NJAMHA

Fact Sheets

Cultural Competency

New Jersey is one of the most ethnically diverse states in the nation necessitating that changes be made in both the professional and support staff complement of mental health agencies.
There are over 70 linguistic and cultural groups in New Jersey each with their own unique set of values. There is an ever-growing need to reach out more to natural helpers and neighborhood organizations and groups to help address such varied subcultures.
The New Jersey Mental Health Institute, Inc. (NJMHI), an outgrowth of NJAMHA, was established in July 2000 to promote quality mental health services through training, technical assistance, research and services. One of its current projects, Changing Minds, Advancing Mental Health for Hispanics, aims to address the nationwide lack of access to behavioral health services among Hispanics. The project will focus on developing a national training model, which will include a curriculum that reflects the needs and cultural preferences of the Hispanic population.

The Medicare Mental Health Modernization Act
The Medicare Mental Health Modernization Act [S. 646 sponsored by Sen. Jon Corzine (D-NJ)/H.R. 1340 sponsored by Rep. Pete Stark (D-CA)] would improve Medicare benefits in several important areas. The bill:

Establishes equal coverage for mental and physical illness.
Eliminates the 190-day lifetime cap on inpatient services in psychiatric hospitals and reduces the 50% co-pay for outpatient mental health services to the 20% level enjoyed by most other Part B medical services.
Expands beneficiary access to a range of community-based residential and outpatient services that provide state-of-the-art mental health treatment.
Addresses the shortage of qualified mental health professionals serving older Americans by allowing state licensed marriage and family therapists and mental health counselors to provide Medicare-covered services.
Requires the Secretary of Health and Human Services to conduct a study to examine whether the Medicare criteria to cover therapeutic services to beneficiaries with Alzheimer’s and related cognitive disorders discriminates by being too restrictive.

This bill has received support from numerous mental health advocacy and provider organizations including: the National Mental Health Association, the American Association of Geriatric Psychiatry, the American Association of Marriage and Family Therapists, the American Counseling Association, the American Mental Health Counselors Association, the American Psychological Association, the National Association of County Mental Health Directors and the National Association of Social Workers.

Insurance Parity

The Mental Health Parity Act of 1996, P.L. 104-204, which has limited protections, will expire on December 31, 2002. The Mental Health Equitable Treatment Act of 2001 (S. 543/H.R. 4066) would modify the Mental Health Parity Act of 1996 by eliminating financial disparities (co-payments, deductibles and other out-of-pocket costs) and restrictions on the frequency of treatments (day and visits limits) for mental health services. The Mental Health Parity legislation requires that employee insurance benefits covering mental health diagnoses be the same as those for medical/surgical diagnoses in areas such as co-payments, service limits, and annual or lifetime spending limits.
Federal mental health parity legislation (H.R. 4066, primarily sponsored by Representative Marge Roukema/S. 543, primarily sponsored by Senator Pete Domenici and co-sponsored by Senator Jon Corzine) is moving forward. The Senate has passed its version, while the House bill has widespread, bipartisan support.
- Every member of New Jersey’s Congressional Delegation is in support of parity legislation
- The Congressional Budget Office (CBO) estimates that the Senate parity bill (S. 543) would only increase insurance premiums 0.9%.
Thirty-four states have some type of parity law, but they do not offer protection for workers and families that receive coverage through self-insured ERISA plans.
Cost is a major detriment to seeking treatment even among people with health insurance because of inferior coverage of mental health services as compared with physical health care services.
The equalization of mental health benefits to medical benefits may encourage persons in need to seek mental health services. This may also contribute to a reduction in the stigma associated with mental illness.
Adequate coverage of mental health services by employee health plans is likely to make more public dollars available to assist those individuals who are unemployed due to a serious mental illness. The public sector often fills the gaps created by restrictive employer-provided plans.
Studies show that non-discriminatory coverage of mental illness benefits employers in that it decreases absenteeism, increases productivity, and results in decreased general medical expenditures.

Common Misconceptions About Mental Illness
Myth: “Young people and children don’t suffer from mental health problems.”
Fact: It is estimated that more than 6 million young people in America may suffer from a mental health disorder that severely disrupts their ability to function at home, in school, or in their community.

Myth: “People who need psychiatric care should be locked away in institutions.”
Fact: Today, most people can lead productive lives within their communities thanks to a variety of supports, programs, and/or medications. In fact, the success rates for treating some mental illnesses are higher than that of many physical disorders including heart disease and cancer.

Myth: “A person who has had a mental illness can never be normal.”
Fact: People with mental illnesses can recover and resume normal activities. For example, Mike Wallace of “60 Minutes”, who has clinical depression, has received treatment and today leads an enriched and accomplished life. Also, John F. Nash, Jr., won the Nobel Prize for Economics after decades of suffering from the debilitating effects of schizophrenia.

Myth: “Mentally ill persons are dangerous.”
Fact: The vast majority of people with mental illnesses are not violent. In the cases when violence does occur, the incidence typically results from the same reasons as with the general public such as feeling threatened or excessive use of alcohol and/or drugs.

Myth: “People with mental illnesses can work low-level jobs but aren’t suited for really important or responsible positions.”
Fact: People with mental illnesses, like everyone else, have the potential to work at any level depending on their own abilities, experience and motivation.

Schizophrenia
Schizophrenia is a serious disorder that affects how a person thinks, feels and acts. Someone with schizophrenia may have difficulty distinguishing between what is real and what is imaginary; may be unresponsive or withdrawn; and may have difficulty expressing normal emotions in social situations. Contrary to public perception, schizophrenia is not split personality or multiple personality. The vast majority of people with schizophrenia are not violent and do not pose a danger to others. Schizophrenia is neither caused by childhood experiences, poor parenting or lack of willpower, nor are the symptoms identical for each person.

What causes schizophrenia?
The cause of schizophrenia is still unclear. Some theories about the cause of this disease include: genetics (heredity), biology (the imbalance in the brain’s chemistry); and/or possible viral infections and immune disorders.

Genetics (Heredity) - Scientists recognize that the disorder tends to run in families and that a person inherits a tendency to develop the disease. Schizophrenia may also be triggered by environmental events, such as viral infections or highly stressful situations or a combination of both. Similar to some other genetically-related illnesses, schizophrenia appears when the body undergoes hormonal and physical changes, like those that occur during puberty in the teen and young adult years.

Chemistry - Genetics help to determine how the brain uses certain chemicals. People with schizophrenia have a chemical imbalance of brain chemicals (serotonin and dopamine), which are neurotransmitters. These neurotransmitters allow nerve cells in the brain to send messages to each other. The imbalance of these chemicals affects the way a person’s brain reacts to stimuli--which explains why a person with schizophrenia may be overwhelmed by sensory information (loud music or bright lights), which other people can easily handle. This problem in processing different sounds, sights, smells and tastes can also lead to hallucinations or delusions.

What are the early warning signs of schizophrenia?
The signs of schizophrenia are different for everyone. Symptoms may develop slowly over months or years, or may appear very abruptly. The disease may come and go in cycles of relapse and remission.

SOURCE: National Mental Health Association

Did You Know
What is mental illness?
A mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life's ordinary demands and routines. There are more than 200 classified forms of mental illness. Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.

Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment, many individuals learn to cope or recover from a mental illness or emotional disorder.

Five Major Categories of Mental Illness

Anxiety Disorders - Anxiety disorders are the most common mental illnesses. The three main types are: phobias, panic disorders, and obsessive-compulsive disorders. People who suffer from phobias experience extreme fear or dread from a particular object or situation. Panic disorders involve sudden, intense feelings of terror for no apparent reason and symptoms similar to a heart attack. People with obsessive-compulsive disorder try to cope with anxiety by repeating words or phrases or engaging in repetitive, ritualistic behavior.
Mood Disorders - Mood disorders include depression and bipolar disorder (or manic depression). Symptoms may include mood swings such as extreme sadness or elation, sleep and eating disturbances, and changes in activity and energy levels. Suicide may be a risk with these disorders.
Schizophrenia - Schizophrenia is a serious disorder that affects how a person thinks, feels, and acts. Schizophrenia is believed to be caused by chemical imbalances in the brain that produce a variety of symptoms including hallucinations, delusions, withdrawal, incoherent speech and impaired reasoning.
Dementias - This group of disorders includes diseases like Alzheimer's which leads to loss of mental functions, including memory loss and a decline in intellectual and physical skills.
Eating Disorders - Anorexia nervosa and bulimia involve serious, potentially life-threatening illnesses. People with these disorders have a preoccupation with food and an irrational fear of being fat. Anorexia is self-starvation while bulimia involves cycles of bingeing (consuming large quantities of food) and purging (self-inducing vomiting or abusing laxatives). Behavior may also include excessive exercise.

Did you know?

Of the 10 leading causes of disability worldwide, five are mental disorders: major depression, schizophrenia, bipolar disorder, substance abuse disorder and obsessive compulsive disorder.
By 2020 it is estimated that depressive illnesses will become the second leading cause of disease burden worldwide.
Less than 4% of medical research funding goes to mental illness research.
1 in every 5 families are affected by severe mental illness in their lifetime (National Alliance of the Mentally Ill).
54 million Americans have a mental disorder in any given year, although fewer than 8 million seek treatment (Surgeon General's Report on Mental Illness).
5.4 million (2.7%) of adults in the U.S. population have a severe and persistent mental illness (Center for Mental Health Services).
Severe mental illnesses are more common than cancer, diabetes, or heart disease (National Alliance of the Mentally Ill).
The treatment success rate for schizophrenia is 60%, 80% for bipolar disorder, & 65% for major depression whereas the treatment success rate for heart disease ranges from 41 to 52% (National Alliance of the Mentally Ill).
A conservative estimate is that a total of 11 million youths have mental, behavioral, or developmental disorders, yet only 1/5 of them receive treatment (National Alliance of the Mentally Ill).
Attention Deficit Hyperactivity Disorder (ADHD) is one the most common mental disorders in children, affecting 3 to 5 percent of school-age children (National Institute of Mental Health).
Older Americans are more likely to commit suicide than any other age group. Although they constitute only 13 percent of the U.S. population, individuals age 65 and older account for 20 percent of all suicides (National Institute of Mental Health).
The #1 reason for hospital admissions nationwide is psychiatric disorders (National Alliance of the Mentally Ill).
Mental illness costs U.S. businesses an estimated $70 billion in medical costs, lost productivity, and other costs (The Wall Street Journal, June 13, 2001).
Some well-known people who suffered from severe mental illness are Abraham Lincoln, Beethoven, Van Gogh, Isaac Newton, Winston Churchill, and Michelangelo (National Alliance of the Mentally Ill).

Recognizing the Warning Signs & How to Cope
Most families are not prepared to cope with learning their loved one has a mental illness. It can be physically and emotionally trying, and can make us feel vulnerable to the opinions and judgments of others. If you think you or someone you know may have a mental or emotional problem, it is important to remember there is hope and help.

Warning Signs and Symptoms
The following are signs that your loved one may want to speak to a medical or mental health professional:

In adults:

Confused thinking
Prolonged depression (sadness or irritability)
Feelings of extreme highs and lows
Excessive fears, worries and anxieties
Social withdrawal
Dramatic changes in eating or sleeping habits
Strong feelings of anger
Delusions or hallucinations
Growing inability to cope with daily problems and activities
Suicidal thoughts
Denial of obvious problems
Numerous unexplained physical ailments
Substance abuse

In older children and pre-adolescents:

Substance abuse
Inability to cope with problems and daily activities
Change in sleeping and/or eating habits
Excessive complaints of physical ailments
Defiance of authority, truancy, theft, and/or vandalism
Intense fear of weight gain
Prolonged negative mood, often accompanied by poor appetite or thoughts of death
Frequent outbursts of anger

In younger children:

Changes in school performance
Poor grades despite strong efforts
Excessive worry or anxiety (i.e., refusing to go to bed or school)
Hyperactivity
Persistent nightmares
Persistent disobedience or aggression
Frequent temper tantrums

Stigma and Discrimination of the Mentally Ill
Mental illness can strike anyone! It knows no age limits, economic status, race, creed or color. During the course of a year, more than 54 million Americans are affected by one or more mental disorders. Despite this, those with mental illness face discrimination in health insurance coverage, housing, and employment, among others. Much of the discrimination is brought about due to the stigma that society places on those with mental illness. The stigma is a result of misunderstandings about the capabilities, limitations and effective treatment options for those with mental illnesses. As a society, we too often perceive all people who have a mental illness as strange, scary, or even dangerous. In fact, when people with a mental illness are asked to identify the biggest problem they face, most say it is simply a “lack of acceptance.”

The popular images of people with mental illness are those of homicidal madmen, women with 16 personalities, or of homeless people talking to themselves. Unfortunately, the mass media are responsible for many of the misconceptions that persist about people with mental illnesses. Newspapers, in particular, often stress a history of mental illness in the backgrounds of people who commit crimes of violence. Television news programs frequently sensationalize crimes where persons with persons with mental illnesses are involved. Comedians make fun of people with mental illnesses, using their disabilities as a source of humor. Also, national advertisers use stigmatizing images as promotional gimmicks to sell products.

Ironically, the media also offer the best hope for eradicating stigma because of their power to educate and influence public opinion.

How can you combat stigma?

Be positive and helpful – Respond to people who have a mental illness as individuals. Learn about the person and deal with him/her on the basis of your knowledge not your assumptions.
Help people with mental illness reenter society - Support their efforts to obtain housing and jobs.
Respond to false statements about mental illness or people with mental illnesses - Many people have wrong and damaging ideas on the subject. Accurate facts and information may help change both their ideas and actions.
Spread the word – Tell others what you have learned.

SOURCE: National Mental Health Association