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Predicting Suicide Attempts and Suicide Deaths Using Electronic Health Records

namini : July 16, 2018 7:47 am : Breaking News

New model substantially outperforms existing suicide risk tools

Suicide accounted for nearly 45,000 deaths in the United States in 2016. Unfortunately, tools currently used to predict an individual’s risk of a suicide attempt or dying by suicide, such as brief self-report measures, have only moderate accuracy. Now, researchers have developed a new prediction model that substantially outperforms existing self-report tools. The study, supported by the National Institute of Mental Health (NIMH), was published online on May 24, 2018, in the American Journal of Psychiatry.

Research has shown that half of the people who die by suicide, and two-thirds of people who attempt suicide, received a mental health diagnosis or treatment in the previous year. These statistics suggest an opportunity for doctors to identify and assist those who are at risk for suicide before they act.

Lead author Gregory Simon, M.D., M.P.H., a senior investigator at the Kaiser Permanente Washington Health Research Institute, and colleagues, set out to develop an improved way to predict suicide attempts and suicide deaths in the 90 days following a mental health diagnosis. The model used data from electronic health records (EHRs) provided by seven major health systems, including the Henry Ford Health System in Detroit, the HealthPartners Institute in Minneapolis, and Kaiser Permanente regions of Colorado, Hawaii, Oregon, California, and Washington.

“By leveraging existing electronic health record data and advancements in statistical modeling, it is possible to significantly improve the prediction of death by suicide and suicide attempts over conventional self-report methods,” said Michael Freed, Ph.D., chief of the Services Research and Clinical Epidemiology Branch in the NIMH Division of Services and Intervention Research.“ Valid and reliable suicide risk prediction models hold tremendous promise to reduce death by suicide, especially when integrated with evidence supported approaches to suicide prevention.”

Anonymized data from the EHRs of almost three million patients who had a mental health diagnosis recorded at either a primary care or a mental health clinic visit between January 1, 2009, and June 30, 2015, were included in the study. The prediction models used information typically available in EHRs or insurance claims: mental health diagnoses recorded during the past five years, mental health medication prescriptions filled during the last five years, and the use of acute-care (inpatient and emergency department) mental health services in the past five years. The researchers created the model using 65 percent of the EHR data and used the remaining data to test its accuracy.

The researchers found that of all the variables included in the model—mental health diagnoses, substance use diagnoses, use of mental health emergency and inpatient care, history of self-harm, and scores on the Patient Health Questionnaire (a standardized depression questionnaire)—were the strongest predictors of suicide attempt and death.

“This prediction model was more accurate than previous models using health records. For example, people with risk scores in the highest five percent accounted for almost half of suicide attempts compared to about one third with previous models,” said Dr. Simon.

The researchers also found that the overall accuracy of the new prediction model exceeded that seen in models predicting other types of health issues, such as rehospitalization for heart failure, in-hospital mortality from sepsis, and high emergency department utilization. The predictive value of the new model was equal to, or better than, widely accepted tools for prediction of major medical outcomes such as stroke in atrial fibrillation and cardiovascular events.

Although prediction models cannot replace clinical judgment, this new tool may help practitioners make better-informed clinical decisions.

“We believe these risk prediction tools are now accurate enough to help clinicians identify people at high risk and to help health systems reach out to people at risk who miss or cancel appointments,” said Dr. Simon.

If you or someone you know needs immediate help, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Learn more about ways you can help someone who might be at risk for self-harm.

July 12, 2018 – Science Update

Reference

Simon, G. E., Johnson, E., Lawrence, J. M., Rossom, R. C., Ahmedani, B., Lynch F. L., … Shortreed, S. M. (in press). Predicting suicide attempts and suicide deaths following outpatient visits using electronic health recordsThe American Journal of Psychiatry. OnlineFirst May 24, 2018.

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Great News from Springfield

namini : June 12, 2018 9:34 am : Breaking News

“Last week we sent out a legislative report about some very good news from the Illinois state legislature in Springfield:It was an article by former Congressman Patrick Kennedy about Illinois’s new insurance parity law, SB 1707.Parity laws are designed to require insurance carriers to cover mental illnesses on the same basis as any other illnesses, and Illinois has had one for several years. But some insurance companies have found ways around it and have continued to deny or restrict coverage for people living with mental illnesses.

The new law is quite likely the strongest parity law in the country, and insurance carriers will find it difficult to get around its provisions.It requires both commercial insurers and Medicaid managed care organizations to show that they are in compliance with Illinois and US parity laws and to take concrete steps to demonstrate that they are notdiscriminating against people with mental health or addiction problems. NAMI and many other mental health advocacy groups have long worked to see that our parity laws are strengthened and SB 1707 is a big step in that direction.

There is other good news from Springfield as well. The first is the budget.For the first time in years Illinois has a balanced budget and it contains some increases for mental health.In particular it provides a 3% increase in Medicaid reimbursement rates for community mental health centers and continues a $27 million program to help community mental health centers pay for psychiatric services, a program which Governor Rauner had proposed eliminating. We are very pleased that he signed the budget the legislature passed.

The General Assembly passed several other laws that will also benefit people living with mental illnesses. Here are the highlights of a few of them:

  • Two of them dealt with access to medications, and both passed with large bipartisan majorities.
    • The first is HB4096. This bill requires the state to create a standard preferred drug list for Medicaid managed care organizations (MCOs). It allows the MCOs to offer more but not fewer drug choices.This will make choosing a managed care provider much easier for people on Medicaid, and will make working with Medicaid easier for healthcare providers as well.
    • The other is HB 4146. It will prevent insurance providers from changing their pharmaceutical benefits, including medications covered, during the insurance year.That way if people sign up for a particular insurance program based on the medications it covers, those medications will be covered for the entire year.
  • Another big win was SB2951 which creates a widespread series of Medicaid pilot programs to establish multi-disciplinary treatment teams which will employ evidence-based practices to provide early diagnosis and treatment for children and adolescents with first episode psychosis or other early onset mental illnesses and/or substance abuse problems.
  • You may have heard that some states are imposing work requirements for people on Medicaid. Research has shown measures like these to be counterproductive, especially for people living with mental illnesses. HB 4165, which passed on fairly partisan lines, will prevent the administration from imposing measures like these without legislative approval.
  • HB 4658 requires schools to provide mental health training to K-12 public school teachers and administrators to help them identify warning signs of mental illness and suicidal behavior in students.It passed both houses unanimously.
  • There is a great shortage of mental health professionals in Illinois, so advocates worked with the legislature to pass five bills which will put a dent that shortage.
  • For decades Illinois has had horrendous system which requires the parents of children with mental health problems, problems so serious that they require residential treatment, to give up custody of their children in order to get the residential placements the children need. Once the parents did that, DCFS would often charge the parents with child abandonment and label them as child abusers. SB2655, which also passed both houses unanimously, will provide additional funding for residential treatment for children with serious mental illnesses and reduce the likelihood of custody relinquishment.It will also provide measures to make any such custody relinquishment only temporary, and prevent DCFS from labeling the parents as child abusers.
  • Amd last, but not least, the budget that the General Assembly passed restores NAMI Illinois’s state funding. Before the Governor eliminated it in 2015, that state funding supplied about 40% of NAMI Illinois’s annual budget. We are glad the Governor agrees it is important to keep NAMI strong so it can continue to support families and individuals impacted by mental illness.

Any one of these bills would be an improvement in Illinois’s broken mental health system, but the fact that they all passed is remarkable.A great big NAMI thank you to everyone who helped make this happen –the many NAMI members who called or slipped in support of the bills, the tireless advocates from the Mental Health Summit, the Mental Health and Substance Abuse Advocates group, the Healthy Minds Healthy Lives Coalition, the Depression and Bipolar Support Alliance, the Illinois Psychiatric Society, the Community Behavioral Healthcare Association, Thresholds and the many other professional organizations and mental health service providers that worked in support of these bills.

And of course a huge THANK YOU to the legislators who sponsored, worked for, and voted for these bills.

Again, thank you to Governor Rauner for signing the budget bill. Now we have to make sure he signs the other bills too.More advocacy may be needed.Stay tuned for further developments.”

– Hugh Brady, NAMI Illinois

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Big Win for Illinois Families: IL House Passes Strongest Mental Health Parity Law in the Nation

namini : June 1, 2018 10:52 am : Breaking News
Illinois families and individuals struggling with mental health and addiction challenges won hard-fought victory for better access to services today. On a strong bipartisan vote of 106-9, the Illinois House of Representatives just passed Senate Bill 1707 – the strongest mental health parity law in the nation. The bill now goes onto the Senate for a vote, possibly as soon as today.

SB1707 is the result of a multi-year Kennedy Forum Illinois campaign to improve parity law enforcement so that people with mental health and addiction challenges can access the treatment they need as required by state and federal law. As part of this campaign, The Kennedy Forum Illinois convened an Illinois Parity Implementation Workgroup with nearly 30 member organizations and spearheaded an Illinois provider survey on the frequency of mental health and addiction treatment denials with key partners.

These efforts resulted in numerous media articles on the damage that mental health and addiction coverage discrimination causes, as well as two House Mental Health Committee hearings on parity, including one on how inadequate parity compliance is helping to fuel our state’s ongoing opioid epidemic, which continues to worsen and killed 2,100 last year.

Specifically, this landmark legislation:

  • Tackles the Opioid Crisis by expanding access to life-saving addiction treatment.
    • The bill prohibits prior authorization and step-therapy requirements for FDA-approved medications to treat substance use disorders;
    • Requires generic FDA-approved medications for substance use disorders to be on lowest-tier of prescription formularies, with branded medications on the lowest tier for branded medications;
    • Prohibits exclusions of prescription coverage and related support services for substance use disorder because they are court ordered, and
    • Requires state regulators to actively ensure plan compliance with parity law utilizing information provided by plans/MCOs and through independent oversight.
  • Increases transparency by requiring health plans to submit parity compliance analyses to the Illinois Dept. of Insurance and the Illinois Dept. of Healthcare and Family Services that align with The Kennedy Forum’s six-step process that shows compliance with federal parity rules and requires plans/MCOs to make parity compliance information available to DOI, HFS, and to individuals via a public website.
  • Improves parity enforcement by requiring the Departments to conduct market conduct examinations/parity compliance audits and report on their enforcement activities annually to the General Assembly and requires the Illinois Auditor General to review implementation state parity law and report to the General Assembly.
  • Closes a loophole in state law that allowed school district health plans to discriminate against mental health and addiction coverage.
By improving accountability and transparency, this legislation will increase parity compliance and access to needed treatment. While there remains much work left to do to end coverage discrimination, SB1707 represents a major milestone not just in Illinois, but the country as a whole.
The Kennedy Forum Illinois thanks Rep. Lou Lang for his tireless leadership on mental health and addiction parity, as well as the Illinois Association for Behavioral Health for its partnership in helping to advance this important legislation. Many thanks also to our numerous partners* for their steadfast support.

*Thank You Supporters and Coalition Members!
American Foundation for Suicide Prevention, American Nurses Association-Illinois, American Psychiatric Association, Chicago Urban League, Community Behavioral Healthcare Association, Depression & Bipolar Support Alliance , Family Guidance Centers, Gateway Foundation, Health & Medicine Policy Research Group, IARF, Illinois Association for Behavioral Health, Illinois Collaboration on Youth, Illinois State Medical Society, Illinois Society for Advanced Practice Nursing, Illinois Psychiatric Society, Live4Lali , NAMI Barrington Area, NAMI Chicago, NAMI Illinois, Rosecrance, Safer Foundation , Smart Policy Works, Sargent Shriver National Center on Poverty Law, TASC, Thresholds

– The Kennedy Forum
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FREE Summer Meals for Kids and Teens

namini : May 30, 2018 1:25 pm : Breaking News

The Community Action Agency of Winnebago and Boone Counties is pleased to announce that the Summer Food Service Program will be back again this year, helping to keep our area kids healthy and nourished so they can return to school in the fall ready to learn.

Kids and teens 18 years old and under can get free meals at supervised sites such as parks, churches, playgrounds, and community centers throughout Winnebago and Boone Counties. Depending on the site, a lunch, dinner, or snack will be provided. Meals consist of fruits, vegetables, grains, protein, and milk. Some sites also provide activities such as arts and crafts, outdoor activities, board games, reading time, and more.

Unfortunately, only 4 in 10 of the eligible kids in our community who rely on school meals actually participate in the Summer Food Service Program. Please spread the word to help us power up our kids for a happy and healthy summer!

To find a site in Illinois, families can text “FoodIL” to 877877 or they can visit SummermealsIllinois.org or call 1-800-359-2163. Parents can also check the Summer Food Site list below to identify a neighborhood site where food is available to their children. Site lists are available at https://rockfordil.gov/city-departments/human-services/community-services/

The Federal Summer Food Service Program is funded through the United States Department of Agriculture (USDA) and administered by the Illinois State Board of Education. The meals are provided by Lifescape Community Services of Rockford.

The list is as follows:

2018 Summer Food Sites for Winnebago and Boone Counties

Residents can contact the participating sites for their individual program details and lunch/snack schedule.

Rockford

Beattie Playground, 1221 Rural St.

Bloom Playground, 2901 Pelham Rd.

Booker Washington Center, 524 Kent St.

Community Kids Zone at East High School, 2929 Charles St.

Elliot Playground, 988 S. Lyford Rd.

Fairgrounds Valley Playground, 1015 W. Jefferson St.

First Evangelical Covenant Church, 316 Wood Rd.

Harkins Pool, 910 Acorn St.

Harmon Park, 1928 East Gate Parkway

Highland Park, 3011 Rural St.

House of Grace, 518 N. Court St.

Ken-Rock Community Center, 3218 – 11th St.

Keye-Mallquist Park, 1702 – 11th St.

Lewis Lemon/Rockford Park District, 1993 Mulberry St.

Liberty Park, 1555 Morgan St.

Mulford Park Apts, 444 Gramercy

Northwest Community Center, 1325 N. Johnston Ave.

Patriots’ Gateway Community Center, 615 S. 5th St.

RESA Youth & Teen Program, 1800 Ogilby Rd.

Ridge Park, 3317 Ridge Ave.

Riverview Ice House, 324 N. Madison St.

Rockford Housing Authority at Blackhawk, 330 15th Ave.

Rockton Centre Library, 3112 Rockton Ave.

St. Elizabeth Community Center, 1536 S. Main St.

St. Paul Church of God in Christ, 1001 Bishop Washington Ave.

Salvation Army, 210 Kilburn Ave.

Sawyer Playground, 2249 Sawyer Rd.

Washington Park Recreation Center, 3617 Delaware St.

YMCA (ID Pennock), 200 Y Blvd.

YMCA (Camp Winnebago), 5804 N. Main St.

Loves Park

Adventure Camp at Pebblecreek – YMCA 5375 Pebble Creek Trail

Wantz Park, 600 Clifford Ave.

YMCA Northeast Branch, 8451 Orth Rd.

Boone County

Boone County Health Dept., 1204 Logan Ave., Belvidere

Capron Lions Club, 305 E. North St., Capron

City of Belvidere, 301 Highline, Belvidere

First Baptist Church, 1255 W. Jackson St.

St. John’s United Church of Christ, 401 N. Main St., Belvidere.

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Lawmakers Pass Bill Positioning Illinois as a Leader in Innovative Early Treatment for Mental Health and Substance Use

namini : May 30, 2018 9:42 am : Breaking News

On strongly bi-partisan votes, the Illinois House and Senate have approved SB2951 – a groundbreaking piece of legislation that will make Illinois one of the first states in the country to create a treatment model specifically designed for youth and young adults experiencing their first symptoms of significant mental health conditions. SB2951 also allows for the delivery of clinical substance use treatment in community-based settings.

This legislation brings Illinois’ treatment system in line with a growing body of research that demonstrates the importance of treating the whole person with a comprehensive set of wrap-around services and meeting a person where they are by delivering treatment in the home or out in the community.

As Illinois works to combat the deadly opioid epidemic and a long-standing mental health crisis, the passage of this legislation represents a sea change. With limited coverage for early treatment, for far too long people struggling with mental health and substance use conditions have had few options for getting the care they need to live well and get back on track.

The right treatment at the right time can make a lifetime of difference.

Accessing a package of treatment services tailored to meet the needs of a person first experiencing a serious mental health condition or substance use condition can mean the difference between a longer, healthier life and a devastating and preventable spiral of repeat hospitalizations, homelessness, criminal justice involvement, and disability.

The treatment models included in the bill compliment the exciting new mental health and substance use pilot projects outlined in Illinois’ 1115 Medicaid Waiver, recently approved by the federal government. A proposal to strengthen access to First Episode Psychosis treatment, originally included in Illinois’ Waiver application but ultimately not approved, makes this legislation even more critical by filling these gaps in services.

SB2951 was introduced by Healthy Minds Healthy Lives (HMHL) and sponsored by Senator Melinda Bush (D – Grayslake) and Representative Sara Feigenholtz (D – Chicago) with support from legislative champion Senator Dale Righter (R – Mattoon). HMHL is a statewide advocacy coalition comprised of a diverse cross-section of stakeholders including people with lived experience, family support organizations, trade associations, policy experts, and treatment providers including Thresholds.

SB2951 now goes to the Governor for consideration.

*****************

For more on the SB2951, please see the bill fact sheet.

For more on the Healthy Minds Healthy Lives Coalition, visit their webpage.

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How Depressed is Illinois?

namini : May 17, 2018 9:56 am : Breaking News

Major depression is on the rise among Americans and certain groups and parts of the country have been hit harder than others, according to a new report from Blue Cross Blue Shield of America.

The data looks at medical claims from Blue Cross Blue Shield members from 2013 to 2016 and found a 33 percent jump in diagnosis of major depression over that time. In total, more than 9 million commercially insured people across the United States suffer from major depression, the report estimates.

Millennials and teenagers have experienced the fastest climb in diagnosis rates, up 47 percent and 63 percent, respectively.

“The high rates for adolescents and millennials could have a substantial health impact for decades to come,” Trent Haywood, the group’s senior vice president and chief medical officer, said in a statement.

Women are diagnosed with major depression at double the rate of men.

The report also found wide geographic differences in the diagnosis of major depression among states. The data showed higher rates of major depression in New England, the Pacific Northwest and various pockets throughout the South and Midwest.

The highest rate of depression was in Rhode Island at about 6 percent, while the lowest was in Hawaii at 2 percent. Every state except Hawaii experienced rising diagnosis rates of depression over the course of the study period.

hoa-depressionrates-map.jpg
 BLUE CROSS BLUE SHIELD

However, the authors note that differences in the effort to screen for major depression can produce varying diagnoses rates across states.

What’s behind the rise in major depression diagnoses?

Read here to find out: How Depressed is Your State?

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Parent/Caregiver Support Cancelled for Memorial Day 2018

namini : April 27, 2018 9:59 am : Breaking News

Sorry for any inconveniences!

No parents and caregiver support May 28, 2018.

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Click here to End the Silence

namini : April 9, 2018 9:54 am : Breaking News

NAMI Ending the Silence is an engaging presentation that helps audience members learn about the warning signs of mental health conditions and what steps to take if you or a loved one are showing symptoms of a mental illness.

NAMI Ending the Silence presentations include a lead presenter who shares an informative presentation and a young adult with a mental health condition who shares their journey of recovery. Audience members can ask questions and gain understanding of an often-misunderstood topic. Through dialogue, we can help grow the movement to end stigma.

NAMI Northern Illinois is excited to announce.. this program is coming soon to a classroom near you! We are search of young adults  (18 – 30 years) who are interested in training to become presenters in school settings that also live a stable life with a mental health condition and have the ability to relate to youth and teens. Fill out the form below to apply!

What Your Audience Will Get

  • Free of cost to schools and communities
  • NAMI Ending the Silence for Students: 50-minute presentation designed for middle and high school students that includes warning signs, facts and statistics and how to get help for themselves or a friend. Research has shown that NAMI Ending the Silence for Students is effective in changing middle and high school students’ knowledge and attitudes toward mental health conditions and toward seeking help
  • NAMI Ending the Silence for School Staff: 1-hour presentation for school staff members that includes information about warning signs, facts and statistics, how to approach students and how to work with families
  • NAMI Ending the Silence for Families: 1-hour presentation for parents and primary caregivers that includes warning signs, facts and statistics, how to talk with your child and how to work with school staff

Why Ending The Silence Matters

ETS

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NO NAMI CONNECTION on Sunday April 1st

namini : March 29, 2018 7:43 am : Breaking News

Sorry all for the inconvenience. Groups will meet regularly again beginning Sunday, April 8.

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NAMI Celebrates Mental Health Victories In Federal Funding Bill

namini : March 23, 2018 6:37 am : Breaking News

FY18 Funding Signals Greater Investment in Services for Individuals with Mental Illness & Families 

Following the release of the Fiscal Year (FY) 2018 federal appropriations package, NAMI is extremely grateful for the increased investments in mental health services and supports. By including significant funding increases for these programs, Congress has taken a crucial step to support individuals with mental illness and their families.

The bill substantially boosts several of NAMI’s key priorities. It includes significant investments in research at the National Institute of Mental Health (NIMH), to the Mental Health Block Grant and to key programs at the Departments of Housing and Urban Development, Veterans Affairs and Justice. These substantial investments signal a commitment by members of Congress to increasing federal support for individuals living with mental illness.

“I applaud Congressional leaders for taking concrete actions to fund critical mental health priorities,” said Mary Giliberti, Chief Executive Officer of NAMI. “This appropriations package invests in key programs for individuals with mental illness, supports important evidence-based services in our communities and promotes research that could result in significant scientific advancements that foster improvements in treatment and recovery for people with mental illness.”

NAMI would like to highlight key areas that will impact people with mental illness and their families:

Investing in Services: The Substance Abuse and Mental Health Services Administration (SAMHSA) will receive an increase of nearly $306 million for mental health programs. The package also increases the Community Mental Health Block Grant (MHBG) by $160 million, the largest single-year increase in the MHBG’s history. This funding increase will also ensure more federal support for programs that provide early intervention in the treatment of psychosis and other mental illnesses.

Investing in Research: NIMH will receive a $109.8 million increase, the largest single-year increase for NIMH since its budget was doubled in FY 2002. Overall, the National Institutes of Health will see a $3 billion increase in its funding.

Investing in Housing: The package includes substantial increases for programs that support non-elderly individuals with disabilities, enable the construction of new Project-Based Rental Assistance units and allow for the development of new Permanent Supportive Housing for individuals that are experiencing homelessness. It also provides funding to assist homeless and at-risk veterans into permanent supportive housing.

Investing in our Veterans: There are major investments in programs for veterans who live with mental health conditions and veterans in crisis. Department of Veterans Affairs’ Mental Health Services and Programs will receive a $580 million increase, including for Vet Centers, which provide mental health and readjustment counseling for combat veterans, and the National Centers for PTSD. The package also increases the investment in veteran suicide prevention programs and outreach, and includes the Honor Our Commitment Act, which requires the VA to provide mental and behavioral health care to hundreds of thousands of veterans who received other-than honorable discharges.

Investing in Jail Diversion and Reentry: The Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) will receive an $18 million increase – its most significant increase ever – to support efforts that promote collaboration between the justice and mental health systems. Veterans Treatment Courts will receive a $13 million increase to assist veterans with mental health and substance abuse conditions with early intervention and treatment rather than punishment. Byrne Justice Assistance Grants, the primary provider of federal criminal justice funding to state and local jurisdictions, will see a $12 million increase.

NAMI is appreciative of the efforts of Sens. Roy Blunt (R-MO), Susan Collins (R-ME), Jerry Moran (R-KS), Chris Murphy (D-CT), Patty Murray (D-WA), Jack Reed (D-RI), Brian Schatz (D-HI) and Jon Tester (D-MT), and Reps. Tom Cole (R-OK), Rosa DeLauro (D-CT), Mario Diaz-Balart (R-FL), Rodney Frelinghuysen (R-NJ) and David Price (D-NC).

“NAMI is grateful to leaders in the House and Senate for their recognition and dedication to supporting these important programs,” Giliberti stated. “While we celebrate these increases in funding, we will continue working with our federal partners to achieve additional investments for mental health research and services in the future.

– Statement given by NAMI National March 22, 2018

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