FEBRUARY 2015

Issue II Vol. IV

5205 Greenwood Ave. Ste 110 West Palm Beach, FL 33407

561-588-3477 www.namipbc.org

NAMI of Palm Beach County recently held its annual Volunteer Appreciation Luncheon to thank the many individuals who volunteered their time and energies to our organization in 2014. NAMI of Palm Beach County has over 50 regular volunteers who help with office assistance, education classes and support groups, speakers’ bureaus and other outreach programs. This year’s Volunteer of the Year Award went to our Executive Director’s husband, Andy Downey. NAMI of Palm Beach County is fortunate to count Andy and the rest of the extended Downey family as friends and key supporters of our organization. Unfortunately, Andy’s easy demeanor and tireless support, combined with his ability to haul equipment, build anything we need, cook large quantities of food for the annual mystery dinner, and appear dapper in a tuxedo, make the rest of us husbands look pretty bad. NAMI volunteers have always been our lifeblood. Other mental health providers focus on the professional expertise they offer to clients, however, NAMI’s strength comes from the shared life experiences of its grassroots membership base. It is the actual participation and active support we provide, from people living with mental illness and from their loved ones, that makes our organization so effective. Showing that you can help others and knowing that you can truly make a difference in someone’s life regardless of your situation, is both validating and empowering. If you would like to

A Message From The President: NAMI—THE FABRIC OF OUR LIVES By Manuel Kushner, NAMI/PBC Board President contribute your time or energies to NAMI of Palm Beach,

please contact us. Most volunteer work requires that you have gone through the Peer-to-Peer or Family-to-Family NAMI courses and that you be properly trained. We’re always in search of support group facilitators as well as class instructors and speakers who are willing to share their life story. There are other volunteer opportunities that do not have this requirement. Volunteers help us set up fundraising events, provide services for our annual walk, deliver resource guides and NAMI brochures to hospitals and physician’s offices, and a host of other tasks that keep our good work available free of charge to the community we serve. Doing good is good for you – and while it is difficult to select one person out of the many great NAMI volunteers, we can only have one Volunteer of the Year Award!

The Voice

Clockwise from top right: (1)Annual

Luncheon Committee members, (2) NAMI

Volunteers enjoying the

lunch and afternoon.

(3) Andy and Liz Downey

WHAT WE’VE BEEN UP TO

Join us for February’s General Meeting

PTSD & Trauma — Wednesday, February 11, 6-8pm

Debra has spent two years providing trauma counseling to adult, adolescent and child victims of violent crimes- - homicide survivors, victims of domestic violence and victims of sexual assault.

She started her own private practice in April of 2014 and continues to provide therapy to clients.

General Meetings are free and open to the public.

Debra Blizzard M.Ed., LMHC

NAMI West Palm Office 5205 Greenwood Avenue, Suite 110, West Palm Beach, FL 33407

Peer Council Activities

Join us for U-Pick Vegetables at “The Girls” Farm Sunday, February 15th at 11:00am Strawberries are not in season but you can pick string beans, grape tomatoes and sapodilla. Tours have been arranged, followed by outdoor table side pizza and refreshments. $5 per person; RSVP required by February 9th The Girls U-Pick 1466 S Military Trail, Suite 3, Delray Beach, Florida 33484 If you have questions, call 561-588-3477 and ask for Michael or Chris

February Peer Council Meeting Friday, February 27th at 4:30pm

Held at the NAMI/PBC Lake Worth Office 1520 10th Avenue North, Suite D, Lake Worth

Pizza and refreshments will be served.

The White Picket Fence is returning in 2015! Please submit your short stories, drawings, poetry, reviews of books, restaurants, movies or video games and more! You can send submissions to kelseyjoyce@namipbc.org or mail them to the NAMI/PBC Office 5205 Greenwood

Avenue, Suite 110, West Palm Beach, Florida 33407. If you’d like, stop by the office and see what we have going on! The White Picket Fence is a quarterly newsletter with content created by and for NAMI/PBC peers.

Florida legislators’ refusal to expand the eligibility criteria for Medicaid as called for under the Affordable Care Act might cost billions of dollars in lost funding for hospitals that treat many uninsured patients, according to a report released in November by Florida Legal Services, a nonprofit legal advocate for the poor. Hospitals in Broward, Palm Beach and Monroe counties stand to lose more than $500 million in annual federal funding. How-ever, if state legislators were to accept the government’s offer to spend about $5 billion a year to expand Medicaid to an esti-mated 760,000 more Floridians, the new revenue would more than offset the anticipated loss of federal funding for hospitals that treat many uninsured patients, Florida Legal reports. The 760,000 residents are those in the “coverage gap,” which means they are not eligible for Medicaid and they do not earn enough income to qualify for government financial aid to buy private health insurance on the ACA exchange. The new healthcare law calls for gradual reductions in certain

FLORIDA LEGAL SERVICES REPORT ON MEDICAID EXPANSION Submitted by Deborah Levine

payments known as Disproportionate Share Hospital (DSH) program funds. The biggest loss stems from a July 2014 agree-ment between Florida and the Centers for Medicare and Medi-caid Services, which administers the healthcare programs on the federal level, which will cut about $1.8 billion a year in statewide funding through the Low Income Pool program (LIP) starting on June 30, 2015. State Medicaid administrators, hos-pital representatives and others have been trying to persuade the Government to extend the LIP program beyond June. The question is this. Currently a portion of our tax dollars are used to pay for Medicaid expansion and goes to the states that accepted that expansion. Why should other states take our share? Floridians’ tax dollars that go to Medicaid expan-sion should be used for those 760,000 Florida residents in the coverage gap. It’s important that NAMI members let their voic-es be heard. Write or call your State and Local legislators and urge them to vote for Medicaid expansion NOW.

WHAT’S COMING UP

We answered 217 phone calls

23 Peer Council Members participated in activities

21 people attended Family Support Groups

69 people attended NAMIConnections

Our staff and volunteers presented to 4 members of our community

19 young adults and 11 adolescents attended the Young Adult & Adolescent Support Groups

In December, NAMI/PBC served 364 individuals

Research is the Cure By Liz Downey

We here in Palm Beach County are so fortunate to have in Jupiter two of the world’s greatest research facilities, Scripps Research Institute (one of only two facilities in the U.S.) and Max Planck Florida Institute for Neuroscience (the only one in the U.S.). Their research fields are vast, but of most interest is their study of the brain and neurological disorders which may affect us all, schizophrenia, bipolar, Parkinson’s, Alzheimer’s, ALS, autism, alcoholism and addiction, MS, and cancer, just to name a few. Their research is critical to understanding how the brain works, which leads to developing new medications, innovative therapies and cures for these illnesses. In December, NAMI Palm Beach County was invited by the Hanley Center to participate in a PBC Drug Summit held at Max Planck. I was honored to sit on one of three panels alongside our new Board member, Dr. McLean Bolton, a researcher at Max Planck, among other distinguished panelists to discuss community education, awareness and outreach. Also in December, NAMI Palm Beach County was invited to an Ambassador’s Dinner to launch Scripps’ 2015 Esther B. O’Keeffe Foundation Neuroscience Symposia. Through Scripps’ Ambassador Program, they have partnered with numerous nonprofit organizations in our community to assist in educating the public about the important work they are doing at Scripps. At this dinner, they announce the very exciting news that Scripps will be hosting three Symposia in 2015. They believe that “research is the cure,” but of course services and

education for brain disorders are complementary missions of the utmost importance. Scripps’ primary mission is to understand how the brain works, what goes awry in brain disorders, and to discover new drugs and novel therapeutics for the treatment and cure of brain disorders. The “Ambassador” program was formed to partner and collaborate with extraordinary organizations and community leaders who are determined to save lives and offer hope to our friends and families. The Department of Neuroscience at Scripps Florida continues to make breakthroughs in brain-related diseases. Some highlights from 2014 include: - Discovery of a mechanism by which the brain “actively” forgets memories. - Finding new therapeutic targets to develop treatments for memory disorders. - Identifying a connection between brain overgrowth and key symptoms of Autism due to a mutation in a specific gene. Living healthy productive lives is important to us all. There can be no health without our mental health so throughout 2015, NAMI Palm Beach County will be keeping you abreast of breakthroughs being made in the area of neuroscience by these two institutes and any upcoming events. We hope you will take advantage of these events and help support the research that is right in our own backyard.

Monthly Member to Mention— Peter Davey Peter has rejoined our Florida NAMI affiliate this June after spending the past two years in Virginia, where he actively participated as a certified peer specialist. He was acknowledged and awarded for his efforts. Upon his return, Pete has wasted no time getting involved here sharing and establishing his know-how. He has formed and is facilitating a weekly Young Adults support group. Peter has also become a certified team member of our REACH program and had to recertify as a Florida Certified Peer Specialist (as it would not carry over from Virginia). Peter is as well a certified W.R.A.P. specialist and is Mental Health First Aid trained. Peter is an avid advocate for mental health. He has blended his relationship as a communicator via social media as well. Peter, in his spare time, has been known to pick up the guitar. As you see, he has quite an agenda. — Michael Garden.

Above, Peter and a few other members of the Young Adult support group enjoying volleyball and a bonfire in Lake Worth this January.

IN THE NEWS

NAMI PBC Psychiatry Blog: Challenges in Psychiatric Diagnosis By C. Kye

Jill Kelderman, PhD, an exceptional local developmental neuropsychologist, referred a 6-year-old-girl “6F,” who was having extreme behavioral, emotional, and sleep difficulties. 6F was exposed to various recreational drugs throughout her gestation. The parts of the brain most vulnerable to insult during fetal development by recreational drug exposure are the parts of the brain that have the most complicated neural circuitry design and that mediate the highest order functions. The prefrontal cortex is the apex of neural circuitry complexity and function. Extreme weakness in prefrontal function results in extreme weakness in behavioral and emotional regulation. This is referred to as a loss of prefrontal inhibition. Antipsychotic medication can be used to increase frontal lobe inhibition. 6F received enough antipsychotic medication to treat an actively psychotic schizophrenic adult – to no avail. 6F also had persistent, long-lasting depression and anxiety features. Routine first-line chemical antidepressants, in spite of their name, are better at controlling anxiety symptoms as opposed to depressive symptoms. 6F received 3 different antidepressant medication trials. These were characterized by a worsening of her irritability and a further deterioration of her sleep or “treatment emergent mania”/TEM. TEM was found in a large, well-designed study to be the one variable most predictive of a missed diagnosis of bipolar disorder (BRIDGE study, Arch Gen Psychiat, Aug 2011). 6F did receive one mood stabilizer trial for bipolar disorder of adequate dose and duration in the form of Trileptal – to no avail. The above constituted the bulk of the medication trials that 6F received continuously over the course of the prior 2 years. She ended up having an excellent clinical response to all target

symptoms in less than 2 months to lithium as a sole mood stabilizer, without any antipsychotic or antidepressant coverage. There are several teaching points to the above presentation. One is the importance of recognizing the significant limitations of our current psychiatric diagnostic system. Recent laboratory-based neuroscience findings have been found to map out well only onto individual psychiatric symptoms as opposed to psychiatric diagnoses which somewhat artificially group individual psychiatric symptoms. When a clinical presentation rests at the intersection of multiple psychiatric diagnoses, it can be more helpful to focus more on specific key symptoms, and to try to construct a narrative in the neural circuitry that accounts for the key symptoms. Oftentimes common symptoms such as inattention, which is part of the diagnostic criteria for the majority of psychiatric disorders, are non-specific. Inattention reflects a dysfunction in the most sophisticated components of neural circuitry that is intrinsic to psychiatric disorders in general. Similarly depressed mood can be more of a secondary vs. a primary phenomena. The TEM and the middle insomnia were key differential diagnosis symptoms for 6F in my mind at arriving at the decision to use the lithium. Strangely enough, and perhaps demonstrative of the somewhat artificial nature of the current DSM diagnostic system: TEM is excluded from the DSM diagnostic criteria for bipolar disorder. Not surprisingly, Kelderman referred 6F to me with a high index of suspicion of bipolar disorder. Another significant teaching point is the importance of using evidence based treatments when possible. The data for lithium as opposed to trileptal is significantly more robust when treating bipolar disorder (Ghaemi SN, Psychiatry, June 2006).

Stress management is an important skill for all parents. These tips can help you learn to manage your stress and live a happier, more satisfying life. By developing your own stress management skills, you are modeling important life skills for your children. Children observe and reenact the stress relief methods they see their parents and other caretakers using. Using poor stress relief skills can mean that as your children grow they will not understand stress as a normal part of life and something that can motivate us to continue working hard; a certain level of stress is actually optimal for survival and success. When stress gets to a problematic level and begins to hold you back from your daily life, it’s time to make some changes. There are some physical coping skills you can employ to handle stress in your everyday life. Mindful, deep breaths are the easiest and most effective stress relievers to date. Just like in yoga class, spend as much time inhaling as exhaling, and focus solely on the oxygen nourishing your body. Regular physical activity is equally important. Even if you only have a few minutes, some quick jumping jacks or crunches will relieve stress and release feel-good endorphins for the rest of

your day. Finally, there are times we just need a time out. Sometimes a mom's best defense to a tantrumming toddler, screaming teen or other kid-induced stress is to walk away- this is especially true as kids grow into young adults and beyond. First make sure there isn't anything harmful around your child, and then go to another room. Not only are you signaling that you don't respond to that kind of behavior, you're also stopping yourself from throwing a tantrum! Find the most quiet place you can, away from all TVs, music and whining. Lock yourself in your bathroom or in your parked car if you have to! And simply sit in the silence. The external quiet will bring internal peace and calm to your churning insides. It’s imperative to make sure you care for your emotional health and well-being. Laughter's not just a result of happiness—doing it will make you happy. Its chemical: Laughing lowers the stress hormone cortisol and increases beta endorphins, the mood enhancers that kick out depression. In addition, crying is not only emotionally renewing, some studies show that shedding tears may literally flush out stress hormones. So take a lesson from your child and toss out your stress. Finally, visual imagery really works in helping us deal with stressful situations, so go ahead and picture palm trees, clear waters and umbrella drinks whenever the need arises!

Stress Relief and Self-Care for Parents

By Dr. Kelly Everson, Palm Beach Behavioral Health and Wellness

Peer and Family Support Groups Call 561-588-3477 for more information

NAMI/PBC Connection Recovery Support Groups

NAMI Office (Lake Worth) 1520 10th Avenue N, Suite D Lake Worth, FL 33460 Saturdays 6:00-7:30pm

Toole Building South County Mental Health Center 16158 S Military Trail, Delray Beach, FL 33484 Mondays 1:45-2:45pm & Wednesdays 10:15-11:30am

Jupiter — Southeast Behavioral Health Network 140 Intracoastal Pointe Dr, Suite 208, Jupiter, FL 33477 Wednesdays 5:30-7:00pm

Amigos Group — Jeff Industries 111 E Coast Avenue, Hypoluxo, FL 33462 Tuesdays 6:30-8:00pm

NAMI/PBC Young Adults Support Group 18-30 Year Olds

NAMI Office (Lake Worth) 1520 10th Avenue N, Suite D, Lake Worth, FL 33460 1st 3 Fridays of the month 6:00-7:30pm

NAMI/PBC Adolescent Support Groups*

NAMI Office (West Palm Beach) 5205 Greenwood Ave, Ste 110, West Palm Bch, FL 33407 Grades 7-8: Tuesdays 5:30-6:30pm Grades 9-12: Tuesdays 6:30-7:30pm

Lake Worth 6801 Lake Worth Road, Suite 101, Lake Worth, FL 33467 Grades 7-8: Tuesdays 5:30-6:30pm Grades 9-12: Tuesdays 6:30-7:30pm

Jupiter 50 South US Highway 1, Suite 309, Jupiter, FL 33477 Grades 7-8: Mondays 5:30-6:30pm Grades 9-12: Mondays 6:30-7:30pm

*Registration required for Adolescent groups; please call 561-588-3477.

NAMI/PBC Family Support Groups

West Boca Raton Library 18685 State Road 7, Boca Raton, FL 33498 1st Tuesday 6:30-8:00pm

Boynton Beach/ Delray Beach (Hagen Ranch Library) 14350 Hagen Ranch Road, Delray Beach, FL 33446 2nd Tuesday 6:30-8:00pm

Jupiter (Southeast Behavioral Health) 140 Intracoastal Pointe Dr, Ste 208, Jupiter, FL 33477 3rd Thursday 6:30-8:00pm

Wellington (Wellington Library) 1951 Royal Fern Dr, Wellington, FL 33414 2nd Monday 6:30-8:30pm

Other Local Support Groups for Peers

South County Mental Health Center Depression Bipolar Support Alliance 16158 S Military Trail, Delray Beach, FL 33484 1-877-858-7474 for directions ALL DISORDERS (Building E. — Toole Building) Wednesdays 7:00-9:00pm

Peer Place Support Center 2100 45th Street, Suite B12, West Palm Beach, FL 33407 561-712-0584 for directions and information DRA (Living in the Now) (12 Step Co-occurring) Sat. 10am Here & Now (12 Step) Saturday 11:00am-12:00pm Peer Support Mon-Fri 9:00am-4:00pm; Sat 9am-1pm

Fair Oaks Pavilion (Behind Delray Community Hospital) 5440 Linton Blvd, Ste 1010, Delray Beach, FL 33484 For directions and info: rossdolphins@bellsouth.net

Jupiter Fire Station No. 19 322 N. Central Boulevard, Jupiter, FL 33458 561-427-0840 or 561-575-9787 for information Depression/Bipolar Thursdays 7:00-8:30pm

Holy Trinity Church 211 Trinity Place, West Palm Beach, FL 33401 Nancy Drevich 561-499-6716 for information Depression/Bipolar Thursdays 7:00-8:30pm

West Boca Medical Education Center 21644 State Road 7, Boca Raton, FL 33428 For directions and info: Jason Spielman 954-217-1757 OCD 1st Thursday 7:30-9:00pm

Living Grace Group 1st Presbyterian Church Youth Bldg. 717 Prosperity Farms Rd, North Palm Beach, FL 33408 1st Tuesday 6:30pm, Contact Ken 561-379-5675,

Trauma Support Group Center for Trauma Counseling, Inc. 801 Lake Worth Road, Suite 101 Lake Worth, FL 33467 Tuesdays 6:30-8:00pm, Contact Helya 561-444-3914

Other Local Family Support Groups

Family Grace Group

First Presbyterian Church Youth Building

717 Prosperity Farms Road, North Palm Beach, FL 33408

1st Monday 6:30pm Jeni Ayers 561-309-5675

ayersjeni@gmail.com for more information

GROUP MEETINGS

Non-Profit Organization

US Postage Paid

West Palm Beach, FL

Permit No. 1327

National Alliance on Mental Illness of Palm Beach County

Mollie Wilmot Center—Palm Healthcare Pavilion

5205 Greenwood Avenue, Suite 110

West Palm Beach, FL 33407

Or Current Resident

NAMI Membership exists at 3 levels: Affiliate, State & National. NAMI is a 501(c)(3) non-

profit, charitable organization—contributions are tax-deductible to the fullest extent allowed by law.

Together, we can continue to fight for all those affected by mental illness. PLEASE NOTE: In

order for NAMI/PBC to receive your full donation, please send your donation to the NAMI/

PBC office. Thank you! FL SOLICITATION REGISTRATION NUMBER: CH6498 “A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SER-

VICES BY CALLING (800-435-7352) TOLL-FREE WITHIN THE STATE. REGISTRATION DOES NOT

IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.”

Members are NAMI/PBC’s lifeblood; your membership helps us continue to provide free outreach, support & education. In bringing mental health issues to wid-er attention, we advocate for better treatment. As our membership base grows, our voice becomes strong-er.

Respect, Compassion & Hope … NAMI Works!

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