NAMI's "Turning over the furniture"

Yes, this is a REAL NAMI document.


How to prepare for an emergency
by 

D.J. Jaffe
Sometime, during the course of your loved one's illness, you may need the police. By preparing now, before you need help, you can make the day you need help go much more smoothly. There are three things to do. 

First, you should establish contact with your local precinct, before you need help. 
Secondly, you should have the attached info sheet filled out in duplicate, ready at all times. 
Thirdly, you should read the article at the end of this page on how to make 911 respond to your calls.
1. ESTABLISH CONTACT WITH PRECINCT

Someday your loved one may be missing from home or hospital. Normally, the police will not fill out a missing persons report & start looking for them until they are gone 24 hours. But by making arrangements beforehand, you can insure that if this happens to you, they will start looking immediately. Or, let's say your relative is becoming increasingly agitated & uncontrollable & you have to call the police to take them to a hospital. It is very likely that the police will go to the hospital of their choice, not yours. But by making arrangements beforehand, you can have a say in where that person is taken. In addition, if your relative is picked up for some crime (drugs, let's say); by making prior arrangements, you can help see that they go to a hospital instead of jail. Finally, it may make it easier for you to get someone involuntarily committed, if & when you have to do that. 

The way to make these arrangements is to call the "Community Patrol Officer Program" (C-POP Officer) at your local police precinct, now, before you need help. If you do not have a C-POP program (i.e, outside NYC), call the station commander.

Tell them that you have a MI relative at home & that you want to make the police aware of it, in case you ever need help. Tell them you are worried that if they are ever missing the police won't start looking until after 24 hours; or that if you need police to take your relative to a hospital, they won't go to the one you want; or that if your relative is busted, they will go to jail, instead of to a hospital. Tell the C-POP (pronounced, "see-pop") officer, that it was suggested that individuals with MI relatives contact the C-POP officers, before help is needed to make them aware of the situation, & that is why you are calling. The officer may think this is unusual, but you should do it anyway. FOLLOW THE CONVERSATION UP, WITH A LETTER ADDRESSED TO THE C-POP OFFICER & SEND A COPY TO THE PRECINCT COMMANDER. 

If you ever do need help, call 911 if it's an emergency. If not, call your local precinct. When the police come, mention the C-POP Officer & Precinct Commander by name. The police who come to your door do not know what to expect. By mentioning these names, you help calm them & help identify that it is not you who needs help, it is your relative. They will also be more likely to listen to you, & may even get the Commander on the phone or walkie talkie. Because you have prepared ahead of time, they are more likely to take the person where you want them to be taken, & to listen to you carefully. Be calm.
2. PREPARE INFORMATION & HAVE IT READY

If your relative needs emergency hospitalization, it will be extremely stressful to everyone. It is made more difficult by the myriad of questions that need to be answered. By having the answers to these questions written and ready, you can insure that the emergency hospitalization will not only be less stressful, but that your relative is more likely to get proper care. For instance, identify his doctor, & what medicines he is currently on, so those medicines can be continued, increased, or removed as appropriate. Indicate what hospital you use. Below is a form you should fill out. After filling it out, make two copies & keep one on hand (in your wallet) all the time. One for you, one for the police, one for the hospital. 


FILL OUT THE FOLLOWING FORM AND KEEP DUPLICATES HANDY

CRISIS INFORMATION PAGE (FOR POLICE/HOSPITAL/EMS)
Please take this person to _____________________hospital.


This person is not a criminal. He/she has a mental illness. Please treat with compassion and dignity. Thank you.


Name__________________________________Age_________ 

Address____________________________________________ 

____________________________________________________ 

Telephone_______________________Birthday____________ 

Social Security #______________Blue Cross #_____________

Blue Shield #_____________Other Med Ins #_____________

Is on SSI?_________Is on SSDI?________Other?__________ 

Eye Color______Hair Color_________Skin______________

Blood Type_________Eyeglasses?_______ 

Height_______________Weight__________________ 

Tatoos?Other Identifying Marks_______________________ 

Military/VA Status?__________________________________ 

Current Primary Diagnosis____________________________

Secondary Diagnosis__________________________________ 

Name of Commanding Officer where patient lives______________

Name of Community Officer where patient lives_________________________

Precinct Phone Number______________________________ 


Name of Doctor______________________________________ 

Doctor's Phone Number_______________________________ 

Name of Hospital____________________________________ 

Current Medicines and Dosages________________________ 

___________________________________________________ 

Suicidal?_____________Violent?________________________ 

Date of Last Hospitalization_________How Long?________ 
Date of Last Crisis____________________________________ 

Allergies?________________Hi Blood Pressure?__________

Name of outpatient program___________________________ 

Number of outpatient program________________________ 

Name of Case/Social Worker__________________________ 
Number of Case/Social Worker________________________ 

In Emergency Contact________________________________ 

Relationship to Patient________________________________ 

Address_____________________________________________ 

Day Phone__________________Eve. Phone____________

How to make 911 respond to your calls

(This article was based on information provided by Dr. Darwin Buschman, Chief Psychiatrist, Manhattan Mobile Crisis Intervention Services.) 

Individuals with neurobiological disorders ("NBD" formerly known as serious mental illnesses) are occassionaly danger to themselves, HYPERLINK "suicide.html"suicidal and/or danger to others. When this happens, you may want to call 911.

It is often difficult to get 911 to respond to your calls if you need someone to come & take your MI relation to a hospital emergency room (ER). They may not believe that you really need help. And if they do send the police, the police are often reluctant to take someone for involuntary commitment. That is because cops are concerned about liability. They don't want to be sued for taking someone to the ER involuntarily. Another reason is that they must stay with the person until he or she is admitted. This can take between 2-48 hours. Cops don't want to sit in ER; sergeants don't want to take two police off the streets. Following is how you can make 911 & the police overcome their reluctance to help.

When calling 911, the best way to get quick action is to say, "Violent EDP." Or "Suicidal EDP." EDP stands for Emotionally Disturbed Person. This shows the operator that you know what you're talking about. Describe the danger very specifically. "He's a danger to himself" is not as good as "This morning my son said he was going to jump off the roof." Be specific. "He's a danger to others" is not as good as "My son has just struck a neighbor for no reason." Also, give past history of violence. This is especially important if the person is not acting up. Again, be specific. "Every time my son gets psychotic, he has hurt himself. Last spring, he cut his 
wrists. I think he's going to do it again."

When the police come, they need compelling evidence that the person is a danger to self or others before they can involuntarily take him or her to ER for evaluation. If the person stops acting out by the time police arrive, this can be difficult. Again, give specific recent examples of danger.
Realize that you & the cops are at cross purposes.
You want them to take someone to the hospital. They don't want to do it. You need to get on common ground with the cops to gain their cooperation. Say, "Officer, I understand your reluctance. Let me spell out for you the problems & the danger. I understand that if you take my son to the ER involuntarily, you'll have to wait with him until the doctors make a decision on whether to admit. I also understand your concern about litigation if you take him involuntarily. Therefore, why don't we work together so my son goes voluntarily." Cops will often change their attitude dramatically if you say this. If a person goes voluntarily, the cops don't have to stay in the ER. They don't have to use handcuffs. If a person goes involuntarily, they go the same way, except in handcuffs. This can often be used to convince a person to go voluntarily. You can say, " I know you don't want to go, but I think you need to go." The cops can say, "You're going to go one way or another, cuffs or no cuffs." Usually the person will go voluntarily when faced with this choice. 

Once the person is taken to the ER, cops leave. So it's a good idea to have a family member accompany the patient. Let the ER security guard, triage nurse, & others know that the person is MI & a danger to self or others. When you go to ER, make sure you have the "How to Prepare for Emergencies" form that is in this newsletter (Note: This is a form with the name, address, SS#, Med history, current med, diagnosis, name and number of doctor, name and number of next of kin, insurance, etc. In otherwords, all the info you would be asked in an emergency). 
911 should be first resort in an immediate emergency, & the last resort when it's not. If your family member needs help, not necessarily hospitalization, try Mobile Crisis Intervention Services. 

While AMI/FAMI is not suggesting you do this, the fact is that some families have learned to 'turn over the furniture' before calling the police. Many police require individuals with neurobiological disorders to be imminently dangerous before treating the person against their will. If the police see furniture disturbed they will lusually conclude that the person is imminently dangerous. 

Read How and why to HYPERLINK "../advcacy/invol.html"change involuntary treatment laws in your state.

THANK YOU FOR YOUR SUPPORT WHICH MADE IT POSSIBLE FOR US TO PROVIDE THIS INFORMATION TO THOSE WHO COULD BENEFIT FROM IT.

NAMI/ NYC (formerly AMI/FAMI) does not endorse any medicines or treatments. This info is a public service as part of our efforts to educate and help others affected by these disorders. Do not rely on it. Consult your doctor before making any decisions. HYPERLINK "../AMIFAMI%20Description.html"NAMI/NYC is a non-profit dedicated to improving the lives of people with neurobiolgical disorders ("NBD", formerly known as 'mental' illness) through education, advocacy, support, and research. If this has been useful to you, HYPERLINK "../AMIFAMI%20Description.html" \l "anchor1400327"PLEASE JOIN US. Send a deductable contribution of $30 (or more) to NAMI/NYC, 432 Park Avenue South, New York, NY 10016 to get on our mailing list or call (212) 684-3AMI. To join chapter outside NYS: 1 800 950 NAMI. This was downloaded from http://www.schizophrenia.com/ami
Families Helping Families is what NAMI/NYC is all about. 
Thank you for helping us help others.

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AMI/FAMI thanks Brian Chiko of HYPERLINK "http://www.schizophrenia.com/"schizophrenia.com for this space and his encouragment and guidance. Posted by D.J. Jaffe HYPERLINK "../DJ.html"djjaffe@aol.com

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PAGE 1

NAMI executive's moment of truth: "Why hasn't my son had a physical?"

From http://www.healthyplace.com/depression/shocked-ect/nami-and-censorship/menu-id-1362/
Publisher's Note by Dan E. Weisburd (former NAMI executive)

WELLNESS issue

"What does it take to make you wake up, Dan?" A voice broke into my sleep. I sat up startled. The clock read, 3:15 A.M. "Why hasn't David had a physical?" Was I asking myself? Where had I been? My eldest son has had schizophrenia for 19 years--as many years as he hasn't had it. Do I remember getting him a physical? No. "Where have you been, Dan?" the now exasperated voice demanded. It sounded somewhat like my stern, long-dead father, or maybe it was my internal scolding severest critic--myself. "You'd know full well if David had a physical. He'd have told you. And you'd know the results! You've let him down again, guy. You're just another negligent know-it-all fraud of a family member telling the world he deserves better, and how much you love him!"

It was 10 A.M. before I could reach Martha Long, the director at The Village ISA in Long Beach, the excellent psychosocial rehabilitation program I'd helped to conceptualize, and where my son was now a member. "No, we don't routinely get them physicals, Dan," she answered apologetically. "I'll be happy to pay for a simple Lipid panel, if there's no budget for it," I said. "He eats lots of Chinese food--grease and sugar--loves steaks, and burgers and cheese-- and we both know he rarely gets any real exercise." She agreed to get David an appointment for a blood draw, because, after all, he probably had my genes and I've had a heart attack, five bypasses and three heart surgeries. Given David's life style and genetic inheritance, he could be courting disaster at age 39.

"He is doing well at his job. And he has a lot of friends, here, He seems much happier." She ended on that optimistic note, and I knew it was true. David was thriving on the life the Village staff had helped him attain. He was committed to recovery.

A couple weeks later I got what would be only the first of many reports. Cholesterol 300. Triglycerides 700. Terrible! Outrageous! Much worse than my readings when I'd had my heart attack. "What does the doctor say about that?" I asked. "They'll test him again in three months," answered his personal service coordinator. "What kind of doctoring is that? That's not good enough," I replied and asked for an immediate retest, "And have someone be sure David's done the necessary overnight fast. That alone could skew the results." "Yes, sir," said the voice at the other end.

The retest gave even worse results followed by the same lame "...retest in three months" reply. I had done a little research of my own between the two tests. It seems that the marvelous new atypical medications significantly elevate both cholesterol and triglycerides in most patients who take them. David was on high levels of both Clozaril and Zyprexa. With our family history he could be destined for coronary disaster--especially as a two-pack a day inhaling smoker whose rumbling cough is frightening to witness. Why hadn't his psychiatrist of eight years warned us?

I brought David home, and took him to his mother's internist, Gilbert Ross, an old family friend, who agreed to be David's principal physician, if David agreed to do what he prescribed. David said, yes. Ross would offer his services pro bono because he didn't want to do the MediCal (Medicaid) paper work, and he knew that if I paid (as a third party) it might be used by the bureaucracy to jeopardize David's SSI and MediCal eligibility.

David's blood work came back from Ross' lab worse than ever, and this time I had been the fasting enforcer. Because of David's profile, Dr. Ross prescribed large daily doses of Lipitor, checked with MediCal and of course they refused to pay for it, so he gave David all the samples he had, and we began a six-week test. At the end of six weeks David's readings were normal! Cholesterol down from 320 to 184. Triglycerides down from 700-plus to 130! Ross wrote the paperwork, and now MediCal had to pay for the costly Lipitor. But what about all the others who are lucky enough to get the new breakthrough atypical antipsychotics? Who would advocate for them?

I called some top people at Los Angeles County Mental Health. No one wanted to reply for the record. Off the record I learned they knew of the problem, and that few if any clients got physicals. Who will pay was the question. And if they got physicals, given their below poverty level lifestyles, medical problems were bound to surface. Who will pay for the needed medical care? It was a question of reimbursement--plain and simple. "Has this non-productive population been written off as expendable? Are they, in reality, putting aside politically correct rhetoric, discard people?" I didn't expect an answer. And I got none.

As we read this issue about wellness we would do well to remember that treatment works and that recovery is possible, but never for a moment must we forget that enlightened social policy and dollars to do the job is what will make what is needed available. And, how do we get that? # # # We gratefully acknowledge the efforts of our co-editors Dede Ranahan, Diane Vines, Suzane Wilbur, and Ed Diksa who brought in a majority of our authors.

Link

Dan, if you read your words at this post, please get your son a REAL physical - not one which supports erroneous medical theories upheld by the the pharmaceutical industry and paid for in human lives.
The 29 testable, verifiable and correctable causes of schizophrenia are listed here.
You will find information on drug withdrawal in our Links column.
And we wish you both the best of luck!

Mental Health & Patient Safety: Broadening our Understanding. Building the Momentum

"Mental Health & Patient Safety: Broadening our Understanding. Building the Momentum

Presented by Ontario Hospital Association

Course name: Mental Health & Patient Safety: Broadening our Understanding. Building the Momentum
Course duration: September 17, 2009 - September 18, 2009
Location: Marriott Eaton Centre Hotel
525 Bay Street
Toronto, Ontario
Canada
Course code: EP 144

Join colleagues from across Canada on September 17 & 18 as the Ontario Hospital Association and the Canadian Patient Safety Institute jointly launch the research paper, “Patient Safety in Mental Health”. The first paper of its kind in Canada defines the patient safety issues unique to mental health and highlights the important opportunities for improving patient safety in mental health.

The Ontario Hospital Association, in partnership with the Canadian Patient Safety Institute, is pleased to present this one-day national conference on patient safety in mental health. This conference will provide participants with the opportunity to hear about current strategies to address some of the critical patient safety issues in mental health from leading experts across Canada and the US.

Topics to be addressed include: the key findings and themes from the research, using evidence and best practice to provide safer care, suicide and risk assessment, transitions of care, and creating safe environments for both patients and staff."

Link: http://www.oha.com/Education/Pages/CalendarofEventDetails.aspx?eventid=EP%20144


We'd like to see a focus on proper physical workups for diagnosis and healing through nutrition. Drugs are a leading cause of dependency, disability, morbidity and mortality.

Remember the Primum - "First, do no harm".

THE EXTRAORDINARY WALKER EXAM helps us understand diagnosis and correction of the real physical causes of mental disorders....



"The following Field Manual was compiled by order of the California legislature. It reveals that 39% of psychiatric patients studied were found to have active medical diseases, many of which caused or worsened their mental condition. The Manual explains the importance of screening patients for disease and lays out a step-by-step process for doing so.
Prepared for theCalifornia Department of Mental Health and Local Mental Health Programs Pursuant to Chapter 376, Statutes of 1988 Assembly Bill

By Lorrin M. Koran, M.D., Department of Psychiatry and Behavioral Sciences,
Stanford University Medical Center
Stanford, California 1991

...The SB 929 Study team performed complete medical evaluations of 476 patients drawn from 24 county mental health programs spread across four Northern California counties and of 53 patients at Napa State Hospital.

The most important findings of that study are: 31,32 para 1. Nearly two out of five patients (39%) had an active, important physical disease.

2. The mental health system had failed to detect these diseases in nearly half (47.5%) of the affected patients.

3. Of all the patients examined, one in six had a physical disease that was related to his or her mental disorder, either causing or exacerbating that disorder.
4. The mental health system had failed to detect one in six physical diseases that were causing a patient’s mental disorder. (Five of 33 cases of physical disease causing a mental disorder had not been detected.)

5. The mental health system had failed to detect more than half of the physical diseases that were exacerbating a patient’s mental disorder. (Twenty-seven of 49 cases of physical disease exacerbating a mental disorder had not been detected.)"
Link - MEDICAL EVALUATION FIELD MANUAL

More on the physical causes of mental symptoms can be found here.