Noticias

Pew Hispanic Center Releases Report on English Usage Among Latinos in the United States

Health Department Launches Poster Campaign In Schools and Clinics To Help Address High Rates Of Depression In Latinas

 University of Miami Receives $7 Million to Study Health Issues in Hispanic Community

New Issue Briefs Feature Lessons Learned from Established Systems of Care

The CHC Health Task Force Priorities for the 109th Congress

Hispanic Directors Association Issues Report on Mental Health for Latinos Noting Few Improvements in State System

The Top Ten Concerns About Recovery Encountered in Mental Health System Transformation

Schizophrenia Population in U.S. Reached 1.5 Million in 2002

Innovative Mental Health Treatment Model Embraces Entire Family Mass.-based Program Aids Parents with MH Issue

Medicare to Cease Automatic Enrollment

TRPI Fellowships Invigorate and Broaden Research Into Latino Issues

L.A.'s Hispanics, Blacks See Answers in Alliance and formation of a new Latino & African American Leadership Alliance

Connecticut Latina, and NLBHA Board Member, Ana Lazu, Wins Prestigious National Mental Health Award. Dynamic Advocate Unites Community of Latinos, Focusing on Culturally Sensitive Care

Members of the Advisory Committee to the White House Conference on Aging, for the Life of the Conference

Mental Health Treatment Center Evaluates Inmates

New Mexico Interagency Behavioral Health Purchasing Collaborative

"New Freedom Commission Viewed as
Having 'Substantial Impact' - A Survey of Mental Health Leaders One Year After the President's New Freedom Commission Report

Hispanic Alcohol Use Studied

Latino Face of America

Louisiana Psychologists Begin Prescribing Drugs

 Spending on Mental and Substance Use Disorders Concentrated In the Public Sector

A Call to Action on Behalf of Latino and
Latina Youth in the US Justice System

NLBHA Testifies before Freedom Commission on Mental Health

Community-Based Program Models highlighted in Commission on Mental Health

 Letter to Service Providers regarding Sept 11th 

Pew Hispanic Center Releases Report on English Usage Among Latinos in the United States

Nearly all Hispanic adults born in the United States of immigrant parents report they are fluent in English. By contrast, only a small minority of their parents describe themselves as skilled English speakers. This finding of a dramatic increase in English-language ability from one generation of Hispanics to the next emerges from a new analysis of six Pew Hispanic Center surveys conducted from 2002 to 2006 among a total of more than 14,000 Latino adults.

The analysis finds that fewer than one-in-four (23%) Latino immigrants reports being able to speak English very well. However, fully 88% of their U.S.-born adult children report that they speak English very well. Among later generations of Hispanic adults, the figure rises to 94%. Reading ability in English shows a similar trend. The analysis also finds that English is spoken more commonly at work than at home.

The report is available at the Pew Hispanic Center's website, www.pewhispanic.org .

The Pew Hispanic Center, a project of the Pew Research Center, is a non-partisan, non-advocacy research organization based in Washington, D.C. and funded by The Pew Charitable Trusts.

University of Miami Receives $7 Million to Study Health Issues in Hispanic Community

The University of Miami School of Nursing and Health Studies has received a five-year, $7 million grant from the National Institutes of Health (NIH) to create a center dedicated to the study of health issues that disproportionately affect the Hispanic community, the South Florida Business Journal reports. El Centro—a National Center on Minority Health and Health Disparities (NCMHD) University of Miami Center of Excellence for Hispanic Health Disparities Research—will be one of 16 such centers nationwide established with NIH funding. Preliminary research will focus on determining which factors influence the incidence and burden of specific conditions that disproportionately affect Hispanics, including substance abuse, HIV/AIDS, sexually transmitted diseases and co-occurring mental health conditions. In addition, the center will develop culturally tailored interventions to remedy these health disparities
(South Florida Business Journal, 9/12/07; University of Miami release, 9/12/07).

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New Issue Briefs Feature Lessons Learned from Established Systems of Care

website: http://rtckids.fmhi.usf.edu/cssi/

Just released, the new series, "System Implementation Issue Briefs," produced by the Research and Training Center (RTC) for Children¹s Mental Health offers concrete examples from communities that have successfully developed systems of care.

This series presents findings of RTC Study 2: Case Studies of System Implementation and seeks to describe how stakeholders facilitate local system of care development as well as what factors, conditions, and strategies contribute to the development of systems of care for children with SED and their families.

Four issue briefs are currently available on-line:

• System of Care Definition (Issue Brief #1) - Provides an expanded definition of the system of care concept in an attempt to create dialogue around the definition.
• Critical Factors in System of Care Implementation (Issue Brief #2) ­ Offers a model for how established system of care communities leverage change, with broad guidelines for use of implementation factors.
• Leadership Qualities in Successful Systems of Care (Issue Brief #3) ­ Describes characteristics of successful leadership within system of care communities based on research findings to date.
• Evidence-based Practices and Systems of Care: Implementation Matters (Issue Brief #4) ­ Provides strategies for the integration of evidence-based practices into established system of care communities.

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The CHC Health Task Force Priorities for the 109th Congress

Full Article: http://www.napolitano.house.gov/chc/chctaskforces/health.htm

The CHC Health Task Force Priorities for the 109th Congress include: eliminating racial and ethnic health disparities, covering the uninsured, increasing the diversity and cultural competence of health professionals, improving health care for Latino elderly, enhancing women’s health, promoting fair and inclusive welfare services, and expanding quality foster care.

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Hispanic Directors Association Issues Report on Mental Health for Latinos Noting Few Improvements in State System

Full Article Click HERE

Mental health services in New Jersey for the Latino community are still inadequate, culturally insensitive and show little improvement from 15 months ago when a panel of experts first issued a report on the subject, according to a report released today by the Hispanic Directors Association of New Jersey (HDANJ). The New Jersey Mental Health Institute collaborated in the effort. The report is a follow-up to our previous report released in September 2005, both of which can be found on our website www.hdanj.org.
The report entitled: “Latino Mental Health – One Year Later: Creeping towards Progress” found the state addressed a few issues such as the establishment of a Council on Mental Health Stigma and appointed several Latino members to the body. Also, on the positive side the state allocated an additional $900,000 to hire bilingual clinicians, bringing the total for this area to $1.9 million.

“However, in many areas dealing with the Latino community there was little or no progress,” the report concluded. The report also found that there are no Latinos with any policy-making role in the Division of Mental Health Services or sitting on many of the state’s professional licensing boards.

“We promised to remain engaged in monitoring mental health programs for Latinos in New Jersey and that is why we reconvened our Mental Health Roundtable earlier this year,” said Elsa Candelario, Chairwoman of HDANJ. “We will continue to meet with state officials to push for greater reform of the state system to make sure it is responsive to the specific needs of Latinos.”

“We cannot say we are overly pleased with the progress thus far,” Candelario concluded.

“Although we appreciate the state and the Division of Mental Health Services’ efforts to date, we strongly believe that much more is needed in order to ensure a mental health service delivery system that not only promotes, but provides high-quality, culturally and linguistically appropriate mental health services for all Hispanics”, added Henry Acosta, Executive Director of the newly formed National Resource Center for Hispanic Mental Health and Deputy Director of the New Jersey Mental Health Institute, Inc.

The panel, which consisted of experts in all aspects of the mental health system, made the following 11 recommendations:

• The establishment of an Office of Cultural and Linguistic Competency within the Governor’s Office.
• Funding for the development and implementation of several targeted public education and media campaigns geared to the Latino population.
• The hiring and appointment of Latinos to policy and regulatory positions at all levels of the mental health system.
• The allocation of $1 million to expand outpatient services in Spanish.
• Every county mental health screening center in New Jersey should be required to have, at minimum, one bilingual, bicultural mental health screener on call, 24 hours a day.
• The establishment of a $1 million scholarship program for students interested in pursuing mental health careers.
• A minimum of 1000 units mental health housing units be set aside for Spanish-speaking mental health consumers.
• Disgracefully low reimbursement rates for free standing clinics must be adjusted so that services can be provided in the community rather than a more costly hospital setting.
• The establishment of a one-year provisional bilingual license for social workers, psychologists and psychiatrists.
• A better statewide effort at data collection regarding services provided to mental health consumers.
• The New Jersey Department of Human Services needs to clarify the impact of the federal Deficit Reduction Act of 2005 on mental health services.

The members of the Mental Health Roundtable were Henry Acosta, MA, MSW, LSW Executive Director of the National Resource Center for Hispanic Mental Health and Deputy Director of the New Jersey Mental Health Institute, Inc., Elsa Candelario, Executive Director of the Hispanic Family Center of Southern NJ, Beatriz Cruz, Director of the Director of Behavioral Health Inpatient Services at Jersey City Medical Center, Reverend Nidia E. Fernández, Chair of the Multicultural Services Committee at Ancora Psychiatric Hospital, Marcello Gómez, President and CEO of Best Practices for Children and Families, Miguel Koschil, Executive Director of the Sunrise Institute for Mental Health, Gliceria Perez of the Puerto Rican Action Board, Daniel Santo Pietro, Executive Director of the Hispanic Directors Association, Martha Silva, Director of National Association for the Mentally Ill en Español in New Jersey, Frank R. Solano, Program Director of the Puerto Rican Family Institute – Jersey City Mental Health Clinic, William A. Vega, Director of the Behavioral Health Research and Training Institute for UBHC at UMDNJ.

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Schizophrenia Population in U.S. Reached 1.5 Million in 2002

Analysis Group Study Finds Highest Prevalence of Disease in Medicaid and Uninsured Populations

http://www.nyaprs.org/Pages/View_ENews.cfm?ENewsID=6248

BOSTON--(BUSINESS WIRE)--A new study published in the November issue of Psychological Medicine was the first of its kind to use administrative claims databases to track the annual prevalence of diagnosed schizophrenia in the United States. Analysis Group, a leading economic consulting firm, co-authored the study alongside researchers from Tulane University, University of Arkansas School for Medical Sciences and Harvard Medical School. Leading the Analysis Group team were Dr. Eric Q. Wu and Vice President Howard Birnbaum. The researchers analyzed data from several insurance administrative databases, including those from private insurers, the California Medicaid (Medi-Cal) program, and the Veteran's Administration, among others.

They estimate that in 2002, the prevalence of diagnosed schizophrenia in the United States reached 1.5 million. "Surprisingly, very little is known about the annual prevalence of this debilitating disease," said Ronald Kessler, Ph.D., Professor of Health Care Policy at Harvard Medical School. "The difficulty researchers face in measuring the prevalence of it is the fact that so many of the people affected are hard to count - many are homeless, unemployed, etc." The study found that diagnosed schizophrenia had the highest estimated prevalence in the Medicaid population; the uninsured population came in close second. The researchers note an enormous lack of prevalence data for a number of other diseases and chronic illnesses in the United States. "Our hope is that the unique methodology we came up with has far-reaching applicability, especially in diseases where it is difficult to measure prevalence rates using traditional epidemiology methods," said Dr. Wu. "For disease states that are unaccounted for in existing epidemiology databases, our insurance administrative data analysis method provides an alternative that can help to help close this gap."

Funding for this study was through Analysis Group internal research and development. Analysis Group, Inc. (www.analysisgroup.com) has provided economic, financial, and business strategy consulting to law firms, corporations, and government agencies for 25 years. The firm has more than 350 professionals, with offices in Boston, Chicago, Dallas, Denver, Los Angeles, Menlo Park, New York, San Francisco, Washington, and Montreal.

Innovative Mental Health Treatment Model Embraces Entire Family Mass.-based Program Aids Parents with MH Issue

Mental Health Weekly October 23, http://www3.interscience.wiley.com/cgi-bin/jhome/110575476

University of Massachusetts researchers and a local nonprofit agency have developed an innovative, strength-based program for parents with mental illness and their families, assisting them with customized support services to help them manage their illness and family responsibilities. Family Options is a pilot program and collaborative effort between the university and Employment Options, a Marlborough, Mass.-based clubhouse serving people with mental illness. Program officials plan to officially launch the program this week with a premier screening of an evidence-based documentary prepared by AstraZeneca, funders of the program, to address the obstacles faced by parents with a diagnosed mental illness. The documentary is intended to educate legislators, ally organizations, and patient advocates. The initiative is currently being piloted with 18 families from Marlborough, Framingham and other communities in the Boston metro area, with the ultimate goal of 30 families participating over the course of a ! year.

Family Options improves the family's support network by assigning them a family coach who assesses each family's individual needs and builds a plan to include local agencies and services. The family coach acts as the liaison between the family and support agencies such as the state Department of Mental Health, the Department of Social Services, local school districts, after-school programs and other local organizations. The program provides 24-hour, seven-day-a week outreach to families in need, including parenting, education, service coordination, and transportation services (see box, this page). Program officials cite studies demonstrating that 68 percent of women and 55 percent of men in the U.S. living with mental illness are parents; however many health care providers fail to ask patients if they have children, they said. Consequently, many parents living with mental illnesses are lacking the support to help them provide a stable, healthy home life for their families. They are also wary of asking for help, fearing their children may be taken away from them, they said.

Family Options is developed to redefine the standards of treating mental illnesses by combining adult and child services to work with the family as one unit. "The issue of treating the whole family is our attempt of changing the ways services are traditionally provided," Toni A. Wolf, executive director of Employment Options, told MHW. "To truly serve the parent, you need to serve the child. To serve the child, you need to serve the parent." Servicing the family as a unit is more effective, said Wolf. "Traditionally our system will see the adult with mental illness and treat their illness, but often do not focus on the stressors in their life that could be barriers to treatment," she noted. "In our industry we have been trained to focus on the pro! blem - w hat is wrong with the individual, what treatment is required, what challenges the individual faces rather than looking at what the person/family have already accomplished - what are their strengths and how to use their strengths to move them forward to achieve their goals," said Wolf. Wolf added, "People know what they are not good at, they need help to see what they are good at, to truly empower them and give them the hope to move closer to recovery and make the necessary changes in their life to improve and enhance their family life."

The model is a composition of evidence-based practices from child and adult research literature and Employment Options is implementing the model and the University of Massachusetts Medical School is researching it, she added. "The children in the family, often feel invisible or isolated, not understanding why mom or dad is behaving the way they are - not understanding the illness. The parent wants to be a good parent, yet due to the illness and stigma is afraid to seek the help that might be required to be a better parent," said Wolf. Stigma is a major barrier, noted Ann Capoccia, coordinator of interagency activities for the child and adolescent division at the Massachusetts Department of Mental Health. "Stigma is alive and well in this country," Cappocia told MHW. People need to be encouraged to seek help when they need it," she said. "Parents need to get the help they should have. They have a tremendous job these days." Cappocia added, "The field is changing. We trying to say let's get a comprehensive picture of the mother, the father, brothers and sisters so we can understand the problem better and make a better impact."

Family criteria

To participate in the program a parent must have:

• Have a mental illness that affects daily living.
• Have had one or more of the following:
  - Hospitalization for a mental illness
  - Disability benefits for a mental illness
  - Mental illness lasting more than a year.
• Be currently receiving mental health services, either treatment or case management.
• Have at least one biological or adopted child living with him or her between the ages of 18 months & 16 years.

Parents must also understand and speak English due to research needs, said Wolf. The researchers at the University of Massachusetts would have preferred working with children age seven and up since there are research tools that can apply to that age group, she said. "However, we really want to at least be able to reach out to a parent that has young children, as well as provide services to young adults who may be first time parents with small children," said Wolf. Wolf added, "We see a growing population of young adults with psychiatric disabilities who are also parents."

Limited family-based programs

Prior to the program's implementation, researchers at the University of Massachusetts medical school examined programs around the country targeting parents with mental illness and their families. They found only 20 programs like that nationwide, said Kathleen Biebel, Ph.D., research assistant professor at the University of Massachusetts Medical School. "Those programs we looked at on average serve 15 to 20 families," she said. "That's not a lot." "We've identified the common elements and key ingredients of those programs," said Biebel. "We taken what we learned and put together all the critical components that are best served for this population," she said. There aren't enough services that exist for families with mental illness, she said. Programs are typically geared either for adults or children, said Biebel. "It's the way funding ! works," she said. "The dollars provide services for addressing either children or adults."

Family Options is unique in that it serves all family members, she said. "All individuals make up a family - not just an individual with a diagnosed illness," she said. The program addresses the goals of the parents, the children and the family as a whole, she said. The program is funded as a research project from AstraZeneca. "We hope the state Department of Mental Health and the Department of Social Services will fund this project in the future to maintain sustainability," she said. Wolf said she would like to see Family Options become a statewide model program and subsequently a national program.

For more information, visit www.employmentoptions.org.

The Family Options program identifies the unique needs of each family and offers personal and customized support services. The program offers:

• Assessment - Families receive an extensive assessment when they join the program to fully identify their individual needs and goals.
• Parenting education - helps parents with mental illness identify the skills needed to provide emotional support to their children and to take care of their illness.
• Specialized support - Helps parents prepare for difficult periods of the day, such as preparing for school and work, and transitioning back from school or work to home. Also focuses on discipline and importance of developing regular routines.
• Service coordination - Ensures both the parent and children receive and attend the services they need, and in turn, meet the needs of the family unit.
• Liaison with the department of social services, Department of Mental Health and other support agencies.
• Visitation support - Enables parents without custody to maintain their visitation schedule.

Medicare to Cease Automatic Enrollment

by KEVIN FREKING, Associated Press Writer October 18, 2006

The federal government has told about 632,000 elderly and disabled people they won't be automatically enrolled in a Medicare drug plan next year. These people are still eligible to participate in the drug benefit, but they will have to shop for a plan and then enroll on their own rather than the government doing it for them. To afford the benefit, many will also need to apply for a low-income subsidy.

Some advocates are concerned that many of the 632,000 could fall through the cracks, not knowing they don't have coverage for their medicine until they show up at their local pharmacy in January. "We're very concerned. We believe many, if not most of the people, simply won't respond to a letter," said James Firman, president and CEO of the National Council on Aging. "Many won't read the letter, they won't understand the letter, they won't know how to fill out the application form." During the first year of the drug benefit, the so-called "dual eligibles" were automatically enrolled because they participated in both Medicaid and Medicare and represented the sickest and most vulnerable among the elderly and disabled. The federal government wanted to ensure that they did not lose access to prescription drugs. But states have informed the federal government that some of those beneficiaries no longer are enrolled in their Medicaid programs, thus they will no longer be automatically enrolled in a drug plan.

The Centers for Medicare and Medicaid Services recognizes that some in the group may miss signing up for a drug plan during the next open enrollment period Nov. 15 though Dec. 31. It has granted the group an extra three months to enroll in a plan without the prospect of a penalty for late enro! llment, said Kathleen Harrington, director of external affairs for the agency. Harrington said the group was also told in the letter last month that they should apply for the low-income subsidy, which could give them access to a drug plan with little or no monthly premium. She also said that the insurers themselves have been told who will need to apply on their own. "It's very much in the interest of the plans to keep them in coverage," Harrington said.

Firman has worked closely with federal officials to enroll low-income seniors in the drug benefit. He has not been critical of the program, so his qualms cannot be dismissed as just more criticism from an outspoken opponent. The beneficiaries he is concerned about qualify for Medicare because of their age or disability. They also had previously qualified for Medicaid because of their incomes. In some cases, the people who lost their Medicaid coverage may have lost eligibility because they're making more money and no longer qualify for the extra help. "But it's more likely that some states tightened eligibility requirements, or the individual did not complete all the paperwork needed to be recertified for Medicaid," Firman said. Firman said that his organization's experience in reaching out to low-income seniors is that about 20 percent will respond to a letter. "We're talking about a population that's sick, may have low literacy. There are a lot of challenges," he said. "What they need is one-on-one assistance from trusted intermediaries." He said he hoped that insurers would take some follow-up steps, too. "We believe the plans themselves should have responsibility for helping their customers do this. It also makes good business sense because they could lose these customers," Firman said. Harrington said there are no plans to follow the letter up with calls, but advocacy groups and other government agencies will undertake outreach efforts in communities deemed to have a large number of seniors eligible for the low-income subsidy.

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TRPI Fellowships Invigorate and Broaden Research Into Latino Issues

CONTACT: The Tomás Rivera Policy Institute,
(213) 821-5615

FOR IMMEDIATE RELEASE August 31, 2006

(LOS ANGELES) - The Tomás Rivera Policy Institute (TRPI) continues to keep pace with the national focus on immigration by awarding research fellowships to three doctoral students, all of whom bring with them a broad base of experience, interest, and expertise.

"TRPI is delighted to have these outstanding doctoral students participating in our fellowship program," said TRPI President Harry P. Pachon, Ph.D. "They bring with them a great analytical capability as well as a freshness of ideas, high energy, and enthusiasm."

The fellowship program, now in its second year, is funded by the University of Southern California and provides a unique opportunity for doctoral level students to participate in policy analysis. Fellows serve for one year and conduct applied research in education, political involvement, and immigration. Potential areas of study include:

- The political mobilization and incorporation of immigrant groups into the U.S. political system;
- The dynamics that shape the lives of second-generation immigrants; and
- The important role of parental involvement in education.

Jillian Medeiros is a doctoral student in USC's Politics and International Relations Program. She has examined the dynamics of Latino partisanship, political participation, and the incorporation of immigrant groups into the political system.

Edward Flores' interests lie in the social sciences and globalization, and on the processes that affect the success or failure of second-generation immigrants. He currently is a third-year doctoral student in USC's Department of Sociology, where he studies international migration and gender issues.

Hernan Ramirez, a graduate student in USC's Department of Sociology, will be studying University of California minority admissions and conducting research on the role of parental involvement in education.

"It will be a learning experience for all of them," Dr. Pachon said. "The academic environment typically precludes participation in policy research because academics and policy analysis each have a specific focus and purpose. Policy analysis is much more problem-oriented and has a contemporary focus on the issues that face society. This fellowship combines the two. It offers them a unique opportunity to blend academics and community involvement."

ABOUT TRPI

Founded in 1985, the Tomás Rivera Policy Institute (TRPI) advances informed policy on key issues affecting Latino communities through objective and timely research contributing to the betterment of the nation. TRPI is an affiliated research unit of the University of Southern California School of Policy, Planning, and Development, and is associated with the Institute for Social and Economic Research and Policy at Columbia University. To learn more about the Tomás Rivera Policy Institute, visit the Institute's website at http://www.trpi.org.

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L.A.'s Hispanics, Blacks See Answers in Alliance and formation of a new Latino & African American Leadership Alliance

National activists hope it's the beginning of a new era in black-Latino unity.

Some city officials see merely a promising - but yet unproven - possibility in ways for the two groups to find common ground over a host of issues that have found them directly at odds in recent years: jobs, housing, education, healthcare, and gangs. Click here for more information.

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Connecticut Latina, and NLBHA Board Member, Ana Lazu, Wins Prestigious National Mental Health Award.
Dynamic Advocate Unites Community of Latinos, Focusing on Culturally Sensitive Care.

ATLANTA , May 16 /PRNewswire-FirstCall -

Depression can be devastating, and when the only services available either ignore your ideals and beliefs, or are in a language you can't understand, mental illness also can seem insurmountable. For her dedication to filling the void of culturally appropriate care for Latinos with mental illness, Ana Lazu has been honored by an independent panel of national mental health leaders with the 2005 Welcome Back Award for primary care. Eli Lilly and Company sponsors the national awards program, which is in its seventh year. Lazu had worked in Connecticut 's mental health community for several years when she began experiencing periods of major depression, anxiety and panic attacks. When the hours of sitting at home in isolation gradually turned into days and months, Lazu decided that she needed to find help. Yet, her search for Latino-specific information yielded unsatisfactory results; her findings either contradicted or neglected to incorporate her Latino traditions, language and culture. "Like other Latinos living with mental illness, I faced a double stigma -- one imposed by society, and one imposed by my culture," says Lazu. "My language, religion and traditions are an important part of my identity, and I wanted to find services that would enable me to preserve my heritage while becoming well." Deciding to take matters into her own hands, Lazu created Latinos Unidos Siempre (LUS), a non-profit organization that has become highly successful in providing culturally sensitive and appropriate care to the Latino population of eastern Connecticut. LUS provides referral, advocacy, education, counsel and case management support to Latinos who have mental illnesses, substance abuse problems, or have family members with these illnesses. Lazu's proudest achievement is LUS's PRIMOS Training Program. Students learn how to overcome cultural and language barriers so that they can secure quality care for themselves. Lazu prepares her students for employment and continuing education, and gives them a comfortable place to learn interpersonal skills and practice English. Students leave the program with a sense of personal value, and a drive to help other Latinos facing similar problems. PRIMOS is the Spanish word for "cousins," and in providing her students with the means to take care of themselves, as well as those around them, Lazu has succeeded in transforming the community into an extended family. "Ana Lazu is a powerful and successful agent of community change," says Dr. Brendan Montano, Welcome Back Awards committee member and assistant clinical instructor at the University of Connecticut School of Medicine. "In less than a year, she went from being the patient to the primary source of aid for hundreds of Latinos with mental illness, educating both patient and provider on the importance of culturally sensitive treatment." Lazu is one of six individuals who will be honored at the seventh annual Welcome Back Awards ceremony on May 21, in Atlanta. Sponsored by Lilly, the Welcome Back Awards is a national program that recognizes outstanding individuals who make a difference in the depression community. In addition to her award, a $10,000 contribution from Lilly will be made on Lazu's behalf to Latinos Unidos Siempre and to the National Latino Behavioral Health Association (NLBHA), for the NLBHA Josie Romero Scholarship Fund. Nominations for the 2006 Lilly Welcome Back Awards may be submitted by anyone wishing to recognize an individual for outstanding achievements within the depression community. For more information, call 800-463-6440 or visit www.welcomebackawards.com

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Members of the Advisory Committee to the White House Conference on Aging, for the Life of the Conference:

Rodolfo Arredondo of Texas.

Lupo Carlota of Tennessee.

Kathleen Correa of New Mexico.

Joseph F. Coughlin of Massachusetts.

Anthony M. DiLeo of Louisiana.

Peggye Dilworth-Anderson of North Carolina.

T. Bella Dinh-Zarr of Texas.

Margaret Lynn Duggar of Florida.

Katherine Freund of Maine.

F. Michael Gloth, III of Maryland.

Carolyn Gray of the District of Columbia.

Carole Green of Florida.

Cynthia Hughes Harris of Florida.

Edward Martinez of California.

Melvina McCabe of New Mexico.

Michael McLendon of Georgia.

Lawrence Polivka of Florida.

Isadore Rosenfeld of New York.

William J. Scanlon of Virginia.

Sandra Schlicker of the District of Columbia.

Joanne Schwartzberg of Illinois.

William J. Turenne, Sr. of Virginia.

http://www.whitehouse.gov/news/releases/2005/05/20050513-11.html

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Mental Health Treatment Center Evaluates Inmates

Clara Garcia
Valencia County News-Bulletin Staff Writer  
May 11, 2005

Los Lunas - For the past year, inmates serving state prison time and in need of mental health treatment are being treated at the new, state-of-the-art facility in Los Lunas.

Construction of the new 104-bed Mental Health Treatment Center , located at the Central New Mexico Correctional Facility in Los Lunas, was completed last February. The 58,000-square-foot facility is the first unit in the state that is designed specifically for mental-health treatment.

Mental Health Treatment Center (MHTC) includes 90-square-foot cells, an isolation room for inmates who may need to be protected from themselves, treatment rooms within each cell area and a closed-circuit monitoring system.

David Wells, assistant mental health bureau chief and staff manager of the MHTC, says the center's main objective is to receive and treat inmates who have been identified at other prison facilities as not being able to function adequately in that population because of suspected mental disorders.

"What we do is we take these individuals, observe them and get a better picture of what is wrong," Wells said. "We then develop a diagnostic criteria."

MHTC is divided into two areas, Wells said. The first area is for inmates who display acute, or emergency, symptoms. Wells explained an inmate with an acute disorder may be someone who has attempted suicide.

"What we'll do is watch them closely so they're not able to harm themselves," Wells said. "We'll stabilize these patients through individual treatment or medications until we feel they are able to released out of the acute setting."

The other unit is the chronic care unit that is designed for long-term treatment. During an inmate's stay in this unit, they are more closely observed to determine what, if any, mental health treatment is needed.

"Ultimately, the goal is to get them to return and function in a general population setting," Wells said. "We develop treatment plans and goals, and we are required to record progress or lack-there-of on a regular basis."

Depending on the individual, the average stay in the MHTC is 90 days, Wells said. Each treatment plan is scheduled for 90 day intervals and after it's completed, it's reviewed and the question is asked, "Is the issue that brought the inmate to the center resolved?"

If not, the inmate will continue treatment for another 90 days. The goal, Wells said, is not to keep them in an acute hospital, rather to get the inmates functioning at an adequate level.

With a staff of 20 councelors and two psychiatrists per unit, inmates who are being treated in the acute unit will be assessed and then will moved through a level system. Each level is basically an increase in privileges.

"After they've achieved all three levels, they are either sent back to their facilities or placed in the chronic units," Wells said. "In those units, we have both individual and group therapy conducted by the councelors.

"We have vocational education programs, woodworking and ceramics," he said. "We also have recreational programming, which includes typical activities and gardening."

Wells said mental health treatment for inmates is very critical for several reasons. Just by virtue of the prison population, inmates tend to have a higher proportion of individual mental health disorders.

According to Wells, the national average of inmates in need of mental health treatment is about 15 percent of the population.

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New Mexico Interagency Behavioral Health Purchasing Collaborative

By Fredrick Sandoval, MPA

On April 19, 2004 New Mexico's Governor Bill Richardson signed into law House Bill 271 that formed a state interagency behavioral health purchasing collaborative. This marked an ambitious and comprehensive endeavor to redesign the publicly funded behavioral health system in New Mexico. The "Collaborative" is comprised of seventeen state member agencies to include department secretaries and executive administrators who provide joint leadership in policy, planning, and oversight of a single statewide behavioral health system.

Today, the state operates multiple contracting systems to purchasing behavioral health services that are generally uncoordinated across departments, service populations, and geographic regions. This results in multiple funding streams, different data systems, and disparate range of cost rates and clinical outcomes. In addition, care coordination is fragmented, administrative operating systems are duplicated, information systems gather and report data unrelated to each other, and consumers and families find a bureaucratic maze of paperwork and access problems created by a system unknown to the average citizen.

This reform of the behavioral health system being undertaken by the State of New Mexico is leading the charge in transforming the behavioral health system with the intent of developing better services, increasing access, reducing administrative costs, reducing fragmentation and giving taxpayers value for their dollar. This new single behavioral health delivery system is interfaced with the fifty-two members of the Behavioral Health Planning Council that is comprised of fifty one percent consumers and families. The new redesign is driven by greater involvement and participation by consumers and families than has ever been the case in New Mexico. The state's Request For Proposal was thoroughly embedded with a consumer and family focus and the guiding principles of recovery and resiliency were scripted throughout the purchasing document. In fact, family members and consumers participated in the review of proposals submitted to the state.

Beginning July 1, 2005, behavioral health services will individually centered and family focused based on principles of the individual's capacity of recovery and resiliency; delivered in a culturally competent, responsive and respectful manner via the least restrictive means; and services will be coordinated, accessible, accountable and of high quality.

Services will be focused on increasing consumer and family abilities to successfully manage life challenges; facilitate recovery and build resilience; provide integrated and community based services; managing care so as to utilize consumer and family abilities and strengths; conduct treatment in consultation with the consumer and where appropriate his or her family, guardian, caregivers and other persons critical to that individual; directing care with the involvement of the consumer and family; provide services that are consumer or family driven or operated; ensure behavioral health wellness promotion, prevention, early intervention, treatment and community support; and ensuring meaningful involvement of consumers and family members and consumer run organizations at all levels of decision making processes concerning operations and oversight of the behavioral health system.

The Collaborative will select a statewide entity to manage the pool of $250 million in behavioral health dollars in February 2005 and the single statewide organization will administer contracts with providers effective July 1, 2005. The public funds will include all Medicaid behavioral health service dollars, state general funds for behavioral health through the state behavioral health authority, federal substance abuse and mental health block grants and other state funds for school-based behavioral health services. The braiding of public dollars in the first year of operation will cut across five state agencies of the Collaborative serving both children and adults.

All of the consumers currently served with public funds will continue to receive services, service providers currently holding contracts will continue to do so at the start of the next state fiscal year, and data and performance measures will continue to be reported as they are today. The transition into the new single statewide behavioral health delivery system has generated an excitement about how improvements to the system can be made by streamlining how the state contracts behavioral health services; how administrative efficiencies can be garnered by reducing the administrative burden on providers; how evidenced based practices can be funded to include ACT, MST, IOP and telepsychiatry services; and how families and consumers can be actively involved in the entire redesign process.

The Collaborative will be evaluated through a grant from the Center for Mental Health Services to ascertain how effective the process of "transformation of New Mexico's behavioral health system" has worked. In my professional role as Executive Administrator for the New Mexico Department of Health, I am assisting in the development, implementation and administration of the new Collaborative and the opportunity to help redesign the behavioral health system is a once in a lifetime experience. Policy change is well underway and the hope and vision for quality care and quality of life is well within our reach. Transformation is possible.

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"New Freedom Commission Viewed as Having 'Substantial Impact' - A Survey of Mental Health Leaders One Year After the President's New Freedom Commission Report

Silke A. von Esenwein, M.A., Thomas Bornemann, Ed.D., Lei Ellingson, M.P.P., Rebecca Palpant, M.S., Lynn Randolph, A.S. and Benjamin G. Druss, M.D., M.P.H.

May 2005 Psychiatric Services

Abstract  
As part of the 19th annual Rosalynn Carter Symposium on Mental Health Policy, held in 2003, an anonymous online survey of symposium participants was conducted to gain insight into participants' perceptions of the impact on their organizations of the President's New Freedom Commission and its recommendations. The participants were national mental health leaders representing a broad range of mental health agencies and organizations. The results of the survey suggest that the New Freedom Commission has had a substantial impact on the organizations represented at the symposium. Findings on successes and challenges in implementing the recommendations suggest areas for ongoing efforts to transform mental health care.

Introduction  
In April 2002 President Bush announced the creation of the President's New Freedom Commission on Mental Health, the goal of which was to "recommend improvements to enable adults with serious mental illness and children with serious emotional disturbances to live, work, learn, and participate fully in their communities" (1). On July 22, 2003, the Bush administration released the commission's final report (2). The commission identified six major goals: building greater understanding among Americans that mental health is essential to overall health; placing consumers of mental health services at the center of their care; eliminating disparities in the delivery of mental health care services; making early screening, assessment, and referral to mental health services common practice; delivering excellent mental health care and accelerating research; and exploiting available information technology to improve access to and coordination of mental health care (3,4).

Although a number of initiatives were created in response to the commission's report (4,5), little information has been gathered about how the mental health community has responded. The Rosalynn Carter Symposium on Mental Health Policy brings together mental health leaders and organizations each year to discuss a mental health policy topic of national importance (6). The focus of the 2003 symposium was the President's New Freedom Commission and how the commission's recommendations can be implemented to transform the mental health system (1). Symposium participants (N=194) were affiliated with local, state, and national government agencies (41 participants, or 21 percent of all attendees), professional organizations (46 participants, or 24 percent), nonprofit organizations (11 participants, or 6 percent), family and consumer advocacy groups (27 participants, or 14 percent), service provision (22 participants, or 11 percent), research and educational institutions (28 participants, or 14 percent), the media (11 participants, or 6 percent), and others (eight participants, or 4 percent).

After the symposium, The Carter Center's mental health program conducted an online survey to gain insight into the symposium participants' perceptions of the impact on their organizations of the New Freedom Commission and its recommendations. The results provide a useful perspective on how a group of national opinion leaders has responded to the commission and its recommendations.

Methods 
In June 2004 an invitation to participate in an anonymous online survey was sent to all 194 individuals who attended the symposium. The survey included three categories of questions. In the first set, respondents were asked to identify which of the six goals listed in the commission's report they personally considered to be the most important for transformation and which goal they considered to be the most relevant and feasible for their organization. In the second set of questions, respondents were asked whether the behavior of their organization had changed in response to the President's New Freedom Commission and whether they considered their organization to be currently aligned with the commission in general as well as with each of the six goals. In the third set, respondents were asked to identify in what respects the commission's report influenced their organization's behavior as well as which facilitators and barriers for successful implementation were encountered by their organization.

Results 
A total of 68 symposium attendees responded to the survey. The respondents were affiliated with government agencies (19 respondents, or 28 percent of all respondents), professional organizations (12 respondents, or 18 percent), nonprofit organizations (four respondents, or 6 percent), family and consumer advocacy groups (ten respondents, or 15 percent), service provision (three respondents, or 4 percent), research and educational institutions (12 respondents, or 18 percent), the media (four respondents, or 6 percent), and other (four respondents, or 6 percent). With the exception of a relatively low response rate in the clinical provider category, the respondents were representative of the symposium attendees overall.

Among the six goals identified by the President's New Freedom Commission, a plurality of respondents (40 percent) endorsed "Americans understand that mental health is essential to overall health" as most important for transforming mental health care in the United States (Table 1). However, most respondents highlighted another goal, "Excellent mental health care is delivered and research is accelerated," as the most relevant to their individual organizations (32 percent). Respondents highlighted several goals as being feasible for their organization to accomplish (24 percent for "Americans understand that mental health is essential to overall health," "Mental health care is consumer and family driven," and "Excellent mental health care is delivered and research is accelerated" respectively).

A total of 41 percent of participants (28 respondents) believed that their organization's behavior had changed in response to the commission's report, and 46 percent (31 respondents) believed that their organization was currently aligned with its goals. Respondents saw the greatest progress in improving mental health delivery and research, the elimination of disparities, and the use of technology (Table 1). The report most commonly influenced organizations' behaviors through facilitating informal discussions among colleagues (50 respondents, or 74 percent), encouraging partnerships with external organizations (39 respondents, or 57 percent), and influencing internal planning (35 respondents, or 51 percent).

The factors most consistently identified as contributing to successful implementation of the recommendations of the New Freedom Commission were willingness to change within the organization (17 respondents, or 25 percent), partnerships with community agencies (13 respondents, or 19 percent), and availability of public funding (nine respondents, or 13 percent). The most common barriers cited were financial constraints (29 respondents, or 43 percent), other competing priorities within the organization (26 respondents, or 38 percent), and lack of local political support (19 respondents, or 28 percent).

Discussion 
This results of this survey suggest that the President's New Freedom Commission has had a substantial impact on the organizations represented at the 19th annual Rosalynn Carter Symposium on Mental Health Policy. Nearly half of respondents reported that at least one change had been made in their organization in response to the commission's report. In particular, the report seems to have had the most influence by stimulating internal communication and by facilitating collaborations with outside organizations.

However, the specific findings on successes and challenges suggest areas for ongoing efforts to transform mental health care. For example, a majority of respondents identified "Americans understand that mental health is essential to overall health" as most important for transformation, but only about 25 percent of the respondents considered this goal as a relevant and feasible one for their organization. This discrepancy suggests that this first goal, which is so critical to transformation called for in the New Freedom Commission's report, cannot be accomplished by mental health policy makers alone. Making mental health essential to overall health requires efforts to reach out to general health policy makers, health providers, and the general public.

The single largest barrier to successful implementation of the commission's recommendations reported by respondents was the presence of financial constraints. The commission was explicitly charged with making recommendations that did not require any new governmental expenditures. This survey's findings support concerns raised by some advocates about achieving the commission's goals in the absence of new funding (7,8,9).

Although participants in the symposium are selected to represent a range of influential stakeholder groups, we recognize that they do not reflect a random sample of mental health policy makers in the United States . The relatively low response rate limited our ability to break down the findings across subgroups of attendees or to conduct bivariate analyses. In spite of its exploratory rather than definitive nature, the survey provides a first structured look at how policy makers view the impact of the New Freedom Commission and its recommendations.

Conclusions 
This survey provides a first glimpse at how the President's New Freedom Commission has influenced mental health organizations in the United States . The previous presidential commission report, conducted a quarter of a century ago, provided advocates with an important tool for fostering change within and beyond their organizations (10). The results of this survey suggest that the current report may similarly serve as a catalyst for transformation in the coming years.

Footnotes 
Ms. von Esenwein and Dr. Druss are affiliated with the department of health policy and management of Emory University in Atlanta . Dr. Bornemann, Ms. Ellingson, Ms. Palpant, and Ms. Randolph are with the mental health program of The Carter Center in Atlanta . Send correspondence to Ms. von Esenwein at Emory University, Rollins School of Public Health, 1518 Clifton Road, N.E., Room 646, Atlanta, Georgia 30322 (e-mail, svonese@sph.emory.edu ).

References 
Executive Order 13263 of April 29, 2002: President's New Freedom Commission on Mental Health. Federal Register 67:22337-22338, 2002

Achieving the Promise: Transforming Mental Health Care in America . DHHS pub no SMA-03-3832. Washington , DC , President's New Freedom Commission on Mental Health, 2003. Available at www.mentalhealthcommission.gov/reports/finalreport/fullreport-02.htm

Druss BG, Goldman HH: Introduction to the special section on the President's New Freedom Commission Report. Psychiatric Services 54:1465-1466, 2003[Free Full Text]

Hogan MF: The President's New Freedom Commission: recommendations to transform mental health care in America . Psychiatric Services 54:1467-1474, 2003[Free Full Text]

Glover RW, Birkel R, Faenza M, et al: The campaign for mental health reform: a new advocacy partnership. Psychiatric Services 54:1475-147, 2003[Free Full Text]

The Nineteenth Annual Rosalynn Carter Symposium on Mental Health Policy: The President's New Freedom Commission on Mental Health: Transforming the Vision, November 5 to 6, 2003. Available at www.cartercenter.org/healthprograms/sym2001_sdoc6.htm

Remarks by A Kathryn Power, MEd, Director Center for Mental Health Services Substance Abuse and Mental Health Services Administration: Plenary Panel: Federal Initiatives in Mental Health Centers for Medicare and Medicaid Services' National Systems Change Conference, Baltimore, March 3, 2004

Iglehart J: The mental health maze and the call for transformation. New England Journal of Medicine 350:507-514

Feldman S: New Freedom Commission Report: a view from managed behavioral health. Psychiatric Services 54:1482-1483, 2003[Free Full Text]

Koyanagi C, Goldman HH: The quiet success of the national plan for the chronically mentally ill. Hospital and Community Psychiatry 42:899-905, 1991[Medline]

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Hispanic Alcohol Use Studied

4/19/2005

A five-year federal study is expected to provide the clearest look yet at alcohol use in the Hispanic community, the Houston Chronicle reported April 13.

The $4.8-million project, funded by the National Institute of Health, will include surveys of 6,000 adult Hispanics in Houston , New York , Miami , and Los Angeles .

"This will help us fill a major gap in epidemiology among Hispanics in the United States ," said lead researcher Raul Caetano of the University of Texas School of Public Health. "We know some things, but there's so much more we need to know. We're talking about a group that makes up 12 or 13 percent of the population. In a few decades, it will be 25 percent."

Americans of Cuban, Mexican, Puerto Rican, and South and Central American heritage are expected to take part in the project. Interviewees will be asked about alcohol consumption, drinking patterns, and attitudes about overconsumption, DUI, and other alcohol-related crime.

Caetano will oversee a team of 150 researchers from the Temple University Institute for Survey Research. The research findings will be used to develop prevention and intervention strategies aimed at Hispanics.

"We know the Hispanic populations, especially the males, have a higher number of drinks during a given drinking occasion than other groups. This is especially true for Mexican-Americans," said Caetano, adding that Mexican-Americans also have high rates of single-car, alcohol-related fatalities and death due to cirrhosis of the liver.

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Latino Face of America

By Alan Caruba
web posted March 14, 2005

A funny thing happened to me while I was pushing a cart up and down the aisles of my local Pathmark supermarket. I hit one aisle and suddenly realized that a very large portion of it was devoted to Goya and other products favored by Latinos. Not being a Hispanic or Latino -- the terms are interchangeable -- I had not noticed that before, but the fact is, New Jersey and nearby New York are major population centers for Latinos, even though much of the Hispanic population remains spread throughout the Southwest and, of course, throughout California.

In the past, I have written some pretty harsh analysis of the impact of illegal immigration on the United States of America . I have not favored the further granting of amnesty to the eight to twelve million illegal aliens here, most of whom are from Mexico , South America, and Caribbean nations. There is, however, a power in numbers and in history. They are both relentless when examined without prejudice.

Let me share some numbers with you from an interesting book, Right Before Our Eyes: Latinos Past, Present & Future (Scholargy Publishing, 1555 W. University Drive, Suite 108, Tempe, AZ 85281, www.scholargy.com ) by Robert Montemayor with Henry Mendoza.

• Latinos are the largest and the youngest ethnic minority in the United States.

• At approximately 40 million today, Latinos account for 13.7 percent of the US population.

• By 2050, one out of every four Americans will be Latinos, a number that will exceed 100 million.

• In 2020, one out of six workers in the US will be Latino; in 2050, it will be one out of four.

• Latinos will spend $700 billion this year.

• Latinos represented between 6 to 8 million votes in the 2004 presidential election; they were estimated to represent the critical swing vote in six States.

All of a sudden, I began to think that maybe Social Security might not go broke if those illegal aliens were given the opportunity to become tax-paying Americans with a better opportunity to have their children schooled so they too can join the workforce as the baby-boomers head toward retirement. What does America need? A "geezer" workforce or one that taps the ability of native-born and immigrant Latinos?

A lot of Americans are going to be very surprised to discover that the taxpayer base in ten years and the workforce in 2020 are going to be predominantly Latino. It will be same kind of surprise I felt when I realized that aisle in Pathmark represented a change I hadn't really noticed.

Part of the problem is that Latinos, particularly native-born, have had an especially hard time climbing the ladder of success in America . The appointment of Alberto G. Gonzalez as the first Latino US Attorney General was widely heralded, but Latinos remain under-represented at the executive levels of business, education, law, politics, and policy. There are exceptions, yes, but they remain exceptions.

Latinos are virtually invisible with the exception of entertainers like Jennifer Lopez and Salma Hayek, musicians such as Emilio and Gloria Estefan, and from the world of sports, golfers LeeTravino, Chi Chi Rodriquez or Nancy Lopez. Baseball has many Hispanic stars such as Alex Rodriquez, Sammy Sosa, and Manny Ramirez. When you look to science, aerospace, art, architecture, medicine, the military, and politics, the names of Latino achievers are barely known to most people, let alone to the vast Hispanic community.

As far as the mass media is concerned, Latinos are an even greater minority than African Americans, but Latinos outnumber them these days. When you read or hear about a Latino it is most likely because they have been arrested. This totally ignores the growing Latino middle class. For those born here and others who arrive here legally or illegally, there is an astonishing 600 Spanish-language radio stations and an estimated 550 Spanish-language magazines, newspapers, and websites. As Montemayor notes, "It is an industry all its own, and it exists within the largest English-speaking country in the world."

Language is a major sore point among advocates and critics of immigration. All previous groups that arrived on our shores, Italians, Russians, Germans and others, embraced English as the unifying language of these United States . It is language that, more often than not, stymies the progress of Hispanic immigrants and, if history is any guide, it is the necessity to learn English that will permit them to make a life for themselves and their children here.

Education is the key to progress, but our education system is in meltdown, poorly serving an entire generation of young Americans and, more often than not, neglecting Hispanic children to the point of their dropping out in numbers too great to ignore without peril to the growth of our economy and the well being of our society.

The numbers of Latinos born here and coming here cannot be ignored. Ways must be found to integrate new Hispanic immigrants into our society, nor should we forget that there are already millions of first, second, third and fourth generation Latinos for whom America is their home. A group that will spend $700 billion this year alone cannot be ignored and that aisle in Pathmark says they are not being ignored.

For those who resist this, a bit of history. Hispanic explorers had begun their travels around the North American continent centuries before their English counterparts. Years before the first English settlement at Jamestown , Virginia , Spanish explorers had discovered and traversed most of what would become the Southern States from Florida to Texas , "discovered Lake Michigan in the north, trekked down the Mississippi River, crossed New Mexico , Colorado , Nevada , and Arizona , and claimed the California coast extending as far north as Vancouver Island . In 1565, the Spanish admiral Pedro Menendez de Aviles founded St. Augustine , Florida ." It would serve as Spain 's military headquarters in North America for the rest of the 16th century.

There are all kinds of issues swirling around the fact that some 400,000 illegal immigrants from Mexico , South America, and the Caribbean are arriving yearly. There are national security issues, education issues, medical care issues, crime issues, language issues, but there aren't values issues. Latinos who risk everything, including their lives, to come here want to work, want their children to have a better life, want to live in a nation that offers real opportunity. And many come here legally, but go unnoted against the television images of those who do not.

So, let's face it. The future face of America is going to be less English, less Scandinavian, less Russian, less Irish, less Italian, less German. We are going to learn to celebrate Cinco de Mayo along with St. Patrick's Day.

Alan Caruba writes a weekly column, "Warning Signs", posted on the Internet site of The National Anxiety Center . © Alan Caruba, March 2005

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Louisiana Psychologists Begin Prescribing Drugs

By MELINDA DESLATTE  ASSOCIATED PRESS  
April 19, 2005

BATON ROUGE, La. (AP) - The fight over whether psychologists should be allowed to prescribe medication, though they lack medical degrees, sparked a fierce debate about patient safety and a high-powered push to get the new law passed last year.

By contrast, the start of the program has received scarce attention. The first of the so-called "medical psychologists" began signing prescription pads more than a month ago with little fanfare, among the first psychologists in the nation to prescribe drugs.

Louisiana and New Mexico are the only states that allow psychologists who complete specialized training and pass a national exam to write prescriptions for medication. Both states began issuing the prescribing certifications and licenses to a handful of psychologists within days of each other in February.

Backers of Louisiana 's new law said it would provide better coordination of patient care, reduce patient costs and offer greater access to mental health services for people who would otherwise have long waits to see a psychiatrist.

"It's not hard to refer them. It's hard to get them to be seen. You can make a referral, but it would take three months," said John Bolter, a Baton Rouge psychologist who wrote his first prescription in February after years of front-line work to get that expanded authority.

Louisiana, like New Mexico, requires psychologists who write prescriptions to consult with physicians, but critics - including psychiatrists, who must have medical degrees - said both training and supervision are inadequate under the new program and jeopardize the lives of patients.

Jason Young, with the American Psychiatric Association, said if the psychologists pushing for Louisiana 's law worried about getting care to underserved areas, the law would have contained incentives for practicing in rural areas with less access to mental health care.

"There were no Louisiana citizens clamoring for this law in the first place," Young said. "This was designed by psychologists."

The issue isn't limited to two states. Thirty-two others have psychological associations looking into prescriptive authority, according to the American Psychological Association, and legislation was introduced in seven states this year.

"For our profession, we see this as a natural evolution," said Russ Newman, executive director for professional practice with the psychological association.

A group of psychologists in Louisiana , who formed their own political action committee and raised thousands of dollars for campaign contributions, sought the ability to prescribe drugs for a decade, with three pieces of legislation falling short over the years.

A power shift in the Legislature changed the fate of the fourth bill, which sped through the state House and Senate last year backed by the governor's chosen legislative leaders, Senate President Don Hines and House Speaker Joe Salter. It was the first bill to get to Gov. Kathleen Blanco's desk during the legislative session.

Though Blanco had acknowledged her hesitancy about " Louisiana standing outside of the mainstream," she signed the controversial bill on the final day she could veto it, saying she was assured by Hines and Salter there were ample safeguards.

And though the debate continued to rage in the medical community, the vocal public discussion ended. The development of the rules for New Mexico 's program took years after the law was passed in 2002, but Louisiana 's procedures were put in place in less than a year.

Louisiana 's prescribing psychologists are limited in the types of drugs they can prescribe. They have to talk with the patient's primary doctor to be able to do so, and they cannot prescribe narcotics - areas Blanco cited as protections for patients.

Only psychologists who have a postdoctoral degree in psychopharmacology for studying drugs and areas like neuroscience and anatomy can write prescriptions under the new law, after passing a national proficiency test. A small group of Louisiana psychologists had completed the training before the law was passed, hoping they'd one day be able to prescribe medication.

Psychiatrists and critics of the new law said the main university to offer a "medical psychology" postdoctorate program ranked in the bottom 10 of 183 schools nationwide offering psychopharmacology programs. They said the training isn't sufficient to teach psychologists about harmful drug interactions when patients are taking medications for other conditions.

Elaine LeVine, a prescribing psychologist in New Mexico , said her new authority helps her better manage care by allowing her to combine medication with therapy, instead of suggesting types of drugs to patients' primary doctors and hoping the advice is followed. She is under scrutiny by a physician as part of New Mexico 's conditional licensing requirements.

Both sides in the debate over Louisiana 's new law expect the number of psychologists prescribing medication to grow, reaching as many as 50 by year's end.

And that has Bea Piker worried.

Piker, executive director of the New Orleans office of the National Alliance for the Mentally Ill, opposed the law when it was before the state Legislature.

"We were genuinely concerned that you can't compare the background and training that psychologists would have versus medical school," Piker said.

"We still have the opposition. We're actually waiting to see what happens," she said.

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Spending on Mental and Substance Use Disorders Concentrated In the Public Sector

Substance Abuse and Mental Healthy Services Administration Release, March 29, 2005

The percentage of mental health and substance abuse services paid for by public sources is increasing, with a smaller percentage provided by private sources, including private health insurance. Public sources paid for 63 percent of mental health spending in 2001, up from 57 percent in 1991. Public sources paid for 76 percent of substance abuse treatment in 2001, up from 62 percent in 1991, according to a new analysis announced today by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The study, National Expenditures for Mental Health Services and Substance Abuse Treatment 1991-2001, shows that public spending for mental health services and substance abuse treatment amounted to $67.4 billion in 2001, while private spending amounted to only $36.3 billion. The data will appear today in the online edition of Health Affairs at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.133

The report provides data on all national expenditures for mental health and substance abuse treatment, and does not include indirect costs such as the impact of mental illness on productivity or societal costs linked to drug-related crime.  Public spending includes spending by all levels of government, federal, state and local, and includes Medicaid and Medicare.  Private spending includes insurance payments, patients paying out of their own pockets and charity care.

"Mental health and substance abuse treatment services spending accounts for a sizeable portion of the health care economy, $104 billion out of a total of $1.4 trillion in 2001," SAMHSA Administrator Charles Curie said. "Two of the most important developments from 1991 to 2001 are common to both mental health and substance abuse treatment. Overall, we have seen a decline in inpatient spending and a shift to publicly financed care.  As we continue to work to improve the community-based services available to people in need, it is clear the public sector is now the major financial driver."

The report calculates that spending on mental health services totaled $85.4 billion in 2001.  Substance abuse treatment costs amounted to $18.3 billion.  The report notes that mental health spending on psychiatric hospitals has decreased, while expenditures for other types of care, particularly prescription drugs, have increased. One in every five dollars spent on mental health treatment is now spent for retail psychotropic prescription drugs (21 percent), up from 7 percent in 1991.

For substance abuse treatment, the report finds that private insurance payments fell by an average rate of 1.1 percent annually, declining from 24 percent in 1991 to 13 percent of expenditures in 2001. The proportion of spending by all private sources fell from one third of all substance abuse treatment spending to one quarter of this spending between 1991 and 2001. 

In contrast, private insurance paid for 22 percent of mental health expenditures in both 1991 and 2001.  Payments grew 5.8 percent annually for mental health care, largely due to payments for prescription medications.  Insurance payments have increased for all health care by 6.9 percent.

The report notes that Medicaid is now the largest single payer of mental health services, exceeding private insurance, Medicare, or other state and local spending.  Medicaid paid 27 percent of mental health expenditures in 2001; Medicare paid 7 percent; other federal spending accounted for 5 percent; other state and local spending 23 percent; private insurance 22 percent; and other private 16 percent.  Spending on psychotropic retail drugs was $18 billion.  Retail prescription medications in substance abuse amounted only to $78 million.

 The report is available on the web at www.samhsa.gov .

SAMHSA, is a public health agency within the Department of Health and Human Services.  The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions, treatment and mental health service delivery system.

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A Call to Action on Behalf of Latino and Latina Youth in the US Justice System

http://www.buildingblocksforyouth.org/latino_rpt/index.html

This report, prepared by Francisco Villarruel and Nancy Walker of Michigan State University, examines the treatment of Latino and Latina youth in the United States Justice System. Within the 83-page report (available here in HTML and PDF formats), the authors utilize a variety of statistical data and narrative research to show that Latino and Latina youth are significantly over-represented in the US justice system and often receive harsher treatment than similarly incarcerated young whites. 

The report includes significant policy recommendations, including the elimination of racial profiling and seeking to employ more bilingual and culturally competent staff in order to ensure better service delivery to the broader Latino community. The site also includes a variety of press releases regarding the report, local and national press coverage, an executive summary, and a fact sheet. Quite appropriately, all of the materials on the site are also available in Spanish. The site will be of great interest to those with an interest in the social justice movement and with the current debates regarding the juvenile justice system. [KM]

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The Freedom Commission is part of the New Freedom Initiative, a massive program with resources scattered across the numerous federal agencies. The Commission has a very specific charge to improve the system. It's mission is to conduct a comprehensive one year study of the U.S. mental health service delivery system, including public and private sector providers, and to advise the President on methods for improving the system. The Commission's goal is to recommend improvements that will enable adults with serious mental illness and children with serious emotional disturbances to live, work, learn, and participate fully in their communities. 
Letter to Dr. Michael Hogan, Chair, Freedom Commission on Mental Health

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NLBHA Testifies before Freedom Commission on 
Mental Health

NLBHA was one of four national racial/ethnic behavioral health organizations testifying before the Freedom Commission in August 2002, about racial/ethnic population issues and needs. The Expert Panel Presentation included NLBHA Board Secretary, Dr. Ruby Martinez; Dr. Stephen Shon, National Asian American Pacific Islander Mental Health Association; Dr. King Davis, National Leadership Council on African American Behavioral Health; and Ethleen Iron Cloud Two Dogs, representing Native American/ Alaskan Natives populations. Expert Panel members were commissioned by the Commission on Mental Health to prepare an Issue Paper on Cultural Competence, Mental Health and People of Color. 

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Community-Based Program Models highlighted in Commission on Mental Health.Issue Paper

Several examples of community-based programs successfully providing services to African American, Asian American/Pacific Islander, Latino, and Native American/Alaskan Native populations are included in the report submitted to the Commission. While there are many agencies that could have been profiled due to their effectiveness in delivering culturally competent services to their communities, only four programs were highlighted by each of the national associations due to space limitations. To view the Latino program models, go to Latino community-based program models 

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Letter to Service Providers regarding 
September 11th

The information below was prepared by Josie T. Romero, former President of NLBHA and Dr. Ruby J. Martinez, former Vice President, immediately after the events of September 11, 2001.

Dear Fellow NLBHA Providers,

The events of September 11 have changed the way we think about our world. On that day, our people and our nation lost a sense of safety and we must be prepared to do the hard work necessary to regain it. As mental health professionals, you each play a vital role in helping our citizens do just that. However, first we must find safety for ourselves. It is our hope that you will take the time to reflect on those things that are meaningful in your lives and that you will work to keep yourselves well and whole so that you may help others find their footing in these next few months. Unfortunately, all too often, it is during times of disaster that we realize just how valuable mental health services are for all people. We have enclosed some documents that you may wish to use in working with clients and families. The Federal Emergency Medical Agency (FEMA) and the Los Angeles County Department of Mental Health (LACDMH) developed these tools, written in English and Spanish. We wanted you to have information for the monolingual Spanish community. Feel free to copy these and distribute them as you wish.  <Download PDF files containing Emergency Disaster Response documents: Four-step Guide to Healing, Reacciónes comunes a eventos traumaticos respuestas normales ante situaciónes anormales>

Please take every opportunity to use your influence and knowledge to inform and educate our community about the normal reactions following traumatic events. It is important that clinicians speak out against acts of hatred, discrimination and racism toward others because of their ethnic background or religion. Our country can heal only with support, love and respect for one another.

Immediately following this tragic event, a team of three NLBHA mental health professionals who specialize in disaster recovery and trauma traveled to New York City at the request of Dr. Rosa Gil, University Dean of CUNY, to provide an assessment of need and immediate crisis intervention. They also provided staff training to the Manhattan Community College staff and consultation and training to several Latino and non-Latino community agencies. NLBHA Board member, Dr. Carmen Vazquez and other NLBHA members in New York are currently working with New York State Commissioner James Stone to ensure that our diverse Latino communities are reached and culturally and linguistically appropriate interventions are provided. 

Thank you for all you are doing to bring healing to those in need. We wish you and your loved ones well.

4-STEP GUIDE TO HEALING CONVERSATION  FOLLOWING DISASTERS FACTS  non-intrusive inquiry into specifics THOUGHTS  encourage linking of facts FEELINGS  support and encourage REASSURANCE  normalization and education Diane Myers, RN, MSN  Leonard M. Zunin, MD  Hilary Stanton Zunin, BA Josie Romero, President  National Latino Behavioral Health Association

 

COMMON REACTIONS TO TRAUMATIC EVENTS A NORMAL RESPONSE TO AN ABNORMAL SITUATION The feelings and reactions below are normal and natural, even though they seem unusual and different. As individuals, we all respond in our own way differently. The memory will always be a part of your life--the incident cannot be erased. Everyone moves at their own pace through stages of crisis and of healing-everyone has their own clock. For some people, there may be ongoing problems. POSSIBLE REACTIONS: Confusion Guilt Crying Concentration Problems Fatigue Memory Problems Sleep Disturbance Religious Confusion Changes in Appetite/Weight Loss of Trust Low Resistance to Illness Flashbacks Frustration Anniversary Difficulties Helplessness Regression Depression Alcohol and Drug Abuse Despair Excessive use of Sick Leave Grief Work-School-Family Problems Anger Withdrawal Outrage Suicidal Thoughts Insecurity Difficulty Returning to Normal Activity Level Anxiety Feeling Overwhelmed Numbness Irritability Feeling Inadequate Gallows Humor SUGGESTIONS: Talk about what happened. Talk about your feelings. Don't Monday morning quarterback-we can always think of what we or others could have done differently. Take care of yourself physically-balanced diet, rest, exercise, maintain a routine. Avoid use of drugs and alcohol-medication should be taken sparingly and only under the supervision of a physician-substances may be addictive and interfere with the healing process. If symptoms persist, seek a consultation from mental health professional.   Josie Romero, President  National Latino Behavioral Health Association

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