A Consumer's Guide to Services Mental Health/Mental Illness National Institute of Mental Health Decade of the Brain U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service DHHS Publication No. (ADM) 92-0214 Printed 1975, Revised 1980, 1987, 1992 For sale by the US Government Printing Office Superintendent of Document, Mail Stop: SSOP, Washington, DC 20402-9328 This brochure was revised by Margaret Strock, staff member in the Information Resources and Inquiries Branch, Office of Scientific Information, National Institute of Mental Health (NIMH). Expert assistance was provided by Lemuel Clark, MD; Junius J. Gonzales, MD; Jack D. Maser, PhD; Jacqueline Parrish, RN, MS; Natalie Reatig; and Matthew V. Rudorfer, MD, all of whom are NIMH staff members. Their help in assuring the accuracy of this brochure is gratefully acknowledged. All material appearing in this volume is in the public domain and may be reproduced or copied without permission from the National Institute of Mental Health. Citation of the source is appreciated. A Consumer's Guide to Services Message from the National Institute of Mental Health Research conducted and supported by the National Institute of Mental Health (NIMH) brings hope to millions of people who suffer from mental illness and to their families and friends. In many years of work with animals as well as human subjects, researchers have advanced our understanding of the brain and vastly expanded the capability of mental health professionals to diagnose, treat, and prevent mental and brain disorders. Now, the 1990s, which the President and Congress have declared the "Decade of the Brain," we stand at the threshold of a new era in brain and behavioral sciences. Through research in animals and humans, we will learn even more about mental disorders such as depression, manic-depressive illness, schizophrenia, panic disorder, and obsessive-compulsive disorder. And we will be able to use this knowledge to develop new therapies that can help more people overcome mental illness. The National Institute of Mental Health has been part of the Alcohol, Drug Abuse, and Mental Health Administration, U.S. Department of Health and Human Services, since 1974. The Congress recently passed and the President signed the ADAMHA Reorganization Act. Under this Act, on October 1, 1992, the research components of NIMH will return to the National Institutes of Health (NIH). NIMH was one of the original NIH institutes. The services components of NIMH will be transferred to the Center for Mental Health Services of the newly established Substance Abuse and Mental Health Services Administration. Twenty percent of adult Americans--or one in five--will have a mental illness during their lifetime that is severe enough to require treatment, and many more have problems that prevent them from enjoying their lives. Often these people suffer in silence, rather than admit they need help. Asking for help is not an easy thing for many people to do, but it is a wise move when a person feels that something is wrong. This brochure offers a guide to finding mental health services. Many individuals who are looking for help for themselves or a loved one ask the same questions. Following are some of the most commonly asked questions and their answers. Q. When I need help, where can I go? A. For information about resources available in your community, contact your local mental health center or one of the local affiliates of national organizations listed in the back of this pamphlet. These agencies can provide you with information on services designed to meet the needs of those suffering from mental disorders such as depression. schizophrenia, panic disorder, and other anxiety conditions. In addition, they will have information regarding services designed for specific cultural groups, children, the elderly, HIV-infected individuals, and refugees. Q. I don't have adequate personal finances, medical insurance, or hospitalization coverage--where would I get the money to pay for the service I may need? A. In publicly funded mental health centers, such as those funded by State and municipal governments, the cost of many services is calculated according to what you can afford to pay. So, if you have no money, or very little, services are still provided. This is called a sliding-scale or sliding-fee basis of payment. Many workplaces make assistance programs available to their employees, often without charge. These programs--usually called Employee Assistance Programs--are designed to provide mental health services, including individual psychotherapy, family counseling, and assistance with problems of drug and alcohol abuse. Q. Are there other places to go for help? A. Yes there are alternatives Many mental health programs operate independently. These include local clinics, family service agencies, mental health self-help groups, private psychiatric hospitals, private clinics, and private practitioners. If you go to a private clinic or practitioner, you will pay the full cost of the services, less the amount paid by your insurer or some other payment source. There are also many serf-help organizations that operate drop-in centers and sponsor gatherings for group discussions to deal with problems associated with bereavement, suicide, depression, anxiety, phobias, panic disorder, obsessive-compulsive disorder, schizophrenia, drugs, alcohol, eating disorders (bulimia, anorexia nervosa, obesity), spouse and child abuse, sexual abuse, rape, and coping with the problems of aging parents--to name a few. In addition, there are private practitioners who specialize in treating one or more of these problems. You may contact local chapters of organizations listed in the back of this pamphlet to learn about various services available in your community. Q. I don't like to bother other people with my problems. Wouldn't it be better just to wait and work things out by myself? A. That's like having a toothache and not going to the dentist, The results are the same--you keep on hurting and the problem will probably get worse. Q. Suppose I decide to go ahead and visit a mental health center. What goes on in one of those places? A. A specially trained staff member will talk with you about the things that are worrying you. Q. Talk? I can talk to a friend for free--why pay someone? A. You're quite right. If you have a wise and understanding friend who is willing to listen to your problems, you may not need professional help at all. But often that's not enough. You may need a professionally trained person to help you uncover what's really bothering you. Your friend probably does not have the skills to do this. Q. How can just talking make problems disappear? A. When you're talking to someone who has professional training and has helped many others with problems similar to yours, that person is able to see the patterns in your life that have led to your unhappiness. In therapy, the job is to help you recognize those patterns--and you may try to change them. There may be times, however, when you will need a combination of "talk" therapy and medication. Q. Are psychiatrists the only ones who can help? A. No. A therapist does not have to be a psychiatrist. A number of psychologists, social workers, nurses, mental health counselors, and others have been specially trained and licensed to work effectively with people's mental and emotional difficulties. However, only a psychiatrist is a medical doctor and therefore qualified to prescribe medication. Q. Since I work all day, it would be hard to go to a center during regular working hours. Are centers open at night or on weekends? A. Often centers offer night or weekend appointments. Just contact the center for an appointment, which may be set up for a time that is convenient for both you and the center. Q. And how about doctors in private practice--do they sometimes see their patients after working hours? A. Many doctors have evening hours to accommodate their patients. Some even see patients very early in the morning before they go to work. Q. I feel that I would be helped by going to a mental health center. Actually, I think my spouse could be helped too. But the ides of going to a "mental health center" would seem threatening to my spouse. Could I just pretend that it's something else? A. No indeed. It's better to talk your spouse into it than to lie. Don't jeopardize trust by being deceptive. However, you may want to discuss it first with the center. Marital or family therapy is available when a problem exists that involves more than one family member. Q. If I go to a mental health center, what kind of treatment will I get? A. There are many kinds of treatment. A professional at the center will work with you in determining the best form for your needs. Depending on the nature of the illness being treated, psychotherapy and/or treatment with medication may be recommended Sometimes, joining a group of people who have similar problems is best; at other times, talking individually to a therapist is the answer. Q. Does talking therapy for mental and emotional problems always work? A. Sometimes it does, and sometimes it doesn't. It primarily depends on you and the therapist. It is important to share your concerns in a serious, sincere, and open manner. Only if you are completely honest and open can you expect to receive the best support and advice. Q. What if I really try, but I still can't feel comfortable with the therapist? A. There should be a "fit" between your personality and that of the therapist. Someone else--or some other method--may be more suitable for you. You can ask your therapist for a referral to another mental health professional, or, if you prefer, you can call one of the associations listed in this booklet for the names of other therapists in your area. Q. What if I am receiving medication and don't think it is helping? A. If there is little or no change in your symptoms after 5 to 6 weeks, a different medication may be tried. Some people respond better to one mediation than another. Some people also are helped by combining treatment with medications and another form of therapy. Q. Does a mental health center provide services for children? A. Yes. Children's services are an important part of any center's program. Children usually respond very well to short-term help if they are not suffering from a severe disorder. Families often are asked to participate and are consulted if the child is found to have a serious disorder--such as childhood depression, obsessive-compulsive disorder, attention deficit hyperactivity disorder, or anorexia nervosa or bulimia--and long-term treatment is needed. Q. I have an elderly parent who has trouble remembering even close members of the family. He is physically still quite active and has wandered off a number of times. Could someone help with this? A. A staff person at a center could advise you about ways you could best care for your parent. You may be referred to a special agency or organization that provides services designed especially to meet the needs of elderly people. The department of public welfare in your county can give you addresses and telephone numbers for both your county and State agencies on aging. These agencies provide information on services and programs for the elderly. Q. I have a friend who says she could use some professional help, but she is worried about keeping it confidential. A. She needn't worry. Confidentiality is basic to therapy, and the patient has the right to control access to information about her treatment. Professional association guidelines plus Federal and State laws underscore the importance of confidentiality in therapist-client relationships and govern the release of records. Some insurance companies require certain information from the therapist as a condition for only if the patient gives written permission. If your friend wants to know exactly who gets information and what kind of information is released, she should ask her insurance provider and discuss it in detail with the therapist. Q. I have a relative with a severe mental problem. Should I urge this person to go to the hospital. A. A person who is mentally ill should be in a hospital only if it is absolutely necessary. In general, most mental health professionals believe that persons with mental illness should live in the community and be treated there. That's why mental health centers and community support and rehabilitation programs stress the importance of having many different services available: day, night, and weekend care,and outpatient treatment through regular visits to an office or clinic. Q. Do emergency cases wind up as long-term patients in mental hospitals? A. Generally no. Mental hospitals are used today for short-term crisis intervention when there are no other community services available or when a person needs extra care to stabilize a drug treatment regimen. Also they serve the small percentage of patients who need long-term, structured, supervised care and treatment in a protective setting. Q. I have heard people use the term "involuntary commitment." What does this mean? A. In an emergency (for example, where a person is considered a danger to self or others), it is possible for someone to be admitted to a hospital for a short period against his or her will. The exact procedures that must be followed vary from one area to another, according to State and local laws. At the end of the emergency commitment period, the State must either release the individual, obtain his or her voluntary consent to extend commitment, or file with the court an extended commitment petition to continue to detain the person involuntarily. Most States require an emergency commitment hearing to be held within 2 to 4 days after hospital admission to justify continued involuntary confinement. Q. Whom can I call if I feel that my rights have been violated or if I want to report suspected violation of rights, abuse, or neglect? A. Federal law provides that each State have a Protection and Advocacy (P&A) System. These agencies are authorized to protect the rights of, and act as advocates for, mentally ill individuals who are, or have been in the last 90 days, residents in mental health care or treatment facilities. The agencies will investigate incidents of abuse and neglect if they are reported to the system, or if there is probable cause to believe that the incidents occurred. For the name of the P&A agency in your State, contact the National Association of Protection and Advocacy Systems at the address listed in the back of this brochure. Warning Signals Many people are not sure how to judge when professional help for mental problems may be needed. There are some behaviors that may be signs of trouble: 1 Is the person acting differently than usual? Could this change be linked to something that has happened recently? Any event, such as the death of a close relative, loss of a job, marital break-up, or even something positive--like a job promotion--can trigger a troublesome emotional reaction. 2 Does the person complain of episodes of extreme, almost uncontrollable, anxiety or "nervousness"? One sign of an emotional problem is "free floating" anxiety that is unrelated to a normal concern such as a child's illness or a backlog of bills. 3 Does the person become aggressive, rude, and abusive over minor incidents or talk about groups or individuals "out to get me"? If such remarks are made in all seriousness, and if violent behavior occurs, it is likely that help is needed and should be sought. Any of these symptoms, if they persist or become severe, may suggest a need for professional help. Fortunately, early identification and treatment of the problems causing this behavior often can make these symptoms disappear. What to Do in Emergency Situations If a person becomes violent, gets completely out of control, or tries to commit suicide, there are several things you can do: 1 In a dangerous or violent crisis, call the police. Often the police are the best equipped, most available resource, especially when violence has occurred or when there is a strong possibility that the person may do physical injury to self or others. Once the emergency situation has been brought under control, if the troubled individual is already in treatment, call his or her therapist. 2 In a nonviolent crisis, contacting other resources may be the best choice. For example, if an individual hasn't eaten for a substantial period of time and has become weak and dehydrated, call his or her physician or therapist. If the person doesn't have one, get him or her to a hospital emergency room where there are doctors on duty--even if you have to call an ambulance to get there. Look in the Yellow Pages under "Ambulances," or call the fire department or rescue squad. Look under the list of emergency numbers in the front of your phone book, or call the operator if you can't find a number in a hurry. Emergency room doctors will treat injuries resulting from violence, a suicide attempt, or a drug or alcohol overdose. They may also be able to provide temporary help for an emotional problem, even if they are not mental health specialists. In addition, they will be able to tell you where and how to get further help. If the person in crisis is a member of a church, synagogue, or temple, you may choose to call the minister, priest, or rabbi. Many members of the clergy are trained to deal with emergencies, or they can refer you to other sources of help. You may choose to call a mental heath or crisis hotline, drug hotline, suicide prevention center, "free clinic," or Alcoholics Anonymous chapter, if your area has such services. Their telephones are often staffed around the clock. Look for a number in the list of emergency or community service numbers in the front of your phone book, or you can find a listing in the white pages under "Suicide," Mental Health," "Alcoholics Anonymous," or ask the operator for help. Another option would be to call the nearest mental health center. If it's not listed that way in the phone book, look for it under "Hospitals," "Mental Health Clinics," or "Physicians" in the Yellow Pages. Mental health centers generally provide a wide range of services. Included in these are: 1 24-hour emergency service--available at hospitals or other mental health clinics at any time of the day or night. 2 Outpatient care--a person goes into the center's clinic for treatment that has been set up on a regular appointment basis. 3 Inpatient service--a person stays at the hospital where care is provided. 4 Partial hospitalization--a person might spend occasional days, nights, or weekends at the center, living at home and going to work as much as possible. 5 Consultation, education, and prevention services--assist schools, community organizations, institutions, and businesses in dealing with mentally ill persons and in developing programs that help in the understanding and prevention of emotional disorders. Treatment Methods The goals of treatment are to reduce symptoms of emotional disorders; improve personal and social functioning; develop and strengthen coping skills; and promote behaviors that make a person's life better. Biomedical therapy, psychotherapy, and behavioral therapy are basic approaches to treatment that may help a person overcome problems. There are many specific types of therapies that may be used alone or in various combinations. Biomedical Therapies Treatment with medications has benefited many patients with emotional, behavioral, and mental disorders and is often combined with other therapy. The medication that a psychiatrist or other physician prescribes depends on the nature of the illness being treated as well as on an assessment of the patient's general medical condition. During the past 35 years, many psychotherapeutic medications have been developed and have made dramatic changes in the treatment of mental disorders. Today there are specific medications to alleviate the symptoms of such mental disorders as schizophrenia, bipolar disorder, major depression, anxiety, panic disorder, and obsessive-compulsive disorder. Electroconvulsive treatment (ECT) is another bio-medical treatment that can help some patients. It is generally reserved for patients with severe mental illnesses who are unresponsive to or unable to tolerate medications or other treatments. While ECT is most commonly indicated in the treatment of major depression, often with psychosis (delusions or hallucinations), it is also used in selected cases of schizophrenia. Severe reduction in food and fluid intake with little physical movement (catatonia), or overwhelming suicidal ideation, where urgency of response is important, are reasons for considering ECT as treatment of choice. Modern methods of administering ECT employ low "doses" of electric shock to the brain along with general anesthesia and muscle relaxants to minimize the risk and unpleasantness to patients. Psychotherapy Psychotherapy is accomplished through a series of face-to-face discussions in which a therapist helps a person to talk about, define, and resolve personal problems that are troubling. Psychotherapies generally appear to be more effective and appropriate than medications or ECT for less severe forms of emotional distress. Short-term psychotherapy, lasting for several weeks or months, is used when the problem seems to result from a stressful life event such as a death in the family, divorce, or physical illness. The goal of the therapist is to help the patient resolve the problem as quickly as possible. Often this takes only a few visits. Long-term psychotherapy, lasting from several months to several years, emphasizes the study of underlying problems that started in childhood. The following is a list of a few types of psychotherapy: Psychodynamic psychotherapy, which may be either long- or short-term, examines important relationships and experiences from early childhood to the present in an effort to analyze and change unsettling or destructive behaviors and to resolve emotional problems. One form of psychodynamic psychotherapy is psychoanalysis, a long-term, intensive therapy that emphasizes how the patient's unconscious motivations and early patterns resolving issues are important influences in his or her present actions and feelings. Interpersonal therapy focuses on the patient's current life and relationships within the family, social, and work environments. Family therapy involves discussions and problem-solving sessions with every member of a family--sometimes with the entire group, sometimes with individuals. Couple therapy aims to develop a more rewarding relationship and minimize problems through understanding how individual conflicts get expressed in the couple's interactions. Group therapy involves a small group of people with similar problems who, with the guidance of a therapist, discuss individual issues and help each other with problems. Play therapy is a technique used for establishing communication and resolving problems with young children. Cognitive therapy aims to identify and correct distorted thinking patterns that can lead to troublesome feelings and behaviors. Cognitive therapy is often combined effectively with behavioral therapy. Behavioral Therapy Behavioral therapy uses learning principles to change troublesome thinking patterns and behaviors systematically. The individual can learn specific skills to obtain rewards and satisfaction. Such an approach may involve the cooperation of important persons in the individual's life to give praise and attention to desirable changes. Behavioral therapy includes an array of methods such as stress management, biofeedback, and relaxation training. Other Treatments Some treatments, called "adjunctive," are used in combination with other therapies, and sometimes they are used alone. They include occupational, recreational, or creative therapies, as well as some that focus on special education. A mental health professional can help a client find the kind of therapy, or combination of therapies, that is best suited to his or her situation. Rehabilitation Services--Community Support Programs Many individuals with severe mental illness find it difficult to work, learn, socialize, and live independently outside a controlled setting. To help in these matters, community support programs offer rehabilitation services, either through free-standing programs that are similar to clubs, or through mental health centers. These agencies offer a variety of activities to assist clients in learning skills that will help them to live and work independently and productively in the community. For information on community support programs, contact your local or State mental health agency. The Helping Professionals: Helping professionals work in a variety of settings, such as mental health centers, outpatient clinics, private and group practice, general hospitals, psychiatric hospitals, nursing homes, and prisons. They also work in residential treatment centers, patient care organizations, family or social service agencies, and the psychiatric departments of university medical centers or teaching hospitals. Who They Are--What they Do Psychiatrists A psychiatrist is a medical doctor who specializes in mental disorders, is licensed to practice medicine, and has completed a year of internship and 3 years of specialty training. A board-certified psychiatrist has, in addition, practiced for at least 2 years and passed the written and oral examinations of the American Board of Psychiatry and Neurology. Psychiatrists can evaluate and diagnose all types of mental disorders, carry out biomedical treatments and psychotherapy, and work with psychological problems associated with medical disorders. Of the mental health professionals, only psychiatrists can prescribe medications. Child psychiatrists specialize in working with children; geriatric psychiatrists concentrate on helping the aged. Psychologists Psychologists who conduct psychotherapy and work with individuals, groups, or families to resolve problems generally are called clinical psychologists counseling psychologists or school psychologists. They work in many settings--for example, mental health centers, hospitals and clinics, schools, employee assistance programs, and private practice. In most states, a licensed clinical psychologist has completed a doctoral degree from a university program with specialized training and experience requirements and has successfully completed a professional licensure examination. The field of psychology, also includes those who specialize in such areas as testing, community organization, industrial relations, and laboratory research. Psychiatric Nurses Psychiatric nursing is a specialized area of professional nursing practice that is concerned with prevention, treatment, and rehabilitation of mental health-related problems. These nurses are registered professional nurses who have advanced academic degrees at the master's degree level or above. They conduct individual, family, and group therapy and also work in mental health consultation, education, and administration. Social Workers Psychiatric (or clinical) social workers have master's or doctor's degrees in social work, have completed a field supervision program, and are licensed/certified. In addition to individual, family, and group counseling and psychotherapy, they are trained in client-centered advocacy. This includes information, referral, direct intervention with governmental and civic agencies, and expansion of community resources. Mental Health Counselors A clinical mental health counselor provides professional counseling services that involve psychotherapy, human development, learning theory, and group dynamics to help individuals, couples, and families. The promotion and enhancement of healthy, satisfying lifestyles are the goals of mental health counselors, whether the services are rendered in a mental health center, business, private practice, or other community agency. Clinical mental health counselors have earned at least a master's degree, and several years' clinical supervision is required before they are certified by the National Academy of Certified Clinical Mental Health Counselors. Case Managers and Outreach Workers These individuals assist persons with severe mental illness, including some who may be homeless, to obtain the services they need to live in the community. Most persons with severe mental illness need medical care, social services, and assistance from a variety of agencies, including those dealing with housing, Social Security, vocational rehabilitation, and mental health. Because such services are uncoordinated in many areas, case managers provide a critical function to monitor a person's needs and assure that appropriate agencies get involved. In many instances they also act as advocates for the client. Case managers can be nurses, social workers, or mental health workers and can be associated with mental health centers, psychosocial rehabilitation programs, or other agencies. Information Resources If you believe that you, or someone you know, might benefit from the services of a mental health professional, mental health center, or one of the organizations described in this brochure, don't hesitate to take advantage of these useful services. For referral to a physician, psychiatrist, or psychologist contact your local medical bureau or local department of mental health listed in the telephone book. And remember that your own physician or clergy is usually aware of places in your community to get help. The following are some excellent information sources: For psychiatrists: American Medical Association 515 North State St. Chicago, IL 60610 American Psychiatric Association 1400 K St., NW Washington, DC 20005 (202) 682-6000 For psychologists: American Psychological Association 750 First St. NE Washington, DC 20002-4242 (202) 336-5500 For psychiatric nurses: American Nurses' Association 600 Maryland Ave. SW Suite 100W Washington, DC 20024 (202) 554-4444 American Psychiatric Nurses' Association 6900 Grove Rd. Thorofare, NJ 08086 (609) 848-7990 For social workers: National Association of Social Workers 750 First St. NE Suite 700 Washington, DC 20002 (202) 408-8600 For mental health counselor: American Mental Health Counselors Association 5999 Stevenson Ave. Alexandria, VA 22304 (703) 823-9800 ext. 383 American Association for Marriage and Family Therapy 1100 17th St. NW 10th Floor Washington, DC 20036 (202) 429-1825 For Psychosocial rehabilitation programs: National Rehabilitation Association 1910 Association Dr. Suite 205 Reston, VA 22091 (703) 715-9090 International Association of Psychosocial Rehabilitation Services Sterrett Place, Suite 214 Columbia, MD 21044-2626 (410) 730-7190 For State mental health centers and programs: National Association of State Mental Health Program Directors 66 Canal Center Plaza Suite 302 Alexandria, VA 22314 (703) 739-9333 For protection and advocacy: National Association of Protection and Advocacy Systems 900 2nd St. NE Suite 211 Washington, DC 20002 (202) 408-9514 For outpatient programs and mental health service facilities: American Association for Partial Hospitalization, Inc. 901 Washington St. Suite 600 Alexandria, VA 22314 (703) 836-2274 National Association of Private Psychiatric Hospitals 1319 F St. NW Suite 1000 Washington, DC 20004 (202) 393-6700 National Council of Community Mental Health Centers 12300 Twinbrook Pkwy. Suite 320 Rockville, MD 20852 (301) 984-6200 There are also a number of consumer advocacy and support organizations. The underlying philosophy of these organizations is that the best helpers are often those who have experienced similar problems. These groups typically provide emotional support and a variety of forms of practical help for dealing with problems that their members share in common. Organizations that have chapters in many communities are: Anxiety Disorders Association of America 6000 Executive Blvd., Suite 513 Rockville, MD 20852 (301) 231-8368 Federation of Families for Children's Mental Health 1021 Prince St. Alexandria, VA 22314-2971 (703) 684-7710 The National Alliance for the Mentally Ill 2101 Wilson Blvd Suite 302 Arlington, VA 22201 (703) 524-7600 or (1-800) 950-NAMI National Association of Psychiatric Survivors P.O. Box 618 Sioux Falls, SD 57101 (605) 334-4067 National Depressive and Manic Depressive Association 730 N. Franklin, Suite 501 Chicago, IL 60610 (312) 642-0049 or (1-800) 826-2632 National Mental Health Association 1021 Prince St. Alexandria, VA 22314-2971 (703) 684-7722 or (1-800) 969-NMHA Recovery, Inc. 802 North Dearborn St. Chicago, IL 60610 (312) 337-5661 There are many self-help or mutual support groups that provide assistance in particular areas such as phobias, panic, bereavement, obsessive-compulsive disorder, anorexia and bulimia, as well as physical disorders such as HIV-dementia/AIDS, cancer, multiple sclerosis, Parkinson's, and many others. Due to space limitations, we are unable to list them all here. Information about self-help groups can be obtained from: National Self-Help Clearinghouse Graduate School and University Center City University of New York 33 West 42nd St., Room 620 New York, NY 10036 (212) 642-2944 Self-Help Clearinghouse St. Claires-Riverside Medical Center Denville, NJ 07834 (201) 625-7101 Self-Help Clearinghouse of the Greater Washington Area 7630 Little River Turnpike, #206 Annandale, VA 22003 (703) 941-5465 Two recently formed technical assistance centers engage in a variety of technical assistance and information sharing activities. They are: Northeast Independent Living Program 130 Parker St. Lawrence, MA 01843 (508) 687-4288 Southeast Pennsylvania Mental Health Association Project Share 311 S. Juniper St. Philadelphia, PA 19107 (215) 735-6367 or (1-800) 866-4226 A list of National Institute of Mental Health publications with information about mental illnesses and their treatment is available from the Information Resources and Inquiries Branch, NIMH, Room 15C-05, 5600 Fishers Lane, Rockville, MD 20857