Understanding Your Needs as a Mental Health Care Consumer

ONCE YOU HAVE A DIAGNOSIS

RIGHT NOW, THERE ARE NO CURES

THE MOST EFFECTIVE TREATMENTS

THE KIND OF THERAPY AND SUPPORT YOU NEED

NORTH CAROLINA’S MENTAL HEALTH SYSTEM

CASE MANAGEMENT

EMERGENCY SERVICES

INPATIENT SERVICES

DAY TREATMENT

Not long ago, most people—including "the experts"—believed character flaws, parents’ behavior and childhood traumas were at the root of all mental illnesses.

Based on decades of research, science and medicine today recognize the biochemical causes of mental illnesses. Unfortunately, the old beliefs—and the stigma that goes with them—are still very much a part of our society and culture.

If you have symptoms of a severe and persistent mental illness, you need information and understanding.

You need to have your illness properly diagnosed.

You need ongoing medical treatment by qualified mental health care practitioners.

You need for your family and friends, your community, your legislators and your health insurer to recognize the biochemical origins of your disease.

You need to be treated with the same level of care, compassion and fairness as people with any other illness.

You need as much independence, autonomy and control of your own destiny as your illness permits.

Perhaps most important of all, you need to be seen first and foremost as a person. No matter how severe and pervasive your illness, you are a person—not a diagnosis—and you deserve a full measure of human dignity and respect.

Since 1983, NAMI North Carolina has been North Carolina’s voice on mental illness. We’re here to help you and your family meet your needs through education, support and advocacy.

IF YOU BELIEVE YOU MAY HAVE A MENTAL ILLNESS, here are some general symptoms to watch for—

• You spend much of your time sitting and doing nothing.

• You have few friends.

• You’ve dropped out of most activities, and you’re not doing as well as you used to at the activities you’re still pursuing.

• You feel deeply sad for no apparent reason.

• Your sadness lasts more than a few weeks.

• You’ve lost interest in things you used to enjoy.

• You feel hopeless.

• You see the world as gray and lifeless.

• You have trouble sleeping, or you sleep much longer than you used to.

• You think about or have attempted suicide.

• You have trouble concentrating.

• Even simple problems seem overwhelming.

• You’re suspicious or afraid of most people.

• You don’t care what happens, even with things you used to consider important.

• You argue with people you used to get along with just fine.

• You laugh at things no one else finds funny.

• Sometimes you feel exceptionally powerful and creative, while at other times, you feel powerless and deeply sad.

• You stay up all night for several nights in a row.

• You hear voices no one else hears.

• People and things around you seem strange and distorted.

If you have several of these symptoms, your first step should be to see a doctor for a complete physical examination. If, based on the results of your exam, your doctor believes you have a mental illness, he or she will probably refer you to a psychiatrist or other mental health care practitioner for diagnosis and treatment.

ONCE YOU HAVE A DIAGNOSIS, try to learn as much as you can about your disease and its symptoms. Knowing symptoms will help you distinguish normal feelings and behaviors from feelings and behaviors caused by your illness. You may also identify the particular symptoms you have when you’re about to have a more severe episode of illness. By knowing and heeding early warning signs, you may be able to get help before a crisis develops.

RIGHT NOW, THERE ARE NO CURES for severe and persistent mental illnesses, but there are treatments that can help you feel better and live a more normal life. Learn all you can about current treatments, and stay alert for new developments as researchers discover more about your disease.

THE MOST EFFECTIVE TREATMENTS for severe and persistent mental illnesses combine drug therapy with psychological counseling and support services.

Since many of the medicines used to treat mental illnesses can take several weeks or even months to become fully effective, try to be patient as you work with your doctor to find the drug or drug combination that works best for you.

Once you and your doctor find a treatment that works, stick with it. You may be tempted to stop taking your medicine and seeing your therapist when you’re feeling better—especially if the drug you’re taking causes unpleasant side effects. But it is extremely important to change or stop treatment only with your doctor’s close and continuing supervision.

THE KIND OF THERAPY AND SUPPORT YOU NEED depends on the nature and severity of your illness. If you have an affective disorder, such as depression, you may benefit most from relatively short-term cognitive behavior therapy combined with ongoing drug therapy. If your illness is classified as a psychosis, such as schizophrenia, you may benefit most from drug therapy combined with support services.

NORTH CAROLINA’S MENTAL HEALTH SYSTEM consists of four state psychiatric hospitals and Area Mental Health Programs throughout the state. While services vary from center to center, all Community Mental Health Centers offer these basic services—

CASE MANAGEMENT. A person or team works closely with you over time to help you get the services and care you need. Your case manager can help you with housing, education, treatment and the life skills you need to live as independently as possible.

EMERGENCY SERVICES. From time to time, your illness may become severe enough to put you and, possibly those around you, in crisis. When you’re in crisis, you need intensive, short-term services—assessment and evaluation of your condition, followed by emergency treatment to stabilize your condition.

INPATIENT SERVICES. If you are ill enough to require short-term hospitalization while your condition stabilizes, your area program provides it, either through its own psychiatric unit, a psychiatric unit at a general hospital, or the state psychiatric hospital serving your area.

DAY TREATMENT. If you don’t need full hospitalization but need fairly intensive therapy to stay out of the hospital, your community center can help you through its day treatment or partial hospitalization services. With day treatment, the center staff monitors your medicine, provides group or individual therapy, recreational therapy, training in coping skills and social development. The staff may also help you develop vocational skills and find a job.

OUTPATIENT AND CLINICAL SERVICES. Your community center staff is charged with making sure you continue to have access to the support, medical care and treatment you need.

With your cooperation, you can help the staff help you benefit as much as possible from the services available.

YOU NEED A VOICE. You need to feel you’re functioning as well as you can and participating as often as possible in decisions that affect you.

If you’re like most people with mental illness, your symptoms vary over time. During periods when your symptoms are less severe, consider such issues as the care and services you want to receive if your symptoms worsen, what kinds of medical treatment you do and do not want, who needs to be notified if you become ill and who can visit if you need to be in the hospital.

Discuss these issues and your preferences with your family, friends and mental health care providers so they will know how you’d like them to manage your care, should you need their help. You may want to prepare an Advance Directives document for your medical records in which you explain your wishes in writing.

Finally, you need a voice in the way lawmakers and society treat you and others who have mental illnesses. To add your voice to ours, call our toll-free Helpline at 800 451-9682 during regular business hours. We can tell you how to contact the closest local affiliate and join us in our efforts to support, educate and advocate on your behalf.