2005 april may.qxd
Caring and Sharing
NAMI Valley of the Sun
Vol. 15, No. 2 Families and Friends Affected by Mental Il ness June - Aug 2014
Mercy Maricopa Integrated Care takes over as RBHA
Mercy Maricopa Press Release
On April 1, Mercy Maricopa launched the state's
newest Regional Behavioral Health Authority (RBHA),
and one of the nation's largest public integrated
Additional events are in the planning stages, so be
behavioral health systems. Arizona is leading a national sure to fol ow us on Facebook and Twit er (@Mercy-
movement toward integrating physical and behavioral Maricopa). You can also reach our communications
health care, backed by a mountain of research that director, Mary K. Reinhart, at
confirms the benefits of treating mind and body together. or community relations director Alex Zavala, at
Now entering the third month of operations, the if you have an event or
RBHA is eager to hear from NAMI members and others story you'd like to share.
about how things are going. What's working and where
Mercy Maricopa's quarterly member newslet er can
can we improve? What ideas do you have for involving be found inside the Together AZ newspaper. Look for our
the community and making sure everyone's voices are first newslet er to arrive in the July edition, which wil be
heard? How can we get the word out about events and distributed, as usual, at Val ey clinics, provider offices,
other happenings in the Phoenix metro area?
peer-run organizations, advocacy agencies, state offices
To that end, we've been holding a series of and other places that people gather.
community forums at clinics and peer-run organizations
Mercy Maricopa also wil be hosting a series of Youth
around the Val ey, and we've been grateful to have NAMI Mental Health First Aid trainings. You can learn more at
in at endance to distribute information.
Higher Doses of Antidepressants; Higher Suicide Risk
commercial names as Zoloft, Paxil, Prozac, Celexa and
Lexapro -- the study suggests one additional suicide
About a decade after the Food and Drug Adminis- would be at empted.
tration first warned that antidepressant medications
Given that antidepressants appear to be less effective
increase the risk of suicidal thoughts and behaviors in in young people than in older patients, and that higher
children, new research has found that kids and young doses do not appear to bring more or faster relief, the
adults who start on high doses of antidepressants are at author of an invited commentary in Journal of the
especial y high risk, especial y in the first three months Americal Medical Association Internal Medicine
of treatment.
suggested that prescribing physicians should abide by
Among patients 24 and younger, those who started the wel -worn maxim "start low, go slow," and monitor
treatment for depression or anxiety with a higher-than- patients closely during their first several months of
usual dose of selective serotonin reuptake inhibitor treatment.
(SSRI) were more than twice as likely to harm them-
On the other hand, it might also be that those started
selves intentional y than those whose treatment began at on high-dose SSRIs are more likely to discontinue their
the customary dose and increased slowly, the study therapy and to suffer from discontinuation syndrome,
which can bring physical symptoms of anxiety and is
For every 150 such patients treated with high initial sometimes linked to unpredictable behavior.
doses of SSRIs -- antidepressants marketed under such
Digital Games Help with Anxiety & Depression
gamelike elements will make its
PTSDCoach app, released in 2011, more
Digital games are gaining notice effective for veterans with post-traumatic
Val ey of the Sun
from some researchers who think they're stress disorder.
NAMI Val ey of the Sun
a novel way to address mental health
It might seem surprising that digital
10810 N. Tatum Blvd.
issues like depression and anxiety. The games are being investigated to treat
game, SuperBetter, is currently the serious mental conditions. But "gamifi-
subject of two scientific trials, including cation" tools like SuperBetter and
Phoenix, AZ 85028
a National Institutes of Health-funded Personal Zen can increase access to
experiment that wil begin this summer. mental health treatment, says Carol
A paper by the creator of Personal Zen, Landau, a professor of psychiatry at the
published in the March edition of Alpert Medical School at Brown Univer-
Clinical Psychological Science, shows sity, who specializes in depression
Jodi Peary, President
the mobile game can decrease anxiety in treatment. "But here's the caveat:
Craig Sparrazza, Vice-President
some users after 25 minutes of use.
Belinda Escalante , Secretary
The Department of Veterans Affairs psychotherapy."
Bev Carling, Treasurer
is internally testing whether more
Members of the Board:
New Support
Group Facilitators
Tad D. GaryJessie Libfeld
NAMI Val ey of the
Sun congratulates
our newest trained
Elyce Yunowich Helen Bradford
Printing & Mailing:
Terry Odhner, Carol Cronlund &
Emergencies, cal 911.
24-hour crisis line, cal 602.222.9444
(Maricopa Crisis Recovery Network)
Want to learn more
For support groups, education classes, special events,
volunteering, membership inquiries contact
NAMI Val ey of the Sun: 602.374.7439 -
Click on the by-lines of
the article or other links
Caring and Sharing is published every 3 months.
this newslet er.
NAMI represents families and friends affected by serious
You can sign up for an e-mail subscription to the
mental il nesses. NAMI Val ey of the Sun is an affiliate of
Caring and Sharing newslet er. You do not have to
NAMI (National Al iance on Mental Il ness) and NAMI
Arizona (the Arizona Al iance on Mental Il ness). NAMI is a
be a NAMI member for this free service.
grassroots, self-help, support, education, research and
E-mail your request to:
advocacy organization dedicated to improving the lives of
adults and children with severe brain disorders.
Caring and Sharing
June 2014
Maricopa County Education Coordinator's Corner
by Debbie Martinez
conducted by Helen Bradford and Marie Martin. The
twelve participants learned so much about facilitating a
support group, and as a result of this training, we have
Education and Family
started four new support groups in different parts of the
Support programs has had
Val ey. The new groups have started in the fol owing
an incredible start since
areas; downtown Phoenix, Mesa, Tempe and Anthem.
January 2014. The year
Please look at our calendar listing for days and times these
began with two Family-to-
groups meet if you are interested in at ending one of them.
Family classes, one in
In late April, Denise Alvarez and Susan Junck
Scottsdale, at Mountain-
conducted a Family-to-Family teacher training. We had a
view Presbyterian Church, a
group of very enthusiastic and dedicated people who want
constant supporter of NAMI
to be able to help their communities by providing the
Programs, and one in Chandler at the Chandler Police Family-to-Family class. The new teachers wil be able to
Department. In the past, we've always experienced some serve the West Val ey, the Southeast Val ey, the East
chal enges in securing a facility to use in the Chandler Val ey, Northeast Val ey and the Payson area. The
area, however, the Chandler Police Department opened exciting news is that we had two individuals who live in
their doors to NAMI and allowed us to use their the Payson area who want to bring this program up to the
Community Room for our very first Family-to-Family Mogol on Rim Area after at ending a Family-to-Family
class in that area. The class was so successful that we are class here in the Val ey. Currently, there is no affiliate in
hosting another one at the same location in June, and the Payson, so these two individuals joined NAMI East
class is almost fil ed.
Val ey, went to the Family-to-Family teacher training and
In March we started a class in East Mesa at the MARC are ready to get to work educating families in Payson. It
Center, East Vil age, another commit ed supporter of was a very inspiring and exciting day, and we are in the
NAMI programs, and we formed a new partnership with process of scheduling and set ing up classes so al of these
Val ey Presbyterian in Paradise Val ey area whose first teachers can utilize the knowledge they gained in the
class started in April.
The consistency in providing these educational
We wil be gearing up for some of the presentation
programs in the same location, with the commitment of programs we set up for schools such as "Parents and
NAMI Family-to-Family teachers keeps these classes Teachers as Al ies." We wil start looking for additional
fil ed. Many thanks to the teachers for their dedication in presenters for the program, "Ending the Silence," to start
keeping these classes ongoing for the community. Many some presentation programs in the Fal . Tempe School
thanks also go to the organizations that al ow us to District has two very large presentations set up in August
continue to host these classes at their facilities.
and October. Currently we wil be working on prelimi-
We also had a great start for the NAMI BASICS nary activities in preparation for these very important pre-
program as wel . We completed one class in Glendale at sentations for our schools and communities.
Arrowhead Hospital and we are currently finishing up
There is so much great work being conducted by our
another one at Paradise Val ey Hospital. We are starting NAMI volunteers. For those who have been helping and
to notice a growth in this program as people become supporting these programs, we thank you very much for
aware of what is offered through NAMI BASICS. We your commitment and dedication.
have another class scheduled at Arrowhead in August.
Val ey Presbyterian Church in Paradise Val ey is offering
their facility to do a BASICS class starting in October. We
wil probably offer a few more before the end of the year.
If you are a NAMI BASICS teacher, interested in
teaching, would you please let me know and we can start
Classes coming this summer:
working on set ing up another class in your area of choice.
June: Chandler
Another great success in late February of this year was
August: Glendale, Scot sdale & East Mesa
the Family Support Group Facilitator training held at
Pre-registration is required!
Desert Banner Hospital. This was an excel ent training
Contact Debbie: 602.759.8177
National Al iance on Mental Il ness
June 2014
NAMI Arizona Holds Annual Meeting
by Jim Dunn
tional partnering to efficiently improve health care
Thank you to al who participated in the 2014 Annual
Joined by representatives from each of the four
Meeting and Celebration "Crankin' Up The Col abora- Regional Behavioral Health Authorities who helped fund
tion." On May 10 we saluted Governor Brewer and the this event and Individual, Family, Affiliate, Government
bipartisan group that supported Expansion/Restoration and Community Leaders from across the State, powerful
last session further strengthening our public health and relationships and determined commitments were made
safety net in the most economical y sensible manner.
throughout the day.
Governor Brewer's keynote address invigorated the
Please share your pictures, videos, and comments
crowd who joined in awarding 2014 Col aborative with me at [email protected] and I wil be sure to
Community Champion awards to Governor Brewer and include them in our website updates at
House Representatives Heather Carter, Victoria Steele, www.NamiAz.org. I wil also send out the pictures from
Doug Coleman, Bob Robson, Jeff Dial, Eric Meyer, and the Governor's Office upon receipt.
Lela Alston, along with Senators John McComish and
Don't forget to mark your calendars for next year's
Lynne Pancrazi.
annual meeting and celebration scheduled Saturday
Extra Special Thanks to House Health Commit ee January 31, 2015, at the same location in the Disability
Champs and Bipartisan SuperStars Representatives Empowerment Center.
Heather Carter and Victoria Steele who stayed throughout
the day to help panel our statewide conversation on inten-
Churches Team Up with NAMI
with schizophrenia, bipolar disorder, depression and the
like, though that is an important part of it. "We are al
Easter is a time of new beginnings. It is the answer, broken," Mr. Warren said in his remarks a phrase Chris-
the pastor Rick Warren remarks, to loss and despair. tians often use to describe the many imperfections of
This Spring, one year after his son took his life while the human world. "We're al a lit le bit mental y il ."
struggling with depression, Mr. Warren, the founding
The larger goal is to get the church directly involved
pastor of Saddleback Church, one of the nation's largest with the care of people with serious psychiatric il ness
evangelical churches, teamed up with his local Roman by training administrators and pastors to handle
Catholic Diocese and NAMI for an event that psychiatric crises, to set up groups within the church for
announced a new initiative to involve the church in the people with serious mental il ness and to establish
care of serious mental il ness.
services within the church for people who need them
Their goal is not only to reduce stigma for people
7:00 - 8:30 pm
Val ey of the Sun
Tuesday, June 3, 2012
Tuesday, July 1, 2014
Tuesday, Aug. 5, 2014
Darwin Chern MD., CMO
Crisis Response Network
CEO Recovery Empowerment
Partners in Recovery
Topic: The New World of
Topic: Programs at REN
Health Information Technolo-
Caring and Sharing
June 2014
Study on Limited Jurisdiction Courts and the SMI
by Dyani Juarez
Conclusion: The LJ courts struggle to identify SMI
offenders. In addition, they lack authority to force
Deinstitutionalization shifted mental y il patients treatment or commit an offender against his wil .
from mental institutions into local communities, but Recommendation: Court personnel should be trained to
failed to ensure that patients continued receiving identify and take appropriate action related to offenders
treatment. The result is an influx of mental health patients with mental health issues. Training should, at a
now navigating the criminal justice system, especial y in minimum, include an in depth analysis of the fol owing
limited jurisdiction (LJ) courts, which deal with minor areas:
• What is SMI and what disorders it encompasses
LJ courts process al cases in the same manner; there
• How a person receives an SMI designation
is no separate set of laws or procedures designed to
• Identifying potential y SMI individuals/offenders
ensure treatment and reduce recidivism for the mental y
• How to effectively deal with, and communicate
il . Rule 11 governs incompetency and mental examina-
with SMI individuals/offenders
• Local resources available to SMI patients and their
This study investigates LJ courts and found:
• At orneys and LJ courts are general y aware of the
• Alternative sentences for SMI offenders in an
concept of SMI, but LJ courts are less familiar than
effort to reduce recidivism
practicing at orneys.
• Rule 11 process in LJ Courts
• Larger jurisdictions are more likely than smal er
jurisdictions to implement mental health courts.
Conclusion: Arizona Rule 11 provide procedures related
• Of LJ courts with no mental health court, half have to competency, but these procedures are costly and do not
no mental health policy at al .
address al mental health issues.
• In most LJ courts, SMI defendants represent a Recommendation: Mental health courts are an effective
smal minority (<10%) of the total caseload.
solution to the problem. While courts are general y not
• LJ court practices vary in how they identify indi- subject to regulations requiring them to ensure that SMI
viduals who may suffer from a mental il ness.
offenders receive treatment, they do have a responsibility
• Many cases against SMI defendants are dismissed to take reasonable measures to reduce the likelihood that
without a Rule 11 evaluation on a motion by the SMI offenders wil continue commit ing new crimes.
Proper treatment improves the ability of a person
suffering from mental il ness to function in society.
Conclusions and Recommendations
Beyond ordering treatment for the offenders who appear
before them, courts can take steps to ensure that these
Conclusion: Many individuals in the criminal justice offenders are placed in environments where they can
system suffer from SMI and do not receive regular benefit from proven methods such as those utilized in the
Assetive Community Treatment model, including home
Recommendation: In the area if law enforcement, the LJ visits by case workers, periods of observation to identify
court system needs education about resources available to when medications should be adjusted, the active involve-
assist a person suffering from a mental episode. Crisis ment of family members, and the assistance of trained
teams are often a superior alternative to arresting and and dedicated treatment staff. Mental health courts are an
filing criminal charges against a person suffering from ideal venue for ensuring that offenders receive the
mental il ness.
support they need.
Conclusion: Even with proper funding, treating mental Conclusion: Mental health courts are often prohibitively
il ness is a serious chal enge.
expensive in LJ courts that rely on local funding.
Recommendation: Agencies providing mental health Recommendation: Regional mental health courts are an
care should be held accountable, and should be required ideal solution for limited jurisdiction courts with scarce
to fol ow through with home visits, at endance to court resources.
proceedings and notification to the court of the status of
the consumer involved in a case.
Read the ful report at
National Al iance on Mental Il ness
June 2014
Calendar of Events & Activities
June - August 2014
Family Support Groups
First United Methodist Church
331 S. Cooper, Suite 142
6:30 - 8:30 pm
Risen Savior Lutheran Church
23914 S. Alma School Rd.
10:00 am - noon
1400 S. Dobson, Rosati Ed Bldg
7:00 - 9:00 pm
Mesquite Conference Room
2nd & 4th
318 E. 15th St.
4:00 - 5:30 pm
Tempe Friends Meeting
Shepherd of the Hil s Church
13658 Meeker Blvd.
1:00 - 2:30 pm
Sun City West, AZ
Arrowhead Hospital
18699 N. 67th Ave.
6:00 - 7:30 pm
Physicians Suite Plaza- Sierra Room
Devonshire Senior Center
28th St. & Devonshire
6:00 - 7:30 pm
(North of Indian School),
21650 N. Tatum Blvd,
6:00 - 7:30 pm
1st & 3rd
Mountain View Presbyterian Church
9832 N. Hayden Road
6:00 - 7:30 pm
1st & 3rd Tuesdays
First Cong. United Church of Christ
1407 N. 2nd St.
7:00 - 8:30 pm
2nd Fridays
Anthem Civic Bldg.
3701 W. Anthem Way
7:00 - 8:30 pm
3rd Tuesdays
Marc Community Resources
Peer Support Training
2nd Floor Training Room 924
N. Country Club Drive
Information or to apply
June 6 - 27, 2014
Arizona Department of Health
8:00 am - 4:00 pm
Services certified curriculum!
Caring and Sharing
June 2014
7:00 - 8:30 pm
Darwin Chern MD., CMO
Partners in Recovery
June 3, 2014
Topic: The New World of
Health Info Technology
7:00 - 8:30 pm
Crisis Response Network
July 1, 2014
7:00 - 8:30 pm
CEO Recovery Empowerment
August 5, 2014
Topic: Programs at REN
Peer Support & Misc Events
7:00 - 9:00 pm
3rd Monday
Support group for people living
SW Network Saguaro Clinic
3:00 - 4:30 pm
with mental disorders.
3227 E. Bel Road
A comprehensive 12-week
Call for dates, times and
course on mental il ness.
A series of six (6) once-per-week
Call for dates, times and
(focusing on
classes for parents / caregivers of
children and
children and adolescents living
with mental il ness.
Oct. 18, 2014 - 9:00 am
Arizona State Capitol Grounds
Information or to volunteer
1700 W. Washington St.
Volunteer Orientation
Phoenix, AZ
Need Help? Contact Mercy Maricopa. 24 hours a day, 7 days a week!
Report Provider Fraud: 602.417.4045
Behavioral Health Crisis Line 800.631.1314
Report Member Fraud: 602.417.4193
Member Services: 800.564.5465
A shout out to:
for providing free classroom space
Mountain View Presbyterian
for Family to Family classes and
Church in Scot sdale
Family Support Groups.
National Al iance on Mental Il ness
June 2014
NAMI Val ey of the Sun Elects a New Board
NAMI Val ey of the Sun has formed its first board of Bev Carling
directors. The board represents members from the
Bev brings over 15 years experience in
previous four NAMI affiliates that recently merged into Finance/Accounting and Operations Management to
one affiliate that serves people in the Phoenix NAMI, since 2002. She served on Affiliate and State
metropolitan area.
boards for 10+ years in various capacities (President,
Treasurer Secretary and Membership Chair). She served
on the Walk Commit ee and as a Walk Team Leader.
Terry served in Air Force ROTC, US Navy, Naval
Reserve, and the Army National Guard. He facilitated Belinda Escalante
support groups, presented IOOV, participated in Health
Belinda has over 15 years of experience working in
Fairs and served as the NAMI resource person for the the human services, education field and business
SAFE program at the VA.
ownership. Currently, her work assists those with disabil-
Support groups have been an important part of his ities to overcome barriers to employment. In 2013 and
recovery, and as a facilitator of two groups, he works hard 2014, she served on the NAMI SEV Board, Southeast
to help others with their recovery experience.
Val ey Outreach Commit ee, and the National Al iance on
Mental Il ness Val ey Walk Commit ee.
Tad D. Gary, MEd, MA, CRC, LPC
Tad Gary serves as Chief Clinical Officer (CCO) of Larry Clausen
Mercy Maricopa Integrated Care.
Larry has worked with diverse populations including
Tad has worked in public behavioral health for over 15 the elderly, intel ectual y and physical y disabled as wel
years and has held multiple leadership roles, as wel as as persons with severe mental il ness. His current position
directly providing counseling and psychosocial rehabilita- as the Executive Director of the Arizona Developmental
tion services. Most recently, Tad was Vice President of Disabilities Planning Council is a great opportunity to
Integrated Care Management with Mercy Care Plan, over- create new and innovative approaches to addressing the
seeing a large department comprised of multiple case key issues posing barriers for persons with developmental
management and behavioral health teams.
disabilities in Arizona.
Craig has been working in healthcare since the early
Jessie is a peer who presents for In Our Own Voice
70's, starting as an ambulance EMT which eventual y led and participated in peer-to-peer and connections groups.
him to obtaining his nursing degree in '78. His nursing She earned an undergraduate degree in Journalism and
practice provided him the opportunity to practice in a Communications. Jesse works as a Clinical Program
variety of set ing, including ER shift supervisor. Craig Specialist at Cenpatico, specializing in Peer and Family
joined NAMI three years ago with a son who has a dual Run Organizations.
diagnosis of bipolar/co-occurring substance abuse. Craig
trained as a facilitator for F2F, Parents and Teachers as Gaye Tolman
Al ies, and Family Support Group. Served on the NAMI
Gaye has been active in the behavioral health arena for
South East Val ey board for the past 2 years.
over 25 years as wel as being CEO of two other non-
profits. She is the CEO for Recovery Empowerment
Jodi Peary, J.D., PhD
Network and is very excited about the new programs that
Jodi is a research psychologist, who takes a develop- wil be starting at that agency. She has always been an
mental psychopathology perspective to understanding advocate for those in need.
resilience versus vulnerability from infancy through
emerging adulthood. Her research projects are aimed at
learning what makes a difference for resilience and how to
A baby is born with a need to be loved,
strategical y target and time interventions or policies to
and never outgrows it.
promote success in disadvantaged children and young
people whose lives are threatened by adversity.
Caring and Sharing
June 2014
Local Family-to-Family Program Gets $10K Grant
NAMI Southeast Val ey is pleased to announce the Ray of Light then gives a grant to the nonprofit organiza-
receipt of a grant for $10,000 for the Family to Family tion of that artist's choice.
program. This grant was the generous award from Chaz
Chaz Buzan was the winner in January of this honor.
Buzan through the Ray of Light Art for Freedom Chaz awarded this grant to support our efforts in
supports the entertainer
Madonna's Art for
Freedom initiative,
creative expression that
brings awareness about
winning video.
Chaz Buzan
Thanks to Chaz and Madonna for supporting metal
Each month, Madonna and a guest curator select an health in our community!
artist who best embodies the mission of Art for Freedom.
See Chaz's award winning performance on:
Ketamine Tested for Treating Severe Depression
take 10 or more days to take effect.
Ketamine is seen by the researchers as a substitute
The first UK study to give ketamine to severely for electroconvulsive therapy (ECT), which is
depressed patients has found that it had dramatic sometimes used for people with treatment-resistant
positive effects on some long-standing sufferers who depression but carries risk of memory loss.
had not responded to other treatments.
One of the reasons the drug is thought to work is
Researchers at Oxford Health NHS Foundation that it has a direct impact on the subgenual anterior
Trust and the University of Oxford observed that 29% cingulate, the part of the brain where overactivity is
of patients in a study, some of whom had suffered from seen in people with depression.
depression for more than 20 years, experienced signifi-
However, the British government announced in
cant improvement in mood four to seven days after their February that ketamine would be upgraded to a Class B
final dose of the drug, with four of the 28 subjects them banned substance in the face of evidence that it has
completely free from depression at that point. It works caused physical and psychological harm to recreational
rapidly compared with some antidepressants, which can users.
Mental Health & Congress
identify and treat people with mental disorders are also
widely approved.
Republicans in the US House are sponsoring the
Democrats in the House, led by U.S. Rep. Ron
"Helping Families in Mental Health Crisis Act." The bil Barber, D-AZ., have their own legislation which they've
provides money for suicide prevention programs and for dubbed the "Strengthening Mental Health in Our
remote video therapy, which is seen as especial y crucial Communities Act of 2014."
in rural areas.
This proposal would launch a White House Office for
Widely backed provisions of the bil include stream- Mental Health Policy, improve mental health services
lining payment for services under the Medicaid program, under Medicaid and Medicare, fund community and
and providing funds for clinics that meet standards for school mental health grants and increase funds to
rigorous, scientifical y supported care.
Substance Abuse and Mental Health Services Adminis-
Provisions cal ing for increased training for police tration (SAMHSA) programs.
officers and emergency medical workers in how to
National Al iance on Mental Il ness
June 2014
Books on Mental Health
Award-winning science and history writer Robert Whitaker investigates the merits
of psychiatric medications through the prism of long-term results. Are long-term
recovery rates higher for medicated or unmedicated schizophrenia patients? Does
taking an antidepressant decrease or increase the risk that a depressed person wil
become disabled by the disorder? Do bipolar patients fare bet er today than they did
forty years ago, or much worse?
Former Washington Post reporter Pete Earley had writ en extensively about the
criminal justice system. But it was only when his own son-in the throes of a manic
episode-broke into a neighbor's house that he learned what happens to mental y il
people who break a law.
This is the Earley family's compel ing story, a troubling look at bureaucratic apathy
and the countless thousands who suffer confinement instead of care, brutal conditions
instead of treatment, in the "revolving doors" between hospital and jail. With mass
deinstitutionalization, large numbers of state mental patients are homeless or in jail-an
experience lit le bet er than the horrors of a century ago.
Diagnosing Psychosis: The Importance of Testing
slight slowing in the right frontal and temporal lobes of
It looked like the teen was having her first psychotic
This finding led Doctors to believe Mia had limbic
break, but actual y it was another disorder.
encephalitis, an inflammation of the brain; the disease
Mia was admit ed to the psychiatry service and can be triggered by an infection or an autoimmune
doctors began tests: A screen for Lyme disease and HIV reaction in which the body at acks itself. (The disorder
was negative. An MRI scan of her brain was clear, is also called anti-NMDA receptorencephalitis or
which ruled out a brain tumor. The diagnosis was antibody-mediated encephalitis.)
atypical psychosis and Mia was started on high doses of
"Time is critical to this prognosis: The sooner
treatment is started, the less likely it is that damage wil
However, Mia's electroencephalogram (EEG), a test occur. A study published last year found that treatment
that measures electrical signals in the brain, showed started within four weeks of symptoms was a predictor
what her doctor said was "a very subtle finding:" a of a good outcome."
Depression Linked to Risk of Heart Failure
were 5 percent more likely to develop heart failure, and
those with moderate to severe symptoms had a 40%
Depression may increase the risk of heart failure, a increased risk.
new study suggests.
"Depression triggers stress hormones. If you're
Researchers looked at nearly 63,000 people in stressed, you feel your pulse going up and your breath
Norway who underwent physical and mental health speeding up, which is the result of hormones being
released. Those stress hormones also induce inflamma-
Over 11 years, close to 1,500 of the participants tion and [plaque buildup in arteries], which may acceler-
developed heart failure. Compared to people with no ate heart diseases," Gustad explained.
symptoms of depression, those with mild symptoms
Caring and Sharing
June 2014
The Cost of Doing Nothing
two weeks in the same ER, waiting for a psychiatric bed
to open up. For many people with mental il ness, the ER
A Mental Health System Drowning in Neglect
can be a kind of purgatory.
Nearly 40% of adults with "severe" mental il ness,
Mental health bed shortages are a national, man-
such as schizophrenia or bipolar disorder, received no made disaster that people rarely notice until it affects
treatment in the previous year, according to the 2012 them.
National Survey on Drug Use and Health. Among adults
with any mental il ness, 60% were untreated.
Mental Health Programs are often the First to be
The result is that, al too often, people with mental Cut
il ness get no care at al .
States cut $5 bil ion in mental health services from
Patients Re-Institutionalized in Jails and Homeless
As states have cut mental health funding, many have
increased spending on prisons and jails. MentalIl -
The USA treats people with mental il ness as second- nessPolicy.org, shows that investing up front in mental
class citizens. They're neglected not just by friends and health can yield big dividends.
neighbors, but by lawmakers, who slash cost-effective
A Georgia study found that providing comprehensive
services and discriminate against them through federal mental health services to mental y il people involved in
policies that block access to care.
the criminal justice system cut the number of days that
participants spent in the hospital by 89%, and the number
Patients Wait Days or Weeks for Hospital Beds
of days spent in jail by 78%. In al , the program saved
From 2009 to 2012, the country eliminated at least more than $1 mil ion in its first year.
4,500 public psychiatric hospital beds, nearly 10% of the
total supply. In March, a Vermont psychotic patient spent
Jump-starting neurons reverses stress susceptibility
develops in response to social stress, if driven high
enough for a sustained period, triggers its own compen-
Scientists traced vulnerability to depression-like satory adaptation, the inhibitory currents that corrects
behaviors in mice to out-of-balance electrical activity out-of-balance electrical activity and produces
inside neurons of the brain's reward circuit.
resilience. So at least in the brain's reward circuit, exag-
The National gerating an abnormality, for a time, proved to be the
Institutes of Mental curative secret, say the researchers.
Health (NIMH) research
Whether by drugs (in this study lamotrigine) or by
experimental y trigger a the application of light, further stimulating an already
compensatory self-stabi- abnormal y high current in the brain produced a com-
lizing response. Once electrical balance was restored, pensatory response on a different brain pathway. The
previously susceptible animals were no longer prone to overal effect meant that the mice were more able to
becoming withdrawn, anxious, and listless fol owing cope with stressful situations.
social y stressful experiences.
The drug lamotrigine is used as a mood stabilizer for
"To our surprise, neurons in this circuit harbor their people with the depressive symptoms of bipolar
own self-tuning, homeostatic mechanism of natural disorder, but until now the reasons why it works have
resilience," explained Dr. Ming-Hu Han. Dr. Han and been a mystery. Optogenetic (use of light) techniques to
col eagues reported on their discovery April 18, 2014 in stimulate neuronal activity in the reward circuit had the
the journal Science.
same positive effect on mice behavior.
The abnormally high excitatory current that
National Al iance on Mental Il ness
June 2014
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Case Study 06.qxd 3/30/06 3:44 PM Page 6-1 A d o l e s c e n t Adapted from Thomson Delmar Learning's Case Study Series: Pediatrics, by Bonita E. Broyles, RN, BSN,MA, PhD. Copyright © 2006 Thomson Delmar Learning, Clifton Park, NY. All rights reserved. ■ White American ■ Doxycycline (Vibramycin) ■ Sexually active teenager ■ Confidentiality of minor client
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