Stop Smoking.... Stop It!

I was recently shocked to learn that a friend has taken up smoking, so that she can feel more confident in social situations. This is a very intelligent woman who is otherwise health conscious. She watches her weight, walks for her health and regularly visits her doctor. She had successfully quit smoking years ago, and has now taken it up again.

She is also a person who experiences mental illness, and it is my great fear that she will become another statistic-one of the thousands of individuals who experience mental illness and are addicted to nicotine.

As a non-smoker, I find it hard to conceive of why, in 2009, with all the facts we know about the dangers of smoking, anyone would start to smoke. The facts about individuals with mental illness who use nicotine are particularly ugly:

About 200,000 of the 435,000 annual deaths from smoking in the U.S. occur among patients with mental illnesses and/or substance use disorders.

About 20% of the U.S. population has mental disorders in a given year. Over 40% of these individuals use tobacco.

Americans with mental illnesses represent an estimated 44.3% of the U.S. tobacco market.

Americans with mental illnesses and substance abuse disorders are nicotine dependent at rates that are two to three times higher than the general population.

Because people with mental illnesses use tobacco at greater rates, they suffer greater smoking-related medical illnesses and mortality.

Why do individuals who experience mental illness smoke more?
Researchers believe that a combination of biological, psychological and social factors contributed to increased tobacco use among persons with mental illness.

Persons with mental illnesses have unique neurobiological features that may increase their tendency to use nicotine, make it more difficult to quit and complicate withdrawal symptoms.

In addition, providers often think that people with mental illness are unable to quit smoking, which is not true. Studies show that people with mental illnesses want to quit smoking and want information about cessation services and resources. Significant evidence shows that smoking cessation strategies work. People with mental illness can successful quit.

Symptom management often takes precedence over preventative health measures. There are clinicians who do not perceive nicotine cessation as a treatment priority, or consider it as too consuming of limited treatment resources.

Historically, patients in psychiatric units were even given cigarettes as a method of reward and control and patients were told that cigarettes could be helpful in their treatment. According to a report by the University of Colorado-Denver, Department of Psychiatry, in the late seventies and early eighties, tobacco companies distributed free cigarettes to homeless shelters, mental hospitals and homeless service organizations. Cigarettes were purchased for persons experiencing mental illness and homelessness, so that these individuals would smoke “clean” cigarettes, not used “butts.”

The tobacco industry also targeted psychiatric hospitals for sales promotions and giveaways.

We talk about the shackles that were used in mental hospitals in the past and the lasting effects of their usage on the national psyche. What of the effects of the knowledge that patients were given cigarettes and encouraged to smoke, when their doctors knew the dangers of tobacco and chose to overlook those dangers in favor of control and submission of patients?

I recently heard a counselor say that he was opposed to a ban on smoking in his consumer-care facility because that is how he builds trust with his consumers-by smoking with them! Imagine if he had said that he built trust through drinking together.

With funding cuts, it is becoming more difficult to find resources for smoking cessation programs. Thousands of individuals who experience mental illness are currently addicted to nicotine and are struggling to find an answer to ending their dependency.

Statistics for this blog was taken from “Smoking Cessation for Persons with Mental Illnesses: A Toolkit for Mental Health Providers”

--Kristen Frame
Compeer Coordinator

The Spanish Inquisition

“Our chief weapon is surprise, surprise and fear….”

Earlier this week, after having attended a meeting, I was struck by how, at what is conventionally understood to be my middle age, I feel remarkably unqualified.

And it wasn’t just about that particular meeting, I have a clear sense of being unprepared for life in general. I pay my bills and I take my dog for a walk (most days) and I go to work every day, but that’s not the leadership role that I imagined for myself as a child: it’s more like I’m a crew member. And there are a great many days when I imagine that I will find myself as one of the red-shirted crew members on the Enterprise: existing only to advance someone else’s story and to be phasered before the second commercial break.

Perhaps I am thinking this way, in part, because, in the transition between Presidents, there has been a lot of talk about leadership. The incoming President and I are almost the same age: that is the only thing we have in common. I can’t even get the dog to come when I call him and so I am dumbstruck at the prospect of being able to lead an entire country.

I could probably come up with a lot of rationalizations, but I suspect the primary motivator in my life is fear and this is what has kept me from taking more chances. I am always playing defense, reacting to events instead of shaping them.

As children, we think in terms of limitless possibilities. Our imaginations take us to places and situations that are risk-free. We fight monsters and rescue damsels in distress and do battle with evil wizards all before dinner. As adults, we learn about limits and the horizon that once seemed so far away starts to come closer until you get to a point where all you do is go to the funerals of your friends and all you think about is not falling at which point the horizon is at your fingertips.

My mother once tried to help me through an awkward teenage moment by counseling me that I was a “late bloomer.” It was another in a long series of lessons in what would now be described as “impulse control.” It was not my time, not my turn; my needs would be met later on. Today I am certain that little or none of that was behind her comment when she said it, but experience has helped to fill in the gaps.

How then do you know when it is your moment? What exactly should I be looking for?
Something clearly happened for the new President to tell him that this was his moment. Was it, I wonder, one of those “It just doesn’t get any better than this” beer commercial moments?

I have read a lot of biographies and the part that fascinates me the most in each of these stories is the moment when the subject goes from the supporting cast to the starring role in their own lives. And, because they are the subject of the book, it is almost always the part of the story that gets glossed over. Perhaps there is an assumption made on the part of the author that because their subject has been deemed book-worthy that all anybody cares about is what happened when they were children and after they were famous. At what point did they think they had the skills/ability/moxie to step into the spotlight?

Don’t get me wrong, I don’t want to be a star, but neither do I want to get to the non-slip part of my life and feel as though I missed my moment.

“History is made by those who show up.” -- Benjamin Disraeli

Showing up is not enough, if it were, I wouldn’t be writing this. I show up a lot but I have never felt like I belonged anywhere.

As a teenager, I performed as a magician at a number of children’s birthday parties. I was never any good but I was and am fascinated by magic. Performing magic for children is rough because they are very difficult to fool. They absorb all of the information that comes at them and work to make sense of it, whereas adults are more likely to make assumptions based on their experience. If a child sees something that doesn’t make sense they call you on it. They look where they are not supposed to look and often see things that adults would never notice.

I bring this up because it is the over-arching fear in my life: that I am going to get caught, that I will be revealed to be a fake, that my lack of qualification will be disclosed.

So we have come to the essential conundrum: to truly “take my turn”—presuming I can recognize it when it comes—will mean embracing and overcoming my fear and stop being surprised.

--Graham Campbell
Associate Director

True Democracy

I recently had the honor of experiencing true democracy. In my role as Compeer Coordinator for Mental Health America of Licking County, I organized a community discussion designed to collect input that will be used to change our health care system.

Tom Daschle, the Secretary-designate of the Department of Health and Human Services on behalf of President-elect Obama, called for individuals and organizations to host what they called “Health Care Community Discussions” in their offices, community rooms, coffee shops and living rooms, between December 15 and December 31.

Despite the fact that this gave us very little time to prepare, we, at Mental Health America of Licking County, decided that this was a wonderful opportunity to share our opinions about the American health care system and how it can be improved. We knew that the experiences of our consumers make them experts and that this issue is too important for us not to share our opinions and ideas with those who will make these decisions.

We invited Compeer program members to a discussion about health care on the evening of December 30th at the Mental Health America offices at 65 Messimer Drive in Newark. We planned to discuss health care, including mental health care, and their experience and concerns.

Invitations were mailed out and, ironically, because several members were sick and unable to attend, only a small group came together to share their perspectives on this important topic. I, too, have been sick and several times considered canceling the event before it got off the ground. But the people who came were enthusiastic and committed to the project.

The discussion became animated as participants took turns describing the problems they had had paying medical bills and their frustrations with trying to find a new psychiatrist in a community where so many are leaving. I, myself, have had my last three psychiatrists quit, before I finally turned to a doctor in Westerville.

Public policy suggestions from the group included making it more affordable for doctors to attend medical school. Despite assistance from insurance, the high cost of prescription medication was another concern of the group. The conversation continued for 1 ½ hours, and although we did not solve the nation’s problems, and we were not all in agreement, there was a feeling of empowerment that came from the sense that someone was listening to you.

At the end of the meeting, a very brief survey was completed and the statements by the participants were collected and entered into the www.change.gov web page for inclusion in the final report.

Because I had registered the event in advance, in order to get the discussion manuals and information, I also received a follow-up query the next morning, asking how the event went and urging me to respond by the January 4th deadline, in order for the information to be passed on to the President-elect.

President-elect Obama says he wants to bring the voices and health care concerns of all Americans to Washington. On his behalf, I want to thank everyone who attended for participating in this discussion and helping to make this happen. For more information about this project, go to www.change.gov/

Compeer is a program of MHA. The program serves people who are recovering from a mental illness. Compeer recruits, screens, trains and matches volunteers in one-to-one friendship relationships with adults receiving mental illness treatment. Compeer volunteers become positive role models and mentors. They help raise self-esteem, increase social and communication skills and encourage independence of their Compeer friend aiding them in their recovery.

Compeer friends also meet for monthly socials. We enjoy socializing together, engaging with guest speakers, going bowling, and trying new things-like cooking.

If you are interested in joining Compeer as a friend or volunteer, or to learn more, please call Kristen Frame, Compeer Coordinator at (740) 345-5658.

Kristen Frame
Compeer Coordinator

January is National Stalking Awareness Month

By Ashley Shaw, PAVE Coordinator, Mental Health America of Licking County

As a violence prevention educator, people often tell me stories about their experiences with violence and many of the stories involve the serious crime of stalking.

According to the Stalking Resource Center, stalking is defined as a course of action directed at a specific individual that would cause a reasonable person to feel fear.

Television and movies promote commonly held beliefs about stalking which are inaccurate. For instance, many think that only strangers, often with a mental illness, are the ones who commit this serious crime, when almost the exact opposite is true. According to statistics from the Stalking Resource Center:

• 77% of female victims and 64% of male victims know their stalker.
• 59% of female victims and 30% of male victims are stalked by an intimate partner.
• Intimate partner stalkers frequently approach their targets, and their behaviors escalate quickly.

Through the impact stalking can have on a victim’s daily life, it is very clear to see why more people need to be made aware of them.

A victim of stalking is very likely to experience serious changes to his or her daily life.

• 26% of stalking victims lost time from work as a result of their victimization, and 7% never returned to work.
• 30% of female victims and 20% of male victims sought psychological counseling.
• The prevalence of anxiety, insomnia, social dysfunction, and severe depression is much higher among stalking victims than the general population.

Because of the prevalence, stalking is something that each of us needs to take seriously. The number of stalking victims in the United States is astounding: 1,006,970 women and 370,990 men are stalked annually. The good news is that there is help available to victims of such a serious crime.

A first line of defense when dealing with stalking is educating yourself about the topic and the legal aspects that can be involved. I urge all readers to familiarize themselves with the topic of stalking so that it can be recognized and prevented as much as possible. The state of Ohio has laws in place to protect victims and prosecute stalkers. Depending on the seriousness of the crime, charges can range from a first degree misdemeanor to a fourth degree felony. Jail or prison time varies as well depending on the specifics of any given case. If you or someone you know is being stalked, call 9-1-1 immediately to get law enforcement involved.

Through education and awareness, communities can support victims and combat the crime. There are plenty of resources available at Mental Health America of Licking County or on websites such as the Stalking Resource Network Website (www.ncvc.org/src).

The P.A.V.E program (Prevent Assault and Violence Education) is participating in a community awareness campaign by hanging up informational posters in area Licking County schools. We hope that through the poster campaign we can build a knowledgeable community that offers support to stalking victims and increases the prevention of potential victims.

For more information please contact Ashley Shaw at (740) 522-2277 or ashaw@mhalc.org.