“The idea of At Ease is to remove as many of the obstacles as possible that prevent active military, veterans, and their families from getting care for post-traumatic stress disorder and other behavioral health issues,” At Ease Founder Scott Anderson said. “It is estimated that only 30% to 35% of military entitled to VA benefits for PTSD ever pursue getting help. What we want to do is to make sure that the people who need care, get it, and particularly that they get care that it is well-documented and proven to be effective.”

The stigma of receiving care for mental health issues is often a barrier that prevents many military personnel from getting the care they need. In an effort to reduce this barrier, At Ease is 100 percent confidential. Because the program is comprised of therapists who volunteer their time, low costs allow At Ease to offer its services at cost effective rates or for free. No one is turned away due to their ability to pay. Another key feature of the program is that unlike other civilian organizations, everyone who works with At Ease has a military connection which allows them to better understand the needs of the client. 

“The military has a very distinct culture, its own language really, so to have a civilian try to understand that and still be able to move the therapeutic process forward can be very challenging,” At Ease Program Supervisor Paul Greenwell said. “Having a past military affiliation is just one more way we’re able to reach these folks and really make a connection quickly.”

As more and more troops return from deployments in Iraq and Afghanistan, the need for mental health services will continue to increase. Anderson cites that somewhere around 400,000 troops will return home with some form of post-traumatic stress disorder, traumatic brain injury, or both. Combined with the number of loved ones who suffer from “virtual or non-combative PTSD” the number of people seeking mental health care could easily reach a million people, according to Anderson.

“There are just too many people for any one resource to serve them all. We have great respect for the services that the VA offers. We apply a lot of the same research and use a lot of the same treatment modalities. We all have to work together because there’s going to be a tsunami of people needing care and we’ve got to serve them and we’ve got to serve them as quickly as possible,” Anderson said.  

In order to serve the flood of people needing services, At Ease is hopeful that funding will allow them to expand services across the state into more rural communities. In addition, the Grand Island office will be launching a teletherapy program where clients can go to any hospital and receive therapy by video conference. At Ease will also be implementing a Web-based, Skype-type of teletherapy where clients will be able to receive therapy from their own homes.   

“We’re hoping that by allowing people to receive therapy from the confidentially and anonymity of their own homes that we’re going to be able to reach a lot more people than through conventional therapy.  It will also help us reach into more remote, rural communities,” Anderson said.

Between the breadth of programs, the reach of services, and the commitment of the staff, At Ease is dedicated to making a difference for military families and removing the obstacles of receiving help for post-traumatic stress disorder.

“The people who are working in this program, chose to work for At Ease because they really care about the veterans. They have the expertise in mental health, they understand the issues, and they also have a passion for working with veterans and military families – that’s number one,” Greenwell said.  “We recognize where they’ve been and the struggles that were a part of that. We really do have a heart for serving them.”

At Ease will be celebrate its accomplishments and look toward the future at its Annual Luncheon on Monday, January 30 at the Centurylink Center. The luncheon, which serves the dual purpose of bringing awareness to the program and helping to break down the stigma of receiving help for post-traumatic stress, will feature former Staff Sergeant Sal Giunta, USA, as the keynote speaker. Mr. Giunta is the first living American to receive the nation’s highest decoration for valor, the Medal of Honor, for actions that occurred since the Vietnam War. Tickets, for the At Ease Annual Luncheon, which cost $50, can be purchased by visiting www.lfsneb.org.

Learn more about At Ease USA by visiting http://www.ateaseusa.org/.

Older individuals must take charge of their own healing and learn to advocate for themselves. They must help others understand that mental illnesses are like other illnesses, they are treatable! Both Theresa and Ken feel that recovery came once they understood the need to be responsible and play a defining role in their own treatment. Theresa and Ken are highly trained, certified peer support workers, and both agreed that it wasn’t until they came in contact with trained peer workers that their own lives began to turn for the better.  

Yes, there is help, there is hope, and there is healing! Thank you Ken and Theresa for having such a positive impact on Not Alone broadcasts!

To learn more about the role of peer support workers, listen to the Dec. 6 Not Alone program by clicking on the play button below, or download the file and listen later. To listen to past broadcasts, visit The Kim Foundation Web site Not Alone podcast page. 

Listen Now

December 6, 2011 – Mental Health Consumers/Peer Advocate

Download

Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.

Nebraska moved forward several years ago with a commitment to close large ‘mental hospitals’ and to develop community based treatment centers to enable consumers to stay connected to their homes and families. Local treatment was intended to help alleviate crisis by providing early, appropriate intervention and care.  In this approach, peer role models encourage other peers to develop the tools and skills needed for help, hope and healing and the results have been impressive. 

The development of peer support services, the proliferation of WRAP classes, Crisis Intervention Training available to police officers, the inclusion of consumers and family members on boards and advisory committees, and the greater participation of consumers in national conferences and workshops has become visible evidence of change. We see the Keya House in Lincoln and the proposed Wellness Center in Omaha as direct reflections of consumer leadership.

A great example of consumer led change centers on a recent request by Nebraska Medicaid to establish a drug formulary, whereby consumers had to accept the least costly of the medications available, rather than having their own physician prescribe medication most effective for each individual. This request was defeated by the Legislature because the consumers urged their state senators not to establish the formulary. They expressed the consequences of this action so logically and eloquently that the Senators agreed and the program was rejected for implementation by the Division of Medicaid Services.

Yes, Nebraska has need and opportunity to improve response or to become more pro-active in many areas of mental health care; however, we can celebrate the fact that consumers are increasingly assuming leadership and responsibility which is leading to meaningful change. Resiliency and recovery are always two worthy goals.

The Kim Foundation also recently visited the VA Hospital for Nebraska-Western Iowa Research Week Open House and learned about research programs in other VA hospitals across the US, and how this research transitions into advancements in Veterans’ health care.   

We were pleased by the long-term research and patient care partnership of Creighton University Medical Center, the University of Nebraska Medical Center, and the Veterans Administration Hospital located in Omaha. Although most of the mental health related research of these medical centers is focused on the effects of substance abuse at this time, we did receive briefings regarding on-going research in other VA centers relating to women’s health, traumatic brain injury and PTSD that were of special interest to The Kim Foundation. We hope the Veterans Administration will continue to acknowledge and strengthen its response to veterans and their loved ones who must live with service related mental health issues.

The Centers for Medicare and Medicaid Services state that the EPSDT service is “Medicaid’s comprehensive and preventive child health program for individuals under age 21.”  The CMS continues, “In addition, Section 1905(r)(5) of the Social Security Act (the Act) requires that any medically necessary health care service listed at Section 1905(a) of The Act be provided to an EPSDT recipient even if the service is not available under the State’s Medicaid plan to the rest of the Medicaid population.”

On March 18, 2011, NAMI National hosted a teleconference with guest speaker Jane Perkins, legal director of the National Health Law Center. Jane is considered the leading expert on EPSDT. Ms. Perkins stated that “States must apply the federal definition of “medical necessity” and that this broad definition cannot be narrowed by state rules. The federal definition of medical necessity is defined in the federal statute which states “If a practitioner of the healing arts deems that a treatment is medically necessary to correct or ameliorate a condition, the state must provide it, whether or not it is covered under any other state plan.”  

Ms. Perkins listed services not covered under EPSDT, which include respite, habilitative care, and home modification. She defined habilitative treatment as ‘to teach a skill they never had.”  This is an important delineation when formally requesting services under the EPSDT provision, continued Ms. Perkins, as the law does include rehabilitative care. Ms. Perkins stressed the importance of wording when requesting services under EPSDT. Such wordings include EPSDT and correct or ameliorate.

Toni Hoy, author of  “Second Time Foster Child,” has used EPSDT as the basis for the Hoy Family federal lawsuit against the state of Illinois, filed in November, 2010.  The suit is pending in the Northern District Federal Court.

Jane Perkins is hosting a 16-month workgroup on EPSDT; The Kim Foundation urges readers to visit her website at www.healthlaw.org. Her email is perkins@healthlaw.org.

Realizing that youth experience loss and grief from a variety of life situations, not just the death of a loved one, Ted E. Bear Holllow recently expanded its programs to reach a wider population of youth in need. Working with organizations such as Girls’ Inc. and The Douglas County Youth Center, Ted E. Bear Hollow is piloting the Growing Through Loss Program, a community-based 12-week comprehensive training program that provides a supportive, therapeutic, and educational learning experience for grieving and depressed youth.

“If kids can learn to cope with loss and grief in healthy ways, the risk for substance abuse and depression is greatly minimized,” Ted E. Bear Hollow Executive Director Nancy Hemesath said. “The Growing Through Loss Program emphasizes prevention. We know helping a kid become healthy with their grief makes a difference.” 

The Growing Through Loss Program was developed by two substance abuse counselors working with youth in juvenile detention centers who witnessed kids anesthetizing their pain with drugs, alcohol, or other harmful behaviors because of losses they had that they never resolved. The program helps kids first identify their loss, whether it be abandonment, divorce, abuse, death or a variety of other issues, and then helps them deal with how the loss has affected them providing them with tools on how to not only understand their grief but provides options to move forward in a healthy way.

Ted E. Bear Hollow hopes to work with various youth organizations in North Omaha throughout the year to bring the Growing Through Loss program to a greater number of kids in need. Because a large percentage of youth have experienced some sort of loss: children in foster care, youth who have dealt with violence, or who are in the court system to name a few, Hemesath sees a great deal of possibility for this program.

“I can’t imagine a foster care child who doesn’t feel like they haven’t had major losses. Loss of a stable home, loss of biological parents, and as youth violence escalates, I know there are more and more youth affected by loss of some sort, Hemesath said. “We always want to make a bigger difference in the community, and reach those who wouldn’t necessarily come to us first, and this program is a great way to do that.”

For example, NAMI Walks for Nebraska will be June 11, 2011 in Elmwood Park in Omaha, with about 700 participants expected. Dollars raised support education efforts including weekly recovery support groups, family-to-family programs that provide information about illnesses of the brain, treatment options, and recovery principles. Peer-to-peer education helps a person with a serious mental illness achieve and maintain wellness, while the NAMI Basics program is developed specifically for parents and other caregivers of children and adolescents who are coping with a serious mental illness or serious emotional disturbance.  Knowledge is power; help, hope, and healing come with knowledge and power!

Take Flight Farms in Omaha have been celebrated as a Center of Excellence in equine assisted activities.  We have recognized and appreciated their work with those experiencing domestic violence and sexual assault, helping individuals to become trusting and secure people once more. At Take Flight Farms, children and teens have learned the value of friendships and working together; they have seen their own actions and attitudes mirrored in the behavior of the horses, and learned how to modify their own behaviors. This year Take Flight Farms added programs through Children’s Hospital for youngsters with eating disorders, a Respite Care program through Eastern Nebraska office on aging, and programs for military groups, which include equine therapy for post-traumatic stress disorder, traumatic brain injury, resilience, and reintegration after deployment. Service men, women, and their families are eligible to take part.

This digital world in which we live can be a puzzle, presenting painful, emotional consequences. Common Sense Media, Omaha Public Schools, and Building Bright Futures presented Omaha’s first Digital Citizenship Week , encouraging us to be the civilizing force in students’ digital world. We are encouraged to raise awareness about the influence of technology on kids, inspiring them to become good digital citizens. Bullying issues, hurtful and demeaning events, understanding how postings can follow a young person well into adulthood, and the effects of the violence expressed in video games on a young person were all components of Digital Citizenship Week.  Cyberbullying, using cell phones and computers to hurt, humiliate, and harass is reaching epidemic proportions. Youngsters receive demeaning text messages, embarrassing photos, and snide opinion polls. This type of bullying is constant, pervasive, and public!  The depression or anxiety resulting from being bullied or hurt can create emotional damage that lasts a lifetime. One great hint is to remind youngsters that all private information CAN be made public! We encourage readers to contact delayne.havlovic@ops.org for more information on this topic.

One very special population that has always held our hearts are the children and youth in foster care. In Nebraska there are about 7000 youth in foster care at any one time. If a teen has not had a relationship with their own family, and has experienced 20 – 30 foster homes, who celebrates their birthday, or buys their graduation dress? Who encourages career goals, or models positive family values for them? We’ve learned that three out of 10 US homeless are former foster children, and about a third of former foster children live at or below poverty level. 

We were encouraged to learn about the National Foster Youth Action Network, and its role in helping youth learn to advocate for themselves and other foster youth. Youth leaders are learning to affect policy issues at the local, state, and national levels, influencing change for the good of youngsters in foster care.  We are extremely proud that through the Nebraska Children and Families Foundation, Project Everlast has developed to help our local youth have the supports and lifelong connections for successful transition to adulthood.  One student commented, “Foster youth age out without knowing what to do in the real world.” Now they are being asked, “What would you like to be in 5 or 10 years?” Foster youth say, “I have other foster youth to talk with who understand my feelings. I’m not just a foster child, but am a person, and people can succeed if they strive to get the most out of life.” We encourage Nebraska foster youth to visit www.nebraskafosteryouth.org.

In closing, I’d like to add a personal note about our family’s young Marine experiencing post traumatic stress disorder, or PTSD.  He was hospitalized for several months, and healing has been a struggle. Our Marine recently received a psychiatric service dog, especially trained to work with PTSD experienced by our country’s active duty personnel and veterans.  Two years ago, our Not Alone radio broadcast interviewed Dr. Joan Esnayra, who initiated a pilot project at Walter Reed Hospital in Washington D.C. regarding the use of psych service dogs, and now we are humbly grateful that, because of the success of Dr. Esnayra’s program, with the encouragement of members of the military command, these especially trained dogs are now bringing hope, help, and healing across the nation to families such as ours.  Since acquiring his dog, our Marine seems healthier and stronger in many respects as each week passes.

From Rights to Reality is designed to respond to two needs in child welfare reform:
1) The need to change a general perception that children who enter foster care usually do not go home; that most parents whose children enter foster care are abusive, as frequently portrayed in the media; and that parents’ needs and children’s needs are usually in conflict. The public needs a more nuanced understanding of the reasons that parents come to the attention of the child welfare system, the supports and legal representation available or unavailable to parents, and the family strengthening that is possible when parents get the help they need.

2) The need to support child welfare reform organizations in developing specific agendas for pushing forward changes in how local agencies treat parents and families. From Rights to Reality consolidates many of the best practices that have helped families to have a significantly stronger voice in their own cases and a greater likelihood of succeeding in safely raising their children at home. From Rights to Reality is designed to help local advocacy and child welfare organizations develop a plan for public education and targeted advocacy.

Each right is illustrated by parents’ stories — stories that show how families can be strengthened and transformed when parents have these rights, and stories that show how families are harmed when these rights are denied.

These rights are essential to ensuring that children receive the best possible care — at home or while in foster care. In child welfare proceedings, children’s needs and parents’ rights are often portrayed as incompatible. Research and practice have demonstrated that, in most cases, this is not true. Children do better if they can remain connected to their parents and return home.

Most of the promising practices described here were advanced through tireless parent advocacy or through meaningful parent participation in child welfare reform. They developed because parents made themselves heard and child welfare practitioners listened. From Rights to Reality gives parents a clear, resounding voice in leading the process of child welfare reform in their communities. Child welfare practitioners must listen and respond. Click here to learn more about Rights to Reality. Below is each of the 15 parent rights.

Parent Rights:

1. I have the right to not lose my child because I’m poor.
2. I have the right to services that will support me in raising my child at home.
3. I have the right to speak for myself and be heard at every step of the child protective service process.
4. I have the right to be informed of my rights.
5. I have the right to a meaningful and fair hearing before my parental rights are limited in any way.
6. I have the right to quality legal representation.
7. I have the right to support from someone who has been in my shoes.
8. I have the right to have my child quickly placed with someone I trust.
9. I have the right to frequent, meaningful contact with my child.
10. I have the right to make decisions about my child’s life in care.
11. I have the right to privacy.
12. I have the right to fair treatment regardless of my race, culture, gender, or religion.
13. I have the right to services that will support me in reunifying with my child.
14. I have the right to offer my child a lifelong relationship.
15. I have the right to meaningful participation in developing the child welfare policies and practices that affect my family and community.

In the wake of great tragedy such as the recent Arizona shootings, the temptation exists to isolate a single factor that can make sense of unthinkable violence. The reality is that a multitude of factors converged to lead events to unfold as they did. To focus on mental illness as the lone predictor contributes to its own tragedy; the false belief that people with mental illness are violent and should be feared.

Research has borne out time and again that mental illness, even at its most severe, is not alone a predictor of violence. The Elbogen study in 2009 outlined the top ten predictors of violence. They were as follows: age (the younger the person, the higher the risk), history of violence, gender (males are more likely to become violent than females), history of juvenile detention, divorce or separation within the past year, history of physical abuse, parental criminal history, and unemployment within the past year.

It is not until ninth on the list that mental illness becomes a factor, and even then, it is only when mental illness exists in combination with substance abuse. A person with mental illness and no history of substance abuse and no history of violence is no more likely to be violent than anyone else in the general population, and in fact, are at two and a half times greater risk of being the victim of violence at some point in their lives.

Mental illness stigma is based largely on the false belief that mental illness equates with dangerousness. Due to stigma, individuals struggling to overcome a mental illness can face a constant series of rejections and exclusions. People struggling to recover from mental illness can find themselves denied adequate housing, loans, health insurance, jobs, and isolated from the support of friends, family and their community. Stigma about mental illness is so pervasive, it is often what prevents people from seeking help.

The only way to fight stigma is with facts. The fact is that 26 percent of people will suffer from symptoms of a mental illness in their lifetime. They are no more likely than anyone else to become violent. There are things we each can do to fight the stigma.

Educate yourself about mental illness. Be aware of hurtful language and challenge media stereotypes. Support those with mental health issues. Understand that mental illness is a disease, much like diabetes or cancer, and can be managed very successfully with proper treatment. Perpetuating misplaced and misguided fear only serves to prevent those who need help from seeking it.

Kathy Seacrest
Regional Administrator
Region II Human Services

Teresa Ward, LIMHP
Director of Outpatient
Services/Day Rehab
North Platte

We’d like to introduce a special mom, the mother of a young adult on the autism spectrum, who also experiences other mental health disorders. As a nurse, the mother attended Nurse’s Day at the Nebraska Legislature in Lincoln on February 3, 2011. Her story motivates readers to become involved in our legislative process, and to truly address the opportunity to change the mental health care system.

I am a nurse and the mother of a young adult on the autism spectrum who also has other mental health disorders. Life is challenging for Zach. He is a kind, witty, and intelligent individual but even the simplest of daily activities can be very stressful for him. I am fortunate that Zach does not resist taking his medication to keep himself balanced – it is second nature to him and part of what he does, just like eating and sleeping. The toughest piece for Zach, is the autism piece, which leaves him feeling isolated – navigating the social world is very difficult for him. Individuals on the autism spectrum may also face other challenges: processing difficulties, sensory problems, learning disabilities, varying degrees of obsessive compulsive disorder, and self-stimulatory (tics) behaviors that are not understood by the general public.

As Zach’s mother I have been keenly aware of the difficulties in navigating the health system for care. I am so thankful for my nursing background. Navigating the system is difficult for me – I can’t imagine how difficult it must be for others. While Zach is blessed to have health insurance, mental and medical health care are just part of the services he needs to move toward a more independent life. The problem, which many of us are so painfully aware of, is the availability of comprehensive mental health services. There are not enough psychiatrists, medicines specific to psychiatric treatment are expensive, and community services and housing are nearly non-existent.

I recently returned to school to get my master’s degree in nursing. I felt compelled to go to school and put my education to work in advocating for mental health and becoming involved in developing policy for this vulnerable population. I have sought out opportunities to become better versed in the legislative process at the state and federal levels. I am hopeful that the new health care law which addresses some of the gaps in mental health care will be a step toward real parity in obtaining deserved care.

February 3, 2011 was Nurses Day at the Legislature in Lincoln. Nearly 275 nurses from across the state gathered for the chance to share their concerns about healthcare with their representatives. There are close to 3 million nurses in the United States. Gallup polls for many years have noted that nursing is the most trusted profession. A trusted group with large numbers can be an important voice for the vulnerable who need advocates in the health care arena. It is so important for us to reach out to our representatives at the state and federal levels to voice our frustration with the present state of mental health care. I learned at the conference that sending our stories (not pre-written letters/emails sent enmasse) motivates our representatives to act. Remember, they want to please you…they need your votes! Individuals on the Health and Human Service (HHS) Committee have more interest in health related issues. They have the ability to take our concerns and write legislation. It is so easy, given our current technology, to communicate with our representatives.

To contact your State Senator go to http://www.nebraskalegislature.gov/ . On the left hand side of the site you will find links on how to find your senator and his/her contact information. You will also find a link to specific committees within the legislature. At the federal level you can find and contact your Senators Ben Nelson and Mike Johanns at http://www.senate.gov/. We have three representatives in the House and you can find and contact them at http://www.house.gov/ .

Change occurs best at the grassroots level. I encourage you and concerned friends and family to contact your representatives, tell your stories, and make your needs known. We cannot wait for help to arrive – we must create it!

Because of their participation in recovery programs, their courage, changed attitudes, and values, and because they had the desire to take the ugly in their life and turn it into a calling to help others, our guests are now role models for their peers. As Peer Support Recovery Specialists, they have the words and the life experience to help others find their own inner strength needed to begin healing.   They have bruised but healing hearts that allow them to facilitate communication amongst individuals, families, and even service providers. Their work involves enabling people to overcome harmful behaviors and addictions; their personal story gives them authenticity, and their journey models resiliency, self respect, and hope for everyone’s future.

To hear more about how Peer Support Recovery Specialists use their experiences to help others, click on the play button below to listen to the January 25 Not Alone broadcast, or download it and listen later. You will need to download multiple tracks of this broadcast to listen to the full program.  To listen to past broadcasts, visit The Kim Foundation Web site Not Alone Archive page. 

 Listen Now

January 25 – Peer Support Through LFS in Lincoln – Track 1

January 25 – Peer Support Through LFS in Lincoln- Track 2

January 25 – Peer Support Through LFS in Lincoln – Track 3

Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guest from across the country.