Republican political purity trumps the need for mental health and substance abuse services

The need is huge for effective mental health and substance abuse programs in Wyoming. The Wyoming Department of Health has been on the forefront of proving those services through its Medicaid-funded waiver programs. They fund treatments for low income residents but also for middle income people who have no health insurance, or insurance that limits coverage for mental health and substance abuse. National insurance parity legislation has helped some, but treatment is expensive, especially if you have to send a child out of state, which our family has had to do three times. And President Obama's Affordable Care Act has helped in the areas of pre-existing conditions and the ability of families to keep their kids insured until age 26. Thanks Obamacare!

Current treatment tactics in wraparound care call for keeping family members close to home. A worthy goal but not always practical in a rural state such as Wyoming. Your regional treatment center may be full so those located in surrounding states may be your only option. Face it, a person in southeast Wyoming has a slew of treatment options along the Colorado Front Range, from Fort Collins down to Pueblo. Same goes for southwest Wyoming. Yes, the state hospital is in Evanston but not everyone qualifies for a stay there, so residents look to Utah's Wasatch Front for alternatives.

And now the Wyoming Department of Health announces cuts to its mental health and substance abuse treatments. These cuts are in keeping with demands by Republican lawmakers to make budget cuts when none are needed. The current budget-cutting mania is prompted less by necessity than by Tea Party-inspired, We Hate Gubment, politics.

From a Wyoming Public Radio story by Willow Belden:

The Wyoming Department of Health plans to cut millions of dollars of funding for Medicaid and for mental health and substance abuse services. That’s to meet a budget reduction required by the state Legislature. Lawmakers directed the Health Department to reduce spending by 4 percent for fiscal year 2014 and to prepare for additional 8 percent cuts in the following two years. Health Department Director Tom Forslund says the cuts will be painful. “The Department of Health provides critical services and funds critical services, and so we can’t cut our budget without impacting those services,” Forslund said.  He says the cuts will mean healthcare providers won’t be reimbursed as much for treating Medicaid patients, which make it harder for low-income people to get medical care. “There will be some healthcare providers who elect not to serve as many Medicaid patients,” he said. “And that’s what’s happened to a lot of states around the country – that the more they cut payments to healthcare providers, the less healthcare providers are willing to see Medicaid patients.” Forslund says for every dollar that the state cuts in Medicaid funding, Wyoming loses a dollar of federal funding as well.

We dread the call in the night, the knock at the door

I often recommend the blog postings of Rodger McDaniel. I just can't help myself. The topics are, well, topical and meaty. The writing is crisp. And the Rev. McDaniel is a feisty Liberal, something we desperately need in Wyoming.

Rev McD served his state as director of the Health Department's Mental Health and Substance Abuse Services Division during the Freudenthal administration. So, when those topics arise, he has the expertise to address them. That's what he did this morning. He wrote about the late Sen.  George McGovern's greatest loss -- the death of his adult daughter, Teresa. After an eight-year stretch of sobriety, she started drinking again. One cold night, she got drunk, wandered out of her house and froze to death in the snow.

When the men with dour faces came to George McGovern's door in 1994, he knew their mission. This haunted him and his wife Eleanor the rest of their lives. They had decided to put some distance between themselves and their daughter. You could call it "tough love." It is the approach that one learns in AA and Alanon. That's little comfort for parents who lose a child.

We know. All of us who have struggled with this issue. We know how hard it is to say, "No more." We all dread the phone call in the middle of the night. Or the stone-faced messengers at the door. Tough love does not take away the sting of losing that boy or girl that we pushed on the playground swing and carried on our shoulders.

Read Rodger's column here: http://blowinginthewyomingwind.blogspot.com/2012/10/1972-was-not-george-mcgoverns-greatest.html

Early intervention and prevention crucial for children's mental health

Here are some points to ponder about children’s mental health. As a parent of children with mental health challenges, and as an adult who's dealt with recurring bouts of depression, I ponder these things often and not only during the upcoming week devoted to education and awareness. Governor Matt Mead will sign a proclamation on Wednesday, May 9, 10 a.m., designating May 6-12 as Mental Health Awareness Week. The following stats come from the Federation of Families for Children’s Mental Health. 

• One in five young people have one or more mental, emotional, or behavioral challenges.  One in ten youth have challenges that are severe enough to impair how they function at home, school, or in the community.
• One-half of all lifetime cases of psychological challenges begin by age 14, and three-quarters begin by age 24.  In addition, 80% of people who experience multiple issues with mental health and substance abuse report onset before the age of 20.
• Suicide is the third leading cause of death in adolescents and young adults. Children experiencing symptoms of psychological challenges, particularly depression, are at a higher risk for suicide.  An estimated 90% of children who commit suicide have a diagnosable mental illness.
• Despite high rates of mental illness in children, 4 out of 5 children ages 6 to 17 who have experience symptoms do not receive any help.  The majority of those who do not receive needed mental health services are minority children.  For example, 88% of Latino children have unmet mental health needs.  In addition, Latino children are less likely than others to be identified by a primary care physician as having a mental disorder.
• Unmet mental health needs may complicate daily activities and education for youth.  Almost 25% of adolescents who required mental health assistance reported having problems at school.  Over 50% of students who experience psychological challenges, ages 14 and older, drop out of high school—the highest dropout rate of any disability group.
• Early detection and intervention strategies for mental health issues improve children’s resilience and ability to succeed in life.  According to a study by the National Institute of Mental Health, preschoolers at high risk for mental health problems showed less oppositional behavior, less aggressive behavior, and were less likely to require special education services 3 years after enrolling in a comprehensive, school-based mental health program.

What can you do?

Create awareness surrounding positive mental health practices and supports.  Work to reduce stigma!

Contact your local, state and federal legislators to request funding for early intervention and prevention programs. 

Encourage culturally and linguistically competent supports and services.

UPLIFT has a terrific list of resources for Wyoming families at http://www.upliftwy.org/resources.html. I am on the UPLIFT board and admit to a certain bias. But it is a terrific list.

WTE Online: CRMC offers psychiatric service through computer

This is a great idea for a rural state (Wyoming) which has high risk factors for suicide, domestic violence and substance abuse -- and one that serves its 580,000 residents with just 30 psychiatrists (one per 19,333 people), most located in cities: CRMC offers psychiatric service through computer -- Wyoming Tribune Eagle Online

UPLIFT presents Rodger McDaniel with public service award

Photos by Mindy Dahl

Wyoming Tribune-Eagle education reporter Josh Mitchell wrote about UPLIFT’s 20th anniversary celebration in Wednesday’s edition.

The celebration was held Tuesday evening in the Cole Elementary school gym. One of my fellow UPLIFT board members, Brenda Ducharme, teaches at the school.

UPLIFT, the Wyoming affiliate of Federation of Families for Children’s Mental Health, presented Rodger McDaniel (shown in lower left in photo with UPLIFT Director Peggy Nickell) with its public service award. McDaniel is the outgoing director of the Wyoming Department of Health’s Mental Health and Substance Abuse Services Division. He will be missed.

I served with Rodger in the early 1990s on the first board of Laramie County Habitat for Humanity. I moved on to other volunteer roles and a few years later, Rodger and his family were in Nicaragua directing that country’s Habitat projects. He returned to his law practice, became an ordained minister and was eventually tapped by Gov. Dave Freudenthal for public service. His retirement was announced last week.

Rodger’s been crucial in bringing vision to a state that struggles with some rotten mental health and drug abuse statistics. Crisis centers – even in the Capital City – are few and far between, as are clinicians. The division’s Medicaid Waiver program for children and teens have helped pay for residential treatment and, even more importantly, aftercare when the child returns home.

Here’s hoping that Rodger and his colleagues have put us on a course that even 2010-style regressive politics can’t change. Wyoming’s new “Code of the West” may be fine for ropin’ and brandin’, but it doesn’t help curtail alarming teen suicide statistics and the state’s shortage of quality children's mental health treatment.

Josh interviewed me for the Nov. 17 story. My two cents worth:

Mike Shay is an UPLIFT board member and both of his children received help from the organization.

UPLIFT outreach coordinators attend school meetings with parents, Shay noted. The organization helps navigate parents through the complex system and connects families with different services, Shay added.

“UPLIFT”s been crucial in Wyoming,” Shay said.

I’d send you to the WTE site to read the rest, but it’s not on there.

As I've said here before, my son struggled with ADHD and my daughter has mental health issues. Both were helped by the incredible UPLIFT staff. We need these professionals to navigate school and government and treatment centers. They serve as guides to us confused, stressed-out parents.

You can find out more about UPLIFT at http://www.upliftwy.org/

Can't leave well enough alone? You must be a blogger.

Did your mom or grandmother ever say, "You can't leave well enough alone?"

Funny expression. When it something "well enough" and why should you leave it alone? Shouldn't it be "well done" or just finished?

Many bloggers I know can't leave well enough alone. Maybe that's what drew them to blogs in the first place. Unlimited space where you can ignore well enough into eternity.

Anyway, some of you followed my serial tale of the Oct. 22 near-miss crash with a drunk driver on I-25. I told the installments on Facebook as sat in my Ford on the way to Pueblo later than day.

I received an "unsafe lane change" ticket which I was going to pay but thought better of it. The young driver who almost killed us was busted for DUI -- drunk at 8:15 a.m. So I decided to write a letter to the Colorado Department of Motor Vehicles and copies to various other agencies (see the end of the letter).

Here's the letter:

Oct. 26, 2010

Colorado Division of Motor Vehicles
Department A
Denver, CO 80243

To Whom It May Concern:

I am not a perfect driver.

But I am a pretty good one.

I drive thousands of on-the-job miles around Wyoming each year. That’s in all kinds of weather. I put thousands of personal miles on my own car each year traveling back and forth between Cheyenne and Fort Collins and Denver, which is my home town.

No tickets. No wrecks. Maybe a few close calls, but that’s to be expected in the Rocky Mountain states, where driving conditions can change in the blink of an eye.

That’s how accidents happen – in the blink of an eye. I may have blinked on Friday morning, Oct. 22, near the Harmony Road interchange on I-25 in Larimer County. I looked in my side view mirror, clicked my turn signal, and then eased into the left lane. I was avoiding the heavy morning traffic merging on to the highway.

Next thing I know, I saw a green Subaru on my left. I pulled back to the right lane, slowed and watched as the Subaru kicked up a cloud of dust from the median and then crossed right in front of me and off to the right. In the chaos, I slowed and pulled off to the right shoulder about 100 yards down the road. I got out of the car and made my way back to the Subaru. It was upright facing the wire fence. The car had a few dings and the tries were flat. The driver was out of the car and seemed to be O.K. I apologized, certain that I had caused the accident. The driver was young, maybe mid-20s, with a sparse beard. He was dressed in black. His hands shook from the shock, or at least that’s what I thought at the time.

Thirty minutes later, he wore handcuffs in the back of a Colorado State Patrol car. He was on his way to jail for driving while impaired.

And I got a ticket for unsafe lane change. Or, as the ticket read: “Changed lanes when unsafe.”

Funny how your perception can change almost instantaneously. One moment I’m feeling terrible because I may have made a bad move that led to the wreck of another person’s car. The next minute I’m thinking, “We could all be dead.” “All” meaning my wife of 28 years, my 17-year-old daughter and me. And the driver of the Subaru who was drunk at 8:15 on a Friday morning.

When I was merging left on the highway, I didn’t see the driver of the Subaru because he wasn’t there. My guess is that he was behind me and tried to speed around me on his way to work, which is where he said he was going. My statement to the police said that “I didn’t see the Subaru.” I meant that literally. When he looked in my side view mirror, the Subaru wasn’t there. And then, in the blink on an eye, he was there and spinning out of control in his 4WD Subaru Outback. That’s one safe car, known for its reliability and safety. That the driver emerged unhurt speaks to that.

But you can give an impaired driver the world’s best car and he or she can find ways to do unsafe and dangerous things in it.

I am contesting my ticket. I may end up paying it when I go to court in Ft. Collins on 1/14/11, and that’s something I can live with. But I want the record to show that the unsafe lane-changing driver was not me but the driver of the Subaru. He was unsafe when he got into his car that morning. He was unsafe speeding down the highway. My miscalculation resulted in his unsafe and unsound response that downed a highway light pole, wrecked his car, and could have resulted in death or injuries to my family and any number of other drivers on the road that morning.

I conclude by commending the Colorado State Patrol, the Larimer County Sheriff and the ambulance EMTs who were at the scene. Professionals all. One patrolman even jumped my car, dead on the side of the road from extended use of emergency blinkers. Thanks to him, we quickly resumed our trip to Pueblo. We were late, but intact.

Sincerely,



Michael Shay

Cc: Colorado State Patrol
Larimer County Court
Farmers Insurance