Not Alone recently interviewed another wonderful author Julia Cook, from Fremont, Neb. who has written amazing books for children regarding a variety of social issues, including divorce, (The D Word); ADHD, (It’s Hard Being a Verb); anger management, (Soda Pop Head); and her latest book, Grief is Like a Snowflake, which talks to children about grief and the reality of losing someone we love.

Realizing the need for books of this nature, written specifically for children, The Kim Foundation is raising money to purchase children’s books to donate to public libraries and elementary school libraries throughout Nebraska, especially in rural communities. If you would care to join us, please send your donation to The Kim Foundation and mark your check for The Book Project. We know these books will help children and parents face their journey with the right tools, and the right words. Thanks for your help!

To listen to the re-broadcast Not Alone program featuring author Sharon Bracken, click on the link below to listen to the October 4 Not Alone broadcast or download the file and listen later. To listen to past broadcasts, visit The Kim Foundation Web site Not Alone podcast page.

Listen Now

Sharon Bracken, author of Eli, the Bipolar Bear – Track 1

Sharon Bracken, author of Eli, the Bipolar Bear – Track 1

Sharon Bracken, author of Eli, the Bipolar Bear – Track 2

Sharon Bracken, author of Eli, the Bipolar Bear – Track 2

Sharon Bracken, author of Eli, the Bipolar Bear – Track 3

Sharon Bracken, author of Eli, the Bipolar Bear – 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.

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.

Click on the button below to listen to the March 22 Not Alone broadcast featuring Jeff Wolfsberg, or download the file and listen later. To listen to past broadcasts, visit The Kim Foundation Web site Not Alone podcast page. 

 
Listen Now

Jeff Wolfsberg, drug addiction specialist – Track 1

Jeff Wolfsberg, drug addiction specialist – Track 1

Jeff Wolfsberg, drug addiction specialist – Track 2

Jeff Wolfsberg, drug addiction specialist – Track 2

Jeff Wolfsberg, drug addiction specialist – Track 3

Jeff Wolfsberg, drug addiction specialist – 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.

The Kim Foundation has previously showcased projects for those who compulsively over-eat, compulsively shop for unnecessary items, or compulsively hoard items that are serving no useful purpose in their homes. Recently, two respected colleagues shared we me new opportunities that are designed to heal and change those who compulsively shoplift and compulsively gamble. 

Jeri Schaben, with the Douglas County Community Mental Health Center told us that there are approximately 7,000 shoplifting arrests per year in Douglas County. That’s about one in every 11 people living in the county! Most are law abiding citizens, except for this addiction, and most want to quit, but can’t!  Shoplifters report that they steal 48 times for every one time they are caught.

Jeri also shared that there is a new self-help group in Omaha — Compulsive Shoplifters Anonymous. Its goal is to help individuals who want and need assistance to stop their addiction. 

Sidney Kauzlarich, M.D., the Medical Director at Douglas County Community Mental Health Center is encouraging individuals to participate. Dr. Kauzlarich stated, “Recovery groups for compulsive shoplifters can be extremely effective in curbing or stopping the behavior. The groups provide support in identifying basic issues that cause the compulsive behavior.” Studies find that those who attend Compulsive Shoplifters Anonymous meetings for more than one year virtually stop their behavior.  

Congratulations to members of Omaha’s Compulsive Shoplifters Anonymous (CSA), for recognizing their addiction, and taking that first positive action toward stopping.  CSA meets every Thursday from 6 p.m. – 7 p.m. at Bergan Mercy Medical Center in the downstairs conference room. For information, contact Jeri Schaben at Douglas County Community Mental Health Center – 402-444-5200.

Another friend, Beth Hansen, MS, LMHP, CCGC, with One World Community Health Center in Omaha, reminded us about the help lines available for those with compulsive gambling behaviors, 1-800-522-4700 from the Nebraska Council on Compulsive Gambling, and 1-800-Bets-Off, which is the Iowa gambling treatment program.

Beth reports that often times, those addicted will call the toll free number, but lose heart and disconnect the call when a counselor answers. Some people will call several times before they actually develop the confidence to talk with someone. This includes friends or family members who will call, then feeling shame or frustration, and will also simply hang up the telephone. When they do build up the confidence to talk, callers are usually pleased with the kindness and the information that trained counselors are able to provide.

People who have stolen money from loved ones or business associates in order to perpetuate their compulsion, people who have lost jobs and families because of their habit, and people facing incarceration because of the financial damage they have caused, can all find some degree of help from addressing their addiction with a trained professional or contacting one of the help lines listed above. Gamblers deserve the opportunity to begin life again without the addiction that has cost them so dearly.   

This season of the year is about repentance, about spiritual discipline, and a recommitment to self improvement; every day becomes a good time of year to help any person with an addiction who is looking for a new beginning.

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!

Jessyca is an amazing lady, and it’s difficult for me to share her story without finding that old familiar lump in my throat. Jessyca is a product of the child welfare system. She was removed from her biological mother by 18 months of age because her mother was unable to protect Jessyca from the men in mom’s life. Pneumonia, cigarette burns on her feet, a skull fracture; there is more, but that lump is here again, were all things young Jessyca had to endure. 

Jessyca was in foster care several years before being adopted by a family in Missouri. Jessyca shares her story as a testimony to how two sisters with the same birth mother and very similar circumstances can have two very different life outcomes.  

Jessyca has a biological sister who spent her early years with their birth mother. She is mildly retarded; her injuries, impaired development and seizure disorder, are a result of abuse and neglect.

One sister, Jessyca, has a graduate degree and has dedicated her career to championing the rights of children for protection and safety. The other sister continues to struggle emotionally and physically.  

Jessyca believes the crisis in the child welfare system is a burden we all share. No one agency can respond to the needs of all children and families. We must all hold child abusers accountable. We can help educate young parents, giving them the tools to be good parents, we can initiate creative ways to provide preventative services. 

Jessyca has been in the homes of gang members, drug dealers, drug addicts, felons, and those with severe and profound emotional illnesses. Jessyca does what she can to help children in need since she, too, was once a child waiting for some one to rescue and protect her.

“As a licensed mental health practitioner and a woman myself, I know that women pride themselves on taking care of others rather than themselves. Often, women who have been deployed have higher readjustment issues and cases of depression because it can be challenging adjusting and integrating back into the role of mother, care giver, or wife,” Niemack-Brown said. “We hear women say that when they come back after being deployed they don’t get the same kind of support or acknowledgement that men receive and they feel isolated.”

Although women have served in the U.S. military since the Revolutionary War, serving in disguise or in non-combat capacities, it is only since 1901 when the Army Nurse Corps was established that women officially joined the military. Since then, opportunities for women to serve have steadily increased and as a result of the progress of the 1990s, women are now excluded from only 9 percent of Army roles.

As of 2009, the number of active duty women soldiers in the armed forces or in the National Guard or Reserves was more than 280,000. Today 8 percent of U.S. Veterans are women with the greatest majority having recently served in Iraq and Afghanistan where about 10 percent of active U.S. Forces there are women.

The Veterans Affairs, dedicated to serving the comprehensive needs of women Veterans, began providing medical and psychosocial services for women in 1988. Today, the influx of women Veterans, whose average age as of 2009 was 48 years, compared to 63 years for their male counterparts, presents opportunities to expand health care services to address the specific needs of women Veterans.

At each of the VA hospital and clinic facilities throughout Nebraska located in Omaha, Bellevue, Grand Island, Holdredge, Lincoln, Norfolk, North Platte, and Shenandoah, the Women Veterans Health Strategic Care Group works to ensure that timely, equitable, high-quality, and comprehensive health care services are provided in a sensitive and safe environment.

“Previously, women’s health at the VA was extremely fragmented,” Cindy Niemack-Brown, Women Veterans Program Manager for the VA Nebraska Western Iowa Health Care System said. “Before women vets might be seen in a clinic for their PAP, but then have a different primary health care provider. Strategically we decided to develop a designated women’s health primary care provider who has specifically chosen to do women’s health to provide all care for the needs of women so when they need care it’s not fragmented.”

Although the VA Medical Center’s long list of health care services for women include treatment for all the general care issues one would naturally assume a hospital would treat including disease prevention, health screening, treatment of chronic conditions, gender specific care, and a wide range of mental health evaluations and assistance, the VA Women’s Health Program also includes reproductive health care services such as infertility evaluation and limited treatment, maternity care, rehabilitation therapies, and programs to address issues of military sexual trauma.

Niemack-Brown says that the hard part is making sure women veterans know what health care services and benefits are available to them. She says that less than a fourth of women Veterans in general use the VA benefits and reports indicate that only 51.3 percent of women veterans from Afghanistan and Iraq have received VA health care.

“We’re doing a lot of outreach to Veterans to help them understand what services are available,” Niemack-Brown said. “A lot of it is education and being sensitive to other issues that may be present. We want women to be aware that the VA is providing comprehensive health care to females throughout their life span. Our mission is not only to facilitate the best health care, but find out what they want in regard to their health care.”

The VA Women Veterans Program is continuously adding to its list of services for women Veterans.

For more information about women Veterans health care, visit the women Veterans link at www.VA.gov or contact your Local County Veteran Officer.

Last year’s Technology Summit identified three barriers in the provision of mental health care for Nebraska: education and clinical supervision, infrastructural administration and technical support, and service delivery. The summit this year addressed opportunities for collaboration among health care providers and payment providers to develop solutions for barriers to providing care through the use of health information technology. Creativity and a positive attitude will define our future successes!

Recognizing the shortage of mental health care providers, particularly in rural Nebraska regions, the challenge has been providing competent care in local communities in a timely manner. Technology is becoming a vital part of the solution to workforce shortage; however, challenges yet to be addressed through the use of health information technology include privacy issues and the absence of comprehensive reimbursement policies.

By keeping the consumer needs foremost and developing strong collaborative efforts among mental health care providers, the opportunities for strengthening Nebraska’s array of treatment and services becomes limitless. Adopting a seamless health information technology solution is a great opportunity for Nebraska to provide meaningful mental health care for our one in four families seeking service. As usual, we begin change by putting aside our established ways of doing business and become open to opportunities offering enhanced service for less cost. Change is difficult, but this is the right time to explore new options.

On October 7, I attended the Mental Illness Awareness Week annual Legislative Breakfast sponsored by Bryan LGH Medical Center in Lincoln. In 1939 Lincoln General Hospital was the first general hospital in the US to provide acute psychiatric hospitalization for adults. This tradition of leadership, public education, and healing in the mental health field continues today under BryanLGH Hospital.  

A highlight of the breakfast was the reading of a City of Lincoln Proclamation signed by Mayor Chris Beutler which recognized that serious mental illness affects one in every four people; mental illnesses are more common than cancer, diabetes, and heart disease, and mental illnesses are the number one reason for hospital admissions nationwide. The Proclamation also reminded us that serious mental illnesses have proven to be highly treatable illnesses, and people can reclaim full and productive lives. As a culture, we need to discontinue wrongly imposing stigma upon those illnesses.

The Kim Foundation extends our appreciation to BryanLGH and the City of Lincoln for their outstanding leadership in drawing attention is such a positive way the needs of those with chronic brain disease.

The Kim Foundation was also invited to attend the annual Spirituality and Mental Health conference sponsored by Alegent Health in late October. Because of the stigmas which, sadly, still abound, people with mental illnesses often feel isolated, rejected, and defeated. Healing becomes more complicated for those who feel they have no hope. The Spirituality Conference encourages healing of the body, mind, and spirit recognizing the strong and positive relationship between faith and healing. Research shows that people with hope demonstrate stronger coping abilities and higher rates of healing. Our spirituality can help us recognize and establish those inner resources.

The conference encouraged dialogue between consumers and members of the clergy asking many questions. For example, how might clergy assist members of their congregation needing mental health care? How will clergy recognize symptoms of these complicated illnesses, and how do they locate appropriate community resources for those in their care? Perhaps as meaningful to the individual seeking hope and healing, how do clergy encourage members of their congregation to extend friendship and acceptance to people with mental illnesses?

The relationship between our health and our faith is profound; we were grateful to see so many pastors, congregation members, and mental health professionals joining the consumers and families for these great discussions.