Rochester Post Bulletin: New law equalizes mental health insurance coverage

By Jeff Hansel
Post-Bulletin, Rochester MN



Insurance that covers 80 percent of the cost for an appendectomy might pay only 50 percent for mental-health care.

After a decades-long battle, that disparity is about to change.

The Paul Wellstone Mental Health and Addiction Equity Act used the $700 billion economic rescue package to gain enough votes. Along with financial rescue came federally mandated insurance equality for people with mental illness.

"Finally it's being recognized," said Pat Schwartzhoff of Rochester, who has experienced depression and talks at school assemblies about mental illness. The bill passed in October and was signed into law by Pres. George W. Bush.

The mental-health equality portion of the bill is just as significant for many people as the Americans with Disabilities Act, which in 1990 banned discrimination against people with disabilities.

Mental illness insurance coverage must now equal coverage for physical illness.

Minnesota's Sen. Paul Wellstone, who died in a 2002 plane crash, fought to pass such legislation, but the needed votes eluded him before his death.

"I am absolutely proud that it's named after my father," said the late senator's son, Dave Wellstone.

The younger Wellstone started working to get the bill passed right after the plane crash that killed his parents, sister and five others.

"We all know somebody with a mental illness or who suffers from addiction," Wellstone said. "This is going to be groundbreaking."

The bill doesn't require that mental health be covered. Instead, it simply requires that, if physical health is covered, that mental health is covered at the same level.

"If it's offered now, then it will have to be brought up to par with the physical illnesses," Wellstone said.

The bill lagged for many reasons, he said. For one, there's a lot of stigma related to mental illness.

"To be able to help leave that legacy that's now in law, it's kind of a way to make sense of things," Wellstone said.

Working for the bill helped him heal.

"When you lose your family, you try sometimes to make sense out of it, and try to have good things happen," Wellstone said.

Pat Schwartzhoff's husband Earl, 64, said he worked as a health-insurance company manager for more than 25 years, supervising, at one point, three states.

"If you have an appendectomy, with most insurance companies, the claim will be handled easily," he said. Not so with mental illness. Two sets of rules exist, one for mental and one for physical health.

"They will quiz you, for lack of a better word. It's like they question the diagnosis of your doctor and you have to jump through so many hoops," Schwartzhoff said.

The new national law takes effect in 2010.

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Laura redefines insanity ... and sheds some light on our modern world

My buddy Laura (or my close personal friend Laura, as I refer to her when I'm trying to bask in reflected glory) writes a fascinating blog about birds called "Laura's Birding Blog" and edits an equally fascinating but whimsical blog called "Twin Beaks" (actually, i think she writes that one, too, but I have learned NEVER to antagonize our local chickadees) when she's not writing books -- or instant messages to me.

This week I happened to share that when you tell IT urchins (the Information Technology students who work at the University where I do) that you have renamed "My Computer" to "Pete," it bewilders them.

Which prompted this thoughtful reply from Laura:

IT urchins are always bewildered. They expect the world to work exactly opposite of the definition of insanity--there is supposed to be a way of analyzing a problem and finding a solution. But computers don't work that way. My computer at work, when it turns on, either has a working cursor or doesn't--you can't predict which times it won't, and all you can do is turn it off and reboot it. And part of the time that works, and part of the time it doesn't. So to make it work one must do exactly the same thing over and over, hoping for a different result.

No wonder IT people are fragile and bewildered.

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The Orange County Register: Giant poodles save the day

The canine versions of Jimmy Stewart and Rita Hayworth help a Santa Ana psychologist work with children.
LORI BASHEDA
The Orange County Register


There I sat on psychologist Amy Stark’s couch with her sidekick Jim sitting practically on top of me. I had only known Jim for a couple of minutes and already his face was so close to mine.

I could smell his breath as he stared hard into my eyes.

Longingly? Wistfully? Sadly? I couldn’t tell.

I wondered what he was thinking. That I was clearly in need of some counseling? Or was he just wondering if I had a can of Purina in my purse?

Jim is a giant poodle.

Standard poodle is the correct name. But Jim is 4-feet tall from his enormous toe pads to his curly head. That’s only a foot shorter than I am. So to me, he’s a giant poodle.

Rita is not as tall as Jim, and more high strung, but she is friendly.

Rita is also a giant poodle.

•••

It was Rita who greeted me when I walked into Stark’s waiting room the other day in Santa Ana.

On the wall hung framed head shots of Jim and Rita with the title: “Employees of the Month.”

And behind the counter, standing on her hind legs, peering out from behind that little window that doctors offices have, was a rather serious Rita, her front paws resting on the counter like she was about to collect a co-pay.

She was taller than me and her head was the size of a human’s. I laughed nervously, but she just stared at me, all business.

Jim and Rita followed me into Stark’s office, which is really too cold a word for what I found. It was more like someone’s cozy living room with sofas and lots of stuffed animals.

“I want this to be a calm place, because we have to talk about some hard stuff here,” Stark says.

A PhD clinical psychologist, Stark gives court-ordered therapy in family reunification and child custody cases. Most of her patients are kids; kids who have been through the wringer and have an easier time trusting giant poodles than humans.

In Stark’s office, the kids let Rita lick their ears and invite Jim to rest his head in their lap.

“Some of these kids come and lay on Jim if they’ve had a hard day,” she says.

Jim tends to go to whoever in the room is upset. If a different person becomes upset, he moves to that person. Basically, Stark says, “if Jim sleeps through a session, we know we’re doing better.”

When Stark’s young patients use puppets to role play, giving her a window into what might be going on in their lives, Rita and Jim are an attentive audience.

“My dogs love to watch puppet shows,” Stark says. “They cock their heads and get really involved. Sometimes they march behind the chair to see the kid and then go back and sit down and watch.”

By the end of a day, they’re exhausted.

•••

At Stark’s home, Jim and Rita unwind on leather recliners in the den. Stark had to teach them to stop reclining because she was afraid they might hurt themselves.

Jim likes to watch TV. “Oh, he loves the Westminster dog show,” she says. “Every year, he watches the whole thing.”

He also likes dramas. But sometimes they upset him. Once, Jim got so worked up over some actors fighting on TV that his baby sitter (Stark was having a garden tour that day) had to turn the station to the gardening channel.

“I gotta say, sometimes I think Jim is not even a dog. It’s like Jim’s a person and Rita is his dog. Like Goofy and Pluto.”

The dogs spend a few weekends a year with a trainer to brush up on their manners so they’re in control at the office. They also get groomed twice a month; the Park Avenue cut. And Stark brushes their teeth twice a week. To keep them healthy, she feeds them Himalayan berry juice, cranberry extract and vitamin supplements with their Purina.

Stark’s first dog was a Boston terrier she got as a child. His name was Princie. “He was a snarly little thing,” she says. And that might explain why she now gravitates to the large dog.

The first dog she bought as an adult was a black standard Poodle she named Greta Garbo. Stark had Greta trained as a therapy dog and together they would visit hospitals and senior homes.

When Greta died seven years ago, Stark drove to Northern California to look over two new litters of giant poodle pups and returned to her home in Floral Park, an English Tudor with English fairy gardens, with Jim and Rita.

•••

Stark initially gave Jim a different name: Spencer, after Spencer Tracy. But he wouldn’t answer to Spencer. So she switched it to Jimmy Stewart. “Plus he’s tall and lanky and very likable like Jimmy Stewart,” she says.

Rita is named after Rita Hayworth. Once while walking Rita in Laguna Beach, a woman overheard Stark call Rita’s name: “Rita Hayworth, come back here!” she shouted. The woman told Stark she had actually been an old friend of Rita Hayworth’s and that her old friend would have been pleased.

As soon as Stark finishes her book about ballroom dancing (she competes at the bronze level), she plans to write a book about Jim and Rita.

“When you think about it, they hear a lot of stuff,” she says.

The book will be stories about them, the kids they’ve helped and the letters and notes they’ve received, some of which are taped to the back of Stark’s office door. “Jim Rocks,” reads one tribute, in crayon.

It won’t be Stark’s first book. She had a book published in 1992 called “Because I said so.” It was about people taking their childhood dynamics into their work lives and the problems that causes. After the book came out, Oprah had Stark on her couch for a show called “Bosses wives who drive secretaries insane.”

Maybe Oprah can have Stark on again.

The show can be called “Giant poodles save the day.”

Contact the writer: dramystark.com714-932-1705 or lbasheda@ocregister.com

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SFGate: Brain workout may help anxiety, study suggests

Charles Burress, Chronicle Staff Writer

Wednesday, December 17, 2008

Could Sudoku be a balm for anxious people?

A new study suggests that intellectually demanding challenges like crossword puzzles or chess may be more successful at keeping worry-prone people from worrying than supposedly relaxing pastimes like watching TV or shopping.

Contrary to theories that "as things get harder, anxious people fall apart, this suggests it's the opposite way around," said UC Berkeley psychologist Sonia Bishop, lead researcher on the study published online this week by Nature Neuroscience.

The study showed that anxious people performed just as well as others when facing tasks that demanded concentration, but they took more time than others to complete tasks that were easier, Bishop said.

Their slower response time to challenges not requiring full attention was accompanied by reduced blood flow to the prefrontal cortex, which serves as the brain's CEO in thinking, planning and active memory.

The study indicated that anxious individuals have a weakened ability to block out distractions and that they might benefit from mindfulness training, which often uses meditation and stress-reduction exercises to help increase one's awareness and focus.

"With some very popular therapies like mindfulness training, people aren't sure why they work," Bishop said. "This perhaps gives us a rationale for why they do."

The results also challenge another explanation for why anxious people face day-to-day problems in concentration and work-related cognitive function, Bishop said. It has been argued that the "fight or flight" response center of the brain, the amygdala, overreacts to threat-related stimuli in anxious people, thus playing a central role in undermining concentration. But the new study suggests that attention-focusing ability in such individuals is impaired even when the amygdala is not extra-active, and thus their difficulties with concentration may be determined by a different mechanism, she said.

The study consisted of simple letter-recognition tests given to 17 volunteers, ages 19 to 48, while blood flow to a section in the front of the brain called the dorsolateral prefrontal cortex was measured by magnetic resonance imaging. The volunteers, seven female and 10 male, were from Cambridge, England, where Bishop did research at the University of Cambridge before becoming an assistant professor at Berkeley in July.

The results were scored according to the difficulty of the tests, including the distraction level of extraneous elements, and correlated to the volunteers' degree of anxiety. Surveys indicate that nearly a fifth of U.S. adults suffer from one or more anxiety disorders in a given year, Bishop noted in the study, titled "Trait anxiety and impoverished prefrontal control of attention."

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Stuck: Cut, Then Run

By Anneli Rufus on December 14, 2008 in Stuck

One poignant thing about the holiday season is all those Ghosts of Christmas, Chanukah and Kwanzaa past: folks who were once essential features around your table or tree but now ... aren't.

Why are they no longer with you? Some are literally gone; they're deceased, and you miss them and mourn them and know you'll never get them back. Others have drifted away. From some friends and relatives, you've grown apart. Yet others ... well, you snipped those bonds for what seemed like good reasons at the time but now you wonder, as the years go by and the gaps around that table or tree increase: Was losing that once-loved one really worth it? What fight was it, what quirk, what offhand remark in the wrong place, at the wrong time?

Sometimes the answer is clear, the moral crime in neon lights, the wound irreparable. She stole my husband. He stole my job. They ridiculed me in front of my children. But other times (most times), when we choose to end a relationship - intimate or platonic or biological - it's because that person insulted us in some way that felt unforgivable. These scenarios are as subtle and diverse as we are. And the trail of burned bridges extending behind us represents one of the trickiest paradoxes in human life: Where do we draw the line between forgivable insults and unforgivable ones, between wounds that will and will not heal? We are told from infancy onward that forgiveness is divine. Yet we are also schooled to sustain sky-high self-esteem, to not abide those who deflate it. Sometimes it's hard to have both. Where do we draw the line between forgiveness and self-abasement, forgiveness and selling out our own souls? At what point can you reliably say that someone has gone too far?

Granted, most people end relationships in stages. They announce that they're upset, they explain why, and the alleged upsetter gets a chance to explain and potentially redeem him- or herself. This either works or not. But at least he or she had a chance. I, on the other hand, am a cut-and-runner. Gone without a trace. Vanishing act. Now you see me, now you don't. I never was the kind to stay and fight. Not that I'm proud ot this: When interpersonal matters reach a certain degree of unpleasantness, rather than talk it out I flee. I always vow to change: Next time, I tell myself. Next time.

But no. I've always been this way. I had a college friend who liked to mock me in public. No sooner would I vouchsafe Gwen a secret than she would announce it at a party in front of everyone.

Guess what, you guys? Gwen would declare, pointing at me. She went to the emergency room in the middle of the night because she thought she had leprosy!

One night at one of those parties I shouldered my backpack, turned and left. This is how it is with cut-and-runners. We reach a saturation point and silently, without warning, flee. Gwen was neither the first nor the last. Cut-and-running is a desperate act and only vaguely punitive. Escape elates one at first, a giggly euphoria as one spends a few days relishing the tingly relief of the survivor. Afterwards - sometimes years afterwards, and often at holidays - regret seeps in. We should have talked. We should have had it out. If for no other reason, then at least to have said: You've hurt me and here's how. A kind of horoscope - if for no other reason, then at least to maybe save others from being hurt somewhere down the road.

This is a core theme in Elizabeth Drummond's intelligently tender new novel An Accidental Light. Two of its main characters are adults long estranged from their parents; after a personal tragedy, each ponders the option of rebuilding those burnt bridges.

How late is too late?

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Thea Gilmore: Songs were Thea's way out of depression

THEA GILMORE

Before the release of Harpo’s Ghost, Thea had been diagnosed with depression. During this time Thea had split with her previous record label and (temporarily) with her long term partner. Prior to Liejacker, Thea was faced with further hard-times when she parted company with her manager of ten years standing, split with her “new” and biggest record label yet after one album - and, almost as if for good measure, gave birth to her first child.

Liejacker is the testament to that journey. It began with Thea still battling off the shadows from her illness, writing her darkest, starkest songs ever. Liejacker also sees Thea at her most direct, “where in the past I’ve probably been guilty of hiding a little bit, falling back on an image or a metaphor - this time I was trying to get to the bone, to just tell it like it is. The genesis of this record was very different from my previous albums. It’s the first album that I’ve really felt a deep burn to make.”

Even whilst making Harpo’s Ghost - perhaps as a reaction to that record’s harder, glossier sheen - Thea spent hours buying up reams of quirky acoustic instruments - old banjoes, harmoniums from India, dobro guitars: and these became the instruments on which the new songs found their home.

The next step was to practically barricade herself in her newly acquired home studio, “Well I say studio... it’s basically a tiny 9 foot square room in my house. I practically had to mount the mike stand on the desk to sing and when I recorded the guitars I’d have to be halfway out the door. But for all the recording oddities, I was making music that was gritty and genuine. The songs kept coming and coming and I was able to record them as they arrived. As a result, I think they have a much less self-conscious feel to them. They are entities in themselves, quite apart from me.”

Thea went beyond merely the writing stage to create musical parts and arrangements herself. Before playing them to producer Nigel Stonier and her team, “The new material was so personal, it told a new story and I wasn’t even sure at first whether I wanted the world to hear that story in quite such direct terms... but the words kept appearing.”

Some of them were positively harrowing; “And You Shall Know No Other God But Me” is a chilling account of the dependencies we all fall prey to at some time in our lives. “The Wrong Side” has a jaunty lope that masks a descent into self loathing and a sympathetic suggestion to her lover that he should jump ship for his own sake and, right at the core of them, “Black Letter”, which has to be the most pithy song about depression since Nick Drake wrote “Black Eyed Dog”.

Just around the corner were the redemptive “Breathe” with its triumphant air of self-acceptance, and “Dance In New York” an exultant ode to the power of longing and the deep need for solid ground. New York takes the role of the eternal lover, arms always open. And then there’s the ethereal “Old Soul”, the album’s first single. Thea wrote the song while 8 months pregnant, and says “I was determined not to turn to mother-mush after having my son. So many people just wait for the fluff to appear in your music as soon as you so much as whisper “pregnancy” and I never really could figure out why. But the concept of “Home” and what it really means to me is a recurring theme in my music, has been for a long time. When I had a child, I really understood what home meant to me. That very deep, primal instinctive warmth for another and the roots that bind you in this life and down every generation to come. That’s my home, and it is eternal.” The metaphysical search is there in the lyric for all to interpret.

And ultimately, there’s the bonding force that both pulls the album’s themes together and also closes the record. “The Lower Road” is an almost unbearably moving peaen to hard won victories, to endurance and forgiveness. It begins with a racist lynching, references the grim shadow of the war in Iraq and everyday domestic abuse, in amidst insisiting that “We will be rolling on”. Not exactly “You’re Beautiful” then. The song closes with perhaps Thea’s finest words yet:

“There’s no telling which way, boys,
This thing is gonna take hold
From the fruit on a poplar tree
To the bruise round a band of gold
From the blood in a far country
To the war of just growing old
We travel a lower road
It’s lonely and it is cold
But we will keep rolling on...”

Emerging from the home studio with her new store of songs, Thea chose to leave the performances untouched - and that’s how many of them appear on the final record. Hence many of the original vocals remain, hence the groove on ‘The Wrong Side “ comes from a cutlery drawer, grill pan and a chimney hood rather than orthodox drums and.hence any guitar solos on the record are by Thea herself.

But having brought the material into her favourite studio, the Loft in Liverpool, and for good measure adding a couple of new tunes to the pot, Thea then called upon some of her favourite kindred spirits. Erin McKeown added vocals to ‘Dance In New York”, and Waterboy Steve Wickham was invited to play fiddle on “The Lower Road.” Zuton-in-chief Dave McCabe duetted on “Old Soul” and unearthed magical, hitherto unheard soft tones to his bluesy voice. Thea was then left with the task of finishing “The Lower Road”, whose narrative is told in several different voices: she delivered “Liejacker”s last trump card by inviting the legendary Joan Baez - a long term fan with whom she has toured the US - to duet on the song. “Joan Baez practically invented my job some forty odd years ago - I can’t think of anyone else on the planet with the voice, the presence and the standing to carry this off.” Not only was Joan pleased to be asked, but she fell in love with the song and has recorded it now for her own forthcoming album.

So Liejacker, born of the darkest beginnings, ends with positives abounding. The mood remains stark and acoustic, with celloes, dulcimers and ukeleles adding colour here, texture there. “Old Soul”, chosen as the first single sets the record in motion with its quest for the truest of truths - and “The Lower Road” closes it. The album is thus framed by guest appearances with an arena filling indie rocker and an iconic folk singer/activist: but while the compliment paid implicitly by their involvement is indicative of the esteem in which Thea Gilmore is held, the songs and the story of Liejacker are solely the work of one pen and one voice, Thea Gilmore. According to Mojo she remains “the most coherent and literate of singer/songwriters”. Liejacker is a beautiful piece of work that will only enhance the evolving legend.

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Ventura County Reporter : Uncomfortably numb

Mental health, illness and wellness in Ventura County

By James Scolari 12/11/2008

Last week my aunt found herself crying in a restaurant for no reason that she could discern, and found that she couldn’t stop. She was with her husband of nearly four decades, a man whom she loves, and their life is good — they raised four daughters, all of whom have more kids than I can count, every one of them well and whole and hale. The bills are paid; by nearly any measure she is blessed, and yet there she sat, in the Olive Garden, unable to stop crying. As I loaned a sympathetic ear to her malaise, I couldn’t help but hear the strains of Pink Floyd, of Roger Waters singing from the landmark album Dark Side Of the Moon:

The lunatic is on the grass
The lunatic is on the grass
Remembering games and daisy chains and laughs
Got to keep the loonies on the path.

It’s not that I minimized or failed to understand her distress; in point of fact, I understood her too well — even if impromptu, irrational tears strike me as, well, a little nuts, though it feels as if it’s more about the age than about her life.

If there was an age that could broker nameless malaise without tangible source, it would be this one.

People often refer to others of good sense or emotional stability as being “well-adjusted,” which connotes a subtext that looks, upon examination, rather dire. Adjusted to what, I wonder — to the generalized, de rigeur madness of a world that evolved more in service of commerce, power and busy-ness than humanity? Fearing that might construe an intuitive leap into a logical abyss, I consulted an expert.

“The term ‘well-adjusted’ suggests a stable personality that can dynamically adjust to life’s vagaries,” offers Matthew Bennett, Psy.D., of the Ventana Center for Psychotherapy. “It’s not an easy thing to build a self — it’s a vastly more difficult endeavor than most realize. The structure of a personality must be flexible and consistent and sustainable, in the face of what are the often-extreme demands of an unpredictable world and its inhabitants. While most of us seem to manage it,” he concludes, “we do so with more difficulty than is apparent to the casual eye.”

Read the full article ....

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