Community care in mental health

#communitycare

#communitymentalhealth

#globalinnovations2014

If ever there was a need for innovation in mental health, it is now. Perhaps that is why we see growing global commitment to develop, evaluate, and scale up promotion, prevention and treatment innovations for mental disorders around the world. Under that premise, the idea of #communitycare in mental health is also gaining momentum. After centuries of the institutionalization of those who suffer from mental health problems, #communitycare in mental health is a refreshing change in the right direction, based on the notion that mental health problems can be dealt with at the community level. In fact, in many ways, the work that iFred does, with projects such as Schools for Hope and Fields for Hope, are also based on the fundamental belief of #communitycare in mental health.

MH innovation

A few months ago, at the London School of Hygiene and Tropical Medicine with support from the Grand Challenge Canada, the Mental Health Innovation Network was created comprising of a global community of mental health innovators: researchers, practitioners, policy-makers, service user advocates. The central aim of this network is to share innovative resources and ideas to promote mental health and improve the lives of people with mental, neurological and substance use disorders. Fundamentally, the network promotes the idea of #communitycare interventions by enabling learning, building partnerships, synthesizing and disseminating knowledge and crucially, by leveraging resources. There are other major initiatives as well like Grand Challenges in Global Mental Health, the World Innovation Summit on Health 2013 (WISH) and the Movement for Global Mental Health which champion the idea of the #communitycare model of intervention.

In February this year, an article appeared in the New England Journal of Medicine, called Transforming Lives, Enhancing Communities – Innovations in Global Mental Health, which highlights not only the need for innovation in global mental health at the community level, but the potential that exists for #collaborativecare and #communitymentalhealth. The article highlights that “despite the robust evidence testifying to the effectiveness of a range of pharmacologic, psychological, and social interventions that can transform lives and enhance communities, the majority of the world’s population has no access to these interventions.” Further, the authors, Vikram Patel and Shekhar Saxena, show that the human rights abuses faced by those who suffer from mental health problems are the worst of modern times. Yet the resource allocation for global mental health remains staggeringly low.

They point to new and innovative measures to tackle the global mental health crisis, in which community care is at the heart of all interventions. In fact, through the Mental Health Innovation Network, these up and coming innovative interventions which can be scaled-up, are being chronicled and discussed and made available for public access. Among some of these innovative interventions, we see the appearance of prevention programs targeted toward youth such as iFred’s Schools for Hope program.

According to the authors of a report drafted (upon which the article is based) in the wake of the World Innovation Summit on Health, on mental health, “at the heart of these innovations lies the health care delivery model of integrated collaborative care. Collaborative care must incorporate an active role for patients and their families and must integrate mental health care with social and economic interventions.”

The authors go on to argue that such care models must focus on the detection and treatment of mental disorders as early in the course of life as possible, since most mental disorders begin before adulthood. They say that “mental health care should be delivered in diverse settings; indeed, most care would be expected to occur outside traditional specialist delivery venues — for instance, in schools, primary health care facilities, the workplace, and patients’ homes.” This is why the focus on #communitymentalhealth is so vital, and also a wonderful example of the importance of iFred’s work in implementing innovative measures to tackle what is a truly global crisis.

A new blog written by Bidushi Dhungel

“Four simple words…I suffer from depression”

I recently came across this video of Kevin Breel speaking to a group of people at a recent TED-X conference and was blown away by his poignant account of what it’s been like living with depression and his hopes for a future without stigma.

As you may remember from my earlier posts, I lost my father when I was Kevin’s age to suicide and I consider myself a depression survivor. It is through the sharing of these stories and personal accounts that I believe we will be able to shine a light of HOPE for the 350 million worldwide living with depression.

I hope you’ll take 11 minutes to watch this video of Kevin. If you live with depression, someone in your life lives with depression, or you don’t think you know anyone living with depression – you need to watch this video. It will be well worth your time.

Watch Kevin’s video here: http://www.causes.com/causes/101854/updates/793004

 

 

Stories from the Field

Americans across the country are getting ready to celebrate the 4th of July holiday tomorrow, a holiday all about the human spirit and a renewal of #HOPE. So it seemed like a fitting time to bring you our first Story from the Field, stories about the people we have had the honor and privilege to meet through the Field for Hope campaign. These narratives, pictures and videos are our way of helping spark positive conversations around depression and mental health in order to help chip away at the negative stigma surrounding the disease.

Earlier this year we met Tim Kahlor at the PRISM Awards in Los Angeles, an annual awards show that honors TV, movie, music, DVD and comic book entertainment that accurately depict mental health issues. Tim’s son Ryan is a military veteran who lives with Post-traumatic Stress Disorder (PTSD). We asked Tim to share his incredible story with us to help kick off our Stories from the Field series.

Contributed by Tim Kahlor

Ryan joined the military in 2002 when he was 18-years-old on a delayed entry program so he could get his braces off his teeth before basic training. He was promised a $12,000 sign-on bonus and told he would be stationed in Germany. We’d sent him to Europe when he was in high school and he loved it. Ryan was always an adventurous kid and loved playing sports; the thought of being paid to keep in shape was his dream job. The military offered him adventure, the ability to work out and stay in shape, all while seeing the world.

Photo of Ryan Kahlor and his rescued shelter cat taken by Hannah Kahlor.

Photo of Ryan Kahlor and his rescued shelter cat taken by Hannah Kahlor.

He left for basic training on March 18, 2003, the day before the war in Iraq started. Ryan was a member of the 1st Armored Division based out of Baumholder, Germany, and was being sent to Holenfeld, Germany, to a non-deployable unit. However when they offered him rank quicker and no tax on his combat pay if he went to Iraq, he accepted the offer. In 2003 Ryan served as an Infantryman in Bagdad, guarding the green zone and then was later sent out on missions in other areas. There was a lot of action, but it was the next deployment that caused the most damage to Ryan. When we saw him next in 2004 he was friendly, but guarded.   

Ryan was married in December of 2005 and deployed to Iraq again in January 2006. That November Ryan endured many struggles, as he was involved in several horrible firefights leaving him to handle many of the dead and wounded. During his two deployments Ryan received repeated injuries to his head and body, including a Traumatic Brain Injury. When he returned to the U.S. they finally sent him to Balboa Naval Hospital in San Diego to be part of the Wounded Warrior Project for Army members who are injured in combat. There, Ryan’s PTSD really began to erupt, resulting in fighting and explosive yelling. One day I found him rolled up in a ball in the middle of the living room. Ryan was sent to Palo Alto’s in-patient program for PTSD at the VA hospital there. Which I believe, to this day, is still the best program I’ve seen Ryan come out of since 2007 for dealing with PTSD.  

When your child is killed in combat the pain of war is over for the soldier or marine, but continues on for their family. When your child lives through combat and comes home with PTSD the mental war of combat is brought from the battlefield into the living room, kitchen, bedroom and to the surrounding community. Ryan was the poster child in 2007 and 2008 for getting and responding to PTSD treatment, but there are always going to be relapses no matter how well treatment has served in addressing the problem. That is the hardest part to get through; the rough times that disillude the thought that the struggle is over after everything seems to be going so well. My family has found that being willing to listen to him when he wants to talk about it and always letting him know I am there for him is one of the most helpful things we can do. I don’t ask questions unless he opens a door that will allow me to ask a questions. There are people that think you can “shake it out of them” or “tell them some story about a cousin, uncle or buddy they knew that was in combat” or the guy that says “you got to pull yourself up by the bootstraps and get on with your life” (my response to that one is ‘what if the boot straps are already broken?’)  Then you have the people who want you to explain why there is more PTSD now than in past wars. I ignore things like the above and celebrate Ryan’s success; I often text him about how proud I am of what he is doing.  

Ryan just finished a semester of college with great grades and we celebrated it as a family going out to dinner. This is major because in the past he couldn’t sit in a classroom long enough to finish a semester. We set goals and plans for future outings together that I know Ryan enjoys. Last summer, Ryan and his wife Hannah took me to Yosemite camping and it was like heaven for us all. I saw the joy in my son’s face taking me someplace that I loved and he loved it too. This year we already have a trip planned at the Kern River and Yosemite hiking the whole time and playing in the river. Ryan teaches surfing and kayaking to wounded warriors during the summer, so we encourage him to keep doing that when he can as well as cycling.  

It is so important that families don’t forget to find time to get help for themselves and the knowledge to help a loved one suffering from PTSD. They should always be aware of signs of isolation and frustration to be readily to supportive. Families dealing with a loved one with PTSD should remember that there will be good days and bad days, and you have to hope that the good days get longer and the bad days get shorter.

Tim’s story exhibits one main and powerful fact: being open and honest about the reality of PTSD can enable our sons, daughters, fathers, brothers, sisters, mothers, and friends to hold their heads up high, walk around unashamed and seek treatment in spite of the stigma. This example further promotes the belief that above all we must love, care, support and advocate on behalf of our loved ones living with conditions like PTSD and depression. Liberate yourself and your loved ones by taking a stand and joining us in the cause to end the negative stigma associated with the disease. Speak out, volunteer, contribute and help us build a community. Take the Pledge to Plant, spread the word and join iFred in honoring the 350 million around the world living with depression.

In this light, I bring you Field for Hope

Kathryn Goetzke, iFred founder

When someone suffers from depression the effects ripple out to those they love.

I can still remember the moment. As I was getting ready for an upcoming weekend visit to see my dad, I called to see how he was doing. I knew something was terribly wrong when I heard a voice that wasn’t his. My mother took the receiver and told me the news that would forever change my life. My dad had taken his life.

My father was a successful businessman, but his pain was no mystery to me. He had resisted treatment because he did not want to admit to weakness in character. I cannot accurately describe in words the deep sense of abandonment, betrayal and total loss of self I felt when he died. I believe that, had he sought help earlier, he might well still be alive today.

Just weeks before he died he sent me a Valentine’s Day card telling me how much he loved me.  How he hoped I would never have to deal with the pain, deep regret and unhappiness he felt all the time. I carry the card with me as a reminder of his pain. It serves as my fuel to change the world for the better as a way to honor his life.

Depression is treatable, yet less than 25% of those with depression are getting treatment in part because of the stigma associated with the disease. This misunderstanding about depression is what prevented my father from getting treatment. As a branding expert, I know that by doing the following we can and will end the stigma of depression.

1. Use a universal symbol, the sunflower, around the world showcasing just how many are working for positive progress.

2. Engage celebrities, politicians, business leaders and activists to talk about their own depression

3.  Bring awareness of the biology of depression, and how our neurotransmitters, hormones, and brain chemistry are affected by everything we put in our body.

4. Focus on hope for those suffering from depression, instead of the negative depictions of depressed people that are often present in the media.

It is in this light I bring you Field for Hope. This global campaign asks people to come together and Pledge to Plant a sunflower to show honor and respect for the 350 million people around the world who live with depression. They need our help.

My dad had it all and did not deserve or need to die.  Do not let one more life be wasted. Pledge to Plant. Join our movement today at Causes.com/FieldforHope or visit www.ifred.org to find out how you can get help for yourself or someone you love.