On October 8th, Mental Health America of Licking County's Bridges Out of Poverty Initiative, in partnership with Denison University, conducted a poverty simulation. This activity is designed to show participants in a tangible way the many complex challenges faced by those who live in poverty.
After the simulation, the participants, some of whom role-play as persons in poverty and others as those public and private sector service providers on whom the poor are so dependant, were given the opportunity to reflect on their experience.
The mind is willing, but there isn't always the time to write for this blog. So we have opted to put this up as a kind of place-holder until the next big idea comes along.
Number of people who received 50 percent discount on prescription drugs also rises
The Centers for Medicare and Medicaid Services (CMS) reported today that nearly 20.5 million people with Medicare reviewed their health status at a free Annual Wellness Visit or received other preventive services with no deductible or cost sharing this year. In addition, nearly 1.8 million people with Medicare have received discounts on brand-name drugs in the Medicare Part D coverage gap, also known as the "donut hole," between January and August of this year. The total value of discounts to people with Medicare in the donut hole is nearly $1 billion through August of this year, with an average savings of $530 per beneficiary.
“Thanks to the Affordable Care Act, more people with Medicare are getting preventive services like mammograms for free,” said HHS Secretary Kathleen Sebelius. “The new health care law is also making prescription drugs more affordable for millions of seniors and people with disabilities.”
Some of the free preventive services available to people with Medicare include:
Mammograms and cervical cancer screenings
Annual Wellness Visit
Cholesterol and other cardiovascular screenings
Colorectal and prostate cancer screenings
“October is National Breast Cancer Awareness month – a great time for women with Medicare to schedule a free Annual Wellness Visit with their doctors. At that visit they can talk about their personal risk for breast cancer, if they should have a mammogram or how often to have one,” said CMS Administrator Donald Berwick, MD. “If you and your doctor decide that a mammogram is in order, Medicare will cover that preventive screening annually, free of charge. Already, more than 4 million women have taken advantage of that benefit this year.”
The rising number of people who are taking advantage of preventive benefits and prescription drug discounts comes as people with Medicare are beginning to review their plan options for next year. The popular web-based Medicare Plan Finder is now available to help beneficiaries, their families, other caregivers, and senior program advocates look at all local drug and health plan options that are available for the 2012 benefit year.
The annual enrollment period begins earlier this year than last year, on October 15, and runs through December 7. People with Medicare will have seven weeks to review Medicare Advantage and Part D prescription drug coverage benefits and plan options, and choose the option that best meets their unique needs or keep the plan they have today. The earlier open enrollment period also ensures that Medicare has enough time to process plan choices so that coverage can begin without interruption on January 1, 2012.
Every person with a Medicare Advantage or a Part D drug plan will also see better value in those plans for the second year. Average Part D drug plan premiums will remain virtually unchanged in 2012. Those in the Part D coverage gap, or do nut hole, will continue to be able to get discounts on covered brand name drugs. People with Medicare will get deeper discounts in the years ahead until the gap is closed in 2020. On average, Medicare Advantage premiums will be 4 percent lower in 2012 than in 2011, and plans project enrollment to increase by 10 percent. All beneficiaries will have access to Medicare-covered preventive services with zero cost-sharing, including the Annual Wellness Visit, bone-mass measurement, colon cancer screenings, and diabetes screenings, as well as influenza and pneumococcal vaccines, to name a few.
For state-by-state information on the number of people who are benefiting from discounts in the donut hole in 2011, go to: https://www.cms.gov/Plan-Payment/
For more information on Medicare’s prevention benefits, go to the Share the News. Share the Health! website: http://www.medicare.gov/share-the-health/ or call 1-800-MEDICARE.
It's hard to watch because it feels very honest and direct.
As adults, we are caught off-guard. It challenges our ideals of what childhood should be like knowing full well that, at the same age, we all kept secrets and pretended to be somebody who only really existed in family snapshots.
To watch this is to have unfocused outrage. Tillie has experienced things that no child should experience, even though to be an adult is to experience everyone of them in some form or other.
We want to help, to reach through the little YouTube window and try in some way to make it better even though we would, at best, only be delaying the inevitable disappointments of adulthood.
The real message of this video is not in the incidents of her life--shocking though they may be--but in how she has chosen to respond. The take-away is that, after all that has happened to her, she is still accepting, still willing to listen, still thinks that everybody, no matter who they are, is "beautiful."
* * *
One of my jobs is to keep the Agency's Facebook pages supplied with new material. To do that, I look at lots of blog posts, news stories and videos from all over the world. Lately, there has been a whole lot of material relating to teen suicide.
It doesn't seem to matter whether the suicide happened in the developing world, the developed world, across the street or across the country, it was remarkable to me how similar the stories are one to another.
The players in each of these dramas have experienced loss, or have been threatened with loss; have been shamed, or believe they have brought shame to their families.
One story that has produced a number of different articles concerns a murder-suicide in Mississauga, Ontario near Toronto. A 16 year-old male jumped from an overpass onto a busy expressway just prior to the discovery of the body of his 17 year-old female friend. The young man survived the fall and being struck by at least one car only to succumb to his injuries a week later.
In the days since this double tragedy, it has come out that the male and female were friends, but that the male wanted more of a romantic relationship and the female did not share the same feelings.
The impact of this story and others like it on adults is generally one of shock and surprise. We can't seem to understand why the young man would take the life of his friend and then try to kill himself. Surely, this was just a case of unrequited puppy love. What's the big deal? Right?
The arc of childhood development is the evolution of empathy. As infants we are completely self-obsessed and, hopefully, before we are turned loose on the world, we have some sense that others may have equally, if not more, compelling needs and desires than our own.
Researchers are now telling us that the brain is not fully developed until the mid-twenties. Seen in that context, the challenges of navigating high school and relationships--romantic and otherwise--seem much more perilous. As adults, we think we are lucky when we find the love of our life, but, as teenagers, every relationship is the love of your life.
I remember the last day of elementary school very clearly.
It was a bright late June day and I was walking home from school crying.
I was absolutely inconsolable because I was never going to see Jane again.
This WAS a big deal. For most of the previous 7 years, Jane had been part of my life. She, along with the Wood sisters, was one of the three who were perpetually ahead of me in terms of grades.
It's not like she and I were friends, but now that school was over, we never would be. She and her family were moving to Ottawa and I wasn't.
I think I can still find the park bench that I collapsed on and where I spent what seemed like an eternity sobbing.
I was learning about loss.
And it was more than the loss of a pet, or a cherished toy, or even a beloved relative: this was the loss of an idea. A secret vision of a theoretical future that was so special that I had dared not speak of it to anyone. In fact, I don't think I really understood how I felt about Jane until I realized that I would never see her again and even that wasn't really real until after I had seen her for the last time.
But when I did, it hurt a LOT.
Everyone has had an experience like mine; one where you figure out what you want and then learn that not only can you not have it now, you won't ever have it. The kind of want that so easily gets mistaken for need. The kind of want that makes your heart race and your chest feel tight and your breath seem hard to catch. The kind of want that makes an 11 year-old kid think that he could take a 90-minute bus ride to Ottawa despite having no earthly idea where to find Jane and a sneaking suspicion that she wouldn't exactly be happy to see me if I showed up.
Everybody has been that way about something, or somebody and so, no matter how hard we might wish to deny it, we all have a way back to understanding what it is, and how it is, that our teenagers are thinking.
We can make that journey--make that connection--if we want to.
But, paradoxically, to be a teenager is to be in a rush to be an adult and we learn from our parents that teenage thinking is not nearly as important as adult thinking. Teenagers are encouraged to "grow up" and to "get serious" even while their brains are still changing and their passions are so monumental because they are so new.
After the constant upheaval of being a teenager, what is desired is to have "adult passions" that are properly sized, proportional, manageable.
It is only after having been an adult for a while that you recognize the trade off that has been made and the space that has been emptied of outsized passions and filled with many too-small and far too trivial sentiments.
* * *
I try to take my dog for a walk every night after work. I should be better about doing this considering all of the things he continues to teach me.
We have two or three routes that we take on a rotating basis. A couple are pretty short and one is so long that he is dragging his tail before we are two-thirds done. I try to mix them up just to keep it interesting for him--go a different route every day--but what I have come to understand is that it really doesn't matter. We could walk the same route every day and it would be the same treat for him. The choice to change up routes is one that I am really making for myself. As far as the dog is concerned, so long as he is out walking, he's happy. I might not be able to tell, but every tree--even though it was in exactly the same spot yesterday--is a new discovery, a chance to catch up on current events.
I have to keep reminding myself of this.
I watch him engage with his world from the other end of the lead. I have to correct myself, stop myself from getting impatient as he makes his tree-by-tree, post-by-post inventory of the neighborhood. I catch myself thinking how could he possibly be interested in smelling the same dried smells that he smelled the day before. To him, they are of course fascinating and nuanced because he receives a lot of his information about the world through his nose. I get much of my information about the world through my head. I associate new information with old information, I see, or perceive, patterns based on experience. As I get older, it takes less and less input to create new, fully formed impressions of the world. My dog gets up every day thinking that it is the best day ever.
* * *
I'm much older now. In theory, I could go to Ottawa any time I wanted.
In theory.
I want to be absolutely clear. I have no interest in tracking down Jane, or anybody else. I'm married and have a dog. (We have a cat too, but we're never sure he's made up his mind to stay with us.)
In theory I could do a lot of things, but the other lesson you learn as an adult is that every choice has a consequence, every decision to move toward something is to move away from something else. And choice by choice, day after day, the once seemingly endless possibilities of your future become the responsibilities of your present.
Instead of treating each new opportunity as a sensation to be experienced, it become an obstacle over which it becomes harder to see from where you have come and that blocks your path to the future.
Tillie, for all the growing up she has already done, has not yet done so much that she can't see her future.
We all know a Tillie, probably more than we realize. Get to know their stories. Listen without judging. Acknowledge them. If you're feeling brave enough, tell them what scares you. The life you save, just might be your own.
The following post was developed with material from the website of the World Federation for Mental Health. Where the pronouns "we" and "our" are used, they should be read as World Federation for Mental Health.
World Mental Health Day 2011 is October 10. World Mental Health Day raises public awareness about mental health issues. The day promotes more open discussion of mental disorders and investments in prevention and treatment services. The treatment gap for mental, neurological and substance use disorders is formidable especially in poor resource countries.
Physical and mental health are intertwined. There is a real need to deal with the mental health problems of people with chronic physical illnesses and physical care of mental health consumers through a continued and integrated care.
The major themes of the Great Push are Unity, Visibility, Rights, Recovery, and planning of this program is now in progress.
UNITY - Perceptions of disunity in the mental health world, probably exaggerated need to be dispelled. The first round of the WFMH (World Federation for Mental Health) Great Global Consensus has demonstrated substantial agreement on fundamental issues with over 530 replies from organizations and individuals demonstrating over 95% agreement on the 10 principles of the World Federation The second round is in preparation and will address the inclusion of mental health as one of the Millennium Goals. The Consensus is designed to culminate in a WFMH/MGMH Consensus Summit" where participating organizations will be invited to fund one representative to the Summit at which the Consensus will form the basis of a WFMH /MGMH “Charter” to the United Nations and Governments stating clearly what mental health related and consumer/users/survivor organizations around the world require governments to do to improve mental health.
VISIBILITY- Mental illness and the mentally ill are invisible, but stigma is everywhere. Our support for mental health must be made visible to governments. How can that be achieved but by public events? We will encourage organized parades, rallies and parties starting on World Mental Health Day (October 10, 2011), involving consumers and their families marching in public together with the support of mental health associations, professionals, academics, volunteers, managers of services and students! Countries will be encouraged to create and fund their own national parades. WFMH insures they happen together on World Mental Health Day. Parades should celebrate good mental health with celebrities and sports persons while calling for better awareness of, and services for mental illness. Parades should be attractive and entertaining for the general public while carrying a strong message. They could collect signatures to hand to governments with demands to do more for mental health both in their own country and abroad. Parades might continue year by year growing in strength and entertainment until a significant change in public opinion and government action is demonstrated. This is already happening in many places, particularly in India and in 2009 in Kalmunai, Sri Lanka, where nearly 5000 students, government and non-government sectors participated in a march two kilometres long. We need to be visible. They have shown us the way.
RIGHTS - Appalling conditions are tolerated in many mental hospitals and abusive treatments for mental illness are common. Governments must not be allowed to tolerate these conditions: There is clearly a strong grass roots need to bring together legal experts and existing organizations to collect evidence and to lobby governments to address these issues across the world and bring them to public attention. We proposed the setting up of a Centre for Mental Health and Human Rights to tackle such issues with governments.
RECOVERY - is an important concept but the term is used in many different ways. WFMH will convene a conference to sharpen the concept and define its principal features. Meanwhile, thousands, perhaps millions, receive no mental health care because of the absence of professionals to assess and diagnose their illnesses, the first rate limiting step to recovery. We now have methods using computer technology able to empower nurses and health assistants, aimed at improving the detection, diagnosis and treatment of mental illness. We recognize that these are only the first steps to true recovery; nevertheless they are an essential starting point. Such methods are already being successfully piloted in India, Europe and Australia. They have potential to bring relief to the untreated. The campaign will promote any appropriate and culturally acceptable method for bringing relief to those suffering mental illness.
Some major activities that WFMH is embarking on include:
The development of a grass-roots campaign so that mental health can have more visibility and priority in the public mind internationally;
Participation in the United Nations process to reformulate the Millennium Development Goals;
Developing strategic partners with international agencies and advocacy groups to promote the Great Push; and
Promotion of the Great Push using both traditional and social media.
The World Health Organization has recently (September, 2010) released a report titled Mental Health and Development which makes the case for the integration of mental health in development efforts. Mental health is intimately tied with key areas of development such as education and human productivity. Our World Mental Health Day theme this year underlines the relationship of mental health with chronic physical illnesses. As we identify non-communicable diseases like heart disease, diabetes, cancer and respiratory diseases as the new scourge, the relationship to mental health is both intimate and unavoidable. The bottom line is that there is no health without mental health and that there is no development without health AND mental health.
Physical and mental health are intertwined. There is a real need to deal with the mental health problems of people with chronic physical illnesses and physical care of mental health consumers through a continued and integrated care.
