November 2001

In Memory

NAMI North Carolina lost one of its foremost leaders when Shirley H. Strobel died on October 9, 2001 from complications due to lymphoma. Like many members, Shirley became involved with NAMI in 1984 because of her son’s mental illness. Her role with NAMI North Carolina was long and distinguished. She served on the NAMI North Carolina Board of Directors from 1995-1999 and as president of the Board from 1998-99. She was president of NAMI Durham at the time of her death.

During her tenure on the NAMI North Carolina Board, Shirley was instrumental in finding grant support to implement the Family-to-Family program in North Carolina. She also was successful securing grant support to establish the NAMI North Carolina Clubhouse grant program to improve the quality of Clubhouse programs. As NAMI North Carolina state president she helped lead the most successful fundraising effort in the organization’s history in response to a challenge match gift. Shirley authored Creating a Circle of Caring, a curriculum to help churches raise awareness of mental illness that is now in its second printing and has been distributed nationally.

Shirley was most proud of her efforts to develop community support programs for persons with mental illness. Overcoming many barriers, she was a founding force in the establishment of Threshold, a Fountainhouse model clubhouse program in Durham recognized as one of the best in the state.

Always passionate about supportive housing issues, her most recent project was the development of Next Step Housing, a 12-unit apartment complex that will provide affordable housing and access to a case manager for individuals with mental illness. The project is scheduled to break ground in November. "To a great extent, it was Shirley pushing it every step of the way," said Nancye Bryan, NAMI North Carolina Board member and a member of the Next Step Board. "If it weren’t for Shirley, it wouldn’t be happening."

In fact, that is the legacy of Shirley Strobel. Her life was marked by commitment, compassion, boundless energy, and her refusal to accept that something couldn’t be done. As a result, she impacted the lives of literally thousands of people who benefited from the education and service programs she was so instrumental in developing. We have lost a leader, a friend, and a champion, but her time with us enriched us all.

CAPITOL INSIDER

With the longest session of the General Assembly in North Carolina history drawing to a close it’s time to look at what happened to the issues on NAMI North Carolina’s agenda.

• Mental Health/Chemical Dependency Substance Abuse. This bill failed to make "crossover," the legislative deadline for bills to pass at least one chamber of the General Assembly. The House Insurance Committee, which has considered this bill for eight years, decided the bill needed even more study and sent the bill to a subcommittee that never met.

• Housing with Appropriate Community-based Services Housing Funds. The state budget contains $1 million for housing for persons with mental illness. $686,000 is for HUD projects while the remaining $314,000 will be used by the Division of MH/DD/SAS to support housing development specialists in community programs and to provide funds to leverage housing development funds.

• State/County Special Assistance. A special provision of the state budget sought to expand a demonstration project to allow up to 1000 individuals to receive special assistance payments to live at home instead of being required to live in an adult care home and to allow those payments to be made at the same level as payments made to adult care homes. This provision passed both the House Appropriations Committee and the House-Senate Human Resource Conference Committee by an overwhelming majority. But when the final budget emerged, the provision had been gutted due to pressure from the adult care home industry. The will of legislators on behalf of individuals who are disabled or elderly had been overturned by the power of backroom politics.

• Work Incentives for Persons with Severe Mental Illness. Due to the State’s dismal fiscal picture, Work Incentives legislation never was considered. Despite the fact that implementation of Ticket to Work would allow persons with disabilities to work (and pay taxes) without losing Medicaid coverage, the cost to implement was seen as a new program in a year where program cutting was the norm.

• Implementation of the US Supreme Court Case Olmstead vs. LC. Compliance with the Olmstead decision will require the development of a wide array of community support services. In perhaps the greatest scare of the session, the Senate proposed closing several institutions, including Dorothea Dix hospital and Whitaker School. No funds were proposed to develop services for these individuals in communities. The public outrage and subsequent advocacy by NAMI North Carolina and other organizations resulted in the proposal to establish a MH/DD/SAS Trust Fund to provide funds to develop needed community services. In the final budget, $47.5 million was committed to the Trust Fund. Dorothea Dix Hospital and Whitaker School will remain open. In addition $200,000 was included in the budget to help develop Assertive Community Treatment Teams.

Although this was a long and difficult session, our advocacy raised the profile of our cause. As the session ends we can say that great strides were made to advance system reform and to fund the development of community services. We should be proud of our considerable success. Many thanks to all of you who, through your advocacy, made that success possible.

For a detailed look at NAMI North Carolina’s agenda and action taken
by the General Assembly, go to  http://www.naminc.org/agenda-home.htm

Affiliate Newsletter Serves Community Too

A successful newsletter bestows many benefits on your affiliate and your community. Informing and educating families, recognizing leadership and service, and fostering connections throughout the community are all goals to strive for. No other project of your affiliate touches so many people.

So besides NAMI members, your newsletter should reach out to and be meaningful for key members of other organizations, clergy, hospital and mental health center staff, and so on. Why? As a growing, volunteer-based organization we look to everyone who is affected by mental illness in the community--not just our members--to help respond to the crisis through education, support and advocacy. As so many people discover they are affected by mental illness, they can begin to respond to our simple message of help and hope.

Let other people know who to call and how to help. Include complete lists of affiliate board members and phone contacts, and contact information for other organizations readers may find helpful, such as local clubhouses, local Mental Health Association, and of course the NAMI North Carolina Helpline phone number and web address! Often we make the mistake of assuming that our readers know how to find this information, but this is not the case. Strive to reach out to the broad community every time.

Your affiliate lives by the kindness and love of your volunteers. Recognize their work in your newsletter. No one wants to toot his or her own horn--that’s your job with the newsletter. Need I say more?

So as you examine your affiliate’s mailing list, not all of them will be members. Some are past members, others are speakers you have invited to address your meetings, your elected officials, and of course DONORS. The newsletter should be mailed to virtually everyone. Also make extra copies for unexpected needs as they arise.

Now a few words about the details…. You can have a great newsletter whether your affiliate has 10 members or 100. A successful newsletter can be one page, front and back, or it can be multiple pages. You may send it out monthly, bimonthly or quarterly. Obviously, cost considerations, volunteer support and community needs will shape the end product.

FIRST: Decide what goals you seek to achieve. Do other community publications provide adequate coverage of issues, events and services? How can yours fit in? Do you intend for your newsletter to provide the main announcement of your meetings? Are you seeking to attract new members? Will you devote space to lengthy educational pieces? How much effort will you devote to affect a polished look and feel? Be careful to not try to accomplish too much. A modest but achievable goal can be built upon over time.

SECOND: Spend an adequate amount of time planning. How much money will you spend? Divide up the work into manageable tasks, and create a timeline from one publication date to the next for all tasks. Be realistic.

FINALLY: Execute and evolve your plan! Predictability is essential. Your newsletter’s ultimate effectiveness will be severely reduced if it repeatedly appears late. News will no longer be news, and the reader will cease to depend on your message. Monitor problems and solve them promptly before the next issue. Discuss options. Streamline. Compromise. Change the timeline. Make the work easier to do.

Be proud of the finished product! Keep several copies for your affiliate’s archive. You are doing great work that really makes a difference in people’s lives! Please call me in the state office to provide you with additional materials you can use.

Memberships for 2002 Collected Now

NAMI North Carolina affiliates are busy collecting membership dues for the 2002 membership renewal effort. NAMI memberships expire each January and we are sure that no one wants to let his or her membership lapse!

If you haven’t paid your renewal dues yet, please contact your affiliate leaders as soon as you can. Renewing now will also save time and effort for your affiliate leaders.

Remember, with your local affiliate membership also comes membership with NAMI North Carolina and our national organization, NAMI.

Please take a moment to renew your membership today!

It Has Been a Remarkable Year

NAMI North Carolina is well into its 2001 Annual Fund Campaign. As a member, friend, or supporter of NAMI North Carolina, you have probably received an appeal to support our programs. I urge you to do so, and to do so generously.

It has been a remarkable year, full of things for which we can be proud:

· Family to Family continues to grow and is now offered in nearly all of our affiliates, assisting over 1500 individuals. Pilot programs are now being launched to offer Family-to-Family classes to veterans through the Veterans Administration Hospital in Salisbury and Family-to-Family training to mental health providers.

· Our Young Families Program is expanding into a third mentoring site to provide direct services to families of school aged children. Since July of this year, six school workshops have been given, impacting 307 school personnel.

· Our advocacy efforts were instrumental in passage of legislation to reform the public mental health and to establish a $47.5 million trust fund to develop community services and supports.

· Clippings is mailed to more than 2500 families.

· Helpline responded to over 2400 calls and distributed thousands of flyers, brochures, and other educational materials to assist consumers and families.

But the success of these marvelous programs has only created greater demand for them. To continue to respond and provide these programs, we must have your help, now more than ever. Our need is urgent because our opportunity is so great. Please pledge now as generously as possible so we can get to work helping those in need.

Thank you for your generous and loyal support.

NICOTINE AND MENTAL ILLNESS

Animal and human studies suggest that nicotine may alleviate deficits in affective regulation and cognitive function and the medication side effects associated with these disorders (Piasecki and Newhouse, 2000).

While the rates of cigarette smoking in the U.S. population decreased from 42.4% in 1965 to 24.7% in 1997 (Morbidity and Mortality Weekly, 1999), rates of cigarette smoking among psychiatric patients have remained high.

In fact, it is estimated that people with mental illness consume 44.3% of cigarettes in this country (Lasser et. al., 2000). This supports the notion that individuals who smoke may have comorbid psychiatric and substance abuse disorders that make smoking cessation very difficult to achieve.

(See Nicotine Addiction and Other Psychiatric Disorders in the online edition of February Psychiatric Times-Ed.)

‘Tis the Season

All holidays can be both a joyful time and a stressful time. As family members of persons with mental illness, or people with mental illness ourselves, many of us have lived for years with chronic worry, and holidays may intensify this.

This year, for all Americans, has had its own tragedies and sorrows. But we still have much to be grateful for.

Here are some holiday tips from people who have been there:

• If your relative or someone else in the family has issues with alcohol, don’t make it available in your home.
• If you are unable to be with or help your loved one with mental illness this holiday season, help someone else. Volunteer to help in your support group or your community.
• Don't judge the value of a gift by its price tag. If you give from the heart, your gift will never be too small.
• Remember, your family is a real family, not a TV family. There will be arguments and rivalries among siblings. If Mom has always criticized you, she still will.
• Also, realize that things will occasionally go wrong. Your kids will get dirty and make noise. You will forget to buy batteries, thaw the turkey, or take the cookies out of the oven.
• Things don't have to ruin your holiday. You may not be in control of other people's actions, but you can certainly control your reaction to them.
• Maintain a good balance between giving of yourself and caring for yourself.
• If you need to, take a time out with a spouse or other sympathetic listener and vent your frustrations.
• As much as possible, keep to your regular schedule. Have meals at the times you are accustomed to.
• Go to bed at your usual time. If you must stay up and visit, try not to make it too late a night.
• You don't have to do everything that's asked of you. Delegate responsibility.

Antidepressants and Mania

It has been generally accepted that antidepressants could induce a manic episode in persons with bipolar. The Stanley Foundation Bipolar Network has conducted a double blind clinical trial comparing three different antidepressants—Wellbutrin, Zoloft, and Effexor—in patients with bipolar disorder who experience a depression that breaks through use of mood stabilizers.

There appears to be a moderate rate of antidepressant response to these agents as a group (33%), and of particular note, a lower than expected rate of inducing mania (12%) during the 10-week acute trial phase. In addition, in the 1-year continuation phase, a relatively low rate of switching into mania (12%) was observed.

This data is in general agreement with other studies indicating that newer (or second generation) antidepressants, when used as adjuncts to mood stabilizers, had less likelihood to produce mania as great as with the first generation tricyclics and monoamine oxidase inhibitor antidepressants.

Even in the population characterized by relatively high rates of rapid cycling, the switch rates on Wellbutrin, Zoloft, and Effexor, when used as adjuncts to previously inadequate mood stabilizers, still remained relatively low. The only discriminating variable between those within the study who switched moods on antidepressants and those who did not was that those with a history of 20 or more prior episodes of mania were more likely to switch than those without this history.

If you would like to read the entire study information release you may request a copy of Volume 6, Issue 2. Contact the Bipolar Network News staff at the NIMH, 10 Center Drive, Building 10, Room 35239, Bethesda, MD 20892 or call 800-518-7326.

Our Heartfelt Thanks

We acknowledge, with many thanks, Beth Greb for the countless hours she has volunteered in the state office over the past two months.

Among other tasks, Beth produced the membership renewal packets which were sent to each NAMI North Carolina affiliate in September.

She has also agreed to work with our affiliates on their membership renewal activities this fall.

Beth’s enthusiasm and her offer of help to NAMI North Carolina are certainly appreciated by the state office staff.

Thank you, Beth!

NAMI North Carolina Board With Term Expirations

President: Ken Farrington (2002) NAMI Forsyth County
Vice Pres: Beth Gariss Hardy (2003) NAMI Guilford County
Secretary: Grace Davis (2003) NAMI Cabarrus
Treasurer: Nancye Bryan (2002) NAMI Durham
Nancy Carey (2004) NAMI Western Carolina
Gerale Condron (2003) NAMI Wayne County
Joe Donovan (2002) NAMI Wake County
Bert Esworthy (2002) NAMI Cumberland County
Evelyn Esworthy (2003) NAMI Cumberland County
Rebecca Faucette (2003) NAMI Randolph County
Richard Greb (2003) NAMI Wake County
Tom Hadley (2003) NAMI Wake County
Dottie Harrison (2004) NAMI Iredell County
Martha Higginbotham (2004) NAMI Forsyth County
Linda Howell (2004) NAMI Western Carolina
Jeraldine Partee (2002) NAMI Rockingham County
Patricia McGinnis (2003) NAMI Foothills
Linwood Simms (2002) NAMI Wilson County
Mary Ann Widenhouse (2003) NAMI Foothills

Appointments Made:

Linwood Simms of NAMI Wilson County, Jeraldine Partee of NAMI Rockingham County and Rich Greb of NAMI Wake County, have been appointed to fill vacancies on the NAMI North Carolina Board of Directors. Welcome aboard!

Some Helpful Numbers

Governor’s Advocacy Council for Persons with Disabilities (GACPD), 1-800-821-6922. Civil rights and discrimination of persons with disabilities.

Family Support Network, 1-800-852-0042. Resources for families of young children.

Social Security Administration, 1-800-772-1213

NC Division of Facility Services, 1-800-624-3004

Division of Vocational Rehabilitation Client Assistance,

1-800-215-7227. Complaints or problems with Voc Rehab.

Suicide Hotline, 1-800-999-9999