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2011 Lilly Reintegration Scholarship
Applications for the 2011-2012 scholarship will be available for downloading here as of October 1, 2010, please check back then.
The Lilly Reintegration Scholarship was established 14 years ago to help people with severe mental illness offset their tuition, books and lab fees. The program is designed to help persons with bipolar disorder, schizophrenia and related schizophrenia-spectrum disorders acquire the educational and vocational skills needed to reintegrate into society.
Click here for more information about the Lilly Reintegration Scholarship.
Trust and Ethics?
There is much concern about ethics and trust of the psychiatric profession in our society today. In particular there has been significant attention paid to the relationships between psychiatrists and the pharmaceutical industry. Failure to disclose money made from the pharmaceutical industry has led to resignations and negative news headlines for a number of prominent academic psychiatrists. But, a more important issue that is not being addressed regarding the trust and respect of our society, is how well we treat are most ill patients.
What is psychiatry’s role in treating illnesses such as schizophrenia, bipolar, and obsessive compulsive disorder?
Historically, the field of psychiatry has allowed its least trained physicians to work with its most ill patients. As we examine our community mental health centers, we often see clinicians with limited experience, and/or limited language and cultural competency working with this group of seriously ill patients. Psychiatry has repeatedly said that psychotic breaks are part of the disease and even with our best intentions little can be done for someone with schizophrenia. It is one of the few fields of medicine that struggles with the notion of “recovery” from the illness. Furthermore, academic psychiatry has done little to connect with psychiatric rehabilitation programs around the nation. In fact, there are seldom strong connections, if any, between academia and community programs.
Numerous thought leaders have spoken to how psychiatry has become heavily weighted biologically, with little to no psycho-social interventions. But these same thought leaders have done little to fix the problem.
Schizophrenia is a real brain disease that demands treatment with state of the art pharmacology and state of the art physicians. Assessments, diagnosis, and good pharmacology are the foundation of treatment for these horrible diseases, but it is just that, the beginning. There needs to be a greater collaboration of senior, skilled psychiatrists in the community. They need to be on the front lines partnering with those that are already there in bringing the badly needed resources to the table. There are millions of Americans struggling with serious and persistent mental illness who have not been able to realize their dreams because of their disease. Being present and actually treating this patient population is key in getting people with serious and persistent mental illness better, back in quality housing, jobs and reconnected with family and friends. These are the outcomes we all should strive for.
Thought leaders need to not only speak about connecting the dots in our community, but lead by example. One way of connecting the dots is to embrace rehabilitation programs that help reintegrate persons with serious and persistent mental illness. There are numerous examples of such programs, Fountain House, ACT/IPS (assertive community treatment with intensive placement services) Fairwether Lodge and many hybrids such as the Village in Southern California, to name just a few. This promotes the message that state of the art psychiatry means bringing all wrap around services together.
One can debate the relationship of psychiatry and pharma companies or even the validity of psychiatry in managing societal behavior or cultural differences; but there is no debate or justification of persons living in their own bodily waste, hallucinating on the streets of America or in the flop houses throughout the land. Here it can be said that as a society we have abandoned are most needy psychiatric patients.
We can begin to regain trust and respect by truly helping these to reintegrate into society.
2010 Lilly Reintegration Awards
The application process for the 2010 Lilly Reintegration Awards is now closed. Please visit this site in May 2011 for the 2011 Awards application.
An application for the Lilly Reintegration Awards recognizes:
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Treatment teams, programs and services that support people living with severe mental illness
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Local and national efforts to improve services and decrease the stigma of mental illness
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Achievements of people living with severe mental illness who give hope to others facing similar challenges
Those honored will receive a monetary contribution donated to their designated program or agency (First place: $5000; Second place: $2500); a trophy and airfare/hotel for two to attend the 2010 Lilly Reintegration Awards dinner in Indianapolis, Indiana, October 14-15, 2010.
Click here for information about the 2009 Lilly Reintegration Award Recipients.
We are what we eat!
As more information emerges around nutrition, we believe it is important to revisit how we approach food. Historically we have struggled with good nutrition, poverty being a major impediment to this goal. Today with a greater abundance of food in the western world, often times choices affect the quality of what we eat. Obesity is becoming a greater killer than smoking, and the cost of this disease is breaking the healthcare budget.
We would love to hear your thoughts and comments about this topic.
Read more >>
The Rehablitation Alliance:
How Do You Take Your Coffee?
Tom Malamud, George Santos, Ralph Aquila
The interaction between doctors and their patients has historically been seen as a key to success in the treatment of illness and an important factor in social-vocational rehabilitation. The “therapeutic” alliance, however, often has been insufficient in meeting the needs of persons with serious and persistent mental illness - medication non‑compliance being a major culprit, as documented in the recently published CATIE study.
While the severity of the disorder or lack of response to an adequate therapeutic regimen also poses a serious challenge, the therapeutic alliance is often adversely affected by the personal experiences of consumers and mental health providers. Brief impersonal encounters, limited diagnostic information, focus on psychopathology and symptom management, narrow‑vision of possibilities, lack of community support and opportunity, fragmentation of services: all these factors can combine to avoid focusing on life goals, strengths, hopes, persistence, creativity, courage, and compassion that are the essential ingredients for building alliances leading to recovery.
The “rehabilitation” alliance refers to the network of relationships that needs to develop over time to support people with disabilities in their pursuit of recovery. It includes the consumer, the clinician, and at least one significant other. While a variety of combinations are possible, at Fountain House in New York City, the alliance typically consists of a clubhouse “member”, a psychiatrist, and a staff or another member. Currently, at Fountain House there are 50 such alliances. Fundamental to them all is the mutual respect, trust and seriousness of purpose that develops as the triads engage each other: stabilizing, restoring, and enhancing the ability of members to function consistently, to regain control of their lives, and to become valued and contributing parts of the community.
While the rehabilitation alliance focuses on health, strengths and life goals; it acknowledges problems and clinical needs. It supports hope, without denying pain or sorrow. It is persistent, recognizing the non‑linear nature of the recovery process. It is creative, identifying opportunities for people to reach their goals. It is courageous, encouraging risk‑taking. It is compassionate, practical and humane. As the work unfolds, the alliance is challenged and strengthened. In a remarkable way, it invites all participants to co‑evolve.
Implications for Practice
The rehabilitation alliance differs from other models with respect to the role that each participant assumes. The member evolves from being a passive recipient of services to an active participant in the treatment process, a co‑team leader. The life goals of the individual become primary to the rehabilitation process, and the objective of treating symptoms as an end unto itself disappears. It should come as no surprise, that one of the observed results of these alliances has been the near perfect medication compliance (almost always involving atypical anti-psychotic drugs) and marked reduction in co-morbid physical side effects.
The role for each practitioner also broadens from one of service provider to collaborator in the joint treatment‑rehabilitation plan. This broadening is only possible when the myth that those with serious and persistent mental illness cannot work is dispelled. Clearly, persons with serious and persistent mental illness can choose, get and keep a job, increase their education, have a circle of friends, pursue a career, have their own living space (given support, opportunity and time). Special mention is made of the importance of the increasing familiarity gained over time. Many of the alliances at Fountain House have existed for more than two years.
While the purpose of the rehabilitation alliance is to support the recovery of members, clearly the interaction also benefits the other participants. Doctors grow when they perceive the intelligence and personality of their patients emerge as the illness comes under control. Additionally, the alliance with the clubhouse gives psychiatrists opportunities to humanize their professional roles.
What is less easy to see, but is equally profound, are the benefits accruing to the third person, i.e. the clubhouse staff/other member. For that person not only are the relationships to the other two participants deepened and strengthened, but in addition the role of being an influence in that process is, itself, enhancing to the personal and professional development of that person.
Lastly, in establishing the alliance as an evidence-based best practice, we are evaluating the effects alliances have on outcomes, and thus, are carefully documenting: length and type of employment, educational improvement, physical health, medication compliance, relapse rates and duration for future analysis and information-sharing as both numbers and time accumulate.
A Great Day...
On Monday May 3rd Fountain House held it's anual Luncheon held at the Pierre Hotel in New York City. There were over three hundred guests and members in attendance. The star of the show as usual are the great accomplishments of the membership, and in addition, Glenn Close who has led the charge against stigma with the "bring change 2mind" campaign. The event brought in significant monies that will be used for the direct benefit of the members. Also in attendance was Rosaylnn Carter, who has just published her latest book " Within Our Reach" addressing the fact that we are closer than ever to real gains in mental health.
There were three guest speakers discussing this years theme "psychosis and its origin". Dr. Jeffery Lieberman, from Columbia University, Dr. Don Goff from Harvard University, and Dr. Elizabeth Baxter, who has overcome her schizo-affective disorder and is currently practicing as a full time private practice psychiatrist in Nashville Tenessee.
To learn more about Fountain House you can go to Fountainhouse.org.
Jury Duty for Persons with Serious and Persistent Mental Illness
A search of the literature for jury duty and mental illness shows the how’s and why's of getting out of jury duty.
However, there is no data that points out the frequency and adherence of persons with serious and persistent mental illness serving as jurors. In most mental health settings, both public and private, it is almost a knee jerk response to excuse persons with illnesses, such as schizophrenia, from taking on their responsibilities as citizens.
We believe, as part of Reintegration, persons in recovery from illness’s such as Schizophrenia or Bipolar Disorder disorder should participate in jury duty.
If anyone has any information on jury duty participation from persons with serious and persistent mental illness please let us know.
PSYCKES: New York State Policy?
Published with permission from the Morning Side Westside Bulletin
Psychiatric Clinical Knowledge Enhancement System (PSYCKES), is a clinical decision support, disease management, and business intelligence system used throughout the New York state inpatient mental health facilities since 2003. The project has been expanded to outpatient article 31 clinics ( free standing clinics not part of a hospital system) since October 2008. There are two arms to this project, the use of polypharmacy (three or more antipsychotic medications or antidepressants) and cardiometabolic risk. The goals of this project are cost containment, guideline compliance and clinical quality improvement.
Click here>>
My Child Has Schizophrenia
What Should I Do?
People with schizophrenia typically exhibit their first symptoms during adolescence or young adulthood, and thus are likely to be living with their parents. When parents first learn their child has schizophrenia, they usually experience a range of strong emotions - shock, confusion, dismay, sadness, and even anger. Parents often search frantically for answers that may not exist. They may even deny their child's illness or blame themselves or their circumstances for the illness. Read more>>
Journey into the Brain with Dr. Jill Bolte Taylor
Jill Bolte Taylor, Ph.D., was a 37-year-old Harvard-trained and published brain scientist when a blood vessel exploded in her brain. Through the eyes of a curious neuroanatomist, she watched her mind completely deteriorate - she could not walk, talk, read, write, or recall any of her life. Because of her understanding of how the brain works, her respect for the cells composing her human form, and an amazing mother, Jill completely recovered her mind and body. In My Stroke of Insight: A Brain Scientist's Personal Journey, Jill shares with us her recommendations for recovery and the insight she gained from having this ironic and unusual voyage into, and back out of, the silent abyss of a wounded mind.
Jill Bolte Taylor is a spokesperson for the Harvard Brain Tissue Resource Center. Known familiarly as "The Singing Scientist," Jill has served on the NAMI National Board of Directors and has presented in San Angelo and at various NAMI Annual Meetings around the country, including many times at NAMI national meetings. She has a brother who is living in recovery from a serious mental illness.
You may purchase Jill’s book through her publisher at http://www.lulu.com/content/458594.
Helping the Mentally Ill and Homeless in Harlem Find a Home
Weston United Community Renewal, is a not-for-profit organization that has been meeting the needs of the mentally ill and homeless in Harlem since it began its work two decades ago. Its award-winning programs, in particular its housing programs, have been gaining widespread recognition ever since. Read more>>
Thresholds Program Helps Break the Cycle of Incarceration and Hospitalization
Before coming to Chicago’s Thresholds Jail & Prison Program four years ago, William Riley, 53, says he had “given up on life.” Managing schizophrenia for most of his adulthood, Riley lived on the city streets and spent nearly every winter in jail; mostly to get out of the cold, but also to get mental health services. Since becoming part of Thresholds, Riley has not been behind bars at all and has not been in a psychiatric hospital in more than a year. He is stable, has his own apartment, and for the first time, Riley sees a future for himself. Read More>>
Portals Celebrates 50 Years
PORTALS, one of the nation’s leading mental health rehabilitation agencies, celebrated its 50th anniversary on May 18, 2006. Los Angeles Mayor Antonio Villaraigosa served as Honorary Chair for the gala celebration, and literary and entertainment icon Sidney Sheldon served as Event Chair. The event honored five recipients of the Golden Bell Awards. Read more>>
People Say I'm Crazy:
A Filmmaker with Schizophrenia Presents His Personal Experience
People Say I’m Crazy is the first documentary on schizophrenia that was crafted by someone who lives with the illness. John Cadigan produced the film to gain a better understanding of how his schizoaffective disorder—a combination of schizophrenia and depression—impacts himself and his family. Read More>>
Hearing Voices (Speaking in Tongues) by Michael Mack
Few works of art are as forceful a commentary on severe mental illnesses and how they affect individuals and their families than Michael Mack’s one-man play, “Hearing Voices (Speaking in Tongues).” The play’s subject: growing up with a mother who has schizophrenia. Read the review>>
Kristy Worthen: A Beacon of Light
She was the sweet, quiet girl who recoiled when asked to speak in front of class – but somehow her artwork spoke volumes. We all knew someone like her back in elementary school – but today, Kristy Worthen is definitely one-of-a-kind.
Now, Kristy regularly speaks to large groups. She shares with them her life experiences - because this shy little girl grew into a troubled young teen, complete with mood swings and depression; then things got worse, the delusions began. While neither Kristy nor her family knew it, she was battling bipolar disorder. Read more>>
I Don’t Need To Take Medicine
The symptoms of diseases such as schizophrenia, schizoaffective and bipolar disorders are both scary and devastating. The good news is, all of these symptoms can be greatly reduced or eliminated by the recently developed, so-called atypical antipsychotic drugs that have fewer of the problematic side effects. But the bad news is half of all consumers with these serious mental diseases stop taking their drugs, leading to a greater risk of relapse.
So why don’t many consumers take their medications? Many reasons are given by consumers including cost and side effects. But one commonly recurring theme is that many consumers simply don’t believe they are ill. Why would anyone take a medication they don’t need?
Read more>>
Reintegration Without Borders
See how the Intercultural Support Center of southeast Portland, OR provides programs and services to refugees with mental illnesses. Read more >>
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