Mental Health, Mental Illness, on Block Island

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

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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]

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?


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.