AN EXTENDED LIST OF SMI ISSUES THAT NEEDS TO BE ADDRESSED by Dede Ranahan

This list represents brainstorming ideas of advocates from across the country. They individuals, families, journalists, and professionals who are living/working with SMI. They have in-the-trenches experience. The list presents a partial picture of the depth and breadth of SMI issues in 2019. If you’d like a copy of this list and the 5-part plan posted yesterday, send me an email and I’ll send the documents to you. dede@soonerthantomorrow.com Thanks for your help.

1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI) FROM A BEHAVIORAL CONDITION TO WHAT IT IS, A NEUROLOGICAL MEDICAL CONDITION

2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

  • Present patients and families with a social worker to support the family unit throughout the care process, including medication and psychiatric treatment.

  • Require mandatory HIPAA training for everyone in the medical profession and mandate a test on proven knowledge.

  • Develop a federal program for the administration of an advance directive (PAD) which includes a universal release of information and designates an agent if a patient’s capacity is lost.

3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD)

4. PROVIDE A FULL CONTINUUM OF CARE

  • Provide inpatient care (IMD waivers), outpatient care (i.e., AOT, Clubhouses), and housing ( a full array from locked stabilization to unlocked intensive, medium intensive, peer run, PSH, asylum).

  • Require a psychiatric standard of care for various SMI diagnoses like other medical specialties.

  • Require prescriptions based on need not ROI for the insurance industry

  • Remove ER’s as entry for mental illness hospitalization. The ER process and its chaotic environment aren’t conducive to the well-being of SMI patients.

5.DECRIMINALIZE SERIOUS MENTAL ILLNESS

  • Eliminate solitary confinement in jails and prisons.

  • Support nationwide civil mental health courts and expand criminal ones that are already established to keep SMI out of jails and prisons.

  • Establish mental health courts on a federal level, and coordinate federal courts and state-run mental illness facilities.

  • Move crimes that SMI commit in the federal system into state courts.

  • Mandate a way for families to provide medical history to jail/prison doctors to inform treatment.

  • Fund a digitized system for medical records in counties/hospitals to jails so information can be transferred immediately upon arrest and incarceration.

  • Provide uniform psychiatric screening of the incarcerated.

  • Use standardized protocols for medication of SMI prisoners.

  • Require strict limits on waiting for trial time.

6. PAY ATTENTION TO SUPPORTIVE HOUSING

  • Provide 24/7 supervised housing for those who cannot live independently.

  • Provide defined levels of support built around a person’s needs, especially long-term care.

  • Clarify Olmstead for SMI. Lease restrictive care isn’t always least expensive or best.

  • Examine, don’t ignore, a person’s ability to handle and benefit from a less restrictive setting.

7. REVAMP INVOLUNTARY TREATMENT

  • Use lack of insight (anosognosia) and grave disability as criteria for determining involuntary treatment.

  • Establish a federal standardized “need for treatment” involuntary commitment law.

  • Base restrictive settings on actual abilities, not wishful thinking or one-track plans.

8. INCLUDE EDUCATION

  • Require mandatory, institutionalized education about SMI for judges, sheriffs, attorneys, district attorneys, law enforcement, and first responders.

  • Require units of SMI education for educators — preschool through university.

  • Revamp Crisis Intervention Training and expand training to all counties.

  • Provide a health proxy form for college students to allow them to release medical information and name who can take care of them in a crisis.

  • Hold universities accountable and required to connect students to crisis intervention, especially during medical leave.

9. GIVE INCENTIVES

  • Incentivize the expansion of medical schools to graduate more psychiatrists, child psychiatrists, internists with psychiatry specialties, psychiatric nurse practitioners and physician assistants.

  • Allow loan forgiveness for providers treating SMI.

  • Give incentives for rural psychiatrists.

  • Incentivize more long-term treatment/stabilization of SMI.

  • Give incentives to psychiatrists to accept health insurance, especially Medicaid.

10. EXPAND ASSISTED OUT-PATIENT TREATMENT (AOT)

  • Federally clarify AOT and create a federal model for AOT law.

  • Offer AOT immediately to everyone upon diagnosis.

11. IMPROVE HOSPITALS

  • Build regional federal hospital for patients who cannot be treated in their home state’s hospitals because of lack of beds.

  • Improve reimbursements to hospitals which lose revenue on SMI patients.

  • End hospital discrimination against SMI “violent” patients and those “difficult to discharge.”

12. INCREASE RESEARCH AND EPIDEMIOLOGY

  • Fund NIMH research specifically for SMI.

  • Establish a Disability Advocacy Program for legal services for SMI when counties/states fail to provide long-term support services or when insurance/managed care and Medicaid fail to cover/pay for long-term supported services and treatment.

  • Pursue better national epidemiology studies for people with SMI.

  • Establish a federal law that requires states to track each SMI diagnosis with bad outcomes like death, homelessness, and incarceration.

13. REVISIT PARITY

  • Clarify parity for SMI and include Medicaid and Medicare in parity law.

  • Enforce violations against parity law.

14. ADDRESS SOCIAL SECURITY AND DISABILITY INCOME ISSUES

  • Change the way social security income for the disabled is taken by states when a patient is admitted to state operated mental health institutions, residential care facilities, and hospitals.

  • Increase disability income to a level where a person can survive and maintain reasonable housing.

16. CREATE PSYCHIATRIC CAMPUSES

  • Build psychiatric campuses with multiple levels of care, supportive housing from most restrictive to least restrictive, and separate independent living apartments.

  • Provide on-campus coffee shops, gyms, recreational facilities, and gardens where people with SMI could work with support as needed.

  • Provide substance abuse treatment services, AA or NA meetings.

OUR 2020 GRASSROOTS FIVE-PART PLAN TO ADDRESS SMI UPDATED by Dede Ranahan

This plan was developed by dozens of SMI individuals, families, professionals, and journalists from across the country. The five issues included in the plan were voted on from a long list of priorities as top priorities. If you’d like a copy of this plan, a cover letter, and an extended list of SMI needs, email me: dede@soonerthantomorrow.com. I’ll send you the documents so you can forward them to those within your sphere of influence — local, state, and national.

As the number of candidates in the 2020 presidential election cycle continues to decline, it’s important to thank those who’ve dropped out but developed good plans that include SMI — Steve Bullock, Kamala Harris — and to refocus our efforts on the remaining candidates - Republican and Democrat. Right now Buttigieg and Klobuchar have good plans. Warren and Booker are working on plans. The White House will be hosting a summit on Transforming Mental Health Treatment to Combat Homelessness, Violence and Substance Abuse on December 19. Thank you for your help.

2020 GRASSROOTS FIVE-PART PLAN
TO ADDRESS SERIOUS MENTAL ILLNESS (SMI)
(Updated December 3, 2019)

FOR ALL 2020 PRESIDENTIAL CANDIDATES
PLEASE ADDRESS THESE TOPICS IN YOUR CAMPAIGN
 APPEARANCES  AND DEBATES


1. RECLASSIFY SERIOUS MENTAL ILLNESS (SMI) FROM A BEHAVIORAL CONDITION TO WHAT IT IS, A NEUROLOGICAL MEDICAL CONDITION.

WHY RECLASSIFICATION IS IMPORTANT
Reclassification will unlock more research funding and help eliminate discrimination in treatment, insurance reimbursement, and the perception of SMI as “behavioral” condition. SMI is a human rights issue. NIMH ranks SMI among the top 15 causes of disability worldwide with an average lifespan reduction of 28 years.

PRESIDENTIAL ACTION
* Create a cabinet position exclusively focused on SMI.
* Push for Congressional appropriations to include schizophrenia in a CDC program that collects data on the prevalence and risk factors of neurological conditions in the US population.

2. REFORM THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

WHY HIPAA REFORM IS IMPORTANT
Overly strict HIPAA laws make it extremely difficult for families and caregivers to partner in the treatment of their loved ones, resulting in important life-saving medical information gaps. By eliminating this barrier, family support will be strengthened, reducing the chance of relapse, homelessness, imprisonment, and death.

PRESIDENTIAL ACTION
* Work with legislators to change HIPAA law to ensure mental health professionals are legally permitted to share and receive critical diagnostic criteria and treatment information with/from parents or caregivers of SMI.

3. REPEAL MEDICAID’S INSTITUTES FOR MENTAL DISEASE EXCLUSION (IMD)

WHY IMD REPEAL IS IMPORTANT
IMD repeal will increase the availability of psychiatric inpatient beds. The IMD exclusion is not only discriminatory to those suffering from neurological brain disorders, it is a leading cause of our national psychiatric hospital bed shortage. It prohibits Medicaid payments to states for those receiving psychiatric care in a facility with more than 16 beds who are 21-65, the age group with the most SMI.

PRESIDENTIAL ACTION
* Work with legislators to repeal the IMD exclusion.

4. PROVIDE A FULL CONTINUUM OF CARE

WHY A FULL CONTINUUM OF CARE IS IMPORTANT
A continuum of care insures that SMI patients receive early intervention at all stages of their illnesses, long-term care when needed, and follow-up treatment (medications and therapies) when they’re released. It reduces visits to jails, ER’s and hospitals, homelessness, and morgues. A continuum of care provides life-time management.

PRESIDENTIAL ACTION
* Create federal incentives to states which are addressing a full array of inpatient, outpatient, and supportive housing care.


5. DECRIMINALIZE SERIOUS MENTAL ILLNESS (SMI)

WHY DECRIMINALIZATION OF SMI IS IMPORTANT
People suffering with other neurological conditions like Alzheimer’s and dementia can get treatment promptly without being kicked out of their homes to wander the streets until they are arrested and put in jail or prison rather than a hospital. Serious mental illness is the only disease where the doors to treatment are shut unless a crime is committed. This is pure and simple discrimination with the disastrous results we see in our country today — homelessness, incarceration, the disintegration of families, and death.

PRESIDENTIAL ACTION
* Work with legislators and others to change “must be a danger to self or others” criteria.
* Work with legislators and others to change involuntary commitment criteria and redefine it in objective terms based on scientific medical need for treatment. Psychosis, like a stroke, is a traumatic brain injury and needs immediate treatment for the best outcome.

Note: Tomorrow I’ll post the extended list of recommendations.

MY RESPONSE TO THE CBS THIS MORNING SHOW ABOUT MENTAL ILLNESS - Dede Ranahan

I just posted this comment on the CBS This Morning Facebook page in response to their program today about mental health:


Thank you for beginning this conversation on CBS. I look forward to more of your programs about mental health/mental illness. I've been a mental health advocate for over 25 years. In my on-the-ground experience, our mental illness issues are getting worse, not better.

My son, Patrick, died in a hospital psych ward where I thought he'd be safe. I've written about this in my book, Sooner Than Tomorrow - A Mother's Diary About Mental Illness, Family, and Everyday Life (April 2019) available on Amazon. I didn't know, as I was writing, that I'd captured the last year of my son's life. He was making regular comments on Facebook which I discovered after he died. I added his comments to my own.

"I could write more about the last few weeks of Pat's life, my frustration and anger with our mental illness system (there is none), the drastic need for change -- sooner than tomorrow. I'd make a case for effective, compassionate care for our seriously mentally ill. I'd point out tragedies that could have been prevented and the urgent need for beds and housing. I'd challenge outrageous HIPAA laws that prevent moms and dads like me from giving and receiving lifesaving information. I'd talk about our missing and homeless children and mothers and fathers. I'd tell stories about our sons and daughters in jails and prisons and solitary confinement without treatment and on and on... My writing would turn into a tirade, and that rant is for another time. Not here. Not on sacred ground (from my book)."

With over 80 serious mental Illness (SMI) advocates from across the country, I quarterbacked our Grassroots 2020 5-Part SMI Plan. We've given it to all the presidential candidates. We want to hear them talking about SMI in their campaign appearances and we want to see their plans for addressing this issue on their websites. Not alcohol abuse. Not opioid addiction. Serious Mental Illness.

I post stories from moms and dads and individuals from across the country on my blog www.soonerthantomororow.com A Safe Place to Talk About Mental Illness in Our Families.

You've begun a serious conversation about mental health/illness. I hope you dig deep into all its many facets. Serious mental illness is a humanitarian crisis and our country's shame.

P.S. I agree with Jane Pauley. I don't like the word "stigma." I prefer "discrimination." And one of the points in our 5-part plan, the first one, is to "Reclassify Mental Illness From A Behavioral Condition To What It is, A Neurological Medical Condition." If you'd like a copy of the 5-Part Plan to send to your local, state, and federal representatives, send me an email and I'll send the documents to you. dede@soonerthantomorrow.com

OUR COUNTRY'S SHAME by Dede Ranahan

My friend, Travis Christian, also known as state prisoner BB8099, is in trouble. Big trouble. I visited with him Sunday at Folsom State Prison in Sacramento, California. He’s in isolation not-so-fondly referred to as the hole. Or solitary confinement. He’s been there about two weeks.

Travis is 33. He has serious mental illness — bipolar disorder or schizoaffective disorder or some other disorder. Who knows? We try to label these illnesses and put people’s brains in neat little boxes. Everyone’s brain is different. Brains don’t fit in neat little boxes.

Travis has served eight years of a ten-year prison sentence. In a psychotic fury he stabbed someone he thought was Satan and ended up incarcerated. Never mind his serious mental illness. Law enforcement says he committed a crime.

While with a prison psych tech, Travis experienced another psychotic episode. He thought the tech was Satan. He punched him. Travis was sent to the hole for months — at first, no radio, no TV, no paper, no pencils, no books, nothing. Travis was allowed four walls and his sick mind.

Earlier this year, I began visiting Travis once a month. The last time I saw him was our best visit. It felt like we were becoming friends who could give and take and talk honestly with each other. Travis looked good — short cut hair, a small beard, bright eyes. He was taking a college health class. He was writing songs and singing them in his prison church. He was counting the dwindling days of his sentence. Only two or so more years. He would move home and work with his mom in her thrift store. He would get a dog. And a girlfriend. He’d be a free man.

A couple months ago, I received a different kind of letter from Travis. He wrote, “I’m doing great. I’m worried about you driving from Lincoln to Folsom to see me. What if you get in a car accident? We’re good, Dede. You don’t have to come visit me anymore.”

I wasn’t sure how to interpret Travis’s letter. Had I offended him? I didn’t know but I wrote back that I would follow his lead. I assured him, “I don’t visit you because I think you need me or because I’m trying to ‘fix’ you. I visit you because I hope to give you a break from your prison routine once a month. And I like talking with you. I like you, Travis.” The next letter from Travis was upbeat again. Lots of positive thoughts and good wishes for me. No mention of more visits.

Last Friday, I received a text message from Travis’s mom, Kathy. “Dede, Travis is in isolation again. Things have been bad. He decided he didn’t need his meds anymore. I begged the prison staff not to take him off his meds. We’ve been down this road before and it always ends badly. The staff said they would monitor him. While they were ‘monitoring’ him, he tried to kill himself by breaking his neck. He was put in a crisis bed for a few days and then released to a new cell with a new cellmate. Something happened. They might be charging him with attempted murder. They say I have to visit Travis to find out what happened. I can't go this weekend. Can you go see him?”

Yesterday, the prison shuttle bus dropped me off at a different building, Block A. I had a 10:30 AM appointment to visit with Travis for an hour and a half. In the visiting area, nine booths lined up with a chair and a phone in front of each prisoner’s box. We would talk to each other over the phone with glass separating us. No hugs. No pats on the back this time. Travis entered the visiting box with his wrists in chains connected to a chain around his waist. He waited for the guard to remove them. He didn’t know I was coming. I tried to smile. I asked, “What happened?”

Travis was on new meds when he was put into the new cell with the new cellie. It takes a while for meds, even if they’re the right meds, to kick in and help organize a disorganized brain. At first, things were okay. But then the cellie said something that set Travis’s mind whirling. He said something about “demons.” Travis said, “I argued with myself for a day. My mind said, ‘Your cellie is Satan.’ I said, ‘No, he’s not Satan.’ My mind said, ‘Yes, he is Satan.’” History repeatng itself.

Travis decided he had to rid his cellie of Satan. He tried to choke him. Three guards fought with Travis to get him to release his hold on his cellie’s neck. They beat him with a club. They broke his shoulder. Travis’s psychosis was strong. It made Travis strong.

Now Travis is in solitary again. An old pattern surfaces — Satan, fear, outbursts, trouble, punishment. Travis doesn’t know how long he’ll be in the hole this time. He doesn’t know what charges he’ll face. The guards brought him a radio a couple days ago. He listens to music. He reads a book. Another prisoner gave him some coffee to brew in his cell. He gets to be outside in the yard — in a 10 X 15 foot cage — for a few hours each week. He’s grateful.

“I’m fine, Dede. I’m fine. I have to learn from this. I have to be an adult and take responsibility for my actions. I used soap to paste photos on my cell wall. I put up photos of myself when I was a little boy. I look at that little boy in the photos. He never thought he’d be in prison. I have to take care of that little boy. I have to take care of me. My mom’s love makes me want to take care of me.”

Travis hasn’t been able to talk to his mom since he got in trouble. He says, “Tell her I love her. Ask her to please send some stamps and envelopes so I can write to her. And some books. I need some uplifting stories to read.”

Kathy and Travis’s sister will visit Travis next weekend. They’ll drive up from Southern California. Kathy says, “I love my son, Dede. I visit him. I put money in the commissary for him so he can buy what he needs. I send him packages. Otherwise, I don’t know how to help him. He’s difficult to treat because he always tries to put on a good face. To seem fine. Prisons like to make money. They make money off my phone calls to Travis. They make money from the visitor vending machines. They make money based on the size of the inmate population. Sometimes, I think they try to keep prisoners locked up to add to their bottom line.”

Shortly before noon I told Travis, “I’ll come visit you again. Like before.”

“Thank you,” he said. “I love you, Dede.”

I waited for the shuttle bus to take me back to the main entrance. I asked a roaming guard, “What percentage of this prison’s inmates do you think have a mental illness?” He said, “A lot. Probably 50 percent.” I told him what had happened to Travis. “Why would they put him back in a cell with another prisoner while they’re still adjusting his meds?” The guard said, “A panel makes the decision about where to house a prisoner. I don’t know if they know what they're doing when it comes to mental illness.”

This guard, probably in his forties, seemed empathetic. He seemed weary. He and I agreed that mental illness is such a huge problem and it impacts so many areas — homelessness, crime, drug and alcohol addiction, suicide — that no one seems to know how to solve it. Appropriate, accessible mental illness care and the decriminalization of mental illness would be a good place to start.

“Don’t stress too much,” the guard said. “Three years ago I had a stroke brought on by stress. Take care of yourself.”

“I try,” I said, “but it’s hard to walk away from all the horrendous suffering going on. I’ve been a mental illness advocate for over twenty-five years. Nothing’s getting better. Everything’s getting worse. This is our country’s shame.”

The shuttle bus arrived. I got on. Travis went back to the hole.

Travis

Travis

ANNOUNCEMENT by Dede Ranahan

I learned a lot writing and publishing my book, Sooner Than Tomorrow — A Mother's Diary About Mental Illness, Family, and Everyday Life.

My beautiful mother, Evelyn (GG), just passed at 101. Maybe that's why I'm feeling my mortality. Limited time to try to make a difference. Every day, I'm saddened, infuriated, and inspired by the stories I read and receive from the SMI population. I'm honored to count myself among you.

So, my wonderful mom left me a few dollars. I could die and leave them to a "worthy organization" or I could entrust them to a "worthy person" — myself. 🙂

Self-publishing a book is a time-consuming and costly endeavor. (Forget a publisher — I'm an unknown author over 70. Don't get me started on age bias.) But I want to self-publish another book. I already have a lot of the material — your stories from my blog. My blog is now being read in over 85 countries. SMI is a global humanitarian crisis.

I'm going to combine your stories into a collection. I already have the title of the book — Tomorrow Was Yesterday. Of course, if I select your story, I will ask you for your permission to use it. If I don't already have your story on my blog, I welcome your submission.

This is a scary thing I'm doing. Announcing an endeavor before it's begun. But I operate this way. My self-motivating quotient won't let me stop until I've realized what I'm proposing.

There are too few of us advocating. There are too many of us not standing up to the status quo. We're exhausted. We're humiliated. We're often hopeless about ever getting help for SMI. We're afraid to tell our stories.

Well, let's begin. We'll do it together. If you need help writing your story and it fits into the format, I'll help you write it. Let's go! Let's do this! What do you think?

Available on Amazon

Available on Amazon

I'M OKAY. ARE YOU OKAY? by Dede Ranahan

I’ve been away from my blog and your stories for a few weeks now. I’ve been taking a break from some of the heaviness of both as I execute my mom’s last wishes and tie up loose ends for her.

My mom, Evelyn, passed on August 21, 2019, at the age of 101. At first, she wasn’t ready. She kept asking when she could leave the ICU and go back to her room in her assisted living facility. “This is the pits,” she said. “I want to go home.”

Two of my daughters, my brother and sister-in-law, and I took turns staying with her. We’d seen her pull herself out of tight places before. We didn’t know if she would do it again. As the week in the hospital dragged on, it became apparent that this struggle might be the last struggle. On the day before she died, I was alone with her for a while. It was difficult for her to talk but she turned to me and said, “I’m okay. Are you okay?” This caught me off guard. I managed to reply, “I’m okay, too. We’re both okay.” That was our last exchange.

Later my mom asked my brother, “What did I do wrong?” Mom was religious about taking her pills every day at the exact right time. We think she thought she might live forever if she just followed “the rules.” My brother said, “Mom, you didn’t do anything wrong.” Then she asked, “When is the funeral?”

Once Mom understood that her life was coming to an end, she made up her mind — as she always did — to go with the flow. She fell asleep for the last time the next day.

I miss my mom but I have to say that my grief for her is different from my grief for my son. Five years since Pat’s passing, sadness pulses in my veins. It lurks in my bones. I think of him every day. Many times every day. Actually, I grieve for him on two levels. I grieve that he’s gone. I grieve for the life that he didn’t get to have due to his mental illness. I grieved for him when he was here. I grieve for him now that his life is over. Other moms and dads tell me the same thing. Somehow, we lose one person twice. I don’t think this pain will abate. It sears my soul.

Death is a natural part of life. My mom’s death seemed natural. She lived a long, not easy, full life. She was my parent and parents are supposed to die first. My son’s death seemed unnatural. He was too young. He tried so hard. He didn’t want to die. One of the last things he said was “Help get me out of here. I have a car waiting around the back. This hospital is killing people.” Pat was delusional but I wonder if he wasn’t onto something. Even in psychosis, he always had an eerie ability to identify the elephant in the room. The next morning, a doctor at the hospital who’d refused to talk to me about my son, called. He said, “I’m sorry. Your son died fifteen minutes ago.”

My mom’s passing is making me emotional again. Losing a child twice to serious mental illness is so damn hard. I’m in tears as I write but soon I’ll get back to my blog and your stories. Our stories must be told. We must tell our stories over and over. Until someone listens.

Meanwhile, I consider my mom’s last words to me. When it’s my turn to leave this life, I hope I’ll have the generosity to show concern for others. I hope I’ll have the grace to say, “I’m okay. Are you okay?”

Pat and my mom

Pat and my mom

TAKING A BREAK. THANK YOU FOR YOUR AMAZON REVIEWS by Dede Ranahan

Dear Sooner Than Tomorrow Readers and Writers:

I’m taking a break from my blog for the next 3 or 4 weeks. I must execute my mother’s small estate, attend to a celebration of her life, and reflect on her life and passing. I’ll also be speaking about Sooner Than Tomorrow at the NAMI Kentucky State Conference. I’m leaving you with some of the reviews readers have written on my Amazon book page. Thank you so much for these comments and recommendations. Reviews are among the best tools in a writer’s toolbox to garner more readers. I appreciate them more than you know.

Away from my blog but always thinking of you. You’re the most dedicated and courageous people on the planet. Have a good month.

P.S. If you’d like a copy of Grassroots 2020: A 5-Part Plan to Address Serious Mental Illness (SMI) to send to 2020 presidential candidates, and to local and state influencers, send me your email and I’ll forward the documents to you. You can also read the plan here in the archives on the right hand side: August 6, 2019, “Please Forward to Those in Your Sphere of Influence.” dede@soonerthantomorrow.com

SOONER THAN TOMORROW — A MOTHER’S DIARY ABOUT MENTAL ILLNESS, FAMILY, AND EVERYDAY LIFE

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AMAZON REVIEWS

kayababy 5.0 out of 5 stars
Thank you for putting your experiences, into words
For so many of us, who have a child with these issues, our experiences have been similar, and we struggle to put them into words. I must say, this diary has been at times the "oh my God, I know exactly what she means" and a flood of tears, while other times a familiar feeling of smiles and happiness from that same place of recognition; it just helps to read it. I am so happy to have this book. It has a sort of sacredness about its story, especially with all of Pat's inputs, so that we get to hear from him, getting to know who he is as well through this excellent book his mother wrote. Thank you again Dede.

Christy B 5.0 out of 5 stars
Well written — heart felt — easy read — honest chronicle of a life ended too soon.
I don't know if "enjoyed" is the right word — very touched by this book. The writing is superb — the chapters short — easy to put down and pick up again. I was engrossed by the family dynamics — daughter, grandmother, mother, sister. The entries about the grandkids are delicious. Pat comes across as a highly intelligent, musically talented, funny guy. Loved his FB posts. A must read. Highly recommend.

Erin Eisner 5.0 out of 5 stars
So many reasons to read this great book!
I found this book interesting and important in so many ways! The author writes with an amazing sense of humor and compassionate insight about every thing from her 101 year old mom and grand-kids, to the ants invading her home. She brilliantly weaves in her late son’s poetry and Facebook posts, which gives true timely context, and reveals how she interpreted both monumental and mundane events she encountered in the year before her beloved son would unexpectedly and mysteriously pass away. While gut-wrenchingly tragic in the end, it has so many uplifting moments I found myself deeply engaged and inspired to learn more about many things. It made me want to read. It made me want to write. It made me want to live. It made me want to hold my two young babies a little tighter and pray they will be spared from mental illness, and if not that I will have the same patience, love and resolve the author had in doing all she could in a climate that makes nothing in this realm easy. To the author—thank you for sharing with the world your beautiful stories about your family and life in general, and thank you for your fight and efforts to improve mental health conditions and policies in this country, and for giving support to other families going through their own mental health challenges. I hope you have and will continue to write more not only for your own peace, but because your words and stories must continue to be shared and heard. You don’t have to have a close family member with mental illness to benefit and appreciate this book— if you are a human on this planet who can read English I highly recommend you read Sooner Than Tomorrow because it has much in it for everyone to ponder.

Paula Quertermous 5.0 out of 5 stars
Dede Ranahan shares a glimpse families endure while trying to get mental health help in time
This book has moved me deeply. Dede Ranahan captures the slippery chasm family members with serious mental illness try to navigate to have some quality of life — and in spite of lack of enough good services. Dede, your writing mesmerized me!! I can relate so much as the mother of an adult daughter with SMI. Every day can contain an element giving you a surge of motherly hope — or a crushing incident that spikes to fear for your child. The exhaustion from living in long term doubt requires support. This book is a gem of information!

L. Turley 5.0 out of 5 stars
I highly recommend this book.
I read books these days in short spurts, often just a few pages at a time, especially when the material hits me in a way that I need to stop and process before continuing. This book is like that for me. It is both a daily journal of everyday events and yet, within those events there is a deep, insightful look at a life that is shared with us for a purpose. I had been waiting until I finished this book to write a review, but it may take me awhile to finish, as I sit and savor these snapshots glimpses into the lives of the individuals within. Dede shares her life and her innermost thoughts in a down-to-earth way as she allows us to walk with her through the journey of her son's mental illness, and reminds us that we are not alone, but we walk together. For those who share this journey and share her prayer for change to come "Sooner Than Tomorrow” and for those who are fortunate enough not to share the journey, but who wish to understand, I highly recommend this book.

NO STORIES THIS WEEK by Dede Ranahan

My 101 year-old mother, Evelyn or GG, is in the hospital and that’s where I’ve been every day for a week. My family and I don’t want her to be alone when she passes. She doesn’t want to go :-( She’s always been a fighter (stubborn might be another word :-) We don’t want her to leave, either, but her quality of life is deteriorating quickly. Please hold good thoughts for her.

My mother, Evelyn, and me 1945. I love you, Mom. It’s okay to go. Pat’s waiting for you. He wants to give you a hug.

My mother, Evelyn, and me 1945. I love you, Mom. It’s okay to go. Pat’s waiting for you. He wants to give you a hug.