Depression Can Be Killed - Avail the Mental Health Care Ways

Out of the many health problems associated with people, there is yet another kind of sickness. This is the mental sickness, which finds its cure in the mental health care. There can be a wide variety of reasons due to which people may undergo depression. A depressed State of mind is something that can have its impact on the physical health as well. The mental health care is directed towards making people realize that life is to be happy. They can feel the positive energy rising high within them. The mental health care is extended towards those people who find it hard to meet the difficulties of life. As A result of this, they start feeling the helplessness that they have been exposed to. This makes it very difficult for such people to carry on with life.

There can be different reasons behind a person getting into such imbalanced state of mind. It may happen due to an unsuccessful marital Relationship, loss of someone very close or failures in the field of career. Present day, even students Undergo this problem due to the excessive pressure put on them for competing with the demanding world. In case of the situations wherein
They fear to meet people who hold high expectations; they get into the depressed state of mind. However,it is not something that has no remedy. Just like any other problem, it can also be dealt with the mental health care. This includes taking good care about the happiness of people. Health care includes boosting up the confidence of people suffering from this kind of problem. The people having depressed state of mind are exposed to wider persecutions of life.

In some cases, the meditation is also a part of the mental health care so as to get a focused approach to solve any kind of problem. In case, proper mental health care is not provided to the person, he may even attempt to commit suicide. The best approach is to let him speak out his heart. A person who takes the aid of mental health care May feel the need to come out of his sad state of mind. As a result of this, he will even make efforts at his end to come out of this depressed state. The Responsibility of health care is to tell him ways to heal himself. An integral part of the health care is to understand the feelings of this person. This will help him to get proper guidance. As a result of the unhappy mind, one generally tends to shirk all meals. This may effect his health. Mental health care also takes care to give him good nutrition.

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Lack of Parity in Treatment in the Mental Health Care Field

A bill was recently passed in the House of Representatives to insure that there existed parity among mental health patients and physical health patients regarding treatment. However, this parity shows only a lack of fair treatment, when it comes to me and my fellow mental health consumers and the way we are treated by the medical system as a whole. We are suppose to have the same affordable services available to us, as well as the high standard level of care with concern to customer satisfaction, that all people receive. This should be the case whether payments are through private or public insurances, which give us the opportunity to receive these services.

Perhaps it's the stigma regarding mental health that still exists. This stigma exists not only among the general public but also within the ranks of mental health treatment teams, which include doctors, nurses, social workers, and many others. On the other hand, it could be that the "powers that be" do not see an impending need for the type of care we need and the undoubtable existence of it being a life and death situation, as is often the case with physical needs. Not only do we hurt emotionally with our pain, but we hurt physically as well. The stress that is placed on us, through poor hospital conditions and a broad use of a non- thorough- plan aimed at treating the individual as a whole in order to produce recovery, is something that should be looked at closely in regards to policy.

First, in looking at the members of the treatment team, who provide our care, it is evident to me through my experience, while receiving services as a consumer and witnessing the implementation and behind the scenes talk of my coworkers while working as a peer provider, that the stigmas are far reaching; and, we are often looked at as a thorn-in-the side of the health care system. As a consumer, I have experienced the rude and disconcerting, downgrading talk from mental health techs and nurses, when even a simple question is asked. Doctors will often give you a ten minute window of time when you are describing what you are experiencing; and, when you do ask a question in regards to your care, you often do not receive an answer in a way which is concurrent with the active involvement that you as a consumer should have in your health care plan. I have experienced caseworkers who do not return your phone calls, because they feel that you are nothing but a bother; and I have experienced a social worker who tells you that if it was up to him you would never be released from the hospital. These are a few of the many ways in which we, as consumers of a mental health system, are treated. Many consumers feel that we have no way of giving customer feedback, nor do we feel that our feedback would be considered to be of any meaning to anyone, even if it was received.

If actually investigated, individuals with even the hardest of hearts would break down to tears as they looked at the facilities and the conditions that we must bear as consumers, while attempting to recover from an episode of psychosis, depression, or another label. They would find hospitals with beds that are nothing more than cots with a thin foam pad on which to sleep. They would find a ward that holds upwards to fifty people with nothing more than two short hallways and a small dayroom area. When the opportunity arises to go outside, it consists of nothing more that walking back and forth on a concrete catwalk with bars above and on the sides and only thirty feet of walking space allowable. In some facilities, the shower must be shared with all fifty people on that ward. It is unkempt and unsanitary, most of the time, and consumers often have to use the shower with no hot water and very little soap. With these conditions, consumers have difficulty maintaining a good quality of hygiene.

These are just a few conditions that can be compared to a hospital room shared by two patients, while in a facility treating physical health problems. As for the food, well, I just won't even go there.

As you can see, the lack of parity is clear and nothing ever seems to be done about it. No quality, unified training for the health professionals exists. I have not seen any upgraded facilities, and there still remains no consumer input into our treatment. This leaves many consumers still far away from the goal of recovery. And, a new rise of consumers have developed who have suffered not only these poor standards of care, but they have also been forced to receive injections, medications, and electroshock treatments ordered by the court. These individuals are now calling themselves "psychiatric survivors." In my opinion, such treatment takes away the very liberties which the court is supposed to protect.

11 Points For Mental Health Care Reform

Due to greater understanding of how many Americans live with mental illnesses and addiction disorders and how expensive the total healthcare expenditures are for this group, we have reached a critical tipping point when it comes to healthcare reform. We understand the importance of treating the healthcare needs of individuals with serious mental illnesses and responding to the behavioral healthcare needs of all Americans. This is creating a series of exciting opportunities for the behavioral health community and a series of unprecedented challenges mental-health organizations across the U.S. are determined to provide expertise and leadership that supports member organizations, federal agencies, states, health plans, and consumer groups in ensuring that the key issues facing persons with mental-health and substance use disorders are properly addressed and integrated into healthcare reform.

In anticipation of parity and mental healthcare reform legislation, the many national and community mental health organizations have been thinking, meeting and writing for well over a year. Their work continues and their outputs guide those organizations lobbying for government healthcare reform..


1. Mental Health/Substance Use Health Provider Capacity Building: Community mental health and substance use treatment organizations, group practices, and individual clinicians will need to improve their ability to provide measurable, high-performing, prevention, early intervention, recovery and wellness oriented services and supports.

2. Person-Centered Healthcare Homes: There will be much greater demand for integrating mental health and substance use clinicians into primary care practices and primary care providers into mental health and substance use treatment organizations, using emerging and best practice clinical models and robust linkages between primary care and specialty behavioral healthcare.

3. Peer Counselors and Consumer Operated Services: We will see expansion of consumer-operated services and integration of peers into the mental health and substance use workforce and service array, underscoring the critical role these efforts play in supporting the recovery and wellness of persons with mental health and substance use disorders.

4. Mental Health Clinic Guidelines: The pace of development and dissemination of mental health and substance use clinical guidelines and clinical tools will increase with support from the new Patient-Centered Outcomes Research Institute and other research and implementation efforts. Of course, part of this initiative includes helping mental illness patients find a mental health clinic nearby.


5. Medicaid Expansion and Health Insurance Exchanges: States will need to undertake major change processes to improve the quality and value of mental health and substance use services at parity as they redesign their Medicaid systems to prepare for expansion and design Health Insurance Exchanges. Provider organizations will need to be able to work with new Medicaid designs and contract with and bill services through the Exchanges.

6. Employer-Sponsored Health Plans and Parity: Employers and benefits managers will need to redefine how to use behavioral health services to address absenteeism and presenteeism and develop a more resilient and productive workforce. Provider organizations will need to tailor their service offerings to meet employer needs and work with their contracting and billing systems.

7. Accountable Care Organizations and Health Plan Redesign: Payers will encourage and in some cases mandate the development of new management structures that support healthcare reform including Accountable Care Organizations and health plan redesign, providing guidance on how mental health and substance use should be included to improve quality and better manage total healthcare expenditures. Provider organizations should take part in and become owners of ACOs that develop in their communities.


8. Quality Improvement for Mental Healthcare: Organizations including the National Quality Forum will accelerate the development of a national quality improvement strategy that contains mental-health and substance use performance measures that will be used to improve delivery of mental-health and substance use services, patient health outcomes, and population health and manage costs. Provider organizations will need to develop the infrastructure to operate within this framework.

9. Health Information Technology: Federal and state HIT initiatives need to reflect the importance of mental-health and substance use services and include mental-health and substance use providers and data requirements in funding, design work, and infrastructure development. Provider organizations will need to be able to implement electronic health records and patient registries and connect these systems to community health information networks and health information exchanges.

10. Healthcare Payment Reform: Payers and health plans will need to design and implement new payment mechanisms including case rates and capitation that contain value-based purchasing and value-based insurance design strategies that are appropriate for persons with mental health and substance use disorders. Providers will need to adapt their practice management and billing systems and work processes in order to work with these new mechanisms.

11. Workforce Development: Major efforts including work of the new Workforce Advisory Committee will be needed to develop a national workforce strategy to meet the needs of persons with mental health and substance use disorder including expansion of peer counselors. Provider organizations will need to participate in these efforts and be ready to ramp up their workforce to meet unfolding demand.

Looking for Light in the Mental Health Care Wilderness

Paul Raeburn writes poignantly of his experiences as a father helping raise three children, two of whom suffer from mental illness-a son with bipolar disorder and a daughter with depression. His account will elicit a shudder of recognition from clinicians with institutional or agency experience and will resonate with the many parents struggling to get help for distressed children from managed care and the medical profession.

Raeburn's son Alex, a fifth grader, "detonated" one day upon learning that his art lesson had been cancelled. Screaming in fury, he ran through the halls at school, smashing the glass on a clock with his fist, barreling through the front door, and leading the school staff and police officers on a chase through the neighborhood. The cops wrestled him down, yelling, punching, and kicking, packed him into a squad car, and drove away.

The accounts of this incident and of the many that follow are replete with details familiar to those who work with bipolar children:

seizurelike rages that give way to exhaustion, sleep, and a subsequent total lack of recall
agitated or rambunctious behavior in class
oppositionality and reckless defiance
risky and rebellious impulsivity
threats to kill
a mysterious decline in academic abilities despite superior intelligence
dark, brooding malevolence interspersed with creativity, brilliance, and sweetness

With the skepticism of a veteran observer, Raeburn traces the family's journey through a maze of hospitals, physicians, therapists, and medication cocktails. Just as age, maturity, and possibly blind luck seem finally to be allowing Alex to regroup, the Raeburns' daughter, Alicia, then in sixth grade, becomes symptomatic and is found to be swallowing handfuls of pills and cutting herself. Once again the family is driven back to the hospitals and practitioners who worked with Alex.

Through the years the Raeburns continue to find the results of treatment frustrating and at best mixed-a pharmacological cornucopia, substance abuse, involvement with the juvenile justice system, and therapists who blame parenting skills, intramarital conflict, and, in Alicia's case, the trauma of rape rather than brain chemistry. Perhaps inevitably, given the severity of the stressors, the Raeburns' marriage dissolves. The parents go their separate ways. Raeburn writes unflinchingly about the loss of his marriage and his own experience of psychotherapy.

New Trends in Mental Health Care

I've been writing about the hurdles that the mental health care system has been facing since the recession struck the country. What I haven't written about is where this whole thing is going and which trends are surfacing.

The trend these days is to shift from "monster units" that house 20 or more people to Community Based and Teaching Family Programs.

On one hand, having smaller case loads makes programming easier and the number of behavioral incidents get substantially reduced by having less crowded buildings. If it's hard to live with just one person under the same roof, imagine living with 20 (with psychological issues). Moreover, staffing big units is not always an easy task and supply of qualified staff has surprisingly shrunk during the past months. We were expecting a surge in demand due to the recession but for some reason (unknown to me) this hasn't happened.

Another advantage of having smaller units is that the stress levels that staff are subject to are greatly reduced (which helps decrease turn-over rates) as a consequence of having fewer incidents and a slower paced environment.

Even though the legal client to staff ratio is 8:1 big units need to have at least a 5:1 ratio to ensure proper coverage during crisis situations and daily programming. This greatly impacts budgets and is one of the main problems that service providers are having across the country. Unfortunately there's no way of reducing FTEs without affecting service quality, the latter being often the loser in this battle since budgets are the priority. I think this is mainly why funding agencies are pushing towards more home-like settings.

Additionally, mental health care facilities have been reticent to expand their community based programs for a simple reason: less beds means less money. But empty beds are starting to pile up so it makes no sense keeping a big building fully operational if you are going to operate at half capacity. It's a waste of resources. Furthermore, if you think about it, TFP and Community based programs give more flexibility and are better suited for growth. If you plan to expand your business it's easier to buy a small house or sign in a family for a TFP than building a big facility from scratch. You are also not constricted to available (physical) space on your campus or center, thus there's basically unlimited possibilities for expansion.

Having smaller units also means lower maintenance costs, and the opportunity to develop more and more diverse programs to fit the different populations.

Something that cannot be stressed enough is the importance of having a homogeneous population in each building. Usually, the bigger the unit the more diverse the conditions it serves. This can make daily activities a nightmare since clients' preferences and needs greatly vary. By having small and homogeneous groups this can be avoided.

While some organizations have reacted faster to the new environment and are currently expanding at a frantic pace, others have been more skeptical and tried to stay on course, crashing into the reality wall. They have realized that the near future doesn't look so bright and therefore, they have started to lay out plans to expand into the community. The fate of some will depend on how fast they can deploy. Other organizations, which enjoy a big enough financial cushion, will have time to make this transition in a tidy manner.

Fernando Tarnogol is an Argentinean psychologist, currently working as Program Coordinator at the Devereux Foundation in West Chester, Pennsylvania.

Mental Health Care

Mental Health Care is concerned with the diagnosis and treatment of mental illness. There are various facets to mental illness. The most heard and common are Alzheimer's disease, schizophrenia, dementia etc.These generally stem out of depression. Let us try and analyze how and why depression sets in.

Depression is one of most common mental illness and can be cured by timely mental health care. It can include both emotional and physical symptoms. Both types are controlled by chemicals called neurotransmitters. Depression does have other symptoms which we usually associate with emotional distress; such as unexplained aches and pains, or digestive problems.

The first step in Mental Health care is to find out how and why these illness occur.Everyone feels down at times, but long-term or severe symptoms may indicate a mood disorder, such as major depression which is also called clinical depression. Dysthymia is a less severe form. Bipolar disorder which was formerly known as manic depression involves alternating episodes of depression and mania. Postpartum depression occurs within a year of childbirth.

Although emotional symptoms have traditionally been used to detect depression, research shows that physical symptoms are also very common and should not be overlooked. The body has nerve pathways that determine how it handles pain sensations and emotions.

The spinal cord is the central 'street' along which the messages go back and forth to the organs, nerves and cells. These messages are relayed by neurotransmitters in the brain, and regulate emotions and sensitivity to pain. However when these neurotransmitters go out of balance, a person can become depressed and is more likely to feel pain or other physical symptoms.

The next step in mental health care is to find out the ways of checking whether an individual is under Depression. The following is the checklist: Is the individual in an irritable mood much of the time? Has he/she lost interest or the pleasure in life? Is the person experiencing constant feeling of excessive guilt? Is there a reduced level of concentration and significant weight gain or weight loss when he/she is not actually dieting?

The other symptoms which can be related to depression are:Unexplained lack of sleep, excessive sleepiness and fatigue. Excessive restlessness or complete listlessness,Recurrent thoughts of suicide,Difficulty in managing diabetes or other chronic illness,Aches or pains that don't improve,Digestive problems, headaches, backaches, chest pain or occasional dizziness and Family history of depression.

The mental health care for the above discussed is to consult a doctor if one manifests five or more of the above symptoms.

Depression and related mental ailments is a biological illness. It needs attention as much as any other illness. Patients need support and patience from friends and family members, while counseling and medication can be treatment options. Medication should be taken as directed by a doctor and may be continued for weeks or months to prevent recurrences.

Mental Health Care Outreach and Social Media

If you work in the mental health field, you are a natural born communicator. Can we all agree that there is no counseling without a true command of language? After all, psychiatrists, counselors and social workers must all be well versed in BOTH, the spoken and written word to succeed within their chosen career fields.

Counseling sessions are based on active listening skills and the ability to successfully organize and summarize what the client shares. In addition, everything learned from each client session must be converted to accurate, comprehensive and concise progress notes. The data is often admissible in legal proceedings, so the mental health professional must be able to use an economy of words which express a multitude of thoughts and details. Let's also just remind everyone that professionalism and field credibility also requires neatness, flawless spelling and grammar and attention to proper syntax.

So, where does Social Media enter in to a discussion about listening, thinking, talking, writing and detail orientation?

Social Media Represents the "New World" of Opportunity for Everyone

Social Media is an important form of communication these days. It is becoming a communication tool of choice for many mentally ill clients, especially when they wish to communicate - anonymously - with others to avoid positive

identification and attached stigma. Mental Health professionals are increasingly spending their counseling time instructing their clients in the safe and productive use of Social Media, for this purpose. The chief goal is ALWAYS to protect the vulnerable from exploitation.

The mental health professional is also using Social Media as a way to gain additional professional knowledge as well as to network with others in his own field; including the many that live and work a great distance away.

There are also new opportunities for degree work and certification through online universities and professional organizations, respectively. There are moderated and open forums for career-related discussions on a variety of professional topics developed to advance the field of mental health care.

Plenty of collegial relations and friendships have been forged in the online world, often leading to one-to-one telephone conversations and live meetups. Face-to-face meeting have always been the goal of Social Media, which is designed as an enabler and not a replacement for physical human interaction.

Job information has been exchanged and employment interview offers are often tendered online. And, then there is the research that keeps the mental health care professional up to date on the changes taking places in his field from day to day. Some of the research and anecdotal contributions are the product of practitioners, just like you and me, who choose the Internet as a place to publish our work and share it with the world. We no longer need to wait for third parties to publish what we write.

Forget the Yellow Pages. You Must be Active in Social Media to


There is another area in which the worlds of mental health care and Social Media often come together - marketing and outreach. Can any nonprofit or private business afford not to avail themselves of the benefits offered through Social Media? I think not. Why? Because, the collective Social Media audience is huge and diverse. We need the kind of visibility and name recognition that the Internet can lead us to.

Most everyone that we need to connect with is already online, with more and more people showing up daily. Facebook, alone, is already at or nearing 600 million users. Confidently, there is no one on earth that does not know - at least - a single person with a Facebook profile.

Marketing and outreaching others in Social Media need not take a huge amount of resources, either. In fact, the entire effort can be limited to just a few platforms and a limited amount of posts on a consistent basis. This is resource allocation, well positioned.

Are you LinkedIn?

All professionals in any field belong on LinkedIn. Create a profile with your credentials, contact information and over time, as many business references as you can gather. Take some time to join some professional groups and pose and answer career-related questions among the group members. There is a lot to learn from others and much one can share to prove his field expertise. It is such expertise that builds professional credibility and helping relations over time. Such relationships are invaluable when it comes to creating all sorts of professional opportunities including business partnerships, client referrals and employment offers. Do not discount the value of LinkedIn as a premier Social Networking platform for mental health care professionals.

Are you Facebooking?

Facebook is another place where the people we need and wish to "talk" to are a great deal of the time. Sure, it is a place where one must be especially careful not to embarrass himself among his friends or professional colleagues, but it is a place where using good posting discretion can balance the fun with the serious. The common denominator is "value." Bring value to others and garner their respect and loyalty.

Facebook does have a business side, too. The Facebook business page offers a place to create and foster community, client and professional relations through providing value to some and offering an outlet for others to do the same. A few well placed posts about happenings in the mental health care field on your Facebook business page and a few more quality posts and comments on the pages of others you seek to have an audience with and you are on your way to growing a successful Facebook presence. Just remember that on Social Media, it's not all about you. Value for others, FIRST. You have the right to pitch your own endeavors about 15% of the time. Do not try and sell in Social Media; work harder to impress. Being respected and liked will get you the opportunities you are looking for.

Have you Blogged, Today?

Blogging is also a great tool to become better known. Show you are an expert in something and share it wherever you can. One or two 400 - 500 word blog posts per week, can quickly establish a professional as an expert that others want to hear from regularly. Invite others to write for your blog, too. Guest bloggers are refreshing and help give the impression that your blog is important enough for others to take the time and contribute to. Their followers will come to read their posts and have a chance to read yours. Often newspaper and magazine writers read the blogs, so don't be surprised when you receive offers to publish your contributions in their print and online publications. This is good for you and your business, because their readers are probably your own target audience.

When did you last Tweet?

Do you need to tweet? Twitter can be effective if you can develop a targeted and convertible following. Building such a dedicated following takes much work. You want to create a following of credible mental health care gurus; respected field publications; a pool of mainstream field nonprofits and for-profit; federal, state and local government leaders; supportive local businesses and potential client groups. Retweeting others and replying to their tweets is just as important as tweeting your own materials. Again, you must limit tooting your own horn to about 15% of your tweets. Tweet value and seek to connect with others. If you can build relations and take them off-line, you are succeeding.

Are you in Constant Contact with your Primary Audience?

Lastly, look into using an E-mail service such as Constant Contact to keep your audience up to date. Send out a monthly newsletter; issue announcements such as new hires and business expansions; announce your Social Media presence: and even create event invitations and holiday E-cards for your contacts. The more you can get your name in front of others, the better it is remembered. Just don't overdo it. Strike a balance by using all of your Social Media tools, timely and appropriately.

This is a very exciting time for mental health care professionals. Their appropriate use of Social Media can do many wonderful things for them; their professions; their businesses and organizations; and the clients they serve.

Pitfalls of Using Health Insurance For Mental Health Care

Because of the unfortunate stigma still attached to mental health conditions, people should think twice before using their health insurance to pay for visits to a mental health professional, such a marriage and family therapist, a psychologist or psychiatrist.

If you do have health insurance coverage, your first reaction might be to think, "Well, if I've got insurance, why shouldn't I use it? That's what it's there for." And, most of the time, that's true. I know I'm certainly grateful for my health insurance when I go to the doctor or dentist.

But it gets more complicated when it comes to mental health care because of negative associations attached to psychological disorders. For example, people probably think differently about an individual who has a physical condition such as a thyroid disorder versus someone who has a psychological condition such as major depression.

The reality is, if you want to get your insurance company to pay for your mental health care, the mental health care provider has to give you a serious psychological diagnosis or the insurance company won't pay for the treatment.

For instance, many insurance companies won't pay for someone seeing a therapist for couples counseling or for "normal bereavement" following a loved one's death. So your mental health care provider needs to find a serious diagnosis that legitimately describes your situation and that will be acceptable to your insurance company. But, once you have that diagnosis, the big issue becomes confidentiality.

Here's how that works. When you're seeing a therapist and paying for it yourself, the information you discuss in session stays in the room for the most part. The therapist doesn't share the information with anyone else, except when they're required to report child abuse or elder abuse or a handful of other situations covered by law or their profession's code of ethics. So the vast majority of the time, the information you share with your therapist stays just between the two of you, and you can feel completely free to share all the deep problems that brought you to the therapist's office in the first place.

However, your sessions won't be so private any more if your insurance company is paying for all or part of your mental health care, because your diagnosis then becomes part of your health record and it's no longer confidential. That could be detrimental to you in the future.

For example, let's say your therapist diagnoses you with major depressive disorder, which is a very common diagnosis. Think about how people view other people who are seriously depressed. They generally have certain expectations of how depressed people behave.

So having that diagnosis in your health record could affect your ability to get a job in the future. It could be an issue in a child custody battle or other legal problems, especially since law enforcement agencies can access your insurance information at any time. A serious mental health diagnosis could cause problems if you tried to obtain other health insurance or life insurance in the future. Those are just a few examples of situations to think about.

The other issue with using insurance benefits for mental health care is that the insurance company might place limitations on the number of sessions you can obtain or require that you get pre-approval from your primary care physician. Some insurance companies are very generous and allow weekly sessions until your problem is resolved, and they don't interfere very much in the therapeutic process. But some companies place a limit on the number of sessions they'll cover in a given year, and that frankly might not be enough to resolve some serious or longstanding problems.

But, to me at least, those pragmatic challenges of trying to get your insurance company to provide adequate mental health coverage pale in comparison to the confidentiality issue I was talking about earlier. Confidentiality really is the Number One thing you should consider when you're deciding whether you want to use your health insurance to cover mental health care.

Renee Haas is a licensed marriage and family therapist and a life coach. She specializes in helping people enhance their relationships, especially doing couples counseling and working with individuals who are having relationship difficulties with a partner, child, parent, boss or other significant people in their lives. She serves therapy clients in California, either in her Moorpark office or via phone or webcam. She works with coaching clients anywhere via phone or web cam.

Suicide Prevention Through Better Mental Health Care

We need to find ways to make life less difficult for people who struggle with mental illness. No one should have to choose between needed medicine and food or shelter.
We all deserve to have our basic needs met with respect and acceptance. Mental illness is not the person's fault any more than cancer or heart disease is. This is hard for most of us to understand.
What we see of mental illness is just the tip of the iceberg.

Many more people suffer silently. We can't see mental illness, it comes to our attention when it is not treated effectively. Sometimes that makes us uncomfortable, and forces us to look at the results of our personal priorities.
Mental health care and suicide prevention should be obvious public health goals. Medicines are getting better and better at keeping depression controlled, but the enjoyment and satisfaction of everyday life is more than just "getting by" emotionally. Suicide means ending your life on purpose. Suicide prevention means making living look better than dying.

Lots of people with depression, and other mental health problems, find new lives with the right mental health care. Others don't have the same opportunities.
Suicide looks like the best or only choice for them. We can't stop all of the hardships of their lives, but suicide prevention has to include making better mental health care more available.

How to help yourself and your loved ones get better mental health care:

Learn the warning signs of depression.

If the depression is mild and not upsetting sleep, appetite, concentration or irritability, look for a licensed counselor, social worker or psychologist.
If there are any of the following,
frequent crying or anger outbursts, or crying for no reason, or loss of temper at little things
unusual irritability, snappiness, impatience, criticism of others
poor concentration, follow through, or are more easily distracted
avoiding family and friends, saying 'no' to most invitations or suggestions
trouble falling asleep, (longer than 20"-30"), staying asleep (should be getting usual sleep or 6-8 hours a night), or sleeping too much ( more than 2 hours longer than usual), or waking up and not getting back to sleep
panic attacks, with physical signs like fast heart beat, shortness of breath, shaking, sweating, dizziness, nausea, chest tightness or chest pain, numbness or tingling in hands or feet
thoughts of death or suicide
new or increased use of alcohol or recreational or prescription drugs
All of the above persons can do counseling, but a person will probably also need someone who can prescribe medication.

Choosing the right Mental Health Professional assures better mental health care for everyone.
Learning more about depression helps you to get better mental health care for yourself and your loved ones. You will pick up on it sooner, and do something about it before it gets disabling.
Thoughts of suicide don't usually come on suddenly, so noticing depression early and getting help can stop a lot of suffering. Spread the word, help stop the epidemic of suicide.

Nine Recommendations to Increase Continuity of Mental Health Care For Schizophrenia Patients

Continuity of therapy is a vital component of quality care for people with serious mental illnesses and must be given more attention by consumers themselves, family members, advocates, providers, administrators, and researchers alike. At the moment, there is an important opportunity to develop a national consensus statement on the principles and practice standards that should form the basis of a continuum of therapy designed to provide realistic assurance that consumers can access vital medications when and where they are needed. Important strides have been made in identifying the specific factors which promote continuity of therapy - it is time to seize this important opportunity as yet another stepping stone to achieving the transformation of America's mental health care system for the benefit of consumers and their families, our communities, and our Nation. A roundtable of mental health experts has developed a set of nine recommendations for enhancing continuity of medication therapy for persons with schizophrenia or serious mental illness, including schizophrenia. They are as follows:

Mental Healthcare Recommendation #1 -

Encourage collaborations between hospitals and community-based organizations. Use fiscal incentives to foster collaborations including the standardization of information and shared electronic health records.

Mental Healthcare Recommendation #2 -

Use a quality improvement approach to enhance continuity of therapy by benchmarking at the organizational level performance and outcomes standards regarding continuity of care.

Mental Healthcare Recommendation #3 -

Ensure all consumers have a level of care management for the transition from inpatient to community. Care management services should be reimbursable by all payers and the disincentives to providing it should be removed.

Mental Healthcare Recommendation #4 -

Hospitals and community providers should focus on the "Pull Model" of transition from inpatient to outpatient care. The Pull Model focuses on involving community-based providers in the transition planning process from the beginning. Provider organizations should focus on staff competency in engagement and strategies and motivational interviewing.

Mental Healthcare Recommendation #5 -

Accreditation standards should be aligned to address and improve continuity of therapy in treating serious mental illness. This may include developing standards to ensure evidence of an active process of care management and transition between levels of care, a quality review of the success of transition plans, and measuring engagement.

Mental Healthcare Recommendation #6 -

Consumers and their families should be educated about the benefits of maintaining their personal health care history. Ensuring that consumers have detailed information about their illnesses and treatment history will help ensure that providers have access to the information they need to provide appropriate care in a timely manner. The options here range from simple paper and pencil logs and medication histories to electronic records on memory sticks.

Mental Healthcare Recommendation #7 -

Consumer-driven recovery planning should include and the appropriate and necessary use of hospitalization. More thoughtful use of inpatient services could lead to a reduction in emergency room use and ultimately to a decrease in the number of hospitalizations.

Mental Healthcare Recommendation #8 -

Parties who collect data about mental health services and performance should share it with appropriate stakeholders in usable and timely ways. Many payers and public entities collect both population and individual specific information about mental health consumers and services. Population-based data should be shared with all stakeholders, including families and consumers to aid in enhancing the system of care.

Mental Healthcare Recommendation #9 -

There should be meaningful involvement of consumers and their advocates in all levels of system delivery and evaluation. Global involvement of consumers and their advocates in the care delivery process is essential. Examples include using peer specialists as part of a treatment team, active involvement in policy and planning, as well as involvement in developing and implementing performance measurement and evaluation.

Applying these Mental Healthcare Recommendations -

While we have learned that maintaining continuity of therapy has a positive impact on consumer outcomes, the barriers and other impediments to ensuring this continuum of care have been long entrenched in mental health and related care systems. An unacceptably high number of people with serious psychiatric issues - including schizophrenia, depression and bipolar disorder - are "falling between the cracks" in the transition between acute inpatient settings and the community causing harm and disruption in their own lives and those of their families and often bringing their recovery process to a halt.

A continuity of therapy initiative is likely to decrease inappropriate use of emergency room services by consumers with schizophrenia or other serious mental illnesses by assuring consistency in the disease management approach used by all community provider organizations. Both of these likely outcomes of continuity of therapy provide cost reductions for the hospital and cost offset for the investments in continuity of therapy initiative and related therapies.