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					                                                                 Sacramento
                                                                 Newsletter
Sacramento’s Voice on Mental Illness                                                                                     April 2008: Issue No 6.04

       General Meetings                        Achieving Mental Health Parity
Monday, April 14                               by Congresswoman Doris O. Matsui                     provide mental health coverage, ensures
                                                  Last year, I was honored to host a field          that group health plans do not charge
Tom Wootton, popular speaker and                                                                    higher co-payments, coinsurance, and de-
                                               hearing in Sacramento on mental health is-
author of The Bipolar Advantage will talk                                                           ductibles, impose maximum out-of-pocket
                                               sues. During that hearing, it became appar-
about his new book and program, The De-                                                             limits, or impose lower visit limits on men-
                                               ent to me how crucial it is that every Ameri-
pression Advantage, bringing his inspiring                                                          tal health and addiction care than for medi-
                                               can not only has access to traditional health
message of encouragement to people with                                                             cal surgical benefits. It also allows the
                                               services, but mental health services as well.
major depression. The Depression Advan-                                                             Department of Health and Human Ser-
tage departs from accepted doctrine on            I heard from people who live with mental          vices, the Department of Labor, and the
mental illness and celebrates the spiritual,   health and addiction-based ailments, and             Internal Revenue Service to penalize health
personal, and social growth possible           their stories resonated with me. It is clear         plans for discriminatory practices.
through the experience of depression.          that living with a mental illness is just as
                                               painful and challenging as living with a                If mental health coverage is included in
Monday, May 12                                 physical illness. And in many ways, mental           a recipients‟ plan, it should be quality, effi-
                                               health patients suffer more because our in-          cient coverage. By passing this legislation,
Michelle Callejas, Mental Health Ser-
                                                                                                    the House has taken the first step to ensure
vices Act (MHSA) Program Manager               surance system discriminates against them.
                                                                                                    that there is equity in financial require-
will present an update on local MHSA               This is why it was such a red-letter day         ments, treatment limits, and out-of-
accomplishments.                               when the U.S. House of Representatives               network coverage. It will end discrimina-
Meeting Location                               passed the Paul Wellstone Mental Health and          tion based on diagnosis.
                                               Addiction Equity Act of 2007 on March 5th of
SMUD Headquarters Auditorium                   this year. This legislation will bring equality to       This legislation is timely and necessary.
6201 S Street, Sacramento 95817                mental health services, and help end the indus-      It will help civilian citizens and our veterans
                                               try prejudice against mental health treatments.      alike. Sadly, we have heard that an un-
Time                                                                                                precedented number of our men and women
General Meetings start at 7:30 p.m.               The Mental Health Parity Act will ensure          returning from Iraq and Afghanistan will
                                               that mental health disorders are treated with        suffer from Post Traumatic Stress Disorder.
          What’s Inside                        the same care and attention as traditional
                                               physical disorders. Under the legislation,
                                                                                                    Ridding our system of the stigma associated
                                                                                                    with mental health treatments will pave the
                                               insurance providers would have to offer              way for our veterans to have adequate ac-
2   Support Groups
                                               mental health coverage that is comparable to         cess to the care they need to be happy and
3   Message from the President                 the coverage offered for medical services.           productive upon their return home.
5   The World’s Leading Stimulant                 The bill, while not mandating plans to
6   Assisted Outpatient Treatment Can’t
    Wait: It’s time to Make Laura’s Law        Father Tells of Slaying Suspect’s Long Ordeal
7   Scientists Spot Biochemical Sign of        by Eric Konigsberg and Ann Farmer                    in 1991, a long struggle in which Leonard
    Depression                                                                                      Tarloff repeatedly found himself working to
                                                  On Saturday, shortly after the police
7   Doctor’s Corner                            arrested David Tarloff, he was permitted to          get his son treatment for mental illness.
8   Membership Form                            talk on the phone with his father.                      David Tarloff, 39, remains at Belleview
                                                  “Dad, they say I killed some lady,” he            Hospital Center, where he was under
            Contact Us                         said, according to his father, Leonard Tarloff.      evaluation after his arrest in the killing of a
                                               “What are they talking about?” Then, Mr.             psychologist, Kathryn Faughey, on the Up-
NAMI Sacramento                                Tarloff said in an interview, his son asked for      per East Side. The police said that after re-
3331 Power Inn Road, suite 140                 things he had always requested during his            peatedly stabbing Dr. Faughy, he then
Sacramento, CA 95826                           numerous visits to the city‟s psychiatric            slashed and seriously wounded Dr. Kent D.
                                               wards: a pile of quarters so he could call his       Shinbach, a psychiatrist working in the
Phone: (916) 874-9416                                                                               same suite. Dr. Shinbach played a role in
                                               parents, and a bag of potato chips.
E-mail: office@namisacramento.org                                                                   David Tarloff‟s diagnosis of schizophrenia
                                                 For father and son, it was the latest and
Website: www.namisacramento.org
                                               most wrenching turn in an ordeal that began                          continued on page 4
         NAMI Sacramento · 3331 Power Inn Road, Suite 140 · Sacramento, California 95826 · 916.874.9416 · www.namisacramento.org




Support Groups
Crisis Information                            NAMI Family Support Group, Natomas              Call (916) 483-5616 for meeting locations.
For family members or consumers needing       Held on the second Thursday of each             Sacramento Borderline Personality Dis-
information or support. Newcomers are wel-    month from 6:30 - 8:30 p.m. Natomas             order Non-BP Support Group
come. Second Monday of each month from        Service Center, 3291 Truxel Road #26            For people who have a family member or
7:00 –7:30 p.m. prior to the General Mem-     (corner of Truxel and San Juan), Sacra-         friend who suffers from Borderline Person-
bership Meeting. “Old” SMUD Headquar-         mento 95833.                                    ality Disorder. Held on the second Tuesday
ters Auditorium, 6201 S Street, Sacramento.                                                   of each month from 7:00 - 9:00 p.m. Loca-
                                               Call facilitator Pat Pavone at (916) 397-
Depression and Bipolar Support Alli-          7831 for more information.                      tion to be announced. Call Lee Gassaway at
ance (DBSA)                                                                                   (916) 421-7354 or
                                              Obsessive-Compulsive Support Meet-
2nd and 4th Wednesday each month from         ing (OCD)                                       Contact: www.meetup.com
7:30 - 9:00 p.m. Sutter Center for Psychia-
                                              Every Monday from 7:00 - 9:00 p.m. Sutter       Meetup.com Groups
try, 7700 Folsom Blvd., Sacramento
                                              Center for Psychiatry, 7700 Folsom Blvd.,       You may find other informal groups that
 See: www.dbsasacramento.org                 Sacramento.                                     keep their own schedules at
Contact: Andrea Hillerman at an-              Call Jim (916) 223-6541 or Steve at             www.meetup.com. Search for a diagnosis
drea@mhasc.org or (916) 366-4601; or          (916) 456-8239 for more information.            to find a group of people that share your
Marilyn Hillerman at marilynhiller-                                                           interests.
                                              Recovery, Inc., Self-Help Mental Health
man@yahoo.com or (916) 648-1358.              Meetings
Dual Recovery Anonymous Group                                                                    NAMI Sacramento does not neces-
                                              Promotes a cognitive-behavioral approach to sarily endorse the organizations and
Every Monday from 1:00 - 2:00 p.m.            managing symptoms and changing atti-        groups listed above. This information
Clean and Sober Building, Loaves and          tudes and behavior. Groups meet weekly.     is offered as a convenience to our
Fishes, 1321 North C Street, Sacramento.                                                     newsletter readers.
                                              Contact: www.recovery-inc.com
Call Susan Young at (916) 236-7679 for
more information.                                     Educational Meetings                    Upcoming Events
Early Psychosis Family Support Group           Family to Family Education Classes
                                                                                              Side by Side: A Journey With Depres-
For families with a member who has a           Offered twice a year, spring and fall.         sion—a funny look at serious survival
newly diagnosed brain disease. Imaging          www.namisacramento.org                       Wednesday, April 9 at 7:30p.m.
and Research Center Conference Room,                                                          The Marsh Theater
UCD Med, Center, 4701 X Street, Sacra-         For the current class schedule see the         1062 Valencia Street@22nd Street
mento. Call for information.                   Sacramento NAMI web site or call (916)         San Francisco, CA 94110
                                               399-5762.                                      For tickets go to www.themarsh.org,
Call Jane Du Bet at (916) 734-2964 for
more information.                              Peer to Peer Education Classes                 Marsh Rising Series or call Brown Paper
                                                                                              Tickets at (800) 838-3006
Emotions Anonymous                              www.namisacramento.org
                                                                                              Comedian Brian Wetzel‟s autobiographical
For people working toward recovery from        The NAMI Peer-to Peer education course is
                                                                                              one man show about his 20-year struggle
emotional difficulties. Tuesdays from 6:00     a nine-week experiential recovery course
                                                                                              with clinical depression and the humor he
p.m. - 7:30 p.m. Wellness Center, 3815         for any person with serious mental illness.
                                                                                              tapped into in order to survive.
Marconi Ave., Sacramento, or Thursdays
                                                   General Interest Meetings                  Festival de la Familia
from 7:00 - 8:30 p.m. Lutheran Church of
the Good Shepherd, 1615 Morse Ave.,            Sacramento Mental Health Board Meeting         Saturday, April 27 10:00 a.m. - 6:00 p.m.
Sacramento. Meet in the choir room.            Held the 1st Wednesday of each month at        Cal Expo
Contact (916) 366-0699 or see http://          7:00 p.m. Sacramento Mental Health             NAMI Sacramento will have a booth at this
allone.com/12/ea/                              Treatment Center (Media Room), 2150            celebration of art, food, music and children‟s
                                               Stockton Blvd., Sacramento.                    activities from more than 22 Latin countries.
NAMI Family Support Group, Sacramento
                                               NAMI Sacramento Board of Director’s
Held on the third Wednesday of each                                                           Walk for Mental Health
                                               Meeting
month from 6:30 - 8:30 p.m. 3135 Wood-                                                        Saturday, October 4, 2008
mark Court, Sacramento 95821.                  3rd Monday of each month at 6:30 p.m.
                                                                                              State Capitol Grounds, Sacramento
                                               conference Room A, 3331 Power Inn
Call facilitator Heidi Sanborn at (916)        Road, suite 140, Sacramento, CA 95826.         This is NAMI‟s biggest fundraiser of the
485-7753 for more information.                                                                year. Please hold the date.
                                                                                          NAMI Sacramento Newsletter April 2008     -2-
        NAMI Sacramento · 3331 Power Inn Road, Suite 140 · Sacramento, California 95826 · 916.874.9416 · www.namisacramento.org



A Message From the President                                                                     Spanish Speakers
                                                                                                 Needed for NAMI Booth
                          I want to begin by    force Education and Training, among
                     noting two of the arti-    other things. We are looking forward to          at Festival de la Familia
                     cles in this month‟s       the Festival de la Familia on April 27, and         NAMI Sacramento is sponsoring a
                     newsletter. First, we      still hope to find Spanish-speaking volun-       booth at the annual Festival de la Fa-
                     are honored to bring       teers to join us.                                milia to be held on April 27 from 10:00
                     you Congresswoman                                                           a.m. to 6:00 p.m. at Cal Expo. We need
                                                    In closing, I want to say I am here in
                     Doris Matsui‟s article                                                      Spanish speaking volunteers to staff the
                                                honor of my mother. She has paranoid
                     regarding the mental                                                        booth to distribute NAMI materials
                                                schizophrenia and depression and was
                      health parity legisla-                                                     which have been translated into Span-
                                                homeless for over 17 year. As I write this,
tion currently being considered at the fed-                                                      ish and to respond to inquiries about
                                                she remains in the hospital fighting massive
eral level. Congresswoman Matsui hosted a                                                        NAMI. If you are able to help please
                                                infection and a poor-functioning kidney. She
hearing last year regarding this topic and                                                       contact Pat Pavone at
                                                taught me what tough really is and to always
our own Heidi Sanborn offered testimony.                                                         pavone@surewest.net or (916) 359-
                                                be a lady. I love you, mom.
That testimony touched Congresswoman                                                             2366 or Caroline Prod at
Matsui, and is a wonderful example of how       With gratitude,                                  caroline@namisacramento.org or
we can make a difference. Just by telling our   Caroline Prod                                    (916) 204-4512.
stories, we can shine a light and find a way.
    The other story I want to mention is        Mark the Date: May 21 PBS                              2008 BOARD OF DIRECTORS
from Randall Hagar, of the California
Psychiatric Association. Randall spoke at       Depression Documentary:                           PRESIDENT
our general meeting last November about         NAMI and Jane Pauley                              Caroline Prod,
Laura‟s Law. Laura‟s Law provides a
way to allow some people who consis-                Don‟t miss NAMI medical director              caroline@namisacramento.org
tently refuse treatment for a serious men-      Ken Duckworth discussing depression as            VICE PRESIDENT
tal illness, to receive court-ordered assis-    part of a panel of experts moderated by
                                                broadcast journalist Jane Pauley on TAKE          Pat Pavone,
tant outpatient treatment. I encourage you                                                        pavone@surewest.net
to learn more about this law and what it        ONE STEP: Caring for Depression, with
can and cannot do. I hope you will talk         Jane Pauley.                                      TREASURER
to your family and friends and listen to all        The program will immediately follow
                                                the national premiere of the PBS docu-            John Gilbert,
perspectives with an open ear.                                                                    jgilb1@pacbell.net
                                                mentary, Depression: Out of the Shadows,
   I am pleased to announce that Tom            on Wednesday, May 21 at 9:00. (Check              SECRETARY
Wootton will be back for our April general      local PBS station listings.) NAMI is the
meeting. He is the author of The Bipolar                                                          Jeanne Templeman,
                                                national outreach partner for the program,
Advantage and a must-see speaker. In                                                              JeanneTempleman@sbcglobal.net
                                                which is a production of Twin Cities Pub-
May, Michelle Callejas from Sacramento          lic Television (Minneapolis-St. Paul) and                     BOARD MEMBERS
County will give a presentation about how       WGBH Boston. YMCA of the USA is the               Belinda Beckett
Mental Health Services Act funds are serv-      community outreach partner. The project
ing Sacramento County. Then in June,            is part of Take One Step, a broader PBS           Linda Beilharz
Sacramento County, NAMI California, and         Health Campaign which previously has              Lloyd Lagerstrom
the California Mental Health Directors As-      addressed heart disease and obesity.
sociation will be serving as hosts of a con-                                                      Al Lipson
versation about the MHSA. This is our op-       Important Notice                                  Valentin Lopez
portunity to tell State and County leaders
                                                                                                  Sherrie Sala-Moore
what we think of the MHSA process and             NAMI programs should not be used to
how we would like to improve it.                replace the specialized training and profes-      Heidi Sanborn
                                                sional judgment of mental health profes-                COUNTY SUPPORT STAFF
   In other news, we are moving forward
                                                sionals. We cannot, and will not, assume
with our plan to hire a part time Executive                                                        Marilyn Hillerman, Adult Family Advocate,
                                                the role of a physician or therapist.
Assistant. We submitted a lengthy applica-                                                        (916) 875-5644
tion package to the United Way to become          NAMI cannot be held responsible for the
                                                                                                   Andrea Hillerman, Adult Consumer Advocate,
a “certified” organization for their Capital    use of the information we provide. Please
                                                                                                  (916) 875-4710
Campaign. The MHSA Steering Committee           always consult a trained mental health pro-
is meeting on the first and third Thursdays     fessional before making any decision re-           Dave Schroeder, Family and Youth Advocate,
of each month and is focusing on Work-          garding treatment of yourself or others.          (916) 875-4183

                                                                                               NAMI Sacramento Newsletter April 2008    -3-
         NAMI Sacramento · 3331 Power Inn Road, Suite 140 · Sacramento, California 95826 · 916.874.9416 · www.namisacramento.org



Father Tells of Ordeal, from page 1

17 years ago and was his principal target,        behavior was troublesome enough that his         ened to kill everyone at the Midway Nurs-
police said.                                      father, on the advice of a personal physician,   ing Home in Queens. After a stay at Elm-
                                                  took him to see Dr. Shinbach. The doctor,        hurst, he managed to avoid being sent to a
    Mr. Tarloff told the police that David had    Leonard Tarloff said, diagnosed “acute           voluntary program at the Creedmoor Psy-
sought out Dr. Shinbach to rob him and then
                                                  paranoid schizophrenia.”                         chiatric Center. Instead he went to Balti-
intended to leave the country or go to Ha-
                                                                                                   more to try to see his brother. Then he
waii with his ailing mother, Beatrice, who           His parents obtained a court order to have
                                                                                                   returned. A spokesman from Elmhurst said
has been living in a series of nursing homes      him involuntarily committed. He was taken
                                                                                                   he could not comment because of confi-
since 2003. Leonard Tarloff surmised that         to Gracie Square Hospital in Manhattan and
                                                                                                   dentiality rules. “He called me and says
his son might have planned to kidnap Dr.          kept for 40 days, the limit under Leonard
                                                                                                   he‟s on Staten Island and in a taxi and the
Shinbach to get access to Beatrice Tarloff.       Tarloff‟s insurance coverage. David Tarloff
                                                                                                   cabdriver can‟t find me,” Mr. Tarloff said.
“I think maybe he thought, „If I have a psy-      was evaluated and committed more than a
                                                                                                   When he met the taxi, he recalled: “He
chiatrist with me, they‟ll let me see my          dozen times after that, family members said.
                                                                                                   looked completely crazy. He said „Dad, I
mother,‟” Mr. Tarloff said. Leonard and           Over the years, he was put on a handful of
                                                                                                   love you. Let‟s go get a Coke.‟” But his
Beatrice Tarloff are divorced.                    drugs used to treat schizophrenic or bipolar
                                                                                                   father would soon call the police, saying
                                                  patients: lithium, Depakote, Haldol. Sero-
   In an interview David Tarloff‟s father         quel and Zyprexa. Several times, he was
                                                                                                   his son had stopped taking his medication
and his brother, Robert, described David‟s        treated at New York Presbyterian/Weill Cor-
                                                                                                   and was acting violently. He was taken to
sudden and precipitous descent into illness                                                        Staten Island University hospital, where he
                                                  nell Medical Center on the Upper East Side.
and their own dealings with a mental health                                                        stayed until November.
                                                  Therapies included shock treatment.
system that, in general, prohibits patients
                                                                                                      On Feb. 1, David Tarloff was arrested at
from being hospitalized against their will           The typical pattern, his father said, in-
                                                                                                   St. John‟s Episcopal Hospital in Far Rock-
unless they have proven to be dangerous to        volved his son taking medication long
                                                                                                   away, Queens, where his mother had been
themselves or others.                             enough to become stabilized, at which point,
                                                                                                   transferred. He was lying in bed next to his
                                                  over the family‟s protest, the hospital would
   Leonard Tarloff, an executive for an                                                            mother,” Leonard Tarloff said. “The guard
                                                  release him. “He‟d feel better and then say to
international transportation company in                                                            says, „You can‟t do that. It's the ICU.‟ He got
                                                  himself, I feel good. There‟s nothing wrong,‟
Queens and Robert Tarloff, a special edu-                                                          into a fight with the guard.” His brother said
                                                  and stop taking his medications.”
cation teacher who is married with three                                                           David and their mother were close. “He com-
children, recalled David as handsome,                 At one point, the family invoked             forted her and she comforted him, he said,
smart and happy when he was growing up            Kendra‟s Law, passed by the State Legisla-       but added, “She did call the police on him
in Corona, Queens. His troubles surfaced          ture after a young woman Kendra Webdale          when he was acting terribly at home.”
after he enrolled at Syracuse University.         was pushed to her death on the subway
                                                                                                      After David Tarloff was examined by a
“He came back home and he was                     tracks by a man who had stopped taking his
                                                                                                   doctor at St. John‟s, who determined that
changed,” his father said. He was moody,          antipsychotic medication. The law allows
                                                                                                   he did not need to be kept there, the police
and at first Leonard Tarloff suspected he         family members and others to seek a court
                                                                                                   took him to the 101st Precinct station
had a drug problem. “All of a sudden, he          order forcing someone to undergo outpatient
                                                                                                   house, Leonard Tarloff said. He said that
became catatonic, he couldn‟t talk.”              psychiatric treatment, even if he or she does
                                                                                                   he frantically tried to get his son commit-
                                                  not meet the standard for involuntary hospi-
    He said his son would see things and                                                           ted. He said he tried to get a social worker
                                                  talization. Leonard Tarloff said, however,
believed that people were looking at him                                                           at Staten Island University Hospital to call
                                                  that even this approach failed, as his son
and were against him. He could not hold a                                                          the authorities and explain just how sick
                                                  was able to frequently avoid those assigned
job for longer than a day; he also attended                                                        his son was, but was told that the hospital
                                                  to monitor him. “They'd come to get him
St. John‟s University and the University of       and ring the bell,” he said. “When he didn‟t
                                                                                                   could not release any information on his
Miami, but left both times before one se-                                                          condition because of confidentiality rules.
                                                  answer, they went away.”
mester was through. He would walk the                                                              David Tarloff was released by a judge the
streets picking up cigarette butts, and his          David Tarloff‟s behavior deteriorated         day after his arrest.
father said he had obsessions. “There were        even more after his mother entered a nurs-
                                                                                                   Leonard Tarloff visited his son at Belle-
times when he would take showers 15 or 20         ing home. Three times, she was transferred
                                                                                                   vue. “He didn‟t really say anything,” he
times a day,” Leonard Tarloff said. If his son    to another nursing home after workers at
                                                                                                   said. “He didn‟t talk about the situation.
said something mean, Mr. Tarloff said, “later     the nursing homes became uncomfortable
                                                                                                   He‟s in a fog. He‟s very lethargic.”
he would say, „I‟m sorry.‟” He added, “But        with her son‟s constant hounding. “He felt
he‟d have to say „sorry‟ in a particular way.     they weren‟t caring for her correctly,” Mr.        “We‟ve done everything we could have
He‟d call back 20 times or more to say it right   Tarloff said.                                    thought of,” Leonard Tarloff said. “My
so that it would go away.”                                                                         son‟s life was over 20 years ago when this
                                                     Last June, the police took David Tarloff
                                                                                                   first struck.”
   In 1991, when David Tarloff was 22, his        to Elmhurst Hospital Center after he threat-

                                                                                              NAMI Sacramento Newsletter, April 2008      -4-
        NAMI Sacramento · 3331 Power Inn Road, Suite 140 · Sacramento, California 95826 · 916.874.9416 · www.namisacramento.org



The World’s Leading Stimulant
                   by Linda Ellis RN, MN        Starbucks coffee and one Rock Star) can           more caffeine to make up for the in-
                                                lead to nervousness, irritability, anxiety,       creased elimination of caffeine due to the
                   Director of Nursing,
                                                tremulousness, muscle twitching, insom-           heavy smoking.
                   Turning Point Community      nia, and palpitations, as noted at
                   Programs                     www.mayoclinic.com. Because the adre-                  Since there‟s obviously more to the
                                                nal glands become over-stimulated, ac-            phrase “I need a cup of coffee” than the
                                                cording to G. Malkmus, it takes a high            mere habit of having a “cup of joe” in the
                                                level of caffeine for some folks just to          morning, a psychiatrist should, as part of
                                                feel normal and “the very thing that cre-         a comprehensive assessment, inquire
   According to the National Coffee As-                                                           about the client‟s caffeine intake, before
sociation, 52% of Americans, representing       ated the problem becomes the cure….”
                                                                                                  making a diagnosis of ADD/ADHD, ma-
100 million people, drink coffee every                The American Psychiatric Associa-           nia, depression, personality disorder as
day. Because most coffee drinkers don‟t         tion in their own diagnostic manual (DSM-         well as schizophrenia. And because evi-
drink just one cup, that amounts to about       IV) classified four caffeine-induced psychi-      dence, albeit some conflicting, regarding
400 million cups per day making the U.S.        atric disorders. These include caffeine in-       the link between caffeine and other dis-
the leading coffee consumer in the world.       toxication, caffeine-induced anxiety disor-       eases such as heart disease, osteoporosis,
To meet this demand $4 billion worth of         der, caffeine-induced sleep disorder, and         and depression exists, primary care pro-
coffee is imported every year. That‟s a lot     caffeine-related disorder not otherwise           viders should also ask about its use.
of coffee!                                      specified (NOS). Symptoms of caffeine
                                                intoxication occurring with consumption                 Given the results of the extensive
   More importantly, however, is how                                                              research available, those of you who con-
much caffeine is consumed. Because it is        above 250 mg have been known to mimic
                                                those of psychosis (agitation, irritability,      sume more than the average 2-3 cups per
present in other products as well – tea, soft                                                     day might consider backing off a bit.
drinks, chocolate, and some medication –        hallucinations).
                                                                                                  Withdrawal from caffeine is best done
caffeine is probably the world‟s leading             Symptoms of caffeine intoxication            gradually by, perhaps, mixing decaf with
legal stimulant. To give you an idea of         can also be confused with the side-effects        regular, and decreasing your intake over
how the amount of caffeine consumption          of psychotropic drugs (fatigue, palpita-          a period of weeks to avoid those unpleas-
might add up in a day, below is a list of       tions), yet, conversely, cessation of caf-        ant withdrawal symptoms. These symp-
the caffeine content in some products:          feine can cause fatigue and drowsiness.           toms, which typically start slowly,
    330 mg - Starbucks grande coffee 16 oz      Further evidence suggests that caffeine           worsen within 2 days, and recede within
                                                may interfere with the metabolism or              a few days, include headache, nausea,
     200 mg - NoDoz maximum strength 1          exacerbate the side effects of the antipsy-       irritability, sleeplessness, confusion,
tablet                                          chotic medication called clozapine. Indi-         anxiety, restlessness and tremor, palpita-
    160 mg - Rock Star 16 oz                    viduals who are on lithium and drink a lot        tions and raised blood pressure. And
                                                of caffeine should be careful to avoid            there are always those brave souls who
    54 mg - Mountain Dew                        dehydration because of the increase in            can quit „cold turkey‟.
    47 mg - Diet Coke                           urinary frequency possibly resulting in
                                                lithium toxicity.                                      Starbucks would have you think that
    30-50 mg - Green tea, brewed 8 oz                                                             you can‟t go without that cup of „double
                                                     An extensive review of the research          expresso macchiato with hazelnut and
    30 mg - Haagen-Dazs coffee ice              on the effects of caffeine done by Dr. A.         low fat milk‟, but, I submit to you, there
cream ½ cup                                     P. Winston from the University of War-            are better alternatives out there that are
    30 mg - Dristan cold medicine 1 tablet      wick in England revealed many interest-           healthier for you. One look at the effects
                                                ing things. Consumption of caffeine may           of caffeine on individuals with or with-
   18 mg - Hershey‟s Special Dark               be higher in psychiatric patients, particu-       out a specific mental illnesses and on
Chocolate Bar 1.45 oz                           larly schizophrenics, than in the popula-         medications used to treat them may be
     The major effect of caffeine is to re-     tion as a whole. One possible theory as-          enough for some to look for their nearest
lieve fatigue and improve mental perform-       serts that using caffeine relieves boredom        Jamba Juice instead.
ance, and for most people who consume a         and apathy while offsetting the sedating
moderate amount – 200 to 300 mg a day –         effects of antipsychotic medication. In
                                                                                                  May Newsletter Contributions
there doesn‟t seem to be a problem. How-        addition, one study found that the in-
ever, when taken in excess, it can be           creased caffeine use may alleviate the            We welcome submissions to the news-
physically and psychologically harmful,         common side effect of dry mouth, while            letter. The due date for the next newslet-
especially in an individual with mental         another study identifying that about 80%          ter is April 13. Submit to Belinda
illness. Chronic, high-dose caffeine intake     of people with schizophrenia smoke, pos-          Beckett at nimabima@aol.com. Submis-
(more than 500 to 600 mg a day or one tall      ited that these individuals may be using          sions may be edited.

                                                                                               NAMI Sacramento Newsletter, April 2008   -5-
       NAMI Sacramento · 3331 Power Inn Road, Suite 140 · Sacramento, California 95826 · 916.874.9416 · www.namisacramento.org



Assisted Outpatient Treatment Can’t Wait: It’s Time                                                NAMI in the Community
to Make Laura’s Law Work in California
by Randall Hagar                               are now beginning to consider adopting
Co-coordinator, The California Treatment       assisted outpatient treatment in their com-
Advocacy Coalition                             munities. In fact, Nevada County is cur-
                                               rently using Proposition 63 funds to imple-
    It‟s been seven years since 19-year-old
                                               ment Laura‟s Law beginning in April.
Laura Wilcox was shot to death at the Ne-
vada County mental health clinic by Scott         In addition, SB 1606 was recently intro-
Harlan Thorpe, a man with paranoid schizo-     duced by Senator Yee which would remove
phrenia who consistently refused treatment.    a number of unnecessary and cumbersome
It‟s been five years since California passed   requirements contained in Laura‟s Law and
Laura‟s Law in her name, allowing counties     will allow counties to maximize their local
to provide court-ordered community mental      dollars while giving appropriate services to
                                                                                                   Kathleen Derby, Coordinator of In Our
health treatment, otherwise known as as-       the individuals who need assisted outpatient
                                                                                                   Own Voice, speaks at Sierra Vista’ Hospi-
sisted outpatient treatment (AOT), to peo-     treatment. The bill will give counties more         tal’s community luncheon on February 21.
ple with severe mental illnesses who           flexibility to use existing county mental           Presentations by Kathleen and Peer-to-
would otherwise be lost to the symptoms        health services, rather than establish a brand      Peer speaker Joe Texiera were very well
of their illnesses.                            new program, to provide Laura‟s Law re-             received and Sierra Vista has arranged
                                               cipients‟ treatment.                                for future In Our Own Voice and Peer-to-
   Back when Laura‟s Law was passed it                                                             Peer presentations at the hospital.
was considered landmark mental health              Specifically, SB 1606 will delete a
legislation by California standards. New       prerequisite for a local mental health sys-
York had enacted a similar law four years      tem to only use AOT in conjunction with
before and was experiencing remarkable         a specified Program for Assertive Com-
results and 40 other states had already        munity Treatment (P/ACT) which re-
adopted assisted outpatient treatment laws.    quires a costly and extremely high staff to
                                               patient ratio. In addition, the reform re-
    Fast forward five years later and, un-
                                               moves a mandate that a county have vari-
fortunately, very little has changed since
                                               ous minimum levels of unconnected vol-
Laura‟s Law was enacted to help people
                                               untary services before it can use AOT;
with the most severe mental illnesses se-
                                               removes a misconception that intensive
cure the life-saving treatments they need.
                                               AOT services must be available to all
That‟s because Laura‟s Law passed with                                                             Nancy Purtell, RN and CEO of Sierra
                                               consumers on a voluntary basis before               Vista Hospital spoke at the March General
two major stipulations that have pre-
                                               implementing AOT for those who specifi-             Meeting about plans to expand that hospi-
vented local governments from applying
                                               cally need it; removes the necessity for a          tal and others in the area to address the
the law. For one, the statue was adopted
                                               local Board of Supervisors to pass a reso-          shortage of acute care psychiatric beds in
without a mandate that requires counties                                                           Sacramento.
                                               lution to implement the law; and provides
to implement Laura‟s Law. In addition,
                                               a planning mechanism for people released
the State did not fund Laura‟s Law and
thus most counties justified not imple-
                                               from hospitals in order to keep them sta-           Host An “In Our Own
menting the law due to budget constraints.
                                               ble in the community.
                                                                                                   Voice” Presentation
                                                   Senate Bill 1606 will restore Laura‟s             In Our Own Voice is an anti-stigma
    Thanks to a new source of mental
                                               Law as it was meant to be. This bill will          presentation given by consumers to all
health funding from Proposition 63 and
                                               give counties the tools they need to provide       types of community audiences, large and
new legislation recently introduced by
                                               continuous, supervised community treat-            small. The focus is on living well with
Senator Leland Yee, counties will find it
                                               ment for people with severe mental illnesses       mental illness and the presentation centers
easier to implement. When voters over-
                                               and help them to not only to recover but live      on the themes of Dark Days, Acceptance,
whelmingly passed Proposition 63 in
                                               fulfilling and productive lives. For more          Treatment, Coping Skills, and Successes,
2004, California established a one percent
                                               information about Laura‟s Law go to                Hopes and Dreams. If your group is inter-
tax on personal income above $1 million
                                               www.lauraslaw.net.                                 ested in hosting a presentation, if you
to fund expanded health services for men-
tally ill children, adults, and seniors.        Randall Hagar is director of governmen-           would like to become a presenter, or if
Proposition 63 now provides a stream of        tal affairs at the California Psychiatric          you would just like more information on
funding for the intensive services that can    Association and a former president of              the program, please contact Kathleen
be used pursuant to Laura‟s Law to help        NAMI Sacramento. He spoke about                    Derby at the NAMI Sacramento office:
those for whom voluntary treatment has         Laura’s Law at the NAMI General Meet-              (916) 874-9416;
proved ineffective. Many local governments     ing in November 2007.                              office@namisacramento.org.

                                                                                                NAMI Sacramento Newsletter, April 2008   -6-
         NAMI Sacramento · 3331 Power Inn Road, Suite 140 · Sacramento, California 95826 · 916.874.9416 · www.namisacramento.org



The Doctor’s Corner
Dr. Robin Zasio is a local Licensed Clinical    they will be judged, scrutinized, or looked      amplifying their messages, Rasenick ex-
Psychologist and owner of the Anxiety           upon negatively or unfavorably.                 plained. When the protein is working prop-
Treatment Center at:                                                                            erly, it‟s like a butler whose “hands are just
www.anxietytreatmentexperts.com.                    It is important to remember that indi-
                                                                                                flying, cooking and cleaning at the same
                                                viduals can experience both shyness and
She addresses mental health questions                                                           time,” he said. But when the brain is de-
                                                social anxiety on a continuum. I recom-
submitted by NAMI Sacramento members,                                                           pressed, “it just sits there in the corner.”
consumers, and readers.                         mend in both situations that help should
                                                be sought when the symptoms are causing             In this post mortem study the research-
Submit your questions to:                       distress or interference in one‟s life. In      ers looked at the protein in the brains of 18
 drrobin@sierrabg.com                          terms of therapy, your might want to ex-        depressed people who committed suicide
 Dr. Robin,                                     plore Cognitive Behavior Therapy and            and compared them to the brains of non-
                                                Exposure and Ritual Prevention Tech-            depressed people. They found the protein
I am concerned about my daughter who            niques. These modalities tend to show the       would have worked less effectively in the
I’ve always thought was shy. Recently           highest positive treatment outcome be-          brains of the suicide victims.
however, I read about a condition referred      cause they help to promote behavioral
to as Social Anxiety Disorder. Can you                                                             The findings raise the prospect of a
                                                changes and integration into activities
help me understand the difference between                                                       blood test that would measure within days
                                                important in one‟s life that may be
the two? And, if she does have Social                                                           whether antidepressants are effectively
                                                avoided. It is important however, that you
Anxiety Disorder, can you share what the                                                        treating depression, Rasenick said. Now it
                                                find someone who is trained in this area
best course of treatment would be?                                                              can take several weeks for patients and psy-
                                                as this is a specialized treatment process.
                                                                                                chiatrists to figure out if an antidepressant is
Ann B.                                                               Sincerely,                 working properly. According to Rasenick,
Dear Ann,                                                                                       only about 30 percent of depression patients
                                                                     Robin Zazio
                                                                                                will respond to a specific drug.
    Your question is right up my alley
since my specialization is in treating
                                                Scientists Spot Biochemi-                           “Unfortunately, we have a very poor
anxiety and related disorders. First, I         cal Sign of Depression                          ability to predict which antidepressants
tend to view shyness as a personality                                                           might be more effective for any individ-
                                                by Randy Dotinga , Health Day Reporter          ual,” said Dr. Gregory Simon, a psychia-
style, rather than a “disorder.” Traits         March 11, 2008
consistent with shyness may include                                                             trist and mental and mental health re-
anxiety or lack of self-confidence around           Researchers say they‟ve discovered a        searcher with Group Health Cooperative in
other people, difficulty thinking of things     biomarker for depression that could lead to     Seattle. “There‟s a long history of research
to say in conversations, lack of knowl-         a quick lab test to determine whether a         using patterns of symptoms or biological
edge of expected modes of behavior in           particular antidepressant is making head-       measures - chemicals measured in blood or
various social situations, passivity, ab-       way against the disease. “This may be a         spinal fluid - to predict response to a par-
sence of outgoing mannerisms such as            very simple biochemical indicator for de-       ticular antidepressant. None of those hoped
good eye contact, an easy smile, a relaxed      pression,” said study co-author Mark            -for predictors have significant value.
posture, and so forth. Although these           Rasenick, director of the interdisciplinary         Genetic tests may provide some clues,
traits can be experienced as quite dis-         Neuroscience Program at the University of       he said, and the new study suggests there
tressing, many people who are shy are           Illinois at Chicago. The test “wouldn‟t tell    might be another approach. “It would not
able to interact with others, and partici-      you which [medication] to start, but it         eliminate trial-and-error, but it would re-
pate in various activities in life such as      would tell you if the one you‟re taking is      duce the waiting time with each trial. But
school, work, and relationships.                working.” It may even be possible to use        it‟s a long way from a study like this one to
                                                the test to determine whether rounds of         a test that‟s useful to patients and doctors.”
    Individuals with Social Anxiety Disor-      psychotherapy are reaping any benefit, he
der may experience all of the above traits,     said. For now, however, such a test is a           Rasenick is hopeful, however, and he said
however, they are coupled with feared           hypothetical, pending further exploration       the proposed test could do more than gauge
thoughts about what others are thinking         of the finding reported in the March edi-       whether drugs are working. It could con-
about them. These thoughts can be quite         tion of the Journal of Neuroscience. At         ceivably measure the effectiveness of talking
obsessional and time consuming resulting        issue is whether the brain itself shows         to a therapist, study co-author Rasenick said,
in isolation and many times, depression.        physical of chemical signs of depression.       since psychiatrists think psychotherapy has a
Individuals who have Social Anxiety Dis-                                                        physical effect on the brain. Rasenick said
order are also preoccupied with fears that         The researchers looked at the interaction    more research and money are needed. The
they will say or do something humiliating       of neurotransmitters and a protein called       study was funded by the U.S. Public Health
or embarrassing, draw negative attention        Gs alpha. In brain cells, the protein acts      Services and the American Foundation for
to themselves, or be in situations whereby      like a kind of butler, passing messages         Suicide Prevention.
                                                from neurotransmitters on the outside and
                                                                                               NAMI Sacramento Newsletter, April 2008       -7-
NAMI Sacramento Membership Form
Please join us! Join others in your community dedicated to improving the lives of people with mental illness in the Sacramento area.
Become part of our grassroots revolution and make a difference! Either detach and mail in the membership form below, or join online at
www.namisacramento.org/membership. Collecting this information helps us to serve our members better. Your information is treated
confidentially and will never be shared outside of NAMI. Please print clearly.

Name: ______________________________________ Address/City/Zip:________________________________________________

(circle one)
Home/Work/Cell Phone: ___________________________ Email: ______________________________

(check one)
Your relation to the consumer:        Ethnicity:                       If you are a consumer, please enter your primary diagnosis:
    I’m a consumer                      Asian                            ADHD                    PTSD
    Family member                       African/Black                    Bipolar disorder        Schizophrenia
    Friend                              Hispanic/Latino                  Dual diagnosis          Unknown
    None, just interested               Caucasian/White                  Major depression        Other
                                         Other                            OCD                     Decline to state
If you are the consumer’s family         Decline to state                 Panic disorder
member, please enter your
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Make checks payable to NAMI Sacramento. Mail to NAMI Sacramento Membership Chair, PO Box 2154, Fair Oaks, CA 95628. NAMI
Sacramento thanks you for your support. Your donations directly help those with mental illness.




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