Mental Health, Mental Illness, on Block Island

advocating for services and support for those who are ill and education for mental health to all on Block Island


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Is doing the numbers enough?

TelemedicineA Post from Board Member Socha Cohen, published in the BI Times

Is Doing the Numbers Enough?

Since its inception, the Tele-Medicine program provided on Block Island has serviced 29 patients, three of whom were escorted off-island by the case worker, Tracy Fredericks. Butler Hospital and Brown University offer the services of a psychiatric intern free of charge under the condition that Block Island pay for the salary of a case worker who receives an hourly wage: the more patients she helps, the higher her wage. In conjunction with a large donor, and the financial support of the Town, NAMI-BI has been raising funds to support Tracy’s salary which ranges from year to year depending upon her case load. “We are providing services to a community where there had been none in the past,” says Gloria Redlich, coordinator of the Coalition for Seniors. “Inherent in mental illness is that for many there are obstacles to reaching out for care.”

National data support Dr. Brownstein, NAMI-BI largest donor, stating, “it’s estimated that 30% of people will have a mental health problem at some point in their lives.  In all populations studied, 1% suffer from schizophrenia, and 5% have major depression.  9.3% of people 12 and over needed treatment for illicit drug or alcohol use in 2009.  Things have gotten worse since then.  So whether they’re taking advantage of the telemedicine program or not, it seems likely that a significant fraction of folks on the island are likely to need it sooner or later, and when the population swells to 10,000 or more in the summer months, the need expands markedly.”

Elspeth Crawford, board member of NAMI-BI and leader in Emotional Education, adds, “Provision of health service of any kind is not about monetary capital, e.g. what you get when you re-model the pavilion, it is about social capital, what a healthy community looks like in the future. Not providing the service has hidden costs on the future that affect us all. There would more disruption and expenditure in relation to other community services, and also, each person who is ill is not a lone person, but may have family and others, all of whom, including the ill person, are less able to contribute to our community and economy if their energy has to be directed in countless ways keeping stability.”

“In short, the bad news is that we’re still not serving as many people as we probably should be”, continues Dr. Brownstein, “and we need to figure out how to “market” the program better. The good news is that we have a program to market–one that probably saves lives.  What’s a life worth?

 

 

 

 

 

 


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Cannabise Use and Psychosis

An article here on research regarding the link between cannabis use and psychosis. It is from a group of scientists working in UK who say that cannabis use can lead to psychosis in certain people. the risk may be greater if use begins early, during adolescence. It may not be a risk to other people, but it needs to be taken seriously.

More research is needed to clarify strength and vulnerability factors in individuals, but that there is a link for some, and a loss of life potential, is already clear.

[This study is from the Guardian and reflects UK statistics, but recognizes trends elsewhere. Far more teenagers seek treatment in the UK for cannabis use than for any other drug including alcohol.]


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Join in the conversation

As a community we can learn from each other, share experience. Any one of us might be a “first responder” to someone who lives here and suffers illness. If you have something to say, join in the Community Conversations. Look at “Can You Help“. Come to the BI NAMI events that are advertised in The Block Island Times and on the Block Island Bulletin Board. Make contact or comment in these community posts. Scroll down below. Write a post – please ask. You might have found an article of interest – please send.


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Community Conversations – Summer 2015

NAMI BI thanks Block Island Times for publishing the letter below as “Featured Letter” on 9/18/15.

In June I wrote to say that NAMI Block Island [National Alliance on Mental Illness] would be taking up the challenge from SAMSHA [the national Substance Abuse and Mental Health Services Administration of the US department of Health and Human Services] to create community conversations about Mental Health. We were aware that this is a frequently taboo topic that can affect anyone, anywhere, and that has impact of some kind on us all. I am writing now to say how wonderfully those to whom we have spoken so far have been responding, how much we appreciate their time and thoughtfulness, and also to let everyone know that we are learning a lot, how much we don’t know as well sharing together much that is already understood. As community conversations develop, we hope we will achieve our aim: That the various responses to behavioral health issues on the island issues can be addressed in ways that complement existing local activities, are better coordinated, consistent, and in the best interests of all.

We don’t know, yet. But, we are hopeful and invite everyone who wishes to join in. Briefly, an outline of what we have heard in talking with more than 20 people representing different island groups: the people here care, and are aware, and as might be expected, each of us sees a different bit of this elephant. We have raised some awareness of each other’s “bits”.

In considerable detail, we found many frustrations, often systemic in origin (rather than negativity). That is, organizations, local or national, may enable individuals to act in their own sphere of authority, but because the nature of mental illness crosses so many boundaries the right kind of action can be difficult to find, and frustration follows. Important matters such as confidentiality, trust, and rights of both family and ill person have to be protected. There were many suggestions about the right kind of “go-to” person or facility that we all know our island does not have, or cannot afford. We heard imaginative ideas for addressing the gaps. We will soon be talking with our community organizations for help in finding ways to develop protocols, say for emergency responses, or prevention of fragmented care, as are appropriate to each organization’s first area of responsibility. We also ask individuals to think about taking part in the programs and trainings that hope to continue bringing to the island, for example our mental health discussion meetings and possibly a repeat of the praised Mental Health First Aid course brought by the school and the library last winter?

Can we improve communication and co-ordination, so that we all feel more competent, whether we should happen to be the “first responder”, or whether we have a particular duty of care? We think that we can, but it will be a developing process. There is work to do in factual research and sharing of information, and finding how lines of communication will work with accountability and confidentiality dilemmas.

Another discovery has been that there is even more confusion and difference in perceptions than we knew. We ourselves in NAMI BI are equally unsure, e.g. there is no accepted definition of Mental Health, and no consensus on “best treatment”. Or, what is the difference between NAMI BI and Block Island Wellness Coalition (working to prevent of substance abuse and create wellness)? We know there is overlap, but what is it? Is NAMI BI a Harbor Church group? [No, it is not, it is a separate 501c organization that is grateful to the church for providing a meeting place.]

We plan a series of communications on specific topics that have arisen as well as more meetings. In the meantime, remember that there is a free telemedicine service provided by psychiatrist residents from Butler Hospital. Phone the Case Manager, Tracy Fredericks [CSP certified], 207 229 6349. Also, see some summaries of issues and suggestions, and previous articles in the BI Times on https://blockislandmentalhealth.org/

We found a very clear sense that Community Conversations are worthwhile and should be continued. We do have a very special place here, thank you Block Island people.

Yours sincerely, Elspeth Crawford


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Compassion and Our Selves

Please let us know the URL to any websites/articles/blogs/stories/videos/books etc you think visitors would find interesting or useful. A brief review of what the contribution is about would be useful too. We will add a post – others are found by scrolling down here. Hopefully this will grow into a resource for us all. However, NAMI BI cannot monitor all the information on other sites and we are not responsible for it. Please let us know if any link or articles suggested seem inappropriate or unhelpful.

bodyscoreA book was recommended by Arietta Slade – it is well worth reading: The Body Keeps the Score, by Bessell van der Kolk.

I am impressed by the integration of neuroscience (in a way I could understand) with a variety of therapies, experience of talk, body, and mind.

A great book.

And, a great article:

Self-Compassion in Kids from uwhealth.org, August 19, 2015 By Shilagh Mirgain, PhD

It turns out psychologists may have gotten it wrong. compassionkidOver the years, there has been a tremendous emphasis in our society on building kids’ self-esteem. Psychologists now think we should be teaching children how to develop self-compassion instead.

The problem is that self-esteem is often developed by social comparison, meaning it requires a person to feel special and superior to others on a variety of dimensions. Kids feel good about themselves when they get the A, win the game, receive the trophy and sometimes even by putting other kids down to make themselves feel better. But this constant comparison needing to be better than other kids instills a belief that it is not ok to be average.  When things don’t go well, feelings of superiority slip and self-esteem takes a nose dive, leaving kids vulnerable to anxiety, insecurity and depression.

What’s the solution?

Teach children how to develop self-compassion. Self-compassion is learning to extend understanding, compassion and encouragement to yourself when things don’t go your way, treating yourself the way you would a close and treasured friend.  Research shows increasing self-compassion has all the benefits of self-esteem but without the downsides. Unlike self-esteem, self-compassion reduces anxiety, lowers feelings of embarrassment when you mess up, and is associated with steadier and more consistent feelings of self-worth.

There are several ways to help foster self-compassion in kids, including:

Mindfulness

In a world driven by distraction, teach your child how to be in the moment. Some ways to do so include:

  • Help them notice things around them, savoring positive experiences when they occur. Teach them how to be present with themselves.
  • Encourage them to take 3 deep breaths when feeling stressed, overwhelmed or distracted to return to the moment and back to their center.
  • Help them develop awareness of their thoughts and feelings, to not ignore them but to also not become overwhelmed by them either.
  • Help them learn how to observe non-judgmentally their internal experience, understanding that they don’t have to believe every thought they think, especially the negative ones, and that emotions, like ocean waves rise and fall if you just let them be.
  • Help your children identify those moments of struggle and difficulty as opportunities to practice self-compassion.

Validate their experience, such as saying, “oh this is a difficult moment,” or “that was really tough to go through,” make them aware of what they are feeling by labeling their emotions “oh you’re sad,” or mad, scared, hurt, etc. and talk through their reactions.

Kindness

Kindness begins when we understand that we all struggle. Teach your children to talk kindly to themselves versus being critical. This builds a stable sense of self. Self-criticism isn’t helpful and only produces a variety of negative consequences, including feeling badly about oneself.  Next time your children start saying something critical, point this out to them and then teach them to reframe these thoughts into something positive and forgiving. The way we communicate with our children establishes a blue print for how they will eventually communicate with themselves. Talk to them in a non-critical way. Teach them how to self soothe during difficult times. Say to a small child, “Let’s practice hugging ourselves like mom and dad do to make you feel better. You can do this for yourself when you feel bad to remember how much you are loved.” Teach older children to put their hand on their heart to self-soothe when upset. These small gestures help them value and feel good about themselves just as they are no matter what is going on.

Teach kids how to be kind to others. Ask what they did in their day to make someone happy, find volunteer opportunities to do together as a family, encourage your kids to write thank you notes, recognize regularly when someone did something nice for another in the family.

Compassion for Others – Common Humanity

Remind your children that they are not alone in experiencing this difficult thing, other kids feels the exact same way. Everyone struggles, feels inadequate, does not get approved of, or fails at something in life. It’s part of our common humanity.  This helps normalize what a child is going through and reduces shame and embarrassment over mistakes made and not feeling good enough.

Encourage them when they see people throughout their day to offer them compassion. Teach them to wish others well, saying silently or verbally to others, “may you be happy, healthy and free from suffering.” . When our sense of self-worth is based on being a human being intrinsically worthy of respect, rather than on achieving certain ideals, our sense of self-worth is much less easily shaken. And that will make for a very good school year ahead.

This school year, instead of seeking to become extraordinary and special, encourage your children to find the wonder and marvel of the ordinary. How to sit with sadness in themselves and others, the comfort that a touch of a hand can provide, the warmth of compassion for themselves and others struggling. Teach them the simple pleasure of wishing someone else well, happiness and ease. Make these ordinary moments come alive for them. Then the extraordinary will take care of itself.

Gratitude

It’s so easy to focus on what’s wrong. Teach your children to focus on what’s right. Studies have shown that children who cultivate gratitude in their lives have better social relationships and do better in school. Make gratitude a part of your daily conversation. During dinner or as part of a bedtime ritual, ask children to share three things they’re grateful for about themselves and their lives. Ask them to reflect on why these things occurred to deepen their appreciation and understanding of the good things in their lives, including aspects of themselves, and not take it for granted.

As we talk about mindfulness, kindness, compassion and gratitude, what we’re really talking about is putting more love out in the world. And that can be one of the most meaningful gifts we can give our children.


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Current Need on Block Island

September 2015: Following from Community Conversations, and talks [e.g. Reed Cosper emphasized how Rhode Island has reduced spending on Mental Health] NAMI BI will prepare an Assessment of Needs. In the meantime – this is what we already know.

The only regular mental health service available on Block Island is that offered by NAMI BI. Emergency or more sporadic need to individuals who have not previously sought regular appointment is given as well as can be managed, depending on the point of access. This can come through the Block Island Medical Center (BIHS) or the Police Department as well as through NAMI BI Case manager, and can involve anything from advice or support to necessary escort off the island.

The island context also means there is variation in need depending on the time of year. The winter population of permanent residents is less than 1000 people. During the summer season, May – October, the need for services applies to island seasonal workers, as well as summer residents who return regularly each year. There are also visitors/tourists who might need a more temporary engagement with the program. Summer population estimate is about 10,000 people.

Mental illness suffers so much from stigma, that many people do not realize how many individuals suffer and their families and friends absorb consequences and also keep quiet. Given Rhode Island statistics* and the number of people in the local population, as the services become better known, it would seem that the number of individuals using the service will continue to increase as they have done each year they have been offered. At one time in 2014, there was a waiting time of four weeks for a client needing a first appointment. Now, in 2015, the current operating process for all activities is only funded for the limited number of hours used by the Case Manager in organizing the once weekly telemedicine appointments. The once every two weeks counselor visits are no longer available due to the retirement of the counselor and a replacement has not been found. The hours for which the manager, Tracy Fredericks, is employed are being used to the maximum, and indeed beyond as she responds willingly to emergency, to enabling referrals since the counselor retirement, and other issues that take more of her time. Extra time is not funded.

Educational meetings mostly take place during the summer season when it is hoped that a wider audience can be reached. The summer programs presented have been made possible by the generosity of the speakers who have given their time freely, and by the venue (Island Free Library) also free. Members of the NAMI BI Board give their time to organize the presentations. In the past, some possible speakers have had to refuse as travel and residence costs on the island could not be borne by either speaker or NAMI BI.

NAMI BI needs are threefold:

First the obvious one for any non-profit, we need donations in order to keep going. As described in more detail below, we want to offer more services and expand programs, both of which are indeed required. A generous donor will match any gift you make so that we can continue to provide psychiatric services and support on Block Island. Donate to NAMI Block Island, PO Box D2, BI RI 02807. All gifts are fully tax deductible.

Second, apart from the case manager, we work with volunteered time and effort. We deeply appreciate the partnerships of Butler Hospital and South Shore Center, the liaison with Block Island Health Services, the free venue for programs offered by the Island Free Library and the publicity from Block Island Times. Expenses are minimal.

For anyone wants to become involved and offer their time, as and when they can do so, there is no requirement for professional knowledge or past experience, just willingness.

Third, as we begin to work out what is meant by creating community conversations on mental health, to offer these and to offer support groups for families, we will be making contact with many other groups on the island. There may be a need to undertake training, or, to bring facilitators to the island. We look forward to interest and collaboration in the two-way discussions that help all of us with these initiatives.

Community opinion is valuable and experiences can be shared. 

More detail: In 2014 about $12,000 ensured the provision of help to residents. If the hours expand as we would like, we will need about $16,000 in 2015. Of course what would be wonderful would be sufficient donation that enabled us to set up an endowment fund, so that we can be more certain that services each year can be properly managed. All donations are helpful, and not just for the monetary value, they show us that the work is valued, that others find it worthwhile. Currently all donations have averaged $12,000 per year over the past three years. This does not allow for any effective increase in operating costs.

A generous donor has offered to match donations received.

Donate to NAMI Block Island, PO Box D2, BI RI 02807.

All gifts are fully tax deductible. 

Both nationally and in Rhode Island State, SAMSHA [The Substance Abuse and Mental Health Services Administration] are prioritizing initiatives that help provide treatment and services for people with mental and substance use disorders, support the families of people with mental and substance use disorders, build strong and supportive communities, prevent costly behavioral health problems, and promote better health for all Americans. “Now is the Time” is the President’s plan to increase access to mental health services. SAMHSA has played a key role in supporting a number of activities outlined in the plan to help build safer communities. NAMI BI is already planning to follow SAMSHA guidelines to launch Community Conversations on Mental Health to enable the Block Island Community. We have begun to build a Community Team (working collaboratively with other groups in the community). We also plan to offer a family series of group meetings.

To do this effectively we believe that at a minimum, we need access to funding for training group facilitators, and for travel, to training events. We think we are already using all the local expertise we have, given freely.

That is, our mission to provide Services, Support and Education, all need funding in the short term. In particular, the ongoing requirement to fund the Case Manager is a necessity for the services to continue even as they are now.

Donate to NAMI Block Island, PO Box D2, BI RI 02807.

*Trends Themes and Effective Practices in State legislation – NB Rhode Island has reduced its spending on Mental Health in past years, not because of less need. Maybe we need political influence too?


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Program Event – Penny Young

For an archive of previous programs – look here

Watch for updates in the Block Island Times and in the BI Bulletin and posted here.

Penny Young, MSN, PMHNP*           
 
Monday September 21st,          
 
the Community Center, 7pm. 
Dialectical Behavior Therapy: A Cognitive Behavior Therapy to treat Overpowering Emotions  and Destructive Behavior.
Dialectical Behavior Therapy [DBT] is a structured therapy and skills training validated in helping people with borderline personality disorder, that has been adapted for other problems such as substance abuse, eating disorders and suicidal adolescents.  Penny is a psychiatric nurse with over 30 years experience in various facilities and private practice where she can also prescribe medication. She specialized in psycheducation (understanding the whole self) and cognitive behaviour therapy and was instrumental in developing DBT at The Institute of Living, Hartford, CT. She and her husband have a home on Block Island.
From the NAMI BI Community Conversations we have been learning that there is a great deal any one of us can do, if we have some information and understanding. We therefore look forward very much to hearing this talk and joining in the discussion. Hope to see you there.
*Note –  MSN is not microsoft – it stands for Master of Science in Nursing, and PMHNP is Psychiatric Mental Health Nurse Practitioner


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Program event – Reed Cosper

For an archive of previous programs – look here

Watch for updates in the Block Island Times and in the BI Bulletin and posted here.

Tuesday September 8th at 7pm

Mental Health Discussion – NAMI BI will present a talk by the retired State Mental Health Advocate, Reed Cosper, at the Community Center on “The Legal Aspects of the Mental Health Crisis: the Right to Be Treated, the Right to Refuse Treatment, and the Rights of the Community


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Program event – Arietta Slade

For an archive of previous programs – look here
Watch for updates in the Block Island Times and in the BI Bulletin and posted here.

Thursday August 20, at 7:00 p.m in The Community Center.

Arietta Slade will give a talk 

“Adverse Childhood Experiences, Attachment, and Health Across the Lifespan” 

Many of us remember hearing her in previous years and look forward to this very much.

Arietta Slade, Ph.D. is Clinical Professor at the Yale Child Study Center, and Professor Emerita, Clinical Psychology, The City University of New York.  An internationally recognized theoretician, clinician, researcher, and teacher, she has published widely on reflective parenting, the clinical implications of attachment theory, and the development of parental mentalization. For the past 13 years she has been co-directing Minding the Baby, an interdisciplinary reflective parenting home visiting program for high-risk mothers, infants, and their families, at the Yale Child Study Center and School of Nursing, one of only 17 certified “evidence-based” home visiting programs in the United States.  Dr. Slade is editor, with Jeremy Holmes of the six volume set, Major Work on Attachment (SAGE Publications, 2013), with Elliot Jurist and Sharone Bergner, of Mind to Mind: Infant Research, Neuroscience, and Psychoanalysis (Other Press, 2008), and with Dennie Wolf, of Children at Play (Oxford University Press, 1994).  She maintains a private practice working with adults and children in Roxbury, CT.


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Community Conversations – Beginning

This letter was published in the Block Island Times in June 2015.

In the past few years, the US Department of Health and Human Services has paid more attention to mental health issues, which have been the poor underfunded relation for far too long, even though statistics suggest that as many as one in five of us will be impacted by mental illness in our lives. They are recommending that communities have conversations around this issue. A national effort is being promoted though the department, through the Substance Abuse and Mental Health Services Administration [SAMHSA] and the National Alliance on Mental Illness [NAMI]. NAMI Block Island, formerly the Mental Health Task Force, is responding to the Community Conversations idea. We like the core principle: To bring two-way conversations about mental health into the community so that the various responses to behavioral health issues can be addressed in ways that complement existing local activities, are better coordinated, consistent, and in the best interests of all.

In our unique community here, we know well that many things have happened, are happening, and that there are separated and overlapping aims as different groups strive to do what they do as well as possible and without getting in each others’ way, too much. And of course we are often the same people in different groups trying to remember which hat we are wearing today. NAMI BI members are arranging to meet with individuals from various island organizations and groups. But, we, like you, have had to think how to be sensible about demands on our time, so we are starting slowly, with leaders or directors of groups, at the points where mental health impact is known to occur. Through fall, we intend to widen the circles, hear from everyone, not just chiefs and chairpersons, notice the overlaps and take in and share the different pictures that others possess. Our intention is to reach ‘everybody’ by this time next year, but we hope you will feel free to reach out and contact us without waiting if you have something to say about the health or otherwise of mental health in Block Island.

I am writing this letter because it matters to me, and also because I feel there is no way to get this right, whatever right is, but we can almost certainly do better when we all work together and have listened to each other. The first experience (that I know of) that put me in contact with mental illness was when I was 20-something, a young teacher of a child who literally ate the palms of his hands, every day. I had not a clue what to do, reported to the head-teacher and the school doctor who may or may not have known what to do either, but at the parents’ evening it became obvious that the really ill person in this was the boy’s father, and there was no way I knew how to respond, nor was there any group to turn to for help. I felt totally on my own, helpless.

I have sometimes wished I had never begun to look for better responses, and enter into the various kinds of learning and training that followed over the years, but mostly I am incredibly glad. Why? Because, I didn’t know what I would gain. I am not afraid of mental illness, or of physical, though disturbed and saddened by either. I am not a doctor or psychiatrist or therapist. However, I do know that when others near me in professional and in personal life have shown signs of illness or become ill, I have been able to hang in and help them find help. Also I have known that often good intentions have been frustrated by – guess what – separation and overlap and right hands not knowing what lefts are up to. So I do like this idea of Community Conversations about the health of mental health here. I hope that those who join in will also like it. [See more and various links on our new website http://blockislandmentalhealth.org.]

Yours sincerely, Elspeth Crawford


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Share Reading / Articles of Interest

Please let us know the URL to any websites/articles/blogs/stories/videos/books etc you think visitors would find interesting or useful. A brief review of what the contribution is about would be useful too. We will add a post – others are found by scrolling down. Hopefully this will grow into a resource for us all.

However, NAMI BI cannot monitor all the information on other sites and we are not responsible for it. Please let us know if any link found here seems inappropriate or unhelpful.


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Activities – overview at spring 2015

Overview Spring 2015: We have been able to accomplish several significant things: both the provision of mental health services on the island, and education and support programs for the community.

Mental health services currently available through NAMI BI:

A telemedicine service is provided by psychiatrist resident doctors from Butler Hospital and the Alpert Medical School of Brown University. This is a free service. The program started as an experiment and has been maintained by Butler Hospital and the Alpert Medical School and NAMI BI, growing into a viable and meaningful resource for those using the service.

[From Butler Hospital Behavioral Health Update, Summer 2014: “Butler Hospital and the Alpert Medical School of Brown University are using telemedicine to provide residents of Block Island access to high-quality mental health care without having to commute off-island to receive it. The program uses innovative software combined with high-density webcams to enable patients and doctors to see and talk to each other clearly.”]

A counselor from South Shore Center (The Community Health Center in Wakefield) comes to the island every two weeks. This service accepts insurance including Medicaid and serves at least as many clients as the telemedicine program. It reaches a somewhat different client group (family support, etc) as well as being used by some who also use the telemedicine service.

To arrange appointments or discuss services, phone the Case Manager, Tracy Fredericks [CSP certified], 207 229 6349.

We also hope to begin a family support group. Please ask about this so that possible times can be arranged.

Education and support to the community through voluntary effort:

There is good co-operation with other island groups, in particular with Block Island Health Service, The Island Free Library, The School Improvement Team, The Wellness Coalition, and the Block Island Times, sharing information and presentation of programs. From May to November monthly public programs on mental health issues have been offered, mostly at The Island Free Library.

These dealt with a variety of subjects, such as the integration of primary care and mental health care, parent-child attachment, different kinds of therapy, emotional education and prejudice, understanding depression. Articles in The Block Island Times increased the impact. All speakers gave their services voluntarily.

And of course we need help to accomplish these things, so we raise funds, stuff envelopes, make contact with interested individuals. We have needs too. Can you help?


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Our current need on Block Island

This letter below has been sent to Block Island Times and the Block Island Bulletin Board, to summarize our activities. More detail is available here, and if you are interested in what we do, please inquire from any Board Member, come to a meeting, and offer your skills to the Board.

December 2018

Dear Block Island Neighbors,

NAMI BI is a non-profit organization working to reduce the effects of mental illness on Block Island. We aim to facilitate access to mental health care, support families affected by mental illness and enable community understanding. Mental illness takes many forms, is prevalent, may be complex and overlap with other needs; so we also promote well-being and health. 2018 has brought developments in NAMI BI activity with very positive outcomes.

First, NAMI BI continues to manage the psychiatric telemedicine program for adults located at Block Island Health Services and to communicate information about the three therapists who have office hours on the island. Our advocacy has brought sought-after developments in services for children and families. A clinical psychologist offering child and family therapy and consultation now visits the island, and a pilot telepsychiatry service for children is planned to launch early in 2019. When available we will inform the community about it, and about how to access it. NAMI BI fosters both the new children’s services and the adult services currently facilitated by Tracy Fredericks, the Case Manager. She is contracted to NAMI BI who pays for her hours through your contributions and a grant from the Town of New Shoreham. Following the launch of the new needed services, we expect these costs to increase.

Second, Block Island Wellness, a “sister” organization supported by state substance abuse prevention funding, has been subjected to strategic changes from RI State Prevention Planning and is now part of the regional South County Prevention Coalition. Recognizing the commonality and overlap with part of mental health aims, NAMI BI has invited the BI Wellness team to combine with NAMI BI to help preserve their specific local knowledge and activity, as well as enabling us to engage with South County Prevention when appropriate. This has been a fruitful follow-up to our Spring 2017 Mental Health Conference that focused on opioids. Further feedback emphasized stresses, isolation and anxieties on the island, and led to the 2018 Spring Conference topic: “Depression, a Community Conversation, What can we do?” The May 2018 conference was well-received by about 30 people attending. In June another twenty residents attended an event on suicide prevention. During July and August we held a series of TED talk programs and discussion group meetings on various aspects of Mental Health and Illness. All these events were well attended by both residents and visitors.  The Family Support Group has also continued to meet regularly each month, and has been a real benefit to all participants. Plans are well under way for the Spring Conference 2019, which will be held on Friday evening 17 May and Saturday 18 May, title “Children and Teens: Won’t They just Grow out of it?” Keep the Date.

The third change this year has been internal, as we said goodbye to Steve Hollaway, the founding president of NAMI BI. In August his place was taken by Jim Hinthorn. We are thankful for the work Steve has done, and are confident that with Jim as leader NAMI BI continues to fulfill its mission.

As you can see, 2018 has been quite a year for NAMI BI and its work in the BI community. We look forward to 2019 as the long hoped for and now developing resources for children and families become a reality. This and our ongoing work need your support and are so worthwhile. We thank you for your past contributions, and in advance for your continued financial support.

Yours sincerely,          

Members, NAMI BI Board,

President: Jim Hinthorn, Vice-President: Kristin Baumann, Treasurer: Pat Tengwall, Secretary: Elspeth Crawford, Members: Beth Gaffett Tengwall, Gloria Redlich, Socha Cohen, Jill Seppa, Kyra Ernst, Sue Hagedorn, Tracy Fredericks (case manager)

[Donations to NAMI Block Island, PO Box 1719, Employer ID Number B3-2915592]

This page was first written in 2015, and although there has been progress, our ongoing needs remain much the same. The only regular psychiatric mental health service available on Block Island is that offered by telemedicine from Butler Hospital and enabled by NAMI BI, although we hope the service for children and families [from Bradley Hospital] will soon launch. Emergency or more sporadic need to individuals who have not previously sought regular appointments are possible, depending on the point of access. This can come through the Block Island Medical Center (BIHS) or the Police Department as well as through the NAMI BI Case manager, and can involve anything from advice or support to necessary escort off the island. Visiting counselors can be available by negotiation – see services.

The island context also means there is variation in need depending on the time of year. The winter population of permanent residents is less than 1000 people. During the summer season, May – October, the need for services applies to island seasonal workers, as well as summer residents who return regularly each year. There are also visitors/tourists who might need a more temporary engagement with the program. Summer population estimate is about 10,000 people.

Mental illness suffers so much from silence and stigma, that many people do not realize how many individuals suffer and their families and friends absorb consequences. They keep quiet. Given Rhode Island statistics* and the number of people in the local population, as the services become better known, it would seem that the number of individuals using the service will continue to increase as they have done each year they have been offered. At one time in 2014, there was a waiting time of four weeks for a client needing a first appointment. Now, in 2016, the current operating process for all activities is only funded for the limited number of hours used by the Case Manager in organizing the once weekly telemedicine appointments. The hours for which the manager, Tracy Fredericks, is employed are being used to the maximum, and indeed beyond as she responds willingly to emergency, to enabling the finding of counseling help, and other issues that take more of her time. Extra time is not funded.

Educational meetings mostly take place during the summer season when it is hoped that a wider audience can be reached. The summer programs presented have been made possible by the generosity of the speakers who have given their time freely, and by the venue (Island Free Library) also free. Members of the NAMI BI Board give their time to organize the presentations. In the past, some possible speakers have had to refuse as travel and residence costs on the island could not be borne by either speaker or NAMI BI.

NAMI BI needs are threefold:

First the obvious one for any non-profit, we need donations in order to keep going. As described in more detail below, we want to offer more services and expand programs, both of which are indeed required. Any gift you make helps us continue to provide psychiatric services and support on Block Island. Donate to NAMI Block Island, PO Box 1719, BI RI 02807. All gifts are fully tax deductible.

New Shoreham Town Council has added a line item in Community Support in the FY 2017/8 budget. This supports about half of the Case Manager salary (at the moment $15,000 is required). We are very grateful to all those who have helped bring about this addition to Block Island community need.

Second, apart from the case manager, we work with volunteered time and effort. We deeply appreciate the partnerships of Butler Hospital and South Shore Center, the liaison with Block Island Health Services, the free venue for programs offered by the Island Free Library and the publicity from Block Island Times. Expenses are minimal. NAMI BI also aims to offer some events each year during May, which is Mental Health Month. These involve our time, and organization skills, and volunteers, of all kinds, for example offering child care so that parents can attend events..

For anyone wants to become involved and offer their time, as and when they can do so, there is no requirement for professional knowledge or past experience, just willingness. Please ask a Board Member and come along to a meeting.

Third, we  create community conversations on mental health, to offer these and to offer support groups for families. We work as closely as possible with many other groups on the island. There may be a need to undertake training, or, to bring facilitators to the island. We look forward to interest and collaboration in the two-way discussions that help all of us with these initiatives. We were part of the Care coalition that enabled the appointment of a part-time Case-worker, a coordinator of human services, to help those who need services of all kinds make contact with providers on the mainland.

Community opinion is valuable and experiences can be shared. 

Financial detail: In 2014 about $12,000 ensured the provision of help to residents. As what is offered has become better known, that had increased. All donations are helpful, and not just for the monetary value, they show us that the work is valued, that others find it worthwhile. We do not have enough to make effective increase in operating costs.

Donate to NAMI Block Island, PO Box 1719, BI RI 02807.

All gifts are fully tax deductible. Employer ID Number B3-2915592

Both nationally and in Rhode Island State, SAMSHA [The Substance Abuse and Mental Health Services Administration] are prioritizing initiatives that help provide treatment and services for people with mental and substance use disorders, support the families of people with mental and substance use disorders, build strong and supportive communities, prevent costly behavioral health problems, and promote better health for all Americans. “Now is the Time” is the President’s plan to increase access to mental health services. SAMHSA has played a key role in supporting a number of activities outlined in the plan to help build safer communities. NAMI BI is already planning to follow SAMSHA guidelines to launch Community Conversations on Mental Health to enable the Block Island Community. We have begun to build a Community Team (working collaboratively with other groups in the community). We also plan to offer a family series of group meetings.

To do this effectively we believe that at a minimum, we need access to funding for training group facilitators, and for travel, to training events. We think we are already using all the local expertise we have, given freely.

That is, our mission to provide Services, Support and Education, all need funding in the short term. In particular, the ongoing requirement to fund the Case Manager is a necessity for the services to continue even as they are now.

Donate to NAMI Block Island, PO Box 1719, BI RI 02807. Employer ID Number B3-2915592, tax deductible.

*Trends Themes and Effective Practices in State legislation – NB Rhode Island has reduced its spending on Mental Health in past years, not because of less need. We need political influence too.