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

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

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

Some of the highlights of the bills they developed are:

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

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

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

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

Thank you,

Matt

Matt Kuntz

Executive Director

NAMI Montana

www.namimt.org

(406) 443-7871

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

NAMIWalk Team Captain Duties

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

NAMIWalk Team Captain Duties

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

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

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

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

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

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

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

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

              Just when a scientific principle or discovery crosses the line

              between the experimental and demonstrable stages is 

              difficult to define. Somewhere in this twilight zone the 

              evidential force of the principle must be recognized, and 

              while the courts will go a long way in admitting experimental 

              testimony deduced from a well-recognized scientific principle 

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

              be sufficiently established to have gained general acceptance

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

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

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

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

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

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

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

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

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

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

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

Angry and Tired

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

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

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

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

Dr. Gary Mihelish

President

NAMI Helena
618 Edgerton Road
Helena, MT 59602

Sticking With Your Treatment Plan

Part Seven of Debra Hoppe's Recovery Series

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

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

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

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

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

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

Don't Give Up

By Debra Hoppe

Part Six

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

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

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

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

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

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

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

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