Options for Seeking Help for Someone in a Mental Health Crisis

This presentation was first offered on behalf of Rep. Tom Murt on September 22nd at St. John’s Lutheran

Church in Hatboro. Due to the importance and timeliness of this topic, we are bringing it back to hold at our

monthly meeting.

Often when facing a mental health crisis involving someone who refuses to seek help, we turn to filing an

involuntary commitment for inpatient treatment (a 302 petition). This sometimes involves the family or the

police. Either way, a frequent outcome is strained relationships and further resistance to pursuing help. Mont-

gomery County now has alternatives that can engage the individual and provide needed help and support with-

out their relinquishing control. Come and hear about these from those who provide them. Speakers include Tory

Bright, Regional Mental Health Coordinator and NAMI MontCo Board member; Jess Fenchel, Director of Cri-

sis Services, ACCESS Services, Inc.; and Pam Howard, Montgomery County Office of Behavioral Health and

Developmental Disabilities.

Date: Wednesday October 5, 2016

Time: 7-8:30 PM

Location: 100 West Main Street, Suite 204

Lansdale, PA

Refreshments will be provided. This event is free and open to the public; however, an RSVP is appreciated

215-361-7784.

montco memo Montgomery County, PA October 2016 Volume XXXVI Issue 2

Please join us to honor

CAROL CARUSO Calendar 2

Message from Our President 3

Message from Our Executive Director

3

Another Report from the NAMI 2016 National Convention

4

Anti-Depressant Drugs Ineffective in Children, Teens

4

Alternative Form of Mental Health Care

5

Thanks to Sponsors of 5th Annual Benefit for the Brain

6

On Line Discussion Resource for Mental Health Community

6

Reserve Now for Our 5th Annual Benefit for the Brain

7

Tributes and Donations 7

Also in This Issue

As we show our appreciation for her many years of service to NAMI Montco

October 20, 2016

5:00 to 7:00 PM

Cedarbrook Country Club 180 Pennlyn Pike

Blue Bell, PA 19422

$20 per person Cash bar RSVP: October 7, 2016 For information: 215-361-7784

October 2016 Page 2

montco memo Volume XXXVI Issue 2

the montco memo is published monthly by

NAMI of PENNSYLVANIA

MONTGOMERY COUNTY

Board of Directors

President Neen Davis First Vice-President Dawn Hogan Second Vice President Dave Davis Secretary Beth Milton Treasurer Stephen Nelson

Victoria Bright Lauren Centola Armand DiYenno Rhea Fernandes Tricia Malott Donna McNelis Jerry Rudakevich Mike Solomon

Executive Director Carol Caruso Editor Beulah Saideman Co-Editor Mary Schuck Editor Emeritus Maryella D. Hitt Office Manager Debra Herbut Bookkeeper Kelly DiBetta Walk Manager Danielle Blanchard

Support Group Facilitators Coordinator Carol Caruso

Abington Presbyterian Church Joan Kozlowski Corinne Smith

Lansdale Rich Kelble Anne Magowan

Lower Providence Presbyterian Church Neen Davis Sue Soriano

Pottstown Nina & Alan McDaniel

NAMI of PA Montgomery County

100 W. Main Street Suite 204

Lansdale, PA 19446 Phone: 215-361-7784 FAX: 215-361-7786

Email: nami-montcopa@verizon.net Web page: www.namimontcopa.org

Letters to the Editor and other articles and contributions are welcome. Send them

to the NAMI Office or by Email to brsaideman@comcast.net

by the 15th of the preceding month

NAMI of Pennsylvania Montgomery County is an approved Donor Choice Agency of the United Way of Greater Philadelphia and

Southern New Jersey

United Way Agency Code # 5076

Calendar

Oct. 5 Nov. 7

NAMI Connection is a peer-run support group for individuals living with mental illness, which meets the first Monday of every month, except holidays, at 6:15 PM. William Jeanes Memorial Library, 4051 Joshua Rd, Lafayette Hill, PA (October meeting rescheduled for Wednesday, October 5th, 6:15 PM).

Oct. 3 Nov. 7

Pottstown Family Support Group, 1st Monday at Creative Health Services, Consumers Library, 11 Robinson Court,, 7-8:30PM.

Oct. 3 Nov. 7

Lower Providence Family Support Group, Lower Providence Presbyterian Church, 3050 Ridge Pike, Eagleville, Room 205. 7 PM. First Monday except on holidays.

Oct. 4 Nov. 1

Lansdale Family Support Group at St. John’s United Church of Christ, Main Street and Richardson Avenue, Lansdale. First Tuesday, 7:00 PM.

Oct. 5 Monthly Information Meeting, Options for Seeking Help for Someone in a Mental Health Crisis, NAMI Office, 100 W. Main St., Suite 204, Lansdale, PA, 7:00 to 8:30 PM.

Oct. 13 Nov. 10

Glenside Family Support Group, Abington Presbyterian Church, 1082 Old York Road, Abington — 2nd Thursday, 7:30 PM.

Oct. 20 Nov. 17

Montgomery County CSP (Community Support Program). 3rd Thursday, 12-2:30 PM, Montgomery County Library, 1001 Powell St., Norristown

Oct—no meet-ing

Board of Director’s Meeting, 3rd Thursday, Lansdale Office, 6:30 PM.

A Note About Our Meetings

Although some of our meetings are held at religious institutions, they are non-denominational and open to people of all beliefs.

At the picnic...

Everyone enjoyed playing Bingo and selecting prizes, especially the kids.

October 2016 Page 3

montco memo Volume XXXVI Issue 2

Message from Our President Dear Friends of MONTCO NAMI-

As you read this, many previously highlighted events will

have already taken place. Our 19th Annual NAMICARE Picnic

took place on September 18th. Great food, music, BINGO and

prizes were a fun part of the day. We had over 125 people attend.

On September 21st, the workshop featuring recipients of the Ben-

efit for the Brain Research and Impact awards took place at the

University of Pennsylvania Hospital. Over 60 people registered

for this exciting event. We partnered with Representative Thom-

as Murt on September 22 when we hosted “Options on Seeking

Help for Someone in a Mental Health Crisis.”

Our Board of Directors has been busy continuing to work on

our strategic plan. This is an exciting time for our affiliate. The

plan will help shape the direction our affiliate will move.

Our Fall Family to Family class has begun in Lansdale. This

12 week evidence based course is highly recommended to all

those family members who have a loved one living with a seri-

ous mental illness. Our next class will be offered in the Spring.

I’d like to give a shout out to two of our dedicated volun-

teers: Rob and Marianne. Thank you! Rob and Marianne are

often seen at our office helping staff with varied tasks.

If you are not yet a member of NAMI of PA Montgomery

County, I ask you to please consider joining.

As always, please contact me with any questions or comments.

Happy Fall!

Neen Davis President, NAMI of PA Montgomery County

The momentum from last month (with our three events, each

very successful; 5 monthly support groups and the start of our

fall Family to Family class) continues. You’ll want to hear our

presentation on engagement strategies and options available in

Montgomery County for individuals living with mental illness

who refuse to seek help on Wednesday, October 5th, 7 PM in our

office.

A reminder: our monthly meetings have moved to the second

Wednesday of the month; however, due to the Jewish holidays,

in October the meeting will be held on the first Wednesday. Our

NAMI Connection Peer Support Group will be held on October

5th rather than October 3rd for the same reason.

In November we will meet on November 9th with a program

on an update on the Stepping Up Program and the work of our

Montgomery County Forensic Coalition, an effort to reduce the

number of people with mental illness who are incarcerated. This

initiative involves collection of data on reasons for incarceration,

charges and length of incarceration, diversion options and re-

entry into the community. This issue hits too many of us and it is

good to know what is being done about it and steps you can take

to help.

Thanks to all who attended our 19th Annual NAMICARE

Family Picnic. The event was a huge success; many friends, par-

ents, children and grandchildren took part in this day of fun and

being together. Thanks also to those who attended our Research

Benefit for the Brain Workshop. Featuring our Benefit for the

Brain Award recipients and their work, this was also well at-

tended (filled to capacity) and offered a look to the future as to

what is needed next to promote mental health recovery. Food for

our advocacy efforts!

Our presentation requested by Representative Tom Murt was

also very well received and offered resources for engagement

strategies and available services for individuals experiencing a

mental health crisis who are not willing to go for help and their

families. This will also be presented in our office at our monthly

meeting on October 5th at 7 PM.

My Retirement Party will be held this month on the 20th at

Cedarbrook Country Club. I hope to see many of you there!

The search for a new Executive Director is in high gear. I

will continue through December and remain active after that as a

volunteer (back to my NAMI roots). We will have a smooth tran-

sition to our new E.D. with no interruption of services.

As always, thank you for all that you do on behalf of persons

living with mental illness and their families!

Carol Caruso

Message from Our Executive Director

Approximately 100 adults and children enjoyed the festivities of our 19th Annual NAMICARE Family Picnic on September 18th at Mermaid Lake in Blue Bell.

October 2016 Page 4

montco memo Volume XXXVI Issue 2

Depression

This convention session was presented by Keri Duckworth,

M.D., Medical Director of NAMI,Arlington, VA. He admitted

his presentation was “off the cuff” since there was a last minute

cancellation and he only had 20 minutes to get to the conference

room from home. His presentation was excellent none the less.

A few points he made were:

Because depression is a mood disorder, there is a risk

of it becoming bi-polar.

It is possible bi-polar is genetic.

Practice cognitive therapy.

Social rythym therapy is for mood moderation.

TMS (Trans Cranial Magnetic Stimulation) is an FDA-

cleared non-drug depression treatment for patients who are not

satisfied with the results of standard drug therapies. This treat-

ment does not have the side effects often associated with antide-

pressant medications. The therapy uses precisely targeted mag-

netic pulses and stimulates key areas of the brain that are under-

active in patients’ depression.

For more information on TMS go on-line to TMS.

Suicides have increased according to a recent CDC study.

One of the reasons is the pressures of social media. There has

also been an increase in major depression patients.

Each year at the NAMI convention there is an update on what

is new in the field of Depression. I’m sure 2017 will offer some-

thing new to talk about as well.

Dawn Hogan

Another Report from the NAMI Convention in Denver

Antidepressant Drugs Are Ineffective for Children and Teens Suffering Major Depression

By Nicole Lyn Pesce, New York Daily News, Wednesday, June 8,

2016

Most drugs treating kids and teens suffering major depression

are majorly ineffective - and even dangerous.

A new Lancet study analyzed 34 trials for 14 antidepressants

involving 5,260 patients ages 9 to 18. It found that only one drug -

fluoxetine, better known by the brand names Prozac and Sarafem -

relieved severe depression symptoms better than the sugar-pill pla-

cebo. Worse, the kids taking venlafaxine (also known by brand

names Effexor, Lanvexin, Viepax and Trevilor) actually showed an

increased risk of suicidal thoughts and attempts.

“When considering the risk–benefit profile of antidepressants

in the acute treatment of major depressive disorder, these drugs do

not seem to offer a clear advantage for children and adolescents,”

concludes the report. “Fluoxetine is probably the best option to

consider when a pharmacological treatment is indicated.”

Medicating children and adolescents suffering depressive disor-

der has long been controversial. The Food and Drug Administra-

tion even slapped a black box warning - its strictest - against the

use of antidepressants in young people up to age 24 in 2004 over

concerns about increased risk of suicides - although no children in

the FDA’s sweep actually killed themselves. But despite the FDA

warning, the use of antidepressants among U.S. and U.K. children

and teenagers up to age 19 has continued to increase.

“Delay in implementing responsible data sharing policies has

negative consequences for medical research and patient outcomes,

as demonstrated by this study,” wrote lead author Dr. Andrea

Cipriani at the University of Oxford in the report.

His analysis of the 34 trials compared the effects of 14 antide-

pressants in young people with major depression up to the end of

May 2015. His team ranked the drugs by how well they treated

depressive symptoms, whether discontinuing the drug caused ad-

verse side effects, and whether the drugs were associated with sui-

cidal thoughts and attempts.

The results? Only fluoxetine (Prozac, Sarafam) showed benefits

that outweighed the risks....And most troubling, venlafaxine was

linked with increased suicidal thoughts or attempts compared with

the placebo and five other antidepressants.

But the authors warn that this doesn’t paint a full picture, since

a lack of reliable data did not allow them to fully assess the risk of

suicidality for all drugs. That’s partly because 65% of the trials

they reviewed were funded by pharmaceutical companies, so al-

most one third were rated as high risk of bias, and another 59%

were rated moderate risk of bias. So those reports could have over-

estimated how well

their drugs worked,

and minimized the

side effects.

The authors sug-

gest that for now, par-

ents and medical pro-

fessionals monitor

children and adoles-

cents taking antide-

pressants closely, re-

gardless of the drug

chosen.

(L to R) Board members Armand DiYenno

and Tory Bright call Bingo with helper Mark

at the 19th Annual Family Picnic on September

18th.

One More Picnic Photo...

October 2016 Page 5

montco memo Volume XXXVI Issue 2

An Alternative Form of Mental Health Care Gains a Foothold By Benedict Carey, The New York Times, August 8, 2016

HOLYOKE, Mass. — Some of the voices inside Caroline White’s

head have been a lifelong comfort, as protective as a favorite aunt.

It was the others — “you’re nothing, they’re out to get you, to kill

you” — that led her down a rabbit hole of failed treatments and

over a decade of hospitalizations, therapy and medications, all

aimed at silencing those internal threats.

At a support group here for so-called voice-hearers, however,

she tried something radically different. She allowed other mem-

bers of the group to address the voice, directly:

What is it you want?

“After I thought about it, I realized that the voice valued my

safety, wanted me to be respected and better supported by others,”

said Ms. White, 34, who, since that session in late 2014, has be-

come a leader in a growing alliance of such groups, called the

Hearing Voices Network, or HVN.

At a time when Congress is debating measures to extend the

reach of mainstream psychiatry — particularly to the severely psy-

chotic, who often end up in prison or homeless — an alternative

kind of mental health care is taking root that is very much anti-

mainstream. It is largely nonmedical, focused on holistic recovery

rather than symptom treatment, and increasingly accessible

through an assortment of in-home services, residential centers and

groups like the voices network Ms. White turned to, in which

members help one another understand each voice, as a metaphor,

rather than try to extinguish it.

For the first time in this country, experts say, psychiatry’s crit-

ics are mounting a sustained, broadly based effort to provide peo-

ple with practical options, rather than solely alleging abuses like

overmedication and involuntary restraint.

“The reason these programs are proliferating now is society’s

shameful neglect of the severely ill, which creates a vacuum of

great need,” said Dr. Allen Frances, a professor emeritus of psy-

chiatry at Duke University.

Dr. Chris Gordon, who directs a program with an approach to

treating psychosis called Open Dialogue at Advocates in Framing-

ham, Mass., calls the alternative approaches a “collaborative path-

way to recovery and a paradigm shift in care.” The Open Dialogue

approach involves a team of mental health specialists who visit

homes and discuss the crisis with the affected person — without

resorting to diagnostic labels or medication, at least in the begin-

ning.

Some psychiatrists are wary, they say, given that medication

can be life-changing for many people with mental problems, and

rigorous research on these alternatives is scarce.

“I would advise anyone to be carefully evaluated by a psychia-

trist with expertise in treating psychotic disorders before embark-

ing on any such alternative programs,” said Dr. Ronald Pies, a

professor of psychiatry at SUNY Upstate University, in Syracuse.

“Many, though not all, patients with acute psychotic symptoms are

too seriously ill to do without immediate medication, and lack the

family support” that those programs generally rely on.

Alternative care appears to be here to stay, however. Private

donations for such programs have topped $5 million, according to

Virgil Stucker, the executive director of CooperRiis, a residential

treatment community in North Carolina. A recently formed non-

profit, the Foundation for Excellence in Mental Health Care, has

made several grants, including $160,000 to start an Open Dialogue

program at Emory University and $250,000 to study the effect of

HVN groups on attendees, according to Gina Nikkel, the president

and CEO of the foundation. Both programs have a long track rec-

ord in Europe.

About three quarters of people put on a medication for psycho-

sis stop taking it within 18 months because of side effects or other

issues, studies suggest. Some do well on other drugs; others do

not.

“I was told by one psychiatrist at age 13 or 14 that if I didn’t

take the meds, my brain would become more and more damaged,”

said Ms. White, who began hearing voices in grade school. “Of

course I believed it. And I became hopeless, because the drugs just

made me feel worse.”

On a recent Tuesday, Ms. White and seven others who hear

voices gathered at the Holyoke Center of the Western Massachu-

setts Recovery Learning Community, which hosts weekly 90-

minute hearing voices groups, to talk about what happens in those

sessions. The group meetings themselves, guided by a person who

hears voices, sometimes accompanied by a therapist, are open to

family members but closed to the news media.

The culture is explicitly nonpsychiatric: No one uses the word

“patient” or refers to the sessions as “treatment.” “We need to be

very careful that these groups do not become medicalized in any

way,” said Gail Hornstein, a professor of psychology at Mount

Holyoke College and a founding figure for the American hearing

voices groups, which have tripled in number over the past several

years, to more than 80 groups in 21 states.

Most of the people in the room had extensive experience being

treated in the mainstream system. “I was told I was a ticking time

bomb, that I’d never finish college, never have a job, never have

kids, and always be on psychiatric medication,” said Sarah, a stu-

dent at Mount Holyoke who for years has heard a voice — a child,

crying — and in college started having suicidal thoughts. She was

given diagnoses of borderline personality disorder and put on

medications that had severe side effects. She asked that her last

name not be used, to preserve her privacy. In the group, other

members prompted her to listen to the child’s cries, to ask whose

they were, and why the crying?

Those questions led, over a period of weeks, to a recollection

of a frightening experience in her childhood, and an effort to

soothe the child. This altered her relationship with the voice, she

said, and sometimes the child now laughs, whispers, even sings.

“That is the way it works here,” said Sarah, who is set to grad-

uate from college with honors. “In the group, everyone’s experi-

ence is real, and they make suggestions based on what has worked

for them.”

(continued on page 6)

Research News You Can Use

October 2016 Page 6

montco memo Volume XXXVI Issue 2

We want to thank our sponsors to date of our 5th Annual

Benefit for the Brain:

Champion: Creative Health Services, Inc.

Progressions Companies Inc.

Hero: PMHCC

Star: Magellan Behavioral Health

Brooke Glen Behavioral Hospital

New Vitae Wellness and Recovery

Lundbeck Inc.

Friend: Mental Health Association of SE PA

Rubin & Badame Attorneys at Law

Dawn & Jerome Hogan

There is still time to be a part of and support this very worth-

while effort to promote research of and recovery from mental

illness. Email ccaruso@namimontcopa.org or call 215-361-7784.

Thank you!

Alternative Form of Mental Health Care

Like many of the other alternative models of care, Hearing

Voices Network is not explicitly anti-medication. Many people

who regularly attend have prescriptions, but many have reduced

dosages.

“I walked in the door on Thorazine and thought I couldn’t get

better,” Marty Hadge said. “About all I could do is lie on the

couch, and the doctors would say, ‘Hey, you’re doing great —

you’re not getting in trouble!’”

Mr. Hadge is now a group leader who trains others for that

role. He no longer takes Thorazine or any other anti-psychosis

medication.

Not everyone benefits from airing their voices, therapists say.

The pain and confusion those internal messages cause can over-

whelm any effort to understand or engage.

“People will come to our program because they’re deter-

mined not to be on medication,” said Dr. Gordon, the medical

director of Advocates. “But that’s not always possible. The idea

is to give people as many options as we can, to allow them to

come up with their own self-management program.”

To do that, proponents of alternative care have much work to

do. The programs are spread thin, and to scale up, they will prob-

ably have to set aside their native distrust of mainstream psychia-

try to form alliances with clinics. In parts of Europe, including

Britain and Denmark, such integration has occurred, with Hear-

ing Voices groups and Open Dialogue-like programs widely

available.

In this country, there is very little collaboration. Ms. White

runs a Hearing Voices group in the forensic psychiatry unit of a

hospital in Springfield, Mass., and there is a scattering of other

medical clinics that work with Voices groups. But the culture

gap between alternative and mainstream approaches to psychosis

and other mental problem remains deep, and most psychiatrists

and insurers will need to see some evidence before forming part-

nerships.

Last month, the influential journal Psychiatric Services pub-

lished the first study of the Open Dialogue program in the United

States, led by Dr. Gordon and Dr. Douglas Ziedonis of the Uni-

versity of Massachusetts.

The results are encouraging: Nine of 14 young men and

women enrolled in the program for a year after a psychotic epi-

sode were still in school or working. Four are doing well without

medication; the others started or continued on anti-psychosis

drugs. Insurance covered about a quarter of the overall costs.

“It’s tiny, just a pilot study,” Dr. Gordon said. “But it’s a start.”

http://www.nytimes.com/2016/08/09/health/psychiatrist-

holistic-mental-health.html?smprod=nytcore-

ipad&smid=nytcore-ipad-share&_r=1

(Continued from page 5)

Thanks to the Sponsors of Our 5th Annual Benefit for the Brain

Tumblr Offers On Line Discussion Resource for Mental Health Community

According to Crain’s, the Manhattan-based blogging site

Tumblr is taking a more discussion-oriented approach to promot-

ing mental health in a space set aside to talk about mental health

issues.

Post It Forward offers the opportunity to view mental health

resource materials amongst a number of personal postings; all

told, there’ve been 16,000 posts to date.

Advocates are posting "a ton of content," including research

studies, resource links and videos on mental health issues, with

the tag "Post It Forward," a Tumblr spokeswoman told Crain’s.

"We can make sure our audience sees it on their dashboards and

it can live beside artwork from users."

"The idea of sharing stories is really important and would

have saved me a lot of suffering as a kid," said one user.

October 2016 Page 7

montco memo Volume XXXVI Issue 2

Tributes and Other Contributions

The Tribute Fund is a good way to mark anniversaries, weddings and other special occasions, and to express sympathy for the

loss of a loved one. We will send a note of appreciation to anyone you designate. Send your check to NAMI of Pennsylvania Mont-

gomery County, 100 W. Main Street, Suite 204, Lansdale, PA 19446. When designating NAMI in an obituary notice, please speci-

fy NAMI of Pennsylvania Montgomery County.

In Tribute:

In memory of Beth Laws Neen and Dave Davis

In memory of Beth Laws Jarema N. Rudakevich and Carol Caruso

In memory of Domenic Leone Jarema N. Rudakevich and Carol Caruso

In memory of David L. Rackow, MD Stephen and Cynthia Ruzansky

Individual Donations

Marie Biddy Ruth Esquirell Scott Evert Bernadette T. Haertsch

Elliot V. Hersh Susan P. Jacobs Richard P. Kelble Anthony J. Malloy

James & Miriam McCauley James Alexander Rauer Peter & Bonnie Schorsch Noelle Wheatley

Corporate Matching Gifts

Emily and Chris Lupcho, Aetna Foundation

Tom Vander Neut, Aetna Foundation

Yingchun Zhang, UnitedHealth Group

Reserve Now for Our 5th Annual Benefit for the Brain November 16th

PENNSYLVANIA MONTGOMERY COUNTY

Dues are for one year and are Tax Deductible. Donations are welcome and are also Tax Deductible.

(Please print clearly)

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What is the best way for us to contact you? Phone ______ Email ______ Snail Mail ______

Make check payable and return to: NAMI of Pennsylvania Montgomery County

100 W. Main Street, Suite 204

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Or join or renew on our website: http://www.namimontcopa.org/join/

Double or triple the impact of your donation at no additional cost! Please check with your employer’s Human Resources Department to

see if your donation can be matched through a company matching gift program.

NAMI of Pennsylvania Montgomery County is also an approved United Way Donor Choice Agency - Code #5076.

NAMI of Pennsylvania Montgomery County is open to all individuals subscribing to its purpose. All members receive NAMI newsletters and are automatically affiliated with NAMI PA and

the National Alliance on Mental Illness (NAMI). NAMI is a non-profit organization under Section 501(c)3 and all dues and donations are tax-deductible. Official registration and financial

information of NAMI PA Montgomery County may be obtained from the PA Department of State by calling toll free within PA 1.800.732.0999. Registration does not imply endorsement.

The official registration and financial information of NAMI PA Montgomery County can be obtained from the Pennsylvania Department of State by calling toll-free within Pennsylvania:

1-800-732-0999. Registration does not imply endorsement.

PENNSYLVANIA

MONTGOMERY COUNTY

100 W. Main Street, Suite 204

Lansdale, PA 19446