Franklin James Cook

Archive for the ‘Advocacy’ Category

Antidepressants Aren’t the Problem, Marketing Them Is

In Advocacy, Mental Illness, Opinion on February 26, 2010 at 1:02 pm

Pills with Dollar Signs

By Franklin Cook, SPNAC Editor

I’ve been reading a lot lately about antidepressant medications, with the idea that I was going to summarize some of the recent debate about whether they are part of the problem or part of the solution regarding suicide. But I have abandoned the idea of writing a summary such as that in this small forum because, for one thing, some of the “debate” about antidepressants and suicide is very polarized, with one camp applauding them as a miraculous intervention to alleviate the suffering of suicidal people and the other decrying them as part of a murderous conspiracy being perpetrated against us all by Big Pharma. Instead, I’ve decided for now that I need to merely try to articulate my conclusions from my reading without elaborating upon them or pointing to supporting documents (in other words, to offer my unadorned opinion, which I don’t often do in the pages of SPNAC, but which seemed an important starting place for me on this topic, while I’m waiting for the New Yorker or the Atlantic or Harper’s to commission me to write a full-fledged essay on the topic).

Here is what I think can accurately be said about antidepressant medications, depression, and suicide:

  • Depression is an illness with its source in the biological structure, content, and processes of people’s brains (internally driven phenomena) AND in the structure, content, and processes of people’s “ways of thinking” about ideas and experiences (externally driven phenomena).
  • There is a clear and direct link between depression and suicide.
  • Medicines (antidepressants) have been developed that — for some people — alleviate the biological symptoms of depression, including their tendency to attempt suicide.
  • In some people, the medicines don’t work or don’t work very well, and in others they cause negative side effects, including increasing in some cases people’s tendency to attempt suicide.
  • The effects of antidepressant medication on the brain are not understood as well as they ought to be understood relative to how widely the medicines are used.
  • The scientific inquiry about antidepressants is a dynamically evolving endeavor, and there is insufficient consensus about some of the most important questions at hand.
  • The clinical usefulness of these medicines has been negatively affected by their marketing and distribution, which has overreached the science supporting their use.

And here is what a list of remedies for the current situation might look like:

  • The use of antidepressant medication must be supported as a treatment option.
  • Clinical guidelines for safe administration of antidepressants must be strengthened, and clinicians must be trained and otherwise equipped to administer them safely.
  • Strict safeguards must be put in place — not via a “warning label” but via an improved standard of practice or even a legal mandate — to keep people who are prescribed antidepressants safe from suicide.
  • Effective patient and public education about depression and its treatment — including the role of antidepressant medication — must be instituted.
  • Effective treatments must be developed, implemented, and supported that address not only the biological sources of depression but also people’s “ways of thinking” that contribute to depression.
  • Research on depression — as well as on both biological and other interventions and treatments — must be done much more strategically, ambitiously, and independently.
  • All marketing of antidepressant medications ought to be suspended while a thorough, independent review of the scientific knowledge about and marketing practices for them is undertaken and recommendations for implementing the remedies above (or better ones) are instituted.

[The abridged URL for this post is http://tinyurl.com/AntidepressantMeds .]

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Suicide Prevention Action Alliance Seeks Grassroots Input

In Advocacy, Policy on July 17, 2009 at 8:33 pm

The Suicide Prevention Action Network (SPAN USA) invites you to participate in this survey if you are among “the grassroots network of survivors of suicide loss, suicide attempt survivors, national, state and community leaders, public and mental health providers and officials, coalition members and leaders, and researchers” involved in suicide prevention.

The survey is designed, according to Bob Gebbia, Executive Director of the
American Foundation for Suicide Prevention (AFSP) “to assist our staff and volunteer leadership as we prepare a summary of the progress made in preventing suicides since the National Strategy for Suicide Prevention was launched in 2001.” Gebbia wrote in an email invitation to fill out the survey,

Perspectives from you … are essential to understanding the accomplishments and challenges of the suicide prevention movement. The information we collect will be used to guide the continuing development of a National Action Alliance for Suicide Prevention, in collaboration with the Suicide Prevention Resource Center (SPRC), and to inform decisions on key priorities for the Action Alliance to address.

The National Action Alliance for Suicide Prevention is the leadership group that was called for in 2001 in the National Strategy for Suicide Prevention:

Objective 2.2: By 2002, establish a public/private partnership(s) (e.g., a national coordinating body) with the purpose of advancing and coordinating the implementation of the National Strategy. Leadership and collaboration are the keys to success of the National Strategy. The establishment of a public/private coordinating body will stimulate the requisite national attention to the issue. Such a body will help to ensure that suicide prevention is perceived as a national problem and the NSSP as a national plan. The partnership will help establish momentum for the plan and will provide continuity over time and legitimacy through the involvement of key groups. And finally, the coordinating body will oversee the implementation of the National Strategy.

[Editor’s note: Please respond to the survey if you’d like to add your voice to the process. It will be available online only until midnight ET on July 27. Also, please pass this URL — http://tinyurl.com/NSSPsurvey — along to anyone you know who is a member of the suicide prevention network described above. FJC]

[The abridged URL for this post is http://tinyurl.com/NSSPsurvey .]

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“Weekly Spark” Shares News One Might Otherwise Miss

In Advocacy, Media, Mental Illness on July 9, 2009 at 3:04 pm

Today’s “Weekly Spark,” a newsletter from the Suicide Prevention Resource Center (SPRC), pointed to an article that I missed in my review of suicide-related news last week: “Chasse case helps spur creation of mental health crisis center.” The story is important both because of the value of mental health crisis services such as the one established in Portland and because of the role of advocacy in bringing about change in society’s response to mental illness. Here’s the story summary, from the “Weekly Spark”:

A new 16-bed mental health crisis center in Northeast Portland will accept people who are suffering a mental health crisis such as suicidal or violent thoughts, hallucinations or severe anxiety. The center will serve as an alternative to jail or the emergency room for people who are in danger of harming themselves or others, and will provide up to 10 days of assessment and treatment. The center was created to improve the county’s response to people in mental health crisis. The issue was brought to the forefront by the 2006 death, in the back of a patrol car, of a man with schizophrenia.

Kudos to SPRC staff for its newsletter, which has led the way in bringing authoritative news to both the specialist and the general reader on a wide range of topics related to suicide prevention. If you’re interested, please sign up for SPRC’s mailing list.

— FJC

[The abridged URL for this post is http://tinyurl.com/SharesNews .]

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2,000 Walkers Light the Way at Out of the Darkness Overnight

In Advocacy, Grief, Prevention on June 28, 2009 at 9:23 pm

By Franklin Cook, SPNAC Editor

As in years past, the 2009 AFSP Out of the Darkness Overnight Walk ended with the final few hundred yards of the walkers’ path being marked by rows of small lights in hand-decorated receptacles. Each of the 2,000 lights represents a loved one who has died by suicide or someone who survived an attempt or someone who struggles with the kind of pain that might cause suicide. SPNAC readers may view the video“‘Out of the Darkness’ Path Illuminated with Thousands of Lights”, which shows the lighted path from this morning’s walk (Sunday, June 28 in Chicago).

At the conclusion of the Walk, Bob Gebbia, AFSP Executive Director, announced that Overnight walkers in 2009 had thus far raised $1.2 million for suicide prevention research, training, and education.

[The abridged URL for this post is http://tinyurl.com/2000Lights .]

Additional videos about a few of my own reflections on the Overnight Walk are available at http://tinyurl.com/MakingMeaning-OOD2009 .

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I’ll Be at the Out of the Darkness Walk on Saturday in Chicago

In Advocacy, Announcements, Grief on June 26, 2009 at 6:41 am

I just wanted to let SPNAC readers know that I’ll be traveling to Chicago early tomorrow morning (Saturday, June 27) to participate as a Crew Member in AFSP’s Out of the Darkness Overnight Walk. This will be my fourth Out of the Darkness Walk (I walked in Washington, D.C., at the first Walk in 2002, then at the second walk in Chicago in 2005, then I started volunteering as a Crew Member in 2007 at the Walk in New York City). My community, the Black Hills of South Dakota is having its first AFSP Community Walk in October of this year (Rapid City, where I grew up, is in the central Black Hills, about 20 minutes from Mount Rushmore).

SPNAC readers may view a video sharing the stories of some of the people who took part in the walk last year in Seattle.

Franklin Cook, SPNAC Editor

[The abridged URL for this post is http://tinyurl.com/OOD-2009 .]

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SPNAC: APA Principles Are a Guide for Mental Health Advocates

In Advocacy, Mental Illness on March 22, 2009 at 3:18 pm

Former Oregon Sen. Gordon Smith, left, talks with Dr. John Wernert, board chairman of the American Psychiatric Association Political Action Committee, during the 2009 Advocacy Day. (Photo for APA by Maureen Keating)

Former Oregon Sen. Gordon Smith, left, talks with Dr. John Wernert, board chairman of the APA Political Action Committee, during Advocacy Day. (Photo for APA by Maureen Keating)

ORIGINAL STORY — In a story for Psychiatric News, reporter Rich Daly explains one of the goals of members of the American Psychiatric Association when they met with members of Congress last month during the APA’s 2009 Advocacy Day.

The enactment of mental health parity and the reduction of the Medicare copay for outpatient mental health services to 20 percent were major accomplishments this past year, and APA leaders are urging Congress and the Obama administration to ensure that psychiatric care is covered on an equal basis with other types of care under any proposals to reform health care.

The article references the APA’s “Principles for Health Care Reform for Psychiatry — Position Statement,” which is an excellent guideline for all mental health advocates to use as we watch over the reshaping of America’s health care system and make sure that creating a sound mental health care system in the nation is a priority. Here are the APA principles:

1. Every American with psychiatric symptoms has the right to a comprehensive evaluation and an accurate diagnosis which leads to an appropriate, individualized plan of treatment.

2. Psychiatric treatment should be based on continuous healing relationships and engagement with the whole person rather than the narrow symptom-focused perspective.

3. Timely access to psychiatric care and continuity of care are the cornerstones for quality, even as a continuum of medical and non-medical services becomes available that would encourage maximum independence and quality of life for psychiatric patients.

4. There must be full parity of psychiatric treatment with the rest of medicine and utilization management must be the same for people with mental illness and well as for other medical illnesses. Payment and utilization should be on the basis of treatment and services and not on diagnosis.

5. Psychiatric care should be patient and family centered, community based, culturally sensitive, readily available for patients of all ages, with particular attention to the specialized needs of children, adolescents, and the elderly. Disparities in the access to care for ethnic and racial minorities must be addressed.

6. Access to psychiatric care should be provided in numerous settings, including private offices, community mental health centers, specialty clinics, and hospitals as well as in the workplace, schools, and correctional facilities. Psychiatric care should be fully integrated with the rest of medicine in primary care settings and in hospitals.

7. Patients deserve to be treated with dignity and respect. When they are clinically able, they are entitled to choose their physician and other providers and make other decisions regarding their care. When they are incapable of doing so, they should receive the treatment they need and when able, they should choose future care.

8. As medical information enters the electronic age, leading to increased efficiency and ease of access to health data on all individuals, the confidentiality of this data must have the highest priority.

9. Patients should receive care in the least restrictive setting possible that encourages maximum
independence and access to a continuum of clinical services.

10. Psychiatric care should be fully integrated with the treatment of substance use disorders.

11. Psychiatric care should have an emphasis on early recognition and treatment as well as prevention. Research into the etiology and prevention of mental illness and into the ongoing development of safe and effective treatment interventions must be supported.

12. Efforts must be intensified to combat and overcome the stigma historically associated with mental illness and its treatments through enhanced public understanding and awareness of mental disorders and the effectiveness of psychiatric treatment.

13. More resources should be devoted to the training for an adequate supply of psychiatrists, especially child psychiatrists, to meet the current and future needs of the population.

* Prepared by the Board AD HOC Work Group on a Mental Health Care System. Approved by the Assembly, November 2008. Approved by the Board of Trustees, December 2008. “Policy documents are approved by the APA Assembly and Board of Trustees … These are … position statements that define APA official policy on specific subjects” (APA Operations Manual).

[The abridged URL for this post is http://tinyurl.com/APA-Principles .]

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Father Crusades against Cyberbullying after Son’s Suicide

In Advocacy, Grief, Prevention on March 15, 2009 at 8:40 pm

ORIGINAL STORY — Reporter Allison Pries, writing in The Hackensack Record, tells the story of John Halligan’s participation in a New Jersey middle school summit, where “the father of a Vermont teen recounted his son’s suicide and put a face to the problem of cyberbullying.”

“Mr. Halligan’s story brought out the emotional side of bullying,” said Nick Schifano, a Ramsey student council officer. “It shows it doesn’t just hurt one person. It hurts family and friends.”

As young people spend more time instant messaging, texting, e-mailing and using social networking sites, the peer harassment that once occurred in hallways and schoolyards has followed them into cyberspace, experts say.

“It’s so much a part of their life,” said Richard Wiener, the Smith School principal. “So we have to equip them to use the technology in a way that’s going to be productive, not destructive.”

Halligan, after a 23-year career with IBM, is delivering the message about Ryan and cyberbullying full-time.

“The schools need and want this,” he said.

In his presentation, Halligan urged the middle school students not to be the folks who laugh at the teasing of others. “A bully wouldn’t exist if it wasn’t for the power trip he gets from bystanders,” he said.

The message from Halligan, explaining how Ryan’s abuse had forever changed his entire family, was particularly poignant.

“(Bullying) is probably the No. 1 assembly topic,” said Spencer Lambert, an eighth-grader from Ramsey who attended the summit. “But hearing it from a firsthand witness — and the emotion — definitely made a difference.”

Halligan’s outreach includes administering the website ryanpatrickhalligan.org, which “is dedicated to the memory of our son Ryan and for all young people suffering in silence from the pain of bullying and having thoughts of suicide.” One of the final paragraphs from the introductory message on the site’s homepage is a moving summary of cyberbullying’s causes and the sources of its solution:

We have no doubt that bullying and cyberbullying were significant environmental factors that triggered Ryan’s depression. In the final analysis, we feel strongly that Ryan’s middle school was a toxic environment, like so many other middle schools across the country for so many young people. For too long, we have let kids and adults bully others as a right of passage into adulthood inside a school building. We place [accountability] for this tragedy, first and foremost, on ourselves as his parents … but also on Ryan’s school administration, staff and the young people involved. As parents, we failed to hold the school accountable to maintain an emotionally safe environment for our son while he was alive. But accountability and responsibility should be shared by all involved — parents, bullies, bystanders, teachers and school administrators … basically the whole system.

[The abridged URL for this post is http://tinyurl.com/FatherCrusades .]

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Senate Hearing Looks at Suicide Epidemic among Native Youth

In Advocacy, Prevention on March 9, 2009 at 10:29 pm
Dana Jetty of the Dakota Nation testifies during a Congressional Hearing. (Senate Indian Affairs Committee photo)

Dana Jetty of the Dakota Nation testifies during a Congressional Hearing. (Senate Indian Affairs Committee photo)

ORIGINAL ARTICLE — Reporter Shelley Bluejay Pierce, writing in Native American Times, distilled the testimony of a recent Senate Committee on Indian Affairs Hearing down to its essence in the voice of Dana Jetty, a 16-year-old high school student and member of Spirit Lake Dakotah Nation in North Dakota, whose sister died of suicide just last November.

“I ask that you support suicide prevention programs in our tribal communities, and I ask that when you have your discussions on the issue of suicide, you remember my sister. She was 14-years-old. She was a beautiful, outgoing teenager with her whole life ahead of her. She was my sister, and she is what suicide looks like in Indian Country.”

The article captures the sense that there is an epidemic of suicide among Native American youth and young adults.

Native youth ages 15-24 have suicide rates more than three times higher than the national average. Across the Great Plains, this rate is even higher.

“Over the past several years in the Rosebud Sioux Tribe alone, we have witnessed dozens of suicides and hundreds of documented suicide attempts. The situation became so bad that in 2007, our Tribal President declared a State of Emergency in order to draw attention and resources to the problem,” explained [Robert] Moore, [Tribal Councilman for the Rosebud Sioux Tribe in South Dakota].

During the Hearing, Sen. Byron Dorgan of North Dakota, who chairs the committee, spoke of the historical context for the situation.

“We need to go back and read the treaties that signed the federal government up for its obligations. Right now, health care rationing takes place on every Indian reservation in America. That is shameful.”

Senate Majority Leader Harry Reid, whose father died of suicide, attended the hearing and reminded everyone of the stigma over suicide.

”It’s important to break the silence about suicide, too often a taboo subject, and to talk openly about it.”

An article in the Albuquerque Journal notes that some funding to address the problem might be forthcoming.

The 2010 budget blueprint unveiled by President Barack Obama on Thursday contained $4 billion for Bureau of Indian Affairs, up $600 million from current year funding. Some of that money could be used on suicide prevention programs, committee members suggested.

SPNAC readers can view a webcast of the complete Senate Hearing, and transcripts of the testimony are also available.

[Editor’s note: In my home state of South Dakota, in fact, Native Americans age 15-24 have a suicide rate of 52 per 100,000, while the rate for people in that age group nationwide is about 10 suicides per 100,000. Keeping in mind that approximations are being used, a more meaningful comparison–to bring home the extent of the epidemic in Indian Country–might be to estimate how many 15- to 24-year-olds would be dying by suicide in, for instance, Boston (pop. 600,000) if the suicide rate there were 52/100K: It would be 312 suicides per year among youth and young adults, compared to the approximately 36 annual suicides per year there now (based on Massachusetts’s suicide rate for ages 15-24, which is about 6/100K). One wonders if a young person were dying by suicide almost every day in Boston if there wouldn’t be more than a Congressional Oversight Hearing and a stray newspaper article or two shedding light on the problem. (Data are for 2001-2005. The data source is WISQARS: Web-based Injury Statistics Query and Reporting System).]

[The abridged URL for this post is  http://tinyurl.com/EpidemicNative .]

[Related SPNAC post: “Youth Suicide among Native Americans Linked to Colonialism” ]

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Two Random Acts of Speaking Out Are Brought Together

In Advocacy, Grief, Stigma on February 1, 2009 at 10:19 pm

By Franklin Cook, SPNAC Editor

Separate items published over the weekend in two different newspapers–one in California and the other in New Jersey–coincidentally brought together the voices of two people who have lost a loved one to suicide. From opposite sides of the continent, each of them was speaking out against stigma .

The first voice comes to us courtesy of Brian Hamilton, sports editor of the Nevada County Union in Grass Valley, Calif., who last week “watched one of the most courageous performances I have ever seen on a basketball floor.”

It came at halftime, with no ball nor hoop necessary. As he grabbed hold of the microphone and [a] thousand or so basketball fans were sitting in absolute solemn silence, Mike Bratton began to tell a story no parent should ever have to share.

“My son … committed suicide,” he said. “And that’s something that’s so often covered up and hidden because of the embarrassment. My son committed suicide, you know, so did I do something wrong? It’s just had that stigma.”

“It’s an every moment, in-your-face, life-lasting reality. It’s something that never goes away, the aftermath and devastating effects of suicide. But it has to be talked about. People have to know. We don’t want it to be glorified, what my son did, but people have to know.”

The second voice comes to us directly from Augusta Santos, in an op-ed piece at MyCentralJersey.com, the website of the Home News Tribune and the Courier News. Augusta suggests that “it’s time for this six-letter word (stigma) to be removed from the Webster’s Dictionary — in order for it to stop having so much power and control in people’s lives.”

I believe and know that until families, communities, and society accept … emotional disorders the same way they accept their physical illness, this six-letter word called stigma will not go away.

Augusta’s husband, John, died of suicide in 2004, and she thinks stigma played a part in his death, so she wrote to her hometown newspaper this weekend to suggest that people do more to make stigma “go away.”

As I lived with John, a man with a heart of gold, who struggled with deep depression, I experienced first-hand what this horrible and debilitating illness can do to the human body …

Never did I imagine that there is an organization called the National Alliance for Mental Illness (NAMI) whose mission is to improve the quality of life of individuals who suffer from a serious mental illness and provide moral support for their families. I believe that health professionals, who have patients suffering with emotional disorders, should go that extra mile to inform the patient and their families of these important organizations.

I’m pretty sure Mike Bratton and Augusta Santos don’t know each other, and it is purely happenstance that what they said recently about stigma got put together here, but the synchronicity of their voices–speaking out bravely against the stigma they and their loved ones have faced–made me wonder how powerful a message we might send to our society about stigma if we all put our voices together.

[The abridged URL for this post is  http://tinyurl.com/SpeakingOut .]

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Attempt Survivor Speaks Out with Art after His Brother’s Suicide

In Advocacy, Grief, Prevention, Stigma on January 28, 2009 at 1:14 am

micartist1ORIGINAL STORY — Reporter Andy Parks, writing for the Northern Rivers Echo in Lismore, Australia, tells the story of Mic Eales, who survived two suicide attempts before his brother Bryan took his life seven years ago.

Bryan’s death was a catalyst for a positive change in Mic’s life. He started harnessing his experiences and creating works of art that deal with the issue of suicide … At the moment he is collecting coffee cups. Mic’s aim is to collect 2101 coffee cups (the latest figure from the Australian Bureau of Statistics for Australians who committed suicide in a year) for a piece he is planning to create.

“It’s about the conversations we don’t have. We have pleasant conversations when we are having coffee, but we don’t go there… If somebody has experienced suicide, we don’t talk about it, we closet it. So I want to be able to open it up to say ‘these are the conversations we need to have.’”

Mic’s creative and provocative way of bringing attention to suicide includes a piece called “Too Few Ladders,” which is based on “‘Snakes and Ladders’ … an ancient Hindu game … used to teach children about the ups and downs of life.”

Mic said most people who had seen Too Few Ladders came up to him and talked about a friend or a cousin who had suicided.

“Everybody knows somebody,” he said.

He still struggles at times with suicidal thoughts, and he deals with them by focusing on his family, meditating, and using “the 12-step program for addicts [adapted] for his own situation.”

Another factor in his survival has been an ongoing correspondence with the daughter of a friend who committed suicide.

“(I tried) to explain to her the pain that somebody goes through: When you get into that dark place, you don’t think about the family. You actually think they are going to be better off without you. They’re weird, twisted thoughts, but they are very real and very logical (at the time). That’s the part you have to fight. You have to be able to look at those thoughts for what they are.”

micartpiece11

Pictured is one of Mic's artworks that combines the pages of a phone book (representing how people often hear of a loved one's suicide) and writings, pictures, and images from throughout his own life (representing all that his loved ones would have to remember him by if he had died by suicide), along with an element of "Too Few Ladders."

[The abridged URL for this post is http://tinyurl.com/SpeaksArt .]

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Prevention Advocate One-on-One with Obama on Train Ride

In Advocacy, Grief, Prevention on January 19, 2009 at 10:41 pm
Matt Kuntz, center, and his wife, far left (partially hidden), chat with Barack Obama and Joe Biden during their pre-Inauguration Day train trip.  (Photo by Alex Brandon, Associated Press)

Matt Kuntz, center, chats with Barack Obama and Joe Biden during their pre-Inauguration Day train trip. (Photo by Alex Brandon, Associated Press)

ORIGINAL ARTICLE — Staff writer Jodi Rave reports in the Missoulian that last Saturday, Matt Kuntz–a survivor of suicide loss from Montana–“was the only guest invited to join President-elect Barack Obama on the caboose deck as the Whistle Stop Tour slowly rolled out of Philadelphia, en route to Washington, D.C.”

“It was just the president-elect, his wife and myself,” said Kuntz, one of 16 “everyday Americans” invited as guests on the train. “It was amazing.”

“As I prepare to leave for Washington … know that I will not be traveling alone,” said Obama [during a speech before departing]. “I will be taking with me some of the men and women I met along the way, Americans from every corner of this country, whose hopes and heartaches were the core of our cause, whose dreams and struggles have become my own … Theirs are the voices I will carry with me every day in the White House. Theirs are the stories I will be thinking of when we deliver the changes you elected me to make … ”

Hopefully, the President-elect will ambitiously promote the cause for which Kuntz has been an advocate in his home state, and as he does, the new President also will transform the lessons being learned about soldiers and PTSD into an opportunity to take the lead on making suicide prevention a national priority.

Kuntz … began dedicating his time and effort to helping the mentally ill after his stepbrother, Chris Dana, committed suicide upon returning from the war in Iraq with the Montana National Guard. In response, Kuntz, now executive director of Montana’s National Alliance on Mental Illness, led the state in creating a program to monitor National Guard soldiers for signs of PTSD … Obama met Kuntz and other veterans when he was campaigning in Montana before last June’s primary. As president, Obama has promised to expand NAMI’s mental health program for soldiers nationwide.

[The abridged URL for this post is http://tinyurl.com/WithObama .]

[Related SPNAC post: “Montana Advocate Will Be Obama’s Guest at Inauguration” ]

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Chicago Group Is a Model for Local Mental Health Advocacy

In Advocacy, Mental Illness, Stigma on January 15, 2009 at 1:42 pm

ORIGINAL REPORT — Staff writer Megan Cottrell reports in the Chi Town Daily News on “members of the group Coalition to Save our Mental Health Centers” who recently “were shocked to find out that North River [Mental Health Center] is set to close its doors at the end of the month.

“It’s absolutely appalling to find out that the center is closing,” says Linda Forbes, pastor of Sauganash Community Church. “Where are the families going to go that need care?”

North River is just one of five centers around the city that will be closed this year by the Chicago Department of Public Health. The department will consolidate these centers into the seven remaining centers that are spread across the city on Feb. 1.

City officials explain that the restructuring is linked to reductions in funding, “most notably a $1.2 million cut from the state,” arguing that the seven remaining centers will be able to provide more efficient, more effective services than the current 12 centers for which “resources have been spread very thin.”

“Right now we have a patchwork situation that makes no sense,” [says Dr. Terry Mason, head of the Department of Public Health]. “What we’re doing will result in care that is consistent and complete.”

“We will not drop any of our patients,” says Tim Hadac, spokesperson for the Department of Public Health. “All patients are being welcomed at the remaining CDPH clinics, if they choose.”

But, of course, accessibility and efficiency often work against one another.

Organizers in North River’s surrounding community say asking the center’s 450 severely mentally ill patients to travel across the city for services is nearly impossible.

“It’s gonna take us three hours at least,” says Lourdes Adrianzen, a patient at North River who lives in Kilbourn Park. “I have to take the bus to the red line. It would take me an hour and a half just to get there.”

In the face of the budget cuts that could be forthcoming in communities everywhere, the care of the mentally ill is going to have to be considered not only in terms of short-term costs but also in terms of a community’s priorities.

“We seem to be involved in more glamorous battles these days, and we forget about those people who need our help,” says [Alderman William Banks].

“How can Chicago afford to have the 2016 Olympics if we cannot afford to help the needy and the mentally ill?” [Forbes] says. “How can we dare to present ours as a first-rate city and give third- or fifth-rate care to the citizens?”

And the Chi Town article closes with an essential point that is ultimately of vital interest across Americal:

Department of Public Health officials say the issue of mental health funding isn’t a problem at the city level — it’s a battle that’s been waging for years on the national stage, for more federal funding.

“For decades, mental health care has long been neglected in our nation’s capital–treated like a poor and unwanted cousin,” says Mason [of the Department of Public Health]. “I am hopeful that with a new President and a new Congress firmly committed to fully-funded health care reform, in 2009 we will at long last see movement in the right direction.”

Chicago’s Coalition to Save our Mental Health Centers is noteworthy because it provides a model for local advocacy; for instance, the coalition’s website is an effective springboard for community action, and its resources include tools such as a locally produced video that superbly tells the story of the group’s efforts.

[The abridged URL for this post is  http://tinyurl.com/AdvocacyModel .]

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Blogger Issues Call to Action for “Mental Health New Deal”

In Advocacy, Mental Illness, Policy on January 14, 2009 at 12:16 am

ORIGINAL POSTMichael Sigman–Chairman of the Board of the Wright Institute of Los Angeles, a postgraduate clinical training institute that provides psychotherapy to economically disadvantaged people–started the New Year with a piece on Huffington Post titled “Time for a Mental Health New Deal.”

America’s economic health is inextricably intertwined with its citizens’ psychological well-being. The very language we use to describe our financial plight — insanity, depression, panic, insecurity, trauma … To give short shrift to mental health programs would geometrically compound the insanity; over and above the humanitarian cost, the financial losses in productivity and from increased crime rates are incalculable.

Sigman recommends a decisive, grassroots response to people’s mental-health-care needs in America:

“We’ve got to organize and lobby hard for a mental health ‘New Deal,’ in which the Feds immediately restore funds for decimated state and local treatment programs, and then create a national mental health safety net so no one falls through the cracks … Let’s take a page from Obama’s grass roots Presidential campaign. Start or join a group at the local level to lobby the president-elect and incoming HHS Secretary Tom Daschle. Bombard your legislators with emails and phone calls. If you’re not an activist, become one. If you can give even a few dollars, donate to a mental health-oriented charity or non-profit.

Yes, these proposals will cost more money and mean more borrowing. But if we don’t act now, the tragic fallout will reverberate throughout society for decades.

By callling for action to promote a Mental Health New Deal, Sigman has highlighted the need to build political will for the next phase of mental-health-care reform now that mental health parity legislation has passed Congress. The importance of building political was clearly articulated when the national suicide prevention movement began to gain traction in 2001 with the publication of the National Strategy for Suicide Prevention, which states

For any preventive action to go forward, three ingredients are necessary: a knowledge base, the public support for change, and a social strategy to accomplish change. [Emphasis added.]

SPNAC readers can refer to the Suicide Prevention Action Network’s (SPAN USA) Legislative and Media Action Center to learn how they can help build the political will to advance suicide prevention in America and in their home state.

[The  abridged URL for this post is  http://tinyurl.com/MH-NewDeal .]

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Montana Advocate Will Be Obama’s Guest at Inauguration

In Advocacy, Grief, Prevention on January 9, 2009 at 9:40 am

ORIGINAL STORY — Reporter Jennifer McKee writes in the Billings Gazette that a Helena, Mont., mental health advocate will be attending Barack Obama’s inauguration as the new U.S. president’s guest.

[Matt Kuntz], who dedicated himself to helping the mentally ill after his stepbrother committed suicide upon returning home from combat, has been picked to be one of 18 ‘everyday Americans’ to celebrate inauguration with President-elect Barack Obama. [They] … will take the train with Obama to Baltimore for a speech, then head off to Delaware to pick up Vice President-elect Joe Biden and his family for a final jaunt to Washington, D.C.

Kuntz, who is now head of the Montana office of the National Alliance on Mental Illness,

was working as a lawyer in Helena in spring 2007 when his step-brother Chris Dana, a Montana National Guard soldier, committed suicide after suffering from post-traumatic stress disorder following his tour of duty in Iraq.

That tragedy compelled Kuntz and Dana’s parents to begin working for better screening for returning soldiers. Eventually … the Montana National Guard adopted a screening program that leads the country when it comes to making sure returning soldiers don’t fall through the cracks.

Kuntz, a former Army officer himself, met Obama briefly this fall during a campaign stop in Billings.

Kuntz said he was impressed then that Obama seemed to really care about the issue of mental-health help for returning soldiers. Obama told Kuntz he wanted to take the Montana Guard’s program nationwide.

“The president-elect realizes that Montana is really leading the country on this issue,” Kuntz said. “This was done entirely by the people of Montana. They demanded better treatment.”

A brief news story from a local television station can be viewed here.

[The abridged URL for this post is  http://tinyurl.com/MontanaAdvocate .]

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Several Mental Health Champions Missing from 111th Congress

In Advocacy, Policy on January 2, 2009 at 1:58 pm

ORIGINAL REPORT — In the edition of Psychiatric News published online today, reporter Rich Daly highlights the loss of mental health champions in the 111th Congress, noting that “the departure of several of Capitol Hill’s strongest mental health advocates will be felt by APA [American Psychiatric Association] and other like-minded advocates when the new Congress convenes later this month.”

Several longstanding mental health advocates retired at the end of the 110th Congress, including Rep. Jim Ramstad (R-Minn.), and Sen. Pete Domenici (R-N.M.), while Sen. Gordon Smith (R-Ore.) lost his bid for reelection … In 2007 Ramstad and Rep. Patrick Kennedy (D-R.I.) embarked on a nationwide tour to highlight the importance of mental health insurance parity that used a series of field hearings to galvanize support for legislative action … Domenici’s accomplishments include extensive leadership on mental health parity, as well as legislation to fund more mental health services for public school children … Smith is most known for sponsoring the Garrett Lee Smith Memorial Act, to create screening programs to identify and help youth at risk for suicide.

Smith and his wife Sharon’s son Garrett–who is memorialized through the legislation Sen. Smith sponsored–died by suicide in 2003 when he was 21 years old. The Smiths have provided leadership through avenues such as Sharon Smith’s service on the board of directors of the Suicide Prevention Action Network (SPAN USA), and they have gained the respect and admiration of the national suicide prevention community. It is widely hoped among suicide prevention proponents and survivors of suicide loss that their influence will continue to be seen and felt even though they no longer represent Oregon in the U.S. Senate.

The report in the Psychiatric News also points to some of the strong proponents of mental health care who remain in Congress, including

[Rep. Patrick] Kennedy and his father, Sen. Edward Kennedy (D-Mass.) … [who] has … dropped his chairmanship of the powerful Judiciary Committee to focus full time on health care reform … Continued support also is expected from … Rep. Chris Van Hollen (D-Md.), chair of the Democratic Congressional Campaign Committee; Rep. Steny Hoyer (D-Md.) the House majority leader; and Sen. Harry Reid (D-Nev.), the Senate majority leader. Reid, who lost his father to suicide, and the other Democratic leaders were supportive of a mental health parity law and a law to end Medicare’s discriminatory copayments for outpatient mental health care.

And several new members of Congress are expected to add their energies to advancing the cause of improved mental health care in America:

Rep. Paul Tonko (D-N.Y.), a former New York State Assembly member who was a sponsor of New York’s mental health parity law, “Timothy’s Law,” enacted in December 2006.

Rep. Jon Adler (D-N.J.), supported several issues of concern to APA and other mental health advocates as a state senator including a state mental health parity bill, youth suicide prevention programs, and postpartum depression awareness campaigns.

[The abridged URL for this post is  http://tinyurl.com/MHChampions .]

[Related SPNAC post: “Suicide Prevention Champion Not Re-elected To Senate” ]

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Single Battalion’s 4 Recruiter Suicides Result in Army Probe

In Advocacy, Grief, Stigma on December 30, 2008 at 10:09 am
Amanda and Patrick Henderson

Amanda and Patrick Henderson

ORIGINAL REPORT — [Editor’s note: The original report includes a brief description of a suicide.] The Army Times on Sunday published a recent Associated Press report by staff writer Michelle Roberts on a Texas-based recruiting battalion that has seen four suicides among its ranks since 2005. The AP report tells the story of the most recent death, that of “Sgt. 1st Class Patrick Henderson, a strapping Iraq combat veteran [who] spent the last, miserable months of his life as an Army recruiter, cold-calling dozens of people a day from his strip-mall office and sitting in strangers’ living rooms, trying to sign up their sons and daughters for an unpopular war.”

The 266-member Houston battalion covers a huge swath of East Texas, from Houston to the Arkansas line. Henderson committed suicide Sept. 20. Another battalion member, Staff Sgt. Larry Flores Jr., hanged himself in August at age 26; Sgt. Nils “Aron” Andersson, 25, shot himself to death in March 2007; and in 2005, a captain at battalion headquarters took his life, though the military has not disclosed any details. All served combat tours before their recruiting assignments.

The Army’s investigation was prompted by Henderson’s widow, Staff Sgt. Amanda Henderson, “herself an Iraq veteran and a former recruiter in the battalion,” and Texas Sen. John Cornyn, a Republican member of the the Armed Services Committee, who “said he will press for Senate hearings.” The investigation was also prompted by the fact that “the Army has 38 recruiting battalions in the United States … [and] Patrick Henderson’s is the only one to report more than one suicide in the past six years.”

He became, at age 35, the fourth member of the Army’s Houston Recruiting Battalion to commit suicide in the past three years — something Henderson’s widow and others blame on the psychological scars of combat, combined with the pressure-cooker job of trying to sell the war.

“Over there in Iraq, you’re doing this high-intensive job you are recognized for. Then, you come back here, and one month you’re a hero, one month you’re a loser because you didn’t put anyone in,” [Amanda Henderson said].

Her criticism of the Army is based in part on what she sees as inadequate care for veterans returning from combat.

[Recruiters] must have a recent evaluation showing no record of mental instability. But Amanda Henderson said her husband, like other combat veterans, rushed through his assessment, insisting he was fine … He suffered a breakdown in the weeks before his suicide … Because he was hundreds of miles from the nearest Army post, he went to a local counselor recommended by the military after an initial visit with an Army doctor. But the counselor had never worked with a combat veteran and couldn’t decipher the military jargon in his medical records, [she] said.

“I don’t want anybody to feel this pain that I have,” she said, her eyes welling with tears. “It’s too much for one person. They need help.”

Another story about the suicide of a combat veteran is told in the video report “The War Within,” which focuses on the aftermath of suicide for the family of Marine Reservist Jeffrey Lucey, a veteran of the Iraq invasion who killed himself at age 23 after he returned home and suffered from Post Traumatic Stress Disorder. “The War Within” is part of a weekly webcast series, In Their Boots, which describes itself as “a compelling new magazine show about the dramatic impact the wars in Iraq and Afghanistan are having on us … [featuring] … service men and women, and their families, in stories that have universal appeal.”

Also last month, PBS NewsHour reporter Betty Ann Bowser examined the issue more comprehensively in “Military, VA Confront Rising Suicide Rates Among Troops“:

The Army says suicides among its active-duty personnel have doubled in recent years, with almost 700 since the year 2000. … Attempted suicides and self-injuries have quadrupled over the past six years.

[The abridged URL for this post is  http://tinyurl.com/RecruiterSuicides .]

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Signs on N.J. Bridge Are a Reminder of Hard Choices

In Advocacy, Policy, Prevention on December 13, 2008 at 2:47 pm

ORIGINAL REPORT — A report today in the New York Times highlights the issue of constructing suicide barriers to prevent people from jumping off of high places to kill themselves. The issue has been in the public eye recently because of a decision to build a barrier for the Golden Gate Bridge, famous for its architectural beauty and infamous as a suicide destination.

The report is about signs for a crisis line’s phone number that have been posted on New Jersey’s Victory Bridge, along Route 35 between Perth Amboy and Sayreville, from where “so far this year, there have been seven suicides and one attempted suicide.”

The issue that comes to the foreground is cost vs. effectiveness:

The New Jersey Department of Transportation paid $5,300 to install the signs on the 150-foot-tall Victory Bridge, which arches over the Raritan River. A spokeswoman for the department, Erin Phalon, said that it considered erecting a barrier, but the $2 million cost was prohibitive.

The report quotes John Draper, executive director of the National Suicide Prevention Lifeline (NSPL, a federally funded suicide prevention crisis line answered nationwide at 800-273-TALK), highlighting the hard choices being faced by government agencies and the public over bridge barriers:

While barriers on bridges have proven to be effective in preventing suicides, no studies have looked directly at whether suicide-prevention signs work, he said.

“In some jurisdictions, there is not enough money or political will to invest in bridge barriers. The next best thing would be to do whatever you can.”

NSPL’s Steering Committee, in fact, states in a paper written by Draper “that the use of bridge barriers is the most effective means of bridge suicide prevention.”

In addition to “reducing access to lethal means” (barriers), the Lifeline recognizes that “promoting access to lifesaving means”—such as signage or other public education media near bridges that promotes awareness of hotlines (such as 273-TALK) or other suicide prevention services—is a supplement to bridge barriers. [Emphasis is in the original.]

The San Francisco Chronicle recently completed an in-depth series that comprehensively covers the decades-long debate about suicide and the Golden Gate Bridge. The series features audio podcasts and video recordings as well as reader comments from November 2005.

[The abridged URL for this post is  http://tinyurl.com/HardChoices .]

Obama Urged To Take the Lead on Internet Safety

In Advocacy, Media, Prevention on December 10, 2008 at 7:29 pm

ORIGINAL REPORT — A report in the Washington Post says “advocates are pushing president-elect Barack Obama to put more resources toward protecting children from crime, harassment and predators on the Web.”

The Family Online Safety Institute … is urging the new administration to appoint a National Safety Officer within the office of the Chief Technology Officer Obama has promised to create. The group is also asking for $100 million a year to fund education and research, an annual White House summit on safety issues, as well as the creation of a national council to coordinate efforts among federal agencies, advocacy and industry groups.

“Young people who are at the greatest risk online are the ones who are already at greater risk in the real world,” [said Nancy Willard, executive director for the Center for Safe and Responsible Internet Use.] “We have to stop thinking about Internet safety as a technology issue and recognize that it is an extension of youth risk behavior.”

UPDATE (12/11/2008): In related news, a post on a Los Angeles Times technology blog states that “YouTube has created a new section of its site called the Abuse and Safety Center, largely as a resource for parents and their teenage children.” It also points to YouTube’s page on “who to call if you are concerned someone is at risk of suicide.”

Here’s the original post, from YouTube’s blog.

[The abridged URL for this post is  http://tinyurl.com/ObamaInternet .]

Social Media ‘Backwash’ Stops Distasteful Pepsi Ad

In Advocacy, Media on December 4, 2008 at 8:57 pm

[Editor’s note: Links in this post lead to pages that include a graphic depiction of suicide.]

ORIGINAL POST — A post today at “Global Idea Network,” Advertising Age’s blog, shares a glimpse of the backstory of Pepsi’s decision to abandon publication of an advertisement for a one-calorie cola beverage that shows a “lonely calorie” graphically killing itself using multiple methods of suicide.

“Here’s how fast and furious social media works,” writes blogger Chris Abraham.

The [original item about the offensive ad] was posted on Ad Age at 4:36 p.m. EST on Dec. 2. I read it and Tweeted at 6:16 p.m. EST the same day. And then I received [an] e-mail from [B. Bonin Bough, PepsiCo’s Director of Social Media] at 5:21 p.m. on Dec. 4.

Here’s an excerpt from Bough’s email:

“I saw your tweet and I just wanted to make sure I responded personally. We agree this creative is totally inappropriate; we apologize and please know it won’t run again. Also, thanks for the feedback and the Digg, it is important to discuss these types of issues. My best friend committed suicide and this is a topic very close to my heart. So again I offer my deepest apologies.”

Abraham concludes, “The lesson here is that social media has eyes everywhere and the network to make sure that advertisers can no longer hide stuff in niche markets.”

There is a word in intelligence about just this thing, and it relates to messaging and propaganda: “backwash.” Social media makes backwash inevitable. Here’s another one from intelligence: “blowback.” Backwash leads to blowback.

If anyone would like write to Pepsi to thank them for pulling the ad, you can do so at

PepsiCo Americas Beverages
Massimo F. d’Amore
Chief Executive Officer
700 Anderson Hill Road
Purchase, NY 10577
Fax: 914-253-2070

UPDATE (12/5/2008): Here’s more of the backstory, in an item posted on James Farrar’s blog “On Sustainability” at ZDNet, titled “Pepsico Saved from Suicide Campaign by Twitter?“.

[The abridged URL for this post is http://tinyurl.com/MediaBackwash.]