The “most wonderful time of the year” can quickly turn into the most stressful time of the year for many. When compounded by a mental illness, common holiday pressures can create a perfect storm of exacerbated stressors, symptoms and setbacks if not proactively addressed.
The reality is that potential hazards exist at every turn during the holidays. These situations can trigger heightened difficulties for people suffering from depression, anxiety, PTSD and other mental illnesses. The holidays can also introduce additional stressors such as complicated relationship dynamics at family gatherings, grief over losing a loved one or simply trying to live up to the unattainable expectations of the “perfect holiday.”…………………………….
The first time it happened, I was nine years old. My fourth-grade teacher asked me to go to the administration office to pick up some papers. When I arrived there, a strange and terrifying sensation came over me, like I wasn’t sure what I was doing.
Am I really here? Is this me or someone else I’m watching? Is this real?
I was freaked out, but managed to tell the woman at the desk what my teacher needed. I sat in a daze while she gathered the papers. It felt like the color had drained from my face and my body was numb. I hoped no one noticed that anything was wrong. There was no way I was going to tell anyone, it was too weird. I wouldn’t have been able to describe it, and I assumed no one would understand. I rushed out of the office and felt better outside……………………………………………..
Secretary Alex Azar, U.S. Health & Human Services, announced that the Administration will allow states to apply for Medicaid waivers to pay for mental health treatment in inpatient settings known as IMDs, or institutions of mental disease. Historically, Medicaid has not paid for treatment in these settings for most adults. While this policy was intended to reduce inhumane institutionalization, it also resulted in unequal coverage of mental health and, tragically, a lack of appropriate options for people with severe mental health conditions. If we treated other chronic conditions this way, far more people would die from diabetes, epilepsy, hypertension and heart disease.
On September 12th, NAMI and 11 of our colleagues on the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) sent a letter to Administrator Seema Verma of the Centers for Medicare & Medicaid Services, calling for Medicaid to cover care provided in inpatient settings, or IMDs and strengthen quality and continuity of care to community services. The ISMICC letter also asked for greater flexibility to pay for evidence-based outpatient services to reduce reliance on hospitalization, such as Coordinated Specialty Care in early psychosis programs and Assertive Community Treatment (ACT) teams. We are so pleased that our recommendations were well received and are being implemented. These changes will make a positive impact on people living with severe mental illness.
“This is a landmark day for people living with severe mental illness and their families,” according to Mary Giliberti, NAMI’s CEO. “ISMICC played a key role in changing the paradigm from neglect to one of care and compassion for the millions of children, youth and adults of all ages who live with severe mental illness in America. We’re grateful that the Administration listened and provided the flexibility and direction for states to improve access to continuity of care for millions of Americans and their families.”
NAMI applauds CMS for issuing a detailed letter to State Medicaid Directors that not only allows greater flexibility for inpatient treatment in IMDs, it also takes heartening steps to encourage states to improve outpatient services, including crisis stabilization programs. Today’s guidance could provide a shot in the arm to mental health care. NAMI strongly urges states to step up to the plate and use this flexibility from CMS to improve care for people with mental health conditions.
CLICK HERE to view November 13, 2018 Medicaid Federal-Policy
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