11 Points for Mental Health Care Reform

Due to greater understanding of how many Americans live with mental illnesses and addiction disorders and how expensive the total healthcare expenditures are for this group, we have reached a critical tipping point when it comes to healthcare reform. We understand the importance of treating the healthcare needs of individuals with serious mental illnesses and responding to the behavioral healthcare needs of all Americans. This is creating a series of exciting opportunities for the behavioral health community and a series of unprecedented challenges Mental health organizations across the U.S. are determined to provide expertise and leadership that supports member organizations, federal agencies, states, health plans, and consumer groups in ensuring that the key issues facing persons with mental health and substance use disorders are properly addressed and integrated into healthcare reform.

In anticipation of parity and mental healthcare reform legislation, the many national and community mental health organizations have been thinking, meeting and writing for well over a year. Their work continues and their outputs guide those organizations lobbying for government healthcare reform. .

MENTAL HEALTH SERVICE DELIVERY

1. Mental Health/Substance Use Health Provider Capacity Building: Community mental health and substance use treatment organizations, group practices, and individual clinicians will need to improve their ability to provide measurable, high-performing, prevention, early intervention, recovery and wellness oriented services and supports.

2. Person-Centered Healthcare Homes: There will be much greater demand for integrating mental health and substance use clinicians into primary care practices and primary care providers into mental health and substance use treatment organizations, using emerging and best practice clinical models and robust linkages between primary care and specialty behavioral healthcare.

3. Peer Counselors and Consumer Operated Services: We will see expansion of consumer-operated services and integration of peers into the mental health and substance use workforce and service array, underscoring the critical role these efforts play in supporting the recovery and wellness of persons with mental health and substance use disorders.

4. Mental Health Clinic Guidelines: The pace of development and dissemination of mental health and substance use clinical guidelines and clinical tools will increase with support from the new Patient-Centered Outcomes Research Institute and other research and implementation efforts. Of course, part of this initiative includes helping mental illness patients find a mental health clinic nearby.

MENTAL HEALTH SYSTEM MANAGEMENT

5. Medicaid Expansion and Health Insurance Exchanges: States will need to undertake major change processes to improve the quality and value of mental health and substance use services at parity as they redesign their Medicaid systems to prepare for expansion and design Health Insurance Exchanges. Provider organizations will need to be able to work with new Medicaid designs and contract with and bill services through the Exchanges. 

6. Employer-Sponsored Health Plans and Parity: Employers and benefits managers will need to redefine how to use behavioral health services to address absenteeism and presenteeism and develop a more resilient and productive workforce. Provider organizations will need to tailor their service offerings to meet employer needs and work with their contracting and billing systems.

7. Accountable Care Organizations and Health Plan Redesign: Payers will encourage and in some cases mandate the development of new management structures that support healthcare reform including Accountable Care Organizations and health plan redesign, providing guidance on how mental health and substance use should be included to improve quality and better manage total healthcare expenditures. Provider organizations should take part in and become owners of ACOs that develop in their communities.

MENTAL HEALTHCARE INFRASTRUCTURE

8. Quality Improvement for Mental Healthcare: Organizations including the National Quality Forum will accelerate the development of a national quality improvement strategy that contains mental health and substance use performance measures that will be used to improve delivery of mental health and substance use services, patient health outcomes, and population health and manage costs. Provider organizations will need to develop the infrastructure to operate within this framework.

9. Health Information Technology: Federal and state HIT initiatives need to reflect the importance of mental health and substance use services and include mental health and substance use providers and data requirements in funding, design work, and infrastructure development. Provider organizations will need to be able to implement electronic health records and patient registries and connect these systems to community health information networks and health information exchanges.

10. Healthcare Payment Reform: Payers and health plans will need to design and implement new payment mechanisms including case rates and capitation that contain value-based purchasing and value-based insurance design strategies that are appropriate for persons with mental health and substance use disorders. Providers will need to adapt their practice management and billing systems and work processes in order to work with these new mechanisms.

11. Workforce Development: Major efforts including work of the new Workforce Advisory Committee will be needed to develop a national workforce strategy to meet the needs of persons with mental health and substance use disorder including expansion of peer counselors. Provider organizations will need to participate in these efforts and be ready to ramp up their workforce to meet unfolding demand.

http://www.thenationalcouncil.org/cs/mission_and_vision

Anxiety Treatment - The Natural Remedy for Anxiety Relief

L-Theanine, naturally occurring in green tea, proves effective in dealing with anxiety symptoms and providing anxiety relief

Anxiety is a state of intense fear, uncertainty, uneasiness, or apprehension due to anticipation of an imagined or real threatening future event. Anxiety can be both physically and psychologically devastating to the Anxiety sufferer's life. Anxiety is often sub-categorized according to the focus of the perceived threat. There is social anxiety, separation anxiety, dating anxiety, performance anxiety, math anxiety, etc. Stress and anxiety often go hand in hand and can result in anxiety depression as the individual feels powerless to receive any anxiety help.

There are a variety of anti-anxiety treatments to consider in overcoming anxiety. For some, anxiety medications prove to be a source of anxiety relief. Other's prefer not to use any of the anti-anxiety drugs and opt for more natural cures for anxiety management. These may include herbs for anxiety, acupuncture anxiety treatments, anxiety vitamins, aromatherapy for anxiety relief, even hypnosis has has proved beneficial overcoming anxiety.

This article discusses the perhaps little known amino acid L-Theanine as a natural remedy for anxiety relief.

L-Theanine is a unique free form amino acid found only in the tea plant and in the mushrooms Xerocomus badius and certain species of genus Camellia, C. japonica and C. sasanqua. Often drinkers of green tea report a feeling of calmness they feel after ingesting a cup or two even though green tea has roughly half the caffeine of coffee. This is due to the high L-Theanine content.

In addition to reducing anxiety symptoms, studies have shown L-Theanine may be effective in promoting concentration, supporting the immune system, improving learning performance, lowering blood pressure, increasing formation of the inhibitory neurotransmitter GABA, and increasing brain dopamine levels among other positive benefits with no known downside.

Studies in cooperation with Taiyo Kagaku Co., The University of Shizuoka, and The Family Planning Institute of Japan have shown that women taking 200 mg L-Theanine daily have lower incidence of PMS symptoms. These symptoms include physical, mental, and social symptoms. Overall, a significant alleviation of PMS symptoms by L-Theanine was observed. 

While still under investigation, L-Theanine appears to have a role in the formation of the inhibitory neurotransmitter Gamma Amino Butyric Acid (GABA). GABA blocks release of the neurotransmitters dopamine and serotonin, playing a key role in the relaxation effect. 

Everyone knows the effects stress and anxiety can have on an individual's physical state of well-being. Fascinating neurochemistry research has revealed that given a shot of GABA essentially turned back the clocks in the brains of older monkeys, whose brain function briefly operated at levels normally seen in monkeys less than half their age.

GABA, or gamma-amino butyric acid, is a neurotransmitter chemical that is essential for optimizing how brain cells transmit messages to each other and acts to put a damper on unwanted brain signaling activity. Although GABA's age-related decline has not been documented in humans, a host of studies in mammals, including other primates, suggests that a similar process is at work in people.

Monkeys ages 26 and 32 -- considered old age for monkeys -- that got GABA directly delivered to their neurons responded to visual patterns, such as flashing vertical and horizontal lines, in much the same way as monkeys aged 7 to 9 years old did. 

Without GABA delivery, the monkeys' aged brains had more difficulty firing neurons that specifically gauge various aspects of depth perception, motion and color. Instead, older monkeys have more random firings that make it difficult to observe visual nuances. In younger monkeys, GABA had no effect since their brains already had optimal GABA functioning.

L-Theanine is considered to be safe based on its historical use as a component of tea and on favorable toxicology studies. Tea is the most consumed beverage worldwide after water, and has been consumed for thousands of years by billions of people. It is estimated that a heavy tea drinker (6-8 cups daily) will consume between 200 to 400 mg of L-Theanine daily.

While dosage for depression and anxiety disorder remain individual, it is recommended to take 100 to 200 mg 1 to 3 times daily for anxiety relief. Based on the results of clinical studies, it has been established that L-Theanine is effective in single dosages in the range of 50-200 mg. It is suggested that subjects with higher levels of anxiety take a dose at the higher end of the effective range (100 - 200 mg) for overcoming anxiety.

http://www.vitamincountry.com/

Depression mental illness by Jean Taylor

Do you suffer from depression? Are you close to someone who suffers from depression? Do you try to hide this fact from the rest of the world? Depression is a mental illness. MENTAL illness. Oh that can't be admitted to anyone! Why not? We accept that our physical body becomes ill, gets diseased, sustains injury so why not our brain?

There is such a stigma attached that we are kept from disclosing to others what is wrong. Others appear to think that a sufferer is either "mad" or needs to pull himself together.

Fortunately society is coming round to the realisation that depression is as much an illness as cancer. For this reason it is becoming easier for the sufferer to seek help by admitting to himself that there is something wrong which needs medical attention.

How do you know when to see your doctor, or persuade your family member or friend that she should seek help? Well depression can come suddenly or creep up gradually so you will decide by what you see or feel. Sudden depression can descend as a full blown mental illness for which the doctor, or ambulance, will immediately be called. In these cases it is taken out of the hands of the sufferer.

Supposing though it has crept up very slowly and is held at bay at certain times but comes out at others. Then you will need to look for various symptoms. Make out a check list and actively observe what is happening.

 Mood is depressed. By this I do not mean that the sufferer is a bit blue. This is an ongoing sadness and emptiness. Can be expressed by appearing very tearful. Cannot be shaken off.

 Feelings of worthlessness. Not wanting to tackle anything because of the sureness that it will not turn out right as they are useless at everything

 Lack of interest. Cannot get enthused by tasks or events which have in the past been a joy. Doesn't want to do anything about it. Maybe does try but can't get involved. Takes no pleasure in anything. Everything is pointless.

 Lack of concentration. Unable to keep the mind focused on the task in hand. May flit from one thing to another without achieving any end result.

 Can't sleep, or sleeps too long. Depression often turns a person into an insomniac. Can't get to sleep easily. Then wakes often throughout the night taking a long time to get off to sleep again. Can have trouble waking and getting up when morning comes.

 Lethargy. Throughout the day feeling tired and lacking in energy

 Weight loss. There may be a lack of interest in eating and drinking and over time this will result in weight loss without conscious dieting or exercise. Tempt with little and often but don't expect the sufferer to tuck into a three course lunch.

 Thoughts of death and/or suicide. May have ideas as to committing suicide or even some sort of plan.

If you keep a record of what you see or feel over a two week time span you will discover just how much affect this mental illness is having. Don't expect to see all these symptoms. Also it is not always easy to spot as there may be quite a lot of cover up if the sufferer is at a stage where he can attempt to put on a front for others to see.

Let's suppose that the sufferer is someone close to you, perhaps within the family. You see them everyday. You will be able to keep an eye on the condition so that you are aware of what is happening when the sufferer is entering an episode of depression. The person himself does not always notice. If you can see an episode starting you can suggest the taking of the prescribed medication.

Be prepared. Depression very, very rarely goes away forever. It recurs. Just be ready to take action on behalf of the sufferer.

Knowing about this illness helps both sufferers and carers. For more information about depression, visit Depression FAQs

Social Media is Helping Reduce the Stigma of Mental Illness

"Social media can help deal with the stigma surrounding mental illness by allowing people anonymity and also offering a forum and a place to connect both for those who want to remain anonymous and those who would speak openly about their experiences." — Jackson Wightman,PR Daily

What Would Jefferson Say?

Jacob Payne, a high-profile political blogger from Kentucky recently filed a lawsuit against an anonymous blogger asking a local judge to order this individual to come forward to identify himself/herself and to cease and desist the publishing of critical comments that Payne considers "defamatory".

This is just one of many similar legal challenges making their way through the judiciary system in recent years.  Every one of these cases questions the basic rights granted by the First Amendment as they may apply to Social Media and the Internet.

Each side attempts to argue whether or not anonymous blogging is protected under our Freedom of Speech.   Supreme Court justices struggle trying to reconcile twenty-first century Social Media technology with our eighteenth century Constitution.  What are the relevant contexts and the original intent within components of debate separated by more than two centuries of cultural change?  This is an especially difficult task since the Web is something that Thomas Jefferson and John Adams could never have even imagined.  Having never conceived of such a technology, could they ever have been expected to grant rights and protections about Social Media?   And, then there is the issue of anonymity?  This they may have given some thought to back in 1776.  In fact, a pretty crafty patriot by the name of Francis Marion often went by the name "Swamp Fox," and no one but the redcoats seem to complain.  By the way, Marion was the character loosely portrayed by Mel Gibson in the "The Patriot."

One Person's Challenge is another Person's Opportunity

Perhaps, the most important Supreme Court case to date is McIntyre v. Ohio Elections Comm.  In that case, The Supreme Court has repeatedly upheld the First Amendment right to speak anonymously: "author is generally free to decide whether or not to disclose his or her true identity."

McIntyre v. Ohio Elections Commission is actually a very critical ruling as it indirectly relates to the use of Social Media as a therapeutic tool to aid in the socialization of those with mental illness.  The protection of anonymity is key in facilitating critical interactions in Social Media.  These positive interactions help to break down many of the stigmas associated with mental illness.  It is their anonymity that allows the mentally ill to explore the Web, interact with others and openly express themselves in a manner that offers them protection from a variety of internal (psychological) and external threats (stigma).

According to Web Rights Guru, Ethan Zuckerman: " Social Media gives people an anonymous forum to talk about the fact they are having difficulties, maybe think out loud, and reflect. Because the Internet has become such an interactive forum they can hear from others and they realize, ‘Wow, I am not the only one.'

While the ability to cloak ones identity from the masses when sharing personal experiences on the Web is most desirable for some, regardless of their mental health.  But, not everyone with mental illness prefers to remain anonymous in Social Media.

Steven Schwartz, struggles with BiPolar disorder and Borderline Personality Disorder.  A former Canadian journalist, Steven authors a popular blog called "the bipolar badger."  In his posts he openly shares his personal experiences dealing with mental illness…and he is brutally honest about it all.  That is not to say that he is unable to laugh at himself and share entertaining anecdotes in his writings from time to time.  Steven seems to believe that revealing himself and being who he really is equates to his own well being; the enlightenment of himself and countless others; and the general good.

For putting his neck on the line, the mental health community owes Steven Schwartz many accolades and many thanks.  But this is just Steven's story.  For others, it is the anonymity that they crave allowing them to shield themselves from the insensitivities they may face from day to day. There is much hurt resulting from unfair stereotyping and the acceptance by others of inaccurate and improper assumptions made about those who struggle with mentally illness.There is little doubt that Schwartz undergoes healthy catharsis as he openly and honestly expresses his personal thoughts and emotions.  Admirable is Steven's stated goal (within his blog) to personally help make a difference in the ongoing campaign to reduce the stigma, shame and misconceptions associated with having mental illness.

Technically Protecting Your Anonymity

All people need to talk with and learn from others about themselves and about the world around them. This is regardless of whether they wish to reveal themselves or remain anonymous.  This is not just a need of the mentally ill; it is a basic human need.  And, as we have learned from the courts; all of those who appreciate democracy place a very high value of their Freedom of Speech along with their right to remain anonymous when sharing their views, publicly.  Those who are mentally ill and who are able to grasp these concepts are among them.

So what basic tips can be offered to protect one's anonymity over the Web these days:

1. Use pseudonyms tied to free, international webmail and blog hosting sites.  These are less easily traceable than the better known fee-based, domestic services
2. Use public computers, wherever possible.  Schools, libraries and Internet Cafes are among the places that offer Social Media access for free or at reasonable cost.
3. Use anonymous proxy servers like those found on a list of public proxy servers.  Chances are you may need help choosing and setting up a proxy server interface, but once this is done it is nearly impossible for your IP (computer /location/identity to be traced)
4. Use a stealth blogging site like "Invisiblog," which allows blog posting by specially created E-mails (Mixmaster) rather than by direct uploading of written material.   It really helps to cover one's personal trail.  There are also ways to further encrypt one's Web contributions with online services such as GPG.  It will take some effort or the need to ask for help setting some of these tools in motion, but it is worth the added attention.

 If Social Media continues proving to be an aid in the overall treatment of Mental Illness, it becomes increasingly important for everyone in the mental health community to advocate for the protection of anonymity on the Web.  This will be a tough battle as the courts must be consistent in their rulings and it will be nearly impossible to create a double standard here.  Can anyone really separate the malicious creep who posts attacks – anonymously – on the Web to avoid detection and prosecution from the mentally ill, who may also let loose from time to time –anonymously- to avoid identification and stigma?   This will be a real challenge.  At stake may be more than the gold standard of Freedom of Speech; it may be the platinum value of good mental health.

http://advancedbehavioral.com/