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Homeless and Mental Health
Gov. Gavin Newsom signed into law Bill 1338 and effective January 1-2023, - a program to require people struggling with severe mental health (with a diagnosis identified in the disorder class schizophrenia and other psychotic disorders) and addiction problems to go into court-ordered treatment.
Newsom signed legislation to create a new civil court system — the Community Assistance, Recovery and Empowerment Court, or CARE Court.
CARE Court is intended to help the homeless population and provide for intervention and treatment before they cause harm or get arrested, and to avoid a conservatorship, or institutionalization.
The policy will also mandate counties to make services available to them.
Read more at: https://www.sacbee.com/news/politics-government/capitol-alert/article265697381.html#storylink=cpy
Effective July 2022: SB 221 Mental Health Law
Sponsored by the National Union of Healthcare Workers (NUHW) and authored by State Sen. Scott Wiener, SB 221 is a landmark mental health law that requires HMOs and health insurance companies to provide mental health and substance use disorder therapy sessions within 10 business days as long as the treating therapist determines that a longer wait would not be detrimental.
National
Hotline 988
- Beginning July 16, 2022, dialing “988” will route calls to the National Suicide Prevention Lifeline.
- The federal legislation dictated that 988 calls have to be answered by certified suicide prevention call centers
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When people call, text, or chat 988, they will be connected to trained counselors that are part of the existing National Suicide Prevention Lifeline network. These trained counselors will listen, understand how their problems are affecting them, provide support, and connect them to resources if necessary
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The current Lifeline phone number (1-800-273-8255) will always remain available to people in emotional distress or suicidal crisis, even after 988 is launched nationally.
Articles
READY FOR THERAPY?
KNOW MORE ABOUT EVIDENCE-BASED TREATMENTS
By Marjorie Bown, LCSW
As a mental health client, it is important that you communicate clearly with your clinician (licensed therapist) when discussing your treatment plan to determine best approach to achieve your goals. Remember your first appointment is your opportunity to address what you want to gain from therapy. And how is your clinician going to help you reach those goals.
It is the treating clinician who will make the final decision concerning a particular intervention but as a client, you must be actively engaged in the process. Be knowledgeable and ask questions about your treatment plan. This will help you to identify whether your clinician is a good fit for you and the likelihood of a positive outcome.
All ethical and experienced clinicians know that they must include Evidence-based treatment (EBT) in their practice. EBT’s are interventions supported by scientific evidence that have demonstrated significant improvement in client’s functioning. Clinicians have the responsibility to deliver evidence-based treatment as part of their best practice. The core categories of evidence-based treatment offered by mental health clinicians include behavioral healthcare and medication treatment.
There are numerous evidence-based treatments in behavioral health care. The widely used Cognitive Behavioral Therapy -to correct unhelpful thinking patterns, or the brief and future oriented Solution Focused Therapy to focus on your strengths. Maybe you might like the non-blaming Narrative Therapy approach to make sense of your stories. There’s also Acceptance and Commitment therapy which integrates various EBTs -if you’re more action oriented. Also, to address substance abuse problems the preferred EBT of Motivational Interviewing Therapy might help you, just to name a few.
These evidence-based treatments do offer important strategies, they can assist with specific interventions based on data and can support reducing bias. Certainly, there are some challenges when using EBT such as human side error, timing issues, generalization of findings, comorbidity problems and other limitations. Thus, the importance to ask questions when engaging in treatment. EBT offers a framework for the clinician, and it can assist clinical expertise and that in itself is an asset.
Keep in mind that a clinician who has specialized in a certain EBT does not necessarily mean they’re a better fit for you. Many clinicians do specialize in an EBT and that’s their main focus and they might not spread to other approaches if their passionate about their specialization.
Some clients due to their history and symptoms presentation may benefit greatly from specific EBT to address their particular functional impairments. EMDR (Eye Movement Desensitization and Reprocessing) is an example of an evidence-based treatment that has proven very successful for some clients with post-traumatic stress disorder.
A great majority of clinicians are Generalists – they may have extensive training and experience that could also make it a good fit for you. Generalists have a broader approach while still implementing EBT interventions.
Here are some helpful questions you could ask your clinician when developing your treatment plan goals:
- What is your general approach to therapy?
- Do you use any specific EBT with your clients? If so, tell me more.
- Do you have a specialization? Or a preference?
- Based on what I’ve already shared with you, what EBT might be more appropriate for me?
- Can the EBT be too strict, and do you allow for individuality?
- Can we move from one EBT to another as needed?
- Are there any non-evidence-based interventions that we can consider if the EBT is not working for me?
References
American Psychological Association. (2021, April 21). Policy statement on evidence-based practice in psychology. https://www.apa.org/practice/guidelines/evidence-based-statement
Cook SC, Schwartz AC, Kaslow NJ. Evidence-Based Psychotherapy: Advantages and Challenges. Neurotherapeutics. 2017 Jul;14(3):537-545. doi: 10.1007/s13311-017-0549-4. PMID: 28653278; PMCID: PMC5509639.
Drake RE, Goldman HH, Leff HS, Lehman AF, Dixon L, Mueser KT, Torrey WC. Implementing evidence-based practices in routine mental health service settings. Psychiatr Serv. 2001 Feb;52(2):179-82. doi: 10.1176/appi.ps.52.2.179. PMID: 11157115.
Drake, R. E., Merrens, M. R., & Lynde, D. W. (Eds.). (2005). Evidence-based mental health practice: A textbook. W. W. Norton & Company.
Evidence-Based Practice: Advantages & Disadvantages. (2017, July 6). Retrieved from https://study.com/academy/lesson/evidence-based-practice-advantages-disadvantages.html.
Three Important Tasks for Mental Health -by Marjorie Bown, LCSW
During this pandemic people have faced a lot more stress than usual. The pandemic has been very distressing to the world. As a therapist I have seen how the need for Mental health services increased significantly. People with mild anxiety suddenly started to have more frequent panic attacks, severe anxiety episodes like never before. Even people without a previous history of anxiety started to develop these symptoms due to the uncertainty of this virus and what could come next. People lost their jobs, their financial stability and some lost their loved one. And of course, Depression has been more prevalent as well.
In the past providers like myself would prescribe socialization as a coping mechanism to combat depression. Exercise of course was one of the major coping tools recommended by professionals to help with stress management and emotional issues. However, these recommendations sounded impractical if you couldn’t go anywhere. It has been challenging with hiking trails, parks and gyms closed or restricted.
We all have seen how the online business has grown pointedly. The ability to go anywhere from home, to tour cities virtually, to shop any store from your living room, to attend meetings, concerts, watch movies, date and anything you can imagine. Being online has been helpful. But it hasn’t been healthier.
Now we’re still in a pandemic, it doesn’t look much better if you look at the statistics. The vaccine is here so we have great hope things will improve. But they won’t improve quick enough. We still need to cope with isolation, safety concerns and lack of resources. Mental health problems do not go away with just medication. Medication will help with many symptoms but one must be purposely involved in getting better and sustaining progress. Having good mental health takes work. Because it is a job. It is a job that pays very well. Your mental health benefits can be amazing if you do your work. It takes consistency and discipline. Sometimes you don’t want to do it but like any job, you’ll do it for the compensation. Remember that your compensation is your own health and that’s irreplaceable.
So here are the three very important tasks to help you achieve your job of being mentally healthy. Along with everything else you may be doing such as going to therapy, taking your medication and/or reaching out to others when needed.
Try to implement these three tasks most days and you will notice overall better mood:
-Mindfulness
Mindfulness has become the most talked about coping strategy in recent times. It has been more visible on television, online and at the doctor’s office. Doctors are prescribing mindfulness exercises and recommending online programs and phone apps to help you develop these skills. Research has demonstrated significant improvement for some people in both mental and physical health. Studies suggest that Mindfulness support and improve the management of chronic pain, stress, high blood pressure, sleep problems and other ailments.
What is Mindfulness -simply stated it's present moment awareness. It allows you to focus on the here-now and to help you get your mind off your worries or negative thoughts and to encourage you to focus more on what your senses can experience right now.
Try 5 minutes per day. The brain will still benefit from it. It’s about frequency not quantity. Don’t do 30 minutes once a month and complain it doesn’t work. People tell me they’re too distracted or impatient and they give up. Great! You’re distracted and impatient. So, work on not being either. That’s the point. You’re trying to calm your mind.
Do short exercises or you’ll become more impatient and distracted. But do it frequently, at least 3 times per week for 10 minutes or less and you will notice the difference. Download a phone app if you want. Go online and watch a video. Or take a mindful deep breath, look around you. What do you see? Describe it. What do you hear? Be silent and listen. What do you smell? Are you connecting with all your five senses? What do you taste? What do you feel (touch)? Try it out. Beginners Yoga is a good form of mindfulness. Breathing slowly while listening to music too. Walking mindfully is another way to pay attention to the moment, by focusing on your surroundings. Mindful eating? yes, eat slowly, savor the food, look at it, smell it, chew in slow motions, you're being mindful of the NOW. Right this moment.
Disclaimer: there are both benefits and risks to practicing Mindfulness. For some people sadness, anger or anxiety can seem stronger at first because you're paying attention in a conscious way. History of trauma or drug use may heighten these reactions. It may not be for everyone just like any practice and/or treatment available. Do inform yourself if you're uncertain about practicing this form of meditation.
-Get Moving
Yes, you heard this one before. Don’t tell me there’s no time to exercise. Nobody has time anyways. You schedule the time just like when you schedule a doctor's visit, or time in front of the tv or social media time or any other activity.
Okay so you hate exercising. Well, a lot of people do. You’re not alone. You don't have to become an athlete. You don’t have to run if you have bad knees. You don’t have to lift weights. You don’t have to bike or swim. However, you can be creative. You can exercise by getting off your seat more often, try pacing, dancing, walking or hiking. No equipment needed.
Anything you do to move around is exercise. If you can only pace for 5 minutes every hour in your backyard, Do it. Do not sit at home all day. If you can walk 3 blocks each day and nothing more, go ahead.
Move. Move. And move some more. Consult with your doctor if you have concerns.
Exercise is good for the mind. Do you have a watch that counts steps? Are you sitting at work all day, walk every hour, Get at least 250 steps per hour. Park your car far from the entrance. Don't take the elevator. Challenge yourself to walk more. Depending on your age and health you can adjust it. If you can only do 5,000 steps per day that’s a lot better than most. Experts recommend about 10,000 steps per day. Talk to your doctor if you have health problems. I’m sure in most cases walking will be strongly supported.
-Be Grateful
I believe this is the most important habit one can develop to improve quality of life. The ability to truly be grateful for each day may take effort if it doesn’t come naturally. You may have heard or read how Gratitude is associated with happiness. Happy people are able to appreciate the little things in life. Happy people see the glass half full. Happy people smile more. Happy people enjoy mundane activities. It does not mean they don’t have problems. They don’t have a perfect life. They aren’t necessarily rich people. But they have one thing most lack: Gratitude.
Gratitude enhances your perspective on life. It allows one to fully embrace the constructive aspects of day-to-day life. This is also within the field of Positive Psychology. A quick search online tells you it studies the effect of positive experiences, strengths and traits such as Gratitude on individuals and society.
Gratitude has been well-studied in many social sciences (Philosophy, Sociology, Anthropology, and more). It is talked about in many cultures, religions, and other disciplines. Buddha taught about Gratitude. That it must be cultivated. Jesus Christ talked about Gratitude, there are many scriptures that tells us to be Thankful. In Judaism there is a daily Gratitude prayer. And Muslims consider Gratitude a great virtue. Gratitude helps people to experience more positive emotions.
How you practice Gratitude? It is not simply saying I’m grateful for my job, health and family. Of course you are. It is deeper than that. Saying it does not mean you are experiencing gratitude. It won’t have an impact on your mood.
Being gracious for your past, your present and what might come in the future takes some mindful acknowledgement. Being grateful is having the discernment to truly appreciate what one can enjoy in life. A grateful individual is less likely to focus on the negative aspects of life. There’s plenty of negatives if you just think about them. There’s always the perceived need for more money, more health, more friends, more love, more time, more fun, more and more. If only this, if only that… if only…. It does not work!
Here’s how to start becoming more Grateful until it becomes more natural: a few times per week before bedtime reflect on what’s going well in your life. Do not allow yourself to think of what’s missing or what could be better. Remember, focus on what is going well. There’re always a few things that are actually pretty good. Take a moment to truly recognize these aspects of your life. Then you can narrow on what went well today. What happened today that you are glad that it did. What exchange, conversation, activity or event went well today. Think hard. Every action can be meaningful.
To make gratitude a better exercise one can keep a gratitude journal. Others may want to say a prayer to incorporate personal beliefs. Others may say a positive self-statement something like “I’m so grateful for my ability to….” “I am so glad that I have …”, “I am happy to be able to enjoy …” “Today was a good day because ….”
And there you have it, a few more tools for your mental health toolbox. Use them with determination.
Edited and Published January 21, 2022
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- Copyright of Marjorie Bown @2022 All Rights Reserved.
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