Sign on to National Campaign in Wake of CT Tragedy

Please consider having your agency join NYAPRS and many others across the nation in signing on to this extraordinary national campaign comprised of peers and providers working together to take the message crafted by Ron Manderscheid below to urge the President and Congress to address the need for gun control, changing our culture of violence and improving the quality and availability of recovery services across our nation. Please send your support to Ron at rmanderscheid@nacbhd.org.

Thanks!    Harvey

 

It is time for the mental health and substance use leadership, behavioral health clinicians, consumers, families and advocates to act together to help end the violence and self-mutilation we as a nation encourage. Ron Manderscheid has written movingly about the need to halt these tragedies.
The victims, their families and all of our children and communities must be comforted. Mental health and substance use clinicians are often at the forefront helping in the aftermath of these too frequent massacres.


How could we in the behavioral health community resolve to change this social environment of destruction?


Would you be willing to work with me to turn Ron's eloquent brief into a sign-on letter from the behavioral health community to President Obama and the Congressional Leadership? To recruit leaders in the behavioral health field to encourage their colleagues and friends to start add in letters to their local Congressional delegations, governors and state legislators? There have been 7 mass killings in the US this year.

A Time to Cry for the Innocents, Then Act

December 15, 2012 by Ron Manderscheid

We must grieve for the Innocents in Newtown, and we must now take action

 

The chasm is unbridgeable between our preparations for the current Holiday Season and the killing of the Innocents today in Newtown, Connecticut. I am certain that, tonight, most of us in America are confronted with and deeply concerned about this rip in the fabric of a typical American community. It could be your; it could be mine. Without a doubt, there is no greater tragedy in a society than losing its young, its own future, so needlessly and so senselessly. Such actions strike at the very heart of who we are and who we hope to become.

So we must grieve—for the families who lost the Innocents, for the families of their teachers who were lost, for the Newtown community, and for America itself. Today was a very, very difficult day for all of us. When threatened this way, we turn to our families, our communities, and our faith. Each provides us needed support at such times of great difficulty.

But we owe the Innocents much, much more than just our crying.  They also deserve our action to find and implement solutions to these social dilemmas of our time.

We must come to terms with the fact that 13 years of war in Iraq and Afghanistan have changed us and our society in ways that we do not yet fully understand. One only needs to turn on a television to view multiple murders each night. Or, just play a video game, and one can participate in several thousand “kills” over the course of an hour. Each day, there are 32 murders in America. Our social integration is ebbing away, and we are rapidly becoming inured to violence and death. In an era of global, instant communication, we are more distant than ever from each other. We must recognize these glaring symptoms and act.

What can we do? We can begin our own road to recovery by taking several major steps that have been very obvious for quite some time:

Immediately ban assault weapons and pistols, such as the Glock. Our Founding Fathers and the Second Amendment never envisioned that we would be using this right to kill each other. Assault weapons were designed for the battlefield, not our closets. We must not be distracted from this objective by the National Rifle Association and the ideology it promotes.

Immediately set about developing new standards for our entertainment industry. Violence and death are projected through every venue. Our movies, television, video games, and music all exude violence and death If possible, computer animations have made this violence ever more horrific. We absolutely must change this deplorable situation.

Immediately set about rebuilding our local communities. One’s community should be a place of support and refuge, rather than of fear. One should not have to fear going to school and being killed. Sociologists have known for centuries that social integration and support do reduce conflict and violence. Good social integration also reduces trauma and its negative effects, including mental illness. The UK has already incorporated this thinking into its approach to health; we must do the same.

Immediately double the capacity of city and county behavioral healthcare systems. All who work in the social service fields know that it is virtually impossible to get mental health care for many people who desperately need it. Only about a third of those with moderate illness and two thirds of those with severe illness ever receive any care at all. Why? Because our city and county systems lack the fundamental resources and capacity to deliver much needed care. The Affordable Care Act provides a wonderful opportunity to change this deplorable situation; we must do it.

Immediately initiate training to recognize the signs of mental illness and to promote help-seeking when needed. Most students go through high school and college without a single hour of training about mental illness, its signs or its treatment. We can’t expect people to step forward or to seek help for a family member with mental illness when we don’t even provide them the rudimentary tools to do so. We know how to do this today; we must.

Yes, we must grieve for the Innocents, just as we grieved for those lost in Tucson, Aurora, and Portland. But, this time, our grieving must have a direction and purpose to galvanize action. The Innocents expect nothing less of us.

 

 

Bazelon Center Statement on Sandy Hook Shooting

Bazelon Center Statement on Sandy Hook Shooting

   

Washington -- December 17, 2012 -- The Judge David L. Bazelon Center for Mental Health Law joins the rest of the nation in mourning the tragic loss of life at Sandy Hook Elementary School in Newtown, Connecticut. While much remains unknown about this incident, it is likely that, once again, two factors are at play: the all-to-easy access to guns, and the lack of access to the crucial community mental health services that people want and need.

 

With respect to weapons, the Bazelon Center believes that no one who is dangerous-whether or not the individual has a mental illness-should have access to guns. In all instances, one's capacity to handle a weapon responsibly should be determined individually, not based solely on a diagnostic label. Restrictions on access to guns should be applied equally to everyone rather than targeting people with mental illnesses.

 

In the wake of similar tragedies, subsequent discussions concerning mental health services have drifted toward increasing the number of psychiatric hospital beds or making it easier for courts to commit people with mental illnesses to involuntary treatment. In reality, every state has provisions to hospitalize people when they are dangerous to themselves or others as a result of mental illnesses and when less restrictive measures are not appropriate. Moreover, while there may be areas of the country where psychiatric hospital beds are in short supply, nationwide many such beds are occupied by people who simply do not need hospital care. 

 

The real problem is that community based services-including mobile crisis services, assertive community treatment, peer supports and supportive housing-are in short supply, delaying hospital discharges and resulting in mental health crises that could otherwise be prevented. While community mental health programs can offer excellent, comprehensive services, lack of resources has resulted in these services often not being available, except to people who are in immediate crisis and who have already endured multiple hospitalizations.

 

A stronger commitment to vital community mental health services is long overdue and must be paired with improved gun laws in order to prevent future tragedies. This is a problem of political will; not know-how.

 

Furthermore, people with mental illnesses are no more violent than people without mental illnesses. Yet, these kind of tragic events unfairly and harmfully tar people with mental illnesses as inherently dangerous. In fact, these Americans not only share the nation's horror at these events, but also bear the additional weight of false stereotypes and discrimination needlessly reinforced by these perceptions.

 

The Bazelon Center is working toward a more humane and just America, where we reduce the likelihood of crises such as we just experienced and where people with mental illnesses can thrive as a part of their communities.

 

###

 

The Bazelon Center for Mental Health Law (www.bazelon.org) is the leading national legal-advocacy organization representing people with mental disabilities. It promotes laws and policies that can enable people with psychiatric or developmental disabilities to exercise their life choices and access the resources they need to participate fully in their communities. 

 

BN: New York Gets Go-Ahead To Set Up Insurance Exchange

New York Gets Go-Ahead To Set Up Insurance Exchange By Jerry Zremski Buffalo News Washington Bureau Chief December 14, 2012

WASHINGTON - The federal government Friday gave tentative approval to New York's efforts to set up a health insurance exchange where uninsured New Yorkers and small businesses will be able to shop for policies starting next October. The state has met the benchmarks it needs to meet in setting up the exchange, officials at the Department of Health and Human Services said. "New York has made significant progress, and in 10 months will be ready for open enrollment where New Yorkers will be able to purchase private health insurance plans," said HHS Secretary Kathleen Sebelius. The creation of the state health insurance exchange may mean little to New Yorkers who currently get health care through their employers, but it will mean a lot to the uninsured, said Chiquita Brooks-LaSure, director of coverage policy programs at the federal government's Office of Health Reform. "It will be a one-stop marketplace where people can find the health plan that meets their needs," Brooks-LaSure said. That's something people will have to do starting in 2014 when, under the Obama health law passed in 2010, most Americans will be required to have health insurance. New York will be ready when that day comes, said Donna Frescatore, executive director of the New York Health Benefit Exchange. The exchange already has a website, http://www.healthbenefitexchange.ny.gov <http://www.healthbenefitexchange.ny.gov/> . And starting in January, the state will begin working with insurers that are interested in offering insurance policies on the exchange. And starting on Oct. 1, 2013, individuals and small businesses will be able to start shopping for insurance on the exchange. In-person "navigators" will be available around the state next fall to help people navigate the exchange, Frescatore added. New York is one of only 18 states that has opted to set up its own exchange. "We want to make sure the exchange is well integrated with our public health insurance programs; we want it to be a seamless process," Frescatore said. "We also wanted to make sure the exchange was designed to meet the needs of small businesses." New York has received $183 million in federal grants to set up its exchange. In contrast, many states - particularly those with Republican governors - have instead opted to either let the federal government run such exchanges or have set up a federal-state partnership. Some states have worried that a state-run exchange eventually would be a costly burden on state taxpayers. "If Virginians are faced with running a costly, heavily regulated bureaucratic exchange without clear direction from Washington, then it is in the best interest of our taxpayers to let Washington manage an exchange at this time," Virginia Gov. Bob McDonnell said Friday in a letter to Sebelius.

http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20121214/CITYANDRE GION/121219482

---------------------

Most Governors Refuse to Set Up Health Exchanges

By Robert Pear New York Times December 15, 2012

WASHINGTON - The Obama administration said Friday that more than half the states had rejected its pleas to set up their own health insurance exchanges, dealing a setback to President Obama's hopes that Republicans would join a White House campaign to provide health insurance to all Americans.

Friday was the deadline for states to notify the federal government of their plans, and administration officials had been hoping that Mr. Obama's re-election would overcome resistance to the new health care law.

Federal officials said they knew of 17 states that intended to run their own exchanges, as Congress intended.

Two of those states, New York and Kentucky, won conditional federal approval on Friday for their plans to create and run state-based exchanges. Kathleen Sebelius, the secretary of health and human services, also approved an application from the District of Columbia.

In seeking federal money, New York estimated that one million people could obtain insurance through its exchange. In addition, said Josh Vlasto, a spokesman for Gov. Andrew M. Cuomo, the exchange will lower the cost of coverage for many New York businesses.

But in Virginia, after more than a year of planning and research, Gov. Bob McDonnell said his state would not operate its own exchange. "Despite repeated requests for information, we have not had any clear direction or answers from Washington until recent days," Mr. McDonnell said.

On Monday, Ms. Sebelius gave preliminary approval to state-based exchanges being established by Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.

The exchanges are online supermarkets where people can shop for private health insurance and obtain federal subsidies to help defray the cost. The Congressional Budget Office has estimated that 25 million people will eventually receive coverage through the exchanges.

Federal officials and federal contractors will set up and run the exchange in any state that is unable or unwilling to do so.

Gary M. Cohen, a federal health official, said the administration "has encouraged states to establish their own exchanges." But, he added, consumers will have access to affordable health insurance in all states, regardless of who is in charge of the exchange.

The concept of an exchange is simple: Competition will drive down prices. But operating an exchange is an immense technical challenge requiring sophisticated information technology to digest and display huge amounts of data on the costs and benefits of various insurance plans.

The federal government and states face a series of deadlines in the new year. On Jan. 1, Secretary Sebelius must determine whether each state will be able to operate its own exchange in compliance with federal standards. By Feb. 15, states must notify the federal government if they want to help with selected tasks, like consumer assistance and the supervision of health plans, in partnership with the federal government.

On Oct. 1, consumers can begin to enroll in health plans, for coverage starting on Jan. 1, 2014, when most Americans will be required to have insurance.

Administration officials said they were delighted this week when a Republican governor, C. L. Otter of Idaho, announced plans to establish a state-run exchange.

However, Mr. Otter's rationale provided little comfort to the administration. He said he did not want to surrender power to "federal bureaucrats." He denounced "the mandates and overreaching federal authority of the Affordable Care Act." He said the law "will do little or nothing to reduce costs while force-feeding us coverage and increasing the size and scope of government." And he said his decision could be rescinded if the State Legislature disagreed with him.

Pennsylvania seriously considered running its own exchange, but Gov. Tom Corbett said on Wednesday that he would not pursue the idea.

"State authority to run a health insurance exchange is illusory," Mr. Corbett said. "In reality, Pennsylvania would end up shouldering all of the costs by 2015, but have no authority to govern the program."

In Tennessee, state officials did a huge amount of planning for a state-run exchange. But Gov. Bill Haslam announced this week that he had decided against the idea because the Obama administration had failed to answer numerous operational questions.

Gov. Chris Christie of New Jersey cited similar concerns in vetoing legislation to establish a state-based exchange last week.

"New guidance continues to trickle out of Washington at an erratic pace," Mr. Christie said.

http://mobile.nytimes.com/2012/12/15/us/most-states-miss-deadline-to-set -up-health-exchanges.xml

BN: Better Mental Health Care Won't Be Enough, Experts Say

Better Care For Mentally Ill Won't Be Enough, Experts Say Mental health care alone won't prevent mass killings

By Jerry Zremski Buffalo News Washington Bureau Chief December 16, 2012

WASHINGTON - For a nation of millions of broken hearts grasping for something, anything, to prevent yet another schoolhouse slaughter, the solution sounds simple:

If we could just get the mentally ill the proper care, then the nation would be spared the agony of one more Newtown.

The trouble is, that's too simple a solution, and one that's unlikely to work on its own, psychiatrists say.

Yes, they say, access to mental health services is not as easy as it should be. There's a shortage of psychiatrists in Buffalo, for example, and insurance problems in many places that often mean psychiatric patients don't get the care they need.

Yet other confounding facts prove that better mental health services alone are not the preventative medicine for mass shootings like the one that claimed the lives of 20 school children and eight adults, including the killer, in Connecticut on Friday.

For one thing, while we don't know if the Connecticut killer, 20-year-old Adam Lanza, was under psychiatric care, we know that some previous mass murderers were - and that it did nothing to stem the bloodshed.

What's more, psychiatrists say it's nearly impossible to identify who among the mentally ill is truly dangerous, and that any effort to do so will only further stigmatize a category of illness where many people already shun treatment out of embarrassment and fear.

And there's one last important fact: The vast majority of mentally ill people are not prone to violence.

Add it all up, and psychiatrists say that improving access to mental health services is likely to be only one of the measures the nation must take if it really wants to get serious about preventing bloodbaths like the one that happened at Sandy Hook Elementary School.

"My fear is always that people will write this off as just about another mentally ill person," said Dr. Charles P. Ewing, a forensic psychologist and attorney at the University at Buffalo who specializes in the psychology of crime. "It's about way more than mental illness."

In fact, at this point we can't even be sure that Lanza was officially diagnosed as mentally ill. In a story that's been marked by misinformation from the start, all we know is that former classmates have said they believe that Lanza had Asperger syndrome, a form of autism marked by social awkwardness and odd use of language.

While we don't know many details of Lanza's mental state, we do know that many people inside and outside the medical profession are calling for better access to mental health services in the wake of the Connecticut massacre.

That's especially true in Buffalo, where a shortage of psychiatrists worries many medical professionals.

Dr. Steven L. Dubovsky, professor and chairman of psychiatry at the University at Buffalo Medical School, said that the shortage stems in part from the fact that some local insurers reimburse those psychiatrists in a comparatively paltry way.

For example, some insurers reimburse psychiatrists only $5 more for a 45-minute patient visit than for a one- to 20-minute patient visit.

The result: Local psychiatric patients often don't get the treatment they need from the right specialist - and often end up in the emergency room with problems that otherwise might have been kept under control, Dubovsky said.

"It doesn't work well for people with serious problems," he said.

Then again, access to the best psychiatric care is not a problem limited to Buffalo.

Dr. Claudia M. Gold, a pediatrician, writer and director of the Early Childhood Social Emotional Health program at Newton-Wellesley Hospital near Boston, said research strongly suggests that early treatment is very important for young children with behavioral problems that could mushroom into violence later.

Yet she runs into a problem when she tries to refer young patients and their parents to top mental health professionals.

"The best therapists often don't take insurance," she said.

Once troubled youngsters become adults, the mental health system can leave people untreated for another reason.

"One complicating factor is that in order to get treatment, people have to want to get treatment - unless they are seen as an immediate danger to themselves or others," said Amanda Nickerson, a psychologist and associate professor at UB's Graduate School of Education. "And even that is difficult to determine."

What's more, there's no guarantee that psychiatric treatment will stop any one mad mind from lashing out. After all, James Holmes was seeing a University of Colorado psychiatrist before he shot 12 people at a showing of the Batman movie "The Dark Knight Rises" in Colorado in July.

And Seung-Hui Cho, who killed 32 people and then himself at Virginia Tech University in 2007, was under court-ordered psychiatric treatment that did nothing to prevent his rampage.

"Most of these people are getting some sort of treatment," Dubovsky said.

Obviously, in the Colorado and Virginia Tech episodes, that treatment was by no means adequate.

If you think you should institutionalize any mental patient prone to any level of violence, the numbers are indeed daunting. Dr. Alec Buchanan, an associate professor of psychiatry at Yale University, has calculated that you would have to lock up between five and 10 troubled people to have a decent chance of preventing a single one from acting violently.

Even then, you would likely miss some dangerous individuals, noted Dr. Marvin Swartz, who served with Buchanan on an American Psychiatric Association Work Group on Violence Risk earlier this year that concluded: While psychiatrists can often identify circumstances associated with an increased likelihood of violent behavior, they cannot predict dangerousness with definitive accuracy."

The problem, Ewing said, is that finding the violent among the mentally ill is "totally unpredictable."

What's more, violence is actually rare among the mentally ill. Research shows that between 92 and 96 percent of mental patients do not have violent tendencies, said Dr. Daniel Antonius, an assistant professor of psychiatry at the University at Buffalo.

"Their relative contribution to violence is so small," Antonius said.

So if locking up the mentally ill won't solve the problem, what will work better?

"I think we have to look at how the seriously mentally ill have access to weapons like this," said Ewing, who is a SUNY distinguished service professor and vice dean for academic affairs at the UB Law School. "Obviously they do. And doing so, they can do great damage."

Swartz agreed, noting that academic research shows gun control to be a better deterrent to violence than any attempt to identify dangerous individuals before they strike.

"The more efficient way to reduce the rates of violence is to make guns less available," he said.

http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20121215/CITYANDRE GION/121219410/1109

Mental Health Apologists Are Enablers

By Jayne Lyn Stahl Huffington Post December 15, 2012

Like many Americans, I'm devastated by the murder of twenty children, and six adults at an elementary school in Newton, Connecticut yesterday.

Like others, for years now, I have been calling for stricter gun control legislation. Understood that Connecticut already has tight restrictions on firearms, but what happened yesterday was just another in a long series of examples of why states alone can't be allowed to make decisions on this issue. There needs to be federal gun control legislation.

Yesterday, I posted a comment to a social media site expressing my profound sorrow, and outrage that an event like the mass murder at a public school should happen yet again. . A commenter wrote: "This is not a gun control issue. It is a mental health issue." Right, guns don't kill people; mentally ill people do. This is simply a more sophisticated gun apologist argument.

Try telling a youngster in East Oakland, Chicago, or Compton who has just watched his brother get blown away by a handgun by a rival gang member that guns don't kill, mentally ill people do...

Try telling that to parents, and youngsters alike in the suburbs, in Florida, in Detroit, in a coffee shop, in a bar. According to the Violence Policy Center, more than 30,000 people a year die as a result of gun violence <http://www.vpc.org/aboutvpc.htm> .

And, according to the Washington Post <http://www.washingtonpost.com/blogs/worldviews/wp/2012/12/14/chart-the- u-s-has-far-more-gun-related-killings-than-any-other-developed-country/> , the U.S. has far more gun-related killings than any other country in the industrialized world.

I'm tired of hearing excuses about why mass murderers commit these heinous crimes, that they suffer from this mental illness, etc. Over the past 30 years, we've seen several horrific mass murders in Aurora, Virginia Tech, and elsewhere, but every day in every city of every state in this country, someone is faced with the prospect of being the victim of a loaded gun.

While the focus is on these beautiful young kindergarten children from a white middle class suburb in New England, it is just as devastating when we lose African-American, and Latino youngsters in working class neighborhoods all over America. And, sadly, this happens every day.

Shootings are routinely reported on local evening news. Citizens of this country have become so accustomed to hearing about people getting shot, and killed every day in some squabble or other that they mentally reach for the mute button.

And, no, Martha. This is not a mental health issue. This is a gun control issue, and a social health issue. First, we need to make guns less readily available, less convenient, and less opportune, and then, as a nation, we need to have a conversation not just about violence, but about our collective anger management issue, an anger management issue that has led to eleven years of non-stop warfare, and a sociopathic addiction to military assault rifles, drones, and other weapons of mass destruction.

This isn't about personal mental health issues, but societal mental health. Even if it were possible to wave a wand and make each and every individual in this country magically sane, we would still have a problem with gun violence. Violence is deeply embedded in our collective consciousness, whether it be instant results achieved from a firearm, or immediate impact of bombs, and remote-controlled killing machines.

So, please, stop trying to personalize this. Stop looking for this or that psychiatric disorder to explain a problem that belongs in the public domain. Stop trying to find new and ingenious ways to not blame firearms. Stop thinking because a state has sane gun control laws, that's all we need.

No, we need federal legislation to regulate firearm sales and use. At a minimum, we need to reinstate the ban on assault weapons. We need to stop sales of firearms on the Internet and at gun shows, and most of all, we need to recognize that this is about our national mental health, and not that of a lone gunman.

http://www.huffingtonpost.com/jayne-lyn-stahl/mental-health-apologists-_ b_2307786.html

Join ACMHA Phone Calls This Week to Organize Action in Wake of CT Tragedy

NYAPRS Note: Members of ACMHA (the American College for Mental HealthLeadership) have taken an inspiring lead in galvanizing our national mental health and addiction recovery communities to take action in the wake of last Friday's horrific tragedy. ACMHA President Ron Manderscheid wrote the powerful call to action below and former President Eric Goplerud is organizing two phone calls this week to organize us to take the next steps.

* Tuesday Noon EST

* Thursday at 5 pm EST.

* Call in number: 218-339-4600 code 426443

Please circulate this widely!

It is time for the mental health and substance use leadership, behavioral health clinicians, consumers, families and advocates to act together to help end the violence and self-mutilation we as a nation encourage. Ron Manderscheid has written movingly about the need to halt these tragedies. The victims, their families and all of our children and communities must be comforted. Mental health and substance use clinicians are often at the forefront helping in the aftermath of these too frequent massacres. How could we in the behavioral health community resolve to change this social environment of destruction? Would you be willing to work with me to turn Ron's eloquent brief into a sign-on letter from the behavioral health community to President Obama and the Congressional Leadership? To recruit leaders in the behavioral health field to encourage their colleagues and friends to start add in letters to their local Congressional delegations, governors and state legislators? There have been 7 mass killings in the US this year. I'd like to schedule a couple of calls this week to determine how to go forward as a field (as busy as this week is, no time could work for everyone). If you are interested and able, please call on Tuesday at noon EST or Thursday at 5 pm EST. Call in number. 218 339 4600. 426443. Please invite others to join, and feel free to forward Ron's profound appeal and this note to others.

A Time to Cry for the Innocents, Then Act

December 15, 2012 by Ron Manderscheid

We must grieve for the Innocents in Newtown, and we must now take action

The chasm is unbridgeable between our preparations for the current Holiday Season and the killing of the Innocents today in Newtown, Connecticut. I am certain that, tonight, most of us in America are confronted with and deeply concerned about this rip in the fabric of a typical American community. It could be your; it could be mine. Without a doubt, there is no greater tragedy in a society than losing its young, its own future, so needlessly and so senselessly. Such actions strike at the very heart of who we are and who we hope to become.

So we must grieve-for the families who lost the Innocents, for the families of their teachers who were lost, for the Newtown community, and for America itself. Today was a very, very difficult day for all of us. When threatened this way, we turn to our families, our communities, and our faith. Each provides us needed support at such times of great difficulty.

But we owe the Innocents much, much more than just our crying. They also deserve our action to find and implement solutions to these social dilemmas of our time.

We must come to terms with the fact that 13 years of war in Iraq and Afghanistan have changed us and our society in ways that we do not yet fully understand. One only needs to turn on a television to view multiple murders each night. Or, just play a video game, and one can participate in several thousand "kills" over the course of an hour. Each day, there are 32 murders in America. Our social integration is ebbing away, and we are rapidly becoming inured to violence and death. In an era of global, instant communication, we are more distant than ever from each other. We must recognize these glaring symptoms and act.

What can we do? We can begin our own road to recovery by taking several major steps that have been very obvious for quite some time:

Immediately ban assault weapons and pistols, such as the Glock. Our Founding Fathers and the Second Amendment never envisioned that we would be using this right to kill each other. Assault weapons were designed for the battlefield, not our closets. We must not be distracted from this objective by the National Rifle Association and the ideology it promotes.

Immediately set about developing new standards for our entertainment industry. Violence and death are projected through every venue. Our movies, television, video games, and music all exude violence and death If possible, computer animations have made this violence ever more horrific. We absolutely must change this deplorable situation.

Immediately set about rebuilding our local communities.One's community should be a place of support and refuge, rather than of fear. One should not have to fear going to school and being killed. Sociologists have known for centuries that social integration and support do reduce conflict and violence. Good social integration also reduces trauma and its negative effects, including mental illness. The UK has already incorporated this thinking into its approach to health; we must do the same.

Immediately double the capacity of city and county behavioral healthcare systems. All who work in the social service fields know that it is virtually impossible to get mental health care for many people who desperately need it. Only about a third of those with moderate illness and two thirds of those with severe illness ever receive any care at all. Why? Because our city and county systems lack the fundamental resources and capacity to deliver much needed care. The Affordable Care Act provides a wonderful opportunity to change this deplorable situation; we must do it.

Immediately initiate training to recognize the signs of mental illness and to promote help-seeking when needed. Most students go through high school and college without a single hour of training about mental illness, its signs or its treatment. We can't expect people to step forward or to seek help for a family member with mental illness when we don't even provide them the rudimentary tools to do so. We know how to do this today; we must.

Yes, we must grieve for the Innocents, just as we grieved for those lost in Tucson, Aurora, and Portland. But, this time, our grieving must have a direction and purpose to galvanize action. The Innocents expect nothing less of us.

Manderscheid: A Time to Cry for the Innocents, Then Act

NYAPRS Note: Some very timely strong and smart exhortations from ACMHA’s Ron Manderscheid.

From: ACMHAMembership-owner at acmha.org [mailto:ACMHAMembership-owner at acmha.org] On Behalf Of rmanderscheid at nacbhd.org Sent: Saturday, December 15, 2012 7:54 AM Subject: ACMHA Membership: A Time to Cry for the Innocents, Then Act

A Time to Cry for the Innocents, Then Act

BEHAVIORAL HEALTHCARE December 15, 2012

by Ron Manderscheid

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We must grieve for the Innocents in Newtown, and we must now take action

The chasm is unbridgeable between our preparations for the current Holiday Season and the killing of the Innocents today in Newtown, Connecticut. I am certain that, tonight, most of us in America are confronted with and deeply concerned about this rip in the fabric of a typical American community. It could be your; it could be mine. Without a doubt, there is no greater tragedy in a society than losing its young, its own future, so needlessly and so senselessly. Such actions strike at the very heart of who we are and who we hope to become.

So we must grieve—for the families who lost the Innocents, for the families of their teachers who were lost, for the Newtown community, and for America itself. Today was a very, very difficult day for all of us. When threatened this way, we turn to our families, our communities, and our faith. Each provides us needed support at such times of great difficulty.

But we owe the Innocents much, much more than just our crying. They also deserve our action to find and implement solutions to these social dilemmas of our time.

We must come to terms with the fact that 13 years of war in Iraq and Afghanistan have changed us and our society in ways that we do not yet fully understand. One only needs to turn on a television to view multiple murders each night. Or, just play a video game, and one can participate in several thousand “kills” over the course of an hour. Each day, there are 32 murders in America. Our social integration is ebbing away, and we are rapidly becoming inured to violence and death. In an era of global, instant communication, we are more distant than ever from each other. We must recognize these glaring symptoms and act.

What can we do? We can begin our own road to recovery by taking several major steps that have been very obvious for quite some time:

Immediately ban assault weapons and pistols, such as the Glock. Our Founding Fathers and the Second Amendment never envisioned that we would be using this right to kill each other. Assault weapons were designed for the battlefield, not our closets. We must not be distracted from this objective by the National Rifle Association and the ideology it promotes.

Immediately set about developing new standards for our entertainment industry. Violence and death are projected through every venue. Our movies, television, video games, and music all exude violence and death If possible, computer animations have made this violence ever more horrific. We absolutely must change this deplorable situation.

Immediately set about rebuilding our local communities.One’s community should be a place of support and refuge, rather than of fear. One should not have to fear going to school and being killed. Sociologists have known for centuries that social integration and support do reduce conflict and violence. Good social integration also reduces trauma and its negative effects, including mental illness. The UK has already incorporated this thinking into its approach to health; we must do the same.

Immediately double the capacity of city and county behavioral healthcare systems. All who work in the social service fields know that it is virtually impossible to get mental health care for many people who desperately need it. Only about a third of those with moderate illness and two thirds of those with severe illness ever receive any care at all. Why? Because our city and county systems lack the fundamental resources and capacity to deliver much needed care. The Affordable Care Act provides a wonderful opportunity to change this deplorable situation; we must do it.

Immediately initiate training to recognize the signs of mental illness and to promote help-seeking when needed.Most students go through high school and college without a single hour of training about mental illness, its signs or its treatment. We can’t expect people to step forward or to seek help for a family member with mental illness when we don’t even provide them the rudimentary tools to do so. We know how to do this today; we must.

Yes, we must grieve for the Innocents, just as we grieved for those lost in Tucson, Aurora, and Portland. But, this time, our grieving must have a direction and purpose to galvanize action. The Innocents expect nothing less of us.

Ron Manderscheid, PhD Exec Dir, NACBHDD rmanderscheid at nacbhd.org V: 202-942-4296; M: 202-553-1827 The Voice of Local Authorities in the Nation's Capital!

Tomorrow's NYAPRS MRLC Webinar Features Medicaid Director Helgerson

NYAPRS Note: With the roll out of phases 2 and 3 of New York's HealthHome initiative, the NYAPRS member Learning Collaborative is turning our focus to the next steps in NY Medicaid Redesign, starting with the creation of integrated Special Needs Plans largely in New York City and health plan-BHO collaborations largely upstate.

Almost two years ago, our NYAPRS Health Home Learning Collaborative was created to provide our members with a comprehensive monthly information exchange aimed at helping them to prepare for and capably operate in the Health Home environment.

Given the many changes to come, we are expanding our focus of service to you with a broader Medicaid Redesign Learning Collaborative (MRLC) that will begin with a December 14th kick off webinar featuring NYS Medicaid Director Jason Helgerson and his team (see below).

In the coming years, our MRLC will build on our strong commitment to provide you with timely information from key leaders, consultants and our own community, helping to connect and support us all through the extraordinary changes to come.

Please make sure and join us on December 14th!

NEXT NYAPRS MEMBER MEDICAID REDESIGN LEARNING COLLABORATIVE

Friday December 14th 2012, 11:00am-12:15pm

"NY's Medicaid Redesign: Where We've Been, Where We're Going"

Featuring NYS Medicaid Director Jason Helgerson

This is a special NYAPRS Organizational member benefit!

Webinar links will be forwarded after registration and prior to the webinar:

The Agenda for the December 14th, 2012 webinar is as follows:

* Welcome, Review of Day's Agenda: Edye Schwartz

* Introduction: Harvey Rosenthal

* Presentation: "NY's Medicaid Redesign: Where We've Been, Where We're Going"

NYS Medicaid Director Jason Helgerson and his team will review MRT related activities to date that have involved our behavioral health community and offer a view of what's to come, including managed care expansion, health care exchanges, Medicaid expansion for the uninsured and the state's Medicaid Medicare Duals Demonstration.

* Questions & Answers

For information on becoming a NYAPRS member please visit our website at http://www.nyaprs.org/join-us/

Don't Miss Out: New Members can register now for the Medicaid Redesign Learning Collaborative at

info at NYAPRS.org

Questions? Contact us at mary at nyaprs.org

PPR: New North Country Peer Support Network Opens

New Service Offers Peer Support For People With Mental Illness

By Jeff Meyers  Plattsburgh Press-Republican  December 12, 2012

 

PLATTSBURGH - A new program being offered locally provides peer support for people dealing with mental-health issues.

Impeerium Peer Network recently opened at 14 Healey Ave., Suite E, to give North Country residents a helping hand, verbal support or just an ear to bend when facing the complicated world of mental-health disorders.

 

FUNDED BY GRANT

The New York State Office of Mental Health earmarked money for recovery centers across the state, said Sheri King, program director for the new service.

“We received a three-year grant for approximately $700,000.”

The National Alliance on Mental Illness-Champlain Valley submitted a proposal to the Community Services Board detailing how it would like to establish a peer-to-peer program to give residents with mental illness another option for support.

The Community Services Board approved the concept, paving the way for NAMI-CV to oversee the new office for the next three years.

“Our ultimate goal is that at the end of this grant, we will become a self-sustaining organization,” King said. “Peer support (for mental-health services) is what the state is looking for, and we expect to be here for the long term.”

 

CONNECTIONS

King was hired for the position earlier this summer and has spent the past few months creating a system that centers on peer-support providers.

“It is clearly a peer-to-peer program,” she said of the four employees who have been hired to offer peer support.

In a traditional support program, she explained, a person with a mental-health illness would schedule appointments with a therapist in a clinician/client format.

With peer-to-peer services, residents seeking support can call or visit the Impeerium Peer Network offices to receive assistance from people who have shared the kinds of experiences they face.

“It’s sometimes easier to talk to somebody who’s walked the walk,” she said. “If I have depression and you have a bipolar disorder, we may not have the same illness, but I understand the stigma attached (to mental illness).”

 

SPECIALISTS

The four employees each specializes in a service of significance for people seeking help:

- The skills builder can assist people in learning certain skills, such as using the computer or applying for a job.

- The support specialist offers emotional support for those tough times everyone faces.

- The community-integration specialist offers support for people who are having difficulty entering public settings.

- The benefits adviser provides support in completing applications for such services as Social Security, Medicaid and Medicare.

“We’re here to empower other individuals having difficulty accessing services in the community,” King said.

Impeerium will also have close contact with area clinical services when clients need support beyond what the Peer Network has to offer, she added.

When first looking at the service as a peer-recovery center, King felt there was a need to find a name that was truly special for the program’s objects.

DelVina Herbest submitted the name Impeerium, identifying a need to include the word “peer” with the idea of providing individuals with the ability to overcome obstacles.

 

http://pressrepublican.com/0100_news/x520559860/New-service-offers-peer-support-for-people-with-mental-illness

 

 

NYPR: Cuomo '13 Agenda Includes Non Profit Campaign Finance Reform

Cuomo Begins Outlining Agenda for Next Year

By Karen DeWitt NYS Public Radio/WXXI December 12, 2012

 

Governor Andrew Cuomo says he wants backing from the State Senate on a number of issues he’s dubbed his “litmus test,” including raising the minimum wage and reforming New York City’s stop-and-frisk policies, as well as campaign finance reform. 

Cuomo maintains he’s not getting involved in the state Senate’s internal power struggle, which has led to a newly formed governing coalition of  30 Republicans and five break away Democrats.  Senate GOP Leader Dean Skelos said this week he can’t guarantee right now that any specific bills will come to the floor. Cuomo says if it turns out that the Senate does not ultimately act on his list of priorities then he says “that will be an issue.”

“I was elected by the people of this state with a specific agenda,” Cuomo said. “I expected it to be acted on.”

Cuomo says he also expects a “functioning” Senate.

“And I expect support,” the governor said.

Cuomo says if he doesn’t get that support, he’ll take his case to the people.

Among the issues Cuomo wants to tackle this year is campaign finance reform. He plans to introduce legislation to regulate electioneering activities by some not for profits that have become increasingly influential players  in funding political campaigns.

Cuomo says as part of campaign finance reform bill that he intends to introduce soon he’ll require that the not for profits, known to critics as “dark money groups,” disclose campaign contributions to politicians. Cuomo says his bill goes further than a plan by State Attorney General Eric Schneiderman, because the attorney general can only regulate the not for profits  registered in New York State.

“You have all these national not for profits that aren’t registered in New York, but we were just watching their advertising during the Presidential campaign,” Cuomo said. “I want them covered also.”

In an interview with public radio, Cuomo stopped short of drawing a line in the sand over the issue of public campaign financing, something many advocates have called for.  The governor says it’s “very, very important,” but did not specifically say that it would be a make or break issue in negotiations with the legislature.

“I very much would like to have the State of New York be the progressive leader when it comes to campaign finance reform,” said Cuomo. “That’s going to be our goal.”

The governor also ruled out a pay raise for legislators, saying “that’s not going to happen this year,” saying it would not be appropriate in the aftermath of Sandy.

And the governor offered the first clues on what’s in the health study on hydraulic fracturing that is currently being reviewed by his health commissioner and three outside experts.

“They’re looking at the experiences of other states in the country where this has been done, reports of possible health consequences,” said Cuomo. “They will then help us make a determination whether there’s a true health risk or not.”

The governor says he believes when his environmental agency finishes the current 90 day extension of a rule making process, than the more than four year review of the gas drilling process will finally be finished.  

 

http://www.wnyc.org/articles/wnyc-news/2012/dec/12/cuomo-begins-outlining-agenda-next-year/

 

Study: 63% of Rise in Military Hospitalizations Due to MH Issues

Report Chronicles The Rising Burden Of Military Mental Health Care

Nextgov  December 10, 2012

 

A study comparing the military’s health care burden during the wars in Afghanistan and Iraq with its prewar burden found that hospitalization of active-duty troops for mental disorders accounted for 63 percent of the increases in hospitalization rates during those wars.

The report Friday by the Armed Forces Health Surveillance Center calculated the difference between the total health care delivered to military members during wartime (October 2001 through June 2012) with that which would have been delivered if prewar rates had persisted during the conflicts. It found that relative to the prewar experience, mental disorders accounted for excesses of more than 6 million ambulatory visits, 42,000 hospitalizations and 300,000 hospital bed days - increases of 35 percent, 63 percent and 48 percent, respectively.

The center, which conducts epidemiological and health surveillance studies for the Defense Department, analyzed treatment for 25 illness or injury categories for active-duty military personnel since Jan. 1, 1988. The study, “Costs of War: Excess Health Care Burdens During the Wars in Afghanistan and Iraq (Relative to the Health Care Experience Pre-War),” was published in the November issue of the Medical Surveillance Monthly Report released Dec. 7.

AFHSC pulled the data from the Defense Medical Surveillance System, which documents military and medical experiences of service members throughout their careers. The study included records for all active-duty servicemen and women - but not members of the National Guard or reserves - in fixed military and civilian facilitates.

“The total health care burdens associated with the wars in Afghanistan and Iraq are undoubtedly greater than those enumerated in this report because this analysis did not address care delivered in deployment locations or at sea, care rendered by civilian providers to reserve component members in their home communities, care of veterans by the Departments of Defense and Veterans Affairs, preventive care for the sake of force health protection, and future health care associated with wartime injuries or illnesses,” the report noted.

http://cdn.govexec.com/media/gbc/docs/pdfs_edit/012011brknwarlogongspot.jpg
Broken Warriors is an ongoing series on mental health issues in the military.

The report drives home the mental burden on the active-duty force after 11 years of war: “Mental disorders accounted for nearly two-thirds of all estimated excess hospitalizations during the war period... The predominance of these causes of excess hospitalizations and hospital bed days is not surprising, because they directly reflect  the natures, durations, and intensities of the combat in Afghanistan and Iraq, as well as the psychological stresses associated with prolonged and often repeated combat deployments.”

Nextgov reported in  March 2011 that slightly more than half of all Afghanistan and Iraq war veterans treated by Veterans Affairs received care for mental health problems, roughly four times the rate of the general population. The Congressional Budget Office reported in February that VA has treated 103,500 Afghanistan or Iraq veterans for post-traumatic stress disorder, or 21 percent of all veterans of those war receiving care from the department.

Dr. Remington Nevin, a former Army epidemiologist who left the service this fall to get a degree in public health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said the mental health report was long overdue. It “finally makes clear the tragic costs of our military's decade of unremitting conflict. Yet with few exceptions these striking totals reflect straight line trends that began 10 years ago and that should have been apparent as early as 2006,” he said.

“The somber conclusions of this report stand in sharp contrast to the optimistic testimony offered by military officials throughout the first five years of war. A critical question civilian policy makers must now ask is why analysis similar to this was not published five or even six years earlier, when it could have aided healthcare planning efforts and informed a meaningful debate on the direction of the war," Nevin added.

President Obama in August issued an executive order to beef up health care for veterans, mandating that VA hire an additional 1,600 mental health counselors by June 2013 and 800 peer counselors by Dec. 31, 2013.

 

http://m.nextgov.com/defense/2012/12/report-chronicles-rising-burden-military-mental-health-care/60045/