The court's role in solving mental health issues in the criminal justice system

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Individuals with mental illness enter the criminal justice system on a repeat basis. What are courts doing to stop the cycle? Should courts get into the business of coordinating mental health treatment for those involved in the criminal justice system? The presenter in this webinar sponsored by the National Center for State Courts, Bureau of Justice Assistance, and the U.S Department of Justice Clearinghouse will discuss these questions in the context of the multitude of mental health court models in operation across the country.

  •  Webinar: The court's role in solving mental health issues in the criminal justice system
  • January 27, 2015, 1:00 PM ET
  • Register here

Why is sleep important?

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Why is sleep important to you?  An estimated 35 percent of U.S. adults report less than seven hours of sleep during a typical 24 hour period.  Sleepiness resulting from insufficient sleep, irregular sleep schedules, or poor quality sleep is a cause of motor vehicle crashes, occupational errors with hazardous outcomes, and difficulty performing daily tasks.  Sleep and wakefulness disorders affect an estimated 15-20 percent of US adults who are more likely to suffer from chronic disorders including depression, substance abuse, hypertension, diabetes, cancer, stroke, and all-cause mortality.  Resilience to stress, emotional regulation, and inter-personal relationships are impaired by sleep deficiency.  Recent findings suggest that investing in sleep health contributes to maintaining brain health, and ultimately protecting cognitive functions necessary for aging-in-place.  Recognizing and addressing sleep health issues presents opportunities for enhancing public health, and improving the well-being of all people.

Societal and health consequences of insufficient sleep are explored in “Sleepless in America” produced by National Geographic Channel in collaboration with The National Institutes of Health.  The documentary explains how research is changing our perception of sleep, sleepiness, and its importance to health.  The idea of “sleep” as a period when the brain simply shuts down has been replaced by an increasingly sophisticated understanding of how the rhythm of sleep and wakefulness is necessary for the biological function in every organ.   Not only does this daily “circadian” rhythm play an important role in learning and the filtering of memories in brain, but it also serves to regulate the energy level of most all cells.  Shortages of cellular energy eventually wear down natural defenses through oxidative stress and abnormalities in protein processing increasing the risk of disease.  Another NIH-funded study helped show that during sleep, a byproduct known as amyloid beta is cleared from the brain at a faster rate than when a person is awake.  Amyloid beta has been connected to Alzheimer’s disease.

What all of this adds up to is the idea that sleep should be considered just as important as eating right and getting enough exercise. Adults should aim for 7-8 hours of sleep, while teens need up to 9 hours a night. But getting good sleep goes beyond being in bed for a set number of hours. The quality and timing of sleep are two other important factors for getting proper rest each night. People who work the night shift may experience problems getting quality sleep.

Here are five tips everyone can use to help improve the quality of their sleep:

  • Keep your bedroom cool and dark
  • Put away/turn off all electronic devices while preparing for bedtime
  • Stick to a regular bedtime and wake time every day, even on weekends
  • Stop drinking caffeine by the early afternoon and avoid large late-night meals
  • Skip the late-afternoon nap, as it can make it harder to sleep at bedtime

The NIH has created a web page that brings sleep information from the many institutes that fund sleep-related research into one place. Learn more at

  • Reprinted from HHS blog post by Michael Twery, Ph.D., Director, National Center on Sleep Disorders Research, the National Heart, Lung, and Blood Institute, December 29, 2014


FDA warns on powdered pure caffeine

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The Food and Drug Administration (FDA) is warning about powdered pure caffeine being marketed directly to consumers, and recommends avoiding these products. In particular, FDA is concerned about powdered pure caffeine sold in bulk bags over the internet. The FDA is aware of at least two deaths of young men who used these products. These products are essentially 100 percent caffeine. A single teaspoon of pure caffeine is roughly equivalent to the amount in 25 cups of coffee. Pure caffeine is a powerful stimulant and very small amounts may cause accidental overdose. Parents should be aware that these products may be attractive to young people. Symptoms of caffeine overdose can include rapid or dangerously erratic heartbeat, seizures, and death. Vomiting, diarrhea, stupor, and disorientation are also symptoms of caffeine toxicity. These symptoms are likely to be much more severe than those resulting from drinking too much coffee, tea, or other caffeinated beverages.

Upcoming NWI webinar on EBT's within wraparound

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This webinar will present an overview of the relevance and alignment of Evidence Based Practices (EBTs) to wraparound care coordination and systems of care more broadly. It will then go on to provide examples of how local systems have ensured that youth with complex needs have access to EBTs within a wraparound context. Examples will include: (1) building comprehensive multi-modal EBTs such as Multisystemic Therapy (MST) into a continuum of care, (2) training clinicians to use flexible approaches to EBT within wraparound teamwork, and (3) supporting family and youth peer support partners and natural supports to serve as "care extenders" for EBT as part of wraparound planning.

About the presenter
John Ossowski, MS, LMSW, is a graduate of the State University of New York and Portland State University. John earned his MSW from Portland State, specializing in community-based practice and social sustainability. His career has bridged the fields of education and social work with at-risk, underrepresented youth. He views the National Wraparound Initiative through a sustainability lens because of the Initiative’s focus on the self-determination and well-being of future generations – both primary requirements for a sustainable society. 

New website shining example of peer-to-peer support in action!

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I don't usually gush about a resource, but dang; I am seriously gushing about the folks at This great web-based resource was produced by and for young adults in recovery from mental health and substance use issues. How sweet is that? Take some time to peruse the website. The website has great content, engaging visual appeal, and is full of well-crafted first person stories. Now this is indeed a worthy read and a brilliant example of the power of peer to peer support among young adults in recovery. Shout it from the rooftops, Network faithful!

Here is how they describe what they do and the journey they took to get there:

    • We help you learn about treatment models, local community supports, and state and national resources.
    • We connect you with other teens and young adults who may be struggling with depression, anxiety, self-harm, thoughts of suicide, addiction, mood swings, eating disorders, substance abuse, or any form of emotional distress or mental illness.
    • We need your input to make this resource meet your needs. Please join our "Let's Talk" forum and tell us what you think!
Okay Network faithful, they are looking for feedback, so go on over to their website and let them know what you think!

Getting mental health services can be hard, not withstanding law requiring parity

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Even though more Americans than before have access to health insurance because of the Affordable Care Act, getting mental health services can still be challenging.

A report released in November concludes that despite a 2008 mental health parity law, some state exchange health plans may have a way to go to even the playing field between mental and physical benefits. The report, released by the advocacy group Mental Health America, was paid for by Takeda Pharmaceuticals U.S.A. and Lundbeck U.S.A., a pharmaceutical company that specializes in neurology and psychiatric treatments.

The report listed the states with the lowest prevalence of mental illness and the highest rates of access to care as Massachusetts, Vermont, Maine, North Dakota and Delaware. Those with the highest prevalence of mental illness and most limited access are Arizona, Mississippi, Nevada, Washington and Louisiana.

Among its other findings:

  • 42.5 million adults in America, 18.19 percent, suffer from a mental health issue.
  • 19.7million, or 8.46 percent, have a substance abuse problem.
  • 8.8 million, or 3.77 percent of Americans, have reported serious thoughts of suicide.
  • The highest rates of emotional, behavioral or developmental issues among young people occur just west of the Appalachian Mountains, where poverty and social inequality are pervasive.

The group found that, while information provided through plans’ “explanation of benefits” might show that there aren’t limits on mental health coverage, limitations including treatment caps and other barriers may exist.

“Parity is in its infancy. Most plans know the numerical requirements around cost-sharing, but few have taken seriously the requirements around equity, around access through networks and barriers to care through prior authorization,” said Mike Thompson, health-care practice leader at Pricewaterhouse­Coopers. “And, in practice, we have a history of imposing much more stringent medical-necessity standards on mental health care than other health care.”

The report doesn’t reflect the fact that many health plans have rolling renewals, meaning they had until Jan. 1 to fully comply with the parity law. America’s Health Insurance Plans, a trade group, said insurers are following the law.

“Our members are committed to mental health parity, and we’re supportive of legislation, and what isn’t apparent is that benchmark plans represented a snapshot in time . . . so that doesn’t give us the full picture,” said Susan Pisano, AHIP’s vice president of communications. “Our plans have really been working to get in compliance.”

Chuck Ingoglia, senior vice president of public policy at the National Council for Behavioral Health, a Washington-based trade group for community mental health and substance-use-treatment organizations, said the report’s findings aren’t surprising, though they are troubling. Implementation of the parity law remains a work in progress, he said.

“The law is based on a sound policy premise — that addiction and mental health treatment decisions and management should be comparable to physical health conditions,” he said. “But this also creates a tremendous barrier to proving violations, as it requires a consumer to obtain access to plan documents for both types of care, which is frequently handled by different plans,” Ingoglia said.

In addition, the report found that some plans weren’t clear about which services were covered. That means consumers would find out a treatment wouldn’t be paid for by their insurer only after they’d received care.

Americans with mental disorders have the lowest rates of health insurance coverage, so obtaining insurance is a good first step, according to Al Guida, a Washington-based lobbyist who works on mental health issues with Guide Consulting Services. But the only way a denial can be reversed is through an appeal, which can be a long and arduous process.

“The vast majority of insurance plans offered on Affordable Care Act federal and state exchanges have close to no transparency, which could lead to abrupt changes in both mental health providers and psychotropic drug regimens, with the potential for serious clinical consequences,” Guida said.

Meanwhile, there is a shortage of professionals offering mental health care — nationally there is only one provider for every 790 people, according to the report.

All of these factors can cause minor mental illnesses to grow more severe, according to Mental Health America’s chief executive, Paul Gionfriddo.

He suggested that mental illness should be screened for and covered in the same way that cancer, kidney disease and other illnesses are.

“Right now we’re trapped in a stage where we wait for a crisis, when they’re in advanced stages, and then we treat it, and we wonder why it’s so hard to treat it more cheaply,” Gionfriddo said.

This article was written by Lisa Gillespie and produced by Kaiser Health News, an editorially independent news service that is a program of the Kaiser Family Foundation.

Dr. Dennis Embry to speak at national children's behavioral health research and policy conference

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New Plenary session announced!

The United States leads the way in scientific strategies that can prevent or protect against lifetime mental, emotional and behavioral strategies. That science is better than the early studies of the Salk vaccine against polio. This talk details how that science could be practically implemented prenatally through late adolescence/young adulthood. Hyperlinks and tools for a national movement will be available, with the relevant scientific references and practical steps.

We are in the midst of an epidemic far greater than the polio epidemic, yet we seem not to notice the epidemic of mental, emotional, behavioral and related physical disorders. The current epidemic in North America makes the polio epidemic look like a bad cold. As a society, we have a sort of collective anosognosia about the epidemic, except when there is a heinous violent crime by somebody obviously in the midst of a psychotic episode. After the event, we endure endless media about who is to blame—as if that actually will stop the epidemic.

Every day hundreds of people die in America from the preventable sequelae mental, emotional, and behavioral disorders and tens of thousands become “infected” with those preventable disorders. This keynote address gives the hard facts about the scale of the epidemic that cuts across every social class, just like polio did. Most don’t know these facts, despite the fact every family in America is touched by the epidemic in both direct and indirect ways that drain the future of America.

Okay, Network faithful, get yourself registered for the conference and be sure to add this plenary session to your schedule. 

About the presenter:

dennisDennis Embry, President/Senior Scientist at PAXIS Institute – Dennis D. Embry is a prominent prevention scientist in the United States and Canada, trained as a clinician and developmental and child psychologist. He is president/senior scientist at PAXIS Institute in Tucson and co-investigator at Johns Hopkins University and the Manitoba Centre for Health Policy. His work and that of colleagues was cited in 2009 the Institute of Medicine Report on The Prevention of Mental, Emotional and Behavioral Disorders Among Young People. Clinically his work has focused on children and adults with serious mental illnesses. He was responsible for drafting of the letter to the Wall Street Journal detailing effective strategies for preventing mental illness, signed by  23 scientists, who collectively represent scores of randomized prevention trials of mental illnesses published in leading scientific journals. In March 2014, his work and the work of several signatories was featured in a Prime-TV special on the Canadian Broadcast Corporation on the prevention of mental illnesses among children—which have become epidemic in North America. 

SAMHSA accepting applications for Suicide Prevention Resource Grant

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The Substance Abuse and Mental Health Services Administration, Center for Mental Health Services is accepting applications for a fiscal year (FY) 2015 Suicide Prevention Resource Center grant. The purpose of this program is to build national capacity for preventing suicide by providing technical assistance, training, and resources to assist states, tribes, organizations, SAMHSA Garrett Lee Smith and other SAMHSA grantees, and individuals to develop suicide prevention strategies (including programs, interventions, and policies) that advance the National Strategy for Suicide Prevention (NSSP), with the overall goal of reducing suicides and suicidal behaviors in the nation. This work includes support of the National Action Alliance for Suicide Prevention (Action Alliance), and working to advance high-impact objectives of the NSSP.

The Suicide Prevention Resource Center (SPRC) is the nation’s only technical assistance center whose mission is to advance the NSSP; a roadmap for action that if fully implemented would significantly reduce the number of suicide attempts and deaths within this country. Full implementation of the NSSP requires multiple approaches at multiple levels among multiple entities. Effective approaches require a comprehensive, sustained, data-drive strategy; an active, effective community component as well as an active, effective, clinical systems approach; and community systems that include a wide range of public and private partners. SPRC’s work must target approaches, systems, and entities with the highest potential to prevent suicidal crises and save the most lives. All of SPRC’s efforts are driven by the ultimate goal of reducing suicide attempts and deaths in this country.

Opportunities for enrolling justice-involved individuals in Medicaid

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State Refor(u)m has added a new blog post about how the ACA offers new opportunities for enrolling justice-involved populations in Medicaid, and the blog includes examples of states that are implementing these types of efforts. Since the majority of individuals released from prisons or jails lack health insurance and many have complex physical and behavioral health conditions, coverage can help justice-involved individuals access appropriate treatment services after their release from incarceration.

  • Read the blog post here
  • See resources from the State Refor(u)m library about health coverage for justice-involved individuals here.

National Council launching Early Onset Schizophrenia Community of Practice

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The National Council is launching an eight-month Early Onset Community of Practice for organizations interested in developing a strategic plan to provide early identification and ongoing treatment for youth at risk or showing symptoms of first episode psychosis. National Council member organizations serving youth between the ages of 12 and 25, apply today for this unique opportunity.

Through the Community of Practice learning activities, participating organizations will create a strategic plan to launch a new service line, which will include:

  • Community partnerships: Identify youth-serving community partners that can serve as a referral sources to your organization.
  • Clinical portfolio: Identify current treatment capacity and gaps, staffing and workflow adjustments, and specific clinical areas in need of adjustment or expansion.
  • Financing: Identify funding sources, compliance, and documentation requirements.
  • Organizational culture: Identify adaptions necessary to organizational practices needed to best serve this population and their families.

Complete the online application by 5:00 p.m. EST on Jan. 30, 2015. Accepted organizations will be charged a nominal fee of $500 for participation.

Questions? Read the full description of the request for applications or contact Adam Swanson, Policy Associate, at or 202-684-7457 ext. 269.

P.S. – At the National Council Conference, renowned public and private sector experts from across the country will coalesce to participate in an early intervention summit and several breakout sessions dedicated to the implementation of clinical and organizational practices to address early onset schizophrenia.

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