Email | Print

I attended the annual conference and 20th anniversary of the National Alliance for the Mentally Ill's New York State (NAMI-NYS) chapter held October 25-27 in White Plains, NewYork. NAMI-NYS was founded in 1982 by Muriel Shepherd when leaders of 12 family support groups determined to make a difference in the quality of life of persons suffering from mental illnesses. They advocated for legislation for comprehensive mental health services including benefits, housing, innovative treatments and rehabilitative community outreach programs.

Among numerous NAMI-NYS successes are the representation of two family members and two consumers in the State Mental Health Planning Advisory Council, and, together with other advocates, the legislation for the Community Mental Health Reinvestment Act of 1993, which allocated money saved from the closing of state psychiatric institutions to community programs.

At the conference, Sharon Carpinello and Linda Rosenberg presented "Winds of Change," the consumer knowledge-centered program involving families. They support recovery by providing tools for employment, wellness, and community integration enhanced by self-help and peer support groups. Mrs. Rosenberg emphasized the importance of mental health issues and the necessity of skill-building in the curricula of graduate students, especially social workers who provide most services.

Darlene Nipper, NAMI director of multicultural and international outreach, discussed attaining a full spectrum of quality and culturally-sensitive services for minorities with emphasis on common interests rather than differences and involvement at the grassroots level. She said: "I think NAMI should engage and involve people from diverse backgrounds into research. I really do believe in change and in getting passed our race differences. We must start thinking of multiculturalism as a value."

Peter J. Weiden, MD, director of the Schizophrenia Research Project at the State University of New York's Downstate hospital held the workshop on "Treating Schizophrenia," with Betts Custer, NAMI-NYS Board Member moderating. Dr. Weiden emphasized the advantages of the new atypical antipsychotics Zyprexa, Seroquel, and Risperdal, which have fewer side-effects than the older drugs. In his opinion, it is worth trying new medications when some fail because each individual has a different reaction to different medications.

Dr. Weiden recognized the limits of ongoing pharmaceutical research, which has not come up with a drug comparable to Clozaril, which works when all other drugs have been tried without improvement. He discussed the awareness among clinicians of the serious weight-gain associated with Zyprexa, yet its effectiveness on the negative symptoms, including withdrawal, blunting of emotions, cognitive and learning problems. Dr. Weiden said, "We can't in psychiatry be certain that a medicine will work. It is an issue of trial and error."

In the 1950's, psychoanalysis was used for people suffering from schizophrenia without positive results. In the 80's, medications were the primary mode of treating it as psychoanalysis seemed detrimental. For the last 15 years, the movement has been the cognitive approach of medications and therapy combined. Dr. Weiden discussed the newest atypical antipsychotic, Aripiprazole, which controls the production of dopamine better than the other atypicals. Too much dopamine in certain parts of the brain induces psychosis according to most theories. "It will help individuals who do not respond to other antipsychotics and does not have vexing side effects; my experience has been that it's been helpful."

David J. Printz, M.D. of the New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, presented "Advances in Schizophrenia Research," and discussed the clinician's diagnostic process. He said diagnosing schizophrenia is complex because "[it] is much stigmatized due to its severity, which influences the person's sense of self." Sleep, appetite, social aspect, the longitudinal course of illness, what triggers episodes, what improves its symptoms, family history of genetic occurrence of mental disorders, co-morbidity, childhood history and thyroid function are all taken into consideration.

Dr. Printz commented on the antipsychotics Zyprexa, Seroquel and Geodon. The weight-gain caused by Zyprexa presents the danger of diabetes, whereas the newer Geodon is not sedative, but known as "caffeinated Risperdal," frequently causing insomnia. Provigil is recommended as "a non-stimulant treatment used against daytime persistent sedation, virtually without side effects." Topomax is prescribed to counter Zyprexa's weight gain and is nicknamed "Stupomax" because of cognitive side effects.

Lamictal, a mood stabilizer for bipolar disorder is prescribed for the control of psychotic depressive episodes in schizophrenia. Lithium and Topomax, he added, cause the most cognitive problems in bipolar patients.

The conference concluded with a keynote address titled: "Research Advances and the Erosion of Stigma: 20 Years of Progress in Mental Health," by former director of the National Institute of Mental Health and host of the award winning NPR radio program The Infinite Mind, Frederick K. Goodwin, M.D.

Dr. Goodwin defined stigma as "prejudicial attitudes and behaviors regarding mental illness, the mentally ill, and/or mental health professionals, whose roots are ignorance, fear, and a sense of helplessness."

"We as professionals tend to be stigmatized by colleagues…. Stigma is heating up in mental health…. Trivializing stigma is more damaging (i.e. mental illness is not a real illness)." He discussed the role media plays in stigmatizing the mentally ill. Seventy percent of the mentally ill portrayed are violent. He heralded the public figures, celebrities and politicians "coming out of the closet" with their mental illness, instrumental in the de-stigmatizing of mental illness. "Mental illness involves the seed of our soul, what is human in us… more complicated because it involves feelings, relationships… because they affect the core of our personhood." He highlighted the impact of the psychopharmacology revolution providing clear evidence of the biological roots of mental illness, infusing optimism and hope for better treatment.