Thursday, June 9, 2011

Does cutting mental health care increase the prison population?

By Suzy Khimm
State-supported mental health care, like many social services, has been especially vulnerable in the recent rounds of budget cuts. Over the past two years, some $1.6 billion has been slashed from non-Medicaid state spending on mental health, according to the National Alliance on Mental Illness. But a growing number of law enforcement officials — along with mental health advocates — are voicing concerns that such cutbacks not only hurt mental health beneficiaries but also overburden the country’s prison system.
In Illinois, where mental health spending has dropped 15 percent since 2009, the Cook County sheriff may file a lawsuit against the state for allow the county jail to “essentially become a dumping ground for people with serious mental health programs,” reports a local ABC affiliate, WLS-TV. The details:
Sheriff Tom Dart says it has gotten so bad Cook County Jail is now the largest provider of mental health treatment in the state. … As much as 20 percent of the jail's population has been diagnosed with some type of mental illness. That's 1,300 to 1,400 people receiving psychiatric care while behind bars.

“What ends up happening is, there’s no safety net to catch them, so they end up committing crimes, getting swept up by the police and coming to jail,” said jail psychiatrist Dr. Jonathan Howard.
The head of Illinois’ mental health department says that the state is trying to make do with limited resources — but acknowledges that it still can’t afford treatment programs such as community-based care that might be more effective, as WLS-TV points out.
Similarly, the Los Angeles Times has examined a public safety program in Nevada that’s also under threat because of mental health budget cuts. The effort pairs police officers in Reno with mental health counselors to reach out to the mentally ill, whether they’ve committed crime, are a threat to themselves, or could be in the future. “Already starved for services, troubled citizens sometimes tumble into homelessness and alcoholism and tussle violently with police, who are usually ill-equipped to help them,” the story explains.
In Nevada and Illinois, as in states across the country, mental health services will continue to be vulnerable to budget cuts. According to University of Chicago Professor Harold Pollack, states deliver many mental health and behavioral services outside of Medicaid and are thus freed from federal coverage requirements — as well as matching dollars — making these services a more tempting target for legislators committed to fiscal austerity.
Mental health advocates have long banged the drum about the connection between mental health and crime, noting especially strong links between recidivism and mental illness. In a recent report on the phenomenon, “Cost-Shifting to Criminal Justice,” NAMI notes that as much as a quarter of prisoners in the United States suffer from a serious mental illness, citing a 2006 Department of Justice study. The group adds that 50 percent of previously incarcerated individuals with serious mental illnesses end up returning to jail — at times because untreated mental illness has led them to violate parole, citing the Council of State Governments.
Such findings may undercut the economic rationale for cutting mental health benefits if states are simply shifting — or increasing — costs to the prison system in doing so. As I've reported previously, many states are also battling to contain prison costs as well as health services. So budget-conscious legislators may be especially willing to think twice if research continues to support this argument.
Suzy Khimm is a staff reporter in the Washington bureau of Mother Jones.

National Association of Peer Specialists

By Steve Harrington, J.D., Executive Director
Peer specialists1 are persons with a lived history of mental illness and recovery journey who help others on their recovery journeys. Because the peer specialist profession is a relatively new phenomenon in mental health services, it is often unknown or misunderstood by other mental health professionals, medical health professionals, and the general public. Confusion and misunderstandings also exist with regard to the roles peer specialists can or should play in mental health services.

Although peer support can be traced to the beginning of humanity, it emerged as a powerful force in mental health in the early 1980s. At this time, mental health institutions were closing across the United States in favor of community-based treatment, where persons with psychiatric conditions could live and obtain support in the communities in which they lived. Peer support outcomes, the popularity of Alcoholics Anonymous, and the reality of recovery from serious and persistent mental health problems combined to create an atmosphere ripe for the creation of a peer support movement in mental health.

Change agents. Peer providers are now commonplace in some mental health systems. Factors driving this trend included
  • The growing recognition of the reality of recovery from even severe and persistent psychiatric conditions
  • A political climate that expected cost-effectiveness for public funds
  • Positive outcomes associated with peer support
  • A ready labor force
  • The establishment of formal peer training and certification of peer specialists
In 2001, Georgia became the first State to obtain Medicaid reimbursement for peer support services (Salzer, Schwenk, & Brusilovskiy, 2010). Since then, 13 other States have followed. In addition to providing direct services to their peers, peer specialists were providing services in a variety of ways (one-on-one support, facilitating support groups, community resource connecting, education, and more)—they were acting as change agents. As employees of mental health providers, peer specialists found themselves in positions to influence organizational policies and practices to enhance service effectiveness (Fukul, Davidson, et al., 2010).

In 2004, the National Association of Peer Specialists (NAPS) was formed to promote the use of peer support in mental health settings. NAPS soon became involved in advising policy makers about peer workforce issues. The organization quickly grew from a handful of dedicated peer specialists to more than 1,000 members representing every State, as well as Australia, the United Kingdom, Japan, Guam, Canada, and several other countries. NAPS acts as a peer support information clearinghouse and frequently responds to inquiries from throughout the United States.

Need for national guidelines, certifications. Our Situational Analysis research has found that the number of States creating peer specialist initiatives has grown dramatically in the past 5 years. The number of States with employed peer specialists is somewhat greater than the number receiving Medicaid reimbursement (an estimate of 25 is not unreasonable), but the exact number is often difficult to determine, as programs are sometimes small and/or isolated. At least two States, North Carolina and Texas, are working toward Medicaid reimbursement for peer support and have made much progress in that regard.

One of the main findings we have come across is the lack of national guidelines or certification for the profession. Each State with a formal peer specialist program exercises control over that program as it relates to certification, training, professional discipline, and other operational issues. Until recently, training was generally offered as 1-week courses to satisfy State certification requirements. A common feature among virtually all training programs is heavy reliance on peers as advisors in basic curriculum development and as instructors. Training courses do appear to be increasing in length and the topics covered, but findings have indicated a great desire among peer specialists for greater emphasis or education on cultural competency, the role of trauma in mental health, and ethics issues.

Meanwhile, certification requirements vary across the States. Some States only require training, while others require training, work experience, successful completion of a comprehensive exam, character references, reference from a psychiatrist, an interview, and background investigations. Despite efforts to foster training and certification reciprocity between States, those efforts have generally resulted in rejections to “outside” assistance or suggestions. Although Kansas, Missouri, and Georgia permit a measure of reciprocity, most States do not and, at this time, appear unwilling to consider doing so.

The number of States with formal certification programs is, at least, growing. In August 2007, the Centers for Medicare and Medicaid Services (CMS) issued guidelines to States wishing to use Medicaid funding for peer support services (Smith, 2007). The guidelines addressed supervision, care coordination, and training and certification. But with the issuing of these guidelines and overall growth in the peer specialist workforce, the demand for continuing education opportunities has grown as well. While many States have spent considerable time and effort to develop the basic certification procedure and requirements, many have yet to reach beyond that to develop continuing education programs.

Role of peer specialists. Another finding in our assessment is just how diverse the peer specialist workforce is. This can prove both a challenge and a reward for our field as a whole. Each peer specialist brings a unique skill set to the mental health workplace. And because the profession is relatively new, there is often great flexibility in how and where those skills are used. Peer specialists work in such settings as general hospital emergency rooms, psychiatric hospitals, jails and prisons, and nursing homes. They also work as educators in communities, drop-in centers, clubhouses, and vocational placement agencies.

The diversity of peer specialists is reflected by more than work setting. Tasks are also variable and include—but are not limited to—individual support, facilitating support groups, educating a variety of individuals and groups about recovery and the true nature of mental illnesses, helping people make the transition from hospital to community, housing and educational support, engagement, wellness coaching, resource connecting, advocacy, supervision, administration, teaching of formal recovery courses, and transportation.2

In recent years, the Department of Veterans Affairs (VA) has made great strides in the training, certification, and hiring of peer specialists for its healthcare facilities. In some ways, the VA’s efforts have encouraged States that once considered peer support meaningless or marginally meaningful to reconsider their positions and, ultimately, create peer specialist programs. Today, the VA has a significant peer workforce that is well-trained and professional and contributes a wealth of positive outcomes (Salzer, 2011; Salzer, Schwenk, & Brusilovskiy, 2010).

Lack of understanding. That said, there appears to be a great number of mental health provider agencies that misunderstand the valuable roles peer specialists can play. Reports from the field reveal that some peer specialists are relegated to roles in which they are unable to use their recovery experiences and knowledge for the benefit of those they serve (or should be serving). There are reports that some peer specialists are providing parking lot security, medication monitoring, office support, or other duties that do not present meaningful peer-to-peer contact.

This may be because peer specialists are often supervised by non-peers who have no specific training on how to supervise peers in the workforce. In addition, peer specialists may work in an environment where coworkers lack knowledge of the recovery paradigm or feel confused or threatened by the presence of people openly in recovery in the workplace.

Failure to understand the important roles peer specialists can play is detrimental to peer specialists, coworkers, persons served, and mental health systems as a whole (Townsend & Griffin, 2006). Lack of understanding often leads to workplace conflicts.

And, despite the well-proven abilities of peer specialists to create positive outcomes in these many settings (Salzer, 2011; Salzer, Schwenk, & Brusilovskiy, 2010; SAMHSA, 2009; Davidson, Chinman, Kloos, et al., 1999), the profession remains underpaid. In describing our target audience for the NAPS Situational Analysis, we found that working peer specialists often live in poverty—despite being employed. Workers often feel disrespected and operate without a meaningful career ladder, even though they have a high motivation to work and succeed at employment, and to help others on their recovery journeys.

Next steps for future. Based on historical information, however, it seems a certainty that the peer specialist profession will enjoy considerable (and likely rapid) growth in the next decade. One recent study has shown that peer support can reduce rehospitalization by as much as 72 percent (OptumHealth, 2011).

It is also clear the need for continuing education will grow as a component of State-sanctioned peer specialist programs, in line with the profession’s growth, maturity, and CMS guidelines.

It is in this environment that NAPS will develop, and ultimately implement, training on recovery-oriented practices in our field. Our vision is a peer specialist workforce proficient in all aspects of recovery—and an environment in which others in the mental health field understand not only the value of recovery-oriented practice but the value peer specialists bring to recovery-oriented practice.

Work toward this vision will involve, first of all, educating the peer workforce to increase recovery knowledge and increasing recovery knowledge and practices in the long term. NAPS aims to develop a recovery-oriented curriculum that is as participatory and experiential as possible. Among other topics, the curriculum will address cultural competency, trauma-informed practices, and ethics and boundaries. As a field, we should also work to create professional peer specialist standards that can be applied nationally.

Continuing education is also important—not only formal continuing education, but also access to the many useful recovery resources that already exist. Too many of these resources remain unknown or inaccessible to peer specialists. NAPS hopes to forge collaborative relationships with organizations across the country to encourage access to depositories of evaluated and organized recovery materials.

We also suggest collaborating with other mental health professions to foster recovery knowledge and acceptance of recovery practices and policies. Peer specialists often observe practices and are subject to policies that inhibit their ability to move service providers toward a recovery orientation. Without a peer specialist workforce comfortable with expressing opinions and suggestions, and coworkers and supervisors willing to listen and consider them, the recovery paradigm is inhibited. Ensuring acceptance of recovery-oriented practices will mean working closely with the other disciplines on developing and implementing these practices and, where needed, helping to educate those who work alongside peer specialists on the key aspects of recovery. One basic first step we can take in marketing recovery knowledge is to develop a fact sheet that describes why, how, where, and when peer specialists perform their work.

One Indiana State mental health official has already noted our distribution of the Situational Analysis will help him promote the hiring of peer specialists in that State (B. VanDusen, personal communications, Feb. 8, 2011). With hard work, we will achieve a future in which peer specialists, as well as recovery practices as a whole, will be widely respected and adopted.

Footnotes:
1Peer specialists may also be referred to as: peer support specialists, peer support technicians, consumer advocates, peer recovery support specialists, recovery specialists, and a myriad of other titles.
2This list is far from exhaustive. Transportation is included here, but it is sometimes debated whether it is a “true” or “valid” peer support task. Transportation of peers can, however, present meaningful opportunities for discussion and relationship-building that supports a individual’s recovery.

References:
Daniels, A., Grant, E., Filson, B., Powell, I., Fricks, L., & Goodale, L. (Ed.). (2010). Pillars of peer support: transforming mental health systems of care through peer support services. Atlanta, GA: The Carter Center. Retrieved June 8, 2011, from http://r20.rs6.net/tn.jsp?llr=toyssnfab&et=1105905864022&s=2292&e=001660qLvW9O2KDTM-CBtwTPznnUmM7xVaYP7xHvKg-J0I3fq3a0rHoE_mxdyhTSjZmdmqRloqWLQdO6EjKmMNsOAh6kwNGrN1dRl-Opg0DEEPtNti-5u5UqLPjEdD6yDbXBBIJVLC-ZCnhPKHSUAeGQm0BOeSqnISLC4UlAqFJZ3s=.

Davidson, L.; Chinman, M.; Kloos, B.; Weingarter, R.; Stayner, D.; & Tebes, J.K. (1999). Peer support among individuals with severe mental illness: A review of the evidence. Clinical Psychology: Science and Practice, 6(2), 165–87.

Fukul, S.; Davidson, L.J.; Holter, M.C.; & Rapp, C.A. (2010). Pathways to recovery: Impact of peer-led group participation on mental health recovery outcomes. Psychiatric Rehabilitation Journal, 34(1), 42–48.

OptumHealth. (2011). Poster presentation from Association for Community Mental Health Administration Summit.
New Orleans, La.

Salzer, M.S. (2011). Presentation from Texas USPRA Conference 2011: Present and future of certified peer specialists: A research overview. Austin, Texas.

Salzer, M.S.; Schwenk, E.; & Brusilovskiy, E. (2010). Certified peer specialist roles and activities: Results from a national survey. Psychiatric Services, 61(3), 520–23.

SAMHSA. (2009). What are peer recovery support services? (HHS Publication No. [SMA] 09–4454.) Rockville, Md.: U.S. Department of Health & Human Services.

Smith, D.G. (2007). Letter to State Medicaid directors. Baltimore, Md.: Department of Health & Human Services, Centers for Medicare & Medicaid Services.

Townsend, W., & Griffin, G. (2006). Consumers in the mental health workforce: A handbook for providers. Rockville, Md.: National Council for Community Behavioral Healthcare.

Reposted at darkestcloset.blogspot.com. From Recovery to Practice Weekly Highlights Volume 2, Issue 21. June 9, 2011. To access the RTP Weekly Highlights and other RTP materials, please visit http://www.dsgonline.com/rtp/resources.html.

Tuesday, June 7, 2011

Therapy to change 'feminine' boy created a troubled man, family says

By Scott Bronstein and Jessi Joseph, CNN
June 7, 2011 -- Updated 1745 GMT (0145 HKT)
Click to play
Family describes anti-'sissy' therapy
STORY HIGHLIGHTS
  • Siblings: Gay brother killed himself decades after treatment to make him more masculine
  • Treatment included withholding maternal attention and punishment
  • Ex-clinic psychologist: It's "inaccurate to assume" therapy caused Kirk Murphy's suicide
Editor's note: Tonight at 10 ET on CNN TV, "AC360ยบ" examines a shocking "experimental therapy" designed to make feminine boys more masculine. See what one family says was the devastating result in a special report, "The Sissy Boy Experiment."

Los Angeles (CNN) -- Kirk Andrew Murphy seemed to have everything to live for.
He put himself through school. He had a successful 12-year career in the Air Force. After the service, he landed a high profile position with an American finance company in India.

But in 2003 at age 38, Kirk Murphy took his own life.

A co-worker found him hanging from the fan of his apartment in New Delhi. His family has struggled for years to understand what happened.
Gallery: UCLA's Gender Identity Clinic
"I used to spend so much time thinking, why would he kill himself at the age of 38? It doesn't make any sense to me," said Kirk's sister, Maris Murphy. "What I now think is I don't know how he made it that long."

After Kirk's death, Maris started a search that would uncover a dark family secret. That secret revealed itself during a phone conversation with her older brother Mark, who mentioned his distrust of any kind of therapy.
"Don't you remember all that crap we went through at UCLA?" he asked her. Maris was too young to remember the details, but Mark remembered it vividly as a low point in their lives.

IReport: Did you participate in similar research?

Wanting a 'normal life'

Kirk Murphy was a bright 5-year-old boy, growing up near Los Angeles in the 1970s. He was the middle child, with big brother Mark, 8, and little sister Maris, just a baby at 9 months. Their mother, Kaytee Murphy, remembers Kirk's kind nature, "He was just very intelligent, and a sweet, sweet, child." But she was also worried.

It left Kirk just totally stricken with the belief that he was broken, that he was different from everybody else.
--Maris Murphy, Kirk's sister
 
"Well, I was becoming a little concerned, I guess, when he was playing with dolls and stuff," she said. "Playing with the girls' toys, and probably picking up little effeminate, well, like stroking the hair, the long hair and stuff. It just bothered me that maybe he was picking up maybe too many feminine traits." She said it bothered her because she wanted Kirk to grow up and have "a normal life."

Then Kaytee Murphy saw a psychologist on local television.

"He was naming all of these things; 'If your son is doing five of these 10 things, does he prefer to play with girls' toys instead of boys' toys?' Just things like this," she said.

The doctor was on TV that day, recruiting boys for a government-funded program at the University of California, Los Angeles.

"Well, him being the expert, I thought, maybe I should take Kirk in," said Kaytee Murphy. "In other words, nip it in the bud, before it got started any further."

Kirk becomes 'Kraig'
Kaytee Murphy took Kirk to UCLA, where he was treated largely by George A. Rekers, a doctoral student at the time.

In Rekers' study documenting his experimental therapy (PDF), he writes about a boy he calls "Kraig." Another UCLA gender researcher confirmed that "Kraig" was a pseudonym for Kirk.

The study, later published in an academic journal, concludes that after therapy, "Kraig's" feminine behavior was gone and he became "indistinguishable from any other boy."

"Kraig, I think, certainly was Rekers' poster boy for what Rekers was espousing for young children," said

Jim Burroway, a writer and researcher who has studied Rekers' work.

I thought, maybe I should take Kirk in ... nip it in the bud, before it got started any further.
--Kaytee Murphy, Kirk Murphy's mother
 
"We have been wondering where is Kraig? A lot of us have talked about it. Where is he today? Is he married or is he gay? Or specifically does he even know that Rekers has been writing about him?" said Burroway. "I found 17 different articles, books, chapters, that he has written in which he talked about Kraig."
Rekers' work with Kirk Murphy helped him build a three-decade career as a leading national expert in trying to prevent children from becoming gay, a career as an anti-gay champion that would later be tainted by his involvement in an embarrassing scandal.

The experiments
The therapy at UCLA involved a special room with two tables where "Kraig's" behavior was monitored, according to the study.

"There was a one-way mirror or one-way window -- and some days they would let him choose which table he would go to," said Maris, who has read about the experiments.

At one table Kirk could choose between what were considered masculine toys like plastic guns and handcuffs, and what were meant to be feminine toys like dolls and a play crib. At the other table, Kirk could choose between boys' clothing and a toy electric razor or items like dress-up jewelry and a wig.

See details about the experimental therapy

According to the case study, Kaytee Murphy was told to ignore her son when he played with feminine toys and compliment him when he played with masculine toys.

"They pretty much told him he wasn't right the way that he was, but they never really explained it to him what the issue was. They did it through play," Maris said.

Rekers wrote that Kirk would cry out for attention, even throwing tantrums, but Kaytee Murphy was told to keep going.

Harsh beatings
At home, the punishment for feminine behavior would become more severe. The therapists instructed Kirk's parents to use poker chips as a system of rewards and punishments.

According to Rekers' case study, blue chips were given for masculine behavior and would bring rewards, such as candy. But the red chips, given for effeminate behavior, resulted in "physical punishment by spanking from the father."

Mark said he was told to participate in the chip reward-and-punishment system as a way to make Kirk feel like the system was OK.

I only meant to help, do the best I could with the parents.
--Dr. George Rekers
 
The family said the spankings were severe. Maris remembers "lots of belt incidents." She escaped the screaming by going to her bed to "lay in the room with my pillow on my head." Later, she would go to Kirk's bedroom and "lay down and hug him and we would just lay there, and the thing that I remember is that he never even showed anger. He was just numb."

During one particularly harsh punishment, their mother recalls, her husband "spanked" Kirk "so hard that he had welts up and down his back and on his buttocks."

She remembers her son Mark saying, "Cry harder, and he won't hit so hard." She says, "Today, it would be abuse."

Sometimes Mark would try to protect his brother, to make his beatings less severe.

"I took some of the red chips and I put them on my side," said Mark, as tears came to his eyes. But he said the beatings were still frequent.

The number of stacked red chips became a telltale sign about the level of tension in the house. When he returned home each day, Mark often looked for the chips in their easily visible location between the living room and the kitchen.

"You looked and were like, 'What's the chip count today? What happened? What changed? How bad is it going to be?' And it was always bad. There was whipping every Friday night. There was no way out of it."
Kirk's formal clinical treatment lasted 10 months, but the family said some of the treatment techniques and practices lasted longer at home.

'Different from everybody else'
Mark Murphy vividly remembers a photo of a smiling young Kirk, age 4, taken a year before the therapy started.

"This is my brother, Kirk Andrew Murphy, right here," Mark said, pointing to the picture. "This is the way he's supposed to be right here," Mark said tearfully.

Mark said the photo shows the last time he remembers his brother as a happy child.

Maris, who was too young to remember Kirk when he went to therapy, said she only knew Kirk after his treatment.

"It left Kirk just totally stricken with the belief that he was broken, that he was different from everybody else," she recalled. "He even ate his lunch in the boy's bathroom for three years of his high school career, if you want to call it that."

CDC: Lack of acceptance can lead to risky behavior for non-straight youth

Kirk's mother said she believes the experimental therapy destroyed Kirk's life.

"I blame them for the way his life turned out," she said. "If one person causes another person's death, I don't care if it's 20 or 50 years later, it's the same as murder in my eyes."

Of course, the actual reason someone commits suicide is difficult, if not impossible to know. The family's allegations that Rekers' therapy caused Kirk Murphy to take his life are just that -- allegations.
When Rekers did not respond to CNN's repeated requests for an interview, CNN producers tracked him down in Florida to ask about the Murphy family's allegations.
It's "inaccurate to assume" therapy led to Kirk Murphy's suicide, says George Rekers, who treated Murphy.
It's "inaccurate to assume" therapy led to Kirk Murphy's suicide, says George Rekers, who treated Murphy.
"Well, I think, scientifically that would be inaccurate to assume that it was the therapy, but I do grieve for the parents now that you've told me that news. I think that's very sad," he said.

Rekers pointed out that the therapy had been decades earlier.

"That's a long time ago, and to hypothesize, you have a hypothesis that positive treatment back in the 1970s has something to do with something happening decades later. That would, that hypothesis would need a lot of scientific investigation to see if it's valid. Two independent psychologists with me had evaluated him and said he was better adjusted after treatment, so it wasn't my opinion." he said.

One of those psychologists has since died. The other -- Dr. Larry Ferguson -- told CNN that he did evaluate Kirk Murphy as a teenager. He said the family was well adjusted and he did not see any "red flags" when evaluating Kirk. But Maris Murphy says Kirk lied to those examining him. "He was conditioned to say what they wanted to hear," she said.

Rekers said he could not give specific details about Kirk Murphy's treatment, citing doctor-patient confidentiality. For him, the bottom line is that the therapy was intended to help.

"I only meant to help, do the best I could with the parents, and I've written articles you can look up, too, on the rationale for our treatment. And the rationale was positive; to help children, help the parents who come to us in their distress asking questions, 'What can we do to help our child be better adjusted?' " Rekers said.
Karl Bryant, a professor of women's and gender studies at the State University of New York at New Paltz, was also taken to UCLA as a child, as a part of a different study of effeminate boys.

Bryant said he thinks the more tragic part of Kirk's story is people "trying to do something good, trying to help ... even in a misguided mode, who end up producing these negative outcomes for people."

Bryant has studied the history of work done with children with opposite-sex behavior extensively, and said the studies are complex.

"I never have -- had tried to kill myself or thought that I was going to kill myself," said Bryant. "But I could identify with that pain of -- of feeling like you want to be something and other people want you to be something that you aren't."

'Unwanted homosexuality'
Rekers, who conducted the therapy on Kirk, went on to build a career of influence based on the premise from his research that homosexuality can be prevented.

He became a founding member of the Family Research Council, a faith-based organization that lobbies against gay-rights issues. Rekers was also on the board of the National Association for Research and Therapy of Homosexuality, an organization of scientists that says its mission is to offer treatment to those who struggle with what they call "unwanted homosexuality."

"He's viewed as an expert by some, you know, when it's -- when it serves their purposes," said Bryant. "So, you know, basically, conservative and what I would call mostly 'fringe' groups have really, you know, Rekers as their poster boy."

Just last year, Rekers' days as an anti-gay champion would come to an end. He hired a male escort to accompany him on his trip to Europe.

Rekers denies any sexual contact with the male escort. Rekers says he's not gay. He claims he wasn't aware that his companion offered sexual favors for sale over the Internet until after the trip, and says he hired him only to carry his bags. But the reporters who broke the story about Rekers' trip say they saw Rekers pushing a luggage cart through a Miami airport, where they took his photo.

After the scandal broke, Rekers resigned from NARTH. And the Family Research Council said in a statement they hadn't had contact with Rekers in "over a decade."

Rekers vacations with 'rentboy'
His reputation among those who oppose homosexuality may be tarnished, but his research is still being cited in books and journals.

As recently as 2009, a book Rekers co-authored, "Handbook of Therapy for Unwanted Homosexual Attractions," cites Kraig's case as a success. That was six years after Kirk Murphy took his own life.
For Maris Murphy, there is more to the story than what was written in case studies about her brother.

"The research has a postscript that needs to be added," she said. "That is that Kirk Andrew Murphy was Kraig and he was gay, and he committed suicide."

"I want people to remember that this was a little boy who deserved protection, respect and unconditional love," his sister said. "I don't want him to be remembered as a science experiment. He was a person."

Journalists Penn Bullock and Brandon K. Thorp contributed to this report.

Friday, June 3, 2011

New National Report Reveals that Adults with Mental Illness are Four Times more Likely to Develop Alcohol Dependency than Adults without Mental Illness

More serious levels of mental illness have higher rates of alcohol dependency
A new report shows that alcohol dependence is four times more likely to occur among adults with mental illness than among adults with no mental illness (9.6-percent versus 2.2-percent).

Based on a nationwide survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) the report also shows that the rate of alcohol dependency increases as the severity of the mental illness increases. For example, while 7.9-percent of those with mild mental illness were alcohol dependent, 10-percent of those with moderate mental illness and 13.2 percent of those with serious mental illness were alcohol dependent.

“Mental and substance use disorders often go hand in hand.  This SAMHSA study adds to the evidence of this connection,” said SAMHSA Administrator, Pamela S. Hyde, J.D.  “Co-occurring mental illness and substance use disorders are to be expected not considered the exception. Unfortunately, signs and symptoms of these behavioral health conditions are often missed by individuals, their friends and family members and unnoticed by health professionals. The results can be devastating and costly to our society.”

The SAMHSA Spotlight report, Alcohol Dependence is More Likely among Adults with Mental Illness than Adults without Mental Illness: was developed as part of SAMHSA’s strategic initiative on data, outcomes, and quality – an effort to inform policy makers and service providers on the nature and scope of behavioral health issues. The report is based on data from the 2009 National Survey of Drug Use and Health – a state-of-the-art scientific survey of a large representative sample of people throughout the United States. 

The full report is available on the web at http://oas.samhsa.gov/spotlight/Spotlight027AlcoholDependence.pdf .  For related publications and information, visit http://www.samhsa.gov/.

Wednesday, June 1, 2011

Culture improves physical, mental health

Published: May 24, 2011 at 8:33 PM
TRONDHEIM, Norway, May 24 (UPI) -- Doctors prescribe exercise to patients but Norwegian researchers say they soon may also prescribe going to the theater or taking up painting for better health.

Researchers Koenraad Cuypers, Steinar Krokstad, Turid Lingaas Holmen, Margunn Skjei Knudtsen, Lars Olov Bygren and Jostein Holmen of Norwegian University of Science and Technology analyzed participation in cultural activities and health involving more than 50,000 participants from 2006 to 2008.
The researchers say they found a surprising link between cultural activities and better physical and mental health.

The study, published in the Journal of Epidemiology and Community Health, found being involved in either receptive cultural activities, such as attending a theater performance or visiting an art show, or creative culture activities, such as painting or music that people participate in, was found to be related not only to good health, but to satisfaction with life and low levels of anxiety and depression.

Men seemed to get a greater perceived health benefit than women did but participation in creative and receptive cultural activities was associated with satisfaction with life, low anxiety and low depression in both genders.

"The results suggest that the use of cultural activities in health promotion and health care may be justified," the researchers say in a statement.

Reposted at darkestcloset.blogspot.com,

Advocates Question Plan to Eliminate California Mental Health Department

California mental health advocates are questioning a plan to eliminate the state’s Department of Mental Health. Rusty Selix, executive director of the Mental Health Association in California, said that a deputy director level position on mental health should be created in the Department of Health Care Services. Selix said that having a department devoted to mental health, all by itself, is an indication that it's a high priority for the state. "There's tremendous fear in the community of eliminating the Department of Mental Health, and to have nothing directly focused on that is a big concern," he said. "We're afraid of losing that attention." (California Healthline, 5/27/11)

Can this be true? Did they read the report about the suicide level in California's prison system?

Senators Push for Reversal of Policy on Condolence Letters

Sen. Barbara Boxer (D-Calif.) and 10 other senators are calling on President Obama to reverse the current policy of not sending condolence letters to families of service members who take their own lives. Although the White House promised in 2009 to review the policy, there has been no progress as of yet. "Unfortunately, perpetuating a policy that denies condolence letters to families of service members who die by suicide only serves to reinforce this stigma by overshadowing the contributions of an individual's life with the unfortunate nature of his or her death," the letter says. "It is simply unacceptable for the United States to be sending the message to these families that somehow their loved ones' sacrifices are less important." (CNN, 5/26/11)

Senate Panel Urges VA to Do More to Prevent Vet Suicides

With suicide rates among veterans increasing, Senate Veterans’ Affairs Committee members last week urged the Department of Veterans Affairs (VA) to do more to prevent veterans from taking their own lives. The VA reported that veterans accounted for roughly 20 percent of the 30,000 individuals who committed suicide in the United States last year. Sen. Patty Murray (D-Wash.), chairman of the panel, said that in at least 13 cases veterans completed suicide or died from drug overdoses while waiting to receive help from the VA. She noted that in April the VA's suicide hotline fielded more than 14,000 calls, or more than 450 a day, the most ever for a single month. (Miami Herald, 5/25/11)

Supreme Court Orders California to Reduce Prison Population

The U.S. Supreme Court ruled last week that California must reduce its prison population by more than 30,000 inmates, citing conditions that violate the Eight Amendment’s ban on cruel and unusual punishment. Justice Anthony Kennedy wrote that the prison system that failed to deliver minimal care to prisoners with serious medical and mental health problems and produced “needless suffering and death.” Suicide rates in the state’s prisons, Justice Kennedy wrote, have been 80 percent higher than the average for inmates nationwide. A lower court in the case said it was “an uncontested fact” that “an inmate in one of California’s prisons needlessly dies every six or seven days due to constitutional deficiencies.” (The New York Times, 5/24/11)

Smoking, diabetes, weight control targeted by fair

NEWARK -- The members of Mental Health America of Licking County's Compeer program planned their wellness fair Tuesday to focus on issues that were important to them -- among them, weight control, smoking cessation, cancer prevention and diabetes.

They also wanted the event to be welcoming to anyone who might happen by. Not in a sterile setting, said Compeer director Kristen Frame, but something more familiar -- hence their choice of the Licking County Library.

"They wanted to do a wellness fair that was peer-led, not intimidating," Frame said.

The Compeer organization, which serves people recovering from mental illness, regularly participates in service projects, Frame said. Tuesday was the first time they'd organized a wellness fair.

Frame said most of the visitors as of halfway through the event had been Compeer members.

Alhough they'd been hoping to attract more residents in the downtown Newark area, Frame said she was pleased with members who had stopped by to receive information from the almost 20 agencies and organizations who had set up booths there.

Because people with mental illness often die decades earlier than their peers without mental illness -- tobacco use and diabetes frequently are cited as causes -- those topics were among the ones spotlighted at Tuesday's event.

A Licking County Health Department display addressed the health hazards of tobacco use and a representative from Arensberg Pharmacy and Wellness Center offered blood sugar testing; representatives from Licking Memorial Hospital, Mental Health America of Licking County's Prevent Assault & Violence Education program and the American Cancer society also were on site to answer questions and pass out information.

Greeting visitors at the door were Compeer volunteers Becky Sforza and Jan Mardis, both of Newark, who were manning a bake sale table to raise proceeds for the organization.

Sforza was a Compeer member for about eight years before she became a volunteer, she said. The organization helped her overcome a lifelong struggle with extreme shyness, and she now is responsible for calling Compeer members to remind them of upcoming meetings.

She and Mardis met because they lived in the same Newark apartment building; they've been volunteering together with Compeer for several years and were glad to have input in the information that was available at the wellness fair.

They also were doing their part to contribute to the friendly atmosphere and spread word about Compeer.
"There's a lot of help out there for a lot of people if they just get it and use it right," Mardis said.
For more information about Compeer, visit mhalc.org/ compeer or call Frame at (740) 522-1341.
Abbey Roy can be reached at (740) 328-8546 or amroy@newarkadvocate.com. Reposted at darkestcloset.blospotcom.

The Deadline for Alternatives 2011 Workshop and Institute Proposals Has Been Extended!

The deadline to submit proposals to present workshops and institutes at Alternatives 2011 has been extended! The new deadline is June 14, 2011!

Everyone is invited to consider becoming a presenter at Alternatives 2011. First-time presenters are especially welcome! Learning from each other is a clear example of self-help, mutual support and the principles of recovery in action!

The Call for Papers is available for download or online submission at http://www.alternatives2011.org!
Reposted at darkestcloset.blogspot.com

HHS announces proposed changes to HIPAA Privacy Rule

A Notice of Proposed Rulemaking concerning the accounting of disclosures requirement under the Health Insurance Portability and Accountability (HIPAA) Act Privacy Rule, is available for public comment. The proposed rule would give people the right to get a report on who has electronically accessed their protected health information.

The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) is proposing changes to Privacy Rule, pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act. HITECH is part of the American Recovery and Reinvestment Act of 2009.

“This proposed rule represents an important step in our continued efforts to promote accountability across the health care system, ensuring that providers properly safeguard private health information,” said OCR Director Georgina Verdugo. “We need to protect peoples’ rights so that they know how their health information has been used or disclosed.”

People would obtain this information by requesting an access report, which would document the particular persons who electronically accessed and viewed their protected health information. Although covered entities are currently required by the HIPAA Security Rule to track access to electronic protected health information, they are not required to share this information with people.

The proposed rule requires an accounting of more detailed information for certain disclosures that are most likely to affect a person’s rights or interests. The proposed changes to the accounting requirements provide information of value to individuals while placing a reasonable burden on covered entities and business associates.

People may now read the proposed rule at: http://www.federalregister.gov/ and submit comments to http://www.regulations.gov/#!home (search for Proposed Rule) through August 1, 2011.

For additional information, click here

Action:

Review the rule and submit your comments.
 
Action Update Footer
The OF-1-MIND Campaign is a product of the Ohio Association of County Behavioral Health Authorities Foundation.


--


OACBHA offers multiple publications, to opt out of this one or subscribe to others visit this link.