Facilitation Notes for M.I.K.A. Mental Illness Community Discussion

M.I.K.A. Mental Illness Knowledge Awareness

Date: Tuesday, March 12, 2019, 10-11:30 AM

Location: Blodgett Conference Room, Marcus Daly Memorial Hospital

Facilitators: Katelyn Andersen and Beth Fischer

  1. Welcome: Beth Fischer (National Institute of Health (NIH) – Rocky Mountain Laboratories) and Katelyn Andersen (Montana State University/Ravalli County Extension) welcomed attendees and ask for participants to give introductions stating their name and role in the community.
  2. Results from the February 2019 survey on Mental Illness: The electronic survey was sent to 100 individuals that were either signed up to receive information regarding mental illness/mental health and/or were identified as providing mental health services in the community. This survey was also posted online and requested individuals to complete it and forward to others who may be interested. The survey received a 188% response rate, far exceeding an external survey expectation of a 10-15% response rate.
    1. Speaker Series: Participants were asked to rank identified topics for the NIH speaker series based on their interest in learning more about the topic. The topics from most interested to least interested: 1) Depression and anxiety, 2) Post-traumatic Stress Disorder (PTSD), 3) Mental health and aging, 4) Drug abuse and alcoholism, 5) Bipolar Disorder, 6) Schizophrenia, 7) Postpartum Depression.
    2. Additional Topics: Participants were asked an open-ended question of, “Is there another topic you are interested in learning more about?” Many comments were received and had the following themes: Suicide (9 responses), Youth Mental Health (9 responses), Personality Disorders – including split, borderline, narcissist (8 responses), Trauma Informed (ACES) (4 responses), Impacts of Mental Illness – insomnia, chronic pain, eating, financial anxiety, fatigue, chronic grief, etc.
  3. NIH Educational Speaker Series: Beth Fischer shared how the idea of this series came together. Kimmo Virtaneva, a researcher at NIH, and his wife, Monica, shared their story of their son, Mika, who was diagnosed last year with paranoid schizophrenia and who tragically completed suicide last fall. Through the support of the institute director, Dr. Steve Holland, Rocky Mountain Laboratories (RML) was given permission to develop a lecture series focusing on Mental Health. This series was intended to educate employees but it was decided these topics would be of broad interest and RML received approval to share the expertise with the community.
    1. Role of RML: RML is a part of the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Health. The mission of NIAID and RML is to do research to understand, treat, and prevent infectious, immunologic, and allergic diseases. RML can assistant community stakeholders in accessing the resources through the National Institute of Mental Health (NIMH). NIMH is the lead federal agency for research on mental disorders. RML can bring in expert speakers to talk about research in mental illness and related topics, which aligns with their role of educating the community about science and public health. RML cannot fund grants or programs for community groups or other agencies, become involved with political, policy or religious activities, or share programs and information that is designed specifically for RML/NIH employees.
    2. Role of NIAID: It is not the intention to provide specific medical advice or endorse any specific approaches. Instead, NIAID provides information to help people better understand their health, diagnosed conditions, and the current approaches related to treatment, prevention, screening and supportive care. NIH urges people to consult with a qualified health care professional for diagnoses and answers to their personal medical questions.
  4. Where do we go as a community from here? Katelyn Andersen shared her role as a facilitator and community liaison for RML and the M.I.K.A. effort. As the facilitator, she will help stakeholders general potential action items, prioritize items, and help stakeholders create community impact related to mental health. The following notes are an overview of the facilitated discussion:
  5. Andersen requested participants to answer the following questions individually.
    1. What is happening in relation to mental health and mental illness? Reponses include the following: Survivor support group; hospital staff education; wellness classes for mental health (starting April 5 at Sapphire Community Health, 10-11 am Fridays); the first event of the MIKA series has opened up conversations; peer support; community education for: depression, psychology of pain; healthy relationships curriculum (9th grade), Anonymous Alert System at Corvallis; support group for survivors; promoting NAMI with: 1) family to family, 2) peer training, 3) provider training; Youth Aware of Mental Health (YAM) training through collaboration at Hamilton High School and Corvallis High School; opening up the community to share: 1) who has family members, 2) providers, 3) consumers; Tamarac-grief group centered in Missoula and other cities has some focus on suicide prevention – well organized group with resources and an interest in working in Missoula and Ravalli Counties; more dialogue decreases stigma; individual awareness and openness; Youth Crisis Diversion Program; education for school staff about youth mental health and illness; “Momedy” May 12 at Dennison Theatre, Missoula; Dementia/Alzheimer’s support group for caregivers through Ombudsman program; Trapper Creek Job Corps works with a wide range of young adults; Marcus Daly Memorial Hospital is doing depression screening on all patients at every visit: Emergency Department; Clinic, Inpatient and appropriately referring and follow up; community awareness, conversations evolving beyond fear; support group for ways to intervene with people at risk for suicide.
    2. What could happen in relation to mental health and mental illness?Reponses include the following: Mental illness resources available locally; support for youth mental health crisis; improved diagnosis; parent informational meetings; electronic use (safety); people in distress could have an easy time of finding help with stress; starting a safety group – dates and times are all to be determined yet; first responder training; recruitment for more psychologists or psychiatrists within our community to support the individuals while staying within their support system; detox unit with more intensive outpatient treatment, crisis stabilization, grief support groups; peer support stories of recovery counseling; support groups that include a peer facilitator as part of team; training for providers; education, training and coordination with all first responders, law and medical, including all providers/clinics – not just Marcus Daly Memorial Hospital; training for providers; Brightways Resiliency Grant (won’t know until August: 7-9th Grade); postpartum resources guide for the county; trainings in perinatal mental health hospital based; more readily available resource guide – hospitals, schools, senior centers; regarding drug abuse: education about pain meds, prescriptions – OxyContin; continue to coordinate training, education and coordination with MDMH and all the schools: schools should include teachers, coaches and kids; postpartum support group – hospital based?; suicide intervention teams and collaborative efforts; home visiting programs for prenatal/post-partum moms; parent/pre-natal/early childhood intervention to address mental health issues earlier; parenting classes; Bitterroot Care for Kids Network Resource Guide (through Western MT Mental Health); going beyond stigma to end discrimination; support groups for child and their adult struggling with specific illness/mental health issue as well as resource list to direct child to more appropriate group; maybe posters describing thoughts and feelings one may be experiencing with link to support group day/time meeting and contact numbers or other resources; support group for parents of youth trauma survivors; support group for parents that lost a child; support group for depression and anxiety; survivor support group; support group for sexual assault survivors; looking at groups that we can offer in the community for grief and loss; support group for PTSD; wellness fair for mental health; attend legislative sessions on mental health/lobby for mental health services funding; better resources for patient placement so they can get the care they need (MDMH willing to work with others); county website of resources for mental health resources with phone numbers for local suicide prevention or support groups; NAMI needs promotion; get greater awareness of mental health, suicide prevention and grief management activities and resources available to all of Montana – we don’t have to reinvent everything in Ravalli County.
    3. Facilitator Notes: Topics were repeated multiple times and grouped together by facilitator and participants during the meeting. Some topics appeared on both questions.
  6. Andersen requested participants to review the responses and share action ideas for community work. Responses include the following:
    1. Promotion/Access of NAMI survivors in Ravalli County – 1 participant
    2. Interventions for suicide risk – 3 participants
    3. Consolidation of mental health resources
    4. Website/resources for the consolidation of mental health resources
    5. Creation of Facebook page with resources/opportunities/meetings related to mental health resources – 2 participants
    6. Update outdated resource guide through Bitterroot Cares for Kids Network
    7. Promotion of support groups
    8. Share mental health resources – local and state – 3 participants
    9. Early childhood education for mental health – 6 participants
    10. Advocates for young adults – 3 participants
    11. Crisis Intervention Training – 1 participant
    12. Judge training – Mental Health Court
    13. Peer support – 3 participants
    14. Provider training for prenatal-birth promotion – 2 participants
    15. Alternatives to support groups – connecting people through activities – 8 participants
    16. Personally invite those not here – 9 participants
    17. Economic development for young adults
  7. Andersen requested participants to mark the responses they would commit to working with a committee to create impact in the community. These responses are indicated above in green text with the number of responses from participants.
  8. The next meeting will be set via a Doodle poll to select a date where those not in attendances could help choose a date.
  9. At the next meeting, participants will review the action items and start action committees with the following guidelines:
    1. Refine the priority area for action: what does success look like?
    2. Define outcomes – action items related to priority area
      1. Set goals for next 60 days
      2. Set goals for next six months
    3. Secure chair and co-chair for action committee
    4. Invite individuals who are not in attendance at the committee meeting
    5. Set date for next meeting related to action committee

Upcoming M.I.K.A. Speakers:

Speaker: Dr. Pedro Martinez

Title: Is this normal? Navigating the lifetime changes from puberty through menopause

Details: PAC, Hamilton, Thursday, April 25 from 7 – 8 pm

In addition to learning from Dr. Pedro Martinez, local “momedians” will share monologues from their Momedy, which is occurring in at the Dennison Theater in Missoula on Sunday, May 12 sharing their experiences.

  • Pedro Martinez, who is an expert in women’s health, works in the Behavioral Endocrinology Branch of National Institute of Mental Health (NIMH). He is a general psychiatrist, also trained in child and adolescent psychiatry as well.
  • A talk describing the “normal” changes that occur due to hormones affecting women’s health and the mile-markers where things tend to go wrong, including depression, post-partum “blues” and related psychoses at any part of the continuum. 
  • What constitutes an actual disorder, the causes, frequencies, symptoms, but also the spectrum of treatments. 


Dr. Susan Borja at the PAC on Monday, May 13th 7pm – 8 pm

Title: to be determined, topic is PTSD

Dr. Susan Borja is an expert the field of traumatic stress research at National Institute of Mental Health (NIMH):

  • Research on how the brain adapts to and extinguishes fear and how the dynamic functions of memory acquisition, consolidation, and extinction are influenced by neurodevelopment, aging, and other factors in at-risk or symptomatic individuals
  • Aspects of disorder inadequately addressed by current therapies; and strategies to prevent chronic post-traumatic stress disorder (PTSD)
  • Research to understand shared and unique mechanisms responsible for co-occurring and comorbid physical and mental disorders
  • Investigating the neurobiological impact of various interventions known to be effective treatments
  • Risk factor, services, and intervention research in the context of disasters and mass casualty events to a) move beyond group-based risk prediction such that assessment would be tied to a continuum of intervention intensity and b) establish transportable disaster mental health response models that draw upon a continuum of intervention approaches sensitive to the nature of the disaster, affected population(s), availability of resources, and the status of health and mental health infrastructure


Coming in the fall 2019:

Dr. Lisa Horowitz from NIMH and a colleague of Dr. Maryland Pao (January’s M.I.K.A. speaker): She will spend a week providing training to medical/non-medical groups educating on the ASQ training for suicide prevention screening.

  • In hospital/medical settings training and development of risk management and tools for what to do when a person presents positive
  • Can also meet with home health aides, parents, teachers, coaches in a workshop style format to discuss how to foster resilience, coping skills, developing a safety plan with someone at risk, and how to respond
  • She VERY much subscribes to “TAKE AWAY TANGIBLES” bridging the gap between research and real life by offering tools for your toolbox

To be confirmed:  Dr. Robert Heinssen with NIMH  to discuss Schizophrenia

  • Robert Heinssen, Ph.D., recipient of the 2014 Special Presidential Commendation from the American Psychiatric Association (APA). Dr. Heinssen serves as Director of the Division of Services and Intervention Research at NIMH. He has been recognized by the American Psychiatric Association (APA) for championing research on early psychosis and translating it into policy and programs for clinical implementation as a new standard of care.
  • Heinssen has played a key role in the development of the NIMH research project, Recovery After an Initial Schizophrenia Episode (RAISE). This groundbreaking project seeks to fundamentally change the trajectory and prognosis of schizophrenia through coordinated and aggressive treatment in the earliest stages of illness. RAISE is designed to reduce the likelihood of long-term disability that people with schizophrenia often experience. It aims to help people with the disorder lead productive, independent lives. At the same time, it aims to reduce the financial impact on the public systems often tapped to pay for the care of people with schizophrenia.