There oughta be a law! (Ron Otto)

On Saturday, June 5th, more than 50 mental health consumers filled the living room at Thresholds’ Dincin Center for Recovery to hear a presentation on psychiatric advance directives (PADs). The 1 1/2 hour educational session was given by Laurel Spahn, a staff attorney for the Guardianship & Advocacy Commission’s Legal Advocacy Service, and Alex Magnus, a mental health consumer.

Most people with a psychiatric illness live in fear of being involuntarily committed to a hospital. This fear is based on the total loss of control they will have in directing their treatment. They will be locked up and then left out of the treatment decision-making process.

PADs are legal documents that help return control to the psychiatric patient and promote their participation in treatment decision-making. These documents allow a competent person to make decisions in advance about mental health treatment preferences in areas including psychotropic medication, electroconvulsive therapy, short-term admission to a treatment facility, and the appointment of a “proxy” decision-maker.

Research has shown a strong interest among mental health consumers in PADs, but only a small percentage of people complete them unless they are given help with the documents. Illinois recognizes two types of PADs – (1) a declaration for mental health treatment and (2) a power of attorney for health care – and it can be difficult to understand their different features and signing requirements without professional assistance.

Laurel and Alex are part of an ongoing recovery initiative at Thresholds to provide education and professional support around advance directives. Laurel and her legal services team will be back at Thresholds to conduct a clinic for people who attended the educational session and wish to complete advance directives.

Tools supporting self-directed care, such as advance directives, are fundamental to mental health recovery. If you would like more information about PADs, the National Resource Center on Psychiatric Advance Directives, www.nrc-pad.org, is the place to start. If you would like help in completing an Illinois advance directive form, you may contact the Illinois Guardianship and Advocacy Commission at the toll free number: 866/274-8023.

Rally at Thompson Center

Yesterday several hundred people (including a great Thresholds group!) rallied at the Thompson Center in downtown Chicago. There was lots of passion and energy. Check out more by Tony Zipple, Thresholds’ CEO, on our Facebook album, or our read our live Twitter-feed from the event!

Speakers talked about how Gov. Quinn’s proposed $90 million cut to mental health funding would decimate services, leave thousands of consumers without the resources they need, and lead to enormous costs in the future. They also talked about how we need to offer community-based services, not institutional care in nursing homes, jails or hospitals. Not only are community based services more effective, they’re also much cheaper.

We made the news in several places… woohoo!

WGN-TV (Channel 9)
Video: Rally for mental health services

CLTV
Video: Rally for mental health services

WBBM-Newsradio
Rally Held Over Fears For Cut In Mental Health Services, Steve Miller Reporting

A few hundred people rallied at the Thompson Center at noon – upset over fears that the state’s mental health services budget will be cut by tens of millions of dollars.

It wasn’t just counselors or providers of mental health services who rallied at the Thompson Center. It was clients. People in treatment for mental illness who say their lives would change dramatically if the state cut off a lot of money to treatment programs.

“My whole family just about is receiving some kind of treatment for mental illness, and we’d be lost without it.”

Nickie Balcerzak is from Calumet Park.

“We need more funding… It saves lives. I just see more crime, more hospitalizations. Being put in nursing homes or ending up on the street is no solution.”

“Balscerzak held a sign that said “We have rights to happiness.”

People also rallied in Springfield. Here’s the video.

Write your state reps!

The Community Behavioral Healthcare Association has provided us with a great sample letter to legislators. Please complete and send, and better yet, forward to friends and colleagues who are committed to our mission and the recovery movement. Thanks, everyone!

Here’s the letter.

You can find your legislators here.

A Labor of Joy (Ron Otto)

Why is physical exercise so often viewed as a joyless experience? It’s almost as if thinking about it reminds people of the story of Sisyphus, the mythological king who deceived the Gods and was punished by having to roll a huge boulder up a hill only to have it roll back down, and cursed to repeat this futile labor through eternity.

Like many people I’ve struggled with getting into the habit of regular physical exercise, but now it feels very natural and the joys of exercise are very real. I include among these joys:

1. reduced stress, anxiety, depression and irritability – the joy of being in a good mood
2. a mental break from overthinking, worries and ruminative thinking patterns – the joy of taking a mental break and having a fresh mind
3. setting a goal of 2 ½ hours of moderate to vigorous weekly exercise and often reaching this goal – the joy of achievement
4. focusing on the immediate (the pattern of my breath and the rhythm of my steps) and not the distant past or uncertain future – the joy of being in the present moment
5. enjoying the sensory and soothing qualities of nature – the joy of nature and the outdoors
6. breaking the cycle of inactivity and being actively involved in the healing process – the joy of active, productive participation
7. experiencing normal fatigue and improved sleep quality – the joy of a good night’s sleep
8. improved energy and motivation – the joy of positive energy
9. less negative expression (criticizing and complaining) and the clearing of suppressed emotions – the joy of relating to self and others in positive ways

Physical exercise has enormous benefits for mental health and well-being. And as we look to develop a more integrated and holistic health care system, exercise-based interventions may become standard care. After all, what harm is there in prescribing joy?

For additional reading on exercise and mental health, check out “Exercise for Mood and Anxiety Disorders: Therapist Guide” by Jasper A. J. Smits and Michael W. Otto.

NY Times on military mental health

The NY Times had a good article on mental health care for soldiers who’ve suffered psychological trauma in Iraq and Afghanistan. The article seems to suggest that the care is long on medication and short on recovery services.

Read the article “Feeling Warehoused in Army Trauma Care Units.”

The Lobotomist – PBS on mental health history

Last night, I watched an American Experience documentary on PBS called The Lobotomist. It’s a powerful, visceral piece, and there were times it was hard to watch.

In the 1940s Dr. Walter Freeman gained fame for perfecting the lobotomy, then hailed as a miracle cure for the severely mentally ill. But within a few years, lobotomy was labeled one of the most barbaric mistakes of modern medicine.

One of the experts suggests that the debate about lobotomy was, at its core, a debate about what makes us human. Is it the absence of illness and pain imposed by someone else… or is it the freedom to choose and the full range of human experience, painful as it may be?

Thresholds wholeheartedly supports the latter option: recovery for persons with mental illness is about empowering and encouraging, not imposing treatments against someone’s will.

Today in Illinois, the treatment we’re fighting against  isn’t as much lobotomies (though they’re still being performed), but nursing homes. Hundreds of people with mental illness are warehoused in these institutions where they’re given high doses of medication… not empowering supports and encouragement that could give them a shot a brighter future. It’s the same story, just different characters.

You can watch the documentary here.

Tribune on Vets with PTSD

The Chicago Tribune ran a very powerful piece this morning on veterans with PTSD.

Wow.

This is such an urgent issue, and Thresholds is in the initial planning phases of a major new initiative to work with homeless veterans in Chicago. Stay tuned for more details later this year.

Read the article.

Recommended Reading (Ron Otto)

Last year I facilitated a wellness and recovery group for persons with mental illness at a Chicago nursing home. A major focus of the group was on the wellness tools and strategies that people use to stay healthy and well.

One of the group’s participants, a woman who always seemed to have a pleasant attitude, made regular entries in a gratitude journal. This seemed like a great idea, but I didn’t give much thought to the value of a gratitude journal until I recently started keeping one myself.

Maintaining the journal has been a transformative experience for me in several important ways. Instead of focusing on the 1 – 2% of things that either annoy me or seem to go wrong in my life, I’m now far more aware of and attentive to the 98% of things that are actually turning out well. My apartment has hot and cold running water, the electricity rarely fails, and now that I’m on the telemarketing no call list, life isn’t too bad.

Keeping the journal has lowered my stress and, at the same time, strengthened my sense of mental and emotional well-being. And although I always felt that my temperament couldn’t be changed too much, I now feel this gentle pull to be more positive and optimistic about life.

The nursing home resident made another suggestion (for which I’m also grateful): when you’re feeling down, read your journal.

Excellent advice!

Check out Oprah’s interview here.

Tour a Thresholds Safe Haven!

Seeing a program is so much better than reading about it. So, we’ve made a short video tour of one of our Safe Havens, which are often a first-stop for someone who is transitioning from homelessness. Enjoy!

CBS2 – Thresholds at Chicago Public Libraries

Last night, Thresholds was featured by CBS2! The report talks about people who are experiencing homelessness and finding shelter in Chicago’s public libraries during the day… and what Thresholds is doing to help these men and women. Check it out!

“Where are you supposed to go when it all falls apart? No job. No money. No home. CBS 2′s Jim Williams reports a growing number of people are turning to Chicago public libraries.”

http://cbs2chicago.com/local/homeless.Chicago.Public.2.1597963.html

Why Not Call it Brain Building? (Ron Otto)

I’m all for calling a spade a spade, yet this may not always be the most rewarding practice. For example, what sounds more appealing to you: “physical exercise” or “brain building?” After watching a recent Public Television Special called “Change Your Brain, Change Your Body” with Dr. Daniel Amen, I decided I’d rather be actively engaged in brain building.

Dr. Amen and a fair number of research studies have convinced me that when it comes to overall health and quality of life, no single activity is more important for both your brain and your body than physical exercise.

The benefits of regular physical exercise go far beyond weight control, physical strength and endurance. They extend to protecting the brain and enhancing its performance by increasing the rate of neurogenesis (the formation of new nerve cells and neuronal connections). Mental exercise also benefits the brain, but its role is more limited to ensuring the survival of the new neurons. Good nutrition and stress management are also key components of brain health.

Recovery from serious mental illness is a matter of developing health and wellness routines that increase one’s mental and physical strength and resilience.

Physical exercise, as it turns out, is exercising the brain. So, call it what you will. Still, when I get off work in the evening the whole idea of physical exercise seems much less appealing than heading off to the gym to do some serious brain building. At least my brain thinks so…and you have to start somewhere!

Watch Dr. Amen on Rachel Ray’s show:

Kankakee Roadtrip Anyone? (Kristin Davis)

I had been planning on devoting an entire post to describing a terrific wellness program in New Jersey, run by a fabulous researcher- practitioner, named Peggy Swarbick, who if we’re lucky, will contribute a blog post sometime soon on what her program is up to. In the meantime, you can read about some of their activities here.

But between writing that post and now, I visited a Thresholds’ run program in Kankakee, which blew me away! Don’t get me wrong, I know that there are many, many good things going on across Thresholds’ programs, and we know about some of them through various internal publications, but these can’t capture everything . . . especially the atmosphere and spirit of a program.

Boy, do I wish you could all go Kankakee to experience it. While the staff and members mourn their old space from which they had to move a year ago, space which included a beloved garden and a beautiful older building that had originally been a school house, they’re in the process of recreating much of what they had to leave, despite being surrounded by an asphalt parking lot. The indoor space is not only adorned with gorgeous paintings, oil-based and watercolor both, but also shows the beginning of what the Program Director, refers to as “the greening of the inside”—seedlings, plants, and flowers. Of course, bricks, mortar, and paintings a program does not make.

It is indeed much more. The membership and staff are participating in walking and smoking cessation groups, and garden both winter and summer to produce food for their two residences. Many members mentioned how much they appreciate living in a rural environment and, I have to say, that Kankakee River is surprisingly gorgeous. This is not to suggest all is a pastoral ideal south of Chicago, many members expressed frustration with how tired they feel on a regular basis and with how hard it is to lose weight. Others indicated they wished they knew how to ask their medical doctors the right kinds of questions. Suggestions welcome.

Luckily, many of these same members have offered to photograph their ideas of wellness and health for this blog as a way to share their vision of what it means to be well and to help shape the Wellness Campaign I had gone to Kankakee to launch, a campaign I now realize will merely supplement what’s already going on!

Taking a Time(less) Out (Ron Otto)

The journey toward recovery from serious mental illness can take a person far beyond the world of psychiatric medications and talk therapy. The struggle for mental peace and emotional well-being often leads to an inner search for meaning, purpose and joy. For some, the practice of meditation becomes a part of this search.

Even without my mental illness, I’m prone to worry, anxiety and stress. So, I’ve tried meditation and found it helpful. Recently, however, when a friend asked me how to meditate I didn’t know where to start. I decided to dust off a meditation CD I hadn’t used for awhile and hoped that playing it would suffice.

The CD, “Inner Renewal” by Master Del Pe, uses breathing techniques, visualizations and positive affirmations to help free the listener of “negativities and discomforts” and bring about a sense of peace and harmony at several levels – physical, emotional, mental, as well as the interpersonal. The listener begins by imagining the most beautiful ocean they’ve ever seen. Master Del Pe’s soothing voice then guides them through a series of affirmations that help release anger, guilt and a host of other distressing thoughts and emotions into the ocean. After listening to “Inner Renewal” it felt like my mind and emotions had gone through the wash and come out cleaner, purer and fresher.

Meditation can’t replace medications and other essential forms of treatment, but it can be an effective way of alleviating some of the stress and strain that accompany mental illness. And this can make it a lot easier for health and happiness to follow.

I don’t recommend any particular style of meditation, but if you’d like to learn more about Master Del Pe, go to www.mdpglobal.com. He’s the one who looks like Mr. Clean.

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!