PLEASE HELP US REACH 2020 PRESIDENTIAL CANDIDATES by Dede Ranahan

Sooner Than Tomorrow Readers,

I’ve been working hard the last couple of weeks, with advocates from across the country, in the development of this Five-Part Plan. Individuals, professionals, writers, journalists, and mothers (always the mothers) have been brainstorming and refining this document. Our intent is to get it in front of every 2020 presidential candidate — Republican, Democrat, Independent. Our goal is to encourage them to talk about serious mental illness (SMI) on the campaign trail and in their debates, and to include a SMI plan on their websites. Right now, no candidate is talking about SMI. It’s as if it didn’t exist.

These are baby steps. We can’t address everything that needs to be addressed in our messed up mental illness system, but we have to start somewhere. We’re trying to help the candidates along. If they don’t have SMI on their radar before the election, they probably won’t have it on their radar once elected.

If you agree with the positions in this plan, and would like to send it to politicians of your choice, send me an email and I’ll email the documents (cover letter, plan, an attachment) back to you dede@soonerthantomorrow.com). The more individual voters the candidates hear from the better.

I, and many others, would really appreciate your support. Dede

A FIVE-PART PLAN TO ADDRESS SERIOUS MENTAL ILLNESS (SMI)
FOR ALL 2020 PRESIDENTIAL CANDIDATES

PLEASE ADDRESS THESE TOPICS IN YOUR CAMPAIGN APPEARANCES AND DEBATES

1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI)) FROM A BEHAVIORAL CONDITION TO WHAT IT IS,  A NEUROLOGICAL MEDICAL CONDITION

WHY RECLASSIFICATION IS IMPORTANT

Reclassification will unlock more research funding and help eliminate discrimination in treatment, insurance reimbursement, and the perception of SMI as “behavioral” condition. SMI is a human rights issue. NIMH ranks SMI among the top 15 causes of disability worldwide with an average lifespan reduction of 28 years.

PRESIDENTIAL ACTION

* Create a cabinet position exclusively focused on SMI.

* Push for Congressional appropriations to include schizophrenia in a CDC program that collects data on the prevalence and risk factors of neurological conditions in the US population.

2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA)

WHY HIPAA REFORM IS IMPORTANT

Overly strict HIPAA laws make it extremely difficult for families and caregivers to partner in the treatment of their loved ones, resulting in important life-saving medical information gaps. By eliminating this barrier, family support will be strengthened, reducing the chance of relapse, homelessness, imprisonment, and death.

PRESIDENTIAL ACTION

* Work with legislators to change HIPAA law to ensure mental health professionals are legally permitted to share and receive critical diagnostic criteria and treatment information with/from parents or caregivers of SMI.

3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD)

WHY IMD REPEAL IS IMPORTANT

IMD repeal will increase the availability of psychiatric inpatient beds. The IMD exclusion is not only discriminatory of those suffering from neurological brain disorders, it is a leading cause of our national psychiatric hospital bed shortage. It prohibits Medicaid payments to states for those receiving psychiatric care in a facility with more than 16 beds who are 21-65, the age group with the most SMI.

PRESIDENTIAL ACTION

* Work with legislators to repeal the IMD exclusion.

4. PROVIDE A FULL CONTINUUM OF CARE

WHY A FULL CONTINUUM OF CARE IS IMPORTANT

A continuum of care insures that SMI patients receive early intervention at all stages of their illnesses, long-term care when needed, and follow-up treatment (medications and therapies) when they’re released. It reduces visits to jails, ER’s and hospitals, homelessness, and morgues. A continuum of care provides life-time management.

PRESIDENTIAL ACTION

* Create federal incentives to states which are addressing a full array of inpatient, outpatient, and supportive housing care. 

5. DECRIMINALIZE SERIOUS MENTAL ILLNESS (SMI)

WHY DECRIMINALIZATION OF SMI IS IMPORTANT

People suffering with other neurological conditions like Alzheimer’s and dementia can get treatment promptly without being kicked out of their homes to wander the streets until they are arrested and put in jail or prison rather than a hospital. Serious mental illness is the only disease where the doors to treatment are shut unless a crime is committed. This is pure and simple discrimination with the disastrous results we see in our country today — homelessness, incarceration, the disintegration of families, and death.

PRESIDENTIAL ACTION

* Work with legislators to change “must be a danger to self or others” criteria.

* Work with legislators to change involuntary commitment criteria, alleviating the subjective nature of “gravely disabled” and redefining it in objective terms based on scientific medical need for treatment. Psychosis, like a stroke, is a traumatic brain injury and needs immediate treatment for the best outcome.


Me and The Jazz

Me and The Jazz

PLEASE JOIN THE CONVERSATION ON MY FACEBOOK PAGE by Dede Ranahan

The following is an ongoing discussion on my personal Facebook page - Dede Moon Ranahan. If you’re on Facebook, please click on my page and join the conversation. Or enter your comments through the comment link below. Or send your comments to me in an email: dede@soonerthantomorrow.com

SMI (SERIOUS MENTAL ILLNESS) ADVOCATES AND SUPPORTERS

GOAL: This effort is short-term. To get SMI recommendations for a national SMI plan before the 2020 presidential candidates (Republican, Democrat, Independent). None of them are currently talking about SMI (not mental health, not drug addiction). SMI. The SMI community is looking for a candidate/s who will champion SMI and its concomitant issues. With adults and children impacted and their immediate families, we represent roughly 72 million people in the US.

THE ASK: That candidates talk about SMI in their campaign appearances and debates and post a national SMI plan on their campaign websites.

To encourage them, we'll be submitting a cover letter, one-page outlined/bulleted plan, references and resources to aid them in developing their plan, and if they will read that far, the full list of 18 topic areas.

RESULTS OF YOUR VOTES FOR THE TOP 5 ISSUES FOR A ONE-PAGE PLAN:
1) Reclassification of SMI as neurological brain disorders
2) IMD (Institutes for Mental Disease Exclusion)
3) HIPAA Reform (Health Insurance Portability and Accountability Act)
4) Continuum of Care
5) Decriminalization of SMI

NOW WE MUST REFINE THIS TOP 5 LIST.
PLEASE ANSWER 1 OR MORE OF THESE QUESTIONS IN A FEW SENTENCES:
1) Why is reclassification of SMI important?
2 )Why is IMD repeal important?
3) Why is HIPAA reform important?
4) Why is a Continuum of Care important?
5) Why is Decriminalization of SMI important?

1) Name one specific action a president can take to advance the reclassification of SMI.
2) Name one specific action a president can take to advance IMD repeal?
3) Name one specific action a president can take to advance HIPAA reform?
4) Name one specific action a president can take to advance a Continuum of Care?
5) Name one specific action a president can take to advance the Decriminalization of SMI.

Thanks, Dede

1. RECLASSIFICATION OF SMI
-Reclassify schizophrenia and related disorders as neurological conditions or neurobiological brain disorders. Eliminate “behavioral health” nomenclature.


2. HIPAA (Health Insurance Portability and Accountability Act)
-Reform current HIPAA laws.
-Present patient and family with a social worker to support the family unit throughout the care process including medication and psychiatric treatment.
-Require mandatory training for everyone in the medical profession about HIPAA and a required test on proven knowledge.
-Develop a federal program for the administration of a psychiatric advance directive (PAD) which includes a universal release of information and designates an agent if capacity is lost. Must include enforcement mechanisms to require mental health/illness facilities to follow the directives.

3. IMD (Medicaid’s Institutes for Mental Disease Exclusion)
-Repeal it.
-To prevent warehousing, use unscheduled check-ups on those receiving services.

4. A FULL CONTINUUM OF CARE
-Early intervention at all stages of illness.
-Provide Inpatient (IMD waivers), Outpatient (ACT, FACT, PACT, AOT, Clubhouses), Housing (full array from locked stabilization to unlocked intensive, medium intensive, peer-run PSH, Asylum).
-Require a psychiatric standard of care for various SMI diagnoses like other medical specialties. Diagnosis should be staged as cancer is.
-Provide more long-term care.
-Remove ER’s as entry for mental health hospitalization. The ER process and chaotic environment are not conducive to the well-being of SMI patients.
-Give federal assistance to states providing supportive housing.

5. DECRIMINALIZE SMI
-Eliminate solitary confinement in jails and prisons.
-Support nationwide civil mental health courts and expand criminal ones that are already established to keep SMI out of jails and prisons.
-Establish mental health courts on a federal level, and coordinate federal courts and state-run mental health facilities.
-Move crimes that SMI commit in the federal system into state courts.
-Provide a digitized system to connect county/hospital medical records to jails and prisons.
-Mandate a way for families to provide medical history to jail/prison doctors to inform treatment.
-Provide uniform psychiatric screening of the incarcerated and use standardized protocols for medication of SMI prisoners.
-Require strict limits on waiting for trial time.

PLEASE INCLUDE SMI IN YOUR PLATFORM by Dede Ranahan

Hi Mental Health for US

Just discovered you and your platform asking 2020 political candidates to talk about mental health in their campaigns. I see no specific mention of serious mental illnesses (SMI) such as schizophrenia, schizo-affective disorder, bipolar disorder, etc. Some people are not able to recover from SMI and languish in prison, in solitary, in not-so-good care homes or in their parents’ back bedroom for years and years.

I belong to a dozen Facebook groups of families of the SMI. Their stories are horrific and from across the nation. They’re not able to find help anywhere.

I want to support your efforts. I’ve been sending letters to candidates and calling on Facebook and on my blog for 2020 candidates to step up, speak about, and put forth national plans for SMI that do the following: Reform HIPAA, repeal the IMD exclusion, do brain research into these insidious brain diseases, provide for long-term care and short-term outpatient services, improve access, provide housing, supported education, and family supports. Not simply mental health. Not simply drug and alcohol addiction. Serious mental illness.

Would Mental Health for US be willing to expand its platform to include SMI - specifically spelling it out, not simply lumping it into mental health?

I hope your answer is yes.

You can read stories about SMI individuals and families — across the US - that I’ve been posting for 31/2 years on my website and blog. You can also read my own story in my book about my and my son’s struggles for over 25 years to get help for his SMI. He died in 2014 on a hospital psych ward. He was transferred, without my knowledge, out of county (lack of beds), his records weren’t forwarded with him, and I couldn’t get doctors to talk to me (HIPAA) even though I was on my son’s Advance Care Directive.

I unwittingly captured the last year of Pat's life in my book which, among other things, includes his story and many stories of individuals and families being failed by the system.

I will sign on and volunteer to help you once I’m satisfied that this undertaking includes SMI and specifically mentions it in your platform.

Thank you. I look forward to hearing from you.
Dede Ranahan

www.soonerthantomorrow.com
A Safe Place to Talk About Mental Illness in Our Families

Sooner Than Tomorrow — A Mother’s Diary About Mental Illness, Family, and Everyday Life
By Dede Ranahan with Patrick Ranahan
http://www.bit.ly/soonerthantomorrow

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https://www.mentalhealthforus.net Please read this platform and send a message asking that it include SMI specifically.

http://www.bit.ly/soonerthantomorrow

TRAVIS & ME - OUR JUNE PRISON VISIT by Dede Ranahan

On Sunday, I visited Travis. I didn’t see him in May because our visiting day fell on Mother’s Day which I spent with family. He walked into the visiting area and, at first, I didn’t recognize him. His hair’s been shaved short — for summer — and he’s growing a beard. He looked great. I told him, “I really like your haircut. And your beard.”

We hugged and Travis said, “I finished reading your book.” (His mother, Kathy, sent him a copy.) Then he said the most perfect thing, “I love Pat. I love all his Facebook posts. He’s so funny. And smart. I think he’ll be an influencer for our generation. I copied the list of his favorite books. I’m going to read all of them.”

Travis’s eyes filled with tears as he spoke. My eyes filled with tears as I listened. Travis was clearly moved. “I totally get him,” he said. “I like him so much.” More tears.

I’m getting such heart-felt reactions to Sooner Than Tomorrow. In reviews, in emails, in cards and letters. Many have commented about Pat and his sense of humor. But, hearing about him from Travis, in person, with tears in his eyes, was mind-blowing for me.

I reached for his hand. “Thank you,” I said.

“I wasn’t sure what to expect when I began reading your book. And then I couldn’t put it down. You’re such a good writer.”

Travis is reading other books, too. He’s taking a college health class during the summer. “It’s really interesting. I’ve read the first three chapters. It’s about physical health, mental health, emotional health — about keeping everything in balance. I’m ready for these college classes. I wasn’t ready for them before I was sent to prison. My self-esteem is much better now. I know I can study and learn.”

Travis was also pumped about a basketball tournament he took part in on Saturday. His team (“We were the ‘crazy’ team. All of us have psych issues.”) beat five other “normal” teams. “We were champions for the day. We never played together before and we just clicked. Sports are important to me. I ran 10 miles (around the prison yard) for the soldiers who died on D-Day. To honor them. I’m in the best shape of my life.”

I asked Travis if there had been any more discussion about transferring him to a prison closer to his family in Southern California. He said, “They’re not going to move me right now. My psychiatrist and my psychologist are going to take me off lithium. It’s affecting my thyroid. Then I won’t be taking any medications. They want to watch me and see how I react. We’re all hoping I can function okay without meds.”

Travis likes his medical team. He thinks they’re competent. He thinks they care about him. “They like me,” he said. “I tell them about my feelings and my emotions. Not every client is open with them and they appreciate that I am.”

“I’m growing,” Travis continued. “I’m making the most out of my time in prison. I’m working out. I’m reading. I’m writing songs for our church service. I’m a better person than I was.”

“Travis, it sounds like you’re focusing on the positive aspects of being here. Do you think other inmates do that?”

“I don’t know. I don’t want to judge anyone else. Probably not everyone does. There are fights and other bad stuff happens. Being here is forcing me to know how to interact with others. It’s not always easy living with my cellie, but I’m learning about relationships. I was kind of a recluse before I came here. I managed a motel in the mountains and I spent a lot of time by myself.”

It feels like our conversations are evolving. Travis asked me questions, too. “How are you doing, Dede?” (good) “How’s your mom?” (good) “How’s The Jazz?” (good) “What books are you reading?” (Mama’s Last Hug by Frans De Waal, I Miss You When I Blink by Mary Laura Philpott, Another Rubber Chicken Dinner by Bev Chinello)

Visiting hours ended. It was time to leave. “Have a good month, Travis. I’ll see you in July.”

I always turn to wave at Travis as I walk away. He’s always waiting. And he waves back.

Travis and me - before his haircut

Travis and me - before his haircut

http://www.bit.ly/soonerthantomorrow

A LETTER TO SHARE OR TO COPY AND PASTE by Dede Ranahan

TO ALL 2020 PRESIDENTIAL CANDIDATES:

I often hear discussions about mental health awareness, but don't hear discussions about serious mental illness (SMI). 
With SMI, (schizophrenia, schizoaffective disorder, bipolar disorder, depression, OCD), some people do not recover and cannot work or live independently. Some are so sick they don't realize they're sick (anosognosia), don't respond to treatment (if they get it), and end up incarcerated, homeless, missing, suicidal or dead.

The SMI population represents roughly 5% (10million) of the mentally ill in the US. And ten times as many people with SMI are incarcerated as are hospitalized. These individuals don't get the attention they deserve and consistently fall to the bottom of the proverbial heap.

If it "takes a village to raise a child," it takes a country to help a "child" with SMI -- parity in mental health care, IMD exclusion repeal (beds), HIPAA reform, housing, hospitalization instead of incarceration, brain disease research, supported education, and on and on. So far, our country is not stepping up. A serious mental illness system does not exist.

The presidential candidate I'll support will have the courage and insight to raise SMI issues and to create a plan to deal with them on a national scale. 

What is your plan for SMI? (Not mental health. Not drug addiction.) I would like to read about it on your website. Thank you for your prioritization of SMI issues.

If you agree, please share widely. Or copy and paste.

#seriousmentalillness #SMI #schizophrenia #schizoaffectivedisorder#bipolardisorder #depression #OCD #parityinmentalhealthcare #IMDrepeal#HIPAAreform #braindiseaseresearch #treatmentnotincarceration#soonerthantomorrow

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