A Personal Account: Mental Health Awareness, Peer Support, and Vicarious Traumatization

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Morning Zen Guest Blog Post ~ Sergeant Christopher J.A. Scallon, MS, Norfolk, Virginia, Police Department ~ 
Originally posted 5/23/16 on the International Association of Chief’s of Police blog  

Law enforcement has found itself adrift within the “perfect storm” of public mistrust, increasingly violent encounters, and the one-dimensional social media soapbox. The struggle to maintain our bearing, for the purposes of establishing some semblance of order and trust amidst such disdain is taking its toll. The vast majority of law enforcement professionals are just that…professional. It is because of these professionals that I am honored to be a part of an internal system tasked with addressing the inherent exposure to trauma by officers experienced on all fronts; peer support.

As a trauma survivor of a deadly force encounter, I can attest to the need for peer support. At the time, no formalized peer support unit existed for me to utilize. However, friends and a strong wife (also in law enforcement) helped me to find my way again. It was during my shooting review board that a respected supervisor pulled me aside and assured me that I would recover and I would eventually use my personal experience to help others.

Challenge Accepted!!! 
The next few years were dedicated to obtaining the academic qualifications, certifications, and revisiting my experiences with the new eyes of a trauma-informed professional. I became a peer for several non-profit organizations and reached out to anyone I knew was involved in a critical incident. Unfortunately, my greatest opposition to providing help was the stigma associated with asking for it. It was clear, I needed to become a champion for change by sharing my uncensored experiences. I requested to teach a block of instruction for all new recruits titled, “Survival Mindset: Preparing for and Learning to Survive Trauma.” Pleasantly surprised, I was met with an overwhelming interest and acceptance of the concepts. A single class evolved into a sought-after presentation to surrounding police academies, and eventually around the country.

Too Much Success? 
Almost immediately, requests to speak with individual officers about finding help and resources began flooding in…it worked!!! I went into overdrive, seeking as many resources available for officers in crisis and vetting the efficacy. I recall a single month when I was helping several officers and began to feel the effects of their trauma. I began falling into the trap of helping beyond my ability. I wish I could say I noticed, but it was my wife who identified my declining mental health. I was becoming distant, fatigued, and frustrated that I was the only one doing anything (far from the truth)!!! I was regressing back to the damaged individual I fought so hard to fix. I had taken on the stress of the officers I was helping and I thought to myself…STOP!!!

Back on Track 
With the help of my wife and my own advice, I reached out for help. I opened up to my wife and I spoke to a close friend and licensed counselor. I needed to understand that desire to help is decidedly different than my ability. Saying “No,” while hard, is an integral part of peer support.

Healthy Peer Support 
Recently, I was working with a local fire department to establish a peer support unit and providing resiliency training. Something a battalion chief said to me stuck. He said, “We mandate Personal Protective Equipment (PPE) for our fire fighters…mental health PPE is just as important.”

We work in a time where peer support is a critical component of law enforcement, as important as our flashlight, handcuffs, weapon, or ballistic vest. Similarly, if we require our public safety personnel to maintain PPEs before going to work, law enforcement must ensure that peer support unit personnel are provided the proper mental health PPEs.

Resources 
There are numerous local and national support services for first responders. Resources that address suicide, substance abuse, grief, depression, vicarious traumatization, wellness, compassion fatigue…etc., are available. My humble suggestion is that we become students of our craft and never stop looking for the help that we will inevitably need. As a peer support unit director, the degree of help we provide is met with an equal responsibility to care for ourselves. To help others, we must recognize the need to help ourselves first.

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scallonChristopher Scallon, MS, is a Sergeant in the Norfolk, Virginia, Police Department. 

Ask Your "Mental Health Reform Champion" Member of Congress Where They Stand on LGBTQ Rights

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Hey, guess what? It is Mental Health Awareness Month and Washington, DC is buzzing with advocates excited to meet with their congressional representatives to discuss meaningful mental health reform. For those advocates making the trek to DC, I am sure that on your list of questions for your congressional representative is something related to the need for improved services for LGBTQ individuals, right? I mean, we talk about the importance of addressing discrimination against the LGBTQ community all the time. The nation is abuzz with discussion about the rights of transgender individuals, who can use what bathroom, and whether or not a therapist should be obligated to see someone if they disagree with their sexual orientation. And of course, you are planning to speak to your congressional representative about LGBTQ equality... right?

Feeling a bit nervous about where to begin? Recent events in Congress are always a good conversation starter. Here is a good one for you to use, as it just took place yesterday.

During the House vote on H.R. 4974, the Military Construction and Veterans Affairs and Related Agencies Appropriations Act, Rep. Sean Patrick Maloney, D-N.Y. submitted an amendment aimed at upholding an executive order that bars discrimination against LGBT employees by federal contractors. 

The vote tally at the end of expired time had the amendment passing, 217 - 206. Democrats cheered, but then slowly began to boo. Something was not right. The vote tally on the screen began to change, with the yae votes slowly decreasing and the nae votes increasing.

The rules of the House are that after the time expires, if a Representative wants to change his or her vote, they need to go to the well of the House Chamber and register their change with the Speaker. But no one was going to the well to change their vote, yet the votes were changing on the screen!

The room got louder and louder with shouts of protest as the tally on the screen showed mysterious vote changes taking place one by one, until the Speaker finally called it after the nays exceeded the yeas by one. The amendment was ultimately defeated 213-212.

Here is why this vote is important for children's mental health advocates
If your congressional representative considers him or herself a champion of mental health reform, then at some point, you need to understand their position on the rights of the LGBTQ community - a community that is highly represented in mental health treatment, support and advocacy. If your congressional representative has voted to disallow basic equal rights protection for the LGBTQ community, you will want to ask them to help you understand the basis of their position, and how it reflects their commitment to comprehensive mental health reform.

Of the seven congressional representatives who switched their votes on the Maloney Amendment without following proper protocol, five are co-sponsors of H.R. 2646, the Helping Families in Mental Health Crisis Act of 2015. H.R. 2646 is a bill that has generated much discussion in mental health advocacy circles over the past few years, and my guess is that many of the mental health advocates making Hill visits this month will be discussing H.R. 2646 with their elected congressional representatives.

Ask your congressional representative how he or she voted on the Maloney Amendment. If they voted no, ask them why, so you can better understand their thinking. Then ask them how they see the basic rights of the LGBTQ community being addressed in H.R. 2646. The ensuing conversation should provide opportunity for you to provide some perspective and possibly broaden the thinking of the individual entrusted to make decisions on behalf of the community in which you live.

Here are the five vote switchers on the Maloney Amendment who are also co-sponsors of H.R. 2646. 

Included below is the CSPAN footage from the floor vote on the Maloney Amendment.

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scottScott Bryant-Comstock
President & CEO
Children's Mental Health Network

When It Comes To Our Nation’s Children, Actions Speak Louder than Words

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Morning Zen Guest Blog Post ~ Randi Carmen Schmidt ~

I grew up in a family that was long on challenges and short on money. To be frank, my parents were both alcoholics and had untreated mental health issues, and we didn’t have much money after my dad lost his job in the 1980’s and we moved to a small town in rural MN. 

Because of where I have been, and what I have been through, however, I find that I am an eternal optimist when it comes to the resilience, strength and potential in children and youth who grow up in difficult situations, whether it is abuse, poverty, or drug and alcohol addicted parents. I am also an eternal optimist that there are adults in this country who want to see these children succeed and will help them achieve their potential. That is why I am very disappointed by what is going on in Congress right now. It seems that while some speak of wanting to help people in poverty and create opportunity in our nation, their actions leave something else to be desired when it comes to children, including low-income and poor children, or children suffering abuse or neglect. 

In the past month, committees in the House of Representatives have three times had the opportunity to do right by children, but instead took steps to make their lives, and their climb to success, that much harder. 

On March 14, the House Energy and Commerce Committee voted to make changes to the Children’s Health Insurance Program (CHIP), a program which provides low-income children health care. The Committee voted to scale back the federal matching rate states receive for helping low-income children get coverage, effectively making it harder and more costly for states to expand coverage to more children. It is estimated that this provision would result in countless low-income children nationwide losing coverage, or for those who don’t have coverage, prevent them from gaining it. 

Then, two days later, on Wednesday, March 16, the House Ways and Means voted to eliminate the Social Services Block Grant program (SSBG). In FY 2013, 48 percent of the SSBG recipients, or 13.5 million, were children. SSBG funds vital programs important to babies, children, youth and families, including foster care, child abuse prevention services, and child protective services. It is estimated that millions of children will be impacted by the elimination of SSBG.

The Committee also voted to deny the Child Tax Credit (CTC), a tax credit which can help parents put food on the table, or pay the heating bill, rent or other basic necessities, to low-income working families with children who file their taxes with an Individual Tax Identification Number (or ITIN) rather than a Social Security number. It is estimated that this proposal would, “increase hardship and push several million low-income children and their parents into, or deeper into, poverty[1].” Three million children, 80% who are American citizens, are expected to be impacted by this proposal.

Now the House Education and Workforce Committee majority has released a bill that proposes to make it harder for schools to provide meals to hungry children in poor communities. 

I can’t imagine what, if anything, abused and neglected children, children in need of health care or a hot lunch, or any child for that matter, did to upset members of Congress so much that they would want to make their challenging lives even harder. But, that is what these proposals would do. And it is troubling that some of the very same people in Congress who support these short-sighted and harmful proposals may play a part in creating a new agenda on poverty and opportunity, one which will more than likely impact some of these very same children. 

The eternal optimist I am has to believe there is an alternative, that there is something better that our elected officials can and should be doing for children. And there is.

Our nation and its leaders, especially those that care about poverty and opportunity in our nation, can and must do better by children, particularly vulnerable children. The first step is making sure that none of these harmful proposals see the light of day again. The second is remembering the needs of children and youth in any public policy or budgetary discussion going forward, including the creation of a poverty and opportunity agenda. 

For while there may be much for our nation to disagree on, I refuse to believe that how we treat the most vulnerable children in our nation is one of them. 

IF you want to tell your members of Congress to support investing in our nation’s children and against proposals that will harm them, click here.

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randiRandi Carmen Schmidt is the Executive Director of the Children’s Leadership Council. The Children's Leadership Council (CLC) is a nonpartisan coalition of children’s advocacy organizations. It is the only national children's coalition solely dedicated to supporting investments in our nation's children and youth, from birth to adulthood. Collectively, CLC's members have affiliates, partners and members in every state in the nation.

Slapped by Stigma

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Morning Zen Guest Blog Post ~ Lisa Lambert

Have you ever been slapped in the face by someone’s prejudiced thinking about mental health needs?  That’s called stigma.  It first happened to me when my son was seven.

My son spent a lot of his 7th birthday party lying on the floor at Chuck E Cheese crying and saying, “I don’t deserve to live – I want to die.”  Like his friends, he would race excitedly from game to game, then run back to me to say, “Guess what I won?”  Then his mood would plummet and I’d see him drop to the floor, disconsolate.  His friends would stop next to him and try to cheer him. Not long after, he had his first inpatient stay.

A year before, we had moved into a newly built housing tract.  The school district was good, the neighborhoods were designed with curving streets and cul-de-sacs, which made them perfect for families with young children who rode their bikes and skateboards.  All the houses around us seemed to be filled with kids the same ages as my two sons and they were soon traveling as a posse to one another’s houses to play with this game or try out that swing set.  Families invited each other to parties and outdoor barbeques.

After my son’s hospitalization (which lasted nearly a month) he insisted on going to each of his friends’ houses to let them know he was home and available to play.  I asked him what he was going to say.  “They told me at the hospital that lots of kids go to the hospital to have an operation or because they are sick,” he said.  “It’s just like that, except it’s your feelings. It’s okay to talk about it.” I felt that little clutch in my stomach that mothers get when they worry.  But what did I know?  This was a new world for us and if the “experts” told my son it was okay to talk about his hospitalization, then I was going to defer to them.

He set out on his neighborhood journey, going from house to house while I stood a little distance behind him.  He did great, shaky a few times but was met with smiles and nods for the most part.

Not long after we got back home, I got a call from Denise’s mother.  Denise was doted on by her parents and had been born some years after her older brother. They lived cater corner across from us and she played often with my son.  Denise was perfectly dressed, her blonde hair done up in dozens of new ways each week.  Denise’s mother was not all smiles and nods on the phone.  She told me that although she felt sorry for my son, Denise was not allowed to ever play with him again.  If he came to the door, he would be turned away.  If he called, the phone would be hung up.  If he was playing in their neighborhood group, Denise would not be allowed to join in.  In fact, she added, she would appreciate it if I told him when he walked in front of their house to please use the sidewalk on the other side of the street.   The rejection couldn’t have been more complete.

I told my son a gentler, highly-edited version of the conversation and it’s something he doesn’t remember today.  But I do.  My judgemental neighbor went from embracing we-are-all-raising-our-kids-together to making it very clear that there were two groups now, “us” and “them.”

Many people believe that there is less stigma today around mental illness, treatment and even psychiatric medications.  They point to the growing number of stories that people like me tell of their own experiences, or that people with their own lived experiences relate.  These stories don’t just provide a name and face, but details about what works and how it feels to experience the slings and arrows of a very tough mental health system.   But an experience with in-your-face stigma changes you.  You lose patience with slow change. You can’t go back to thinking that it’s lack of education or inherited attitudes.  It’s more than that.  Stigma is an ugly thing.

Researchers say stigma is a term “which has evaded a clear, operational definition.”  It actually has three parts:  lack of knowledge (ignorance), negative attitudes (prejudice) and excluding behaviors (discrimination).  Like many others, my son and I have experienced all three.

Stigma is not just carelessly using words like crazy or psycho. It’s shunning like my son and my family experienced.  One mom told me recently that her child was ostracized by her ex-husband’s entire family, who wished to hide her son’s mental health needs.  It’s seeing your child shunted to the psych evaluation room from the emergency room as soon as they hear the mental health diagnosis.  Another mom recently wrote, that even though her daughter overdosed on pills and was violently ill in the emergency room, “they stuck her in a psych room with a security guard” because they “thought she was faking it.” It’s being denied opportunities like the parent who told me she had to choose between a therapeutic school with a stripped down curriculum, or an academically challenging one with no therapeutic supports for her brilliant, beautiful daughter with extreme mood swings.

The hurt caused by an experience with stigma stays with you for a long time.  You feel a little more mistrustful, a little more righteous anger and have warring impulses between disbelief and cynicism.  I’m hurt, you feel; this is unjust, you think; this must stop, you realize.  We need to keep telling those stories, we need to keep waging our awareness campaigns but we need something more.  We need warriors.

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lambertLisa Lambert is the executive director of Parent/Professional Advocacy League (PPAL) and a Children's Mental Health Network Advisory Council member. Lisa Lambert became involved in children’s mental health as an advocate for her young son in 1989 through the CASSP family network in California. After moving back to Massachusetts, she began supporting families whose children and youth had behavioral health needs. Her areas of expertise include mental health policy, systems advocacy and family-driven research. 

Would a Republican President Dare to Dismantle Obamacare?

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dawesarticle

This year marks a critical juncture for our country – one that presents both opportunities and challenges for health reform, and will determine whether or not we embrace the traditions of the past 150 years and move toward a more equitable, accessible, and patient-centered health system. What is most concerning today is that if we do not pay close attention to our history of comprehensive health reform, the remarkable gains we have fought so hard to attain over a century and a half, could be wiped out, moving us backwards in terms of health care coverage, access, delivery, and equity.

The Supreme Court, in its history, has never overturned a major health law, but we watched with bated breath whether the Court would do so this time around with the Affordable Care Act – a law more sweeping than previous health legislation and which incorporated broader civil rights protections. Fortunately the Supreme Court has so far followed contemporary precedent regarding health laws, but how could we be sure the Court wouldn’t do what a prior Court did in 1883 when it overturned the Civil Rights Act of 1875? In both instances when the Supreme Court ruled in favor of upholding the Affordable Care Act, the Court punted the demise of this law to the political process, arguing “[m]embers of this Court are vested with the authority to interpret the law; we possess neither the expertise nor the prerogative to make policy judgments. Those decisions are entrusted to our Nation’s elected leaders, who can be thrown out of office if the people disagree with them. It is not our job to protect the people from the consequences of their political choices.”

Now with the Supreme Court settling the constitutionality of the Affordable Care Act, history affords us an opportunity to understand whether it is even possible six years after a major health law has been implemented to completely dismantle it via the political process. The answer is a resounding yes! Contrary to the belief held by many proponents of the ObamaCare law that Republicans are bluffing about their attempts to repeal the Affordable Care Act or that it could never happen at this point, that simply is not the case. 150 years ago, the Freedman’s Bureau Act was signed into law after the Civil War affording blacks and others access to health care across the country, especially in the South. However, seven years after this law was enacted, having survived every reauthorization, Congress decided to shut it down indefinitely – jeopardizing care to our nation’s most vulnerable people.

The Affordable Care Act is a test of whether we will go back 150 years to a time in our nation’s history when there was no appetite to implement a law overwhelmingly helping groups that were marginalized or uphold a law that would have elevated rights and protections for vulnerable populations. It is very clear that this is the first health reform statute in recent decades allowed to stand, but just like the Freedman’s Bureau, which lasted only seven years … if we are not careful, ObamaCare could see a similar fate.

I was quite hopeful that partisan political attacks on ObamaCare were subsiding when the Republican-led Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) one year ago, which reauthorized most of the programs that were in the Affordable Care Act. In fact, the MACRA legislation even expanded some of the ACA policies such as delivery and payment system reforms, making it in essence the health reform extension bill. However, the political backlash escalated again when the Supreme Court upheld ObamaCare once more last summer in 2015.

150years150 Years of ObamaCare explores the hidden backstory of the Affordable Care Act, shedding light on the creation and implementation of the greatest and most sweeping equalizer in the history of American health care. I wrote this untold story to draw back the curtains and offer an insider’s look into the crafting of the health reform law and provide an unprecedented review of the health equity movement past, present and future.  I wanted to develop a resource highlighting the little known leadership efforts over the past 150 years to push for mental health reform, minority health reform, and universal health reform and how and why these efforts were successful this time around.

150 Years of ObamaCare highlights how and why the health reform law became the most inclusive law ever passed by Congress, not only in terms of its content, but in terms of the process - the stakeholders who were brought to the table, including racial and ethnic minorities, LGBT individuals, women, people with disabilities, and veterans. The book also highlights what we have left to do to ensure these reforms are not only implemented, but implemented in a manner that will greatly benefit all of our communities.

I wrote 150 Years of ObamaCare so that current and future generations of health equity advocates, students, and scholars can learn from our efforts, build upon our successes – understanding what strategies we employed and why, what challenges we faced internally and externally, and how we overcame them.

I also wrote this book to help leaders across our nation, whether in health care, public health, policy, and in other areas gain a better understanding of this landmark law – overcome some of the challenges it presents and leverage the numerous opportunities that are available.

Those who continue to oppose the Affordable Care Act would, undoubtedly, be on the wrong of side of history just like those 150 years ago who opposed and worked to effectively undermine a law intended to provide access to medical care to African Americans and other groups. 150 Years of ObamaCare highlights this historic inflection point, and what is at stake after November 2016. 

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dawesDaniel E. Dawes is a healthcare attorney and the Executive Director of government relations, health policy, and external affairs at Morehouse School of Medicine. In addition to his executive role, Daniel is a director of health policy and a lecturer of health law and policy at the Satcher Health Leadership Institute and holds a faculty appointment in the Department of Community Health and Preventive Medicine. During the negotiations around health reform, he founded and chaired the National Working Group on Health Disparities and Health Reform, a working group of more than 300 national organizations and coalitions that worked to ensure that the health care reform law included health equity provisions to reduce disparities in health status and health care among vulnerable populations. In recognition of his efforts, he was one of 13 experts who were invited to serve on the Health Equity Leadership Commission, which provides guidance on implementing health reform to members of Congress, the Obama Administration, and officials at the Department of Health and Human Services. He is a frequent speaker and author of several publications on health reform and health equity. He is the author of the new book, 150 Years of ObamaCare (Johns Hopkins University Press).

Behind Enemy Lines - Exploring Resilience

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army
Morning Zen ~ Scott Bryant-Comstock ~ 

It’s early, the sun not yet on the horizon, the blue mist of a morning promise in the air. It’s cold enough that my breath is making vapor plumes – not good for a 10-year-old commando on a mission. The elements of stealth and surprise are critical if this mission is to be successful. I’ve got to calm my breathing – the dash from across the street took the wind out of me. My destination is ten yards away, but those ten yards might as well be ten miles.

During the summer of my tenth year, most days were spent in front of the house with my neighborhood friends playing War – a game where we pretended to be soldiers, just like Sergeant Saunders from the television show Combat! We would choose sides and battle for hours, drawing up intricate attack plans, leading commando raids against other warriors, and terrorizing them with great delight. Then they would lead a charge against us, and we would battle fiercely, dying dramatic deaths, lying still for a few moments and then leaping up to engage in combat all over again. I spent many an afternoon crawling on my belly, reveling in great imaginary acts of heroism, as only a 10–year-old boy can.

Growing up in a neighborhood where the families living around us had money while we were living on stale bread and puffed rice, resulted in some unusual situations. For a 10-year-old boy, fitting in and feeling “normal” was important. So when a bill collector came to our house looking for money or a public-utility truck came to turn off service for lack of payment, it could ruin an otherwise great day – especially if I were standing in front of the house with my friends.

Some days, utility trucks might come down the street three or four times. Ducking for cover when they did make their way toward our house became an almost comical routine for me. As soon as one of the trucks appeared coming down our street I would make a beeline for the house, flinging open the back door and locking it behind me. Then, I would dash over to the kitchen window, heart racing, and watch for the arrival of the utility truck. If the truck stopped at our house, I would crouch under the kitchen window, stealing glances every once in a while, checking to see what was going on outside, feeling ashamed and knowing that I would not go back outside for the remainder of the day.

If the utility truck continued by the house, I would wait a few minutes and come back outside to rejoin the game. Someone would invariably yell, “Hey Comstock, where did you go? Jeeze, ya can’t just leave in the middle of war!” I’d make up some vague excuse and leap back into battle, Kids being kids, my seemingly bizarre actions would soon be forgotten, and the war would rage on.

Ten yards, that’s all I need. But there is movement in the house, and I’ve got to get under the window without being seen. Making my way out of my temporary hiding place behind the bushes, I inch my way across the lawn, flat on my belly, pushing in front of me the two empty milk jugs I have brought with me. My t-shirt and jeans are instantly soaked but its too late to turn back. My heart beats wildly with excitement. Looking up, I see someone’s shadow reflecting off of the drapes covering the window. I hear voices from inside the house. Darn, they’re up already. I hadn’t counted on that.

Now, it wasn’t too bad when the power company showed up to turn off the electricity, because the meter box was on the side of the house, out of view of the street. But the water company – oh, man, that was tough. The truck would pull up and park right next to the main, which was directly in front of our house. It always seemed like the guy would sit in the truck for an eternity before getting out. Once out, he would go to the back of the truck and pull out a long metal rod, about four feet in length, with a funny looking end on it, sort of like a cross. Slowly, he would saunter around the truck, tapping his rod on the ground, making his way over to the water main.

I’m pressed against the wall under the window, soaking wet, but thrilled just the same. I reach up to the spigot to disconnect the hose. Cold morning and cold hands – this is harder than I thought. I make two attempts to undo the connection but fail. My hand stings with pain each time I try to wrest loose the fitting, but I’ve got to get that hose off. On the third attempt, the hose loosens. Pulling my hand away from the spigot, I notice blood oozing from an inch long slice on my palm.

The guy from the water company was cool because he could remove the thick concrete plate that covered the water meter with ease. As if performing live theater, he would wait until the crowd of pre-adolescent boys had gathered around and then would remove the concrete cover. Everyone would press together to be able to see what lay beneath. I would even find myself straining to see from my private spot in the kitchen, peering through the window in the space created by moving the drapes to one side, ever so slightly.

With the hose fitting off the spigot, I bring the first milk jug up close to the opening and give the handle a full turn. The sound of the water running is deafening, or at least it appears that way to me, so I quickly turn it off. Maybe if I turn it on slowly. Much better. I hold the milk jug at a 45-degree angle and slowly fill it with water.

One jug filled and capped, working on the second. The gash on my hand stings from the cold. Lulled into a daydream about my “commando raid” and the “life-threatening shrapnel wound” I have received, the sound of hard rapping on the window above me jars me to my senses.

Hey there, what are you doing?” Oh jeez, it’s Mrs. Baber, and she looks pissed. “Hey, hey, stop that! What are you doing?”

Grabbing the two jugs, I stumble to my feet and run for it in an all-out sprint. Looking back while running across the lawn, I see water pouring from the spigot. I also see Mrs. Baber’s front door beginning to open. In my panic and haste, my feet tangle and I fall to the ground, losing my grip on one of the milk jugs. As I hit the ground, the jug slides across the lawn and into the bushes. For a split second time slows to a crawl as I lie flat on my back watching the water gurgling out of the jug at a dreamlike pace. The sound of Mrs. Baber’s voice yelling at me brings me back, and I realize I have to get away. I grab the remaining jug lying by my side, pull myself up and dash across the street, the sound of Mrs. Baber’s angry voice trailing in my ears. I fling open the gate to our side yard, scoot in and slam it shut. Leaning against the fence, safely back from behind enemy lines, I lower myself to the ground, letting out a long slow sigh of relief.

On those occasions when we had no running water in the house, it was my job to make sure there was at least enough for Mom to be able to freshen up before heading off to work in the morning. Asking neighbors for water or riding up to the gas station on my bike to fill up empty milk jugs was not a viable option – much too embarrassing. No, the best option was to raid the water supply of unsuspecting neighbors, several within a stone’s throw from our house. The predawn hours of early morning offered ideal conditions for such a raid. The street would be quiet, the air calm, and visibility muted at best. Perfect conditions for a 10-year-old commando on a secret mission behind enemy lines.

Quietly letting myself into the house, I tiptoe to Mom’s bathroom and fill the commode tank with the jug of water. The house is still, no one will be up for at least another 30 minutes. Time enough for one more raid.

Back outside I peer over the fence on the side of our house and see that Mrs. Baber has gone back inside. It’s too risky to try her house again. Bringing the milk jug up close to my chest I begin making my way down the street, darting from house to house, using my best commando skills to search for the perfect target. This time, I will not be seen.

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Do you have a first-person story of resilience you would like to share with Network readers?

Send it in!

scottScott Bryant-Comstock
President & CEO
Children's Mental Health Network

 

With the Love of Music

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Morning Zen Guest Blog Post ~ Leah Bennett ~

I was born in Birmingham, Alabama in 1998. My home was a cheap, run down apartment complex. It was also the home of drug deals, murders, and meth labs. I lived with my African-American dad and my white mother in a completely black community where my mother and I, with my lighter skin, got stares every time we left our home. My mother was an alcoholic, and we often got into car wrecks. I lost my two front teeth in a car accident. I didn’t get to celebrate like other kids when their teeth fell out. The tooth fairy didn’t visit me. Instead I waited at the police station with my dad for my mom to be bailed out of jail.

Two weeks after my 6th birthday my dad passed away from leukemia. My mom started smoking cigarettes again, her drinking increased dramatically, and she became addicted to prescription pills. She would often pass out and I would wash the vomit off of her face, and put a warm towel on her head. When she had the energy to leave the house, she would either leave me at home alone, or take me with her. We made trips to the houses of men who were strangers to us both, and I would sleep on the floor next to the bed, or on the couch alone in fear while she gave herself away.

My grandmother knew about the drug addiction and alcoholism. I would call her late at night when my mom was passed out and she’d come pick me up quietly and take me home with her. I always ate plenty at her house as there was never food in my home. She must have told my school, because one day in 3rd grade I was called into the principal’s office. A social worker was there and asked me about my home life. I didn’t want to get my mom into trouble, so I lied about almost everything, until they asked about food. She asked me to name every food we had in our house but I couldn’t because our fridge was mostly bare.

My grandmother would take me to school everyday and pick me up. She was like a mother to me. One weekend my grandmother and I drove past my school and saw a billboard that read, “Violin Lessons”. My grandmother immediately asked if I wanted lessons, and thank God my seven-year-old self said ‘yes’. The next week, I was signed up for the school orchestra. It was a brand new program at my inner-city school. On the first day the room was packed with maybe 70 kids. By the second day we all received our instruments, but there were half of us left. By the end of that week, the orchestra consisted of a 3rd grade cellist named Isaiah, and me. Our teacher remained upbeat though.

Within two weeks however, our school ended the program so I began to go for lessons at my teacher’s house after school, and it saved me. I will never forget her determination to share music with Isaiah and me. She was so in love with the music, and I had never seen someone so passionate about their job before. Instead of worrying about my mom, or our future, I fell in love with youtube videos of famous violinists that my grandmother would show me. I wanted to be the girl performing on the stage, clad in a beautiful dress, making people feel things they’d never felt.

On June 27th, 2007, two months before my ninth birthday, I woke up at my grandma’s house. My grandma yelled for me to come downstairs because my mother was on the phone. When I heard my mom’s overly cheerful voice on the line, I knew something was off. She said she was quitting smoking and drinking and wanted to start over and make life good for us. She said she had to shower and that she’d be over in an hour to pick me up and that we’d go straight to the park and then get ice cream. I was ecstatic. After an hour passed, I took my bag outside and waited on the front porch. Another hour passed, but I wasn’t upset because my mother was always late. More hours passed and it got dark outside. My mom wasn’t answering her phone. Later that evening my grandma got a call. She started crying, and I knew immediately what had happened. I had been anticipating it forever. She hung up and asked me if I wanted to stay or go, and I said stay. She told me I was a good girl, and left. They had found my mom dead in the bathtub—she had overdosed. I blamed myself. I wasn’t there to take care of her, to put a cold wet towel on her head, to throw the pills away.

Soon after, my aunt and uncle from Ohio came to Alabama for the funeral and I learned that they would adopt me. I started fourth grade in my new home, joined the school’s orchestra, and began to take private music lessons. My new parents encouraged me to make goals for myself, and presented me with as many musical opportunities as they could.

leahviolin
Music is something that can’t desert me, or be taken away from me. It never changes. I’ve been playing violin for 10 years now. I want to share my gift with as many people as possible and make a career out of what I love. Today I struggle with severe depression, ADD, and anxiety. It has been difficult at times to achieve good grades, but I attend therapy because I’m determined to beat my mental illness. I’ve been suicidal, and almost hospitalized, but I’ve overcome it. I know I have something to offer the world and I’m learning my worth. I’m a violinist, a pianist, a percussionist, a guitar player, composer, a beginner cellist, and a vocalist. I’ve been teaching violin and piano for three years and would love to teach in the future as well. My past experiences have made me a stronger musician, and I’ve learned to harness my illnesses through music. When I play, my ADD disappears, and I’m able to concentrate clearly. My anxiety melts and my depression fades when I’m deep in a piece of music. When I feel useless, when I can’t stand myself, I remind myself that I have a gift that others do not. Music is magic, it heals, and if I had not discovered it on a car ride with my grandmother so many years ago, I don’t know where I’d be today.

This piece was originally Leah’s college application essay.

leahLeah Bennett is 17 and lives in central Ohio, U.S.A, with her adopted parents and young brother. She is a senior in high school and will be attending Wittenberg University in the fall, where she plans on studying music.

Special thanks to Kusi Okamura, Editor, The Wild Word, for encouraging the sharing of this story.

Special thanks to Kusi Okamura, Editor, The Wild Word, for encouraging the sharing of this story. - See more at: http://www.cmhnetwork.org/media-center/morning-zen#sthash.dZCUVMmA.dpuf

The Affordable Care Act at Five Years: Where Is Prevention?

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Morning Zen Guest Blog Post ~ Deborah Klein Walker

Five years in, the Affordable Care Act (ACA) has improved the delivery of health care in the United States. But more could be done, especially in preventing disease and promoting wellness, if we are to have a healthier nation in the next generation.

First, let’s take a look at some of the success of the ACA. Almost 17 million more Americans have been given insurance coverage and 31 states have expanded their Medicaid programs for the people who are most vulnerable in their states, resulting in a drop in the uninsured non-elderly population to 12 percent. Second, although the United States spent about $3 trillion dollars in total national health expenditures in 2014 and has the highest cost per capita for health care for all industrialized nations, there has been a slowing of the cost curve for U.S. health spending. Major ACA payment reform initiatives for Medicare, including incentives to hospitals to reduce readmissions and infections, have reduced Medicare spending per beneficiary to a rate below inflation.

Millions of dollars are being spent to transform the health delivery system by integrating all parts of health systems, called Accountable Care Organizations, for both Medicare and Medicaid patients. In addition, states are serving as laboratories for health care transformation via the State Innovation Model grants and waiver options awarded to state Medicaid agencies. Many of these efforts include reforming the primary care system by creating medical and/or health homes, integrating behavioral health into primary care, and enhancing care coordination for patients with chronic conditions. All of these efforts are important and will most likely lead to better quality health care and health outcomes for patients. But to truly achieve better health at lower costs, we’ve got to address all aspects of health, and that includes preventing disease.

One emphasis of the ACA in the past five years has been on assuring that all evidence-based health screenings and other clinical preventive services are implemented. For example, the ACA includes a mandate that all insurers must pay for any clinical preventive service that receives an “A” or “B” recommendation by the United States Preventive Services Task Force. The Centers for Disease Control and Prevention 6|18 initiative is a collaboration with purchasers, payers and providers to accelerate the implementation of 18 evidence-based interventions for a patient within and outside of the clinical setting in six high-burden health conditions through reducing tobacco use, controlling asthma, controlling blood pressure, preventing healthcare associated infections, controlling and preventing diabetes, and preventing unintended pregnancy. That’s a start. But it won’t get us all the way there.

The United Health Foundation’s state rankings for access to health care and chronic disease prevention strategies reveals that there is great variation in states in uptake of immunizations and chronic disease prevention (e.g., whether a patient had a blood pressure screen or a cholesterol check). All the prevention indicators varied by income, race/ethnicity, education and location in the country. States in the Northeast performed much better on these measures than states in the Southeast. Hispanics report receiving less preventive services than non-Hispanic blacks and whites.

The problem? There has been little emphasis on addressing the root causes of poor health by investing in prevention in community settings. Better health for individuals and communities depends on a variety of factors, such as having clean and safe water and food, clean air, as well as safe places to play and exercise. Community-wide campaigns that focus on positive health behaviors are one effective strategy to support and create environments for individuals and families that supports wellness. However, less than 5% of $3 trillion dollars spent on U.S. health care funds public health and related community-based prevention or population health efforts. To date the Prevention and Public Health Trust Fund has provided nearly $5.25 billion (less than .01% of the total health care costs) in additional resources to communities for prevention of disease and promotion of healthy lifestyles.

A new Centers for Medicare and Medicaid Services demonstration effort, called Accountable Communities for Health, is an important step in coaxing health care systems to embrace the larger community in which patients live. Recipients of these new ACH grants are required to connect with public health and community-based organizations to facilitate efforts that will improve the health of the entire community. In addition, several of the State Innovation Model grants (e.g., Oregon, Minnesota, Vermont and Colorado) funded by CMS to state Medicaid agencies have embraced the creation of community health organizations as well. In one case in Oregon, health insurer Trillium is giving $1.33 per member per month to the county health department for community prevention activities in its coordinated care organization. Other insurers should follow this example and dedicate part of their budgets to public health and community providers of population-wide prevention services.

Prevention with a focus on the social determinants of health in a community needs to be an emphasis of the ACA in the next five years. If we fail to do this, the United States will continue to struggle with expanding health care costs and suffer from poorer health outcomes compared to other industrialized nations.

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walkerDeborah Klein Walker is a Vice President and Senior Fellow at Abt Associates. She is the current president of the American Orthopsychiatric Association and a former president of the American Public Health Association and the Association of Maternal and Child Health Programs. She served as Assistant and Associate Commissioner for 16 years at the Massachusetts Department of Public Health. The opinions expressed are her own and do not reflect those of Abt Associates.

This article was featured on the Huffington Post website, March 7, 2016

 

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lisaLisa Lambert is the executive director of Pa

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Deborah Klein Walker is a Vice President and Senior Fellow at Abt Associates. She is the current president of the American Orthopsychiatric Association and a former president of the American Public Health Association and the Association of Maternal and Child Health Programs. She served as Assistant and Associate Commissioner for 16 years at the Massachusetts Department of Public Health. The opinions expressed are her own and do not reflect those of Abt Associates.

Ask me a question, I’ll tell you a story

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Morning Zen Guest Blog Post ~ Lisa Lambert

lambertI felt a wrench in my heart when I stopped running support groups.  It wasn’t the late nights or trying to make each one worthwhile.  It wasn’t even that I had some version of burnout (I didn’t).  It was missing out on the next installment of everyone’s story.  I knew by then that even the parents who seemed to have things under control were often living a version of Mr. Toad’s Wild Ride.

There was Joe, who worked in construction and got up in the dark every morning, yet drove around several nights each week trying to find his 15 year old son.  He knew his son was using a variety of drugs and he also knew if he could keep him safe for a few more weeks, there would be a slot in a program for him.  There was Annabelle whose son, Bobby, tried to jump out of 2nd story school window when he was 9.  She fought to get him in a therapeutic program and when she finally did, her own mental health problems surged up.  There were Rick and Susan, who problem solved like crazy to make sure their daughter graduated high school.  She would only eat one kind of pizza, sold several towns away, so they would drive those miles several times each week to avert the obsessive, restrictive food focus that bled into other parts of her life.

I wondered if Joe’s son got into the program and if it helped.  I worried that Annabelle was so exhausted from fighting for services and wellness for her son that she had no energy left to battle for herself.  I fervently hoped that Rick and Susan – who did so much to get that diploma – got their daughter into a college and that she stayed enrolled.  And I wondered if they all thought about my story and my son’s journey, too.

Support groups are ground zero for telling your story.  There is no wrong way to share it.  You can make it short and hit the high points.  You can ramble, cry, smile and pick up the thread.  You can tell it all at once or in installments.  Others will nod, maybe comment or offer help and you know they are your comrades in arms, fighting the good fight with you.

Talking about your experiences in a support group can be therapeutic.  Others can see where you sailed through and where you were flying by the seat of your pants.  They might jump in and point you to resources you need or suggest strategies you haven’t thought of.  You learn what parts of your story make others sit up and nod and what parts don’t get the same reaction.  While you are getting help, you are also learning to tell your story.

For many of us, there comes a time when you decide to tell your story publicly to someone else.  Maybe it’s a journalist, maybe it’s a legislator, maybe it’s an audience of people who’ve never raised a child with mental health needs.  You want them to understand, to be moved, to feel the injustice, the hurt and the determination to make things better.  You are willing to forgo your privacy and expose your pain in order to help the families coming along behind you.  You want to make a difference.

Storytelling is one of the most powerful tools we have.  It is the medium for translating emotions and experiences into action.  Personal stories can educate about challenges and inspire people to do something about them.  Leaders often call great stories “inspiring” while journalists call them “compelling.”   But most of us have to learn key storytelling skills.  We start by knowing we have a story to tell and it deserves to be told well.

When you tell your story in a more public way, you consider other things as well.  Your time (or print space) is limited, so you focus on what aspect you’d like to tell.  If you want to make a point about lack of services or too-high-to-jump-over barriers, you think of what would be most dramatic things to highlight.  Sometimes you choose the parts that are most likely to help the families coming along behind you.   As Patricia Miles writes, this is the first skill set of family partners: the decision to blend their private story with their public role.

Telling your story isn’t only about touching people or creating change in the system that serves our kids and families.  Just as the stories from Joe and Annabelle and Rick and Susan stayed with me, our stories stay with the people who hear them.  After someone hears a parent tell their story, I am often asked – sometimes a year later – what happened to that youth or those parents?  Did the young person get better or achieve their promise?  Did the parents leave those times of crisis behind and become able to step back a little?  Or if I was the one who told my own story they ask, How is your son doing?  We often have no idea who remembers us and who is rooting for us.  And that’s actually pretty cool.

Change, they say, happens one person at a time.  Just like storytelling.

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lambertLisa Lambert is the executive director of Parent/Professional Advocacy League (PPAL) and a Children's Mental Health Network Advisory Council member. Lisa Lambert became involved in children’s mental health as an advocate for her young son in 1989 through the CASSP family network in California. After moving back to Massachusetts, she began supporting families whose children and youth had behavioral health needs. Her areas of expertise include mental health policy, systems advocacy and family-driven research.

lisaLisa Lambert is the executive director of Parent/Professional Advocacy League (PPAL) and a Children's Mental Health Network Advisory Council member. Lisa Lambert became involved in children’s mental health as an advocate for her young son in 1989 through the CASSP family network in California. After moving back to Massachusetts, she began supporting families whose children and youth had behavioral health needs. Her areas of expertise include mental health policy, systems advocacy and family-driven research.

- See more at: http://www.cmhnetwork.org/take-mental-health-to-heart/we-dont-tell-you-lambert#sthash.iXnbDKDd.dpuf
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