Demand Hope. Demand Recovery. Nothing less than life will do.

I hosted a public celebration at Pioneer Courthouse Square to mark the end of a hugely successful fundraising campaign for the OHSU Knight Cancer Institute. The Phil and Penny Knight Foundation challenged Oregonians to raise $500 million dollars to fight cancer. Make that goal in two years, Knight said, and his foundation would match the giving. OHSU raised the money in a record sixteen months, with 85% of the giving coming from within Oregon. We made it. It was a moving and emotional experience to learn of the remarkable breakthroughs in saving the lives of people diagnosed with cancer, and to imagine the gains that will accrue after a one billion dollar investment in cancer detection and prevention.

In nearly every area of public health, startling improvements are being made. If research on cancer, heart disease, stroke and diabetes has proven anything, it is that research investments save lives. As Dr. Brian Druker pointed out, research dollars devoted to leukemia allowed him to create a lifesaving drug, Gleevec, which has revolutionized the quest for a cancer cure and saved countless lives.

Sheila Hamilton, Mark Ganz, Ceo of Cambia Health Solutions, Oregon Governor Kate Brown

Sheila Hamilton, Mark Ganz, Ceo of Cambia Health Solutions, Oregon Governor Kate Brown

Now, let’s look at the tenth leading cause of death. Suicide. In 2014, 41,000 people died by suicide, and yet, public and private investments in research are meager, according to the U.S. National Suicide Prevention Research Efforts 2008-2013 Portfolio Analysis. Unlike other causes of death, the suicide rate has shown no decline over the last fifty years. Overall, Americans are now more likely to die by suicide than in an automobile accident. Suicide is the second leading cause of death for teens ages 15-34. And the rate of suicide among middle-aged Americans has increased by 30% since 1999.

What is most perplexing is the accepted rate of failure. Many people who die by suicide are under the care of physicians. In the month before their death by suicide, about half saw a general practitioner. According to the National Alliance for Suicide Prevention, thirty percent of those who die by suicide saw a mental health professional. Health care professionals often fail to ask about suicide risk because they were never trained to or they don’t know how to recognize suicide warning signs.

If we could improve suicide identification and care in primary settings, or in emergency departments, where most people go when they are feeling suicidal, we would have the potential to save lives. If we adopted the expectation of recovery in care settings, we could save lives. If we invested in the prevention of suicide like we invest in the prevention of heart disease and cancer, we could save lives. We know this because we are watching the rate of suicide decline in other countries that have made suicide prevention a priority.

41,000 lives a year are in the balance.

The dedicated folks at OHSU have a great saying. “We fight cancer differently. We win.”
Imagine a similar phrase for the prevention of suicide. “Demand Hope. Demand Recovery. Nothing less than life will do.”

Dr. Xavier Amador, “I Am Not Sick, I Don’t Need Help!”

Among the greatest frustrations in caring for a person with mental illness is Anosognosia, or lack of awareness. Dr. Xavier Amador talks with me about how to get the help your loved one needs. Amador is the director of the LEAP Institute, an internationally renowned leader in his field, with numerous books, authoritative research, worldwide speaking tours and extensive work in mental illness.

Dave Dahl of Dave’s Killer Bread on mental illness

Dave DahlI have always admired the redemptive story of Dave Dahl, a former convict who turned his life around by making the killer recipe called “Blues Bread,” that revolutionized the bread industry. Dahl became the face of Dave’s Killer Bread, and helped turn a family baking industry into a multi-million dollar brand. Dave’s Killer Bread is the nation’s favorite organic sliced bread.

In November of 2013, Dahl’s fate turned during a widely publicized incident with Washington County police. Many people reported he was drunk or high. In fact, Dahl was experiencing his first psychotic episode, a terrifying experience he recounts in this interview.

Thank you, Oregon!

01-Sheila-Hamilton

As part of Mental Health Awareness Month, Trillium Family Services, Oregon’s largest provider of mental and behavioral health care named its Mental Health heroes. I’m humbled and grateful for the opportunity to stand for people struggling with brain disorders.

Please learn more about Trillium Family Services’ trauma-informed approach to care. It is revolutionary, hopeful and the new industry standard for care. wwww.trilliumfamily.org

Some Words of Encouragement

All the Things We Never Knew

I chose to write about mental illness in All the Things We Never Knew for one reason–to give people hope. It was excruciating to watch my former husband descend into mental illness and not know where to turn or who to ask for help.

The unexpected gift of writing on this topic is that people now share their most closely held stories with me; they are vulnerable and open, recounting life experiences that aren’t generally water cooler talk.

After hearing about my book, the big burly guy who sat next to me on an airplane told me in detail about his brother, an Iraq war veteran, who suffers from PTSD so severely he sweats through his sheets every night. “He served three tours,” the man said, “and he’s still at war.”

A hairdresser told me about her battle with postpartum depression, and how, after months of seizures she believed were caused by anti-depressants, she attempted to take her life. If her baby hadn’t crawled in the bedroom as she was downing a bottle of pills, she says, she wouldn’t have found her way to recovery.

An older gentleman listened quietly to my brief description of the book and then whispered, “You young people are so brave. I’ve never told anyone about my depression.” I smiled and said, “I’ve never told anyone else I’m not young.” We shared a good laugh.

One in five Americans suffers from a mental health disorder. But, those numbers don’t hint at the tens of thousands of people who suffer in silence. Darkness wins, shame wins, and people feel more alone, and unworthy of love.

Brene Brown defines vulnerability as “Emotional risk, exposure, uncertainty.” It fuels our daily lives. As a therapist in her 12th year doing research, Brown says, “Vulnerability is our most accurate measurement of courage; to be vulnerable, to let ourselves be seen, to be honest.” What stops many from showing vulnerability is shame. Shame, according to Brown, is not guilt. It is a focus on self. Shame is highly correlated with addiction, depression, violence, aggression, bullying, suicide, and eating disorders.

So, here’s my message: If you are one of those people shaming yourself, denying yourself love, hiding from your emotions, know this. You are not alone. There are so many people who want to hear your story and they want to help. People who care are waiting to hear from you at Lines for Life, NAMI, Trillium Family Services, and your local County Mental Health services. These people will fight for you, with kindness and compassion. Be vulnerable, be open, and do not give up. Demand hope. Demand recovery. You are worth it.

How I Learned the Truth about “Magic Bullets”

In August of 2006, my former husband wasn’t sleeping well. He was stressed by the impending failure of his business, a marriage in shambles and his father’s worsening health. He needed help. He reached out to a friend of his, a doctor, who prescribed anti-depressants.

Within 48 hours of taking his first pill, David announced, “I’m hearing voices telling me to jump from the Vista bridge.” His tone was so detached, it was as if he was delivering the news that the mail had just arrived. I dropped the dish I’d been drying to the hardwood floor.

As I would later learn, people with bipolar disorder are at very high risk for suicidal ideation. Antidepressants may also increase suicidal behavior in pediatric, and possibly, adult, major depressive disorder. Mixed states are associated with suicidality and antidepressants, especially when administered as monotherapy. The anti-depressants had pushed David over into a manic conversion.

“Overprescription” was a word I would later understand when I saw David catatonic in a hospital, drooling, physically unable to move his limbs. The approach was not, “What are the factors that contributed to this man’s breakdown?” but instead, “Try a drug, any drug.” It was as if recovery wasn’t in the realm of possibility, until doctors could find a magic cocktail of pills. David was largely unresponsive to the medication. Twenty-four hours after being released from a psychiatric hospital, he took his life.

Award-winning science and history author Robert Whitaker is determined to solve a puzzle: why has the mental illness epidemic grown in size and scope, even as the country spends billions of dollars every year on antidepressants and antipsychotics?

Whitaker points out that as the psychopharmacology revolution has unfolded, the number of disabled mentally ill in the United States has skyrocketed. Mental illness now disables 850 adults and 250 children every day. According to Whitaker’s book, Anatomy of an Epidemic, “Those numbers only hint at the scope of the problem, for they are only a count of those who have become so newly ill that their families or caregivers are eligible to receive a disability check from the federal government.”

Psychiatry has largely forsaken the practice of talk therapy for the seductive and more lucrative practice of prescribing drugs. Although we know that many people are helped by psychiatric drugs and will personally attest to how the drugs have helped them lead normal lives, there are a host of deeply troubling consequences to a culture that favors prescriptions over therapy.

Whittaker’s book, “Anatomy of an Epidemic,” won the best investigative journalism book of 2010 for “Punching holes in the conventional wisdom of treatment of mental illness with drugs.”

The Foundation for Excellence in Mental Health Care formed in 2011 in response to the growing crisis. The international mental health community matches private philanthropy to non-biased research and programs that lead to recovery.

The strategy is three fold; Research, recovery program development, and education. Grants from the Research Fund and donor-advised funds drive research that is free from the influence of the pharmaceutical industry. The Recovery program development provides real alternatives to medication and the dissemination of effective recovery-oriented programs. The education curricula support professional symposiums, education and support groups, community dialog and educational films as some of the ways donors are changing the conversation and getting the expectation of recovery into the mainstream.

As Gina Nikkel, the CEO of the Foundation for Excellence in Mental Health Care says, “Ours is nothing like a standard corporate mission. It is a statement of deeply felt solidarity and a rousing call to action. We can reform mental health care-the time has come- and Excellence gives us the structure we need to do so effectively.”
——————
Antidepressants and suicidal behavior in bipolar disorder.
McElroy SL, Kotwal R, Kaneria R, Keck PE Jr.
Bipolar Disord. 2006 Oct;8(5 Pt 2):596-617. Review.

The Foundation for Excellence in Mental health Care
www.mentalhealthexcellence.org

Robert Whitaker: www.MadinAmerica.com

Sukey Forbes, The Angel In My Pocket, A story of Love, Loss, and Life after Death

“I’d die if that happened to me.” That’s what Sukey Forbes often hears from people when she talks about the loss of her beloved six-year-old daughter. But, as you’ll hear in this conversation with Forbes, her greatest loss also became the source of her greatest and most profound transformation.

As Dani Shapiro says, “What can we do when the unthinkable happens? We have choices, of course. We can break, become tough, allow cynicism to seep into all our broken places. Or, as Sukey Forbes illustrates in this remarkable book, grief can kick the door wide open and let the light in. The Angel in My Pocket is a devastating and beautiful paean to the human spirit.”

Dealing with a mental illness? Here are your legal protections

One of the most beautiful and heart-wrenching experiences I’ve had since writing this blog is hearing your stories regarding mental health. A mother shared her hope after finally finding a medication that worked for her daughter’s depression and anxiety disorder. A daughter grieved the normalcy she had before her brother had his first schizophrenic break. And a  well-known personality in the Portland area contacted me to say that he suffers from bi-polar disorder and is terrified of telling his employer. He doesn’t fear the stigma as much as the thought that he will likely be fired if his employer learns of his diagnosis.

I asked Dana L. Sullivan, one of the leading employment attorneys in the Northwest to offer advice for people who may be hiding a mental illness from their employer.

A new stage of grief: forgiveness

SunsetDr. Elisabeth Kubler-Ross has described the five stages of grief as denial, anger, bargaining, depression and acceptance. When a loved one commits suicide, that list is incomplete. We are haunted by the questions, “Why would he?” or “What could I have done differently?”

I’d propose one more stage of grief to Kubler-Ross’s list in the case of suicide: forgiveness. It was not until I reached this stage of forgiveness that I was able to sort out my own failings from those of my husband. In accepting responsibility for my part in David’s death, I was able to understand his sense of futility and his unwillingness to face his illness. I forgave him. And in doing so, I was finally able to understand his decision.

In all of the research I’ve done to attempt to understand David’s decision, one particularly well written piece by Jay Neugeboren sticks with me. Jay’s brother, Robert, had been in the New York mental health system for nearly forty years, and had been given nearly every antipsychotic medication known to humankind. Jay began interviewing hundreds of former patients who had been institutionalized, often for periods of ten or more years, and who had recovered into full lives: doctors, lawyers, teachers, custodians and social workers. He was fascinated with the question–what had made the difference?

Some pointed to new medications, some to old. Some said they had found God. No matter what else they named, they all said that a key element was a relationship with a human being. Most of the time, this human being was a professional, a social worker or nurse, who said, in effect, “I believe in your ability to recover, and I am going to stay with you until you do.” The author points out that his brother had recently recovered from his mental illness, without a recurrence for more than six years, the longest stretch in his adult life.

Given the lack of hope or optimism during David’s hospitalization, this study affects me deeply. But it also provides a blueprint for those of us who want to commit our lives to connecting deeply with others, especially those who may be suffering. We need one another to lead healthy lives, and when faced with the prospect of illness, be it mental or physical, we need to believe others can help us through to the other side. We need to believe that it is no different to ask for help with a brain illness than it would be for a cancer patient to ask for chemotherapy. We need to have faith in our own ability to endure, and when hope wanes, as it will with the illogical ups and downs of any disease, we should track our way back to our hearts.

Sheila Hamilton is the author of All the Things We Never Knew, available for pre-order on Amazon.com. For more information on Sheila’s story, please read prior blog posts, or contact the author below. Thanks!

 

A Trauma Informed Approach to Care: Trillium Family Services CEO Kim Scott

As part of Mental Health awareness month, I hope you’ll listen to Trillium Family Services CEO Kim
Scott talk about a Trauma informed approach to care.

Scott says the key principles of a trauma informed approach:

  1. Realizes the widespread impact of trauma and understands potential paths for recovery;
  2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
  3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
  4. Seeks to actively resist re-traumatization.

The intervention programs attempt to respect the survivor’s need to be informed and hopeful regarding their own recovery. The team also recognizes the interrelation between trauma and symptoms of trauma, such as substance abuse, eating disorders, depression and anxiety. Trillium’s counselors work in a collaborative way with survivors, family and friends of the survivor and other human agencies.