After losing his father and then his 21-year-old daughter in the months leading up to Christmas 2003, Paul Reed knew his holiday celebration would be drastically different.
“You just don’t feel very festive after that,” Reed said, explaining how his family decided to move the celebration’s location and adapted other traditions as well. “It changes the holidays forever onward.”
Family holiday celebrations can be among the most special events of the year. But they’re also ripe for potentially uncomfortable social interactions, ranging from heartbreaking — such as a recent death in the family — to just plain awkward — such as deciding how to tell your latest companion he or she isn’t actually invited to Christmas dinner.
In all cases, experts say communicating openly and embracing — or at least facing — reality are critical to making those get-togethers go smoothly.
“There is no replacement for open communication,” said Omri Gillath, a Kansas University associate professor of social psychology, who specializes in close relationships. “So as soon as you start planning your vacation or holiday, you should put the questions on the table and say, ‘What do you want to do?’”
Death in the family
Reed, a chaplain for the Visiting Nurses Association of Douglas County, said someone disappearing from a family circle not only changes relationships, it can also change economic realities and logistics. Talk about all of it, he said, from who will play host to Christmas dinner to, if necessary, a maximum budget for holiday gifts.
“The first thing to do is to just acknowledge the fact that things are going to be different,” he said. “Pretending that things are as they always have been is probably not productive.”
For those who are grieving, Reed suggested gently encouraging them to participate in holiday gatherings instead of withdrawing.
New traditions to try might include buying a gift in honor of the person who died and donating it to a charity or — if you have a creative family — gathering to make ornaments or other decorations that remind you of that person.
The Christmas he lost his father and daughter, who died in a car accident in early December, Reed moved his family celebration from his house to another adult child’s. In the next few years, they also moved from having all the children’s names on Christmas stockings to the grandchildren’s instead, shifting the focus to the youngest generation.
Reed also pastors a small church in Oskaloosa, where he enjoys the Christmas Eve experience of coming together as a community instead of limiting the holiday to family only.
“It’s neat sometimes to see people from very many different walks of life that come together on a Christmas Eve to enjoy carols and take communion together,” he said.
Breakups and blended families
Some couples that divorce stay friends; other splits get nasty. Decisions about whether to continue celebrating the holidays together should be on a case-by-case basis, Gillath said.
“You can try to do it for the kids,” he said, but added that may not be the best choice if tensions are too high: “Kids can sense it.”
For a newly blended family, the holidays can be a great opportunity to take the group’s relationship to the next level, Gillath said.
In either case, communication — again — is paramount. That goes for gifts, too. Establishing rules can help avoid divorced parents getting into an ugly gift-giving competition or, for a blended family, gifts being unfairly balanced among children.
In either family situation, be ready for change.
“It’s OK if things are not perfect,” Gillath said. “It doesn’t have to be Hollywood.”
Ah, to bring or not to bring the new love interest home for Christmas dinner?
Gillath said it’s best to put the question on the table sooner rather than later and just ask, “Do you want to do it together or alone?”
To help assuage the potential awkwardness of this conversation — because it’s one where both parties may not be on the same page — talk openly with no blaming or forcing, Gillath said. Tell your partner what you want, which should take into consideration that person as well as the relatives you might be taking him or her home to.
“Bringing your special friend home has a meaning for people,” Gillath said. “Even if it doesn’t for you, it might for other people.”
Consider whether your elderly grandmother or others might become attached to the guest. Consider how comfortable your parents — or whoever’s hosting the get-together — are with feeding an additional person and buying additional gifts. If you’ll be staying with relatives for an extended period of time, consider whether you’ll be comfortable having the love interest around that long, too.
“You want to think about the aftermath of all that,” Gillath said. “If it’s not that serious, maybe … you don’t want to force it into that.”
Single looking to mingle
If you’re single, the holidays can be a great time to stay that way, said relationship expert Rachel DeAlto, author of “Flirt Fearlessly: The A to Z Guide to Getting Your Flirt On.”
Not only can you avoid stressors such as whether or not to get the person you’re seeing a gift or wondering why you didn’t get invited to his or her holiday party, you can make the busy season work to your advantage, according to DeAlto’s tips.
For one, say yes to all the parties, happy hours and get-togethers you can.
“You never know who you could meet,” she said.
Also, the energy and electricity that buzzes around the holidays can be reinvigorating — which is always attractive.
“If you are enjoying the holidays, embracing the time you have with friends and family, and loving life, your confidence will soar,” DeAlto said. “So will your dating life.”
Enterprise — Michael Rutz is filled with anger, frustration and sadness. The day before, he attended the funeral and graveside services of his only son, Daniel, who died at age 28 after battling mental illness.
Daniel suffered from attention deficit hyperactivity disorder, bipolar disorder, major depression and anxiety. Rutz said he relied on prescription drugs to get through each day.
“He was always trying to find a way where he could just be at peace with himself and deal with life around him,” Rutz said. “He always said, ‘I want to be normal.’”
During the past two years, Daniel was in and out of two of the state’s three hospitals for the mentally ill —Osawatomie State Hospital and Larned State Hospital — 12 times. Some stays were three days and others were three weeks, and then he was referred to various outpatient programs. Before his death on Sept. 24, he was seeing a counselor about twice a month after being released from the Osawatomie hospital in August.
“We have no long-term care in Kansas where we can work with people,” Rutz said. “We give them some medication and we kick them out. There’s nobody to work with them.”
State mental health advocates say that, unfortunately, this father’s story is common. They receive at least 100 calls a year from people with similar frustrations.
“Long-term care for many people is an evasive concept. For many it’s the community jail or the streets or the prison or the revolving door,” said Rick Cagan, executive director of the Kansas chapter of the National Alliance on Mental Illness, or NAMI.
He said one in 17 adults experiences a serious mental health disorder, like major depression, in any given year, and the services available to help treat them are limited.
Amy Campbell, lobbyist and coordinator for the Kansas Mental Health Coalition, said the current system is so underfunded that it is just trying to stabilize residents in crisis instead of providing all of the community supports that are needed for individuals to get better.
“This is one of the reasons why diagnosis of a serious mental illness is often kind of a death sentence in the sense that they won’t live a normal lifespan. These folks often die much younger than they ought to, and it’s terrible,” she said. “When we are spending all of our time trying to plug the holes of the immediate crisis, how are we able to work to improve our overall system of care?”
Rutz, 57, an Army veteran and special education teacher at Abilene High School, talked about his son’s mental illness and the multitude of obstacles he faced in trying to get him help during a two-hour interview at his home in the small central Kansas town of Enterprise, where he serves on the city commission.
“Daniel loved to go bicycling, he loved the outdoors and liked to go fishing and hunting,” Rutz said. He left the living room and came back with a collage of photos that he had framed in memory of his son. They showed Daniel as a baby, playing as a boy and smiling as a teenager and adult. These were his good days.
Daniel was born in Manhattan and grew up there with an older and younger sister. Rutz described him as an active boy who liked to get into mischief. He recalled touring a castle while on a family vacation in Austria and Daniel, about age 7 at the time, wanted to get in a 200-year-old canon and then he got stuck.
“We thought we might have to cut him out of that cannon, but we finally got him unwedged and out of the cannon,” he said, with a smile.
As a teen, his dad said, he started hanging out with the wrong crowd and drinking too much alcohol and using illegal drugs like marijuana. He was in and out of treatment for substance abuse. He attended Manhattan High School through his sophomore year and received a General Educational Development degree. Then he worked at a number of places, including Fort Riley, Solomon Corp. and Great Plains in Abilene.
“He was a very good worker and could do just about anything, but he had a hard time keeping jobs because he had a hard time getting up out of bed to go to work,” Rutz said.
At age 21, Daniel had a son, Ryan, with girlfriend Cassie Pemberton, whom he met in grade school.
Pemberton, 26, of Shawnee, said they had an off-and-on-again relationship because of his mental illness — something she admits she just couldn’t understand.
“When Ryan was born, I had a C-section and he did everything for the first week. Daniel was always loving and caring and a good guy when he could be there,” she said.
Through his 20s, Daniel’s depression and anxiety became severe. He no longer wanted to be around people and would sleep a lot. That was the main symptom, his family said, but sometimes he couldn’t sleep or eat. He depended on prescription medications to get him through each day, and his dad became an advocate for him — he had to.
Rutz called legislators and various treatment centers in seek of help for his son. With the help of U.S. Sen. Pat Robert’s office, he was able to get his son on disability and the Medicaid program. Daniel received $900 a month — not enough to cover his treatment, housing and food. He had to spend $2,800 every six months before he was eligible for free care for medicine or a doctor’s appointment.
When it came to finding an inpatient treatment facility, Rutz said they either cost more than $15,000 for a 30-day stay or they didn’t accept Medicaid.
“I’ve talked to many people, from CEOs all the way down to factory workers, who have gone through this type of situation — frustrated, had to mortgage their house in order to send their kids to an inpatient care facility and they only last 30 days,” he said.
During the interview, Rutz would refer to two huge folders that contained documents about Daniel’s treatments, all of which were running together like one big nightmare. Every once in a while, he would thumb through them for information.
He said Daniel often went into state hospitals because he was under- or over-medicated and as a result would be out control. So, Rutz would either meet him in or take him to a hospital emergency room where he would be screened. If the screeners thought he was a threat to himself, they would send him to a state hospital. If not, they would give him medication and send him home. If he was sent to a state hospital, he would be stabilized with medications and then referred to a center for outpatient treatment. But, Rutz said his son was never stable enough to be on his own. He couldn’t be trusted to get that outpatient care, and he desperately needed psychological counseling and someone who could help control his medications.
“I am not saying that Daniel wasn’t at fault for this because it was part of his responsibility to cooperate, but we did not do a very good job of helping him,” Rutz said.
Rutz said half of the time his son would seek help on his own and other times he had to go involuntarily. Because Daniel was an adult, there was only so much Rutz could do, which was frustrating. He did have control over Daniel’s finances and tried to monitor his medications so he didn’t take too much. Rutz said although his son signed a release of information, some doctors were better about sharing information than others.
“The problem is Daniel, like others, thought he could control the medication on his own but he couldn’t,” Rutz said. “We butted heads a lot. We disagreed a lot, and he thought I was controlling him too much.”
Rutz found an apartment for his son in Manhattan, and that’s where he was living before his last hospitalization. Rutz said they called each other every day. If his son didn’t call, he would ask Daniel’s mother, Ulrike Rutz, or his sister to check on him.
“If Daniel didn’t live in my house, I never knew when that phone call was going to happen,” Rutz said. “He would call me and always tell me he loved me. He needed that reassurance. He was a very sensitive individual.”
Cagan, of NAMI, said his nonprofit agency has long talked with state leaders about the lack of continuum care for people with mental illnesses. He believes most people with serious mental illness can live independently as long as they get the treatment and support that they need at the community level.
The problem is that Kansas has cut $38 million in funding for mental health services during the past four years, according to a report “State Mental Health Cuts: The Continuing Crisis” that was released last November by NAMI. That funding was for Mental Health Reform grants, Medicaid patients, a Community Support Medication Program and psychiatric inpatient screenings, among other services. Kansas ranked ninth in the nation in cuts to funding for mental health services.
Cagan said he would like to see more community hospitals providing “crisis or stabilization” beds, where patients can have a chance to be safe and “chill out” before everyone determines whether the person is going home or to a state hospital. He said it’s a lower cost option than shipping them to a state hospital or sending them home too quickly where the situation may worsen to the point that law enforcement has to get involved.
Additionally, he said there needs to be more intensive treatment options. Such options could include programs where case managers check in with patients daily, offer counseling more than once a week and/or provide peer support similar to a sponsor in Alcoholics Anonymous. “The formula for recovery is complex and has to be individualized,” he said. “Too often, the public and health centers and doctors and families think treatment equals a prescription, and that’s very shortsighted in our view.”
Another problem is state hospitals are underfunded at a time when they are needed most. He said more people are seeking treatment because the stigma isn’t quite what it once was and because symptoms tend to flare up during tough economic times. “The state hospitals have had huge issues with being over census, so patients are being released without being able to be supported at the community level. The pressure is there to push them out the back door because there are so many waiting at the front door. Now, the state will deny these claims, but I think the evidence is there,” Cagan said.
Campbell, of the Kansas Mental Health Coalition, said access to mental health services isn’t just a problem for the uninsured, but for everybody because insurance dictates how much treatment someone can receive. Too often, it’s not enough.
Campbell said evidence shows that people with mental health issues are more likely to succeed and more likely to be weaned off medications that may have very serious side effects if they are engaged in cognitive behavioral therapy and peer support groups. She’s lobbied for such changes under the state’s new program for Medicaid, called KanCare, that’s set to begin Jan. 1.
“It would be advantageous for the Medicaid program because that individual would be more likely to achieve a better level of functioning and their need for expensive medications and state hospitals would be less,” she said. So far, Campbell said she hasn’t received an answer about whether the program will include all three types of care. Her fear is that the three companies hired by the state to run the Medicaid program will put more restrictions on accessing care, but she’s hopeful that won’t be the case.
Like Cagan, Campbell also believes more services need to be added at the community level. She said the state lacks the support that a patient needs once he or she gets out of state or private hospital. “There are really no good options for supervised care or residential care within communities and so we find ourselves trying to fit the people to what’s available instead of getting the treatment to the person,” she said.
Daniel’s last hospital stay was July 26 through Aug. 10 at Osawatomie State Hospital in August. Once released, he lived with his dad who was trying to get him treatment through a Central Kansas Mental Health Center.
Rutz said the last time he saw a counselor was Aug. 22. About Sept. 17, he saw a doctor who refilled his medications for 30 days. Rutz said Daniel was suppose to have seen a counselor at least twice a month, but he didn’t and no one followed up to ensure it was done.
“He was having a hard time with depression and staying in his room more,” Rutz said. “I encouraged him to get out and do something — bike, see people, go to the gym with me.”
On Sept. 23, Daniel traveled to Shawnee with his girlfriend and his son. They had a great time, Pemberton, the girlfriend, said. They went to a store to rent movies and Daniel ended up playing around on a skateboard that was among some toys. That night, he read to his son and gave him a necklace. The next day, Pemberton went to work and when she came home Daniel was still in bed. She didn’t think much of it because it was typical for Daniel. A while later, she checked on him again and realized something was terribly wrong. She called 911 and performed cardiopulmonary resuscitation, but it was too late. While the official cause of death has not been determined, the family believes it was an unintentional overdose of prescription medications.
Pemberton said Daniel talked about his illness with her the night before and thought he might need another hospital stay because it provided more structure. “He knew that he needed help, but I don’t think he knew how to get it,” she said.
Pemberton’s sister made the agonizing call to Daniel’s parents and she reached his stepmother, Renauda.
Rutz said, “It seemed like it took her an eternity to tell me that Daniel had died.” The tears began to fill his eyes. “We knew it could have been possible. We dreaded that call.”
At first, he said he was filled with rage and he bruised his hand by punching a wall.
“I was upset because,” he said and paused, struggling to get the words out. “You go back and you flash in your mind, “Did I spend enough time with him? Was I there enough times? Could I have done more?”
Rutz said he and his wife jumped in the car and rushed to Shawnee because he wanted to hold his son one last time, but he was too late. Through tears, he grabs a cross that’s on a necklace he’s wearing. “This is a cross I got him in June that says “Love dad,” he said. “It was for his birthday.
Pemberton said Daniel and his dad were close. “He did everything for his son. There is nothing more that he could have done,” she said.
One year ago, Rutz started a new group in Abilene called the “Family Support Team.” The group meets quarterly and involves agencies like the American Red Cross, Kids in Crisis, the police department, the sheriff’s department and a food bank. The group had its first “Family Resource Day” on Sept. 29 and about 100 families attended.
“I started this because I knew how difficult it was for me to get answers. It wasn’t easy for me to track down disability,” Rutz said. “I think information is very powerful. The more you know, the more you can help yourself and your family.”
MENTAL HEALTH RESOURCES
• Kansas chapter of the National Alliance on Mental Illness: 800-539-2660 or namikansas.org.
• Kansas Mental Health Coalition: 785-969-1617.
• Association of Community Mental Health Centers of Kansas Inc.: 785-234-4773 or acmhck.org.
• Keys for Networking Inc.: 785-233-8732 or keys.org.
By Associated Press
WICHITA - Scarce mental health resources in Kansas are boosting county jail populations with inmates who might be better served in a psychiatric ward than behind bars.
Some counties such as Johnson and Shawnee have created pods at their jails where prisoners suffering from mental illnesses are segregated from the general population.
But in Sedgwick County, the state's second most-populous county, Sheriff Robert Hinshaw has tried and failed for three years to get such a pod built at the county jail.
The Wichita Eagle reported that Hinshaw, who lost his re-election bid in August, said 49 inmates out of the jail's average population of 1,463 would be housed in a mental health pod, if the jail had one, and there are about 225 others who are taking some form of medication for mental disorders.
Of those 49 inmates, 43 are in custody on felony charges, including seven who are charged with murder or attempted murder.
"It's frustrating," Hinshaw said. "I think it's something that we do need in the Sedgwick County Jail. Right or wrong, regardless of how you feel about it, we see more people with mental illnesses being incarcerated, and we need to have the tools to provide the proper level of care."
Jails have become mental health institutions to some degree because the state's mental hospitals have waiting lists, and most counties, including Sedgwick, don't have long-term facilities for people with mental illnesses.
The average length of stay for an inmate is 28 days, but for the 49 inmates Hinshaw would house in a special pod, the average is 165 days. Sedgwick County spends nearly $68 per day to house one person in the jail.
With an average daily population of 650 to 700 inmates, Johnson County estimates about 17 percent of its inmates are mentally ill.
Johnson County's jail has two special units for people with mental illnesses, one for men and one for women. The sheriff's office also has started a "forensic assertive community team" that tries to help people reintegrate back into society after leaving jail.
Tom Erickson, a spokesman for the Sheriff's Office, said the county's special pods helps reduce the time mentally ill inmates spend behind bars because of the attention they receive while there.
"In the end, the more effectively we work with our mental health population while they're in custody and keep them on their medications, the less likely they are to come back. Although we invest some money up front, in the long run it's much more cost-effective," Erickson said.
He said an inmate struggling with mental illness might get back on medications in jail, but not have the resources to stay on them after being released. He said the county works with inmates to get them help the help they need to stay out of jail in the future.
Shawnee County, whose jail is operated by the county Department of Corrections, has three pods for people diagnosed with mental problems.
Richard Kline, director of the department, said one pod is for inmates on suicide watch, one is for inmates "you can't put in a general population" because of mental illness, and the third is available for inmates who may have a combination of mental and medical problems.
"It's a constant balancing act," Kline said. "We're the largest inpatient mental health facility in Shawnee County. We just are."
Shawnee County has been using special pods since 2002, Kline said. It has an average inmate population of about 475, and about 20 percent have serious and persistent mental illnesses.
"The economy is tough all over, so community resource dollars are tightening up," Kline said. "Access to the state hospitals is becoming more and more difficult. So even if someone wants to voluntarily commit themselves to Osawatomie or Larned, they've got a waiting line. If they don't have adequate support systems, well then, something happens and they end up in jail. The lack of state mental health facilities is a ripple effect. It ripples back to the community and then within the community, they end up in the jail."
BY JENA AND ED BLOCH
“Blame is just a lazy person’s way of making sense of chaos.” — Doug Couplan
Language is a useful tool. It is intended to help us ease communication. However, language can distort and mislead us. Language is interpretive, created out of mind and therefore capable of great story-telling. And as we know, stories can be based in fiction or nonfiction.
Stories may oversimplify, use unnecessary complexity, misdirect, lack specificity, distort information and be overly dramatic. In spite of our mind’s ineffective or inaccurate interpretations, these stories are all we have to describe our mental state.
And it is from these stories that mental health professionals create diagnoses and treatment plans. It is also from these stories that the story teller develops and reinforces attitudes and belief systems about him or her and the world.
When someone sees a mental health professional, he or she describes an experience they are having. The descriptive words are considered “symptoms.” These symptoms are then used as evidence of a disorder, such as depression, anxiety, etc.
What are we really describing when we relate our symptoms? What is driving the story we are telling? Is our interpretation accurate? First, let’s consider what symptoms really are.
Symptoms are the result of the accumulation of an individual’s unconscious internal experiences engaging with external forces. In other words, symptoms are caused by waves of internal energy.
These waves of energy come from genetic forces, experiences in the womb and at birth, childhood experiences, and more recent experiences of adolescence and adulthood. Our experiences are absorbed by the brain and all the cells in our body. These experiences are stored as brainwave and cellular energies. They are then triggered or stimulated by something within our environment creating a feeling (a wave of energy) and the resulting symptom (emotion).
Sometimes when emotional symptoms become so uncomfortable that our own healthy and not-so-healthy efforts to soothe them fail, we find ourselves in the office of a mental health professional telling our story. But again, when our story is a description of so many unconscious experiences, how do we know the story is accurate? Unfortunately, more often than not, the desire for relief from discomfort overrides the need for accuracy.
Regardless of the accuracy of the story, some interventions may offer some relief.
Counseling can help soothe by altering the story, giving the story a new twist, resulting in an altered belief and a different current experience. (We do know that our beliefs can affect our cells and therefore the energy produced. For more, read “The Biology of Belief” by Bruce Lipton).
Medications may help change the experience of the energy waves previously described and provide some relief (along with some potential side effects).
Exercise, a change in nutrition, improved sleep and other lifestyle changes can alter the effects of the energy waves.
Meditation can have short-term and, with a dedicated practice, long-term impact on how energy manifests within and can therefore reduce symptoms.
There are a variety of alternative and traditional modalities that can alter the effect of old energy patterns. There are even processes (“The Presence Process” by Michael Brown and Brainwave Optimization by Brain State Technologies are examples we have discussed in previous columns) that are viewed to alter energy at the causal point.
Why have this discussion? If we are to most effectively change our experience, we need to be conscious of the unconscious patterns that exist within and work with those energies rather than the triggers to their activation.
Our tendency is to blame the current circumstances for our discomfort. A co-worker, a spouse, a friend may be blamed as the cause of our discomfort when in fact they are mere triggers to old energy patterns. Aside from trying to get back at the perceived offender, we may even consider dramatic reactions like changing our workplace, getting a divorce or getting rid of the friend. These reactions are akin to trying to fix clogged pipes by cleaning out the sink.
IMPORTANT NOTE: If you are being abused by a co-worker, spouse, or friend there is no discussion. Get away from the abuse.
Since unconscious patterns are driving our symptoms, the first step is to make them conscious. This will place the blame firmly where it belongs, on old energy patterns.
Getting conscious requires slowing down reaction time. Practice will tell you what will work to create greater consciousness and change the intensity of your reaction.
Here are some tips to getting conscious and becoming less reactive:
Don’t blame the other person or situation for your discomfort. “This is my reaction and I will manage it.”
When you are experiencing discomfort, ask yourself, “Does the current situation match the intensity of my reaction?”
It is often helpful to remove yourself from a situation for a brief time to get conscious. A brief restroom break with an adult conversation in the mirror may do the trick.
Have you experienced this emotional state before? Is it similar to a childhood experience?
What are the words you are using to describe your experience? Are they accurate to the current situation? If not accurate, offer yourself a more accurate description.
Stay with the facts. Ask yourself to look at the interaction that triggered your discomfort and remove the drama. What are the facts without your emotional interpretation?
— Jena and Ed Bloch can be reached at email@example.com.
FORT RILEY (AP) - A group of top Army officials is in Kansas to wrap up a national assessment of the physical and mental health of soldiers and their families.
The officers have spent the week touring Army posts in Georgia, North Carolina and Texas. They'll discuss their findings Friday afternoon at Fort Riley after reviewing services and facilities at the northeastern Kansas post.
The delegation is led by Gen. Lloyd Austin, the Army's vice chief of staff.
Programs reviewed by the team include suicide prevention, care of wounded soldiers, prevention of sexual assault and evaluation of disabilities.
If you think postpartum depression just affects mothers, think again. Dads can suffer, too.
Carrie Wendel-Hummell, a graduate student in Kansas University’s Department of Sociology, said a 2010 study found that 10 percent of fathers experience depression within one year of having a child, which is twice the normal rate for depression in men.
While maternal postpartum depression is prevalent and can have negative personal, family and child developmental outcomes, she said there is less research on the prevalence, risk factors and effects of postpartum depression among fathers.
Wendel-Hummell said often postpartum depression is portrayed as a problem of hormones, but it involves many other factors such as sleep deprivation, social isolation and financial strain.
“Many mothers and fathers are getting postpartum depression and other mood disorders well after the hormones are supposed to be back to normal,” she said.
Since May 2011, has been interviewing parents who have went through an emotionally difficult time after the birth of their first child as part of her dissertation research project. She wants to learn more about the causes of distress and how they differ between moms and dads.
Among those she has interviewed is Kyle Stern, 29, of Kansas City, Mo., who suffered anxiety after the birth of his 19-month-old son Sam.
At the time, he knew he wasn’t himself, but he wasn’t sure what was wrong until he searched online and found some dad blogs.
“There was one where a dad talked about how he was a survivor of paternal postpartum depression or something like that,” Stern said. “It was the first time I had even heard that dads might suffer.”
During the first three months after Sam was born, Stern had a lot on his plate.
He was working a full-time job in information technology, pursuing a master’s degree in education at Kansas University and taking care of household chores. And his wife, Amelia Stern, 29, a school psychologist, was suffering postpartum depression. That meant he also was taking care of their newborn most of the time. Amelia said at her lowest point, she wanted to run away because she didn’t feel like she was being a good mother.
With the help of medications, she recovered and that’s when Kyle let down his guard and his postpartum depression started to show.
“Kyle was so busy taking care of me and compensating for everything that I was going through that he didn’t really have time to take care of himself and process what he was going through,” Amelia said.
She said Stern is typically laid back, loving, helpful and a good problem-solver, but that had changed. He became more short-tempered and grumpy and small daily tasks would overwhelm him, especially when Sam cried.
“When Sam was fussy, it almost felt like the world was closing in around me,” Kyle said. “It was like I wanted to be the best dad but felt like I was failing when the baby cried. Thoughts like, ‘I can’t take care of my own baby started to creep in.’”
At times, he said it felt like everything was happening at once and that everyone was talking louder and louder.
“It’s almost like I perceived things completely different than what was actually happening. Everything seemed to be elevated, like if Sam was crying it seemed to be the worst cry,” he said.
Sometimes, he would lose his temper and that frightened him the most.
“It’s like where did this loving person and guy that wants to be a great dad go during this experience,” he said. “It’s like I become a completely different person.”
After talking to his wife, he decided to approach his primary care doctor in Lawrence. The doctor helped Kyle figure out that he was suffering from anxiety and not so much depression and then prescribed medication for him. With a few days, Kyle said he noticed a difference.
“Things didn’t stress me out so much, so it was a great breakthrough for me,” he said.
Wendel-Hummell said she would like to see more education for fathers and a screening process. Currently, there’s nothing available because fathers don’t go to the doctor for a postpartum checkup like mothers do.
Melissa Hoffman, a state coordinator for Postpartum Support International, said men often are at higher risk for postpartum depression when their wife is suffering. She said while the symptoms are similar, there’s often a later onset.
“There’s a lot of reluctance to talk about it just like with moms and maybe even more so because of the idea that a man shouldn’t have those feelings,” Hoffman said.
HAVE YOU SUFFERED?
Carrie Wendel-Hummell, a Kansas University doctoral student, is conducting research on parents who went through an emotionally difficult time after the birth of their first child. She is looking at the differences between mothers and fathers. Her goal is to conduct interviews with at least 45 parents.
To qualify, parents must meet the following criteria:
• You had strong feelings of sadness, fear, anxiety, anger or frustration after your first child was born.
• You were married to or living with the child’s other biological parent when your first child was born.
• You are 18 years old or older.
For more information or to participate contact, Wendel-Hummell at 785-393-6366 or firstname.lastname@example.org.
Two years ago, Karen Meats thought she would be celebrating the joys of being a grandparent after her daughter Sara Vancil had a baby girl, but it ended up being what she described as a nightmare.
“It was probably the most terrifying thing that I have ever witnessed,” she said. “It was like I lost my daughter.”
Lawrence resident Vancil, 32, a financial aid administrator at Kansas University, suffered from severe postpartum depression after the birth of her first child, Tessa. She believes there were a number of things that contributed to the mental illness, and it started with a rare birthing experience where Tessa was born in just two hours.
When she went home, she was unable to eat and retain the food, and she couldn’t sleep. Then, she had issues with breast-feeding.
“I’m a very Type A person, definitely on top of things and in control,” she said. Suddenly, she felt out of control.
“I started developing anxious thoughts like, ‘I can’t do this,’ ‘I want my life back,’ and ‘This is a huge mistake,’” she said. “Once those thoughts are in your head, you have a hard time getting rid of them.”
She didn’t feel a bond with her baby and was talking to her mom and 32-year-old husband, Brian, about giving her up for adoption or running away. Meats said her daughter didn’t really help care for Tessa and when she did, it was regimented. She recalled Vancil giving her a bath and how she didn’t play with Tessa or kiss her.
“It was pour the water over her head, wash her hair, get her out and try to get away from her and back to bed,” she said. Meats said they also went through a bargaining stage where if she fed Tessa, then she could go back to sleep.
Two weeks after the birth, Vancil had a breakdown and she started crying and becoming hysterical. She even talked about suicide.
Her husband, who had suffered from depression for years, called Stormont-Vail HealthCare in Topeka and she was admitted voluntarily.
“We were familiar with the signs, the symptoms, the treatment,” she said. “I think his level of knowledge when he saw the struggles I was going through was maybe more advanced than other dads might have been, so I think he got me help a little bit faster.”
Vancil was released after about five days and they connected her with a case manager in the Healthy Families program through the health department. She said a lot of her anxiety was about being a good parent and so they thought more education would help. She also was prescribed medications.
“The key thing was I just wasn’t feeling bonded with my daughter. I think that’s a common feeling among a lot of moms with postpartum depression experience,” she said. “It’s not an automatic thing. It’s not so fast or natural, but it makes you feel really guilty and then the guilt is just this self-perpetuating cycle.”
During the first three months after Tessa was born, Vancil tried a number of medications and treatments including attending a Lawrence postpartum support group, seeing a therapist at Bert Nash Community Mental Health Center, where she went through its intensive outpatient program, and seeing a psychiatrist in Kansas City.
Vancil was hospitalized again at Stormont-Vail and then at Two Rivers in Kansas City, Mo.
“In all of my treatment, I was never really treated by anyone who had experience, training, interest or knowledge of postpartum mood disorders,” she said. “I don’t recall ever being screened specifically for postpartum conditions. I was always treated as if I just had depression.
“I felt like I had developed this condition that was going to last forever. I was never reassured that it was temporary.”
Vancil believes the turning point in her recovery was when her menstrual cycle returned about three months after giving birth. She and Brian were staying in McPherson with their parents at the time.
“For me, it was like a switch turned on,” she said. “One day, I was just better. Things started to lift. I started to feel like smiling again.”
Her mother won’t soon forget receiving a call from Brian’s dad who said she was changing Tessa’s diapers and playing with her. Now, the two are as close as a mom and daughter can be.
“They are attached at the hip,” Meats said, with laughter. “Sara’s an awesome mom.”
WHERE TO GET HELP
• The Pregnancy & Postpartum Resource Center of Kansas City — 866-363-1300.
• Postpartum Support International's Kansas coordinators — 785-550-6795, 785-505-3081 or 913-530-3837.
• Headquarters Counseling Center’s 24-hour service — 785-841-2345.
• Bert Nash’s 24-hour service — 785-843-9192.
• National Suicide Prevention Life-Line — 800-273-8255.
• Lawrence Memorial Hospital emergency room — 785-505-6100.
Lawrence nurse starts support group for mothers who suffer from postpartum mood disorders after suffering herself
Four years ago, Melissa Hoffman started a support group in Lawrence for women who suffer from postpartum mood disorders.
“When I went through it, there was nothing in Lawrence. I was a childbirth educator and a nurse, but I just felt so alone. I felt like nobody else felt like this,” she said.
She had panic attacks and intrusive thoughts that caused her reluctance to seek help. She finally reached out to her doctor when her son was 9 months old.
“I was just offered a prescription for a medication and sent on my way without any explanation of what was happening to me,” she said.
Four months later, she attended a presentation by Pec Indman, author of “Beyond the Blues,” in Lawrence. She went to take notes for her job.
“It was like, ‘Oh my God. That’s me. She’s talking about me,” Hoffman said. She bought the book and read it that night. Then, she reached out the Pregnancy and Postpartum Resource Center in Kansas City and spoke to the founder Meeka Centimano, who also experienced postpartum depression.
“It was the first time I didn’t feel alone,” Hoffman said. “I promised myself when I recovered that there would be something in Lawrence.”
Not only does she lead a weekly support group at Lawrence Memorial Hospital, but she’s also a volunteer for the Pregnancy and Postpartum Resource Center and she’s Kansas coordinator for Postpartum Support International.
“So often women don’t seek help because of the stigma that surrounds it and for fear of what people might think,” she said. “There’s also fear of, ‘Will they take my baby away?’”
Hoffman said 80 percent of women will experience what’s called the “baby blues” or the normal adjustment period. “It’s like an emotional roller coaster ride and getting used to your role as a new mom,” she said.
Baby blues should be resolving and getting increasingly better within two to three weeks.
If conditions persist past the three-week mark, Hoffman said women should seek medical help. Postpartum depression occurs after one out of eight deliveries. While it’s called postpartum depression, women can suffer a range of mood disorders, such as anxiety, post-traumatic stress disorder, obsessive compulsive disorder, panic disorder and psychosis.
“Women often have more than one and they often cross over,” she said. “These are all separate diagnoses and one won’t lead to the next. Depression may become more serious depression but won’t lead to psychosis.”
Symptoms of postpartum depression include: crying, sadness, anger, change in sleep, change in appetite, loss of pleasure, headaches, stomachaches and rapid heart beat. Hoffman said symptoms can appear in pregnancy 10 percent of the time.
Women also can have intrusive or disturbing thoughts and they often are associated with the baby.
“These women are the very least likely to ask for help because they are so horrified and disturbed by the thoughts,” Hoffman said. “They are at high risk of suicide because of the guilt they feel from having those thoughts.”
Hoffman said these intrusive thoughts should not be mistaken for psychosis. Psychosis involves hallucinations and delusions, which the woman does not recognize as alarming. Psychosis is a break from reality and it is a mental health emergency.
“Women are not to blame in this,” Hoffman said. “They didn’t do anything to cause it, but there are things that put them at risk.” She puts the risk factors into three categories:
• Medical — history of infertility, thyroid disease, severe premenstrual syndrome and mood changes while taking birth control or fertility drugs.
• Social — poor system of support, stressful life events like a move or job change, quick return to work and short hospital stay.
• Emotional — family or person history of mood illness, poor stress coping skills, early childhood issues, relationship problems, loss of loved one, previous episode of postpartum depression and symptoms during pregnancy.
Hoffman said women should get a medical evaluation to rule out other illnesses. Then, there are three treatment options: medications, therapy and social support.
Hoffman said her support group, “Build Your Village,” meets Monday evenings, and the attendance typically ranges from 2 to 8.
“It’s a place to talk and not be judged. We support each other but try not to advise,” she said. “It’s a lot of things to a lot of people.”
Hoffman said there’s still a lack of resources and services in Lawrence when it comes to caring for postpartum depression. Women are having to seek inpatient and outpatient care in Topeka and Kansas City.
“My dream would be that every woman would be screened in pregnancy and postpartum, and then when somebody was identified as needing services that Lawrence would have a network of providers who have specific knowledge of postpartum mood disorder in place to see her in a timely manner. Truly, so often that is necessary.”
Hoffman said there were signs of anxiety after giving birth to her second child but they were manageable because she had the knowledge, right care and support to make a difference. Her sons are now ages 8 and 5.
“I knew so much more and was prepared for what might happen and so were the people who support me,” she said. “That made a huge difference.”
LAWRENCE SUPPORT GROUP
Melissa Hoffman, a registered nurse, facilitates a weekly support group Build Your Village for mothers suffering from pregnancy and postpartum adjustment challenges. The group meets from 6 p.m. to 7:30 p.m. Mondays at Lawrence Memorial Hospital, 325 Maine.
For more information, contact Hoffman at 505-3081.
Editor’s Note: This is the first in a series of stories on postpartum mood disorders. Tomorrow: Residents share their personal experiences.
Aaron Polson kissed his wife good night, and she said, “That’s the last kiss.”
He asked why she said that.
“Well, we are going to be in prison tomorrow,” she replied.
Her comment was surprising but familiar.
His wife, 40-year-old Aimee Ziegler, a Free State High School guidance counselor, had struggled with postpartum psychosis and depression for eight years. She was first hospitalized for the illness after the birth of the couple’s first son, Owen, in 2003, and she had her first psychotic episode after the birth of their second son, Max, in 2006.
At the end of last March, the symptoms of her illness had returned. He knew the signs well: dilated eyes and icy cold fingers. She would rub her fingers together and play with the back of her hair. She feared people were out to get her and that she would lose her job and go to jail.
Four months earlier, Ziegler had given birth to their third son, Elliot. She loved being a mom and longed for more children despite her illness.
“She never accepted her diagnosis. She would call it postpartum stuff or issues or trouble. I don’t think she ever knew how bad it was,” Polson said.
After kissing his wife, he slept in the bedroom with his older sons, who were feeling restless. The boys’ bedroom was underneath the couple’s bedroom where Ziegler was sleeping.
“I woke up so many times that night just listening like, ‘Is she awake?’ I had checked on her before I went to bed, and she was asleep,” he said. “She had taken a sleeping pill that was prescribed for her.”
Then, he woke up to the sound of someone pounding on the front door of their home. It was the police. Ziegler had died about 2:20 a.m. She drove her car around some crossing gates and onto the railroad tracks, where she was hit by a train in North Lawrence.
Postpartum psychosis is a rare illness compared with occurrences of postpartum depression or anxiety. Postpartum psychosis is diagnosed in about 1 to 2 of every 1,000 deliveries, and of those only 4 percent go on to commit infanticide or suicide.
“Aimee is a rare statistic,” said Meeka Centimano, a therapist who is a founder of the Pregnancy and Postpartum Resource Center in Kansas City.
Among symptoms of psychosis are delusions or strange beliefs, hallucination, hyperactivity, paranoia and rapid mood swings. Women who suffer a psychotic episode are experiencing a break from reality. In their psychotic episode, the delusions make sense to them and seem meaningful.
“Psychosis can be tricky. There can be times when mom seems really connected, and then there are periods where she becomes very disoriented and isn’t making sense. It can be really hard to know what you are looking at,” Centimano said.
She said psychosis and depression are different illnesses.
“A woman doesn’t become depressed and then becomes so severely depressed that she becomes psychotic. They are two parallel paths, and they are very different. It’s different mechanisms in their brains.”
During an interview in his Lawrence home, Polson talked frankly about his relationship with his wife, her illness and how he’s coping with her death.
“I cried a lot, especially early on,” Polson said. “I yelled a lot — not around the kids. I would have grandma watch the kids, and then I would get in the car and go out to the lake and just yell.”
Polson, 37, said he met Ziegler through a mutual friend, and he had to pursue her because she was working full time and coaching several sports.
“It was the old-fashioned I had to chase her down,” he said. “Aimee was a very driven person. She was go, go, go, all of the time.”
She was from St. Louis and had earned a degree from the University of Missouri and then earned a master’s degree in social work at Kansas University. During her last year at KU, she was an intern at Bert Nash Community Mental Health Center where she helped write a grant to start a WRAP program. WRAP, which stands for Working to Recognize Alternative Possibilities, focuses on bringing mental health services to schools.
Polson grew up in Clay Center, a small, central Kansas town, and earned a bachelor’s degree from Kansas State University, and then moved to Lawrence where he first worked at Hastings as a department manager.
After dating a couple of years, they married on June 16, 2001. By then, Polson was an English teacher at McLouth High School, and Ziegler was a WRAP counselor at Free State High School. They enjoyed their work, traveling and spending time with family. Then, they decided to start one of their own.
Their first son, Owen, was born Aug. 8, 2003.
Ziegler’s close friend Heather Coates recalled meeting her for lunch while she was on maternity leave.
“She was so happy and so excited to be a mother,” she said. “Aimee was always a good storyteller, and there was lots of laughter.”
But her mood gradually changed. Coates noticed she wasn’t smiling as much, and she would be at a loss for words. It became hard for her to take care of Owen.
“It was like she couldn’t respond to all of his needs,” Coates said.
Six months after Owen was born, Polson noticed that his wife was anxious and had trouble sleeping and focusing. That May, he graduated from KU with a master’s degree, and that’s when he noticed a significant difference.
“I remember walking down the hill, but she really wasn’t there. It was surreal because it was suppose to be a celebration, but it wasn’t,” he said.
The symptoms escalated from there, Polson said. She told him that a co-worker was out to get her and the person was going to get her fired and make her lose her license. She shared suicidal thoughts.
“This is tough because this is what happened,” he said. “But she talked about going out and watching the trains and thinking about driving out and just letting the train hit her.”
Polson started following her to work to make sure she got there safely. Meanwhile, his mother temporarily moved to Lawrence to help care for Owen.
They were able to convince Ziegler to seek help in June — nine months after Owen was born — at Stormont-Vail HealthCare in Topeka.
“My wife was a very stubborn person,” he said. “She didn’t take time off for a headache, so she wasn’t going to do anything. She didn’t want to go to the hospital. She didn’t want to do any of that, but it was good.”
She was there for about a week, and they prescribed medication. She also began attending a postpartum support group in Kansas City.
Polson said she recovered “pretty well” but wasn’t the same.
Their second son, Max, was born in April 2006, and Polson said he had a lot of trepidation.
“The summer was great. I was thinking, ‘Maybe we are going to be OK,’” he said.
Ziegler was scheduled to return to work Aug. 1, but she didn’t make it. She had been up the night before pacing and called her parents around 5 a.m. and told them, “We’re free.” Then, she went into the bedroom and shook Polson to wake him up. She said, “We’re free Aaron. We’re free.”
It was her first psychotic episode.
“She was just gone. She was out of touch with reality,” he said.
He called Coates, and she came over to watch the children while he took Ziegler to Lawrence Memorial Hospital’s emergency room. Coates described it as scary: “I had never seen anyone like that before. She was talking and walking but wasn’t at all herself. She wasn’t making any sense and was paranoid.”
On the way to the hospital, Ziegler got out of the car. Police found her and took her home. Then, she pushed past the police, Coates and Polson and took the children — Max was 3 months, and Owen was about to turn 3 — into a bedroom and locked the door.
“That was traumatic. It was intense,” Polson said. The police were able to coax her out of the bedroom, and then they took her to the hospital.
“That was the easiest time to get her into the hospital because it was done involuntary,” Polson said. “She didn’t have a choice.”
While doctors prescribed medications for Ziegler, she often didn’t take them, or she would break them into smaller pieces and take just a piece. Polson said that was a point of contention for them.
Ziegler seemed OK for a while, but then her psychosis fired up again, and she was hospitalized a few months later. Polson recalled taking her to see a psychiatrist. He said Ziegler thought there were unmarked police cars that were waiting for them.
“That was a pretty scary time, and I wondered if she would recover,” he said.
“Aimee was someone who was just full of life and was the center of what was going on. She was just vibrant, and that was gone. I mean, that was gone at home and around me. Whatever she had left, she used it when she was around other people.”
Free State High School principal Ed West described Ziegler as the go-to person on many issues, especially ones dealing with mental health or at-risk youth.
“She was energetic, positive. Everybody just loved her for her energy and disposition and attitude, and she was a successful guidance counselor. She worked real well for us,” West said.
As a guidance counselor, she managed the class schedules of between 350 and 400 students, making sure they were on course to graduate.
“She was just so knowledgeable,” he said.
West said that some of her colleagues knew she suffered from depression and that she was trying to cope through exercise and diet. But not many, if any, knew she suffered from psychosis.
“She hid it very well,” he said.
Polson said Ziegler wanted a third child but he didn’t, and he thought they were taking the necessary precautions.
“I remember the day she told me,” he said about her third pregnancy. “I just felt like someone hit me with a wrecking ball. It was a total surprise. I just started to cry.”
Polson’s mother, Joy Polson, who had helped take care of her grandchildren and Ziegler over the years, decided to sell her house in Clay Center and move to Lawrence.
“I had seen Aimee very tense and not the old Aimee for a while, and it had gotten worse the last few years,” she said. “I didn’t know, but I was pretty sure she would need help because she had so much trouble with the other two.”
Everyone was on high alert and prepared when Elliot was born Dec. 15.
“She promised me in the hospital. I still remember making her promise me that she was going to take the meds,” he said.
But she didn’t.
“She made it through that,” Polson said.
A few months later, Ziegler returned to work, and Polson said she seemed OK until a few days before she died. She had called and said she was going to stop at a fast-food restaurant and asked what everyone wanted.
“When she brought the food in, I could tell something was wrong,” he said. “She said, ‘I need to talk to you.’”
They went outside, and he saw the familiar signs. Then, she started to tell him about someone who was out to get her and was going to make her lose her license.
“She said she was going to go to jail,” Polson said.
He said he was able to reason with her unlike times before, and they had a full schedule of events the next day. He had a forensics tournament in Wichita, and she was scheduled to take Owen to a soccer game and then attend a baby shower that she was throwing with Coates and another friend.
Coates said Ziegler was late to help set up at the baby shower, which was unusual. When she finally arrived, Coates knew something was wrong.
“The way she took the food out of the bag that she brought in. My heart just sunk. I could tell,” Coates said. “I just thought, “Oh my God. Oh my God. Oh my God.”
She knew her friend was in trouble, and she said Ziegler isolated herself at the shower by saying that she needed to feed Elliot.
“Aimee left early, too, and she was searching for a reason to leave. She made an excuse,” Coates said.
She said another friend walked Ziegler to her car, and she agreed Ziegler wasn’t OK. Coates said she had to leave town after the shower and then work the next morning, but she planned to catch up with Ziegler the next day when they could be alone.
That evening, Ziegler watched the KU men’s basketball team play in the Final Four against Ohio State with her family.
“It was a great game and win; then we went to bed, and she had a rough night,” Polson said.
Polson called his mother to come watch the children early the next morning because his wife was having another psychotic episode. It was the first time Joy Polson had witnessed one.
“I would explain it as a catatonic state,” she said. “She was just standing and staring and saying, ‘No. No. No.’”
Polson said he took his reluctant wife to the LMH emergency room in hope she would be hospitalized or receive medications, but she received neither after a mental health assessment. Instead, she went home around lunchtime with a prescription for sleeping pills and an order to call a psychiatrist in two or three days.
“I felt so defeated that day because I was doing what I thought was the right thing,” he said.
That day — it was a Sunday — Ziegler hung out at home and held the baby a lot. Polson had sent Coates several text messages to let her know about the situation, and she decided to let her friend get some rest.
Early Monday morning, Coates received a call that there was trouble at the house. It was similar to the call she received when Ziegler had locked herself in the bedroom with her kids.
“I thought, ‘OK, I’m ready. I will go over and get her to the hospital,” Coates said. But on her way, she learned that her friend had died.
“I just thought we had time,” she said. “I thought we had time, and we didn’t.”
“I’ve asked myself a million times if there was more I could have done,” Polson said. “Grieving is a long process, and I am by no means through it.”
He copes by writing, reading and exercising, but it’s his boys who help him get through each day. His older sons have a full slate of summer camps and classes. In their spare time, they enjoy playing basketball, going swimming and watching movies with dad. They also help take care of Elliot, their baby brother.
Polson described Owen as tender-hearted and Max as a thinker. One day Max came home after studying snakes and told his dad: “You know, baby snakes don’t need their mommies.”
Those moments are tough.
He said they know that their mother died in a train accident and that she wasn’t feeling well.
“I’m going with the best advice I have, which is to answer the questions as they come and don’t be afraid to talk about it, but don’t force it upon them when they are not ready,” he said.
Coates described Polson as a wonderful father and husband.
“I’ve watched him with her through her illness, and he’s just been very loving and supportive,” she said. “I just kept thinking that a lot of men would have given up because it was so hard for so long. He just wouldn’t give up. He stood by her and tried to give her everything she needed and just loved her.”
WHERE TO GET HELP
• The Pregnancy & Postpartum Resource Center of Kansas City — 866-363-1300.
• Postpartum Support International's Kansas coordinators — 785-550-6795, 785-505-3081 or 913-530-3837.
• Headquarters Counseling Center’s 24-hour service — 785-841-2345.
• Bert Nash’s 24-hour service — 785-843-9192.
• National Suicide Prevention Life-Line — 800-273-8255.
Inadequate mental health services emerged as the top concern at a public health forum Thursday evening in Lawrence that was attended by about 50 people.
Among the messages: “Lack of psychiatrists in area,” “our hospital does not do enough for residents who are in mental health crisis,” and “lack of mental health services delivered in the home.”
Melissa Hoffman, a community education specialist at Lawrence Memorial Hospital, said she offers a perinatal mood support group for women who are suffering either in pregnancy or after pregnancy.
“I often find that they have a hard time accessing health care outside that group whether it be a therapist or psychiatrist or doctor. There’s not a network of providers in place,” she said.
The Lawrence-Douglas County Health Department hosted the forum to present the results of its 38-page Community Health Assessment, which identified 13 areas that were of concern to residents. Then, attendees were asked to help narrow down the list. Here’s how: There were 13 poster boards that had an area of concern written on them and there was a glass jar nearby. Participants were given two pennies and then asked to place them in the jars of most concern.
Here’s their list from the highest priority to the least followed by the number of votes each received, and the second number is the total votes from all four public forums:
• Inadequate access to mental health services: 19, 36
• Poverty and few job opportunities (tied for second): 11, 20
• Disparities in health outcomes and quality of life: 6, 12
• Insufficient access to health care and other services: 5, 16
• Lack of physical activity: 5, 13
• Limited knowledge of available health and other services: 4, 12
• Limited access to safe and affordable housing: 3, 9
• Inadequate transportation linking people to services, jobs and recreation: 3, 8
• Limited access to dental services: 3, 6
• Lack of access to health insurance coverage: 2, 13
• Inadequate access to affordable, nutritious food: 2, 11
• Abuse of alcohol: 0, 8
• Prevalence of abuse and intimate partner violence: 0, 2
Lawrence resident Bob Oakes said his top concerns were few job opportunities and lack of health insurance coverage, which he said are closely tied together and wonders if they should be.
"Employment often can get you health insurance but is that the right model to deal with?" he asked. "There have been a lot of people railing, 'Obamacare, Obamacare, Obamacare,' but what other options do people have other than working or going without?"
His wife, Diane, voted for the same issues.
"I think poverty is a key driver in most of the difficulties that folks face in trying to live a healthy lifestyle," she said. "My other concern is access to insurance which goes right along with that."
Christina Holt, of Kansas University's Work Group For Community Health and Development, was a key researcher for the assessment. While collecting information for the report, she spoke to residents in one-on-one interviews and small focus groups about the challenges they face.
"There's a lot of disparity in health outcomes and in quality of life here among different groups of people," she said. "Even though statistics tell one story when you hear personal stories from people in their daily experiences, it tells another story."
Holt said there were several that stood out. Among them:
• A Haskell Indian Nations University student, who worked in downtown Lawrence until late at night, said she had to walk home to campus because there was no bus available. She said there are no sidewalks on part of the route home and some areas have poor lighting. She described the walk home as very scary.
• Several East Lawrence residents said the only way they could get to the city pool was by taking the bus, and the only route available was 90 minutes.
• A North Lawrence resident, who didn't have a vehicle, said she used the Dollar General for her grocery store. She knows it's not ideal but she doesn't have the means to go elsewhere.
"I think the assessment underscored community members' concerns about a number of issues ranging from access to affordable and healthy food to things that we don't necessarily even think about every day like walkability and bikeability or infrastructure of our community and whether it supports health," Holt said.
At Thursday's forum, she listened to residents' concerns about mental health services. She said they included lack of services for people in mental health crisis and a lack of in-patient care.
"There's been some tragic outcomes of that recently in our community and I learned about that," she said.
If you were unable to attend a forum, the health department is accepting comments at Continue-the-Conversation.org.
Forty-three-year-old Lorraine Cannistra credits Bert Nash Community Mental Health Center for helping put her life back on track and giving her hope for the future.
Cannistra, who has cerebral palsy, said she thought she could handle her mental health challenges on her own. But she couldn’t.
“My world just came crashing down at one point. Eventually, I found my way to Bert Nash, and they helped me navigate what was wrong with what I was doing and gave me the skills to interact with people better,” she said.
She was among 10 community members who spoke Monday evening about Bert Nash’s services during its annual Pioneer Celebration. The event, held at Maceli’s, was attended by about 100 people.
Cannistra said she was diagnosed with depression, post-traumatic stress disorder and borderline personality disorder. She began receiving Bert Nash services about 12 years ago and currently receives case management once a week.
“I have a whole lot of hope for the future. I’m getting close to being employed part-time,” she said. Cannistra has a bachelor’s degree in English and creative writing and a master’s degree in rehabilitation counseling. She hopes to combine the skills and become a grant writer.
“I think the services that I have received at Bert Nash have helped me develop more into the person that I want to be,” she said. “Left to my own vices, I have periods of depression and periods of intense anger and that’s not how I want to be.”
She received a standing ovation.
Patricia Roach Smith, chief operating officer at Bert Nash, said the more people talk about their mental illness, like Cannistra, the better, because talking helps reduce the stigma.
“The more we talk about it, the quicker we get treatment and the more effective the treatment,” Roach Smith said. She said one in four people would suffer a diagnosable mental disorder in any given year. “That is a whole lot of us.”
Among the event’s honorees were Douglas County Commissioners Jim Flory, Mike Gaughan and Nancy Thellman and County Administrator Craig Weinaug. They received the Pioneer Award for continuing to fund Bert Nash with about $2 million per year.
Roach Smith said the funding is crucial because the center’s state funding has been cut 65 percent since 2008. Despite the cut, Bert Nash is committed to serving anyone regardless of ability to pay. It charges fees based on a sliding income scale.
“That sliding fee scale is underwritten by Douglas County through the support they provide to us. It’s a very important piece to making sure all of our citizens are served and have good mental health,” Roach Smith said.
In 2011, Bert Nash received $9.8 million in funding and spent $10.1 million. Its top funding sources:
• Fees for services — 54 percent.
• County funds — 22 percent.
• State funds — 9 percent.
• Grants — 5 percent.
It served 5,531 individuals last year: 35 percent were ages 18 and under, 46 percent were between 19 and 40; and 19 percent were older than 41. Forty-six percent were males, and 54 percent were females.
Depression and anxiety were its top diagnoses.
Bert Nash also recognized two employees with its coveted Sandra Shaw Spirit Award, which is named after the late Sandra Shaw, who served as CEO at Bert Nash for 22 years. The award is chosen by the staff, which includes 180 part-time and full-time employees. The winners:
• Stephanie Shelley, financial manager, a 17-year employee.
• Joe Harris, receptionist for Community Support Services, a 13-year employee. He works with clients who have severe and persistent mental illness.
“I enjoy helping clients in the community and seeing them getting better and just knowing I have a part in that,” he said.
BY SCOTT ROTHSCHILD
TOPEKA — Advocates for those with mental illness on Tuesday described the state's mental health system as crumbling and urged legislators to restore funding that has been cut over the past few years.
"Our state's mental health system is not strong enough to meet the demands placed on it," said Glen Yancey, who is president of the Kansas Mental Health Coalition.
"Either we begin to reinvest in it now or we will see the costs of untreated mental illness continue to grow," Yancey said. "Those costs manifest themselves in more emergency room visits, more incarcerations, more trips to state hospitals and, sadly, more suicides. We starve the mental health system in Kansas at the risk of more broken lives."
Mental health reform grants have been cut by $20 million, or 65 percent since 2008. Nearly $10 million was cut in 2010 because of Medicaid rate reductions and the system has sustained cuts in other areas as well.
In addition, Yancey said the coalition is extremely concerned over Gov. Sam Brownback's push to privatize Medicaid by January, saying that he feared cost-cutting will override access to effective treatment options. "The devil is in the details," Yancey said of the proposal. "Careful implementation and meaningful legislative oversight of Medicaid reform is critical," he said.
As Yancey said that, Lt. Gov. Jeff Colyer, who is Brownback's point man on Medicaid reform, was standing to the side and nodded his head in agreement.
Colyer then spoke next to the crowd of several hundred gathered at the Topeka Performing Arts Center.
He said the goal of transferring Medicaid to managed care companies was to reduce costs and improve health care for the more than 350,000 Kansans who receive services through the state and federally funded program.
"We want to start reforming the system so that we get results," said Colyer. He said the proposal was "not an old days managed care." He added, "They (the managed care companies) don't make any money unless you get services, unless there is patient satisfaction."
‘The Waiting Room’ exhibition offers thought-provoking look at health issues like breast cancer, bulimia, domestic violence
It’s a typical doctor’s waiting area. There are chairs, books and magazines along with background noises of coughing, heavy breathing and the ding of an elevator now and then.
Once inside, it’s much, much more.
Welcome to the “The Waiting Room: Lost and Found,” a mixed media installation at the Alice C. Sabatini Gallery at the Topeka and Shawnee County Public Library. The exhibition takes a thought-provoking, in-depth look at six health issues as they relate to women — depression, anorexia, bulimia, dementia, domestic violence and breast cancer.
Lawrence resident Marguerite Perret, a professor of art and design at Washburn University, is the lead artist on the exhibition which includes paintings, sculptures, audio and visitor interaction.
“We wanted to put a light on some of these areas because there are misperceptions or biases and some things have stigmas attached to them still today,” she said.
A small area is devoted to each health issue and at the focal point is a specifically-designed chair with detailed fabrics, designs and underlying messages. If you look closely at the fabric on the chair in the breast cancer area, you will notice cancer cells and plant forms representing the Pacific yew tree which is used to make the popular breast cancer treatment drug Taxol.
In the anorexia area, if you look through the wooden chair and into the glass it’s sitting on, you will see the word: HELP. It’s carved into the chair representing the relationship between eating disorders and compulsive cutting.
Joanne Bergmann, of rural Lawrence, helped with the project by doing the upholstery for four of the chairs — one of them represented bulimia, something she said she didn’t know much about until seeing the exhibit.
“It’s very educational. There’s a lot of research that goes into it,” she said. “I think it’s amazing and really creative.”
Perret and the other three artists, including her husband Bruce Scherting, picked health issues that they’ve experienced themselves or through someone in their families.
Perret was diagnosed with breast cancer in her early 40s through a mammogram. She had surgery and radiation and hopefully, she said, no longer has it.
“For me with my experience, the idea was whether you could still be attractive even though you’ve had surgery which makes you not the norm, especially on a part of your body that is so important sexually,” she said.
The chair looks like one that would sit in front of a vanity, feeding into the feeling of attractiveness; yet, it is a bit elongated and odd looking. There’s also metal shelving next to the chair which brings the clinical feel into it.
“It’s that idea of the beauty plus the strangeness or the oddity,” she said.
Sitting on the chair, there’s a magnifying glass that looks like a mirror. Perret believes there’s tremendous pressure on women to catch the disease through self exams, and if they don’t, then there’s a feeling of guilt. “Instead of reflecting on yourself, you are inspecting yourself constantly,” she said.
Underneath the chair is cloud-like shape of pink, satin fabric. Perret said it can mean a variety of things: release of exhaustion, swimming in medication or dreaming that the cancer is flowing out of you. For her, it depicts the feeling of being surrounded by too much “pink” marketing.
Her treatments were in October which is National Breast Cancer Awareness Month. She said stores were selling pink-frosted cupcakes and cookies but she didn’t feel like celebrating.
“What was it all about. Happy Breast Cancer?” she asked.
The more products she saw, the more furious she became, and so she began collecting them: dish sponges, aluminum foil, duck tape, yogurt lids, gloves, underwear, pepper spray, wine, bubble wrap. They are now part of the exhibition.
“I just find all of that really odd and strange and needing some critique,” she said. “We don’t say it’s bad in the show. We just present it so people can think about it.”
In each tableau, there is a plain, black chair where visitors can listen to short — 2 to 8 minute — audio recordings of people talking about their personal experiences.
In one, a daughter talks frankly about the progression of her mother’s dementia and how she eventually lost the ability to communicate with her. She said she would never forget the day that she moved her mother from an apartment to an assisted living facility. She said her mother was angry with her and they were both crying.
In the domestic violence exhibit, the stories are real but the voices are of actors for safety. A man talks about his six-month relationship with a woman who seemed fun-loving in the beginning, but then turned violent because of her use of alcohol and drugs. He said she attacked him and threatened to kill him and yet, he still thinks of her as the victim — not him.
Visitors also can share their thoughts and stories. Dozens of messages are clipped with clothespins to a set of mattress springs that is leaning against a wall. Among them: “Don’t give up — get away,” “How far will he/she go?” and “You deserve better.”
In the bulimia area, individuals can write messages on cupcake wrappers and napkins and then shove them through the “Gut Reaction Chair.” They end up scattered on the floor below, representing the binge and purge cycle. One note reads: “I am 68 years old. I have suffered from anorexia since my teenage years. Nothing can or could make me eat if I didn’t want to. I was never treated but grew up anyway.”
Perret said they’ve also held community art workshops where people shared their health stories and some of the works also are on display. She said one woman got teary-eyed as she talked about how lucky she was to have caught a blocked artery before having a full-blown heart attack. Another participant talked about his new normal after suffering a traumatic brain injury in a car accident.
“They are so personal and so amazing and so powerful from every aspect,” Perret said.
TO VIEW IT
“The Waiting Room: Lost and Found,” a mixed media installation addressing women’s health, is on display through March 16 at the Alice C. Sabatini Gallery at the Topeka and Shawnee County Public Library, 1515 SW 10th Ave. in Topeka.
• Weekdays — 9 a.m. to 9 p.m.
• Saturdays — 9 a.m. to 6 p.m.
• Sundays — noon to 9 p.m.
There will be an informal discussion about the exhibit from 6:30 p.m. to 7:30 p.m. March 16 in the library’s Marvin Auditorium, Room 101A. The principal artists and several partners and writers will attend. The event is free and open to the public.
Lawrence Memorial Hospital nurse coordinates mental health services for hundreds of patients each year
Paula Dupigny-Leigh has been a psychiatric nurse for 40 years.
“I was never real attracted to the medical aspects of nursing and so I knew mental health was going to be my niche,” the Lawrence resident said during an interview in the atrium of Lawrence Memorial Hospital. “It’s been my passion to take care of the mentally ill population.”
Dupigny-Leigh grew up in McPherson, graduated from Wichita State University and applied to work at the world-renowned Menninger Clinic in Topeka.
“I thought this was the holy grail of psychiatry and thinking as a new grad that there was probably no way I would get a job there,” she said. But, she did, and she worked there for 30 years in a variety of areas — crisis, geriatrics and outpatient care.
In 2001, when she knew the Menninger Clinic would soon be moving to Houston, she applied for a job in geriatrics in LMH’s mental health unit and was hired. Then, in 2004, LMH closed its mental health unit.
Janice Early, communications director, said there were no psychiatrists who would admit inpatient mental health patients and that’s still true today. Also, patient volumes were not sufficient to sustain a quality program. But, LMH kept Dupigny-Leigh onboard and she became the clinical coordinator of mental health.
Dupigny-Leigh said she hasn’t come across a job like hers in the hospital industry. She coordinates mental health care for inpatients and outpatients, teaches classes on suicide precaution and behavior management and provides guidance to staff. She also screens hospitalized patients to determine if they may need mental health services. For example, sometimes dementia can be mistaken as a mental health disorder among the elderly.
Dupigny-Leigh said mental health issues are common. She recently provided a report on the mental health services provided in 2011 at LMH. Among the statistics:
• 1,182 — patients came to the emergency department requiring a psychiatric assessment.
• 659 — of those patients were moved to the Crisis Stabilization Service area where patients are treated for mental health.
• 641 — patients were transported to a mental health facility.
• 103 — psychiatric consults were provided to hospitalized patients.
• 702 — nurse consults were provided by Dupigny-Leigh to patients who were hospitalized or using outpatient services such as oncology and cardiology.
She said depression and anxiety are the most common mental health issues seen in patients.
“Heart disease and depression really go hand in hand. There does seem to be a lot of depression in people who are rehabilitating from heart conditions,” she said.
Challenges in care
Dupigny-Leigh said she meets with patients once or twice, but if they need ongoing therapy or medication management, she provides them with referrals. But this can be challenging for a variety of reasons: no services, waiting lists, affordability.
She said there is a shortage of psychiatrists in Lawrence. She said most of them — three — are at Bert Nash Community Mental Health Center, which is across the street from the hospital, but there are a few who have private practices.
“To try to find adequate medication follow-up for psychiatric patients can be a real challenge. More of the primary care physicians are taking on that role,” she said.
She said they will medically detox people at LMH for drugs and alcohol and then will help them find an inpatient or outpatient program, but often there’s a wait and that’s not good because the chances of relapse are huge. She said it’s tough to find an inpatient substance abuse treatment program for men.
“Also, in my personal experience, you have to have a pretty good relationship with your therapist and not everybody matches the first time,” she said. “So, you might have to try two or three people to find the person that works for you. That can be really challenging.”
Dupigny-Leigh said there has been an increase in the number of violent and out-of-control patients who are coming into the emergency room and she said a lot of it is related to drugs and alcohol abuse.
She said when a person comes into the ER, he or she is always first evaluated from a medical aspect even if they say, “I’m suicidal,” and have no wounds. She said vitals will be taken and any appropriate testing will be done. And, she encourages people to seek mental health help at the ER.
“I don’t see mental health as being any different than appendicitis or a heart attack. So, I think when people are truly in crisis, I think that’s where they should come,” she said.
There is someone available 24/7 in the ER who can do a mental health assessment. Once a patient is medically stable and it’s determined they have mental health needs, they are moved into an area near the ER called the Crisis Stabilization Service unit. It’s a quiet area that has three rooms designed for the safety of patients. Patients transferred to the area suffer from depression, anxiety, substance abuse or have suicidal thought or intent.
In this area, further testing is done to determine whether a patient needs inpatient or outpatient treatment and then LMH will help find those services.
“We don’t have problems finding inpatient beds most of the time,” Dupigny-Leigh said. She most of the patients go to Stormont-Vail HealthCare in Topeka, but other places include Shawnee Mission Medical Center and Two Rivers Psychiatric Hospital in Kansas City, and Cushing Memorial Hospital in Leavenworth. She said most of the patients who are transported involuntarily go to Osawatomie State Hospital. She said a patient will be hospitalized if an assessment determines that the patient is dangerous to himself or herself or others.
“Unfortunately in our day and age, psychiatric hospitalization is due to self harm, suicidal, homicidal or injury to others or someone has such an acute psychosis that they can’t take care of themselves. Almost everyone else is seen on an outpatient basis,” she said.
TOPEKA, Kan. (AP) — A House panel has scheduled testimony from military leaders, veterans' organizations and health care providers to discuss the mental health needs of soldiers and veterans.
The House Veterans, Military and Homeland Security Committee will hear the testimony Tuesday. The meeting will include a review of an interim report prepared by the Joint Committee on Kansas Security on veterans' issues.
Scheduled to speak to the committee are Sheli Sweeney of the Kansas Association of Community Mental Health Centers, Robbin Cole of Pawnee Mental Health Services, Laura Snow of the Veteran's Administration Eastern Kansas Health Care System in Topeka and Gregg Burden of the Kansas Commission on Veteran's Affairs.
It’s healthy to make resolutions for the coming year even if you oftentimes don’t follow through.
“Improvements are good, and self-improvement is fantastic. I don’t think we should ever get to the point where we are like, ‘I’m done,’” said Marciana Vequist, a therapist at Bert Nash Community Mental Health Center. “I think we should always be growing. Change is good.”
When making a resolution, Vequist recommends setting realistic goals and framing them in a positive way. For example, don’t set a goal of losing 20 pounds. Instead, set a goal of exercising five times a week for 30 minutes. Also, share your goals with a friend or loved one because it will hold you more accountable.
Susan Johnson, nutritionist with K-State Research and Extension — Douglas County, takes it a step further. She says to be successful you must be specific, write it down and tell a friend.
“Research shows that if we just write down what we eat or write down how much we exercise, we are going to be more successful,” she said. “Sounds crazy, but it’s true.”
Exercising more and eating healthier tend to be among the top resolutions. Others include: organization, saving money, stop smoking and going to church more often.
Lawrence health experts recently offered their tips on being successful in the new year:
Vequist says exercise is the best medicine and hopes everyone resolves to do more.
“That doesn’t mean you have to run a marathon or work out at the gym every day for two hours. It just means having some kind of routine,” she said. “I think that makes people feel a lot better.”
Chad Richards, owner of Next Level Sports Performance, said it’s important to start with something you enjoy whether it’s lifting weights, boxing, biking or dancing.
“Finding something that you love is ideal,” he said.
Also, link exercise to something positive whether it’s walking a dog or listening to your favorite music.
“Everyone has that soundtrack that gets them moving regardless of what they were planning on doing. It gets you happy, amped up and excited about what you are doing,” he said.
He recommends having short-term goals and short-term rewards like getting a massage.
Also, be patient.
“It took a certain mount of time to get out of shape, so it’s going to take the same amount to get in shape or maybe double that. That’s the realization of it,” he said.
Keep it simple.
Johnson said too often people want to overhaul their diet and change too much at once. Instead, she suggests picking one or two habits and trying them for a month and then re-evaluating to see if they are working. Maybe, it’s eating whole-grain bread instead of white.
“We want to keep it so simple that we hardly even recognize that we are doing it,” she said.
Another example would be to eliminate one 12-ounce soda every day. That would be 140 calories a day or 51,100 calories a year. That equals 14 pounds.
“I don’t ever want to recommend a particular diet because there should never be a diet. It should be a lifestyle change,” she said.
If you’re looking for suggestions on how to improve your eating habits, she has eight and they are from the book “Water with Lemon” by Zonya Foco and Stephen Moss. They are:
• Drink water.
• Include breakfast every day and stop eating two or three hours before bedtime.
• Tame your sweet tooth. Don’t just switch to sugar substitutes but gradually cut back on sugar, starting with maybe cereals. “Once our taste buds no longer enjoy that heavy sweet taste, then we naturally eat less sugar without feeling deprived.”
• Find the fat. Eat more of the good kinds that are contained in salmon, nuts and seeds and less of the kinds found in baked goods.
• Replace processed foods with wholesome foods that are produced on farms. “We really need to avoid food that have enhanced colors and preservatives that you can’t even pronounce. If you look at the ingredients and they are basic, that’s a good thing.”
• Eat only until you are no longer hungry. Eat slower and savor each bite and don’t feel like you need to clean your plate. Also, know what your weak links are whether it’s continuing to eat that extra bite at the table, sampling while cooking or buying junk food at the store. For Johnson, it’s buying it. “If it’s not in my house, then I won’t eat it,” she said. “Some people can have chocolate in their desk and not touch it, but not me.”
“There’s not a perfect plan for eating right. Moderation is still the key,” Johnson said.
Kimberly Erwin, owner of Family and Home Organizing in Lawrence, joked that most people don’t get that tingling feeling that she does when it comes to organizing.
“So, you need to look at it as a tool for the things you actually want to do in life,” she said. “It helps you enjoy life more, be more productive and prevents those little emergencies from happening.”
Before starting, you need at least two things: a filing cabinet for papers and a little tray or cup to hold odds and ends like paper clips and pens.
“A lot of times we have piles because we don’t have the proper containers for them,” she said.
When organizing, keep it manageable by doing just a corner of a room or a closet. Maybe, it’s just the shoe rack in the closet. She said to only keep things that:
• Inspire you or that you really love.
• You need.
• You regularly use.
Get rid of items that are depressing and that bring you down, like things you are never going to get around to fixing or using.
• Create a master calender that has everyone’s schedule and the household budget.
• Don’t check the mail until you have time to sort it.
• Pay bills online. “It’s more efficient, I think, and more peace of mind and productive, just making sure you have money in the bank. Instead of remembering I need $60 for this one and $120 for that one. Just remember the maximum amount you need every month to cover bills.”
Dan Cary, a Lawrence financial planner, said everyone needs to take a look at where they stand financially and then set goals.
“Most Americans don’t know where their money goes, they just know it goes,” he said.
He said people should have three to six months worth of savings for emergencies, a retirement plan and a will.
“Seventy percent of Americans don’t have a will and when you have children, it’s so important,” he said.
He also recommends paying down debt as early as possible, but he said that needs to be weighed with accumulating savings. It’s good to do both, and it’s possible if you live within your means, make a plan, and stick to it.
He won’t soon forget a client who approached him in 1994. She was a respiratory therapist, single and in her mid-40s. She questioned whether she would ever be able to save enough to retire. She said to him: “I think I will be living under a bridge. I can’t save any money.”
He said she started by putting spare change under her sink and then taking it to the bank. She was able to retire three years ago.
“The important thing is to have a goal in mind,” he said.
Vequist, a therapist, said she commonly sees people who are distressed about their financial situation. “Debt brings a lot of psychological distress for people and it’s one of the common things that I see.”
Jeff Barclay, lead pastor at Christ Community Church, supports resolutions whether they are spiritual or about giving up french fries.
“I think any kind of commitment of renewal is a super idea,” he said.
However, he’s more in favor of resolving daily to do good things rather than waiting until Jan. 1.
“The minute we start improving our lives we have the power to help others, and I think that’s when the real energy starts,” he said.
Kansas ranks seventh in the nation when it comes to cutting state funding for mental health programs.
Its spending went from $115 million in 2009 to $97 million in 2011, a 16-percent decrease.
The data was released Wednesday in a 13-page report, “State Mental Health Cuts: A National Crisis” by the National Association of Mental Illness.
Kansas is among 34 states that have cut a total $1.8 billion, despite the need for mental health services increasing because of economic distress and troops returning home from war.
“Budget cuts mean people don’t get the right help in the right place at the right time,” said Rick Cagan, executive director of NAMI Kansas. “Local communities suffer and families break under the strain.”
With appropriate services, people living with mental illness can and do recover. Without services, they often end up in hospital emergency rooms, homeless, jail or dead, mental health advocates say.
Lawrence’s Bert Nash Community Mental Health Center, which serves 5,600 Douglas County residents annually, has lost more than $1.1 million during the past several years.
In state fiscal year 2010, Bert Nash lost $565,000, which resulted in cutting a program that helps people transition from a hospital into the community. It also cut funding for a housing assistance program.
Over the years, it has reduced community outreach and staff.
Gov. Sam Brownback has proposed cutting $15 million in funding to community mental health centers in 2012. CEO David Johnson estimates that will cost Bert Nash another $372,000.
“Cutting mental health is penny-wise and pound-foolish,” Cagan said. “Costs get shifted to emergency rooms, schools, police, local courts, jails and prisons. The taxpayer still gets the bill and it often costs more.”
On average, it costs:
• $428 per day in a state psychiatric hospital.
• $80 per day at Larned Correctional Mental Health Facility.
• $15 per day at a community health center.
In Kansas, the number of people served in state hospitals rose from 3,595 in 2007 to 4,058 in 2009, a 13-percent increase.
The hospitals have often been full or over capacity. Twice last year the state shut off voluntary admissions to the hospitals. Despite increased demand, the state closed 14 of 50 beds at Rainbow Mental Health Facility in Kansas City, Kan.
“We have been lucky to avert any unfortunate instances or occurrences of things in our local communities. But I think it’s just a matter of time because of reduced access to service because of funding cuts,” said Mike Hammond, executive director of the Association of Community Mental Health Centers of Kansas.
“We are hopeful that this report will weigh heavy on the minds of policymakers.”
In response to the ranking, Gov. Sam Brownback's spokeswoman Sherriene Jones-Sontag said, "Over the last decade, Kansas lost private sector jobs. That's why our top priority has to be to restore economic growth while creating new private sector jobs. Once that happens, there will be more resources available for every priority of state government. With a nearly $500 million budget deficit in fiscal year 2012, our state faces very difficult decisions on how to best meet our increasing financial obligations while ensuring the needs of our most vulnerable Kansans are met."
Here are the best and worst states when it comes to funding cuts to mental health programs in 2011, according to the NAMI report. The percent is how much has been cut since 2009.
- Kentucky — $214 million, down 48 percent.
- Alaska — $89 million, down 35 percent.
- South Carolina — $138 million, down 23 percent.
- Arizona — $369 million, down 23 percent.
- Wisconsin — $371 million, down 22 percent.
- Nevada — $187 million, down 17 percent.
- Kansas — $97 million, down 16 percent.
- California — $3 billion, down 16 percent.
- Illinois — $639 million, down 15 percent.
- Mississippi — $224 million, 15 percent.
- Missouri — $467 million, up 3.7 percent.
- Nebraska — $113 million, up 3.9 percent.
- South Dakota — $47.2 million, up 4 percent.
- North Dakota — $67 million, up 4 percent.
- Maine — $212 million, up 5 percent.
- Arkansas — $76 million, up 6 percent.
- West Virginia — $152 million, up 7 percent.
- Rhode Island — $91 million, up 7 percent.
- North Carolina — $338 million, up 21 percent.
- Oregon — $377 million, up 23 percent.
Roxanne Reneé, a depression survivor, will give a program about natural mental health.
Reneé is the author of “Laughing Again: A Survivor’s Guide to Healing Depression.” She also is a motivational speaker, wellness trainer and therapeutic life coach at Wellness Dimensions, and serves on the chaplain team at Liberty Hospital in Missouri.
The free program will be from 7 p.m. to 9 p.m. Jan. 10 at the historic Carnegie Building, 200 W. Ninth St.
The program will include information on an upcoming eight-week course offered by Natural Mind in Lawrence. It starts Jan. 24 and costs $249.
Among the guest speakers during the course: Reneé, Stephen Ilardi, author of “The Depression Cure” and a KU professor of clinical psychology; Corey Priest, of Wellness Dimensions; Dr. Farhang Khosh, naturopathic physician of Natural Medical Care; Staci Hendrickson, nutrition therapist; Brian Stites, personal trainer; Melissa Mitchell, yoga instructor from Breath Holistic Life Center; Doug Hitt, physical therapist and deep ecologist; and Todd Wyant, massage therapist.
For more information about the program or eight-week course, contact Sue Westwind at 331-9630 or visit www.naturalmindwellmind.com.
Suicide, bullying and Dialectical Behavior Therapy were among the topics discussed during an online chat today on WellCommons.com.
Bert Nash Community Mental Health Center leaders Pat Roach Smith, chief operations officer; Eunice Ruttinger, director of adult services; and Janice Storey, director of children and family services, answered several readers’ questions.
To read the transcript of the chat, click here on WellCommons.com.
If you have a suggestion for a health-related chat, please contact health reporter Karrey Britt at email@example.com.
Here's a terrific column by Tom Keegan, sports editor of the Journal-World. After taking Mental Health First Aid at Bert Nash Community Mental Health Center, I have learned a lot about this very important issue. I agree with Tom — this guy deserves recognition.
BY TOM KEEGAN
There isn’t a more overused word in sports. Meet an athlete who fits the definition.
His name is Ron Artest and on Nov. 19, 2004, he jumped into the stands to confront a fan he incorrectly believed was the one who pelted him with a cup of Diet Coke. In the ensuing brawl between members of the Indiana Pacers for which Artest played and fans of the Detroit Pistons, Artest clocked a fan. Artest was suspended for the remaining 73 regular-season games plus the playoffs.
The word on Artest had been out for years: Talented but crazy.
Here’s a better scouting report: Pro-active hero.
Noted as a defensive specialist, Artest scored 20 points in Game 7 to help the Los Angeles Lakers defeat the Boston Celtics for the NBA championship last June. During a postgame interview, Artest stared into TV cameras and told the world he wanted to thank his psychiatrist. He later corrected himself because his therapist actually is a psychologist.
Here’s a guy who desperately needed help with his mental health, was ordered by the court to receive it, and thanked the person who helped him deal with his intense anger issues. Now look what he’s doing.
Artest is raffling off his one and only NBA championship ring on his website, ronartest.com, for $2 per raffle ticket (minimum purchase of five tickets). All the proceeds are going to fund mental health services for youths. Artest wears a size 15 ring, but when it came time to order his championship ring, which features, according to his website, “16 oversized round brilliant white diamonds,” he ordered a size 11 so that he wouldn’t be tempted to keep it.
He said he hopes to raise $2 million. He already has raised awareness for the long-neglected, once-too-taboo-to-mention area of health care.
Who knows how much trouble and embarrassment Artest could have avoided had he had the sort of counseling help so many youths will get thanks to his raffle, which ends when a winner is picked on Christmas Day.
Dave Johnson, CEO at Bert Nash Community Mental Health Center in Lawrence, is stoked about what Artest is doing.
“I have been the head of a mental health agency for more than 31 years and the more I learn about kids’ mental health problems, the more I am convinced this area is our greatest resource need,” Johnson said. “Some facts: The median age of first-onset of anxiety disorders in the U.S. is 11 years old. Eight percent of high school students have attempted suicide. The younger you are, the less likely you are to get the mental health services you need.”
Johnson said he is going to log onto ronartest.com to purchase raffle tickets.
“If I win, I will donate it to Bert Nash for a raffle to support WRAP, our program to place mental health clinicians in schools,” Johnson said.
Artest just might inspire other athletes to have similar raffles. For example, Olympians who can’t decide which child to leave their gold medals to might donate them for auction to benefit local mental health centers. The possibilities are endless.
It’s only November, but so far, Artest deserves serious consideration for Sportsman of the Year for 2010.
You can help raise awareness about mental illness by participating in Bike 4 The Brain.
The fifth annual event will be Labor Day at Johnson County Mental Health Center, 6000 Lamar, in Mission.
Registration begins at 7 a.m. and the event is at 8 a.m.
Bicycling courses include 10, 25, 50 and 64 miles. The cost is $20 if signed up before Friday, and $25 thereafter.
Bike 4 The Brain supports nonprofit organizations that help people who are affected by mental illnesses.
If you don’t bicycle, there is a 5K fun run/walk.
For more information or to register, visit www.bike4thebrain.org or call 913-323-6529.
A few weeks ago, I was lamenting to my friends that I seemed to have gone missing. I wondered what ever happened to the girl who foolishly stayed up (or out) too late on a regular basis, and whose refrigerator was usually stocked with only condiments.
I was horrified to discover that that girl was missing. In her place was a woman who wore sensible shoes and who made calendars for her family's dinner menus, two weeks at a time. This new woman makes budget spreadsheets and instead of watching trash TV or going to bars in her free time, she uploads baby pictures to Flickr and researches preschools.
Upon this discovery, I ran screaming into the street, desperately looking for my former self. She has to be here! She's here somewhere! Maybe she's just hiding under a pile of recycling in the garage. That girl never recycled, so she probably doesn't know what it is.
Alas, she seemed to be gone forever. I couldn't find her anywhere. I had to call in help.
I called my mother. "We need a weekend," I told her. We needed to get in touch with our non-parent selves. Our selfish and irresponsible sides needed to come out of storage. Two of our friends were playing a show at The Bottleneck on Friday night, so it seemed like a perfect time for Grammy to spend a little extra time with her newest grandbaby. We shipped him off to central Kansas for the weekend so we could attend the show and spend a Saturday doing whatever our little hearts desired.
It's a winner all around. Johnny got a little grandparent loving (read:spoiling), my husband and I got a little relief from our ridiculously routine lifestyle, and Grammy got to snuggle Johnny's neck for three days.
We love being parents. Don't get me wrong. We spent our whole child-free weekend talking about "our guy" and how cute he is and how he's the very best one and how happy we were going to be to go get him on Sunday. Nothing makes me happier than waking up in the morning to his sweet face or coming home from work so I can lay on the floor while he plays cars on my stomach. So I felt a little guilty, spending a weekend away from our boy - especially because we both have full time jobs and our time with him is limited anyway.
But everyone needs a weekend off from time to time. It's important, as parents, that you remember to be married people. It's important to, once in awhile, stop thinking about the budget and the house that needs new paint and the baby's bowel movements and just focus on yourselves. We ran around, had bloody mary breakfasts, and pizza for most of our meals. I put on my favorite black skirt and a Rumblejetts t-shirt on Saturday and turned up the volume on my life. My husband, over lunch at Johnny's, looked at me when I exclaimed I'd like a shot, and yes I know it's only 1:00 in the afternoon, and said "Now THAT'S the girl I married!"
Turns out I don't have the stamina I once did, and I had to curl up on the couch with a movie on Saturday night instead of enjoying my last night out on the town. But that's a good thing, too. A moment of peace, a lull in the storm. My husband and I have only been married just over two years. We needed to reconnect as husband and wife, instead of Mom and Dad.
One day, if our son asks us, "Why did you ship me off to a grandparent several times a year?" I'll tell him to look around at his intact household and say "So you can have this. So Mom and Dad can stay married and you can enjoy their sanity. Otherwise, I'd be shipped off somewhere, and you'd be visiting me in a padded cell."
And by the way, the guilt? It vanished pretty quickly. As I located that missing girl, any feelings of regret about our freedom melted away. We're already thinking of our next child-free weekend. October work for you, Grammy?
One in four American adults will suffer from a diagnosable mental health disorder during the next year.
Yet there’s still a stigma about mental health.
Patricia Roach Smith, chief operating officer of Bert Nash Community Mental Health Center, said she hears these words often: “It happens to other people. It’s a unique problem.”
But it’s not.
Bert Nash provided services for 5,915 Douglas County residents in 2009. On average, 12 new clients were admitted for services every business day.
Another misconception is that mental health disorders are not treatable, but they are. It’s important to seek help.
“I think a lot of people really try to kind of pull themselves up by their bootstraps and tough it out, and it’s just so unnecessary. It’s very treatable,” Roach Smith said. “And we know the longer people go with untreated depression, the more depressed they get and it actually causes some brain damage. It really is a disorder that you don’t want to leave untreated.”
She said research shows that more than 65 percent of medications for mental health disorders are written by primary care physicians. That’s because the average person’s mental health disorder will manifest in physical ways such as being tired or unable to make decisions, and that’s when people feel comfortable getting help.
“There’s less stigma, and they have a relationship with their primary care physician,” Roach Smith said.
An abundance of services
Bert Nash, which celebrates its 60th anniversary Sunday, is one of 26 community mental health centers in Kansas. It offers an array of outpatient mental health services for adults and children. They provide traditional services like couple’s therapy and medication management, and nontraditional services like case management and group therapy sessions.
“Teens are not all that interested in having some adults tell them what to do. So, we offer a group experience where kids can share with other kids the challenges that they have,” Roach Smith said. “A lot of times you can see a lot of validation in a situation like that.”
Bert Nash does a lot of community outreach. It provides education on topics such as holiday stress, job loss, managing depression and substance abuse. Two years ago, the center began offering Mental Health First Aid Training to help people know what to do in a crisis situation. It was one of the first Community Mental Health Organizations in the nation to do so.
Bert Nash also has mental health professionals available 24/7 to provide emergency care.
“We believe strongly that mental health is fundamental to health in general,” Roach Smith said.
Making the first phone call to seek help is the biggest hurdle for most people.
“As Americans, we really are pretty self sufficient and we like to think of ourselves as being able to handle anything,” she said.
Longtime Lawrence residents Doug and LaDonna Stephens were among them. They adopted three sons when they were infants. The youngest, Zach, now 18, has developmental and physical disabilities that began about age 2.
Zach’s special needs escalated in grade school.
“We really were kind of at the end of our rope in terms of just the stress and the strain with all of the disabilities he had, and caring for him. It was taking a toll on my other two sons and our family,” Doug Stephens said.
His son’s primary diagnosis is atypical autism asperberger’s syndrome, but he also has epilepsy, Tourette syndrome and attention deficit hyperactivity disorder.
“We would get services here and there, but we were really looking for somebody to provide us with some comprehensive services,” Stephens said. “We needed a team. We needed someone, like Bert Nash, who could really look at the whole picture.”
A referral to Bert Nash from a health professional outside the Lawrence community was the answer to the Stephenses’ prayers.
They participated in family counseling, and all of the boys received various services, especially Zach.
Bert Nash case manager Rhonda Stubbs has helped Zach with school, social skills, and life skills. He is finishing his education at a private school in Kansas City, and Stubbs is helping him apply for jobs. Zach’s condition has improved since grade school.
“They have been very helpful for us for many years,” he said.
Doug Stephens is one of 13 people who serves on the board of directors. He has become an advocate for mental health because he knows about the stigma.
“It’s a thing that families often are reluctant to want to admit, and if they do, there’s a tendency to keep that quiet,” he said. “That needs to change.”
Lawrence resident Mariah Riling, 21, credits Bert Nash for giving her the coping skills to survive.
At age 17, Riling had tried to commit suicide three times and was hospitalized twice. She took an overdose of pills all three times, and tried to cut her wrist once.
She was referred to Bert Nash after her last suicide attempt, which left her in the hospital for one week.
“I was reluctant to go at first,” she said. “But, I had hit rock bottom to the point where I wanted to get better, and then Bert Nash was there to pick me up and help me with that process.”
She entered the Dialectical Behavioral Therapy program, and received one-one-one counseling along with group therapy over the course of a summer. She attended the group therapy with her mother, and Riley said it brought them closer.
“I wouldn’t have been able to get past it without help. I don’t even know if I would be here today,” Riling said. “I still use the skills that I learned to function daily.”
After graduating from high school, she joined AmeriCorps and went to California to work for the American Red Cross Relief Program. She worked with people who were displaced by wildfires.
While there, she decided to pursue a career in which she could help others.
She returned to Lawrence and Bert Nash, where she works part-time as a psychosocial worker while pursuing a psychology degree at Kansas University. She helps people with housing issues.
In January, she stopped taking medications. Riling said she is able to recognize the signs of depression and seek help.
In high school, Riling said she didn’t talk about her mental disorder. Now, her perspective has changed. She knows she is not alone.
“I don’t like the stigma that’s involved with people who have a mental health issue,” she said. “It can happen to anyone. I was a kid that people thought smiled all of the time, and I looked happy. I had good parental support and good siblings. People didn’t know that I was struggling with a mental illness, but I was.”
Bert Nash Community Mental Health Center, 200 Maine St., is a nonprofit community mental health organization that offers outpatient, research-based services for Douglas County residents.
To make an appointment or for more information, call 843-9192. It’s also the number for emergency services which are provided 24/7.
The center’s top diagnoses so far this year:
Major depressive disorder (recurrent, moderate), 87.
Depressive disorder (not otherwise specified or NOS), 85.
Anxiety disorder (NOS), 63.
Mood disorder (NOS), 62.
Dysthymic disorder, 50. It’s a chronic type of depression in which a person’s moods are low.
Adjustment disorder with mixed anxiety and depressed mood, 50.
Post-traumatic stress disorder, 46.
Adjustment disorder with depressed mood, 45.
Generalized anxiety disorder, 43.
Major depressive disorder, recurrent, severe without psychotic features, 40.
DECADES OF GROWTH
Bert Nash Community Mental Health Center will mark its 60th anniversary on July 5. Here’s a look at the changes and growth:
• On July 5, 1950, Bert Nash Clinic opened inside Lawrence Memorial Hospital.
• During the first six months of operation, its budget was $7,280. It served 131 clients with a full-time psychiatric social worker and a psychiatrist and psychologist who worked one half-day a week.
• In 1959, it moved to the Jennie Watt house at 342 Mo. because it needed more space.
• In 1960, it had a budget of $23,147. It served 298 client with a full-time psychiatrist, social worker and secretary, and a part-time psychologist.
• In 1961, its name was changed to Lawrence-Douglas County Mental Health Center to reflect that it was more than a clinic.
• In 1965, the name was changed to Bert Nash Mental Health Center.
• In 1970, it had a budget of $67,443 and six full-time employees. The center served 378 clients.
• In 1970, it was incorporated as a non-profit organization which made new funding available. The name was changed to Bert Nash Community Mental Health Center.
• In 1973, a 24-hour answering service was initiated.
• In 1980, the clinic’s administrative offices and child and family services were moved to 336 Mo.
• In 1980, The Endowment Trust Fund was established.
• In 1981, it had a budget of $608,150. A total of 20 employees that served 698 clients.
• In 1990, the clinic had 56 employees and 2,021 clients. Its budget was $1.8 million.
• In 1999, the clinic moved to its current location inside the Community Health Facility at 200 Maine.
• In 2000, the clinic had a budget of $5.7 million, 3,879 clients and 144 employees.
• In 2000, it marked its 50th anniversary with a two-day summit: Building a Better Community.
• In 2002, the second-floor mural “Life Changes” by Van Go Mobile Arts Inc. was dedicated. Van Go is an arts-based social service agency that serves high-need and under-served youth.
• In 2005, Nancy Shontz Educational Series was established to provide continuing education for the center and community.
• In 2009, the clinic served 5,915 people.
• On July 1, the clinic had 180 employees and a budget of $10.1 million.
• Oct. 9, it will celebrate its 60th anniversary with the Bert Nash Dash and Bash, a race and downtown block party.
Bert Nash Community Mental Health Center is marking its 60th anniversary Oct. 9 with the “Bert Nash Dash and Bash” in downtown Lawrence.
The event begins at 4 p.m. with the Nash Dash, a 5k and 10K race, that starts and ends at Seventh and Massachusetts streets.
Besides the race, there will be live music, street entertainment and children’s activities in the 600 block of Massachusetts that will continue until about 11 p.m. Food and beverages will be provided by Lawrence establishments.
The event is free and open to the public. Proceeds from the food and vending at the event will benefit the Bert Nash Endowment.
If you are interested in sponsorship or volunteer opportunities for the event, contact Cindy Hart at firstname.lastname@example.org.
For more information, visit www.bertnashdashbash.org.