Friday, February 18, 2011

Self-help for the mentally ill?

Classes and support groups complement medical solutions


By TONY EVANS
Express Staff Writer

NAMI representatives Gail Wray, left, and Wendy Norbom discuss support programs earlier this week at Iconoclast Books in Ketchum. Photo by Willy Cook

On Monday evenings, a small group of people gather at St. Luke's Hailey Clinic to talk about their struggles with mental illness. They suffer from depression, bipolar disorder and other conditions. They are members of the National Alliance on Mental Illness Wood River Valley chapter Connections Program.

NAMI is a nonprofit organization founded in 2000 in the Wood River Valley. NAMI National was founded in 1979 as a community-support and information network for families suffering from mental illness.

"We try to stay motivated and to deal with mental illness in our family and work life," said one member of the group who asked to remain anonymous.

He said he has suffered from attention-deficit/hyperactivity disorder throughout his life, and recently found a way to participate in the community. He said he hopes to help others who may be struggling with a mental illness.

"I started from a withdrawn position and decided I need to get out," he said. "I saw a notice in the newspaper about a nine-week NAMI Peer to Peer Training and called them."

The man was one of seven people who later attended a weekend facilitator training in Boise, hosted by NAMI National representatives and designed to train people to help others through the difficulties of living with a mental illness.

"People get frustrated with medications," he said. "They interfere with sleep or other areas of our lives. Medication needs can also change. Now that I am a facilitator, maybe I can help others."

Due in part to cutbacks in mental-health services in the Wood River Valley, an increasing number of people diagnosed with mental illnesses, and their families, are turning to one another for support. Support groups and classes are complementing medical treatments, providing much-needed mentoring for those suffering from a mental illness and its effects on families.

"Grassroots groups have found out what works," said National Alliance on Mental Illness spokesman Tom Hansen. "They are led by people in recovery themselves. If the mentally ill don't get services, they isolate and don't get reintegrated into society. That's not healthy for those who need social stimuli."

Hansen, who stepped down as president of NAMI Wood River Valley two years ago, said recent Idaho Department of Health and Welfare cutbacks for mental health may have contributed to a rise in attendance at NAMI classes and support groups.

The department had its budget trimmed by $1.6 million in December, triggering the loss of another $6.5 million in matching Medicaid federal funds, for a total of $8.1 million. Most of the cuts affect programs for low-income adults with severe mental illness, including support in managing medication and group therapy for severely mentally ill clients.

The agency closed nine of its 29 offices in Idaho last year, including a Health and Welfare office on Main Street in Bellevue, leaving about 80 mental health clients without a place to receive counseling and medical prescriptions. To get into the mental-health care system, a person now must drive to Twin Falls. As a result of the closure, most of the local consumers of mental-health services either lost eligibility or lost accessibility.

A few years ago, Hansen said, Medicaid paid for up to 32 hours per week of psycho-social rehabilitation services for the mentally ill in Bellevue. That number dropped to 10 hours or less in 2010 and was reduced to less than five hours per week in January.

"That remaining five hours of [psycho-social rehabilitation] services is on the cutting block right now," said Hansen, whose son suffers from a mental illness.

Hansen has advocated at the state level for increased mental-health services for almost 10 years.

Psycho-social rehabilitation services workers help patients reintegrate into a community, get medications and job training, and teach basic living skills.

"We could be going back to the 1940s and 1950s when we just warehoused the mentally ill," Hansen said.

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He said treating the mentally ill outside the communities in which they live is more expensive.

"When someone is in a crisis and gets picked up, it can cost the county $60,000 to $80,000 for one cycle of the illness when you include the cost of lawyers, police, drugs and psychiatrists," he said. Canyon View (a short-term mental health facility in Twin Falls) is $1,000 dollars per night."

Hansen is member of a Community Mental Health Task Force formed in Blaine County last summer in the wake of the Health and Welfare office's closing. The task force is made up of county representatives, St. Luke's hospital workers, psychiatric counselors, social workers and NAMI advocates.

"We decided to focus first on data collection," said Erin Pfaeffle, manager of the St. Luke's Center for Community Health in Hailey.

She is one of three chairs of the task force, along with Blaine County Deputy Prosecuting Attorney Tim Graves and County Commissioner Angenie McCleary.

Pfaeffle said St. Luke's has seen a spike in the need for mental-health service scholarships in recent months. St. Luke's provided 56 scholarships in the past four months, compared with 30 for the previous year.

"The numbers have jumped significantly," Pfaeffle said.

The scholarships pay for up to $200 of therapy, based on self-reported needs. The money pays for clinical practitioners, social workers, psychologists and psychiatrists, all of whom sometimes reduce their rates for the program.

"The information we have gathered so far points to a need for a coordination of services, one place where a person's long-term needs can be managed, or a safe environment to meet," Pfaeffle said. "We are going to build something for this community."

She said she thinks St. Luke's Wood River Medical Center will play a role in this.

"They are open to hearing our proposal," she said. "Anything we can do as a community to support one another. To show that mental illness is not something to be embarrassed about and pushed under the rug is excellent."

Pfaeffle said she envisions a form of community-wide "network therapy," involving many people around patients' care, including family, friends, co-workers and doctors.

"NAMI groups are part of network therapy," she said. "It has to be a community process, where people recognize the resources around them [and] feel welcome, safe and part of a community."

About 35 people currently participate in NAMI classes and workshops, aimed at reducing stigma and providing support for those suffering from mental illnesses, but the anonymous member of the NAMI Connections Program quoted earlier said he would like to see more people in the program.

"We want to expand the group so it would be more inclusive of broader ideas in the community," he said. "This is one of the goals of the Connections Program. You need to be constantly trying to increase your group because gravity is always trying to pull it smaller."

"The Connections Program is a powerful tool because it allows people to connect once a week with someone they trust," Hansen said. "Unless someone is intimately involved with mental illness, they don't understand it. Fellow support-group members can help get someone focused on getting their medications, or try to push them to get help if they are in a crisis."

But he said many people in need of help remain out of reach for another reason.

"Many people with mental illnesses don't think they are sick," he said.

Tony Evans: tevans@mtexpress.com

NAMI classes and support groups:

- Family to Family: Open to families and friends of mentally ill patients. Weekly interactive meetings to study NAMI-approved textbook, covering range of mental illness diagnoses and related issues. Twelve sessions under way, but closed to any more participants.

- NAMI support group: Ongoing support group for families and friends of mentally ill. Meets first and third Wednesdays at St. Charles Church annex, 311 S. First Ave. in Hailey, downstairs, 6-7:30 p.m.

- Peer to Peer: People with mental illnesses mentoring others through an interactive, NAMI-certified program. Begins Feb. 23, running for nine weeks in Hailey, time and dates to be announced.

- Connections Program: Open weekly meeting for those who may be suffering from a mental illness, with NAMI-trained facilitators. St. Luke's Family Medicine, 1450 Aviation Drive, Hailey, Mondays, 5:30-7 p.m.




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