NAMI Convention: A Discussion with Mike Fitzpatrick, Executive Director

We're in the process of rolling out our NAMI Connection Program, which will be in every large urban area in America - it's a recovery support group. They are free and held a couple of nights a week. People with mental illness can simply walk into those groups. They're run by peers who were trained by us. We're in the beginnings of that roll out. This year we will be in 15 states and in 16 more states next year.

RC: NAMI has been trying to gain entry to the inner city of Trenton. What got us started was one person from NAMI who was a member of a congregation there.

MF; One of the things we do well is that we have a lot of electronic publications that are beyond Beginnings, Avanzamos, and NAMI Advocate, which are hard print publications. One of our more popular ones is FaithNet [http://www.faithnet.nami.org/], which is focused on the faith community realizing that many people, when they experience mental illness in their family or in their lives, turn to the clergy first.

RC: When I first got sick, that's where my mother took me.

MF: What we know is that most people, when they become sick, don't go to the mental health system first. There are at least two or three other stops along the way. It's incumbent on us to make sure that, in terms of self care, people understand what health care is and that the larger community understands...teachers, or the faith community, or general practitioners, which are all places where people tend to turn first.

RC: I was diagnosed with schizophrenia in 1956. There was only one medication. The choice was going to the state hospital or staying in the upstairs bedroom. I've seen the whole spectrum of change over the years.

MF: I think the lives of people who get ill today are so different. And there are challenges. One of the problems we have in this country today is the small number of people with serious mental illness who are able to return to work. Also, there are a large number of people on the waiting list for housing. We need affordable, permanent housing. And we really need a third generation of medications. The second generation hasn't really met the promise. We need to be working very hard for a cure...I think the work on genomics holds great promise, but it's 10 years out, maybe more. But in the end, I think what we'll have is individualized medication. That's where we need to be.

RC: I'm interested in education of the provider.

MF: One of the things we know is that there are huge work force issues in this country. And they're really in two parts. One is that much of the care that people tend to get is provided by people who don't stay in their jobs very long. In some states, because of the wages, we compete with fast food or mall jobs. And those are sort of the front line workers. And then, when you're talking about psychiatrists, social workers, and psychologists, it's really important to keep them up to speed so they understand what best practices are...what are evidence-based services, what are the best medications. And focusing on general practitioners... except for perhaps schizophrenia, virtually all other treatment is predominantly prescribed by general practitioners. There are some states, for example, particularly rural states, where there are counties where they've never seen psychiatrists and probably never will. And so what you do is end up dealing with telemedicine and training health care clinic staffs.