House Approves 2010 Funding for Mental Illness Research and Services

July 27, 2009

On July 24, by a vote of 264-153, the House cleared legislation that includes funding for mental illness research and services for FY 2010. The bill, known as the FY 2010 Labor-HHS-Education Appropriations bill (HR 3293) includes a $52 million increase for mental illness research at NIMH, as well as an $8.4 million increase for the PATH program (outreach services for homeless individuals with serious mental illness) and a $17 million for the Childrens Mental Health program. The Senate takes up the FY 2010 Labor-HHS-Education Appropriations bill in Committee next week.

Mentally Ill Immigrants have little hope for care when Detained

Mentally ill immigrants have little hope for care when detained
11:20 PM CDT on Sunday, July 12, 2009
By EMILY RAMSHAW / The Dallas Morning News
eramshaw@dallasnews.com
AUSTIN – Jose Fernandez Sanchez was delusional when he broke a window to enter his neighbor's apartment. The schizophrenic and epileptic 45-year-old, who had gone to an Austin hospital the day before, complaining of hearing voices, told police he was trying to light a candle for his dead mother. But instead of taking Sanchez to get medical attention, authorities started deportation proceedings against him, leaving the legal permanent resident in a detention-center cell for eight months. By the time a judge saw Sanchez, he was so catatonic that he couldn't answer a simple question.
Sanchez was one of the lucky few: His siblings pooled their money to hire an attorney, who made a compelling case to an immigration judge. Sanchez went from the detention center to a San Antonio psychiatric hospital, where he should have been all along.
But most mentally ill immigrants aren't so fortunate. They get limited mental-health care while in detention, advocates say – and that's only if they're diagnosed. They aren't entitled to competency hearings before standing trial. And the majority of them face judges without legal counsel, and with little recourse to defend themselves from deportation.
"I felt like I didn't have the power to get help. They didn't care how they were taking care of me," said Sanchez, who emigrated from Mexico in 1988 and received amnesty in the United States. "I was very scared, because I knew if I was sent back to my country, they wouldn't be able to help me like the U.S."


National guidelines

Immigration detention officials say they have strict guidelines for mental-health care in detention centers. All inmates receive a mental-health screening as part of their intake exam, they say. Those with suspected mental illness are referred for more tests and treatment. In fiscal 2008, detention-center personnel performed nearly 30,000 mental-health interventions – including providing emergency care to detainees seen as suicide risks.
"We are continuing to work ... to improve the services and the availability of health care to those in our custody," said Tim Counts, spokesman for U.S. Immigration and Customs Enforcement.
But immigration court officials acknowledge there's little guidance for how to handle mental health once these detainees come before a judge. Although judges can't accept an admission of guilt from an "unrepresented incompetent," there are no immigration-court proceedings to determine a person's competency. Judges have to go with their gut – which can be tough to gauge with language barriers and the frequent use of long-distance video conferencing.
"There are no rules or any guidelines or any laws related to determining mental competency," said Elaine Komis, spokeswoman for the Executive Office for Immigration Review, which oversees deportation hearings for the U.S. Department of Justice. "When judges encounter someone who seems to be mentally incompetent, they do try as much as possible to arrange for some kind of pro bono counsel."
Social-justice advocates say that's not good enough. Researchers from the nonprofit advocacy group Texas Appleseed have teamed up with pro bono attorneys from the Akin Gump law firm to study mental-health procedures in detention and deportation proceedings. Their focus is on Texas, which houses a third of the country's immigrant detainees and is home to eight of the nation's 55 immigration courts.
These advocates say detention facilities don't consistently follow mental-health standards, and often don't have enough mental-health workers to handle the estimated 15 percent of detainees suffering from mental illness.
Until early this year, they say, two Texas detention centers housing a combined 2,700 people shared a single psychiatrist. As a result, they say, detainees who receive mental-health treatment in the community rarely get it once they're incarcerated. They miss medicine doses, get misdiagnosed or are prescribed drugs with which they aren't familiar.
"There are no real standards for diagnosing or dealing with mental-health issues while in the system," said Steve Schulman, a partner with Akin Gump who heads the firm's pro bono practice.

Lack of hearings

Advocates say that even if someone is diagnosed with mental illness in the detention setting, it's rare for that to get passed along to a judge.
Unlike in the criminal- justice system, there are no mental-competency hearings. Fewer than half of detainees have legal representation. Immigrants represented by attorneys are 50 percent more likely to avoid deportation, but the government has no obligation to appoint counsel for those who can't afford it.
"The end result is that people are being deported without regard for their mental health," said Ann Baddour, senior policy analyst at Texas Appleseed.
In one case, advocates say, a severely mentally ill woman was nearly deported to Russia because she told authorities she was a Russian immigrant. She was actually a U.S. citizen from Indiana. In another, a Haitian immigrant whom a criminal court had declared incompetent to stand trial was taken into custody by immigration officials at a psychiatric hospital.
Sanchez's siblings are sure their brother would have wound up back in Mexico – or worse, dead – if they hadn't been able to hire an attorney.
"He was never evaluated properly, never given proper treatment," said Sanchez's brother, who asked not to be identified because of his immigration status. "He was all alone in there. We feared the worst, that he would be deported or even take his own life."

Loved One Refusing Meds in the Hospital?

In the state of Texas, even if a person is committed involuntarily to the hospital for treatment, that person has a right to refuse medication. So what can be done to help your loved one? An application can be made to the county judge under Texas Health and Safety Code § 574.104. "PHYSICIAN'S APPLICATION FOR ORDER TO AUTHORIZE PSYCHOACTIVE MEDICATION." This can actually be done at the same hearing for the commitment order, but may be done as far out as 30 days after the application is filed with the court. Or, if the hospital is in a different county (as Rusk State Hospital and Terrell State Hospital is for Smith County) the original county court may transfer this type of jurisdiction to the hospital's county court. This way the person does not have to be transported back to their original county for the hearing. Sounds logical doesn't it?

So how does Smith County compare? Smith County has typically longer hospital stays than other counties with a cost to taxpayers of $363 per person per day as indicated in this DSHS report. Statewide, the average length of stay in a state hospital is 36 days. For Rusk State Hospital it is 45 days. Why is this? Are the patients getting more treatment? Actually the opposite is true. For those from Smith County and refusing medications, the application for court ordered medications is probably sitting on the county judge's desk. These hearings are not scheduled in an expedient manner and the Smith County Judge refuses to transfer the jurisdiction to Rusk County because this costs a few hundred dollars. So, by saving a few hundred dollars, the county judge is costing the taxpayers thousands.

Now, I have mentioned the financial impact not because that's the most important concern, but, because (1) it's easy to follow the tax dollars, and, (2) dollar signs speak louder to politicians than humanity issues. Nothing speaks louder than dollar signs to politicians seeking re-election except for maybe voters calling and stating their concern. What can you do about it? Contact the Smith County Judge and tell him you are concerned about the probability that applications for court ordered medications are not being handled in an expeditious manner. Or, just ask him questions about how long this process takes or how it happens. Be polite and your concerns will probably be taken seriously. This is the grassroots way of making a change in government.

Please leave your experiences in the comments section.

Public Comment on Community Mental Health Block Grant Plan

Public Comment on Community Mental Health Block Grant Plan
The Texas Department of State Health Services (DSHS) is submitting an application to the Substance Abuse and Mental Health Services Administration (SAMHSA) for Block Grant funding for Federal Fiscal Year (FFY) 2010 for Community Mental Health services for youth and adults throughout the state’s 11 health and human services regions. These federal funds provide approximately 31 million dollars a year to Texas for the provision of Community Mental Health Services.

The Mental Health Block grant program awards funds to states to establish or expand an organized, community-based system for providing mental health services for adults with serious mental illness (SMI) and children with serious emotional disturbances (SED). Funds awarded are to be used to carry out the approved state plan, to evaluate programs and services set in place under the plan, and to conduct planning, administration and educational activities related to the provision of services under the plan. The Community Mental Health Services Block Grant accounts for approximately 7% of DSHS expenditures of Community Mental Health.

For complete details on submitting public comments on the Draft Mental Health Block Grant (MHBG) Plan, please see the MHBG page. Comments must be received by 5:00 p.m. Central Daylight Saving Time, Thursday, August 14, 2009.

Criminal Justice Symposium at NAMI Convention

The Criminal Justice Symposium at last week’s NAMI Convention in San Francisco featured excellent presentations by Judge Stephen V. Manley of Santa Clara County’s Mental Health Court and Kathleen Connolly-Lacey who co-founded San Francisco’s Behavioral Health Court. Santa Clara’s Mental Health Court is the largest such court in the nation, serving 1,600 individuals with mental illness and substance abuse disorders, most of whom have been charged with felonies. San Francisco’s Behavioral Court is a collaboration in the best sense of the word between the court system and the mental health system. Individuals served by the Court (also primarily charged with felonies) have access to an array of services, including Assertive Community Treatment, supportive housing, and supported employment.

A particularly moving moment occurred when Judge Manley introduced a young woman who was a graduate of his Court five years ago. Since her arrest and diversion, she has made great progress in recovery, has moved to Albuquerque, NM and was attending the NAMI Convention as a representative of NAMI-New Mexico. She later told me that she believes that Judge Manley’s compassion and support “saved my life.”

Prior to speaking at the Convention, Judge Manley, this year’s recipient of NAMI’s Sam Cochran Criminal Justice Award, stopped by the studio’s of KQED, Northern California’s public radio station, and gave an interview about the Santa Clara Court. Here is a link to that interview.

http://www.californiareport.org/archive/R907090850/a

Thanks to Judge Manley and Ms. Connolly-Lacey for their excellent presentations and for compassion and strong commitment to recovery for people with mental illnesses.

Doc puts inmates' mental health first

From my SA news:
By Melissa Fletcher Stoeltje - Express-News


It's become a given among mental health professionals that jails are now the largest psychiatric hospitals in the country. In Bexar County, as in others around the nation, roughly one out of four inmates suffers from some kind of mental illness.

That translates into some 800 inmates at the county jail being treated for a psychiatric disorder — hundreds more than patients being cared for at the San Antonio State Hospital.

Dr. Sally Taylor, administrator of psychiatric services at Bexar County Jail, has been on the front lines of the struggle to treat and rehabilitate mentally ill prisoners.

Before that, she was the medical director of the psychiatric emergency room at University Hospital for 17 years, dealing with some of the most disturbed and violent patients and training scores of medical students and other health professionals.

But she's done more than that. By all accounts, Taylor has been a tireless advocate for the mentally ill in San Antonio, working with local advocacy groups to reduce stigma about mental illness, encourage churches to address mental disorders and promote education and community awareness about mental disease.

Recently, she worked with other mental health groups on legislation to compel mentally ill prisoners to take their medication.

This is important for those who have been found incompetent to stand trail and are in jail awaiting transfer to an inpatient competency restoration program.

This will allow treatment for those with severe mental illness who are a danger to self or others or who lack the capacity to understand the risk of refusing treatment, and who have been excluded from court ordered treatment simply because they are located in jail.

It might even help some inmates enough that they could enter outpatient competency restoration.

The bill was signed into law by Gov. Rick Perry.

Because of her work, Taylor was recently one of 41 psychiatrists around the country to be given the prestigious 2009 Exemplary Psychiatrist award by the National Alliance on Mental Illness, for which she was nominated by the local NAMI chapter.

“Psychiatrists who are honored have really gone the extra mile,” said Michael Fitzpatrick, executive director for NAMI. “We awarded Dr. Taylor not only for her work in (University Hospital's psychiatric ER) but for her engagement with us on policy, corrections and faith-based initiatives. She's just outstanding.”

Yolanda Alvarado, chairwoman of the Bexar County Mental Health Task Force, said Taylor was the driving force behind the compelled medication legislation.

“I know that it came from her brain,” Alvarado said. “She got the judges involved, too. She actually went to testify. Because she's a doctor, she carries such credibility.”

Speaking from her office inside the jail, Taylor, who earned her medical degree from the University of Texas Health Science Center, said mentally ill people off their medication often commit petty crimes — criminal mischief and the like — then wind up in jail.

Before the legislation she worked on became law, they couldn't be compelled to take medication in jail, unlike in mental health facilities. They would be judged incompetent to stand trial.

“And then what happens is they end up languishing in jail for two or three months because there are no open beds at the state hospitals,” she said.

“And for all that time they're deteriorating and getting worse. I worry that some of these people might never be restored because the brain stays sick for so long.”

Sometimes an inmate goes into the state hospital for competency restoration, then comes back to the jail and again refuses medication — which sends him or her back to the hospital. It's becomes a cycle.

Taylor, to appease advocacy groups that resist the idea of compelled medication, helped craft the legislation to apply only to those inmates who are deemed a danger to themselves or others.

But her goal is not just to help restore sick inmates to competency. In 2008 she advocated for more than 100 inmates who had committed misdemeanor crimes to have their charges dropped so they could then enter treatment programs, rather than incarceration.

“In coordination with the district attorney's office, the probate court, the jail staff and the Center for Health Care Services, we were able to get civil commitments sending them to the state hospital,” she said. “That may not sound like a lot of people, but for us it was a brand new process, and it became a well-oiled process.”

Taylor applauds the city's award-winning jail diversion program, which trains police officers to recognize mentally ill law-breakers and take them to ERs and other treatment facilities instead of jail.

But she said much more needs to be done with regard to the long-term needs of mentally ill lawbreakers.

“We do a great job recognizing the (mentally ill) at the front door, but the problem is the back door,” she said. “Bexar County is one of the lowest counties in per capita funding for mental health in Texas, and Texas is 48th or 49th out of the 50 states in terms of funding for mental health.

“You can do all the screening and all the jail diversion that is possible, and I'm completely in favor of that, but you've got to have services for people when you send them out in the world.”

Too often, she said, released mentally ill inmates confront a host of obstacles on the outside that hobble them in being compliant with their medical care. And then they re-offend.

“If somebody comes to the jail because it's a place to sleep and eat, you want to be able to provide that on the outside,” she said. “We don't have enough residential units, we don't have enough housing, we don't have enough supported employment, we don't have support services, we don't have intensive case management. So we drop the ball.”

Taylor, who swims and makes jewelry to de-compress from her high-pressure job, said she is drawn to working with the prison population because she is able to help give voice to the voiceless.

“I like helping people that the rest of society shuns,” she said.

Annual NAMI Texas Conference in October

Practicing From the Shadows

Lawyers and Judges are not immune from mental illness. The Texas Lawyers' Association Program has the following video available on their website "Practicing from the Shadows: Depression and the Legal Profession" DVDs now available. Click here to watch the video. Call TLAP at 1-800-343-8527 for a free copy. This is an excerpt from the Texas Lawyers' Assistance Program:

The nationally acclaimed Texas Lawyers' Assistance Program (TLAP) has evolved from helping lawyers with substance abuse disorders and alcoholism to assisting lawyers, judges and law students with mental health issues. The March 2007 issue of the Texas Bar Journal features articles and information about TLAP and the services offered.

TLAP was created to provide for the identification, peer intervention and rehabilitation of any Texas attorney or law student whose professional performance is impaired because of substance abuse, dependency or mental health disorders. Current estimates indicate that anywhere from 10,000 to 15,000 lawyers in Texas suffer from substance use disorders or mental health issues affecting their law practices. TLAP can help save the lives of these attorneys. Our work also contributes to the protection of the public, the improvement of the integrity and reputation of the legal profession, and, because assistance to an affected lawyer often prevents future ethical violations, the reduction of disciplinary actions.

What Lawyers Need to Know About Suicide During a Recession: Prevention, Identity and Law Firm Responsibility

This is a free download from the American Bar Association.

Suicide is our most preventable form of death. Many attorneys are in frequent contact with populations at elevated risk for suicide. In their professional roles, attorneys occupy a strategic position to intercept suicidal communications and identify and refer potentially suicidal clients, as well as employees and colleagues, for professional assessment and possible life-saving treatment. In addition Model Rule 1.14 gives the attorney broad power and responsibility when representing clients with diminished capacity.

Attorneys also have the highest rates of depression and suicide of any profession. Statistics suggest that the rate of suicide attempts among attorneys and their clients is increasing as the effects of the recession widen.

This program addresses the ethical responsibility employers have to assist attorneys in their employ that may be suicidal.

Officer Caught Beating Schizophrenic Says He Did Nothing Wrong

Contempt, by some, for the mentally ill is as old as the hills and much work in our enlightened society still needs to be done. Perhaps this officer falls within that category, or, perhaps not - as preliminary information is sketchy. At first glance: this is another disheartening story and sign of our times.
Officer Caught Beating Schizophrenic Says He Did Nothing Wrong

Bills Waiting to Be Signed By Governor Perry That Impact MHMR Centers

The general sense among Community MHMR Centers is that the 81st Legislative Session provided substantial and significantly new resources for improved community-based services across Texas. Some examples include: increases in medicaid waiver services for developmental disabilities; enhanced crisis services; stimulus and infrastructure funds; and a new benefit package in medicaid for substance use treatment. For a final listing of Senate and House bills relating to behavioral health or developmental disabilities that are awaiting the Governor's signature, click here .

from:
David Evans
Executive Director
Austin Travis County Mental Health Mental Retardation Center

The Advocacy Handbook: A Guide for Implementing Recommendations of the Criminal Justice / Mental Health Consensus Project

Download Handbook pdf.

The Advocacy Handbook reflects a shared effort among NAMI (the National Alliance for the Mentally Ill), the National Mental Health Association (NMHA), the National Association of State Mental Health Program Directors (NASMHPD), the Bazelon Center for Mental Health Law, and the Criminal Justice / Mental Health Consensus Project.

Transforming the Mental Health of Veterans

By Sam Shore, MSSW
Director, Texas Mental Health Transformation Project
Department of State Health Services

As a recipient of a Mental Health Transformation federal grant from the Substance Abuse and Mental Health Services Administration, Texas is charged with building a solid foundation for delivering evidence-based mental health and related services, fostering recovery, improving quality of life, and meeting the multiple needs of mental health consumers across the life span. As directed by the Governor of Texas, DSHS serves as the administrative home of the grant in Texas. The Governor directed 14 state agencies and consumers/family members to form the Mental Health Transformation Working Group. At its August 2008 meeting, the Transformation Working Group recommended that DSHS coordinate a subgroup to identify the behavioral health needs of veterans returning to Texas from Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom, and to describe gaps and provide recommendations.

Texas has the third largest population of veterans in the United States and contributes a significant number of the military service members deployed as part of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom. According to the RAND Corporation’s Invisible Wounds of War report, up to 15% and 14% of service members returning from Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom are affected by post-traumatic stress disorder or major depressive disorder, respectively. These conditions require ongoing behavioral health services and supports for veterans as well as their families.

Many federal, state, and private organizations provide behavioral health services for veterans. At the federal level, the U.S. Department of Veterans Affairs has primary responsibility for combat veterans who have been discharged from active duty. Veterans Affairs offers comprehensive health care coverage for veterans, including inpatient and outpatient mental health and substance abuse diagnosis and treatment. Veterans Affairs also offers counseling and reintegration services at hundreds of Veteran Centers across the country, including 15 in Texas. All combat veterans and their families are eligible for Veteran Center services at no charge for military-related issues, including confidential screening, counseling, and linkage to other services.

At the state level, multiple state, federal, and private partners have joined together in a memorandum of understanding under the name “Partners Across Texas.” This partnership is an interagency and multi-organizational collaboration to enhance support for Texas veterans and their families. A variety of services are available from agencies, such as the Texas Veterans Commission, Texas Military Forces, Health and Human Services Commission, Department of Assistive and Rehabilitative Services, and Texas Workforce Commission, along with DSHS. State services ensure that veterans are linked to federal benefits and are supported, as they attempt to return to work and deal with the physical, psychological, and emotional impacts of combat experience. As part of Partners Across Texas, the Texas Information and Referral Network (2-1-1 Texas) and the TexVet: Partners Across Texas website (www.texvet.com) provide comprehensive information about services in Texas for veterans and their family members.

At the local level, there are 37 DSHS-funded community mental health centers that serve as a foundation for the locally managed public system of care for Texans with serious mental illness. The centers provide an array of behavioral health services that veterans or their family members may need, including crisis services and case management. Many other individuals and systems also interact with veterans at the community level, including the criminal justice system, courts, employers, hospitals, schools, and community groups.

Based on the identified gaps and the resources currently available, the Mental Health Transformation Working Group Returning Veterans Subgroup recommended the following:

*

Data. Collaborate with federal and state partners to gather comprehensive data on the behavioral and physical health status of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom veterans and their families.
*

Service utilization. Develop outreach strategies utilizing the Texas Information and Referral Network (2-1-1 Texas), 12-Step Groups, peer support services, and the TexVet: Partners Across Texas website.
*

Quality and effectiveness of services. Provide education and training to medical and behavioral health service providers, information and referral specialists, law enforcement officers, and others to increase understanding of veterans’ behavioral health issues.
*

Health care coverage and access. Explore options to address gaps in health care coverage and access, especially for families of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom veterans. Evaluate the costs to help pay health insurance premiums for families of these veterans, and encourage Veterans Affairs to refer veterans to qualified community providers when there are gaps between needed behavioral health services, and those available at the Veterans Affairs facility nearest to the home of the veteran.
*

Coordination and communication. Cultivate partnerships among multiple federal, state, and local entities to foster improved coordination. Build upon partnerships established in the “Partners Across Texas” memorandum of understanding, and coordinate recommendations with other efforts at the state and national levels.

Given the great number of Texas veterans, these partnerships must be maintained and strengthened. The Mental Health Transformation Working Group will move forward with these recommendations, and address the behavioral health needs of veterans and their families.
For more information

* Behavioral Health Services for Returning Veterans and Their Families: Services, Gaps, and Recommendations. A 2008 Report of the Returning Veterans Subgroup of the Mental Health Transformation Working Group, www.mhtransformation.org.
* Invisible Wounds of War: Summary and Recommendations for Addressing Psychological and Cognitive Injuries. A 2008 Report by the RAND Corporation, http://www.rand.org/pubs/monographs/2008/RAND_MG720.1.pdf.
* TexVet: Partners Across Texas, (www.texvet.com)

Bringing Them Home: Addressing the Behavioral Health Needs of Veterans and Their Families

By Kay Hart, MPAff Candidate
Lyndon B. Johnson School of Public Affairs
The University of Texas at Austin

No one leaves war unchanged and those changes may include both physical and mental trauma that adversely affects the quality of life for those who serve in the military and the families that love and support them. Nationally, 1.5 million soldiers have served in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) and 60% of these soldiers are married and/or have children. With the third largest population of resident veterans and 14 major military bases, Texas is deeply impacted by issues affecting military personnel and their families.

In many ways, especially those related to mental health, the impact on military personnel serving in OEF/OIF and their dependents is unprecedented. For example, half of those serving have been Reservists or members of the National Guard. These service men and women do not deploy from or return to regular military bases. Thus, they and their families often do not have the support that comes from living in a community of people who share their experiences.

Another unprecedented aspect of OEF/OIF is the number of deployments faced by many in the military. Nearly 500,000 service men and women have been deployed for more than one tour with four and five tours being common. Being deployed more than once increases the exposure to trauma for military persons, and lengthy and frequent separations increases the stress experienced by their loved ones.

Also, unlike previous conflicts where the typical soldier was a young, single male, 20% of those serving in Iraq and Afghanistan are female and most soldiers have families. In fact, 23,000 of those serving in OEF/OIF are single parents with custody of their children. Dual military families, where both spouses serve, are also a significant factor in the military. As a result of these changing demographics, 2 million children have been directly affected by the deployment of a parent and 40% of these under 5 years old.

All of these factors combine to produce significant mental health risks for active duty military personnel, veterans, and their families. It is estimated that 30-40% of Iraq veterans will face depression, anxiety, or Post Traumatic Stress Disorder (PTSD). In addition, 320,000 OIF/OEF veterans have experience Traumatic Brain Injury (TBI), a physical injury to the brain that is associated with symptoms similar to PTSD.

The family also faces mental health risks associated with both the deployment and reunion phases of military service. With so many infants and young children experiencing separation from one or both parents, mental health workers are concerned about attachment issues and negative impacts on brain development. Furthermore, adolescents with a deployed parent are more likely to participate in risky behavior, such as teen pregnancy and substance abuse. These are compounded by troubling evidence that the stress of loneliness and worry experienced by the caregiving spouse results in an increased risk for child maltreatment during periods of deployment. Even after the return of the military family member, difficulties in adjustment and mental or physical health issues faced by the veteran can result in increased anxiety and depression in their children.

Promoting resilience in the families of veterans and service personnel offers hope that behavioral health issues can be avoided in the long-run. People with resilience are able to harness inner strength, access external help, and rebound more quickly from setbacks. Without resilience, people turn to unhealthy coping mechanisms such as substance abuse and may develop significant mental health problems. The task of helping military families develop greater resilience rests with the entire community.

An important first step in promoting resiliency is recognizing the warning signs of mental illness and knowing what treatment options are available. The National Center for Posttraumatic Stress Disorder provides excellent information about warning signs and treatment options for PTSD and other mental health conditions. They also provide information for the family about coping during deployment. This information is helpful not only for families affected by deployment, but for those who want to support them during this time.

Promoting resiliency and offering support to veterans and their families can happen in a variety of ways. For example, a group in California offers Surf Camp to the children of wounded or fallen service members. There are numerous organizations like this and it is important to connect them with members of the community that want to help and veterans and their families that need help. TexVet: Partners Across Texas (TexVet P.A.T.) is a collaborative effort of various local, state, and federal entities and programs to ensure the availability of a system of resources and referrals for members of our military service, veterans, and their families. The TexVet website provides valuable information that helps provide those connections.

While no one leaves war unchanged and the burdens of war are born by even the children of those that serve, those burdens do not have to be born alone. Bringing our service men and women home to stable families, strong communities, and a committed mental health care system can provide the best outcomes for everyone affected by the trauma of war.
For more information

* The National Center for Posttraumatic Stress Disorder
http://www.ncptsd.va.gov/ncmain/information/
* Coping When a Family Member Has Been Called to War
http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/familycoping.html?opm=1&rr=rr116&srt=d&echorr=true
* Surf Camp
http://www.ourmilitary.mil/Content.aspx?ID=45009891
* TexVet
http://www.texvet.com/

Study on the Fiscal Return on Investment in Expanded Mental Health Services in Texas

Costs, Consequences, and Cures!!!
An Assessment of the Impact of
Severe Mental Health and Substance Abuse Disorders on
Business Activity in Texas and the
Anticipated Economic and Fiscal Return on
Investment in Expanded Mental Health Services

The benefits from implementing a $20 million hypothetical
jail diversion program would include a positive net annual
impact of $1.074 billion in total expenditures and 6,420
permanent jobs. The yearly increment to State tax receipts
that could be expected was calculated to be $53.964 million,
or a return of $2.70 per dollar of investment and $53.71 in
overall benefit.

Mental Health Transformation

A primary goal of the Mental Health Transformation effort in Texas is to make the mental health system consumer and family focused. The Department of State Health Services (DSHS) has allocated funding to establish a mental health consumer, family, and youth training and technical assistance center through a contract with Mental Health America of Texas and the National Alliance for Mental Illness-Texas.

Nominations are being accepted for members of a 15-member advisory committee that will define the role and scope of this training and technical assistance center. The majority of committee members will be consumers, family members and youth. The remainder will be other individuals in the mental health field who are committed to achieving consumer-focused transformation. Nomination forms are due by June 1, 2009. To request the nomination form or more information, call (512) 454-3706, Ext. 204, or email Kathi@mhatexas.org.

What is NAMI?

Fox's new show "Mental"

From My S.A.
Nicholas Gonzalez, who comes from a San Antonio family of doctors, will soon be playing one on TV.

The Central Catholic High graduate portrays a first-year resident in a mental health ward in Fox's new summer medical-mystery drama, "Mental."

Gonzalez called the series groundbreaking.

"For the first time, we have a drama that delves into the head, the psyche, the subconscious of patients, rather than just giving us reactions from the doctors," he said in a phone chat from Los Angeles.

For instance, in one episode, a woman who suffers from the fear of water clutches the side of a hospital pool. When she's asked if she's ready to go underwater, we see what she sees: a frightening ocean of high waves and sharks.

Each episode of the Tuesday night series presents a new puzzle for the doctors to solve.

"Mental," which debuts at 8 p.m. May 26 on Fox, is one of many new and returning shows coming viewers' way this summer. Lots of reality shows will fill the warmer months, along with a sprinkling of scripted comedies and dramas.

The season also is known for taking more chances and introducing quirkier characters, such as "Mental's" Dr. Jack Gallagher (Britain's Chris Vance, "Prison Break") a radically unorthodox psychiatrist who becomes the new director of mental health services at an L.A. hospital.

Take Jack's entrance: As a naked delusional patient violently confronts the staff, Jack strips down to nothing as well to gain the patient's trust.

"Jack's got this edge to him," Gonzalez said, "he ramps it up and says let's screw the system a bit."

Gonzalez's character, Dr. Arturo Suarez, is the only one who likes Jack from the beginning and takes his side. Arturo also has his colorful moments. He's a bit scruffy with a light beard and confident to the point of being cocky. He's forever hitting on fellow resident Chloe (Marisa Ramirez) even though she's gay.

In a future episode, a woman who's addicted to sex checks into the ward, and "Arturo is forced to take a little of his own medicine," Gonzalez said.

Gonzalez gets back to his hometown whenever possible to visit his family, mom Sylvia Mosier and dad Dr. John Gonzalez, a prominent S.A. dermatologist.

Much of his time recently was spent in Bogota, Colombia, where the bulk of "Mental" was shot as an expense saver and where Gonzalez met his girlfriend, telenovela star Mimi Morales.

Gonzalez has had no problem finding work since landing the role of a boxer on former Showtime series "Resurrection Blvd" at the age of 24. He's guest-starred on many series, including "Grey's Anatomy," "CSI: Miami" and "True Blood." He's also starred in movies, was a regular on the PBS series "American Family" and played a sexy gardener on "The O.C."

Offscreen, he's an ace at cards as well, recently winning $50,000 in the latest World Poker Tour Celebrity Invitational.

At the age of 33, Gonzalez says he has never felt more fulfilled: "I'm in love with my 30s. It's been just awesome."

He's also excited about a future role. He says he has been cast in one of the most buzzed-about shows of the fall, the CW's remake of "Melrose Place." He'll play a detective trying to solve a murder.

"It's a fun character — a man among all these boys and girls," he said with a laugh, adding, "I used to be hot ass and now I'm just old ass."

After Seeing the Soloist - Letter to NAMI - Tyler

Dear NAMI-Tyler,
After seeing "The Soloist" it makes me want to ask the question does having a mental illness make us criminals? Then we should at least be treated with medications in prison. Does being homeless constitute a crime? Then I think society may need to improve it's treatment of us.
If friendship can help a person who is living with mental illness recover then we need to use the people that are living with their mental illnesses to help those suffering the same things. The sick need a friend that can listen not with judgement but with an understanding mind and heart. The sufferers may find that the survivors of mental illness are particularly more able to understand them than someone that hasn't lived through similar situations. While we all have suffered loneliness, maybe not to the extent of sufferers of mental illness, we can in our humanness identify at least a little bit with them and can give sufferers a prayer, a kind thought or word just to say that there is a way out. There is a rainbow after the storm. You can live with a mental illness. You can have hope.

Long Waits the Norm

…The U.S. Department of Health and Human Services has designated 184 of the state's 254 counties as mental health professional shortage areas, meaning the number of professionals needed to provide adequate care to mental health patients is inadequate. That includes Gregg, Upshur, Rusk and Smith counties. …Since 2000, the number of mental health counselors and social workers dwindled from 72 counselors per 100,000 Texas residents to 66 counselors per 100,000 residents in 2007, according to a report by the Texas Hogg Foundation for Mental Health. The same reports also states that the number of psychiatrists dropped from seven per 100,000 residents to six per 100,000 Texas residents in 2007.
From the Longview News Journal.