Newly minted pastor Ed Stetzer, writing in CNN.beliefnet, writes of his dealings with a man in his congregation. This person would often disappear for days at a time, and later Stetzer would hear that the fellow had spent hours praying the psalms. Later the man killed himself, leading Stetzer to reflect of aproaches churches could use to better engage parishioners with mental illness.

This led Spetzer to reflect on the kinds of practices that would lead to better acceptance of persons with mental illness. One of these is to view the church community as a refuge, as a place of welcome or safety. It is intriguing that the meaning of the word "asylum"—which not has such a negative connotation—means safe place or sanctuary.

Most of us, unless we have the personalities of saintliness, find ourselves in an irritable mood once in a while. Parents may be particularly prone to these episodes. One hopes that they pass without even a cranky word; although it's difficult to stifle one's facial expression.

Justin Meyer, writing in the Washington Post, brings refreshing honesty to this topic. He hangs up on customer representatives. He watches his children on the playground with the guardedness of a Papa Bear. When driving, he says, "I cut off other drivers in traffic, then flip them the bird."

As Edward R. Murrow said, there are two sides to every story. Our previous probing into an increase and acceleration in funding for research into the brain waxed positively. A different viewpoint—now taken by major pharmaceutical industries—suggests that their interest in brain research is waning. Reuters reports the following:

"Many pharmaceutical companies harbor deep doubts about whether neuroscience is worth their investment dollars as a boom period for once-highly profitable psychiatric medicines comes to an end and new drugs prove hard to find."

April is World Autism Awareness Month, with Autism Awareness Day annually on April 2.

What is Autism Spectrum? It is not easily defined, even by professionals. Modalities of treatment likewise vary and are in their infancy—even as strides are made.

AMHF calls our readers' attention to this often-misunderstood and easily misidentified diagnosis. Asperger's syndrome (or disorder), for example, is an even lesser-understood manifestation and form.

This year—especially this month—we hope you will take a moment to reflect on the myriad mysteries of the brain, especially as manifested in the diagnosis Autism.

President Barack Obama made headlines with his proposal to encourage American scientists to work toward understanding the great mysteries of the brain. Done as a massive project, this could rival past collective enterprises such as Getting a Man to the Moon; when President Kennedy suggested this, it took everyone's breath away. It looked unattainable in the early 1960s. But the country did it.

The new project has garnered unusual bipartisan support.

Since the Greek philosophers there has always been great interest in the brain. St. Thomas Aquinas believed it was necessary but not sufficient for human consciousness. Descartes believed there was an interaction between the brain and the soul: melding somewhere in the pineal gland.

Many other philosophers have speculated that consciousness is a byproduct of the brain itself and concluded that we are the products of the natural forces we are comprised of. As such, our lives our determined by the forces of chemistry, biology, genetics, and past experience.

Several months ago the Cuomo administration announced that budgets for nonprofit agencies serving the developmentally disabled would be cut.
This had led to an outcry from parents, community members, and those who work at these agencies. Recently it was announced that the cuts would be changed.

Although this is helpful, it still leaves most organizations with expenses that would not be covered by incoming monies. And the loss will be substantial.

The Mid-Hudson Valley in New York State may be atypical from many other localities: it has the highest proportion of developmentally disabled persons in the country. Over 10,000 developmentally disabled residents from Willowbrook, Letchworth Village, and Wassaic Developmental Center have been re-integrated into the community. A large number of jobs—private and nonprofit—are part of the caring network.

Federal budget cuts, and state cuts, will hurt the families and people with developmental disabilities, as well as reduce many jobs. The Poughkeepsie Journal reports this morning.

This is the fifteenth movie in the AMHF series of twenty-one. Rain Man won four Academy Awards at the sixty-first Oscars show: Best Picture, Original Screenplay, Director, and Actor—Dustin Hoffman's second in a remarkable performance.

The film revolves around the relationship between a younger, self-centered brother, likewise played to perfection by Tom Cruise, an inheritance, institutionalization, the misunderstanding of individuals on the autism spectrum, and how family ties can trump all failings. It is a feel-good movie with a message about how society reacts to individuals' unusual mental conditions.

Consumers of mental-health services may not realize the extensive system of codes that go into insurance billing and medical records, both for mental-health services and other medical services. For mental health, every person who receives insurance reimbursement receives a diagnostic code from the most current Diagnostic and Statistical Manual of the American Psychiatric Association, as well as a code describing the service. The codes are called CPTs (Current Procedural Terminologies).

There are nearly 300 diagnostic codes in the DSM IV TR. These range from well-known and common conditions such as major depression, bipolar disorder, obsessive compulsive disorder, and panic disorder. Lesser known diagnoses such as Munchausen's syndrome are also included. The clinician is also able to note a secondary code if a learning disorder, developmental disorder, or personality disorder is diagnosed.

After physicists split the atom, unanticipated positive effects emerged—such as medical isotopes—and many negative ones as well. Where do we store the waste? How do we understand fallout and its deadly effect? What happens when there are nuclear plant accidents?

Biologists work in a similar environment as they work to split the genome. Once again, there may be negative effects unrealized. One is the temptation to use genetic manipulation to "improve" humanity. A look at what happened a century ago gives pause. Then, and now, genetics may be viewed as a way to enhance human thinking and mental health.

Word from ABILITIES FIRST in Poughkeepsie, NY

October 5, 2012, Poughkeepsie, NY—As Dr. Lori Crispi’s term on the board of Abilities First, Inc., a Dutchess County based nonprofit that serves children and adults with disabilities, was coming to an end, she felt that she couldn’t just walk away. “I enjoyed being part of the organization so much, especially the work I did on a committee that allowed me to be around the adults with disabilities that the organization serves. It just didn’t feel right walking away, I wanted to do more.”

One of the areas of the organization in need of support had just the opportunity for Crispi, an Associate Professor of Psychology at Marist College. Abilities First’s Work Training Center (WTC) is a vocational program where adults are able to do paid work for private businesses with the assistance and support of Abilities First staff who are trained in working with adults with disabilities. Until 2009 the WTC was able to offer an adult education program through Dutchess County BOCES, who provided the staffing until funds for the program were no longer available. The participants at the Work Training Center were not happy. “For the past three years not a week goes by that one of our participants doesn’t ask me when the program is coming back,” says Charlie Bender, Director of WTC, “these are adults with disabilities that were school aged at a time when educational opportunities for them were limited or not available at all. Many of them have the capacity to learn but have never been given the opportunity.”

Although the education of children and teens with autism is covered both in Public Law 94-142 and Individuals with Disabilities Education Act (IDEA), even with these supports some parents and advocates worried that the intense needs of those with autism were not being fully addressed. This led to the passage of PL 109-416. This act:

(1) provides information and education on autism spectrum disorder and other developmental disabilities to increase public awareness of developmental milestones;
(2) promotes research into the development and validation of reliable screening tools for autism spectrum disorder and other developmental disabilities and disseminate information regarding those screening tools;
(3) promotes early screening of individuals at higher risk
for autism spectrum disorder and other developmental disabilities as early as practicable, given evidence-based
screening techniques and interventions;
(4) increases the number of individuals who are able to confirm or rule out a diagnosis of autism spectrum disorder and other developmental disabilities;
(5) increases the number of individuals able to provide evidence-based interventions for individuals diagnosed with autism spectrum disorder or other developmental disabilities; and
(6) promotes the use of evidence-based interventions for individuals at higher risk for autism spectrum disorder and other developmental disabilities as early as practicable.

Decades ago I was a pre-doctoral intern in clinical psychology and was assigned a therapy case of a young man who would probably now be considered to be experiencing an autism spectrum disorder. He was extremely guarded, withdrawn, and tactile defensive (not liking to touch objects in his environment). Three times each week we met in the play therapy room.

After several weeks he had not said a word and liked to play repetitively with an ambulance, cars, and a house. I was starting to wonder about the effectiveness of the entire endeavor and brought it up with my supervisor. "Just wait and listen and observe," she said. After several months I discovered that one of his parents had died at home and had been taken by ambulance from his house. Soon he began to talk about this. And he began to talk about other things as well.

The Individuals with Disabilities Act (IDEA) lists conditions present in a child that can qualify him or her for special services in the educational system in preschool. These are:

*Chromosomal Abnormalities (e.g., Down syndrome)

*Syndromes (e.g., fetal alcohol syndrome)

*Neuromuscular Disorder (e.g., cerebral palsy, spina bifida)

*Central nervous system (CNS) abnormality (e.g., caused by bacterial/viral infections of the brain or head/spinal trauma)

*Hearing impairment (not correctable with surgery)

*Visual impairment (not correctable with glasses, contact lenses, or surgery)

*Diagnosed psychiatric conditions (e.g., reactive-attachment disorder)

*Emotional/behavioral disorder (i.e., not achieving expected milestones including lack of interest in others, inability to communicate emotional needs, self-injurious or other persistent stereotypical behaviors)

*Diagnosis of autism

*Orthopedic impairment

*Other health impairments (e.g., heart condition, tuberculosis, sickle cell anemia, asthma)

*Traumatic Brain Injury

There are occasions when a child will need to be tested—not by a school or clinical psychologist, but by a neuropsychologist. This occurs when a child displays a brain-based disorder, which can mean an entire spectrum of disorders. Learning disabilities, developmental disabilities, head injuries, cancer, and even gunshot wounds are among the kind of problems studied by neuropsychologists.

Many people still have the idea that psychological testing is mostly practiced in clinics and hospitals, and have images of psychologists sitting with clipboards giving Rorschach Inkblot tests and intelligence tests. In actuality, most psychological testing is now done in schools, and it has a preventive function: to identify mental retardation, learning disabilities, emotional disorders, and other problems that interfere with learning and can be treated.

In each year, more than 1,500,000 children are newly diagnosed with problems such as learning disabilities, mental retardation, and other handicapping conditions. Frequently it is a school psychologist, working with parents and teachers, who administers tests to a child and works with the team in the school to come up with a treatment plan.

The American Psychological Association has announced, in the January 2012 issue of American Psychologist, "Guidelines for Assessment of and Intervention With Persons of Disabilities." This document lists twenty-two practice-guidelines for psychologists who work with persons displaying disabilities of various kinds. The task force for this report was chaired by Kurt F. Geisinger of the University of Nebraska, Lincoln.

The first five guidelines cover the following areas: Psychologists strive to learn about disability paradigms, examine their beliefs and reactions toward those with disabilities (and how this may affect their own work), increase their knowledge about working with persons with disabilities, learn about federal law that support and protect people with disabilities, and provide barrier-free barriers for services.

Finally Hollywood has discovered a good man with the right stuff to play the part of an incredibly loving father who happens to be a graduate of the Bronx High School of Science, loves baseball, and who has just a enough of Asperger's syndrome qualities (a mere scent) to bond closely with his nine-year-old, a boy so riddled with fears that when he sees the swing set in Central Park he immediately sees in his mind an awful swing crash catastrophe. Dad finds unlimited fun ways to engage his intellectually gifted and timid boy, through fantasy trips and excavations of all kind, topped by the search for the Sixth Borough of New York, which floated away from the city one day and never returned.

Many remember Curt Schilling for his postseason successes with the Boston Red Sox, including one in which he pitched while in pain and with a bloodied sock. Schilling recently announced that he has formed his own video-game company, which will be releasing a fantasy-oriented game for gamers. The story behind the story here is that Schilling acknowledges that he has ADHD and that video games have had a positive role in his life in dealing with his ADHD.

Like many with ADHD, Schilling said he has always had a need to be immersed in interesting activities in order to remain focused. He said that during his teenage years, he "must have read The Lord of the Rings 20 times" and early in life he found that video games could help keep him interested in doing something constructive. He found that baseball-video games were too simple to hold his interest, and he became an avid gamer of fantasy games.

In the recent yearly "Reports of the Association" issue of the American Psychologist (December 2011), the American Psychological Association announced "Practice Guidelines Regarding Psychologists' Involvement in Pharmacological Issues." This report notes several factors that will make psychologists more involved in medication-management issues. One survey noted that the number of Americans using antidepressants increased from 6.7 percent in 1990 to 15.1 percent in 1998. Another study indicates that psychologists reported that 43 percent of their patients were using psychotropic medications. In two states, Louisiana and New Mexico, as well as the US Military, psychologists who have been "appropriately trained" are able to prescribe medications.

The task force that came up with this report noted that there is a continuum among psychologists concerning how involved each is with regard to psychopharmacological issues. This article notes three particular points on the continuum for psychologist involvement in psychopharmacology. First, the group of psychologists with actual prescriptive authority (a small, but growing group). Second, psychologists who actively participate in medication decision-making, such as by offering a consultative recommendation about a class of medicines or even a particular medicine to someone (physician, nurse practitioner), retain the legal responsibility for prescribing. Third, psychologists who provide information that may be relevant to pharmacotherapy decision makers, such as referring someone for a medication evaluation or discussing with patients how to address medication concerns with their prescriber. Following are some of the ideas the Task Force came up with.