possible.”

“So what can we do?” Timmy’s father asked.

Mrs. Woolridge pointed to the sheet. “We’re basically trying to prevent any potential neural disruptions into expanding into a major brain disruption event - psychosis. Some of the ways to avoid that are pretty simple. You can start off by eating well, taking Omega 3 vitamins, exercising and keeping regular sleep patterns. Oh, and don’t do any recreational drugs. Seriously, anything that messes around with the brain to make a person feel high could be really, really dangerous for you. That includes marijuana.”

“We’ll pick up some Omega 3 vitamins on the way home,” Timmy’s mother said.  “The rest of it shouldn’t be a problem.  Timmy’s a good kid, but we’ll keep an eye on him.”

“I will too,” Mrs. Wooldridge said with a smile. “Timmy, I’ve got a present for you.”

“A present?”

Mrs. Woolridge pulled a box out from under her chair. The box had a picture of a boy wearing a headset while looking at a small handheld video game tablet. “It’s a fun way to make sure that you’re brain is doing okay. It’s got one of the EEG headsets that you used when you put on the goggles and followed the dot. Basically, you just put on the headset, breath in the holes on the side of the machine, play the video game, then breath in the holes in the side of the machine again.”

“What kind of games do you have,” Timmy asked.

“They’re fun,” Mrs. Woolridge promised. “Way more fun than the dot and frog tests. It’s basic cognitive training along with some relaxation through mindfulness and neurofeedback.”

“How often does he have to use it?” Mrs. Johnson asked.

“We’ll start out with just twice a week, maybe Monday and Thursday. If he’s doing well, then we’ll drop it down to once. If things aren’t going well, then we’ll boost it up to three times. The exercises are great for the brain even if you don’t have a susceptibility to mental illness.”

“What do you mean if I’m doing well?” Timmy asked.

“The machine will automatically report back to me on your galvanic skin response, brain waves, stress hormone levels and cognitive skills. It’ll wave the flag if there’s excess anxiety, depression, or other dramatic changes in thought processes. We’ll increase the frequency of the exercises if either of those variable suggests we need to.  If things really get out of line, I’ll recommend a therapist for relaxation and communication skills training. If the neurons are still struggling to talk with each other, then you’ll have to go to a psychiatrist to take a closer look at what’s going on and maybe even prescribe something.”

“Prescribe something? I remember my mother’s medication had some pretty horrible side effects,” Mr. Johnson said.

“There probably won’t be any need for medication.” Mrs. Woolridge said. “But in the worse case, the medication that they give before psychosis now doesn’t have anywhere near the same side effects as the old ones. The ingredients in one of them, that focuses on the neurotransmitter glutamate were even sold over the counter to treat people that had taken too much aspirin.”

“Thank God,” Mr. Johnson said.

Timmy wasn’t listening anymore. He already had the box half open. “This looks awesome,” he mumbled.

End Notes

Eye Movement - http://www.iovs.org/content/28/2/366.full.pdf

Motor Proficiency in Children with Psychosis - http://ptjournal.apta.org/content/63/2/194.full.pdf

EEG Symmetry Patterns Predicting Anxiety and Depression - http://www.ncbi.nlm.nih.gov/pubmed/16223557

Basal Ganglia - http://en.wikipedia.org/wiki/Basal_ganglia

Prospective Biomarker for Schizophrenia - http://psychcentral.com/news/2012/03/29/prospective-biomarker-for-schizophrenia/36687.html

Using Biomakers to Identify and Treat Schizophrenia - http://www.sciencedaily.com/releases/2012/07/120711134557.htm

Cortisol levels Increased in Youth with Psychosis - http://www.medwire-news.md/47/101079/Psychiatry/Cortisol_levels_increased_in_youth_at_high_risk_for_psychosis_.html

Attention, Memory and Motor Skills as Childhood Indicators of Risk of Schizophrenia - http://ajp.psychiatryonline.org/article.aspx?articleID=174316


Palau Early Psychosis Study: Neurocognitive Functioning in High Risk Adolescents - http://www.ncbi.nlm.nih.gov/pubmed/17005375

Neurocognition in Early On-Set Schizophrenia and Schizoaffective Disorders - http://www.ncbi.nlm.nih.gov/pubmed/20215926

Electrodermal Predictors of Functional Outcome and Negative Symptoms in Schizophrenia - http://www.ncbi.nlm.nih.gov/pubmed/16008777

Distinguishing Youths At Risk for Anxiety Disorders From Self-Reported BIS Sensitivity and its Psychopsysiological Concomitants - http://www.ncbi.nlm.nih.gov/pubmed/23016527

Effects of Stress, Depression, and Their Interaction on Heart Rate, Skin Conductance, Finger Temperature, and Respiratory Rate: Sympathetic-Parasympathetic Hypothesis of Stress and Depression - http://www.ncbi.nlm.nih.gov/pubmed/21905026

Glutamate, Shizophrenia and other CNS Disorders - http://www.promentispharma.com/technology/Glutamate/index.html