Each year, PLACES provides behavioral healthcare to nearly 300 adults, about two-thirds of whom are homeless. The majority have been diagnosed with a serious and persistent brain health disorder. In this issue, we take a close look at stigmas about those disorders and what is being done to create a more open-minded environment.

By Roy Craig, Executive Director, and Brian Wlodarczyk, Clinical Services Director

One of the most intransigent barriers to mental health treatment is stigma: direct or indirect discrimination simply because a person has a health condition that, through no personal fault of their own, impacts their mood, thinking and behavior. While people diagnosed with most illnesses are not treated this way (think cancer or diabetes), why do we stigmatize those with brain health disorders? The world finds ways to discount, discredit and disgrace the mentally ill at many levels: systemic, social and personal.

One of the first places to look is how federal and state laws fund treatment of people diagnosed with these brain disorders. There are major funding differences between physical and behavioral health diseases in the Medicaid and Medicare systems, in many healthcare insurance plans, and in various state laws and regulations that guide disparate funding. Further evidence is found in areas such as inpatient rehabilitation stays. Just as for many other illnesses, sometimes a hospital stay is indicated to help alleviate symptoms and treat the condition. As former Congressman Pat Kennedy said in USA Today, “Mental health is a separate but unequal system.” He added, “We have a wasteland of people who have died and been disabled because of inadequate care.”

Our summer 2018 newsletter provided a detailed outline of funding decisions for mental health treatment made by the federal government in the 1960s. That’s essentially when federal funding was greatly reduced and state and local governments were expected to take on responsibility for hospitalizations, treatment, medication and supportive housing. The end result was, and still remains, severe cuts in mental health treatment dollars and the steady reduction in available residential options for behavioral healthcare. Imagine the uproar if, rather than reducing funding for behavioral health, similar funding cuts were made to the treatment of cancer or heart disease.

Social stigma can impact the ability and willingness of physicians and other health care workers to identify brain health disorders. It often keeps people from admitting to or discussing the impact of brain disorders on their family and its individual members. Because brain health issues are shrouded in this stigma it is difficult for social networks of those with brain health issues (friends, family, employers, etc.) to understand the challenges caused by these diseases. The issues can be made worse by the increased probability of being bullied, harassed and victims of violence.

According to the National Alliance on Mental Illness (NAMI), one frequent result of stigma is for individuals to be ashamed for something that is out of their control. Far too often the stigma negatively impacts an individual’s educational, vocational, social and family-relational experiences as well as one’s ability to maintain safe, affordable and stable housing. However, personal stigma may perhaps be the most damaging when it prevents individuals from seeking help.

Given the alarming increase in the occurrence of mass shootings, including the recent horrific incident in our community, it is important to mention what we know about the connection between mental illness and violence. In general, the research indicates that people with serious mental illnesses are no more likely to commit heinous violence than the general population. However, there may be an increase in the propensity for violence if the mental illness goes untreated.

At PLACES, we believe it is important to be a strong, clear voice to help normalize (de-stigmatize) brain disorders. One way is by advocating for more funding to support prevention efforts and treatment. Another way PLACES supports removing stigma is to challenge people about their attitudes and the language they use to refer to people who live with brain health issues. Every person who has been diagnosed is an individual with a legacy and a story, and should be respected as such.

We spend considerable time at PLACES on training staff that our work to provide housing and behavior healthcare services should be guided by the values of respect, dignity and compassion. These values are the basis of all human relationships, including therapeutic ones. This culture is so important to our company that a significant part of staff performance evaluation involves how well these values are a part of their daily work.

Meet Our New Clinical Services Coordinator

Amber Howard joined PLACES in August as its Clinical Services Coordinator, reporting to clinical director Brian Wlodarczyk. Amber is a Licensed Professional Clinical Counselor with Supervisory Designation (LPCC-S) who earned her master’s degree from Wright State University in Counseling, with a focus on Marriage and Family Counseling.

Amber graduated with bachelor’s degrees in psychology and Spanish from Ohio University and studied abroad for a quarter in Pamplona, Spain.

Amber has worked in outpatient settings with children, adolescents, families and adults with a variety of mental health, physical and environmental barriers. Some of her previous roles include case manager and counselor in community mental health settings, counselor and then director at an agency that provides in-home and office-based services to adults with developmental disabilities, director of a foster care agency, director of an outpatient drug treatment facility, and counseling in a private practice setting.

Amber specializes in severe and persistent psychiatric disorders, both in adults and children. Her professional goal is to provide the best caliber of services possible through education, supervision and support. She likes to think outside the box, provide new solutions to persistent problems, and help others feel appreciated and confident on a daily basis.

Muppet’s Mom Is Addicted

Mother’s Opioid Addiction Is Challenge for Newest Sesame Street Character

With deaths from opioid overdose rising to epidemic proportions, Sesame Workshop (the non-profit educational organization behind Sesame Street) recently introduced a new Muppet whose mother is battling addiction. The fuzzy green puppet with yellow hair named Karli debuted this May, but her storyline was expanded in October to include the fact that she is in foster care because her mother is in treatment for opioid addiction.

“Having a parent battling addiction can be one of the most isolating and stressful situations young children and their families face,” said Sherrie Westin, president of social impact and philanthropy at Sesame Workshop. “Sesame Street has always been a source of comfort to children during the toughest of times, and our new resources are designed to break down the stigma of parental addiction and help families build hope for the future.”

Over the five decades Sesame Street has been on the air, the show has not been afraid to tackle tough issues, creating one puppet who was homeless and another with autism. Sesame Street creators were motivated to incorporate this new storyline because 5.7 million children under age 11 live in households with a parent who has a substance use disorder.

The non-profit chose to incorporate Karli in its online resources rather than on its broadcast in order to give adult caregivers more choice over how and when they introduce the topic to youngsters. Sesame Workshop created the videos and articles because other non-profit partners were asking for more resources dealing with substance abuse.

Parental drug addiction is the second most common form of recurring trauma for children, after neglect, according to Christy Tirrell-Corbin, executive director of the Center for Early Childhood Education and Intervention at the University of Maryland. Tirrell-Corbin said, “There’s far too many children who are experiencing adverse events, this being one of them, to let this go unaddressed.”

Jerry Moe, the national director of the Hazelden Betty Ford Children’s Program, agrees. As a child therapist, he helped Sesame Workshop develop their resources for the pre-school age group. “These boys and girls are the first to get hurt and, unfortunately, the last to get help,” Moe said. “For them to see Karli and learn that it’s not their fault and this stuff is hard to talk about and it’s OK to have these feelings, that’s important. And that there’s hope.”

» Download the newsletter as a printable PDF