It Helps to Have a System (Ron Otto)

Inadequate nutrition contributes greatly to the poor health and shortened lives of persons living with serious mental illness (SMI). Poor nutrition leads to excessively high rates of obesity, diabetes and other serious medical conditions for this population.

Efforts to address this problem, at an agency level, are often piecemeal and demand funding and staff resources that are in short supply. Staff and persons served often lack knowledge and skills in the area of meal preparation and nutrition.

Mainstay, Inc. has designed a menu planning and costing system called Fiore for social service agencies that serve persons with disabilities living in group homes. Fiore’s large selection of healthy, low-cost recipes, and meal planning and preparation software provide staff and persons served with much needed nutrition education. Its computer applications allow an agency to track food costs and health data. For more about the Fiore system, go to http://www.emainstay.com/fiore.html.

Thresholds is going to pilot the Fiore nutrition system at 5 of its group homes, including its diabetes house. We believe that this preventative health initiative will help us achieve the goal of better physical health, and length and quality of life for persons with SMI.

Recovery from serious mental illness requires mental and physical resilience: a strong mind and a strong body. A good nutrition education program serves both of these needs.

John’s Smoking Recovery Story

I started smoking cigarettes when I was 32 years old. I went through a 28 day program for recovery from drugs and alcohol. I felt like I had to do something because I wasn’t doing drugs or alcohol anymore. It helped me with the edginess and anxiousness I was feeling from withdrawal from drugs and alcohol, and helped me stay sober. I like the relaxation.

I was also working at Brach’s Candy Company and my co-workers would smoke after meals, so I started smoking after meals too. It also took my mind off the drugs I wasn’t using anymore, and kept me relaxed.

About 6 months later I relapsed after some family problems and became depressed. I started smoking more and more to help cope with boredom and anxiety.

I smoked for 28 years, smoking almost a pack a day, about 17 cigarettes. I decided I wanted to quit in 2009. I tried the patch alone and cut down a little. Another motivating factor for me was a preacher’s wife who had lung cancer who I saw on TV. She looked so bad and horrible, and it scared me so much. She was drying up in front of my eyes. She got a lot of people’s attention, even nurses were quitting behind her story.

Then the Freedom from Tobacco group was offered and I joined, kept using the patch and got weekly support. The 4 D’s were very helpful for me. One of the 4 D’s-Doing Something Else- was really helpful. I like to exercise. I have an exercise machine in my apartment especially for my stomach. I also have a relaxation tape. I like to play the tape to calm myself down when I think negative or disturbing thoughts and want to be at peace. I use the patch daily, prescribed by Dr J. I don’t pay anything for it-it’s free! I will probably wear the patch for at least a few more months. Dr J. says the longer I wear it the lower my cravings will be when I stop.

I stay quit because I am free from smoking and putting all this pollution in my body! If I could tell you one thing-Don’t smoke! It’s bad for your health. I never thought I’d want to quit but now that I have, I feel really good about myself!

Thresholds on WTTW last night!

Last night WTTW aired a fantastic piece on Thresholds! The report interviews two members and explains how and why a job is so powerful.

Check out the video here!

A Message to Sports Fans (Ron Otto)

Every now and then I ask Thresholds members about their hobbies. When someone responds “sports”, I like to follow up with the question, “What sports do you participate in?” Often, the answer is “I don’t. I watch them on TV.” This sounds to me like television watching, and not sports, is the actual hobby.

Whatever the case, there is a real need for physical activity among people in recovery from serious mental illness (SMI). Very high rates of diabetes, cardiovascular disease and metabolic syndrome affect this population. A sedentary lifestyle is all too commonplace.

This is why we started a walking and bicycling club at Thresholds several years ago. With generous donations of bikes from a corporate sponsor, and enough funding to support hiring a part-time bike club coordinator, the Walking and Biking Club is in good shape. Since its inception in 2007, over 300 hundred members have joined the club. Many participate every year.

Member Patrick Sturmer states, “The Bike Club has been a very good part of my recovery. The Bike Club has also helped me with some physical health problems, such as lowering my blood pressure and helping keep my diabetes under control.”

The Thresholds Walking and Biking Club is one way to address the early mortality rate for persons with SMI. Recovery is a long journey. It helps if we make it a healthy one. Several hundred Thresholds members are doing exactly that!

CEO Tony Zipple in the news

Thresholds’ CEO, Tony Zipple, is on the cover of this month’s Behavioral Healthcare Magazine, and he’s featured in a story about leaders in the industry.

You can check out this month’s edition here.

Congratulations, Tony!

Keeping away the SAD

I just ran across an article in the WSJ on how to keep away the winter blues. Check it out!

Here’s the link.

Treating Mind and Body (Ron Otto)

What comes to mind when I say the word, “psychiatrist?”

I asked several people this question and answers ranged from “drugs” and “medications” to “a person who helps with psychiatric problems.” Absent from people’s responses was any mention of physical health care.

Persons with serious mental illness (SMI) have high rates of physical illness which often goes undiagnosed and untreated. They are less likely to report physical health problems. Due to the nature of mental illness, they may be suspicious of doctors or unable to clearly state their physical health care needs. Last, there are a host of physical problems that arise from using psychiatric drugs; including diabetes and metabolic syndrome.

If we are to reduce early mortality for persons with SMI, psychiatrists must play a key role in addressing the physical health needs of their patients.

Thresholds’ psychiatrists agree and will now be writing referrals for physical checkups on an annual or as needed basis for Thresholds members. They are also very willing to get on the phone and make an appointment for them.

The psychiatrists’ actions speak much louder than words about the importance of providing integrated healthcare services to persons with mental illness.

Thanks Docs!

Saying no to smoking (Ron Otto)

Twenty five years ago I walked out of a hypnotist’s office $40 poorer and a thousand ways richer. With the help of some guided imagery I had quit smoking.

The hypnotist suggested I drink a lot of cranberry juice in the next few days to clean the nicotine out of my system. I followed the advice and never picked up a cigarette again. I went from being a 4 pack a day smoker to becoming a much happier, healthier human being that afternoon.

Quitting smoking was possibly the best decision I ever made. I set and achieved an important life goal and, in the process, took a serious step toward improving my health and self-image. It was a very real turning point in my recovery from mental illness.

Depending on how you look at it, smoking can be a state of nirvana – a brief and beautiful vacation from the terrifying voices and images of schizophrenia – or a form of slow suicide. Maybe it’s something of both.

Regardless of how you view smoking, the reality is that it cuts life short – maybe 10 years short. And if we’re going to make any serious progress towards reducing early mortality for those with severe mental illness, smoking becomes the unavoidable issue.

This week I signed up for an on-line course in learning how to help others to quit smoking. The course, Basic Skills for Working with Smokers, is offered by the University of Massachusetts Medical School. You can learn more about it at http://www.umassmed.edu/tobacco/training/basicskills_online.aspx

Signing up for this course may not be the best decision I ever made…but it could be the second best!

Tony Zipple Testifies on Nursing Homes

This week Thresholds’ CEO Tony Zipple testified at a hearing by Gov. Quinn’s Nursing Home Safety Task Force. The Tribune quoted him in an article about the hearing (here):

Illinois nursing homes currently house about 15,000 people whose primary diagnosis is a mental illness. The state has launched two pilot programs aimed at moving hundreds of mentally ill people out of nursing homes, but that is “a relatively small demonstration, relative to the need,” said Anthony Zipple of Thresholds mental health centers.

Under questioning by Gelder, Zipple estimated that roughly 10,000 mentally ill residents could be moved into less institutional settings within five years if the state moved “lines in the budget from institutional care to community care.

The Tribune still seems to be focusing on the very few number of violent crimes by people with mental illness in nursing homes, but it’s great to see a little more balanced perspective:

Mark Heyrman, a board member of Mental Health America of Illinois, was among those who said the mixing also is a disservice to psychiatric patients, who often receive substandard treatment in nursing homes and could be more cheaply and effectively housed in community mental health centers and assisted living arrangements.

Way to go Mark and Tony for continuing to tell the real story: that IMDs (Institutions for Mental Disease) don’t promote recovery — community-based services do.

Bright Futures reader Joe Ferguson commented on this story as well in our first post on the Tribune’s coverage of nursing homes. Thanks, Joe!

Peer it Forward (Ron Otto on Health & Wellness)

“How have you helped another member with their health and wellness during the past month?”

Everyone on the Thresholds’ All Agency Members Council (AAMC) is now asked this question at the start of the monthly meeting. The AAMC is a group of about 30 people receiving services at Thresholds, and the Council’s members represent many of Thresholds’ program sites.

Asking members to help each other  is part of a new peer health advocacy initiative at Thresholds. The initial results are impressive. Members are taking other members to medical appointments, sharing doctor and dental resources, checking in on the sick and starting their own physical activity groups – just to name a few of their helping efforts.

“The peer health initiative is good. It’s given us more responsibilities and it’s teaching us how to help others. We don’t always have our caseworkers to lean on, especially late at night. It’s good that members can lean on each other.” —Allison Gaiter, AAMC Vice President

There are many ways to make a difference and to help reduce early mortality for those with serious mental illness. Each of us can make a big difference at a personal level. Members of the AAMC are showing how this is done.

30 members. 30 steps toward better health — it adds up!

A Note from Dan about the APA Achievement Awards, Conference

Last week, I had the privilege of attending the Institute on Psychiatric Services sponsored by the American Psychiatric Association in New York. The conference was a fascinating look at the latest research findings from various members of the organization. I, along with Ginnie Fraser and Rochelle Frounfelker, represented Thresholds as we received our Gold Achievement Award for our Supported Employment Program.

We were in great company.

During a presentation on Friday, all of the award winners talked about their programs, enlightening all of us about new systems and interventions being put into place for various populations. The Bronze Award Winning team from the South Bronx Mental Health Council discussed their C.O.P.E. Program addressing early interventions for children with ADHD and Behavioral Disorders. The program’s early results indicated lower use of prescription stimulant medication in children, fewer incidences of punitive discipline for parents, and overall greater quality of life for the families who took part in the multi-step parenting education process.

The Silver Award Winning group from New Jersey, CHOICES (Consumers Helping Others Improve their Condition by Ending Smoking) is a consumer-driven program for smokers with mental illness in that state whose goal is to increase awareness of the importance of addressing tobacco use in mental health consumers. The program utilizes innovative stage-based interventions through peer-to-peer tobacco education to inform consumers about smoking consequences, issues regarding smoking and mental illness, and options available to make quitting easier. The shocking statistic that 44% of all cigarettes consumed in the US were consumed by people with psychiatric disorders resonated heavily with this presentation, and CHOICES is working to motivate consumers to reduce use and give them options for quitting. More information can be found at www.njchoices.org.

The Gold Achievement Award is given to two entities – a community-based program (Thresholds) and an academic or research institution. This year’s other Gold Award went to the  San Diego Hospice and The Institute for Palliative Medicine led by Dr. Scott Irwin. Dr. Irwin discussed the role of psychiatry in palliative and hospice settings, as well as the importance of quick pharmacological interventions in people experiencing depression, anxiety and other disorders while in hospice care. More information about the Institute and the San Diego Hospice may be found at www.sdhospice.org.

In addition to our presentation for the APA, I also had the opportunity to listen to a presentation led by Dr. Robert Cabaj and Dr. Joe Ruggiero about substance abuse in the gay and lesbian community that focused heavily on the use and abuse of crystal methamphetamine and its correlation with HIV transmission. I also got to enjoy a lighter moment of film frivolity during Dr. Sharon Packer’s presentation on “Sinister Psychiatrists in Cinema.” The workshop explored the role of the psychiatrist in early, mid-century and modern film, including such luminaries as Caligari, Dr. Mabuse, and most recently Dr. Hannibal Lecter. Dr. Packer is also an expert on the psychoanalysis of comic book Superheroes for those interested. More information about Dr. Packer’s books may be found on Amazon.com.

Thresholds Wins Prestigious Awards for Supported Employment Program

Thresholds announced it has received two national awards recognizing its program that helps people with serious mental illness obtain jobs. Thresholds’ Supported Employment Program earned the Gold Achievement Award from the American Psychiatric Association and is one of four organizations honored in an awards presentation Oct. 9 in New York City during the opening session of the Institute of Psychiatric Services. The award includes a $10,000 grant provided by Pfizer, Inc.

You can read more about this disctinctive honor in this full press release.

Last photos from Camp

For some members, it was their first time fishing

Our last trip to Camp returned just before Fall arrived, and I got the photos back today.

Today’s rainy, cloudy weather makes me wish I were there right now!

Carrie Fisher in “Wishful Drinking”

Just found this very cool article about Carrie Fisher (Princess Leia in the original Star Wars movies) and her one-woman show, “Wishful Drinking.”

The show is coming to Broadway and is a brutal (and funny) treatment of Fisher’s personal experiences with mental illness, addiction, relationships and Hollywood. You can learn more on show’s Web site.

It sounds both very funny and very human. I’d love to see it.

At [one] point she confesses: “I don’t have a problem with drugs so much as I have a problem with sobriety.”

Many of the stories are surreal, like the anti-drug counseling she got from none other than Cary Grant, or the time George Lucas told her Princess Leia couldn’t wear a bra because “there is no underwear in space.”

“I’ve gotten to a place where these things are stories,” she explains. “Now I’m at a distance and I can talk about them and I can try to perform magic — to alchemize this vulnerable, painful stuff and make you laugh. . . .”

As on stage, she’s brutally honest about everything, from tough stuff like how electroshock therapy helps her bipolar disorder to her lighthearted belief that she has the power to turn lovers both gay and bald. The only time she flashes anger is at critics who nastily say Princess Leia has aged poorly since her time in a bikini and chained to Jabba the Hutt.

“I’m sorry I didn’t eat just lettuce and sunflower seeds,” she says. “Here’s what I’ll do: I’ll stop eating, stop the meds and you can come visit me in a mental hospital, where I’ll be really super thin and probably wearing the metal bikini.”

Good for Carrie Fisher! It’s time we had a show on Broadway that deals with mental illness and uses humor to help people understand what it’s like to have a mental illness.

NAMI Rally for Recovery

Thresholds Board Member Fred Friedman spoke passionately at the rally

Yesterday over the lunch hour, NAMI of Greater Chicago held the annual “Recovery Rocks” rally downtown at the Thompson Center. Dozens of members and staff from Thresholds were present. State legislators and local leaders spoke passionately about the need to increase state funding for mental health services in the community.

Thresholds’ Board Member Fred Friedman and Thresholds member Jessica were the only two consumers to speak. They gave powerful testimonies to the effectiveness and importance of recovery services such as those Thresholds offers.

There’s a documentary about Fred here, and Jessica’s amazing story is in an earlier post.