Mark Your Behavioral Health Calendars!

May 2017



Hepatitis Awareness Month


Mental Health Month


National Military Appreciation Month


May 1–7: Children's Mental Health Awareness Week


May 3–9:  National Anxiety and Depression Awareness Week


May 10–16:  Alcohol- and Other Drug-Related Birth Defects Awareness Week


May 14–20:  National Women's Health Week


May 14–20: National Prevention Week


May 4: National Children’s Mental Health Awareness Day


May 14: National Women's Check-up Day


May 18: HIV Vaccine Awareness Day


May 19: National Asian and Pacific Islander HIV/AIDS Awareness Day


National Association of Addiction Treatment Providers (NAATP) Leadership

Barton Creek Resort & Spa

Austin, Texas

May 2123, 2017


Association for Psychological Science

Sheraton Boston Hotel

Boston, Massachusetts

May 2528, 2017


Altarum’s Twitter Chat on Behavioral Health
Scheduling of the next Behavioral Health Twitter Chat is in progress. Stay tuned for another #AltarumBHchat soon. Follow Altarum on Twitter for the latest notifications.

Note from the Director

BHTAC Director's Note - semicolonAmy Bleuel…do you know that name? Many of you will not, but will know the organization she founded, Project Semicolon, a global nonprofit dedicated to presenting hope and love for those who are struggling with mental illness, suicide, addiction, and self-injury. Her project adopted the punctuation mark as a symbol of continuing a life, just as a semicolon continues rather than ends a sentence. “In literature, an author uses a semicolon to not end a sentence but to continue on,” she said. “We see it as you are the author, and your life is the sentence. You’re choosing to keep going.” The idea resonated for many people struggling with issues, such as depression and suicidal thoughts—inspiring many to get semicolon tattoos.

Amy Bleuel, a young women who felt she had no voice and no influence, became a powerful advocate for and changed the life-course of so many people with depression and thoughts of self-harm and suicide. When Amy herself died by suicide in March, many had difficulty accepting this tragedy. Amy was the face of recovery for many—recovery from substance use, mental health challenges, suicidal ideation, and childhood trauma and abuse. If someone like Amy who seemed to “have it altogether” and “so much to live for” could take her own life, many wondered, “What chance do I have?”

The truth is, none of us really knows the struggles gripping the lives of others. So many are struggling, and we often feel overwhelmed—where to start, what to do, how to help—and wonder if we really make any difference at all. But we do. Remember the starfish story?

The Starfish Story
Original Story by: Loren Eisley

One day a man was walking along the beach when he noticed
a boy picking something up and gently throwing it into the ocean. 

Approaching the boy, he asked, What are you doing?

The youth replied, Throwing starfish back into the ocean. 
The surf is up and the tide is going out.  If I dont throw them back, theyll die.

Son, the man said, dont you realize there are miles and miles of beach and hundreds of starfish? 
You can
t make a difference!

After listening politely, the boy bent down, picked up another starfish,
and threw it back into the surf. Then, smiling at the man, he said

I made a difference for that one.

You can make a difference to at least one person and then, who knows? Like Amy, one can become thousands of people across the country and then people all over the world. Do not think for one moment that you do not make a difference, but ask yourself, “What kind of difference will I make in the world today?”


Diana Williams

Director, Behavioral Health Technical Assistance Center (BHTAC) 


Stories of Recovery


The following stories of recovery are part of the #WeAreRecovery campaign. Submit your story here to be shared on social media for the #WeAreRecovery project, or here for the #WeAreRecoveryAllies campaign. All stories are unique, and yours can inspire others. Your story may be featured in an upcoming issue of BHchat Corner: News You Can Use. If you have questions, email the BHTAC team.

#WeAreRecovery - PamPam from Rocky Mount, Virginia, writes: In the early 2000s, I was an accomplished member of the local running community and well-respected as a mom, a professional, and an athlete. In truth, I was anxious and fearful, self-medicating with alcohol, trying desperately to keep my struggles hidden. Ultimately, I began spiraling out of control. I finally entered treatment on April 17, 2006—and took my first steps into sobriety. However, the foundation of recovery that saved my life was not built without extreme difficulty; I still faced the consequences of three DUI convictions, which included a three-month jail sentence. When I walked out of that jail on Dec. 31, 2006, the seeds had been planted that would ultimately grow into my desire to help those fighting battles similar to mine, and to show them there is hope, there is redemption, and there is recovery. Without asking for help and finding my own recovery, none of my running success, let alone my personal or professional well-being, would be possible. 

#WeAreRecovery - CassandraCassandra from Maple Valley, Washington writes: #MyRecovery has taught me how to live again. Recovery has given me a new joy and hope for my future. I am now almost 2 years sober from drugs (pain killers, Adderall, anything and everything) and alcohol. This picture was taken on my one-year recovery birthday. Recovery has brought many new people into my life who support me and have been there with me through thick and thin during challenges. Recovery is not easy, but it is worth it. It has cleared my mind and has given me a family, job, friends, compassion for others, joy, hope, encouragement, happiness, and much more. I have become an activist for recovery. I have begun public speaking; sharing my story of use to recovery. Becoming sober has been a huge part of my life; I realize that addiction is an unspoken disease in the community that needs to be brought into the light. Thank you.

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Spotlights and Highlights


The BHTAC team is encouraged that the current administration sees the opioid crisis as an issue that deserves its attention; however, although this legislation seems filled with good intentions, it appears short sighted.

Spotlights and Highlights - gavelThe Centers for Disease Control and Prevention reports that 91 Americans were dying every day from opioid overdoses in 2015, and those numbers continue to rise. So far, fighting this epidemic has been a losing battle. Legislation is being proposed to address elements of the epidemic, like that posed by Senators McCann and Gillibrand, but a comprehensive approach that addresses the root cause, not the symptoms, is needed. The 7-day prescription bill may help people who have not yet experienced problems with opiates, and several states are trying this approach. Massachusetts, Connecticut, New York, Maine, Rhode Island, and other New England states have enacted similar laws and are not finding them to have the effect they hoped. Not only are the new laws not seeming to affect opioid overdoses, doctors are reporting that the new legislation that was not supposed to affect individuals who rely on opioid pain relief, like those with cancer or in hospice, has done so.  Moreover, there is real concern that if primary care doctors stop prescribing opioids for those who are addicted without offering support, education, or recovery alternatives, it will lead to an increase in heroin use when people with addiction seek street drugs after prescriptions are stopped.

The good news is that legislation to begin to address the root problems of addiction has already been passed—Comprehensive Addiction Recovery Act (CARA)—yet remains unfunded. Although not perfect, CARA is multifaceted and includes interventions for substance use, from prevention to treatment and recovery. BHTAC’s position is that it makes good sense for congress to review this legislation and begin to identify funding to support its implementation. At this juncture, there’s no need to start from scratch, try to re-create something that already exists, or apply Band-Aids to the gaping wound. The most comprehensive legislation to address substance use disorders has been crafted and passed. It just needs funding.

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Spotlights and Highlights - AHP logoAdvocates for Human Potential, Inc. (AHP), has held SAMHSA’s Center for Substance Abuse Treatment (CSAT) Women, Children and Families (WCF) training and technical assistance contract since 2008. The contract funds a range of efforts supporting workforce development and effective treatment and recovery support for women with substance use and co-occurring disorders. To date, the WCF contract has sponsored five classes of the Women’s Addictions Services Leadership Institute (WASLI) and produced three large-scale webinar series focused on different aspects of substance use and co-occurring disorders in girls and women (i.e., Girls Matter!, Women Matter!, and Relationships Matter!). Additionally, the contract has developed guidance documents related to treatment considerations for women.

AHP is currently engaging subject-matter experts in support of a forthcoming SAMHSA document on recovery services and support that meet the needs unique to women with substance use and/or co-occurring disorders.  On March 22, AHP conducted a dialog session at the Targeted-Capacity Expansion (TCE) grantees’ Peer-to-Peer Services conference in Bethesda, Maryland. The session was facilitated by Deb Werner, senior program manager and project director of the WCF contract and Pat Tucker, senior program manager at AHP.

The 90-minute dialog began with a broad discussion by all 18 attendees to identify salient topics specific to women’s recovery experiences. The group agreed to focus their 45-minute small group sessions on three groups that would address the areas of family, housing, and trauma. Each group was provided two guidance questions—“What do we know about our topic?” and “What are the strengths, weakness, opportunities and challenges?”—in each area.

The breakout groups produced a rich body of reflections and recommendations with a wide range of considerations. All three topics areas noted the consequence of women’s roles as caregivers and in various interpersonal relationships. This is often a significant challenge for women navigating policy and systemic issues particularly within the criminal justice and child welfare systems. Because of this, participants emphasized the importance of value-based recovery services, building and maintaining healthy relationship skills, and allowing for the appropriately timed services for women. The TCE grantees are an essential voice in the development of this document.

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It’s a startling statistic to hear that alcohol is involved over a quarter of all suicides in the United States; that is approximately 7,500 each year. Alcohol can increase impulsivity, negative self-image, and high-risk behaviors while decreasing self-esteem. Although SAMHSA’s National Prevention Week is this month, the links between suicide and alcohol and drug use are increasingly prevalent and in need of year-round attention. 

Spotlights and Highlights - pills and alcoholAccording to the U.S. Department of Health and Human Services, several surveys have uncovered the relationship between alcohol and other drug use and suicidal behavior. Contributing factors include lower minimum-age drinking laws, histories of depression and substance use challenges, and co-occurring disorders. It is important to remember that those who are dependent on substances often have other risk factors for suicide, such as personal loss, trauma, and job or financial problems. Behavioral health workers should also be aware of the target populations who are most likely to have alcohol as a contributing factor to suicide, including men, elders, Veterans, and Native American/Alaska Natives.

Behavioral health workers are researching suicidal individuals who have substance use problems, striving to curtail the number of preventable deaths. They are using preventive services and testing treatments for at-risk populations. And, everyone can continue to look for signs: if someone is threatening self-harm or looking for ways to attempt it, talking about death and suicide, or showing suicidal tendencies, call 911 or the National Suicide Lifeline at 1-800-273-TALK.


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Latest in Research


Latest in Research - ultrasoundIn a recent study conducted by the University of Montreal, researchers have discovered a higher risk of birth defects in women who use antidepressants during their first trimester of pregnancy. According to the senior author, Anick Bérard, this risk increases from 3% to 5% in women who do not take antidepressants and from 6% to 10% for women who take these medications, with different medications being associated with different types of birth defects, including heart, lung, eye, ear, face, and neck defects.

Previous studies conducted by Dr. Bérard has established links between antidepressants and low birth weight, gestational hypertension, miscarriages, and autism. Her new study is among the first to examine the link to birth defects among depressed women.

“We only looked at the first trimester because this is where all the organ systems are developing,” Bérard says. “At 12 weeks of gestation, the baby is formed.”  The article notes that antidepressants used during this timeframe has the potential to interfere with serotonin intake by the fetus, which can result in birth defects. According to the study, serotonin during early pregnancy is essential for the development of all embryonic cells; any insult that disturbs the serotonin signaling process may result in a variety of malformations.\

With more women being diagnosed with depression during pregnancy, this study has direct implications on their clinical management, the study notes, especially as the effectiveness of antidepressants during pregnancy has marginal effect on a woman’s depression. The need for caution with these medications and alternative non-drug options should be considered.

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Two of the most birth defects of the spinal cord and brain are spina bifida and anencephaly, which occur when misfolded proteins accumulate in the cells of a developing nervous system, forming insoluble clumps which causes widespread cell death. These same types of protein clumps also play a major role in Alzheimer's, Parkinson's, and Huntington's disease.  In a recent study, researchers have identified this link that may lead to new treatment for both neural tube defects and these neurodegenerative diseases.

According to the study’s lead author, Zhiyong Zhao, Ph.D., a researcher at the University of Maryland School of Medicine, the link was surprising, noting that "The association suggests that these disparate diseases may have more in common than we previously realized."

Latest in Research - cellsThe researchers studied pregnant mice with diabetes and found that their embryos contained clumps of at least three misfolded proteins that are also associated with the three neurodegenerative diseases listed above. The scientists also examined whether it is possible to reduce levels of the misfolded proteins in the pregnant mice, and in doing so, reduce neural tube defects. During the study, they gave the mice sodium 4-phenylbutyrate (PBA), a compound that can reduce mistakes in molecular structure by aiding the molecules that ensure proper protein folding. The animals that received PBA experienced significantly less protein misfolding and fewer neural tube defects in the embryos. PBA has already been approved by the U.S. Food and Drug Administration for other uses; if it proves safe and effective in humans for this purpose, it could potentially reach individuals who need it much more quickly than an entirely new drug.

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Behavioral Health Twitter Chat - tweet birdScheduling of the next Behavioral Health Twitter Chat is in progress. Stay tuned for a new #AltarumBHchat soon. Follow Altarum on Twitter for the latest in behavioral health news and notifications about upcoming discussions. Visit BHTAC for a list of Altarum’s previous Twitter chat guests and Storify to view the full conversations.

The Altarum Behavioral Health team is on Facebook and Instagram. Be sure to “like” the pages to stay connected with the behavioral health community.

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Contact Information
Sarah Litton
Manager, Communications and Public Affairs


Altarum is a nonprofit organization that creates and implements solutions to advance health among vulnerable and publicly-insured populations.