Mental Health Awareness

The Patient As Advocate
March 22, 2009, 12:01 pm
Filed under: awareness, Education | Tags: , , , ,
Stand Up, Speak Up – Getting the Best Care for Yourself
Everyone has a role in providing the best health care for you – organizational executives, physicians, therapists, nurses and technicians. And, above all, YOU! You do this by becoming an active, informed, and involved consumer and member of the health care team. 

Medical errors are one of the leading causes of death in the United States, with almost 98,000 occurring annually according to the Institute of Medicine. The more involved we are, the less likely we are to have an adverse reaction. Ways to do this include

Speaking up if you have any questions or concerns, and ask again if you still dont understand. It is your body and you have the right to know.

Pay Attention to the care you are receiving. Make sure you are getting the right medications, for instance. Don’t assume anything. 

Educate Yourself about your diagnosis, any medical tests or procedures you will have done, and be an active participant in determining your treatment plan.

Ask a trusted family member or friend to be an advocate for you that can ask questions you may not think of under stress, and may not remember the answers to.

Know what medications you take and why you take them. Know their side-effects, and how long the side-effects should last if you are just beginning a medication. Learn if there is anything you can do to alleviate the side-effects. Medication errors are the most common health care mistake.

Participate in all decisions about your treatment. You are the center of the health care team.

After following these general rules, more specifically, try to:

Inform your doctors about medications your are taking, including prescriptions, over the counter drugs, and herbal or dietary supplements.

Inform your doctors about your allergies any any adverse reactions you may have experienced

Inform your doctors of any dietary restrictions you may have

Ask your staff for written information about possible side effects to your medications

Be an advocate of your own care. Ask your friend or relative to also be your patient advocate

Question your nurse, doctor, or pharmacist if your medications look different from the way they looked before, or if the number of medications is different

Learn about your condition by asking your doctor, nurse, therapist, or any other reliable sourse any questions you may have regarding your illness

Make sure that your prescriptions are legible

If you are in the hospital, when you are discharged if you have any questions regarding your treatment plan to be used at home, ask your doctors or staff for an explanation.

Finally, discuss any concerns you have with your caregiver in an assertive (not aggressive) manner.




Grading The States


 National Average is a D 14 States Improve Grades; 12 Fall Backwards State Budget Crises Threaten Ruin Washington, D.C. – The National Alliance on Mental Illness (NAMI) has released a new report, Grading the States, assessing the nation’s public mental health care system for adults and finding that the national average grade is a D.

Fourteen states improved their grades since NAMI’s last report card three years ago. Twelve states fell backwards. Oklahoma showed the greatest improvement in the nation, rising from a D to a B. South Carolina fell the farthest, from a B to a D. However, the report comes at a time when state budget cuts are threatening mental health care overall.

“Mental health care in America is in crisis,” said NAMI executive director Michael J. Fitzpatrick. “Even states that have worked hard to build life-saving, recovery-oriented systems of care stand to see their progress wiped out.” “Ironically, state budget cuts occur during a time of economic crisis when mental heath services are needed even more urgently than before. It is a vicious cycle that can lead to ruin. States need to move forward, not retreat.”

This is the second report NAMI has published to measure progress in transforming what a presidential commission on mental health called “a system in shambles.” NAMI’s grades for 2009 include six Bs, 18 Cs, 21 Ds and six Fs, based on 65 specific criteria such as access to medicine, housing, family education, and support for National Guard members.

“Too many people living with mental illness end up hospitalized, on the street, in jail or dead,” Fitzpatrick said. “We need governors and legislators willing to make investments in change.”

In 2006, the national average was D. Three years later, it has not budged. NAMI is the nation’s largest grassroots organization dedicated to improving the lives of individuals and families affected by mental illness.

Full Grading the States report online at:

How can I help myself if I am depressed?
February 27, 2009, 11:42 pm
Filed under: depression, Education, Resources

How can I help myself if I am depressed?

See your doctor or mental health professional to set up a treatment plan; this may include medication, support groups, or psychotherapy.

Try to be an active participant in your care. Stick to the treatment plan and educate yourself about your condition.

Engage in mild exercise: it has been shown to reduce depression symptoms.

Take care not to become isolated; stay involved with or expand your support network.

Make sure that you continue to do things that you love doing.

Set realistic goals for yourself. If you’re feeling overwhelmed by tasks of daily living, break up large tasks into smaller ones; set some priorities and do what you can as you are able.

Try to spend time with others and confide in a trusted friend or relative.

 Expect your mood to improve gradually. Often times with treatment, sleep and appetite will improve before your depressed mood dissipates.

Remember that positive thinking will replace negative thoughts as you respond to treatment.

Where can I go for help?

Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors.

Recommendations can come from your local NAMI affiliate, your health insurance provider, or the SAMHSA treatment locator (800) 729-6686, option #2).

Community mental health centers or outpatient clinics. Mental health programs at universities, medical schools, and state hospital outpatient clinics.

Family/social services or clergy.

Peer support groups or education programs can be found through your local NAMI affiliate, local hospital, or other mental health organization.

Employee assistance programs.

Check the phone book or internet under “mental health,” “health,” “social services,” or “physicians” for other resources.

If you are thinking of hurting yourself, please call a crisis line at 1 (800) 273-8255. You will be routed to the crisis center near you, or go to your local hospital emergency room.

Information adapted from,, and

Bipolar Disorder at work

Bipolar Disorder Exacts Twice Depression’s Toll in Workplace

Productivity Lags Even After Mood Lifts

Bipolar disorder costs twice as much in lost productivity as major depressive disorder, a study funded by the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) has found. Each U.S. worker with bipolar disorder averaged 65.5 lost workdays in a year, compared to 27.2 for major depression. Even though major depression is more than six times as prevalent, bipolar disorder costs the U.S. workplace nearly half as much — a disproportionately high $14.1 billion annually. Researchers traced the higher toll mostly to bipolar disorder’s more severe depressive episodes rather than to its agitated manic periods. The study by Drs. Ronald Kessler, Philip Wang, Harvard University, and colleagues, is among two on mood disorders in the workplace published in the September 2006 issue of the American Journal of Psychiatry.

Their study is the first to distinguish the impact of depressive episodes due to bipolar disorder from those due to major depressive disorder on the workplace. It is based on one-year data from 3378 employed respondents to the National Co-morbidity Survey Replication, a nationally representative household survey of 9,282 U.S. adults, conducted in 2001-2003.

The researchers measured the persistence of the disorders by asking respondents how many days during the past year they experienced an episode of mood disorder. They judged the severity based on symptoms during a worst month. Lost work days due to absence or poor functioning on the job, combined with salary data, yielded an estimate of lost productivity due to the disorders.

Poor functioning while at work accounted for more lost days than absenteeism. Although only about 1 percent of workers have bipolar disorder in a year, compared to 6.4 percent with major depression, the researchers projected that bipolar disorder accounts for 96.2 million lost workdays and $14.1 billion in lost salary-equivalent productivity, compared to 225 million workdays and $36.6 billion for major depression annually in the United States.

About three-fourths of bipolar respondents had experienced depressive episodes over the past year, with about 63 percent also having agitated manic or hypomanic episodes. The bipolar-associated depressive episodes were much more persistent — affecting 134-164 days — compared to only 98 days for major depression. The bipolar-associated depressive episodes were also more severe. All measures of lost work performance were consistently higher among workers with bipolar disorder who had major depressive episodes than those who reported only manic or hypomanic episodes. The latter workers’ lost performance was on a par with workers who had major depressive disorder.

“Major depressive episodes due to bipolar disorder are sometimes incorrectly treated as major depressive disorder,” noted Wang. “Since antidepressants can trigger the onset of mania, workplace programs should first rule out the possibility that a depressive episode may be due to bipolar disorder.”

Future effectiveness trials could gauge the return on investment for employers offering coordinated evaluations and treatment for both mood disorders, he said.

Also participating in the study were: Dr. Kathleen Merikangas, NIMH; Dr. Minnie Ames and Robert Jin, Harvard University; Dr. Howard Birnbaum, Paul Greenberg, Analysis Group Inc.; Dr. Robert Hirschfeld, University of Texas; Dr. Hagop Akiskal, University of California San Diego.

The National Institute on Drug Abuse (NIDA), Substance Abuse and Mental Health Services Administration (SAMHSA), Robert Wood Johnson Foundation and John W. Alden Trust provided supplemental funding.

In a related NIMH-funded study in the same issue of the American Journal of Psychiatry, Drs. Debra Lerner, David Adler, and colleagues, Tufts University School of Medicine and Tufts-New England Medical Center, found that many aspects of job performance are impaired by depression and that the effects linger even after symptoms have improved.

The researchers tracked the job performance and productivity of 286 employed patients with depression and dysthymia, 93 with rheumatoid arthritis and 193 healthy controls recruited from primary care physician practices for 18 months. While job performance improved as depression symptoms waned, even “clinically improved” depressed patients performed worse than healthy controls on mental, interpersonal, time management, output and physical tasks. The arthritis patients showed greater impairment, compared to healthy controls, only for physical job demands.

Noting that 44 percent of the depressed patients were already taking antidepressants when they began the study and still met clinical criteria for depression — and that job performance continued to suffer despite some clinical improvement — the researchers recommended that the goal of depression treatment should be remission. They also suggest that health professionals pay more attention to recovery of work function and that workplace supports be developed, perhaps through employee assistance programs and worksite occupational health clinics, to help depressed patients better manage job demands.



© 2001-2007 National Institute of Mental Health. All Rights Reserved

Book Recomendation


Hurry Down Sunshine

by Michael Greenberg (Other Press 2008. 238 pages.)

An excellent memoir—written by the father of a 15-year old daughter about her onset of bipolar disorder and its impact on their extended, blended family. His description of life on a psychiatric ward is exceptional: marked by critical insight and occasionally dark humor. He describes the uncertainty that marks the process of treatment and recovery, which will recur throughout his daughter’s life.

House and NAMI partnership
February 2, 2009, 7:36 am
Filed under: awareness | Tags: , , , ,



FOX TV’s HOUSE & NAMI Renew Partnership

The hit FOX TV drama House has once again teamed with the National Alliance on Mental Illness to raise money and awareness in support of people with mental illness and their families.

T-shirts bearing the slogan (or “House-ism”) “Normal’s Overrated” went on sale Thursday, January 22 with proceeds benefiting NAMI.

A similar partnership in 2007 raised over $130,000 for NAMI.

The 2009 partnership was announced to the media at an exclusive 100th episode party for the show last Wednesday in Los Angeles, where the NAMI logo was proudly displayed along the red carpet.  In addition, House cast and crew members each wore the special t-shirts to the event.

House is making an enormous contribution to public education by lending the show’s celebrity profile to raise funds,” said NAMI executive director Mike Fitzpatrick, who was in attendance at the event.

“NAMI thanks the producers, cast, and crew of House. You are making a difference in people’s lives.” Fitzpatrick added.

The event was covered by multiple media outlets including Entertainment Tonight which aired a piece featuring the cast of House discussing the relationship between the show and NAMI.

NAMI has created a special section on where visitors can purchase t-shirts, see highlights from the event, and even help NAMI by downloading a widget which can easily be added to social networking profile pages such as Facebook and MySpace. 

Join NAMI and House in celebrating this important partnership by purchasing your t-shirt today.

Facts and Statistics
January 25, 2009, 9:06 am
Filed under: Uncategorized


  • Workplace stress causes about 1 million U.S. employees to miss work each day. (AIS, 2003)
  • Work-related stress can double people’s risk of dying from heart disease. (BJM, Oct. 2002)
  • Workplace environments have a greater effect on employee stress levels than the number of hours employees work. (UA, 2003)
  • American employees used about 8.8 million sick days in 2001 due to untreated or mistreated depression. (NCQA, Sept. 2002; NIMH, 1996
  • Employee absenteeism due to depression costs U.S. businesses between $33 billion and $44 billion per year. (NCQA, Sept. 2002; NIMH, 1996)
  • Anxiety-related disorders cost the United States $42 billion a year in work-related and medical losses. (NIMH, 1999)
  • In a typical workplace with 20 employees, four will likely develop a mental illness this year. (NIMH, 2002)
  • The percentage of employers who offer insurance coverage for mental illnesses dropped from 84 percent in 1997 to 79 percent in 2002. (SHRM, 2002)
  • Workers who abuse drugs cost their employers twice as much in medical and worker compensation claims as workers who do not abuse drugs. (NIDA, 2003)


  • People who have major depression and anxiety disorders are 60 percent less likely to relapse if they exercise regularly and continue exercising over time than if they take medication alone. (PM, June 2003)
  • Depression is a major public health problem that affects up to 6 million American men and 12 million American women annually. (NIMH, 2003)
  • The treatment success rates for such disorders as depression (more than 80 percent), panic disorder (70-90 percent) and schizophrenia (60 percent), surpass those of other medical conditions, such as heart disease (45-50 percent). (NIMH, 2002)
  • Less than half of all Americans who have serious mental illnesses do not receive adequate treatment each year. (NEJM, 2005)
  • Although about 16 percent of American adults will develop depression at some point, only one-fifth will receive the care they need to treat the condition. (JAMA, June 2003)
  • An estimated 2.5 million Americans have bipolar disorder. The actual number may be 2-3 times higher since as many as 80 percent of people with this illness go undiagnosed or misdiagnosed. (NMHA, 2003)

Diverse Communities

  • Only 33 percent of African Americans enrolled in Medicare managed care health plans receive follow-up care after being hospitalized for a mental illness, compared with 54 percent of white Americans. (JAMA, March 24, 2002)
  • One-third of all Latinos (33.2 percent) lack health insurance coverage, a far higher proportion than any other ethnic group. (USCB, 2001)
  • Ninety percent of African American youths who enter the mental health system live in poverty. (USSG, 2001)
  • While the suicide rate for white teenage males fell somewhat between 1986 and 1997, the rate for African American male teens increased dramatically during the same period (7.1 per 100,000 to 11.4 per 100,000). (USSG, 2001)
  • Suicide rates among Native American adolescents and young adults account for 64 percent of all Native American suicides. (CDC, 2001)
  • More than three-quarters of teens (78 percent) report that kids who are gay or thought to be gay are teased or bullied in their schools and communities. (NMHA, 2002)
  • Up to 42 percent of teens who are homeless are also gay, lesbian or transgender. (GLBTP, April 30, 2003)
  • About 70 percent of Southeast Asian immigrants to the U.S. who receive mental health care have symptoms of post-traumatic stress disorder. (USSG, 2001)

Children and Families

  • Kids who say other students bully them at school are 50 percent more likely to admit they brought weapons to school during the past month than students who’ve never bullied or been bullied. (NICHHD, 2003)
  • Nearly 4 percent of boys and more than 6 percent of girls have symptoms of post-traumatic stress disorder caused by violence they have endured or witnessed. (JCCP, 2003)
  • Although as many as 8.1 million Americans age 12 and older have tried the illegal “club drug” Ecstasy, only 1 percent of American parents believe their children have taken the drug. (PDFA, 2002)
  • Five to 9 percent of children in the United States have a serious emotional disturbance. (USSG, 1999)
  • About 13 percent of children between 9 and 17 years old have an anxiety disorder. (USSG, 1999)
  • Between 3 and 5 percent of school-age children have attention-deficit hyperactivity disorder. (USSG, 1999)
  • An estimated 1 percent of teenage girls in the United States develop anorexia nervosa, and up to 10 percent of those may die as a result. (AABA, 2001)
  • Nearly two-thirds of boys and three-quarters of girls in juvenile detention centers have a psychiatric disorder. (AGP, Dec. 2002)
  • Only about 21 percent of children in the United States who need mental health services actually receive them. (AJP, Sept. 2002)
  • About every two hours, a young person commits suicide. (AAS, 2002)
  • Three million teenagers have considered or attempted suicide in the past year. (SAMHSA, 2002)
  • Suicide is the third leading cause of death among people under 24 years old after accidents and homicide. (CDC, 2002)
  • Families with children constitute the fastest growing segment of the homeless population – 41 percent, up from 34 percent in 2000. (NCH, 2003)

College Students

  • Ten percent of college students have been diagnosed with depression. (NMHA, 2001)
  • Seven percent of college students have an anxiety disorder. (NIMH, 2000)
  • Approximately 5 percent of college women have bulimia. (AABA, 2001)
  • The number of freshmen reporting “below average” emotional health has been on the rise since 1985. (UCLA, 2002)
  • More than 75 percent of college students reported feeling “overwhelmed” in 2001, while 22 percent were sometimes so depressed they couldn’t function. (ACHA, 2001)
  • The suicide rate among males between the ages of 15 and 24 has nearly quadrupled over the last 60 years, and the rate among females in the same age group has doubled. (CDC, 2002)

Older Adults

  • Older adults who are caregivers to spouses or other relatives may be at an increased risk for developing heart disease, arthritis, osteoporosis and some cancers due to long-term stress. (OSU, 2003)
  • Medical treatment outcomes are worse when complicated by mental health problems. For example, rehabilitation from a hip fracture or a heart attack is less successful and more expensive when complicated by depression. (NIMH, 2003)
  • About 11 percent of adults over age 55 have an anxiety disorder. (USSG, 1999)
  • While 4.4 percent of older adults have a mood disorder such as depression, up to 20 percent have significant symptoms of depression. (USSG, 1999)
  • Older men are far less likely to seek and receive treatment for depression than older women. (UCLA, 2003)
  • Older adults enrolled in Medicare pay 50 percent of outpatient mental health treatment costs, but they pay only 20 percent of costs associated with other medical services. (AMA, 2002)
  • About 17 percent of older adults qualified to receive benefits through Medicaid were not enrolled in their state programs. (NCOA, 2002)
  • The highest rate of suicide for any age group (19.4 per 100,000) is among people age 85 and older. The second highest rate of suicide (17.7 per 100,000) is among those between age 75 and 84. (AAS, 2002)
  • Men commit 83 percent of all suicides among people 65 and older. (CDC, 2001)


  • The poor health and premature deaths of people who lack health insurance coverage cost the nation between $65 billion and $130 billion annually. (IOM, 2003)
  • One in five American families has at least one member who lacks health insurance coverage, a situation that can place the entire family at risk for financial ruin and poor health. (IOM, Sept. 2002)
  • Parents in 19 states surrendered custody of nearly 13,000 children in 2001 to get their youth the mental health treatment the parents could not afford. (GAO, 2003)
  • Between 28 and 30 percent of the U.S. population has a mental health disorder, substance abuse disorder or both. (USSG, 1999)
  • Untreated and mistreated mental illness costs the United States $105 billion in lost productivity and $8 billion in crime and welfare expenditures each year. A 5.5 percent increase in spending by businesses and government on mental health treatment could cut these costs by half. (BJP, 1998; NMHA, 2001)
  • Full mental health insurance parity will increase insurance premiums by only 0.9 percent. (CBO, 2000)
  • Regular physical exercise can help people reduce stress, depression and anxiety, and enable them to cope better with adversity. (UNM, 2003)
  • More than 600,000 visits to hospital emergency rooms due to drug use were recorded in 2000. (NIDA, 2003)
  • Alcohol and drug abuse cost society about $245.7 billion in 1992. Of this amount, about 46 percent was borne by governments. (NIDA, 2003)

Key to References
AABA – American Anorexia Bulimia Association
AAS – American Association of Suicidology
ACHA – American College Health Association
AGP – Archives of General Psychiatry
AIS – American Institute of Stress
AJP – American Journal of Psychiatry
AMA – American Medical Association
BJM – British Journal of Medicine
BJP – British Journal of Psychiatry
CBO – Congressional Budget Office
CDC – U.S. Centers for Disease Control and Prevention
GAO – General Accounting Office
GLBTP – Gay, Lesbian, Bisexual and Transgender Health Access Project
HA – Health Affairs Journal
HU – Harvard University
IOM – Institute of Medicine
JAMA – Journal of the American Medical Association
JCCP – Journal of Consulting and Clinical Psychiatry
NCH – National Coalition for the Homeless
NCOA – National Council on the Aging
NCQA – National Committee for Quality Assurance
NEJM – New England Journal of Medicine
NICHHD – National Institute of Child Health and Human Development
NIDA – National Institute on Drug Abuse
NIMH – National Institute of Mental Health
NMHA – National Mental Health Association
OSU – Ohio State University
PDFA – Partnership for a Drug-Free America
PM – Journal of Preventive Medicine
SAMHSA – Substance Abuse and Mental Health Services Administration
SHRM – Society for Human Resource Management
UA – University of Arkansas
UCLA – University of California, Los Angeles
UNM – University of New Mexico
USCB – U.S. Census Bureau
USSG – Mental Health: Report of the Surgeon General