PEPPNET Quarterly Newsletter / med.stanford.edu/resources.html
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June 2017 | Issue:No. 06

In the News

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AB-1315 Mental Health: Early Psychosis Detection and intervention

AB-1315 has passed the California Assembly and will be considered by the California Senate.  The existing Mental Health Services Act, an initiative measure enacted by California voters in 2004 as Proposition 63, establishes the Mental Health Services Oversight and Accountability Commission to oversee various mental health programs funded by the act.  Per the Bill’s text, “[AB-1315] would establish an advisory committee to the commission for purposes of creating an early psychosis and mood disorder detection and intervention competitive selection process to, among other things, expand the provision of high-quality, evidence-based early psychosis and mood disorder detection and intervention services in this state by providing funding to the counties for this purpose […]. The bill would also establish the Early Psychosis and Mood Disorder Detection and Intervention Fund within the State Treasury and would provide the moneys in the fund are continuously appropriated to, and under the administrative control of, the commission for the purposes of the bill.”  Read more about AB-1315 on California Legislative Information’s website (here).
 
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PEPPNET's Brandon Staglin Honored in Washington D.C.
Congratulations to PEPPNET Steering Committee Member, Brandon Staglin, who was awarded the 2017 Mental Health America Clifford W. Beers Award earlier this month. The Clifford W. Beers Award is Mental Health America's highest honor and is presented to mental health consumers who best reflect the example set by MHA founder Clifford W. Beers in his or her efforts to improve conditions for and attitudes toward people living with mental health conditions.  

In related news, Brandon made a strong case for the tremendous potential of early intervention programs for individuals experiencing psychosis in his Huffington Post blog article published last month, which featured contributions from the PEPPNET Lived Experience workgroup. 

How to Boost Recovery for Individuals with Psychosis
"We live in an increasingly chaotic world. As political debate and federal governmental action ignites more controversy, many of us in the U.S. and elsewhere find it difficult to manage our mental health. Congress’ vote on May 4 in favor of the American Health Care Act (AHCA) adds fuel to the fire (in potentially detrimental ways for mental healthcare). In addition to the suffering such a sociopolitical environment engenders, the financial burdens of brain illness on our society are rising, including costs for serious mental illness. Schizophrenia, for example, affects about 1.1% of the world’s population, and also affects the caregivers who assist those afflicted. The estimated U.S. economic burden from schizophrenia nearly tripled from 2002 – 2013. While recovering from schizophrenia’s symptoms and stigmas, folks not only need medical care but also face challenges supporting themselves and resuming productive roles in society, multiplying the total 2013 U.S. cost to an estimated $155.7 billion. Federal and state programs for early treatment have emerged to address this issue, which have shown encouraging results, but political challenges remain. The more of us who speak up in support, the stronger the outlook for those of us in need."

Read Brandon's complete article about defending early care on The Huffington Post (here).  

In Their Own Words

Strong 365 is a public education project of One Mind Institute. Through its online resource hub, social networks and blog, the digital campaign seeks to identify young people in need of support for psychosis, and connect them to information and treatment earlier.
 
In its My Story of Strength series, launched last year, individuals who have experienced psychosis during their youth explore how the often uphill and sometimes winding road to recovery can reveal unexpected strengths, personal growth and opportunities. The series celebrates what it means to be a proud survivor -- a daily warrior for one's own health and well-being, a stigma fighter, and a voice for others finding their way through recovery.
 
You can find My Story of Strength stories on the Strong 365 YouTube channel and blog.
 
The Strong 365 creative team - all of whom have been personally touched by psychosis in their lives - is also collaborating with a number of early psychosis treatment teams to develop their own similar content specific to their local communities.
 
Share your Story of Strength, or pass the opportunity along to someone who may appreciate it, by submitting on Strong 365’s Tumblr, or email founding director Chantel Garrett chantel@strong365.org.

Spotlight On

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The ETCH: Early Treatment and Cognitive Health Program
Catherine Adams, LMSW, ACSW, CAADC
It is a bit of a love story—this thing called ETCH:  Early Treatment and Cognitive Health.  Beginning in 2010, Catherine Adams was approached by the administration at her CMH center to provide leadership to a RAISE: Recovery After an Initial Schizophrenia Episode research site in Michigan.  A team of energized staff was assembled and the journey began. The team quickly discovered that the spirit and philosophy of the NAVIGATE: Early Treatment Program was a perfect fit; and the access to national experts on the NAVIGATE team headed by Dr. John Kane opened the door to professional growth and participant success. It allowed for a certain opportunity to partner with young adults and their natural supports to celebrate their inherent resilience.

Four years later, as the research came to a close, it became clear that the CMH center where the program began was not going to be able to continue to support the program. Ms. Adams was so impressed by (and passionate about) this new way of reaching young adults and providing robust support early on that she was compelled to find a way to continue.  She and an original RAISE team member, Raelyn Elliott-Remes, formed ETCH. Doors opened on October 1st, 2014 and ETCH now serves 46 young adults and their supports. In addition, Ms. Adams serves as the Michigan Trainer and Consultant for First Episode Psychosis programs receiving FEP Mental Health Block Grant Funding. She, Raelyn Elliott-Remes, and Kelly Curtis provide training and implementation support to NAVIGATE sites overseen by Network 180.  Michigan is now home to four NAVIGATE-FEP locations as noted below with plans for additional sites in the near future. 

The burgeoning of FEP support options across the United States is a hope-filled trend and the generosity amongst programs, professionals, peers, participants and their supports is a key ingredient to growing our knowledge and expertise, reaching farther and wider and truly supporting recovery for those experiencing psychosis.
 
Michigan NAVIGATE programs:

 
Michigan FEP Website:  www.michiganminds.org   (debuting soon)
To learn more about ETCH programs, training opportunities or its early beginnings—please contact Cathy Adams at adams@etchwellness.org or 517-481-4800, ext 101.

From the Research Front

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How Occupationally High-Achieving Individuals With a Diagnosis of Schizophrenia Manage Their Symptoms

By: Erika Roach, M.A.
A recent study by Dr. Amy Cohen and colleagues (including best-selling author and professor Elyn Saks who has a diagnosis of schizophrenia) sought to learn how individuals who have recovered from schizophrenia and achieve occupational success manage their symptoms.  Given the unemployment rate among individuals with serious mental illness is around 80%, occupational functioning is one objective measure of recovery in schizophrenia and gainful employment is considered a hallmark of stability and recovery. 
 
Through a series of in-depth person-centered interviews, five categories of coping strategies were identified among the twenty study participants:
  • Avoidance behavior – actively avoiding specific situations and/or behaviors they had previously found worsened their symptoms.
  • Utilizing supportive others – connecting with family, friends, or professional supports to provide objective insights into symptom exacerbation and non-judgmental support.
  • Taking medications –  taking medications to support stability even when it did not eliminate all symptoms
  • Enacting cognitive strategies – employing strategies to systematically reason through their problematic thinking, its basis in reality, and possible alternative interpretations
  • Controlling the environment – adjusting surroundings to prevent, minimize, or address the impact of symptoms.
Three additional categories– engaging spirituality, focus on well-being, and employment or continuing education– were identified among some interviewees. Most participants who utilized coping strategies to manage their symptoms reported utilizing multiple strategies. Typically these strategies were used to manage positive symptoms (i.e. hallucinations) rather than negative symptoms (i.e. motivation and social engagement).
 
Although participants were able to identify strategies that have helped them effectively manage their symptoms, it is important to note they still reported experiencing life challenges that related, at least in part, to their illness. Thus, the findings from this study highlight the fact that individuals can thrive in their occupation and education, even while experiencing ongoing symptoms and struggles. In fact, as noted above, some individuals consider employment and continued education to be important coping strategies in and of themselves.

The findings of Cohen et al. suggest that service providers, consumers, caregivers, and researchers can reflect and expand on the strategies shared by the study participants in order to re-conceptualize and advance what is possible in mental health recovery, especially when consumer voices and lived experiences are prioritized.  

References:
Cohen AN, Hamilton AB, Saks ER, Glover DL, Glynn SM, Brekke JS, Marder SR. How Occupationally High-Achieving Individuals With a Diagnosis of Schizophrenia Manage Their Symptoms. Psychiatric services (Washington, D.C.). 2017 Apr 1; 68(4):324-329.

Upcoming Events

Staglin Music Festival for Brain Health
When: Saturday, September 16, 2017
Where: Staglin Family Vineyard, 1570 Bella Oaks Ln, Rutherford, CA 94573, United States
Registration required: https://www.music-festival.org

Celebrating over two decades of research funding, the Music Festival for Brain Health is one of America’s most important fund-raising events focusing on brain disorders, with an historical total, including grants from the National Institute of Mental Health, surpassing $256 million. In 2016, $5.6 million was raised to support the research to find cures for brain disorders. The Music Festival for Brain Health benefits One Mind Institute (formerly IMHRO), and One Mind™, each partnering to support research, education, treatment, and to fight the stigma surrounding brain disorders. “The momentum continues to grow as we search for the causes and cures of brain disorders,” said Garen Staglin, President of One Mind Institute and Co-Chairman of One Mind™. “Each year we continue to fund important research, while raising awareness and reducing stigma, all of which are critically important in helping lead to advances and improvements in brain health.”
 
Learn More →
First Episode Bulletin is a quarterly newsletter produced by the Prodrome and Early Psychosis Program Network (PEPPNET). Funding has been provided by the Robert Wood Johnson Foundation.

Copyright © 2017 Prodrome and Early Psychosis Program Netwowrk (PEPPNET), All rights reserved.


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