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{ timecode: 0, handler: 'blob', id: 1, data: {text: 'REPRESENTATIVE JOE ARMSTRONG: As we move into our next panel we’re going to ask them to move up. But to introduce that panel is the Vice Chair of NBCSL Health Committee. He is also a legislative '}},
{ timecode: 14, handler: 'blob', id: 2, data: {text: 'leader, he is the minority leader in the Virgin Islands, he was educated at Fisk University with a dual degree, from a program with a dual degree at Meharry Medical College and Fisk University, he has '}},
{ timecode: 31, handler: 'blob', id: 3, data: {text: 'a Bachelor’s, Associate of Arts, and is a certified healthcare administrator. He was elected to pubic office in 1988 from the St. Croix district. He has hosted NBCSL several times in the Virgin '}},
{ timecode: 49, handler: 'blob', id: 4, data: {text: 'Islands and let’s bring on our vice chair to introduce the next panel, Representative Usie Richards. REPRESENTATIVE USIE RICHARDS: Good morning, and good morning to the individuals that have '}},
{ timecode: 73, handler: 'blob', id: 5, data: {text: 'also joined us in Columbia, South Carolina and those in Jackson, Mississippi. It is indeed an honor and a pleasure for me to be able to not only introduce this panel but to be a moderator for a topic '}},
{ timecode: 86, handler: 'blob', id: 6, data: {text: 'that I consider not only interesting, but at - sometimes very confusing. I say that because when we speak of culture, mental health and stigmas... at least in my mind, I understand culture to be a way '}},
{ timecode: 101, handler: 'blob', id: 7, data: {text: 'of life and irrespective of whether or not we believe that we can look at culture simply as African Americans and as black, that culture varies, it varies in each and every different jurisdiction and '}},
{ timecode: 112, handler: 'blob', id: 8, data: {text: 'so that we are intended to have an opportunity to hear from individuals who will be able to assist us not only in beginning to understand what their perspectives are as it relates to culture, but more '}},
{ timecode: 124, handler: 'blob', id: 9, data: {text: 'importantly as we speak about mental health we look at stigmas as we are so often reminded of that people may say simple things like don’t judge a book by the cover or may believe that '}},
{ timecode: 138, handler: 'blob', id: 10, data: {text: 'perception is everything when usually what we perceive to be actually is not and so that I want to begin to introduce individuals who are here to be able to lead us through this discussion. The first '}},
{ timecode: 153, handler: 'blob', id: 11, data: {text: 'panelist that we have with us a social worker, has a Master’s in social work, Ms. Wilma Townsend, who has her own consulting company, the president of WLT Consulting, specializing in mental '}},
{ timecode: 167, handler: 'blob', id: 12, data: {text: 'health recovery, consumer involvement, cultural competence. She\'s also served as a member of the American College of Mental Health Administration, a founding member of the Multiethnic Advocates for '}},
{ timecode: 181, handler: 'blob', id: 13, data: {text: 'Cultural Competence in Ohio. She is also a current board member of the National Leadership Council on African American, a recognized international consumer leader in the recovery movement, the author '}},
{ timecode: 193, handler: 'blob', id: 14, data: {text: 'of a number of books, The Emerging Best Practices in Mental Health Recovery, Consumers in the Mental Health Workforce: A Handbook for Community Providers. She has also been involved in Understanding '}},
{ timecode: 205, handler: 'blob', id: 15, data: {text: 'My Recovery Process, A Trainers Guide and Participants Handbook. She has provided consultation to a number of individuals throughout North America and a number of states to include Pennsylvania, Utah, '}},
{ timecode: 218, handler: 'blob', id: 16, data: {text: 'North Carolina, Hawaii, Ohio. Also, outside of the United States, in Canada. Please welcome Ms. Wilma Townsend. I will introduce everyone before you come up to the microphone. She will be followed by '}},
{ timecode: 234, handler: 'blob', id: 17, data: {text: 'Dr. Altha Stewart who is a psychiatrist, a healthcare administrator, a nationally recognized consultant in the public sector and also on minority issues in mental healthcare. She served as a '}},
{ timecode: 250, handler: 'blob', id: 18, data: {text: 'consultant for a variety of community organizations and groups, and most recently the National Leadership Council on African American Behavioral Health. She served as an executive director of the '}},
{ timecode: 263, handler: 'blob', id: 19, data: {text: 'Detroit-Wayne County Community Mental Health Agency. She has also served on the historic 1999 White House Conference on Mental Health. She has numerous awards to include the 2001 Welcome Back Award in '}},
{ timecode: 277, handler: 'blob', id: 20, data: {text: 'psychiatry from the Eli Lilly company, the 2002 NAMI Award which is the Exemplary Psychiatrist Award, and she is also a past president of the Association of Women Psychiatrists and the Black '}},
{ timecode: 293, handler: 'blob', id: 21, data: {text: 'Psychiatrists of America, please welcome Dr. Altha Stewart. We also have with us Ms. Tara Lubin, I hope I pronounced your name correctly, from the National Conference of State Legislators, who serves '}},
{ timecode: 307, handler: 'blob', id: 22, data: {text: 'as a senior policy specialist for the Forum for State Health Policy Leadership. She’s also specialized in the health workforce issues such as mental health, oral health and how issues related to '}},
{ timecode: 320, handler: 'blob', id: 23, data: {text: 'prisoner reentry, has written and contributed to a number of articles and papers specifically focusing on general healthcare workforce issues, racial disparities in oral health, Alzheimer’s '}},
{ timecode: 333, handler: 'blob', id: 24, data: {text: 'disease, and quality care. She received her Bachelor’s degrees in sociology from the American University. For those of you who do not recognize our last speaker, she is sure not the Minority '}},
{ timecode: 345, handler: 'blob', id: 25, data: {text: 'Whip from the Ohio state, you are replacing, they have a little agenda in front of them that has been revised and so I want to make sure they don’t mistake you for the state senator ----Minority '}},
{ timecode: 363, handler: 'blob', id: 26, data: {text: 'Whip Miller from Ohio. She is replacing that speaker, please welcome Ms. Asia Casey who is a young person and a master social work student at Michigan State University, an instructor, a recruitment '}},
{ timecode: 377, handler: 'blob', id: 27, data: {text: 'director of the Adolescent Division Program at MSU, she is also involved in intensive family care at the community mental health in Lansing, Michigan, a member of the Multicultural Students and Social '}},
{ timecode: 390, handler: 'blob', id: 28, data: {text: 'Work at Michigan State University, please welcome Asia Casey. Did I get that correct? And before I turn the microphone over to the speakers let me quickly share these quick quotes. I am reminded of '}},
{ timecode: 406, handler: 'blob', id: 29, data: {text: 'one of them, it says “It’s not the load that breaks you down, but it is the way you carry it.” These individuals are going to be able to inform us and hopefully we\'ll be able to '}},
{ timecode: 417, handler: 'blob', id: 30, data: {text: 'learn from them how to make sure the load is appropriately carried by those of us in the community. It said if you can’t change your fate then you must change your attitude and hopefully you can '}},
{ timecode: 430, handler: 'blob', id: 31, data: {text: 'help us change our attitudes. Welcome, Ms. Townsend. WILMA TOWNSEND: First of all, thank you very much for inviting me. I need to say to you before I even get started, this is a very passionate '}},
{ timecode: 444, handler: 'blob', id: 32, data: {text: 'discussion for me. I caught a couple of legislators yesterday at the reception and I think I kind of bit their ear off because it is very passionate for me and you’ll see why by the time I get '}},
{ timecode: 459, handler: 'blob', id: 33, data: {text: 'done. First of all, when one decides that they really need treatment and that either they themselves decide to go in or somebody forced them to go in, the last thing you need is to have somebody up in '}},
{ timecode: 479, handler: 'blob', id: 34, data: {text: 'your face letting you know that your culture don’t make a difference. So, culture competence to me is about persons who work in the system knowing how to work with me within my culture and '}},
{ timecode: 498, handler: 'blob', id: 35, data: {text: 'believe me, my culture makes a difference in my treatment and in my wellness. A lot of people don’t understand that. They think it’s about the medicine. The medicine is a small part of it, '}},
{ timecode: 513, handler: 'blob', id: 36, data: {text: 'a very small part of it. I’m a professional. I’m also someone who has major depression. You know what, I’ll shout it from the hilltop because there’s too many of us who '}},
{ timecode: 529, handler: 'blob', id: 37, data: {text: 'won’t go and get the treatment that they need to be able to do that. I worked in the system before I was diagnosed. I come from a family where my grandfather also suffered from mental illness. '}},
{ timecode: 545, handler: 'blob', id: 38, data: {text: 'My grandmother lived with him for 10 years with that illness. They had been married for years. When they decided it was time to take him for some treatment, which was many years ago, there '}},
{ timecode: 565, handler: 'blob', id: 39, data: {text: 'wasn’t a mental health center to service us as African Americans. At this point, I lived in the state of Maryland. Because we came from a very small rural community and because the family unit '}},
{ timecode: 581, handler: 'blob', id: 40, data: {text: 'and the church was everything, when it came time to take him to get services there were five carloads of Thomases that went to Crownsville State Hospital to take him to get services. What they ended '}},
{ timecode: 597, handler: 'blob', id: 41, data: {text: 'up with was someone coming out talking to them telling them, “Yeah he’s crazy all right. Go home and think about him as dead, okay? Because he’s going to be here forever.” My '}},
{ timecode: 613, handler: 'blob', id: 42, data: {text: 'family didn’t know what to do. Had no idea what to do. They went back home, they had a meeting. They decided that maybe the professionals knew what they were talking about as it came to giving '}},
{ timecode: 631, handler: 'blob', id: 43, data: {text: 'him treatment, because they didn’t know anything about this, but they sure as heck didn’t know what they were talking about when it came to matters of the heart and that nobody was going '}},
{ timecode: 641, handler: 'blob', id: 44, data: {text: 'to tell them to go home and see him as dead, and never go see him again. So, every Sunday after church, some family members would go and see him. You know what? That hospital hated, hated our family '}},
{ timecode: 657, handler: 'blob', id: 45, data: {text: 'for coming to do that, because that meant we were asking questions. That meant we had certain expectations, and they didn’t like that. I ran away from the mental health system for years. Every '}},
{ timecode: 679, handler: 'blob', id: 46, data: {text: 'time I went to school they gave me placement at a mental health center, and I said, “I ain’t doing this. I’m not doing it.” Finally, I worked in Michigan, in the upper '}},
{ timecode: 692, handler: 'blob', id: 47, data: {text: 'peninsula, with the Native Americans and was a director of their Indian Child Welfare Agency. I did a lot of mental health. Because it wasn’t called mental health it was okay. When I left there '}},
{ timecode: 709, handler: 'blob', id: 48, data: {text: 'I ended up in the mental health system in Ohio and ended up being the director of their child welfare agency and at that point I decided, okay, what’s going on here? I’m staying here for '}},
{ timecode: 722, handler: 'blob', id: 49, data: {text: 'maybe two or three months at the most. I get the phone call to come back home to Maryland. My grandfather had died. Y\'all, he stayed in that hospital for 40 years, and that’s where he died. It '}},
{ timecode: 736, handler: 'blob', id: 50, data: {text: 'became a passion at that point with me that this is not what life is supposed to be about for someone who suffers from mental illness. And at that point I decided, okay God, I got the message, '}},
{ timecode: 751, handler: 'blob', id: 51, data: {text: 'I’m here. So, I’m here, folks. Okay. When I became ill one of the things that happened to me was around things that I experienced that was related to my culture. When I went to the doctor '}},
{ timecode: 771, handler: 'blob', id: 52, data: {text: 'to express that he ended up saying to me, “I want to put you in the hospital.” And I told him, “I don’t think so. I don’t think so. Because as long as I can stand and do '}},
{ timecode: 786, handler: 'blob', id: 53, data: {text: 'this, this, and this, and take some responsibility to work with my illness and you work with me, then I don’t need to be in a hospital. But, I will say to you if these things happen to me - we '}},
{ timecode: 802, handler: 'blob', id: 54, data: {text: 'can make a contract - then you have my permission to put me in the hospital.” That doctor understood. He understood my culture and where I was coming from to be able to work with me. One of the '}},
{ timecode: 824, handler: 'blob', id: 55, data: {text: 'ways in which I was able, though, to be able to understand how to have that conversation with my doctor is I understood that there was a recovery process in mental illness. Most people don’t '}},
{ timecode: 838, handler: 'blob', id: 56, data: {text: 'understand that. Most people understand - think that once you have an illness that that illness is with you forever. And it is, but that you will stay very sick for the rest of your life and that '}},
{ timecode: 855, handler: 'blob', id: 57, data: {text: 'there is no recovery mode. There is. So, what’ s recovery? Recovery is about wellness, folks. It’s real simple. There’s a bunch of words I put up here that came from the New Freedom '}},
{ timecode: 869, handler: 'blob', id: 58, data: {text: 'Commission Report and it’s about living in your community and being a part of your community. But it’s really about you taking responsibility, working in partnership with some '}},
{ timecode: 881, handler: 'blob', id: 59, data: {text: 'professionals or others and having that sense that your life is not totally taken away from you. Unfortunately, a lot of our system, just as Dr. Poussaint pointed out in his presentation last year, '}},
{ timecode: 899, handler: 'blob', id: 60, data: {text: 'it’s set up where they make you think you’re ill and your illness is everything about you. So, what ends up happening is a lot of African Americans who come into our system to get '}},
{ timecode: 913, handler: 'blob', id: 61, data: {text: 'services, they’re frightened to death. They don’t know what’s going on. Then all of a sudden you get a professional who’ll sit up there and give you medication and say, now go '}},
{ timecode: 923, handler: 'blob', id: 62, data: {text: 'over here to this day treatment program because you can’t work any more. Go over here and sit down and watch TV because you don’t have a voice any more. Then that medication that they give '}},
{ timecode: 935, handler: 'blob', id: 63, data: {text: 'to you is - the dosage, many times it’s so high that you end up with side effects that you don’t understand and you can’t function at your best abilities so you think this is the way '}},
{ timecode: 950, handler: 'blob', id: 64, data: {text: 'you’re supposed to live for the rest of your life. I’m here to tell you that is not the case. I am not sitting watching TV. I am not in the day treatment program. It does not affect my '}},
{ timecode: 964, handler: 'blob', id: 65, data: {text: 'brain that I cannot think. But, if you put me on medication that’s so high, it does. It does. And hear me: I’m not saying that we don’t need medication. We know with research that '}},
{ timecode: 983, handler: 'blob', id: 66, data: {text: 'medication may affect us differently, that’s why the last two presenters, it’s so important what they said. You’ve got to have those clinical trials on us. I’ll be the first '}},
{ timecode: 995, handler: 'blob', id: 67, data: {text: 'one to tell you, I’m not sitting up there running for no clinical trials either though. Okay. Because I don’t feel safe and I’ve got to feel safe. So that means the people '}},
{ timecode: 1011, handler: 'blob', id: 68, data: {text: 'that’s doing the clinical trials, I want them to look like me. I want to feel like they have my heart in mind when they do these clinical trials. So, we want to be able to get the best that the '}},
{ timecode: 1031, handler: 'blob', id: 69, data: {text: 'mental health system can provide for us. And, we want to be able to do our best to live out in the community and be productive citizens out in the community. That’s what recovery is about. '}},
{ timecode: 1045, handler: 'blob', id: 70, data: {text: 'People have talked all day long about the different barriers and I’m not going to read through them because I think all you all already know them. I want you to know how these barriers have an '}},
{ timecode: 1060, handler: 'blob', id: 71, data: {text: 'effect on us, the individuals that are receiving the services though. I don’t know whether you all know this or not, but do you know the death rate for individuals, all individuals, who receive '}},
{ timecode: 1073, handler: 'blob', id: 72, data: {text: 'mental health services is 25 years of death greater than the general population. That’s for everybody. The National Leadership Council, now I’ll talk a little bit more about this, have '}},
{ timecode: 1088, handler: 'blob', id: 73, data: {text: 'asked that the next study that they’re getting ready to do on the death rate for mental illness. Now break out, what is it for African Americans? We suspect it’s probably 35 years greater. '}},
{ timecode: 1101, handler: 'blob', id: 74, data: {text: 'We’re dying in our 40s and 50s. That’s inhumane. We won’t have a community. The suicide rate for African American males has gone up five times greater than what it was just 10 years '}},
{ timecode: 1126, handler: 'blob', id: 75, data: {text: 'ago. We never committed suicide before. Our black males between the age of 10 and 25 are committing suicide left and right, and that’s not even including the ones that are in gangs that go out '}},
{ timecode: 1143, handler: 'blob', id: 76, data: {text: 'and start shooting up and hoping that they get shot. We’re losing our children. There are more African Americans with mental illness in our prisons than receiving services in our mental health '}},
{ timecode: 1166, handler: 'blob', id: 77, data: {text: 'centers. That’s because when we get ill now and the police come and pick us up, they pick us up, put the crime to us, send us on to prison versus sending us for treatment. And it also has a lot '}},
{ timecode: 1186, handler: 'blob', id: 78, data: {text: 'to do with us, because of our fear of admitting that we have an illness. Our fear of youths in the mental health system and because we haven’t had people to advocate, don’t treat us this '}},
{ timecode: 1203, handler: 'blob', id: 79, data: {text: 'way when we do come in. We did a study in Ohio years ago on looking at - we assumed that African Americans did not go in for treatment after they left the state hospitals. What we found out was 25% of '}},
{ timecode: 1221, handler: 'blob', id: 80, data: {text: 'them left after the first visit and never returned. Another 25% left after the second visit. When we went out and then talked to - because my job a lot of times is to go and talk to the individuals '}},
{ timecode: 1237, handler: 'blob', id: 81, data: {text: 'who are receiving the services. So when we went out and talked to them and did a survey and found out that most of them said they left because there wasn’t anybody in there that looked like them '}},
{ timecode: 1249, handler: 'blob', id: 82, data: {text: 'that could talk to them about them. That’s a disgrace. So, we need to make sure that our social work students go into the mental health field and understand on how to be able to use and work '}},
{ timecode: 1267, handler: 'blob', id: 83, data: {text: 'within that. Some of the practices that we know that does work. First of all it’s a good, correct diagnosis with correct medications. There have been studies on top of studies on top of studies '}},
{ timecode: 1287, handler: 'blob', id: 84, data: {text: 'that shows the misdiagnosis of African Americans. Most people who show up at our mental health centers get diagnosed with schizophrenia. Another piece of information for you. It wasn’t until the '}},
{ timecode: 1307, handler: 'blob', id: 85, data: {text: '1970s, wasn’t that long ago that most white clinicians didn’t believe that African Americans could suffer from depression. Because we are happy people. So, we got the diagnosis of '}},
{ timecode: 1327, handler: 'blob', id: 86, data: {text: 'schizophrenia. If you get the wrong diagnosis you get the wrong medication. If you get the wrong medication your symptoms stay the same and you still suffer. So, why would you trust that system? There '}},
{ timecode: 1348, handler: 'blob', id: 87, data: {text: 'needs to be a change with it. Working with the natural support entities of African American communities. We know that working with the churches and the natural support systems make a huge difference. '}},
{ timecode: 1362, handler: 'blob', id: 88, data: {text: 'Huge difference. Getting them to even understand that recovery is possible. We have a number of places where they’re beginning to work with African American churches. One of our board members is '}},
{ timecode: 1378, handler: 'blob', id: 89, data: {text: 'working with T.D. Jakes. He is now doing a whole thing on mental illness and behavioral health. It is making a huge difference. People are coming in and saying, “I think - I don’t feel '}},
{ timecode: 1396, handler: 'blob', id: 90, data: {text: 'good and I’m crying all the time. Help.” Accessing the community support services around housing, support of employment and peer support. Real important. And then having family and '}},
{ timecode: 1413, handler: 'blob', id: 91, data: {text: 'consumer support groups. There are a number of support groups around the country. Someone asked a question from Mississippi that was from NAMI - it’s a family support group. We don’t have '}},
{ timecode: 1431, handler: 'blob', id: 92, data: {text: 'that in many of them that’s African American. We don’t have that many consumer-operated services or support groups for our consumers. We know what we know from research is that when you '}},
{ timecode: 1443, handler: 'blob', id: 93, data: {text: 'get mental health services and you’re connected to a support group your chances of reintegrating in the community and your recovery being higher is greater than someone who just goes in for '}},
{ timecode: 1460, handler: 'blob', id: 94, data: {text: 'mental health services alone. So, there’s a number of best practices. The policy area. I’m not going to go through these. I’m just going to say to you, and this is my challenge to '}},
{ timecode: 1477, handler: 'blob', id: 95, data: {text: 'you: when I was in Ohio I was the director of the Office of Consumer Affairs and I’m really sorry that Senator Miller isn’t here because I was hoping that he was going to come and talk '}},
{ timecode: 1496, handler: 'blob', id: 96, data: {text: 'about this. He and I partnered. I worked for the state, but I fed him every piece of information there was. He committed with three other black legislators that every year, every year, he went and had '}},
{ timecode: 1519, handler: 'blob', id: 97, data: {text: 'asked for a meeting with the director of mental health. He had three questions every year for them. What’s the issues? What’s the outcomes? How are you paying for it? But he already knew '}},
{ timecode: 1539, handler: 'blob', id: 98, data: {text: 'what the answers were because I already fed it to her, so when she gave him, or if she did give him something different he was ready. Even if she gave him the same thing, which most of the time, 99% '}},
{ timecode: 1553, handler: 'blob', id: 99, data: {text: 'of the time she did he would say it’s not enough. Now, what’s our agenda for next year? It helped me to be able to carry out an attempt to get to a culturally competent system of care. I '}},
{ timecode: 1570, handler: 'blob', id: 100, data: {text: 'was able to bring together all of the agencies that serviced the African American communities. I was able to set up some of those family and consumer support groups. I was able to look at the research '}},
{ timecode: 1586, handler: 'blob', id: 101, data: {text: 'and say okay, this is what the research is saying. The clinical trials, my questions last night. What we ended up finding out was a lot of drug companies has these clinical trials and very rarely, '}},
{ timecode: 1602, handler: 'blob', id: 102, data: {text: 'like we said what we included. There was one that did include us. It was a professor from, now he’s at Howard University, who did a clinical trial for African Americans. What we found out was '}},
{ timecode: 1615, handler: 'blob', id: 103, data: {text: 'that that medication that they were looking out was more effective for African Americans than it was for whites. But when it came time to divvy it out, because they was charging, it was something like '}},
{ timecode: 1631, handler: 'blob', id: 104, data: {text: '$9,000 to get these pills into gear and the company says, African Americans folks ain\'t going to pay for this. So, what did they do? They didn’t market to us. In fact, not only did they not '}},
{ timecode: 1645, handler: 'blob', id: 105, data: {text: 'market it to us, they never released the findings. That’s what was even more inhumane.1 Because no one knew that they should be looking at that population. Lastly, let me say that I’m the '}},
{ timecode: 1663, handler: 'blob', id: 106, data: {text: 'president of the National Leadership Council on African American Behavior Health. We are an organization in which we are advocates for mental health issues at the national level. Our group is made up '}},
{ timecode: 1679, handler: 'blob', id: 107, data: {text: 'of mental health professionals, family members and consumers. We want to be able to partner with legislators, different organizations to push the agenda for what should be happening correctly for best '}},
{ timecode: 1695, handler: 'blob', id: 108, data: {text: 'quality services for African Americans. I have a little postcard that any of you can get. I will also say that for NLC, we represent all of those African American mental health agencies who sometimes '}},
{ timecode: 1717, handler: 'blob', id: 109, data: {text: 'can’t have a voice, because if they do it could cut their funding off. But we can have the voice for them. So, thank you very much and I am just so honored and so thankful that you have put this '}},
{ timecode: 1735, handler: 'blob', id: 110, data: {text: 'on your agenda. This has been something, I have been working in the field for 30 years, this has been something that we have been looking forward to for years, so thank you very much. DR. ALTHA '}},
{ timecode: 1752, handler: 'blob', id: 111, data: {text: 'STEWART: Good morning. I’ve been given the difficult task first of all of following Alvin Poussaint. You started off with my mentor and role model in the field, who in fact, challenged me to '}},
{ timecode: 1769, handler: 'blob', id: 112, data: {text: 'become a doctor in the first place and I wound up becoming a psychiatrist. So, first I have to deal with that. Then, I have to follow my boss. This is just, God testing me, I don’t know. So, '}},
{ timecode: 1784, handler: 'blob', id: 113, data: {text: 'this is God’s way of testing me and then I stand up here... I was sitting there listening to the opening this morning and Alicia mentioned a group that I’m the immediate past president of, '}},
{ timecode: 1794, handler: 'blob', id: 114, data: {text: 'the American Psychiatric Foundation and the award that Lilly gave them, the grant that Lilly gave them to help veterans. Terry Williams was mentioned. I had the honor of interviewing Terry Williams '}},
{ timecode: 1806, handler: 'blob', id: 115, data: {text: 'for the American Psychiatric Foundation last year right after the publication of her book, Black Pain: It Just Looks Like We’re Not Hurting and I’m standing here with my own - I’m '}},
{ timecode: 1818, handler: 'blob', id: 116, data: {text: 'from Memphis, Tennessee, with my own state representative whose passion is mental health. So, I feel like this is memory lane for me. I don’t know all of you, but I feel very much at home. '}},
{ timecode: 1829, handler: 'blob', id: 117, data: {text: 'Finally, I feel like Wilma and I make a perfect bookend because you’ve heard now the passion from the person who has had to use the system and not always found it user friendly, shall we say. I '}},
{ timecode: 1843, handler: 'blob', id: 118, data: {text: 'am the person with passion who has managed the systems and tried to make them more user friendly all over the country. I shared with my dinner companions last night that my approach to being an '}},
{ timecode: 1857, handler: 'blob', id: 119, data: {text: 'administrator in mental health has been when they come to get you - and they will - get out in front and make it your parade. So, that’s how I’ve managed to last through my time in '}},
{ timecode: 1868, handler: 'blob', id: 120, data: {text: 'Philadelphia, in New York City, and in Detroit, Michigan. All very heavily populated cities with African Americans, all very political cities, all three of them the city and the state that everybody '}},
{ timecode: 1882, handler: 'blob', id: 121, data: {text: 'loves to hate. So, I’ve had this sort of tortured experience as a professional in the mental health arena, but I do feel like I’ve come full circle. Before I get into my 10 minutes, let me '}},
{ timecode: 1895, handler: 'blob', id: 122, data: {text: 'just say one thing in response to something one of the previous speakers said. It was about the Medicaid cost savings pilot and the response to that question that was raised by someone, and someone '}},
{ timecode: 1905, handler: 'blob', id: 123, data: {text: 'mentioned the unintended consequences. I would argue that they are very much intentional consequences because by incorporating these cost savings measures and assuring that people will relapse, I can '}},
{ timecode: 1921, handler: 'blob', id: 124, data: {text: 'tell you experiences in Tennessee where people who are on the best possible medicines in terms of efficacy in the hospital where their symptoms are stabilized, where they’ve become managed and '}},
{ timecode: 1931, handler: 'blob', id: 125, data: {text: 'are looking forward to returning to the community, but can’t get those medicines in the community because the Medicaid formulary doesn’t cover them in the community. That hospital enjoys '}},
{ timecode: 1941, handler: 'blob', id: 126, data: {text: 'the fact that the consequences of cost savings, are people keep coming back to the hospital. In our great state and in the western part of our state where I’m from, some of the people who own '}},
{ timecode: 1952, handler: 'blob', id: 127, data: {text: 'the hospitals are the same people who mange the people in the community. So, they get it coming and going. Let me disclose it: I am a student of Alvin Poussaint, so I like to tell it like it is. '}},
{ timecode: 1963, handler: 'blob', id: 128, data: {text: 'Because my topic today was to be on eliminating stigma and getting the African American community to recognize, acknowledge and become more aware of issues with respect to mental illness, I want to '}},
{ timecode: 1982, handler: 'blob', id: 129, data: {text: 'ask you all to do a little reading after you leave here. There’s a whole series of books that have nothing to do with science and medicine and everything else. Terry Williams’ book is one '}},
{ timecode: 1993, handler: 'blob', id: 130, data: {text: 'that I would encourage to read if you haven’t, Black Pain: It Just Looks Like We’re Not Hurting. It was just published last year. B.B. Moore Campbell who I am going to talk about a little '}},
{ timecode: 2003, handler: 'blob', id: 131, data: {text: 'bit more wrote two books, 72-Hour Hold, which was her fictionalized version of what a family has to deal with when a loved one has mental illness. She also wrote a very good children’s book, '}},
{ timecode: 2015, handler: 'blob', id: 132, data: {text: 'Sometimes My Mommy Gets Angry, which is excellent for family members whose adult children especially have mental illness, but whose grandchildren aren’t quite sure how to handle it. These are '}},
{ timecode: 2029, handler: 'blob', id: 133, data: {text: 'very good lay person books. These are written by people who write. These are not scientists, medical professionals, psychiatrists and the like. Standing in The Shadows, we heard a little bit about '}},
{ timecode: 2041, handler: 'blob', id: 134, data: {text: 'black men not wanting to recognize depression. A good friend of mine and a former board member of the American Psychiatric Foundation, as a matter of fact, John Head, wrote this book about his own '}},
{ timecode: 2053, handler: 'blob', id: 135, data: {text: 'experience with depression, Standing in The Shadows. It’s got a subtitle, but I can never remember, his name is John Head. And then finally, Willow Weep for Me by a woman named Mary Anna '}},
{ timecode: 2065, handler: 'blob', id: 136, data: {text: 'Danquah, her experience as a black woman with depression and trying to get treatment for that depression in the midst of a stigmatized community, the African American community. There’s a quote '}},
{ timecode: 2078, handler: 'blob', id: 137, data: {text: 'in there that I love where she talks about how black women can’t really get depressed because we have too much to do and if you find a black woman taking Prozac something is wrong with the world '}},
{ timecode: 2089, handler: 'blob', id: 138, data: {text: 'because we cannot tolerate this. We have stuff that we have to do. So, I would encourage you to read that yourself and to encourage others to read, because these are things that I think people in the '}},
{ timecode: 2102, handler: 'blob', id: 139, data: {text: 'community who aren’t already understanding mental health can relate to because these are stories and we as a people appreciate a good story, we learn by story, we grow up listening to stories. '}},
{ timecode: 2114, handler: 'blob', id: 140, data: {text: 'We encourage people to tell their stories by way of that. I’m going to go real quick through my five, I’ve only got five slides. I decided to do a myths and facts slide because '}},
{ timecode: 2128, handler: 'blob', id: 141, data: {text: 'there’s so many common mistakes, misperceptions, misunderstandings about mental illness. First of all that they’re not very common. In fact, they are most common, as common as most other '}},
{ timecode: 2139, handler: 'blob', id: 142, data: {text: 'medical disorders. Now, I’m a doctor so I see mental illness as a diagnostic quandary for myself, but they are very common. Nearly every family in America is affected by mental illness. If there '}},
{ timecode: 2154, handler: 'blob', id: 143, data: {text: 'are 50 people in this room, 1 in 5 it is projected, 1 in 5 Americans suffers from some form of mental illness. Every family, everybody’s got an Uncle Joe – remember Soul Food? '}},
{ timecode: 2167, handler: 'blob', id: 144, data: {text: 'Everybody’s got an Uncle Joe and a cousin June bug. Everybody. I don’t care where you come from, where you are now, you have that in your family. I know I do. We don’t talk about it, '}},
{ timecode: 2177, handler: 'blob', id: 145, data: {text: 'as Wilma said. We don’t talk, especially we don’t talk about it out in public, but we all know it’s there. This includes co-occurring disorders like substance abuse and some others. '}},
{ timecode: 2189, handler: 'blob', id: 146, data: {text: 'So, if it’s not schizophrenia, depression, bipolar, anxiety disorder, ADHD, it’s a major substance abuse problem that is compounded by the complications of a mental illness like '}},
{ timecode: 2204, handler: 'blob', id: 147, data: {text: 'schizophrenia, depression, bipolar disorder. Second myth. People with mental illnesses can’t hold jobs. I’m just going to point to Wilma. Because she’s already told you. She’s '}},
{ timecode: 2215, handler: 'blob', id: 148, data: {text: 'not sitting, watching TV, smoking cigarettes, and drinking coffee. Okay. Productive citizens are there in the mental health population as well. Business owners, contributing members of their '}},
{ timecode: 2227, handler: 'blob', id: 149, data: {text: 'communities. There is nothing you can do about mental illness. Mental illnesses are real and effective treatments are available. Everywhere you go that should be something that you say when people '}},
{ timecode: 2238, handler: 'blob', id: 150, data: {text: 'say, what’s your position on mental illness? Mental illnesses are real and effective treatments are available. I spent five years as president of the American Psychiatric Foundation. This is the '}},
{ timecode: 2247, handler: 'blob', id: 151, data: {text: 'charitable arm of the largest professional organization for American psychiatry and I don’t remember a day when I was representing that group where that was not my starting statement. Mental '}},
{ timecode: 2259, handler: 'blob', id: 152, data: {text: 'illnesses are real and effective treatments are available. It’s easy, it’s understandable, and more importantly it is true. In reality, we have many more new treatments on the horizon '}},
{ timecode: 2272, handler: 'blob', id: 153, data: {text: 'including medications, psycho-social programs, recovery efforts are underway. We’ve got all kind of tools in our in our arsenal but we don’t get the people in to benefit from them and '}},
{ timecode: 2285, handler: 'blob', id: 154, data: {text: 'that’s one of the things that stigma causes. People with mental illnesses are violent and unpredictable. The unfortunate part of this is, most of the time when you hear about mental illness in '}},
{ timecode: 2296, handler: 'blob', id: 155, data: {text: 'the general public, this is what you hear about, a mentally ill person pushes someone off the subway platform. A mentally ill person drops a concrete block on a car and does property damage, a '}},
{ timecode: 2304, handler: 'blob', id: 156, data: {text: 'mentally ill person is killed in a shootout with the police who come because they’re paranoid and they’ve got knife and the police shoot them. In Detroit we had a deaf man who had mental '}},
{ timecode: 2314, handler: 'blob', id: 157, data: {text: 'illness who was shot in his front yard because the police wouldn’t listen to the family who were saying, “He’s deaf, he can’t hear you. He can’t hear you. Let us tell him '}},
{ timecode: 2323, handler: 'blob', id: 158, data: {text: 'to put down the rake that he is wielding,” because he thought they were there to harm him. And they shot him. So, in reality, most of the people with mental illness are not violent. They are '}},
{ timecode: 2335, handler: 'blob', id: 159, data: {text: 'more often targets of violence than they are themselves violent. Some of the barriers you\'ve heard about miss- misperceptions and stereotypes. These abound. Mental illness is evidence that the devil '}},
{ timecode: 2351, handler: 'blob', id: 160, data: {text: 'is in you and you need to pray. Now, I am as God-fearing and Christian a woman as you will ever see. But, even I understand with all the training that I have that I’m fighting an uphill battle '}},
{ timecode: 2360, handler: 'blob', id: 161, data: {text: 'and I have friends who talk about the faith community. I had a black minister tell me, a Baptist minister tell me, it ain’t the faith community child, it’s the black church, that we have '}},
{ timecode: 2370, handler: 'blob', id: 162, data: {text: 'to make a connection with in a very real way and the same way it took years to overcome the stigma surrounding HIV and AIDS. And finally the black church has embraced that and become much more '}},
{ timecode: 2383, handler: 'blob', id: 163, data: {text: 'forthcoming in terms of providing support and services. We’re fighting that same battle with mental illness. I recently had an experience that I will probably carry to my grave in shock where a '}},
{ timecode: 2395, handler: 'blob', id: 164, data: {text: 'minister told the congregation that next Sunday everybody was going to bring their medicine, for everything that they take medicine for, put it on the alter because they didn’t need any of that. '}},
{ timecode: 2405, handler: 'blob', id: 165, data: {text: 'Now, with diabetes, hypertension, cardiovascular illness, cancer, and AIDS running rampant in our community? I’m afraid of the pastor who says don’t take no medicine. I’m like Wilma, '}},
{ timecode: 2419, handler: 'blob', id: 166, data: {text: 'I don’t trust a whole lot that goes on in my profession and I’m suspect just like the general public. On some things I think there’s enough evidence to support the fact that we '}},
{ timecode: 2429, handler: 'blob', id: 167, data: {text: 'really do need to pay attention to doctors sometimes when they’re telling us, you need your medicine for your diabetes, your hypertension, and your depression. This is not a bad thing. Cultural '}},
{ timecode: 2441, handler: 'blob', id: 168, data: {text: 'beliefs. You already heard that. You heard Dr. Poussaint talk about it. You heard Wilma talk about it. So, I won’t belabor that. I do want to take a moment though to talk about inadequate '}},
{ timecode: 2449, handler: 'blob', id: 169, data: {text: 'education, awareness, and understanding of mental illness. In New Jersey and California state legislators took it upon themselves and decided that cultural competence wasn’t happening fast '}},
{ timecode: 2461, handler: 'blob', id: 170, data: {text: 'enough. It wasn’t penetrating the system strongly enough and so they passed legislation that requires healthcare professionals to demonstrate that they have been engaged in training in order to '}},
{ timecode: 2477, handler: 'blob', id: 171, data: {text: 'renew their licenses or to get their initial license. I think that’s a task for you to carry away and think about advocating strongly in support of. I think that’s the wave of the future. '}},
{ timecode: 2491, handler: 'blob', id: 172, data: {text: 'People aren’t doing this on their own. People aren’t becoming culturally competent because it’s the right thing to do. Even though the evidence is there that says, if you are not '}},
{ timecode: 2501, handler: 'blob', id: 173, data: {text: 'providing culturally competent care you’re not providing good quality care to a diverse population. Every one of you needs to consider how would I in my own home legislature work on an effort '}},
{ timecode: 2515, handler: 'blob', id: 174, data: {text: 'like this? And I would ask you to look at the New Jersey and California models. While there was some serious push back initially from the healthcare professional community, in the end legislators '}},
{ timecode: 2527, handler: 'blob', id: 175, data: {text: 'prevailed because it was in fact the best way to achieve what each state now has as part of the mandate in either their Department of Health or their Department of Mental Health. Cultural competence '}},
{ timecode: 2541, handler: 'blob', id: 176, data: {text: 'is all over the priorities and state plans and everything. How do you measure it if nobody is doing it? And why won’t people do it? Because you don’t make them do it. There are two things '}},
{ timecode: 2551, handler: 'blob', id: 177, data: {text: 'you can do to make healthcare professionals move. You can incentivize them, which I heard talked about this morning, or you can mandate. Those are the only two things that get our attention. And '}},
{ timecode: 2560, handler: 'blob', id: 178, data: {text: 'I’m one of them so I can tell you honestly this is how we do it. If you don’t tell us we have to do it, we’ll do it as best we can, but until you require it, it’s not going to '}},
{ timecode: 2569, handler: 'blob', id: 179, data: {text: 'really penetrate. If you incentivize us and say, well you know once you do that, then you’re eligible for these other things. Texas has a program where if you do the cultural competence you '}},
{ timecode: 2581, handler: 'blob', id: 180, data: {text: 'actually get a discount on your malpractice insurance and you all know that’s skyrocketing. So, I mean there are all kinds of creative ways that people are working on this, so I would encourage '}},
{ timecode: 2589, handler: 'blob', id: 181, data: {text: 'you to poll your members and find out what they’re doing around this, and if there’s a position that you can take, take it and get the support of groups like the National Leadership '}},
{ timecode: 2597, handler: 'blob', id: 182, data: {text: 'Council, like the Black Psychiatrists of America, like the Association of Black Psychologists, like the NMA Section on Psychiatry and Behavioral Sciences. Get them engaged in helping you to prepare '}},
{ timecode: 2608, handler: 'blob', id: 183, data: {text: 'the necessary language and things like that. And then there is the misdiagnosis that Wilma talked about. I can remember reading in the literature back in the dark ages when I was in training in the '}},
{ timecode: 2619, handler: 'blob', id: 184, data: {text: '‘70s that misdiagnosis was a critical issue that could only be resolved with strong research and attention to detail and using structured interviews. Well now we’ve got the research, '}},
{ timecode: 2631, handler: 'blob', id: 185, data: {text: 'we’ve got the structured interviews that are supposed to do away with all the cultural bias and everything and we still get major misdiagnosis across the board when it comes to black people. The '}},
{ timecode: 2642, handler: 'blob', id: 186, data: {text: 'other thing we have working against us is today’s cultural competence tends to focus on language and other than US English as a first language kind of issues. Because it’s believed that '}},
{ timecode: 2657, handler: 'blob', id: 187, data: {text: 'black people don’t need translation services when it comes to providing healthcare or health literacy education. We’re falling behind the curve now in terms of being eligible for certain '}},
{ timecode: 2667, handler: 'blob', id: 188, data: {text: 'kinds of programs that would move us toward a more culturally competent provider system. Because we don’t speak a different language, because we don’t come from a different country, we '}},
{ timecode: 2678, handler: 'blob', id: 189, data: {text: 'haven’t immigrated recently and because of some other things that are now used as sort of the standard for achieving cultural competence. We’ve got to be very diligent and vigilant about '}},
{ timecode: 2688, handler: 'blob', id: 190, data: {text: 'not falling too far behind in this struggle. The lack of understanding by the general healthcare system is another major problem. It is one of the primary access points, believe it or not, for mental '}},
{ timecode: 2701, handler: 'blob', id: 191, data: {text: 'health services. We talked about Medicaid – we had speakers talking about Medicaid earlier. Black people in my part of the state, for example, the western part of Tennessee, we are 80-85% of the '}},
{ timecode: 2712, handler: 'blob', id: 192, data: {text: 'Medicaid population in the state, in that section of the state and we have one black mental health provider, we have no one speaking on our behalf in terms of encouraging cultural competence and now '}},
{ timecode: 2728, handler: 'blob', id: 193, data: {text: 'we have a Medicaid system that has combined mental health and primary care so that it’s the integrated model of care that people are talking about. But we have primary care providers who '}},
{ timecode: 2739, handler: 'blob', id: 194, data: {text: 'don’t understand mental health, but they’re now responsible for ensuring the people within the population get mental health treatment. We’ve got to do a better job of assuring that '}},
{ timecode: 2747, handler: 'blob', id: 195, data: {text: 'the primary care providers who are an initial point of entry provide good access but don’t understand treatment and follow-up very well - we’ve got to get them trained to do a better job '}},
{ timecode: 2757, handler: 'blob', id: 196, data: {text: 'also. So, why do we focus on this eliminating stigma? I’ll go through this. We already know 1 in 5 people suffer from some form of mental illness. We know that people with mental illness die 25 '}},
{ timecode: 2769, handler: 'blob', id: 197, data: {text: 'years earlier than their counterparts in society who are not mentally ill. Twenty-five years earlier and that’s because if you’re mentally ill your only sense of being is the mental '}},
{ timecode: 2781, handler: 'blob', id: 198, data: {text: 'illness. Nobody checks your blood pressure. Nobody checks you for diabetes. Nobody follows up to see if you might, because of family history, be a candidate for some cancer prevention or cancer '}},
{ timecode: 2793, handler: 'blob', id: 199, data: {text: 'identification study. Nobody does anything to your physical health because after all you are just mentally ill. And that’s how you’re identified. The fears, the myths, the cultural '}},
{ timecode: 2802, handler: 'blob', id: 200, data: {text: 'barriers within the African American community that keep people from going to treatment, we don’t talk about it. We just don’t talk about it. We don’t talk about it as it affects us '}},
{ timecode: 2814, handler: 'blob', id: 201, data: {text: 'individually. We don’t talk about it as a community. There is a long legacy of psychological damage that has been done to African Americans in this country that has never been dealt with, that '}},
{ timecode: 2826, handler: 'blob', id: 202, data: {text: 'is a principal underpinning for many of the psychological illnesses that we now have to deal with. Untreated people with mental illnesses wind up homeless or in jails, in prisons. Jails and prisons '}},
{ timecode: 2838, handler: 'blob', id: 203, data: {text: 'are now the primary focus of treatment: they’re the primary mental health treatment facility in this country. In order to get more African Americans in the clinical trials you already heard '}},
{ timecode: 2849, handler: 'blob', id: 204, data: {text: 'this, we’ve got to decrease the stigma, we’ve got to educate the community and we’ve got to make sure the people know what they’re getting into. Three things I want to leave '}},
{ timecode: 2857, handler: 'blob', id: 205, data: {text: 'you with. Mental health education advocacy strategies. How many of you know that July is now B.B. Moore Campbell Minority Mental Health Month? I see one hand in the back. That is federally legislated '}},
{ timecode: 2871, handler: 'blob', id: 206, data: {text: 'now. Every July you are celebrating B.B. Moore Campbell Minority Mental Health Awareness month. Because B.B. was such a strong advocate before her death for mental illness, the month was named after '}},
{ timecode: 2885, handler: 'blob', id: 207, data: {text: 'her. I would encourage each of you to sponsor one thing during that month. To focus on getting the word out about mental health. Mental illness is real, effective treatments are available. Use that '}},
{ timecode: 2895, handler: 'blob', id: 208, data: {text: 'tag line as much as you want. The outreach activities and collaboration with all the groups that we’ve talked... about sponsor and support in an ongoing way, a forum, a town hall meeting, a '}},
{ timecode: 2906, handler: 'blob', id: 209, data: {text: 'radio show, your local cable access television shows that many of you have. Use mental health as a topic and bring your local experts in to talk about what’s going on in your area and push for '}},
{ timecode: 2918, handler: 'blob', id: 210, data: {text: 'people to talk about it at home. Public education and media. If any of you have those local cable shows or radio shows or access to them, when you’re there talking about health, mention mental '}},
{ timecode: 2929, handler: 'blob', id: 211, data: {text: 'health, just get it out there. Get your constituents thinking about it. Get them talking about it. Get them wanting to know more about it so the people like us can come in and help them with it. '}},
{ timecode: 2940, handler: 'blob', id: 212, data: {text: 'There’ s lots of other things in terms of PSAs, pro bono PR firms to help you with putting them together, working with natural support communities, support groups, the NAACP, the National Urban '}},
{ timecode: 2951, handler: 'blob', id: 213, data: {text: 'League, The Black United Fund all have their respective health or healthcare kinds of communities. Begin working them into the agenda also. I’m going to stop there because I’ve gotten my '}},
{ timecode: 2961, handler: 'blob', id: 214, data: {text: 'note about a minute so thank you very much. TARA LUBIN: Good morning everyone. Again, my name is Tara Lubin. I am a policy analyst at the National Conference of State Legislatures. I am sure most of '}},
{ timecode: 2976, handler: 'blob', id: 215, data: {text: 'you are familiar. We are a bipartisan organization representing all the state and territorial legislatures and our mission is to improve the quality and the effectiveness of state legislatures, to '}},
{ timecode: 2987, handler: 'blob', id: 216, data: {text: 'promote policy innovation and communication among state legislatures, and also to ensure that state legislatures have a strong cohesive voice in the federal system. I forgot to say, I really '}},
{ timecode: 3001, handler: 'blob', id: 217, data: {text: 'appreciate you inviting me here today, thank you very much. I am really honored to be here today and on this panel. I was invited to speak about prisoner re-entry and health and mental health issues. '}},
{ timecode: 3013, handler: 'blob', id: 218, data: {text: 'NCSL recently had a project with Morehouse, it’s actually through Community Voices through the National Center for Primary Care at the Morehouse Gold Medicine Project on Prisoner Re-Entry and '}},
{ timecode: 3025, handler: 'blob', id: 219, data: {text: 'Health. It was a year and a half project that ended in April of 2008 and the goal of the project was to engage with legislators and legislative staff on the issue of healthcare access and coverage and '}},
{ timecode: 3037, handler: 'blob', id: 220, data: {text: 'support for people exiting corrections facilities. We did a lot of different things through the project including a meeting where we visited a jail that had a prisoner re-entry program, but everything '}},
{ timecode: 3051, handler: 'blob', id: 221, data: {text: 'culminated at the end of the project with a policy brief that you have in your packets called “Returning Home: Access to Healthcare After Prison” and a lot of what I’m going to talk '}},
{ timecode: 3061, handler: 'blob', id: 222, data: {text: 'about are things that we learned through the research for that policy brief, and I encourage you to read it. To start out with some statistics, I am sure a lot of you know these already but each year '}},
{ timecode: 3078, handler: 'blob', id: 223, data: {text: 'almost 700,000 men and women are released from prison into communities across our country. More than half of all the people in US jails and prisons have a mental health issue and that number is 56%. '}},
{ timecode: 3089, handler: 'blob', id: 224, data: {text: 'And then when you add together chronic physical issues or health issues, mental health issues and substance abuse issues, the number becomes more than 80% of people in prisons have at least one of '}},
{ timecode: 3104, handler: 'blob', id: 225, data: {text: 'those problems. When you look at all black men across our country, 4.7% of black men were incarcerated in our country in 2005 and when you just look at the age range of 25 to 29 the number becomes 12% '}},
{ timecode: 3121, handler: 'blob', id: 226, data: {text: 'of African American males and that’s compared to 3.9% Hispanic men of the same age range and 1.7% white men of the same age range. So, it’s clear that, also that many people exiting '}},
{ timecode: 3136, handler: 'blob', id: 227, data: {text: 'don’t make a successful transition. Two-thirds are re-arrested within three years and one-half are returned to prison either for parole violations or new crimes. So, it’s clear this is a '}},
{ timecode: 3149, handler: 'blob', id: 228, data: {text: 'very vulnerable population with more chronic conditions, more disease, lower income usually and less educational attainment, so states have implemented policies to ease the transition back to the '}},
{ timecode: 3162, handler: 'blob', id: 229, data: {text: 'community and here are some reasons why it is important to do so, what you get for reasons to implement these policies. First of all you get reduced recidivism. Data from a preliminary study, '}},
{ timecode: 3173, handler: 'blob', id: 230, data: {text: 'that’s the name of the study, shows that when those exiting corrections facilities are enrolled in Medicaid upon release they commit fewer offenses and the time between offenses is longer. You '}},
{ timecode: 3185, handler: 'blob', id: 231, data: {text: 'get reduced costs. For example, the Pennsylvania Department of Corrections estimates that the cost of incarcerating an average prisoner is $80 a day, but the cost of incarcerating a mentally ill '}},
{ timecode: 3198, handler: 'blob', id: 232, data: {text: 'inmate is $140 a day. You get increased public safety, obviously, because fewer people are committing fewer crimes, and then improved infectious and chronic disease management which reduces direct and '}},
{ timecode: 3211, handler: 'blob', id: 233, data: {text: 'indirect healthcare cost to the state. So, one of the things that states are doing is Medicaid suspension or making sure that people are connected to Medicaid upon their release, so obviously Medicaid '}},
{ timecode: 3226, handler: 'blob', id: 234, data: {text: 'coverage is very important to re-entry issues since the finances of care of so many former prisoners. Medicaid coverage is an important asset to former prisoners but so is information and support to '}},
{ timecode: 3241, handler: 'blob', id: 235, data: {text: 'obtain those services. Federal rules don’t allow the use of federal funds to provide Medicaid services to prisoners. Traditionally and historically states have terminated prisoners\' Medicaid '}},
{ timecode: 3256, handler: 'blob', id: 236, data: {text: 'benefits when they arrive to avoid breaking these federal rules. As recently as 1999 all states terminated Medicaid benefits upon incarceration, but CMS, The Centers for Medicare and Medicaid '}},
{ timecode: 3270, handler: 'blob', id: 237, data: {text: 'Services, in recent years have realized this problem and have encouraged states to suspend rather than terminate benefits or to in other ways help prisoners apply for Medicaid benefits before their '}},
{ timecode: 3282, handler: 'blob', id: 238, data: {text: 'release to make sure that they’re connected. So, what some states have done in terms of Medicaid suspension... In April, 2008 New York established a suspension requirement through an '}},
{ timecode: 3293, handler: 'blob', id: 239, data: {text: 'administrative directive. In this case, what happens is that at incarceration people who are on Medicaid are switched to suspension status and then the inmate\'s information is forwarded to the '}},
{ timecode: 3305, handler: 'blob', id: 240, data: {text: 'appropriate agency and benefits are reinstated for at least four months at which point the case is subject to eligibility review, but immediately when they are out the door they have access to care, '}},
{ timecode: 3317, handler: 'blob', id: 241, data: {text: 'they have access to their meds, whatever else, therapy, whatever else they need. Florida has a law that states that anyone entering prison who is receiving Medicaid benefits must have those benefits '}},
{ timecode: 3327, handler: 'blob', id: 242, data: {text: 'reinstated upon leaving prison and in 2005 Maryland passed a law that requires suspension of benefits and prohibits termination of Medicaid benefits at incarceration. And North Carolina under a 2008 '}},
{ timecode: 3341, handler: 'blob', id: 243, data: {text: 'administrative directive requires suspension. States are also engaging in just pre-release re-entry planning, for example, California’s Department of Corrections and Rehabilitation established a '}},
{ timecode: 3356, handler: 'blob', id: 244, data: {text: 'standalone office to deal with re-entry planning in 2006. It’s called the Division of Re-entry and Recidivism Reduction and it deals with improved case management, continuity of support between '}},
{ timecode: 3369, handler: 'blob', id: 245, data: {text: 'custody and parole and other things. SAMHSA promotes the APIC model. It’s called the Assessment Planning Identification Coordination Model and it was piloted in two counties, one in New York and '}},
{ timecode: 3381, handler: 'blob', id: 246, data: {text: 'one in Maryland. It emphasizes a cooperative effort between the inmate and corrections staff and community providers. In New York, Riker’s Island has a program called the RIDE Program, '}},
{ timecode: 3394, handler: 'blob', id: 247, data: {text: 'Riker’s Island Discharge Enhancement Program. It includes early screening and assessment and pre-release application for Medicaid benefits and connection to case management in the community. '}},
{ timecode: 3406, handler: 'blob', id: 248, data: {text: 'Collaboration across agencies is another really important thing since re-entry involves many different issues in different departments. Virginia’s Department of Corrections partners with local '}},
{ timecode: 3419, handler: 'blob', id: 249, data: {text: 'jails in a three-phase re-entry program. The first two phases are pre-release and they include education about community resources and work release programs. Up until recently Georgia had a program '}},
{ timecode: 3431, handler: 'blob', id: 250, data: {text: 'and unfortunately it was cut due to budget constraints, but it was called the TAPP Program and it was Transition and Aftercare for Probationers and Parolees and it paired newly released mentally ill '}},
{ timecode: 3443, handler: 'blob', id: 251, data: {text: 'inmates with case managers who helped former inmates find housing and schedule and attend medical appointments and secure other services. What can states do and what are their options and how to think '}},
{ timecode: 3461, handler: 'blob', id: 252, data: {text: 'about this issue? States can ease the transition to the community by suspending Medicaid coverage as I said or making re-enrollment for those qualified a part of exiting the system and creating '}},
{ timecode: 3473, handler: 'blob', id: 253, data: {text: 'programs across agencies or collaborating to getting services easier after leaving prison. Two important things are to think about not just think about mental health and not just think about physical '}},
{ timecode: 3485, handler: 'blob', id: 254, data: {text: 'health, but think about really the whole spectrum. Substance abuse issues, mental health, and physical health and chronic conditions. Also, don’t think about re-entry just from a health '}},
{ timecode: 3494, handler: 'blob', id: 255, data: {text: 'standpoint, but think about, these people need housing, they need employment and case management, so think about that broadly as well. Of course, re-entry starts at entry. Almost every single person '}},
{ timecode: 3506, handler: 'blob', id: 256, data: {text: 'in the corrections system is going to one day exit, so to think about it from day one when they enter is important. We definitely need more data on this topic. Data collection is important and we can '}},
{ timecode: 3518, handler: 'blob', id: 257, data: {text: 'get comparative benefits of various programs, but there are evidence-based practices to draw on and learn from and that’s what I wanted to share with you today. Thank you very much. ASIA CASEY: '}},
{ timecode: 3531, handler: 'blob', id: 258, data: {text: 'Hello everyone. Like they said earlier my name is Asia Casey and one thing that wasn’t said was that I am a social work intern at Ingham Regional Medical Center so we get a lot of mental health '}},
{ timecode: 3544, handler: 'blob', id: 259, data: {text: 'patients there. I want to thank you for inviting me to this experience. This is my first time being on a panel of this caliber. I’ve only spoken on panels at Michigan State for students so this '}},
{ timecode: 3559, handler: 'blob', id: 260, data: {text: 'is a different experience for me. So, thank you very much. This is a great experience. So, I guess what I’m going to speak on is the program that I work for which is the Adolescent Diversion '}},
{ timecode: 3573, handler: 'blob', id: 261, data: {text: 'Program at Michigan State and the Adolescent Diversion Program is a program that works with youth, first-time offenders in Ingham County and court system. MSU students, MSU psychology students or some '}},
{ timecode: 3589, handler: 'blob', id: 262, data: {text: 'aren’t actually, but MSU students will work with those teens or the ages are between the ages of 8 and 17 and they will work with them for 18 weeks in an intervention based on single system '}},
{ timecode: 3607, handler: 'blob', id: 263, data: {text: 'design and community-based interventions and it’s a two semester course. It’s actually a class at Michigan State. In the course... the first semester they get trained on cultural '}},
{ timecode: 3620, handler: 'blob', id: 264, data: {text: 'competency and how to work with kids within their community, especially whose background is way different from theirs. The majority of our students right now in our first semester, we have 49 students '}},
{ timecode: 3633, handler: 'blob', id: 265, data: {text: 'and there are 11 African American MSU students that are in the program so the majority of the students are Caucasian so we speak on cultural competency a lot, because we have a lot of questions within '}},
{ timecode: 3649, handler: 'blob', id: 266, data: {text: 'the classroom about how to deal with certain situations or how to speak lightly on things to not really offend other people. So, cultural competency is something we work on a lot within the class. For '}},
{ timecode: 3669, handler: 'blob', id: 267, data: {text: 'instance, in the classroom, outside of the classroom a youth - which are the kids that are in the program - was working with an advocate - which is the MSU student - and the 13 year old wanted a baby '}},
{ timecode: 3686, handler: 'blob', id: 268, data: {text: 'and she wanted to be pregnant and she was of Latin descent and the student asked her if she was Catholic because all of the Latinos she knows are Catholic, so the youth didn’t know how to '}},
{ timecode: 3703, handler: 'blob', id: 269, data: {text: 'respond to this question, so she just didn’t respond at all because she didn’t know exactly what she meant by that. We get a lot of things of that nature. Some of the things in cultural '}},
{ timecode: 3720, handler: 'blob', id: 270, data: {text: 'competency that we do is, for me being an African American instructor, it’s sometimes kind of hard for some students to raise their own concerns, but I let them know to just kind of let down all '}},
{ timecode: 3736, handler: 'blob', id: 271, data: {text: 'guards and I tell them how I feel in certain situations and that kind of gets them a little bit more loose with talking about some situations. We do a word association project where we have a list of '}},
{ timecode: 3753, handler: 'blob', id: 272, data: {text: 'different titles and the students write down the first thing that pops in their head, once we say the name, and then we discuss those word associations and then use that within working with their '}},
{ timecode: 3771, handler: 'blob', id: 273, data: {text: 'cases. So, there are a lot of things with regards to cultural competency that does need to be addressed, especially within this field because they are working with youth that is in the court system '}},
{ timecode: 3785, handler: 'blob', id: 274, data: {text: 'and background the majority of the time is different from their own. So, that’s something that we do address a lot. I don’t have a wonderful presentation or anything, but I just wanted to '}},
{ timecode: 3800, handler: 'blob', id: 275, data: {text: 'say that. REPRESENTATIVE USIE RICHARDS: We do want to thank the panelist and remind everyone that we intend to stay on schedule. We are going to go directly to Columbia, South Carolina and allow them '}},
{ timecode: 3817, handler: 'blob', id: 276, data: {text: 'to ask on one question and then we’ll do the same for Jackson and we’ll come back and take a question if we have any additional time, if you could take us to Columbia, South Carolina. '}},
{ timecode: 3825, handler: 'blob', id: 277, data: {text: 'REPRESENTATIVE LEON HOWARD: Thank you. I would like to thank the panelist as well. We have one question and Ms. Ava Brumfield will read that question. AVA BRUMFIELD: Yes, with most state’s '}},
{ timecode: 3836, handler: 'blob', id: 278, data: {text: 'budgets having been slashed for mental health agencies, there seems to be little political will to fiscally address the mental health crisis. How would you advise advocates on making minority and non '}},
{ timecode: 3850, handler: 'blob', id: 279, data: {text: 'minority policymakers care enough about this issue that they make mental health care a funding priority? What message about mental health resonates with liberal and conservative policy makers? DR. '}},
{ timecode: 3864, handler: 'blob', id: 280, data: {text: 'ALTHA STWEART: If I understand the question, what kind of message can we give that will resonate to assure that mental health funding becomes a priority? I would repeat mental illnesses are real, '}},
{ timecode: 3878, handler: 'blob', id: 281, data: {text: 'effective treatments are available and every family is affected. It doesn’t break down around Democrat, Republican, liberal, conservative. In fact, some of the best federal legislation up to and '}},
{ timecode: 3893, handler: 'blob', id: 282, data: {text: 'including the parity battle for mental health was predicated on the fact that people’s personal experience finally weighed in. We are very clear in the field that if we have legislators who are '}},
{ timecode: 3907, handler: 'blob', id: 283, data: {text: 'comfortable talking about their personal experience that compels other legislators to listen to their colleagues in ways that we have not been able to. When we have consumers as opposed to mental '}},
{ timecode: 3920, handler: 'blob', id: 284, data: {text: 'health professionals talking to legislators it’s a story that people can’t avoid hearing and they can’t avoid responding to in some way, and I think we just got to get much better at '}},
{ timecode: 3932, handler: 'blob', id: 285, data: {text: 'sharing these stories and talking about the fact that, again, mental illnesses are real, effective treatments are available, every family is affected. TARA LUBIN: This is Tara Lubin. And just to add '}},
{ timecode: 3948, handler: 'blob', id: 286, data: {text: 'onto that, talking about re-entry populations, there’s just too many people in our prisons and it costs way too much money to keep them there so if we’re talking about mental health in '}},
{ timecode: 3959, handler: 'blob', id: 287, data: {text: 'terms of re-entry it saves money in a variety of ways to address mental health issues for that population. WILMA TOWNSEND: This is Wilma Townsend. Mental illness is part of healthcare. We are in this '}},
{ timecode: 3979, handler: 'blob', id: 288, data: {text: 'country right now fighting for healthcare. Of course it’s political. It’s more than political. It’s the livelihood of any community and any individual and to be able to deal with '}},
{ timecode: 3992, handler: 'blob', id: 289, data: {text: 'that on the legislative level is going to take some work of all of us to be able to get that across to people and I’m telling you the research won’t get done, the best practices '}},
{ timecode: 4003, handler: 'blob', id: 290, data: {text: 'won’t get done unless we politically go in and show people that those things exist so that we can get the money for it. REPRESENTATIVE USIE RICHARDS: Thank you. We’re going to move to '}},
{ timecode: 4014, handler: 'blob', id: 291, data: {text: 'Jackson, Mississippi. We’ll take one question from there. SPEAKER: Mississippi’s question is: Since mental health is such an unheard of and undealt-with issue in the African American '}},
{ timecode: 4031, handler: 'blob', id: 292, data: {text: 'community, and since the churches show actual focus of strength, information and motivation, how do mental health providers encourage church leaders and congregations to get involved in supporting '}},
{ timecode: 4045, handler: 'blob', id: 293, data: {text: 'mental health education and treatment and how do we eradicate passivity of mental health issues in the local church? DR. ALTHA STEWART: This is Dr. Altha Stewart again. I feel almost obligated since I '}},
{ timecode: 4059, handler: 'blob', id: 294, data: {text: 'raised an issue specific to the black church in at least weighing in on this. I’m sure others have comments as well. I think one of the things as the question points out the black church is, in '}},
{ timecode: 4071, handler: 'blob', id: 295, data: {text: 'fact, fundamentally a locus of support and congregation and providing important information throughout the community in a variety of ways and I will tell you honestly I think the black church can step '}},
{ timecode: 4087, handler: 'blob', id: 296, data: {text: 'up and host forums in the congregation. I think we can help prepare, we’ve worked with black ministers for example in the Memphis area, to have them put on their topics for sermons, specific '}},
{ timecode: 4102, handler: 'blob', id: 297, data: {text: 'issues related to mental illness and to draw from the scripture, in talking about depression in the Old Testament and how faith and the loss of faith contributes to depression in many of the people in '}},
{ timecode: 4115, handler: 'blob', id: 298, data: {text: 'the Bible and that there are hymns that resonate with these illnesses that are part of the choir\'s mission. In addition to that part of the service itself I think the black church can stand up and say '}},
{ timecode: 4129, handler: 'blob', id: 299, data: {text: 'that these are things that we now have to talk about in the same way that we talked about the importance of civil rights and the importance of stopping the violence, and the importance, in my town for '}},
{ timecode: 4139, handler: 'blob', id: 300, data: {text: 'example, infant mortality rivals any third world country. I think we’re number two in the nation in terms of infant mortality. Worse than some third world countries and the black church stood up '}},
{ timecode: 4150, handler: 'blob', id: 301, data: {text: 'and said enough, this is enough. We can’t have our babies dying before their first birthday. I think there are similar things in the mental health arena that if the black church would get '}},
{ timecode: 4161, handler: 'blob', id: 302, data: {text: 'involved in it would provide a safe place for people to come and to talk and to hear about these things and also provide in a very real sense a safe place for people with mental illness to come and '}},
{ timecode: 4174, handler: 'blob', id: 303, data: {text: 'feel again to be part of a community, beyond their mental health community. To be part of a community. I can’t tell you the number of people who felt like they weren’t welcome back in '}},
{ timecode: 4185, handler: 'blob', id: 304, data: {text: 'church after they had a psychotic break because of their behavior when they were experiencing the problem. I think there are many things that the church can lead the way in helping the general '}},
{ timecode: 4196, handler: 'blob', id: 305, data: {text: 'community of African Americans in this country. Understand, these are still our people. These are our family members. These are folks who count on us to be there, to be supportive of them during their '}},
{ timecode: 4207, handler: 'blob', id: 306, data: {text: 'illness and beyond. REPRESENTATIVE USIE RICHARDS: Thank you. This is going to be our last question. I’m trying to get everybody back on schedule, the representative from Illinois and please '}},
{ timecode: 4216, handler: 'blob', id: 307, data: {text: 'remember that at the end of today we do have an additional question and commentary and discussion period that we will include everyone within that process. STATE REP. KAREN YARBOROUGH: Thank you. '}},
{ timecode: 4226, handler: 'blob', id: 308, data: {text: 'State Representative Karen Yarborough from Illinois. Three of the four of you talked about, and you, Tara, to a greater extent, about mental health issues in the prisons. I’d like you to discuss '}},
{ timecode: 4238, handler: 'blob', id: 309, data: {text: 'the supermax prisons which we have all across the United States in which people are incarcerated 23 out of 24 hours in severe isolation and in many of the prisons they don’t have step-down '}},
{ timecode: 4252, handler: 'blob', id: 310, data: {text: 'programs and so these people are just kind of you know sent out and I’m sure the recidivism rate is very high. 2 TARA LUBIN: It\'s horrible and inhumane and I personally think, not talking for '}},
{ timecode: 4264, handler: 'blob', id: 311, data: {text: 'NCSL, but I think it\'s a practice that absolutely has to stop. And I think that you\'re right, that it must increase mental health issues among people that suffer in that way, but I can\'t really '}},
{ timecode: 4276, handler: 'blob', id: 312, data: {text: 'discuss it in any further way, unfortunately. REPRESENTATIVE USIE RICHARDS: I want to thank our panelists, Ms. Casey for coming and at least keeping us green and hopefully we’ll be able to find '}},
{ timecode: 4287, handler: 'blob', id: 313, data: {text: 'some way to share with you what we are learning here in our experiences. We are appreciative of the information relative to re-entry because I am sure in each and every one of our communities we have '}},
{ timecode: 4298, handler: 'blob', id: 314, data: {text: 'a great problem with the number of individuals, particularly black men in prison being released back into our community and not getting the services that are required and if there’s anything '}},
{ timecode: 4308, handler: 'blob', id: 315, data: {text: 'that we’re going to take away from you Dr. Stewart is that we know that there are more others other than Elizabeth Kubler3 Ross On Death and Dying. We don’t have to worrying about '}},
{ timecode: 4317, handler: 'blob', id: 316, data: {text: 'listening to Dr. Joe McCue on the Steps We Took. We don’t have to go to the movie and look at, what was that? The - One Flew Over the Cuckoo’s Nest. Now, we have some other books that we '}},
{ timecode: 4328, handler: 'blob', id: 317, data: {text: 'can in fact read and for you we are most grateful for your presence Ms. Thompson, the trials makes us think and thinking makes us wiser, wisdom makes life profitable. Your presence has shown that '}},
{ timecode: 4345, handler: 'blob', id: 318, data: {text: 'today. We thank the entire panel for joining us. We have the chairman to give us some quick directions so we can get back on our schedule. I thank all of you. REPRESENTATIVE JOE ARMSTRONG: Let’s '}},
{ timecode: 4356, handler: 'blob', id: 319, data: {text: 'thank this panel and let’s thank Senator Richards.'}},
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