Cenpatico Blog

-By Cyndi Campbell, Manager, Clinical Research and Development

Last month we shared some statistics about mental health and substance abuse that highlight the impact of behavioral health on our overall wellness and the importance of considering this as we discuss healthcare reform.  The statistics from SAMHSA remind us that behavioral healthcare does not just impact one individual; it affects children and communities for generations.

Recently the Substance Abuse & Mental Health Services Administration (SAMHSA) released the results of research on the high rate of occurrence and the impact of children living with substance using or abusing parents.
“The research increasingly shows that children growing up in homes with alcohol- and drug-abusing parents suffer…The chronic emotional stress in such an environment can damage their social and emotional development and permanently impede healthy brain development, often resulting in mental and physical health problems across the lifespan. This underlines the importance of preventive interventions at the earliest possible age.” – SAMHSA Acting Administrator Eric Broderick, D.D.S., M.P.H.

SAMHSA reports:
•    Almost 7.3 million children lived with a parent who was dependent on or abused alcohol
•    About 2.1 million children lived with a parent who was dependent on or abused illicit drugs
•    5.4 million children lived with a father who met the criteria for past year substance dependence or abuse, and 3.4 million lived with a mother who met these criteria.

Often when a parent’s alcohol or substance abuse is out of control, the child is identified as having a problem first.  Maybe a teacher or school nurse has noticed sleepy eyes or school work below the child’s ability.  Some children begin to take on more responsibility at home as they have gotten used to taking care of their parents and sometimes siblings too.

According to The Center on Addiction and the Family (COAF), the definition of a child of an alcohol or substance abuser “is any child whose parent (or parental caregiver) uses alcohol or other drugs in such a way that it causes problems in the child’s life.”

When parents or caregivers are using or abusing alcohol or other drugs family life can be unpredictable and chaotic.  Frequently communication, rules, or expectations are unclear or inconsistently enforced.  Parents may display wild swings in behavior from loving, to withdrawn, to out of control.  This can be confusing to children leading to feelings of worry, insecurity, anger, and self-blame.

These confusing feelings can become disruptive behaviors for children.  On the surface it may look like, or be expressed as, other commonly diagnosed psychiatric disorders for children such as attention deficit disorder (ADD), attention deficit-hyperactivity disorder (ADHD), anxiety, and depression.  Children who display these symptoms should be referred to a mental health professional for assessment.

There are many ways even occasional substance use can impact their children.  Substance use for adults can lead to broken marriages, loss of jobs and economic stability in the household.  These types of challenges may seem to the parent to be theirs to deal with, but children feel the effects of the stress as well.  Stress is well known to lead to health problems in adults, but children too can develop physical health problems due to stress such as headaches or asthma.

The encouraging news is only 1 out of every 4 children of alcohol abusers will become an alcoholic themselves, 75% will not (COAF).  Many children with substance using or abusing parents and caregivers are able to find ways to succeed in life. Identifying with positive role models and learning to tap into their own positive coping skills helps children to be resilient and successful.

More resources on this topic can be found at:
Substance Abuse & Mental Health Services Administration  http://www.samhsa.gov/
Center on Addiction and the Family:  http://www.coaf.org

This entry is filed under Blog.

…”there can be no health without mental health”

- William Emmet, Director, Campaign for Mental Health Reform, September 10, 2008.

Cenpatico welcomes the “merry month” of May not only because it is the harbinger of real Spring for much of the country, but because it is Mental Health Awareness month.  Two weeks ago I commented on the staggering impact of alcohol abuse in our country. Here are some of the staggering facts about the overall impact of mental illness and substance abuse in our country(1):

* One in four adults Americans has a mental disorder, substance use disorder, or both
* Mental Illness is the leading cause of disability in North America for people between the ages of 15 and 44.  Further, the burden of disease from mental disorders exceeds those from any other health condition.
* Adults with serious mental illness die, on average, 25 years sooner than those who do not have mental illness.
* Roughly 30,000 + people take their own lives each year.  Suicide is often the third leading cause of death for young people aged 10-24.
* Treatment for mental health and substance use disorders is effective.  Recovery rates for mental illness are comparable to and even surpass the treatment success rates for many physical health conditions.

As you know, health care reform is a hot topic now, and thanks to the recent parity legislation, behavioral health is becoming a more prominent issue.  But don’t relax yet; we still have a long way to go.  I continue to be disappointed in the lack of meaningful presence at the national healthcare reform table by advocates, behavioral health provider associations, and, yes, leaders from the managed behavioral health care industry.  All three groups have critical experience and knowledge that needs to be discussed and shared in any effort to reform our system.   Toward this end of healthcare reform that understands the role of behavioral healthcare, Cenpatico endorses the principles outlined by the National Association of County Behavioral Health & Developmental Disability Directors (NACBHDD):

1) Behavioral healthcare is essential to healthcare reform.  (See the well known stat’s above if you have any questions or doubts)

2) Coverage does not guarantee access.  For example, adults with serious mental illness (SMI) are a medically vulnerable population and need consistent and ongoing support not only in adhering to a viable behavioral health treatment plan, but also a physical health plan.  Often adults with SMI are compromised by their illness to a point where they are not able to effectively access medical help even with coverage.  Further, there are many in the physical health side of our healthcare system that avoid and discriminate adults with SMI, usually out of a lack of understanding, communication and support.

3) Prevention and wellness strategies are essential.  We still focus too much in our healthcare system on treatment versus prevention and wellness.

4) Integration of behavioral healthcare and physical healthcare.

5) Embrace recovery principles:  Among these are self-direction by consumers, individualized treatment, strengths-based approaches, and peer support.

6) Mental health workforce development.  In particular for the Medicaid consumer, we are facing a crisis of having access to appropriately trained prescribers for psychotropic medicines.  We have to provide better training and support of all physicians as well as adding different types of prescribers due to the psychiatrist shortage.

But what about just maintaining good mental health in the absence of a diagnosable mental illness or substance abuse disorder?  I love the Mental Health America site “Live Your Life Well”  www.liveyourlifewell.org.  They have identified the best top ten list I’ve seen for maintaining your emotional and overall mental health.  I think everyone should have this list in their wallet/purse printed as a reminder to:

1 – Connect with others
2 – Stay positive
3 – Get physically active
4 – Help others
5 – Get enough sleep
6 – Create joy and satisfaction
7 – Eat well
8 – Take care of your spirit
9 – Deal better with hard times

and most important if the top 9 aren’t working, 10- Seek professional help when you need it.

I hope that all of you will pay attention to healthcare reform in Washington.  Get involved and find out where your local representatives and Senators stand on the principles outlined by  NACBHDD.  Make sure they understand that without good behavioral healthcare, there is no effective healthcare in the United States.

(1)SAMHSA Communication Dialogue, National Association of County Behavioral Health & Developmental Disability Directors (NACBHDD), April 2, 2009.

This entry is filed under Blog.

Cenpatico will be a Start/Finish Line Sponsor at the annual NAMI Kansas Walk this Sunday, May 3, 2009.  The two-mile walk will start at 11 am at Washburn University in Topeka, Kansas.

Deb Burnham, Network Manager at Cenpatico, has served on the NAMI Kansas walk committee for the past two years.  She assists with locating entertainment for the event.  This year, Bobbie the Balloon Man, will entertain walkers prior to the start of the walk.  Cenpatico will also provide bottled water for the event.

“Cenpatico’s involvement with NAMI Kansas Walk for the Mind of America demonstrates our commitment to recovery and the importance of raising awareness of the mental health needs of Kansans,” said Deb.

NAMI WALKS for the Mind of America is a fundraising and awareness-raising component of NAMI’s Campaign for the Mind of America.  Launched in 2003 with pilot sites, the NAMI WALKS program has grown to include nearly 70 communities around the country, including the Kansas walk program.

In addition to our involvement with the walk, Cenpatico is also a corporate member of NAMI Kansas.  Click here for more information about NAMI Kansas.

This entry is filed under News.

Cenpatico/IMHS and Prevent Child Abuse Texas are teaming up to train Child Care and School Personnel on child abuse.  The trainings titled Child Abuse and Neglect: It’s Everyone’s Problem hopes to teach Child Care and School personnel how to recognize child abuse and what to do to put an end to it.

“We are pleased that we could assist PCAT in their work towards prevent child abuse across Texas,” said Cenpatico/IMHS Foster Care Training Manager Frank Vega. “Everyday we see the traumatic impact that abuse has in the lives of the children we serve in the STAR Health program. Anything we can do to keep even one kid from experiencing the pain of abuse and neglect is well worth it.”

The training will take place July 11 at the Austin Community College Eastview Campus. Pre-registration costs $15 and on-site registration costs $20. If you are a Child Care or School worker and would like to know more about the training please contact PCAT at (512) 250-8438 x. 18 or e-mail rscoggin@PreventChildAbuseTexas.org

This entry is filed under News.

The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death.

ALCOHOLICS ANONYMOUS, The Big Book

Excessive alcohol consumption is the third leading preventable cause of death in the United States.*

Alcohol abuse plays a significant and direct role in five of the top ten leading causes of death in the United States: Heart Disease, Cancer, Stroke, Accidents and Diabetes. Alcohol abuse and dependence cost the U.S. an estimated $220 billion in treatment costs and productivity impact on our society; this is more than the costs associated with cancer or obesity. One survey published by The Journal of the American Medical Association estimates that the number of alcohol attributable deaths is about 75,000 + deaths per year which would make it, the sixth leading cause of death. Many studies have demonstrated that alcohol is involved in a majority of car accident deaths, homicides, sexual assaults, suicide, and domestic violence. Put it all together and the problem of alcohol abuse and dependence is staggering.

I could go on and on with mind numbing statistics, but the point here is that I think we seem to have lost our focus on this very important disease shared by 14 million Americans. I am an avid reader of periodicals and watch TV news and I am surprised at how little attention has been paid to alcohol awareness during this month. I did see one piece on CNN that followed the tired and worn path of whether alcoholism is a disease versus a moral defect of character (i.e., will power). If alcohol as a drug is responsible for more deaths and costs to our society then all the other drugs put together, why is this not making the headlines? I believe the answer is because alcohol is the only major drug of abuse which is legal.

The dirty secret in our county is that much of our drug policy and subsequent laws to make drugs illegal have little to do with concern about public safety. If you research public policy and the laws that made various substances illegal in this country, you will be shocked to see the laws put in place were more about either the association between drugs and stigmatized groups in our society, or some perceived threat to family values, our idealized view of the American way of life. For example, the movement that resulted in making marijuana illegal in the 1930’s was tied to the concern about immigration, i.e., the perception that Mexican immigrants were bringing the drug into our society. Marijuana use was also linked with African-American jazz musicians and this new form of music was considered a major threat to the youth of the country at that time.

I urge us all to rethink the war on drugs and to consider placing our efforts, money and focus on our true number one drug problem. I know it doesn’t make a very sexy story. It is no longer trendy, and our national celebrities have moved on to the newest diseases that capture the public imagination. Cenpatico and other managed behavioral health organizations (MBHO’s) need to make sure that we continue doing as much as we can to educate and help our providers consistently assess the impact of drinking on our consumers’ lives — recovery from mental illness is not possible in any case where someone is abusing alcohol. We need to do a better job at supporting the transfer of new treatment technologies based on evidenced based practices; many have yet to make it into most substance abuse treatment programs. For example, in spite of several medicines available that can now help those with alcoholism and other addictions recover, we still see these options rarely used. As MBHO’s, we also have an ongoing obligation to educate and support PCP’s in their ability to screen and talk with their patients about the effects of excessive drinking.

P.S. Some of you may have gotten the impression that I want go back to prohibition. No, that didn’t work then just like our current prohibition laws with drugs are not working now. I am in favor of toughening the consequences of drinking behavior. For example, I think we have done a good job on making the consequences more severe for driving under the influence.

So let’s get back to basics and focus on our number one drug problem: Alcohol

*Alcohol-Attributable Deaths and Years of Potential Live Lost–United States, 2001; The Journal of the American Medical Association, v.292, No. 23, December 15, 2004.

This entry is filed under Blog.