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President Trump signed the Suicide Designation Act of 2020 into law on Saturday, designating 988 as the dial code for the National Suicide Prevention Lifeline. Founded in 2004, the network of 161 crisis centers is backed by the federal government and provides a toll-free number for anyone in suicidal crisis or emotional distress. The law also allows states to enact fees to offer these expanded services, in the same way they currently do for 911. “The need for 9-8-8 is urgent. Without appropriate care, people with mental illness end up on our streets, in jails and in emergency departments — and dying in tragic encounters with law enforcement,” said Daniel H. Gillison, Jr., NAMI CEO, in a statement. “By signing this bill into law, we are making real progress toward ensuring people in crisis get help, not handcuffs. We are grateful to Congress and the FCC for their efforts in moving this legislation forward and making 9-8-8 a reality.” The coronavirus pandemic has disrupted the health care system and made it difficult for many Americans to access vital mental health services.
Make sure that you get some mental health support if you need it. Oh, by the way, doing so may mess up your career. After all, over the years, relatively little has been done to alleviate one of the big barriers to doctors seeking mental health services: career and licensure concerns. But recently, KIND Healthy Snacks and the National Alliance On Mental Illness (NAMI) have launched an effort to change such situations. They’ve started petitions on Change.org for medical boards in five states (Florida, Wyoming, Alabama, Oklahoma and Idaho) to stop asking overly-intrusive mental health questions on their medical license applications. In this way, KIND and NAMI are asking medical boards to be kinder to physicians, so to speak.
The Covid-19 pandemic has been somewhat unique in that the crisis has continued for an extended period. Such moments of uncertainty can take a significant toll on those already facing mental health challenges. "Any loss of social support can have a meaningful impact on people with mental illness," said Katherine Ponte, founder of the online peer support community ForLikeMinds and lives with bipolar 1 disorder (NAMI Blog writer and NAMI-NYC Board member). During the last week of March, Ponte and researchers at Yale University School of Medicine conducted an online survey that included 193 people who self-identified as living with a mental illness. The survey, published in Psychiatric Services, found that most of those living with a mental illness (98%) said they had at least one major concern related to the Covid-19 pandemic. "I definitely feared that my mental illness would get worse," she said. "In the past, my manic episodes have been triggered by world tragedies." Ponte also emphasized that there is a light at the end of the tunnel. In response to trauma, some people can experience what is called "tragic optimism," which occurs when someone remains hopeful and builds resilience. These responses can culminate in what is referred to as post-traumatic growth. Ponte said that her hope for the nation is growth after trauma.
While police departments have come under heightened scrutiny in recent months amid a racial reckoning stemming from fatal encounters with Black Americans, so have their actions in mental health emergencies. Experts and communities across the US are taking a hard look at whether law enforcement should be the first line of response. "The short answer to that is no," says Shannon Scully, senior manager of criminal justice policy at NAMI. "The law enforcement field is not equipped, nor should it ever be the first responder to a mental health crisis." But with other mental health resources vastly underfunded or non-existent in many parts of the country, police departments have taken on the task by preparing patrol officers for these emergencies with the help of mental health training. "But NAMI remains concerned about any model that inherently relies on law enforcement involvement in responses to mental health emergencies," Scully told CNN. "The solution here is really looking at the mental health services and support centers in the community and then how law enforcement plays really kind of a secondary, supportive role," she says. And there likely won't be a one-size-fits-all approach for every community.
The presidential debate was dominated by chaos and crosstalk. But one moment of empathy broke through the muddle for some people watching: a spotlight Biden put on his son Hunter’s struggle with addiction. Coping with mental illness and substance addiction is widespread, and often invisible. One in five Americans deal with mental health issues in any given year, and, according to data from the American Addiction Centers, the two struggles often co-occur. Daniel H. Gillison, Jr., CEO of NAMI told Yahoo News that since the onset of the coronavirus pandemic, his group’s helpline has seen a 65% increase in calls and emails from people looking for help. “While NAMI cannot comment on specific candidates, we know that discussing substance use and mental health conditions openly on such a national stage helps to get people talking about these issues and ultimately helps people feel more empowered to get the help they need,” Gillison wrote. “As a result of this collective crisis, more people are discussing their mental health challenges and vulnerabilities openly which helps normalize these conversations and destigmatizes mental health concerns.”
Daniel Prude’s family knew he needed psychiatric care and tried to get it for him. When Joe Prude called the police to report his brother missing, he was struggling to understand why Daniel Prude had been released from the hospital hours earlier. Less attention has been paid to what happened to Daniel Prude in the preceding hours, when he was treated and released after a psychiatric assessment at Strong Memorial Hospital. Medical decisions in a case like Daniel Prude's are high-stakes, with little margin for error, says Dr. Ken Duckworth, CMO of NAMI. "Emergency psychiatric assessment is very challenging, and the potential for catastrophic outcomes following your decision is very real," he says. Prude's case is unusual because the consequences of doctors' decision to release him have played out so publicly, says NAMI's Duckworth. "You make a very big decision, which usually has no known outcome. You put this person in the hospital, you go on to the next patient. You send this person home, you go on to the next patient," he explains. Duckworth adds that he would not second-guess the actions of Prude's hospital team in the moment, but with the benefit of hindsight, "there's overwhelming evidence that he had a psychotic illness and was quite vulnerable," he says. "He didn't need to die."
Amid a nationwide movement for racial justice and police reform sparked by the recent killings of several Black men and women, many people have spoken out against police shootings of people experiencing mental health crises. "A person shouldn't lose their life because they’re experiencing symptoms of a mental health condition," said Angela Kimball, national director of advocacy and public policy at NAMI. "People deserve help, not handcuffs." Nearly 15% of men and 30% of women booked into jails have a serious mental health condition, the National Alliance on Mental Illness estimates. The CAHOOTS program in Eugene, OR now responds to a range of mental health related crises and relies on techniques that are focused on harm reduction. "The idea there is to assume that the vast majority of crisis calls really aren't going to need law enforcement involvement, and more and more locations are starting to explore that model," Kimball said. "We're thinking that that is really the future of crisis response, focused on behavioral health with law enforcement support only when needed." Big change is also on the horizon for July 2022, Kimball said. That's when the 988 national mental health hotline goes live. "The intent is that 988 would eventually be able to dispatch and connect with a range of crisis response services – mobile crisis teams, crisis stabilization programs," Kimball said. "However, that infrastructure is highly localized, so whatever might be available in one state may be very different."
“NAMI was founded by parents of adult children with schizophrenia over 40 years ago and we’re proud to be a part of the of the Accelerating Medicines Partnership for Schizophrenia, a watershed moment in our field,” said Daniel H. Gillison, Jr., CEO of NAMI. “This partnership is a new opportunity for coordinated research on the root causes and progression of schizophrenia, a complex, long-term medical illness. NAMI is dedicated to this partnership which represents the best of the public, private and academic communities. We can all agree that we need better treatments for psychosis and this partnership has the potential to fast-track progress in this area.”
Covid-19 has left lots of people feeling anxious and depressed. But it’s hard to untangle whether this is a normal response to a difficult situation or actual pathology. According to survey results released by the CDC on August 14, 30% of respondents reported symptoms of anxiety and/or depression, versus 11% during the same time period in 2019. Dawn Brown, director of community engagement at NAMI, which runs the free NAMI HelpLine for people seeking support and information, writes that, between March and July, they’ve seen a 65% increase in calls. Some callers have preexisting mental health conditions and reached out because of concerns about accessing medication or treatment during a pandemic, she writes; others did not have anxiety or depression diagnoses but were beginning to experience symptoms.
In a crisis? Call or text 988.