The Bell: MHA's Newsletter

Volume 8, #1 | Winter 2013

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The Bell Story
MHA Bell
During the early days of mental health treatment, asylums often restrained people who had mental illnesses with iron chains and shackles around their ankles and wrists. With better understanding and treatments, this cruel practice eventually stopped.

In the early 1950s, Mental Health America issued a call to asylums across the country for their discarded chains and shackles. On April 13, 1956, at the McShane Bell Foundry in Baltimore, Md., Mental Health America melted down these inhumane bindings and recast them into a sign of hope: the Mental Health Bell.

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President’s Corner: Time to Change the Conversation - Time for Change

By Wayne W. Lindstrom, Ph.D., President and CEO
Dr. Wayne Lindstrom

When President Obama announced his mental health initiatives in January, he called for a national dialogue to increase understanding about mental health. We applaud the President for taking this step, which was one of the key recommendations we made to Vice President Biden's Newtown Task Force.

As we said: "Where we must begin is to change the national conversation...Our priority must be to facilitate the pathways for people to access appropriate treatment and supports without fear of shame, marginalization and discrimination." We welcome the opportunity to play an active role in this initiative, which the administration plans to formally launch later in March. 

When Clifford Beers founded Mental Health America more than a century ago, he responded to critics who suggested he start his movement anonymously: “I must fight in the open.” His legacy continues to guide our work to eliminate stigma, end barriers to care and treatment through the passage and full implementation of mental health parity and health reform, and expand investment in in services that promote hope and recovery.

For too many, there continues to be a real fear of discrimination and self-stigma. That’s why a national conversation is so urgently needed. We must continue to work to end any conversation that equates mental illness to violence, because it does not, as we argued in this op-ed in USA Today.

We need to ensure others can talk freely and openly about mental health. I recently had the opportunity to meet former Heisman Trophy winner Herschel Walker who courageously speaks about his mental illness and the importance of seeking help. We must fight in the open and provide a platform for those still in the shadows so they can share their stories and give voice to the reality of recovery.

We have to go further and create lasting solutions that promote mental wellness. The health of our citizens, our economic productivity, and the strength of our communities are being undermined by social conditions, including poverty, discrimination and lack of social support. To remedy these problems, we must include mental health promotion and mental illness prevention in an integrated public health model that fully recognizes the interrelationships of physical and mental well-being. It is essential to creating a society in which all are able to lead healthy and fulfilling lives.

We will be addressing these and many related issues at our 2013 Annual Conference, Why Wellness Works: Breakthroughs and Pathways to Whole Health, June 5-8, at National Harbor, Maryland. It will empower attendees with strategies to transform the health of their communities and promote the prevention of and recovery from mental health and substance use conditions. You can find more information on the Conference and speakers in this issue. I hope you will attend.

 

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2013 Mental Health America Annual Conference: Why Wellness Works: Breakthroughs and Pathways to Whole Health

Come spend a few days with us this summer at our Annual Conference from June 5 - 8, 2013.  

We are excited about our theme, Why Wellness Works: Breakthroughs and Pathways to Whole Health, and can’t wait for you to experience the Gaylord National Resort & Convention Center in National Harbor, Maryland.

We have embraced the theme of wellness with the understanding that our overall well-being is tied to the balance that exists between our emotional, physical, spiritual and mental health.

Here are a few of the breakout sessions that we have in store for you:

  • Improving General Health for Mental Health Consumers:  Current Trends in Research, Policy and Practice
  • Six Promising Complementary and Alternative Treatments for Mental Health Conditions: A Comparative Evidence-based Approach
  • Trauma-Informed Recovery
  • Connecting Spirituality and Wellness Across Cultures
  • Wellness and the Role of Intimacy
  • Incorporating Mental Health in Corporate Wellness: Strategies that Work, Produce a Return on Investment and Strengthen Your Organization
  • Healing Companions: How Dogs Transform the Lives of People with Mental Illness

All components of the conference have been developed with the theme in in mind, including the morning and afternoon activities and wellness sessions, such as zumba, crystal singing bowls, aromatherapy, horticultural therapy and reiki. These will provide you with the tools you need to integrate wellness into your life, programs and communities. You can select to participate in the activities during your registration process. 

Get complete conference information at www.mentalhealthamerica.net/go/annualconference.

Early Bird Rate Available: To register for the conference and take advantage of the reduced early-bird rate, go to: http://www.mentalhealthamerica.net/go/annualconference/registration.

 

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2013 Mental Health America Annual Conference: Keynotes, Awards

Keynote Presenters

Geoffrey Canada   GEOFFREY CANADA, President & CEO, Harlem Children's Zone
During his keynote address on Friday, June 7th, Mr. Canada will share his experience with models for reform that combine educational, social and medical services for youth from birth through college.
     
David Granirer   DAVID GRANIRER, Founder of Stand Up for Mental Health
At the Clifford Beers Awards Dinner on Friday, June 7th, Mr. Granirer will share his personal story of mental illness and discuss how he teaches comedy to his fellow consumers as a way of building confidence and fighting public stigma.
     
James Prochaska   DR. JAMES PROCHASKA, Director, Cancer Prevention Research Center
On the morning of Saturday, June 8th, Dr. Prochaska will discuss significant breakthroughs that are being achieved in producing changes to enhance whole health within specific populations.

 

To obtain more information about Mental Health America’s conference speakers and presentations, visit http://www.mentalhealthamerica.net/go/annualconference.

Awards:

Each year we take great pride in recognizing the outstanding work and leadership that exists in the affiliate field and beyond. Take some time to review the 2013 Awards Nomination Guide to determine if you know of people with whom you work that should be recognized for the Clifford Beers Award, the Youth Advocacy Award, or the Sandy Brandt Volunteer Award. The deadline for submissions is March 31, 2013. To obtain more information on the award process and submissions criteria and requirements, visit http://www.mentalhealthamerica.net/go/annualconference/2013awards.

Scholarships:

We are pleased to announce that the Substance Abuse and Mental Health Services Administration (SAMHSA) is looking to provide financial support to consumers of mental health services for attendance at our 2013 Annual Conference, Why Wellness Works: Breakthroughs and Pathways to Whole Health.

In order to apply for this scholarship you must be a mental health consumer and a United States citizen.

To review the scholarship criteria and to download the application, go to http://www.mentalhealthamerica.net/go/annualconference/2013awards.

A completed application must be submitted via U.S. Mail and postmarked on or before the deadline of April 2, 2013. No faxed or e-mailed submissions will be accepted.

Questions about the application can be directed to Tim Kennedy at 703-838-7540 or tkennedy@mentalhealthamerica.net.

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Capitol Hill Update: The Fiscal Landscape

Washington is once again facing major fiscal deadlines over the next 90 days—– the looming sequester, an expiring continuing resolution for the current fiscal year, budget and appropriations bills for FY2014, and then the debt ceiling.

Sequester: Unless Congress acts by March 1, a series of automatic cuts – called a sequester – will result in a cut of approximately $7.5 billion from Labor, Health, and Education programs, including mental health and addiction services, supports and research. In particular, the sequester will trigger a $178 million funding cut to the Substance Abuse and Mental Health Services Administration, which would result in thousands of people living with mental health and substance abuse conditions going without the health care they need. Up to 373,000 children and adults with severe mental disorders could go untreated.  These threats come at a time when states have cut back funding for mental health care by a combined $5 billion over the last three years. To date, deficit reduction efforts have included nearly $1.5 trillion in mostly discretionary funding cuts and only $600 billion in revenue increases – nowhere near the balanced approach that is often touted by the principals.

The outcome of the sequester remains uncertain. Although a few proposals have been presented to delay the deadline, there has been little movement on them. Mental Health America helped organize support for a letter signed by over 3,200 national and state organizations urging Congress to prevent the sequester.  We also participated in several dozen meetings with the Administration and Congress to highlight the impact of the sequester cuts on the mental health and addiction community. 

Funding for Current Fiscal Year: The government is currently operating under a Continuing Resolution (CR), which provides funding until March 27.  If Congress doesn’t act to extend funding, the government will shut down on March 28. The CR included a modest 0.2 percent increase for discretionary programs—not insignificant given that dramatic cuts could have been implemented through the legislation. But the March 27 deadline is perilous because it allows Congress another opportunity to leverage more spending cuts. It is also likely that any deal to avert the sequester would also address funding levels for the current fiscal year.

FY2014 Budget: The Administration has already indicated that it will not release the FY2014 budget until March given the uncertainty over the sequester. Congress has already begun to work on next year’s budget. The Budget Control Act of 2011 already set strict discretionary limits that might serve as a guide for the Senate’s new Budget Committee Chair, Sen. Patty Murray (D-Wash).  Action on the budget will be accelerated given the late start and a pledge from Congressional leaders to pass a budget. 

Debt Ceiling: The final fiscal deadline involves the debt ceiling, which was extended to May 18 by Congress. Any agreement on approving the debt ceiling—the government’s borrowing authority—might include more deficit reduction through spending cuts, including changes to entitlement programs such as Medicaid.

As Congress addresses these fiscal deadlines, Mental Health America will continue to work with our broad coalition to avert spending cuts or block any attempts to “carve out” certain programs.

 

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Advocacy Notes: Legislative Priorities, Mental Health Parity

Legislation Introduced: In the aftermath of the Sandy Hook tragedy, Congress has paid more attention to mental health. Mental Health America participated in a House briefing, the Senate held its first hearing on mental health in seven years, and we met with over two dozen Congressional offices. As a result, many of our legislative priorities for the 113th Congress have already been introduced.

  • Mental Health in Schools Act (S. 195/H.R. 628)—The bill would expand the availability of comprehensive school-based mental health services for students in communities across the country. The legislation, which was introduced in the Senate by Sen. Al Franken (D-Minn.) and in the House by Rep. Grace Napolitano (D-Calif.), is strongly supported by Mental Health America and was one of our key recommendations made to the administration’s Newtown Task Force. The legislation builds on the highly-effective Safe Schools/Healthy Students program, authorizes competitive grants to local school districts to assist them in early interventions and referrals for treatment, promotes positive support and education for students and their families, and provides for culturally and linguistically appropriate staff training. Urge your legislators to cosponsor the legislation by using our Action Alert.
  • Excellence in Mental Health Act (S. 264)—The legislation would require the roughly 2,000 health centers designated as Federally Qualified Community Behavioral Health Centers to cover a broad range of mental health services, including 24-hour crisis care. It would also integrate mental health services with general services that are currently treated separately and increase support for families of people living with mental health issues, at a cost of $1.4 billion over 10 years.
  • Mental Health First Aid Higher Education Act (S. 153/H.R. 274)—The bill authorizes grants to universities to train staff in Mental Health First Aid.
  • Garrett Lee Smith Memorial Act Reauthorization of 2013 (S.116) – This bill renews the commitment to critically important youth and college suicide prevention programs, which provide a comprehensive approach to addressing the national problem of youth suicide.
  • Behavioral Health IT Act (not yet introduced) – The legislation extends federal incentive payments for health information technology to behavioral health facilities and providers that are currently ineligible for this funding.

Administration Pledges Final Rule on Parity: Last month, President Obama promised that his administration would issue this year a final rule implementing the Mental Health Parity and Addiction Equity Act. Mental Health America and fellow mental health and substance use advocates have pressed the administration to issue the rule, which has held up implementation of the law. Although an interim rule provides guidance on some issues—such as caps on out-of-pocket costs— it stopped short of specifying non-quantitative treatment limits. In addition, health plans are unsure which mental health care services should be deemed medically necessary. Studies have shown that only a small minority of Americans even know that the law was passed and they may be entitled to more comprehensive coverage of mental health and substance use treatment.
  

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Health Reform Update: Essential Health Benefits; State Decisions on Exchanges, Medicaid Expansion

A number of important developments have occurred over the past weeks on implementation of the Affordable Care Act (ACA). The administration issued a final rule on Essential Health Benefits and a number of states made decisions on what type of exchange they will establish and whether they plan to participate in the expansion of Medicaid.

Essential Health Benefits: The Obama administration released its final rule on Essential Health Benefits, which defines what insurers must cover under individual and small group plans sold within and outside the new state-based exchanges scheduled to launch in 2014. The requirements also apply to benefits provided to those newly eligible for Medicaid coverage. Insurers must cover 10 broad categories of care, including mental health and substance use disorder services and prescription drugs. The rule says insurers must have procedures to allow patients to get “clinically appropriate” prescriptions which are not included on the plan’s list of covered medications. It also retains requirements that insurers offer at least one drug per therapeutic category, or the same number as a state’s benchmark plan, whichever is greater. Many state benchmark plans require at least two drugs per class.

Exchanges: There are three types of exchanges that can be established under health reform: state-based, partnership, or government-run.  The majority of states (26) will allow a federally-run exchange. Seven (7) states have chosen to partner with the federal government and 18 have decided to run their own exchange. Essential Health Benefits apply to plans offered in all the exchanges and there must be parity in coverage. A map of state choices may be found at http://healthreform.kff.org/the-states.aspx.  

Medicaid Expansion: The Supreme Court's ruling on the ACA allowed states to opt out of the law's Medicaid expansion. Eight states recently decided to join the program; sixteen are undecided or leaning for or against expansion; and 13 have indicated they won’t participate. A map of state choices can be found at http://www.advisory.com/Daily-Briefing/2012/11/09/MedicaidMap#lightbox/1/.

The impact of a state’s opting not to expand will be felt most by very low-income individuals who have not previously qualified for Medicaid. Choosing to expand would allow access to a Medicaid alternative plan for individuals who otherwise qualified but did not previously enroll, or where caps prevented them from enrolling, in their state’s Medicaid program before 2009. Additionally it would afford coverage to adults between the ages of 19 and 65 with incomes between 100 and 130 percent of the Federal Poverty Level (FPL) (about $15,000 for an individual and just over $30,000 for a family of four).

If a state does not opt for Medicaid expansion, people whose incomes fall between 133 and 400 percent of FTE would neither have access to an expanded Medicaid program, nor be eligible to receive private federally-funded insurance through any type of state exchange. This would continue the disproportionate coverage gap that presently exists for people with mental health conditions and substance use disorders.

In states that opt against expansion, more people would likely be uninsured and these low-income individuals might be required pay the penalty tax for not enrolling in an insurance plan under the ACA (http://healthreform.kff.org/~/media/Files/KHS/Flowcharts/requirement_flowchart_2.pdf).

Advocacy Steps: Mental Health America is continuing to work with our affiliates through our Regional Policy Council to advocate in states that have not opted for expansion. Plans offered through the expansion will differ from the traditional state/federal Medicaid cost-sharing split. For first three years, the federal government will pick up 100 percent of the costs for these new Medicaid beneficiaries, with the federal match phasing to 90 percent thereafter. 

Under all state Medicaid Alternative Benefit Plans, Essential Health Benefits Benchmarks will apply. Mental Health America and many of its affiliates submitted comments to the Centers for Medicare and Medicaid (CMS) regarding ER and hospital copays, drug-sharing costs, supplementing the benefits provided by benchmark plans, and ensuring that the new rules are fully consistent with the requirements of the Mental Health Parity and Addiction Equity Act.

 

SZ Magazine

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Mental Health Month 2013: Pathways to Wellness

Mental Health America is proud to continue its tradition of celebrating “May is Mental Health Month,” which began in 1949. This year’s theme is “Pathways to Wellness.”  Along with 240 affiliates from across the country, we have been able to reach and educate millions of people through an array of media platforms, local events and screenings.  

Our 2013 objectives for May is Mental Health Month are to: increase awareness among the general public that good mental health is essential to overall health and well-being; and raise awareness regarding actionable steps that all Americans can take to maintain, protect, and improve their mental health.

Look for additional material on Mental Health Month on our website in the coming weeks. And follow us on Twitter using the hashtag #mhmwellness.

 

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Around the Country: Affiliate Highlights

From California to Oklahoma to Pennsylvania to Indiana, Mental Health America affiliates are making a difference in their local communities.

Mental Health Association in Tulsa: Behavioral Healthcare magazine profiled the Mental Health Association’s nationally recognized Housing Services program, which offers safe, affordable housing to 875 Tulsans, many of whom are battling mental illnesses and overcoming homelessness. The article notes that in July, the 100,000 Homes Campaign ranked the Association No. 2 in the nation in the percentage of chronically homeless people moving into permanent housing each month.

Mental Health Association of San Francisco: Mental Health Association of San Francisco’s programs and leadership in the domain of positive and peer supports for people with collecting and cluttering challenges is featured in a New York Times blog post. The story exemplifies the connection between mental health and substance use innovations, prevention, peer support and community benefits that prevent homelessness and counter shame and stigma.

Mental Health Association of Southeastern Pennsylvania: MHASP’s Certified Peer Specialist Services and the Peer Empowerment Programs is one of the five finalists for the first-ever Scattergood Foundation Innovation Award. Voting for the five finalists, which will determine the winner, will be open until March 18, 2013. To vote and support MHASP, go to http://scattergoodfoundation.org/innovideas/mental-health-association-southeastern-pennsylvania. You will see a box that says “Vote for this Innovation.” Each email address will be allowed one vote per innovation nomination. All votes will be tallied internally in the website and will not be visible to the public.

Mental Health America of Vigo County: Mental Health America of Vigo County (Indiana) in October celebrated the new YOUnity Village in Terre Haute. This 30-unit supportive housing development was crafted by an institute team including MHA of Vigo County, Hamilton Center, and Halstead Architects. This project received LIHTC, HOME, and Development Fund resources along with a Shelter + Care grant from the Indiana Housing & Community Development Authority.

Younity Village

Caption: Wayne W. Lindstrom, Ph.D., president and CEO of Mental Health America, helps cut the ribbon of the new YOUnity Village.
 

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The e-Bell Newsletter is published by the Mental Health America, which works with its 240 affiliates nationwide to promote health, prevent mental disorders and achieve victory over illnesses through advocacy, education, research and service. To receive the e-Bell, visit Mental Health America’s Web site www.mentalhealthamerica.net  or call 800-969-6642.
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