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Lighting the Way A publication of Monroe Community Mental Health Authority August 2018

From the Director’s Desk Can you believe how fast summer has gone by? I feel like we were just getting ready for warm weather and cook outs and now we are getting kids ready to go back to school and looking forward to pumpkin-spiced everything! MCMHA spent the busy summer months preparing to apply for a license to practice Outpatient Therapy for Substance Use Disorders (SUD). Many national population statistics indicate that about fifty percent of people who live with mental illness often also live with a co-occurring substance use disorder and vice versa. Our community has also let us know that treating substance use disorders is a priority. We spent some time talking with other providers in the community and assessing the need for service and decided that it was important for us to step up our involvement in Monroe’s Recovery Community. Our initial steps toward this goal include getting our license from the State of Michigan and hiring and training SUD competent and certified staff. When those steps are achieved, MCMHA will begin to provide outpatient therapy to individuals who are already in our services who also have an SUD diagnosis. As we move into September, we are busy with National Suicide Prevention Month. As you may know, suicide is the 10th leading cause of death in the United States, taking the lives of nearly 45,000 citizens annually. In order to raise awareness, reduce stigma, and send a message that “no one is better off without you,” MCMHA is proud to partner with multiple agencies in our community for two big events. On Wednesday, September 12, the film Suicide: The Ripple Effect will be shown at the Phoenix Theatre at the Mall of Monroe. This film is part of a global mission to help reduce the number of suicides and suicide attempts around the world. A question and answer discussion will follow the film. The theatre can hold a total of 200 viewers. Tickets are $5 each and can be purchased at MCMHA and Gabby’s Grief Center, with proceeds going to the Monroe Suicide Prevention Committee. MCMHA has purchased the rights to show this film, and we expect to have more screenings/showing in the future at various venues. Also in September is the 14th Annual Suicide Remembrance Vigil at 5:30 pm in Loranger Square. This event, which the public is encouraged to attend, is a very moving community event for anyone whose life has been impacted by suicide. The vigil is sponsored by Gabby’s Grief Center, and there will be mental health professionals and grief counselors to answer questions and provide resources. Don’t forget that MCMHA’s Annual Town Hall will also be held on September 26 at 3:30 pm. The Town Hall is one way that we seek your input on how we are doing. We also recognize consumers who have made progress in their recovery and community members and businesses who have been excellent community partners. We look forward to seeing you there!

Lisa Jennings Chief Executive Director

Inside Rights Corner…………...2 Genoa Healthcare….….3 Substance Abuse Coalition………..4 Customer Services….5 8 mental health red flags….....6 Relationship between food & mood……...…...7 2018 Consumer Satisfaction Survey…...........8 Monroe County Jail Diversion……………..9 10 best self-help books….10 10 raw foods to improve mental health………..11


Rights Corner

The Rights Office wants you to know…

Guardians

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A guardian is a person who is chosen by the court to make decisions for an individual that is unable to manage their own affairs. Although a guardian is empowered to make many decisions for a person, there are often limits to the guardian’s decision making ability (e.g. just financial or medical decisions) that do not prevent a consumer from making his/her own decisions on what to do each day. The best way to find this out is to look at the guardianship Court Order. Additionally, the Michigan Mental Health Code provides certain rights and protections to consumers, regardless of their guardianship status. Even if a consumer has a court appointed guardian, any services or treatment provided by CMH or any other staff acting on behalf of the agency, must comply with the Mental Health Code and any other applicable laws, policies, etc. For example, even if a guardian tells staff to do something such as hide medications in a consumer’s food or tell a consumer to go to their room for misbehaving, staff cannot comply with the guardian’s request if it goes against the rights guaranteed by the Mental Health Code or other written standards such as a consumer’s Individual Plan of Service or doctor’s orders. Here’s how to reach us: Monroe Community Mental Health Authority Rights Officers: Shelley L. Koyl and Coy Hernandez 1001. S. Raisinville Road Monroe, MI 48161 (734) 243-7340 *For hearing impaired access through the Michigan Relay Center call (800) 649-3777.


Genoa Healthcare Genoa Healthcare operates a full-service, on-site pharmacy located within the Monroe Community Mental Health Authority in Monroe, Michigan. Our pharmacy has been in this location for almost five years and our pharmacist, Caroline, and pharmacy technician, Toni, have been serving our consumers for over three years. Genoa is the most experienced pharmacy provider specializing in the behavioral health community, partnering with centers to provide pharmacy care for their consumers. Genoa currently has over 400 pharmacies in 45 states and the District of Columbia. Genoa pharmacies offer a unique on-site pharmacy setting based on the needs of the center they are located in and strive to be the pharmacy of choice to both their center partners and their consumers. Consumers benefit from the interaction they have with the pharmacist; the organization eliminates inefficiencies by directing pharmacy functions back into the pharmacy and have more control over how medications are handled. Although Genoa is a nationwide company, they have retained the feel of the hometown pharmacy and the services that go along with it. Being on-site allows Caroline and Toni to work closely with Monroe CMHA’s prescribers, nurses, and caseworkers, to provide the best possible care for their consumers. For consumers of MCMHA, Genoa Pharmacy can:      

Conveniently fill all medications on-site, saving them multiple pharmacy stops Assist with insurance plans and questions, including Medicaid and Medicare Provide medication delivery options Dispense multiple medications in Convenient Adherence Packaging so they are easier to take Provide prior authorization assistance Personalize services to fit their needs Transfer prescriptions from existing pharmacies to Genoa

Please stop by and say hello or ask about Genoa’s services! Our phone number is (734) 636-1486. We are open Monday through Friday, 8:30am to 5:00pm and we close for lunch 12:30pm1:00pm. Submitted By: Caroline Harper

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Customer Services is Here for YOU!! As you seek or receive services from our agency there may come a time when you may need additional information. This may be in regards to available services, how to access services, how to file a complaint or an appeal, or other areas of information or questions you are seeking answers for.

As Customer Services I may be an employee of the agency but I want to assure you that my main function is to be an advocate for the consumers/ families and guardians. I also ensure that the organization provides care that is respectful and free of stigma. The main areas of focus are Education and Training for staff, consumers, families and guardians. Performance Improvement, Public Relations and the most important is attending to the needs and wants of the consumers, families and guardians. I am available to talk to you in person or by phone Monday through Friday from 8:00 a.m. to 5:00 p.m. After hours by appointment. If you wish, you may also send me an email at bgates@monroecmha.org. My direct line is 734-384-8780. Submitted by: Bridgitte Gates; Customer Services Manager

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8 Mental Health Red Flags we should all be aware of Every one of us goes through ups and downs as a normal part of life. Sometimes there’s a reason for the lows: a parking fine, a disagreement with a loved one, a rubbish day at work. Sometimes, they come out of the blue with no warning whatsoever. If you live with a mental illness, it’s vital to be watchful for the signs that your emotional wellbeing is taking a turn for the worse. At least 50% of people with depression will have at least one relapse, but knowing what these red flags are and acting on them promptly could help to prevent a temporary low turning into a serious downward spiral. ‘Often, a close friend or family member notices new signs and differences quicker than the individual experiencing them,’ says Dr Antonis Kousoulis, assistant director of the Mental Health Foundation. If you experience these warning signs, you should seek help as soon as possible: early intervention is critical in preventing major problems. So what signs can we be aware of, in ourselves and others? 1. Sleep issues. ‘Sleep disturbances are a classic physical symptom that someone’s mental health may be deteriorating,’ says Dr Kousoulis. Finding it hard to fall asleep at night or waking in the early hours can be a sign of depression, while not feeling the need to sleep at all could indicate the onset of bipolar hypomania. I know that when I’m feeling so exhausted I can’t get through the day without a nap, my depression is getting worse 2. Eating too little – or too much. ‘Mental health problems often have an impact on appetite; it’s important to note how dramatic or persistent the changes are,’ Dr Kousoulis explains. Some people with depression lose their appetite altogether; others turn to comfort eating and start to gain weight. On its own, a change in appetite may not be anything to worry about (who hasn’t turned to chocolate to get through a crappy day?) but combined with other symptoms, it could suggest your mental state is taking a turn for the worse.

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3. Loss of interest in everyday activities. If you can’t summon up the energy or enthusiasm for the things you usually enjoy, and find yourself cancelling plans, take it as a possible warning sign. ‘Often, such symptoms only last a few days, but it’s important to understand your limits and capacity and take action if they’re persistent,’ Dr Kousoulis advises. 4. Changes in libido. When I’m depressed, my lack of interest in everyday life extends to the bedroom. I’m too exhausted for sex, feel hideously unattractive and don’t even want to be touched. On the other hand, people experiencing mania may notice a surge in their sex drive, and can’t get enough. Changes in either direction could be symptomatic of mental illness and worth paying attention to. 5. Problems coping with daily stresses. Stress as a condition is not the same as depression, but if molehills are turning into mountains and you’re finding it hard to cope with stresses that you’d usually take in your stride, a visit to your GP might be in order. 6. Indecisiveness. I can barely decide what to cook for dinner when I’m unwell, and big decisions are totally beyond me; my husband chose our entire bathroom décor because I just couldn’t commit to a choice. ‘This, along with irritability and difficulty concentrating, could be an early sign of anxiety or other mental health problems,’ Dr Kousoulis says. 7. Emotional sensitivity. If you’re usually a stoical sort but find yourself literally crying over spilt milk, or are constantly on the verge of losing your temper, be aware of the possibility that your mental health is worsening. Keeping a mood diary for a week or two could help you establish whether there’s a pattern you need to be concerned about. 8. Withdrawing from social contact. Depression tells me that I’m a burden and should just quietly disappear from everyone’s life. I cancel plans and go into a self-imposed exile. But if you’re mentally unwell, surrounding yourself with understanding people is more important than ever. ‘Spending time with the person to support and listen carefully is important,’ Dr Kousoulis agrees. ‘But it’s equally important to balance the help you can offer with knowing your limits when someone needs immediate professional attention.’ If in doubt, book that doctor’s appointment: it could put the brakes on your mental decline, and restore you to health sooner rather than later.


What is the Relationship Between Food and Mood? It is well known that unhealthy eating patterns can cause mood swings. Blood sugar fluctuations and nutritional imbalances are often to blame. Without a steady source of fuel from the foods we eat, our mind and bodies don’t function well. Here’s how some unhealthy eating habits can alter your mood and emotional wellbeing: Skipping meals. Missing a meal, especially breakfast, can lead to low blood sugar. This will likely leave you feeling weak and tired. Cutting out entire food groups. If you reduce the variety of foods in your diet, it can be more difficult to get all the essential nutrients you need. Low levels of zinc, iron, B vitamins, magnesium, vitamin D, and omega -3 fatty acids are associated with worsening mood and decreased energy. Eating too many refined carbohydrates. High intakes of unhealthy, processed carbohydrates, such as white bread and pastries, cause blood sugars to rise and fall rapidly. This can lead to low energy and irritability. Beyond mood and general well-being, the role of diet and nutrition on mental health is very complex and has yet to be fully understood. However, research linking the two is growing at a rapid rate. In recent years, evidence shows that food can contribute to the development, prevention, and management of mental health conditions, including depression and anxiety disorders. Researchers are also taking a closer look at why diet may influence mental health. Studies are exploring diet’s effects on gut microbiota (organisms in the intestinal tract), neuroplasticity (brain’s ability to modify structure, wiring and function), oxidative stress (cellular damage) and chronic inflammation. While we still have much to learn about the effects of dietary patterns on mental health issues, evidence suggests that eating a healthy diet can have a protective effect. In fact, many believe that good nutrition is as important to mental health as it is to physical health. Here are some positive changes you can make to improve your eating to support your mental health: 

Eat at set intervals throughout the day

Choose less refined sugars and eat more whole grains

Include protein at each meal

Eat a variety of foods

Include omega-3 rich foods, like oily fish, in your diet

Reach and maintain a healthy weight

Drink plenty of fluids, especially water

Get regular exercise

Following a healthy eating plan can keep you energized and help you to feel your best. While good nutrition is an important component of your emotional well-being, it is not a substitute for proper medical care and treatment. If you have concerns about your mental health, talk to your health care provider.

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2018 Consumer Satisfaction Survey Part of Monroe Community Mental Health’s commitment is to providing quality care to the people we serve. This includes getting feedback from consumers, guardians, and family members on how they fel about and experience their CMH services. There are many ways we seek this type of feedback, and one of those is through a yearly satisfaction survey. For 2018’s satisfaction survey’s, phone survey’s were conducted. By providing a phone survey we are able to get better feedback and information from our consumers, guardians and family members. In collecting the results, we looked at items that had a total score of 90% or less and whether those items would require a plan to improve satisfaction in that area. Our consumers, guardians and family members are asked anywhere from eight to twelve questions with the opportunity to provide feedback on what they like or would like to see changed at MCMHA.

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The survey results for Monroe CMHA in 2018 are: 1. In our children survey, children between the ages of 10 and 17 are contacted. All questions asked were above a 90%, with the exception of the question, “I am doing better in school and/or at work”. That question received a 85.71%. 2.

Adults with a mental illness. All questions asked received above a 90% with the exception of the question, “I am encouraged to ask questions about my treatment and medication”. That question received a 82.14%

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Individuals with a Developmental Disability and their guardians were highly satisfied with their services being provided and all questions had a 90% or better rating.

The top two questions above that received a score lower than a 90% will be looked at to see what improvements can be made. Overall people surveyed said they were highly satisfied, but we also know there’s always room for improvement when it comes to having high quality services for those we serve! As always, you can contact Customer Services for any questions you may have about this survey data, any feedback you have, or to find out ways you can get involved in giving feedback to Monroe CMHA. Customer Services can be reached at 734-384-8780. Submitted By: Bridgitte K. Gates; Customer Services Manager


Monroe County Jail Diversion The Monroe County Board of Commissioners signed the Stepping-Up Resolution “Stepping Up to Reduce the Number of People with Mental Illnesses in Jails� in 2015. Monroe County was one of the first in Michigan to sign this resolution and joins 11 other counties in Michigan, 302 nationally, to take this important step as a community to address the needs of individuals with Mental Illness through jail diversion programming. Approximately 20% of adults in the United States have a mental Illness (from anxiety, to depression, to major mental illness.) Approximately 7% of police contact involves a person with mental illness. It is estimated 32% of individuals booked in the Monroe County Jail in 2015/2016 had a Serious Mental Illness based on an initial mental health screen. Monroe County is in the fourth year of a multi-year grant designed to address the incarceration of individuals with mental illness through community treatment, jail diversion, community education, and a Mental Health Recovery Court. The grant encompasses the Sequential Intercept Model, a national best practice designed to assist individuals contacting the justice system. The Jail Diversion grant is currently funded through the Michigan Department of Health and Human Services (MDHHS.) The Jail Diversion grant has funded Crisis Intervention Training (CIT) with two officers certified to provide the training to local law enforcement, road patrol, dispatch to educate on effective interaction with individuals who may be in crisis and/ or consumers of the mental health system. The first CIT course occurred in May 2018, with additional training scheduled. Additional services, funded through the Jail Diversion grant, include Certified Peer Support Specialist (CPSS) services both in jail and in the community. The CPSS staff have served an average of 70 individuals in jail this fiscal year through group and individual interventions. Moral Reconation Therapy (MRT), individual and group therapy services have also been provided in jail and outside of the jail to justice involved individuals. MRT is a systematic treatment strategy that seeks to decrease recidivism among juvenile and adult criminal offenders by increasing moral reasoning. The Monroe County Mental Health Recovery Court (MCMHRC) was founded by Judge Jack Vitale in 2016, in collaboration with the MCMHA. The MCMHRC Program is a problemsolving court, serving individuals who present with justice-involvement and a serious mental health condition. The MCMHRC Program aims to support public safety by reducing recidivism through therapeutic intervention, intensive court supervision and linkage to community resources; supporting the unique needs and goals of individual participants. MCMHRC is in its second year of operation, having received more than 180 referred candidates since October 2016, and serving nearly 20 active participants. The inaugural graduation ceremony will mark the first graduation event held by MCMHRC and will celebrate the successful graduation of two program participants. The MCMHRC grant is currently funded through the Supreme Court Administrators Office (SCAO) with one position partially funded through the Monroe Community Mental Health Authority (MCMHA.) Michigan State University continues to work with MCMHA and the Monroe County Jail, collecting monthly data and studying trends across the State of Michigan for all grant funded programs. Submitted By: Geralyn Harris, Chief Clinical Officer

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Mental Health on the book shelf: 10 of the best self-help books The Mental Health Foundation shows that two thirds of us experience a mental health problem in our lifetimes. There’s no manual on mental health, just as there are no ‘one-size-fits-all’ symptoms, diagnoses or cures. But there are thousands of books available offering advice and strategies to help live with the various forms, from OCD to depression, anxiety to autism, as well as stories of support from others that have been lost and found and want to share the message that, however we are feeling, we are not alone. In the words of Reasons to Stay Alive author Matt Haig: “Words, just sometimes, really can set you free.” Here Toni Jones, founder of self-help book club Shelf Help shares her picks of the best mental health titles.

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Mad Girl by Bryony Gordon From running the marathon in her bra and pants to getting Prince Harry to share his own, very personal stories, Gordon has done a lot to highlight mental health. But it’s her own frank and funny story about life with OCD that will really offer comfort to anyone feeling alone in their compulsions. Reasons To Stay Alive by Matt Haig A book on depression that everyone should read, whether you suffer with mental illness or not. This award-winning ‘modern classic’ is as much a celebration of being alive as a look at the dark side of living. And its core message is the most important of all - that nothing is ever hopeless. (And a PS for any selfhelp super geeks out there, Haig’s follow-up ‘Notes on a Nervous Planet’ is out in July). The Little Book of Mindfulness by Patrizia Collard Can you find 10 minutes a day? Or even just 5? That’s all you need to reduce stress, improve mindfulness and find more peace in your life, according to this best-selling mini book. A small but powerful stressbuster. The Upside of Stress by Kelly McGonigal If you can’t stop stressing, then you may as well learn how to do it better! In this book Health Psychologist Kelly McGonigal argues that a) stress can be GOOD for us and b) by embracing stress and changing our thinking, it could actually become a powerful ally. May The Thoughts Be With You by Charlotte Reed Artist Charlotte Reed doodled herself out of depression, and the colourful characters she created went on to star in their own picture book of ‘thoughts and wisdom to inspire your days.' How to be Human: A Manual by Ruby Wax So, there is a manual! And this book, a three-way production from the comedian, a monk, and a neuroscientist, has been billed as a ‘handbook for those in despair.’ Wax promises that it ‘answer every question you've ever had about: evolution, thoughts, emotions, the body, addictions, relationships, kids, the future and compassion.’ The Anxiety Journal by Corrine Sweet Journaling is a powerful tool for calming the mind and putting a different perspective on situations so it lends itself brilliantly to helping deal with anxiety. This book is filled with exercises to soothe stress on the go as well as keep track of how far you have come The Anxiety Solution by Chloe Brotheridge A simple and inspiring guide to reducing anxiety from a former sufferer and now qualified hypnotherapist. If anxiety is impacting your life this book is full of good news; mostly that anxiety is a learned behaviour (not our default state) and so it can be un-learned. NB The Anxiety Solution is the Shelf Help book of the month and you can join the conversation on Facebook or Instagram. Odd Girl Out by Laura James James in an autistic woman in a neurotypical world. She was diagnosed as autistic when she was an adult, wife, parent and professional and this memoir tracks the time after the diagnosis in her midforties, offering brilliant insight into being a grown-up negotiating the spectrum and what it means to be ‘different but not less’. Being Brave: My Story Through The Chaos Of Loss And Depression by Larry Meyler A self-published memoir that is the story of a huge journey – physically, emotionally and spiritually – but is also the story of a normal guy with late-diagnosed depression who could be your boyfriend, brother, dad, friend or son, trying to deal with life and his place in the world.


The 10 raw foods scientists say improve mental health the most: Carrots Bananas Apples Dark leafy greens Grapefruit Lettuce Citrus fruits Fresh berries Cucumber Kiwifruit

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Researchers also found that cooked and canned fruits and vegetables were only associated with elevating mood rather than any of the other mental health variables measured. And there are some raw vegetables that also only improve mood. These include:

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Celery Cabbage Red onion Tomato Mushrooms

Cooked, canned or frozen mood improvers are:      

Pumpkin Mixed frozen vegetables Potatoes Sweet potatoes Broccoli Aubergine


Monroe Community Mental Health Authority P.O. Box 726 1001 S. Raisinville Road Monroe, MI 48161


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