Aurora Offers Primary Care Physician Training on Behavioral Health

Identifying Mental Illness

  • Parents of a teenage son visit their primary care physician to find out why he is suddenly failing classes
  • A new mother sees her obstetrician because she has been sleeping all the time and has lost her appetite.
  • A man and his wife seek advice from the physician to find out why he is absent from work so frequently due to illness
  • A young woman makes a suicide attempt several days after seeing her physician for feeling lethargic and down

woman-in-crowdPeople with mental illness or addictions often seek help for physical symptoms. People with depression, anxiety, bipolar disorder or addictions typically are seen in primary care more than any other setting.  In a recent NAMI survey, 89 percent of families responded that they had discussed mental health concerns with their child’s primary care physician. Addiction, depression and other mental health problems can go undiagnosed  and untreated.  Primary care physicians can play a critical role in identifying a mental health or substance abuse issue and making appropriate treatment referrals.

Nearly one in 10 Americans 18 and older is depressed, according to a Centers for Disease Control and Prevention study in the Oct. 1 Morbidity and Mortality Weekly Report. One in four adults has a diagnosable mental disorder in any given year, according to the National Institute of Mental Health. Primary care providers have significant opportunities to identify behavioral health problems early and intervene in a manner that prevents further deterioration and avoids significant future costs. Screening and early intervention are priorities that may not only improve outcomes for individuals but also, over time, provide savings to the system.

In the primary care setting, physicians should look for signs of mental health problems, such as trouble sleeping and eating, experts say. In children, doctors should look for atypical behavior that begins suddenly, such as irritability or a drop in grades with a good student. Physicians should incorporate behavioral health screenings into wellness check ups for all patients, and routinely screen for depression, particularly with pregnant and perinatal women.

Mental Health America (MHA) believes that primary health care providers should be encouraged to identify signs of mental health or substance use issues at the earliest possible time. This position is also endorsed by the American Academy of Pediatrics and (for depression) the United States Preventive Services Task Force.

Training for Primary Care Providers

Aurora Behavioral Health Services, in partnership with Kubly Foundation, is offering on-line CME modules for primary care providers on the following behavioral health related topics:

If you or someone you know would benefit from addiction treatment or mental health services, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

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Handling Holidays, Gatherings… and Food

Kristina Vollmer, PhD is a psychologist at Aurora Behavioral Health Center Sinai.

Kristina Vollmer, PhD is a psychologist at Aurora Behavioral Health Center Sinai.

Holidays and gatherings can be a particularly difficult time for many people who are trying to change their eating in order to live healthier lives. It is particularly difficult for people who are have undergone Bariatric Surgery, or are preparing for Bariatric Surgery.  Here are some tips and strategies to keep in mind so that you are able to thoroughly enjoy yourself without getting off track!

  • Recognize that you cannot control things the same way you do at home.  This may make you angry. It is important to recognize your frustration rather than to eat it.
  • Acknowledge your cravings – trying to ignore that you even have them sets you up to give in to them. Say to yourself:  “I really want (specific food), but this is the new me. I don’t need (specific food) to feel good about this holiday/occasion or to enjoy myself.”
  • Before you go out, take the time to imagine how the food will be at this event.  When will you eat? What will be served? How hungry will you be? Will there be foods that will trigger you to overeat? Will there be healthy foods that will satisfy you? Will there be foods that you want to treat yourself to? How much do you want to eat? How much and what do you need to eat? Now, being as realistic as possible, decide how you can handle the event in the most positive way for you.
  • Have a goal you DO want to accomplish at the event.  Make it about “doing something” rather than trying to prevent something.  It is fine to have food goals, but you also need to have personal, emotional, spiritual, and relationship goals as well. Remember, gatherings are suppose to be about enjoying each other’s company; not about the food!
  • After the event is over, think about what you could do the next time. Could you suggest a different place? Could you arrive after the eating is over? Could you help plan a healthier selection?
  • Review what was uncomfortable, and then strategize for how to handle it differently in the future. Review what worked well, and congratulate yourself for even small accomplishments.
  • Get adequate sleep!!  You will eat more calories and crave carbs/sugar/caffeine if you are sleep deprived.
  • Never arrive hungry.  Eat something before you go.  Have a protein bar or other items you can carry with you in case the food gets delayed.
  • Don’t skip meals and starve in an attempt to make up for what you recently ate or are about to eat.
  • Offer to bring a food so you know there will be at least one healthy choice there.
  • If at a restaurant, be the first to order so you are not influenced by others decisions. Plus, everyone else is too focused on trying to remember what they are going to order to pay attention to what you are ordering.
  • Have a loved one be an ally for you in the situation – fix a plate for you, help handle situations, help make good choices, help you leave if needed.
  • At social events, don’t fill silence with food. Many people will eat and drink because they don’t know what to say or how to act.  Instead, make an effort to get to know people beyond superficial small talk.  When we do that, we have a tendency to eat less.
  • Use small plates – if there is a salad plate use it for the meal.
  • Cover your plate with your napkin when you’re done so you won’t nibble unconsciously.
  • Arrive late, after food is served.
  • Try to avoid alcohol, it will lower your resistance.
  • Sit far away from the buffet line or kitchen.
  • Plan a walk with loved ones after the meal.
  • Have an “exit” plan.  Know when to use it!
  • It is OK to say no to cake!  If you watch, there are usually a few others who also decline.
  • Do things that keep you moving or keep your hands occupied. If it’s a social outing, bring a clutch instead of a purse, or keep a glass of water in your hand.  Volunteer to write down the gifts at a shower, bring games to play, help clean up, offer to take people’s plates when they’re done with them, offer to cut the cake or hand it out (and take note of the different ways people decline cake or other desserts!).
  • It is OK to throw food away.  Most of us have been made to feel guilty that there are starving people everywhere who would appreciate the food.  In reality, you eating the food is NOT going to help starving people any more than throwing it away will!  You can compost the food, feed other animals, or take it to a homeless shelter if it is truly too hard to throw away.

Remember, gatherings are supposed to be about enjoying each other’s company; not about the food!

Kristina Vollmer, PhD is a psychologist at Aurora Behavioral Health Center Sinai.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

How do you create and maintain structure for children?

Eight helpful hints for parents

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Diane Bucaro, LCSW, is a therapist at Aurora Behavioral Health Center in Wauwatosa

Have you ever had a parent tell you that every morning they are 15 minutes late to work? Or that their child is  glued to their favorite cartoon and they need to do their homework, chores, and get ready for bed in the next 30 minutes?

Here are some general tips/guidelines I use with parents.

1. Most kids respond well to a routine. Whenever possible have consistent bed times, wake up times, and meal times. (Per Super Nanny 4:30-5:30pm is the best dinner time for children younger than age 5. Obviously, this will depend on work schedules, do the best you can given your family’s needs).

2. Sleep is essential. Children between the ages of three and six need 10 to 12 hours of sleep overall. By age four or five, children typically have outgrown a nap. Children ages seven to twelve need 10 to 11 hours of sleep a night, according to the American Academy of Pediatrics.

3. Have the parent do their best to offer nutritious foods. Parents can have a pad of paper in the kitchen to jot down meal ideas or if you are running low on an item. Preparing meals ahead of time to heat up when you get home, and researching crockpot recipes can be very helpful for busy parents. It is also wonderful to have at least 3 “go to meals” — something that can be made quickly and easily at home (pasta, sandwiches) that is not the drive thru at the nearest fast food chain. When it comes to new foods and specifically vegetables it is also helpful to remember that it may take several trials of a food before a child may say they “like it”.

4. Have house rules and established consequences for “broken rules”. If parents have established consequences they are less likely to become “heavy handed” or ignore them and regret this later. However, sometimes ignoring is an appropriate strategy. An example of appropriate ignoring maybe when the child burps loudly at the table and is looking directly at the parent for a reaction. In situations like that, any reaction plays into the child’s hands.

AUR_108443959 (1)When applicable, use positive reinforcement such as “good job, I’m so proud of you”. Make a behavioral chart or plan for things that may be more difficult for that child. The parent can develop a token system for a specific time frame of positive behavior.

Dr. Matthew A. Johnson, has developed a system called “Positive Parenting with a Plan” which has specific guidelines to use positive and negative reinforcements for behavior.  He has written a book for parents if they need more help to guide behavior for children ages 5 and up. Some kids respond well to time outs or having treasured objects taken away for a short period of time (1-7 days, the younger the child the shorter the time).

5. Organization: a place for everything. This can be essential to get out the door on time. Have a place for coats, shoes, backpacks and papers. Often we take off items off near the outside door or set down bags, unload items. This area can soon be cluttered and in disarray, especially if there are multiple children in the home. Have a system where kids stuff hats and mittens in their coat sleeves as soon as they take them off. Another option is to set out a basket for hats and mittens. Have a system for kids’ school papers after they have completed them. Have items ready the night before school/work.

6. Have adults be positive role-models by taking good care of themselves and overall showing displays of good citizen. Example, you find an iPhone at the library and you turn it into lost and found.

7. If possible, have a support network of relatives and friends that are positive or may understand what it is like to be raising children or may even be able to give you a break from time to time.

8. Screen time, less is more. If you think about it the more time in front of a screen is typically the less time for exercise, academics, creativity and social interaction. Some families decide to have regular TV times, computer or game times as a reward. I often recommend for the television to be off when getting ready for school in the morning, as well as during meal-times and homework times.

If a parent is really struggling with challenging behaviors or there is a concern that the child is often sad, angry, aggressive, inconsolable or having some other social/emotional distress it can be very helpful to have the child/family assessed for therapy services.

For more information, contact Aurora Psychiatric Hospital at 1-877-666-7223 or visit the Aurora Psychiatric Hospital website.

 

 

April is Alcohol Awareness Month

NCADD (National Council on Alcoholism and  Drug Dependence) has sponsored Alcohol Awareness Month since 1987. It is an opportunity to raise awareness of alcohol abuse and encourage people to make healthy, safe choices.

ncadd%20alcohol%20awareness%20month%202013-%20logoDrinking too much alcohol can lead to health problems, including alcohol poisoning, hangovers, and an increased risk of heart disease. If you are drinking too much, you can improve your health by cutting back or quitting. Keep track of how much you drink, avoid places where overdrinking occurs, and find new ways to deal with stress. If you are concerned about someone else’s drinking, offer to help.

If you or someone you know is struggling with a drinking problem, Aurora Behavioral Health Services offers treatment programs that can help.

If you or someone you know is battling addiction, contact Aurora Behavioral Health Services us — online or by phone at 1-877-666-7223 — as soon as possible

April 10 is National Alcohol Screening Day. How do you score?

ncadd%20alcohol%20awareness%20month%202013-%20logoNational Alcohol Screening Day is an outreach, education, and screening program that raises awareness about alcohol misuse and refers individuals with alcohol problems for further treatment.

Thousands of colleges, community-based organizations, and military installations provide the program to the public each year.

What are the warning signs?

If you answer “yes” to any of the following questions, you may have a problem with alcohol:

  • Do you drink alone when you feel angry or sad?
  • Does your drinking ever make you late for work?
  • Does your drinking worry your family?
  • Do you ever drink after telling yourself you won’t?
  • Do you ever forget what you did while drinking?
  • Do you get headaches or have a hangover after drinking?

If you or someone you know is struggling with a drinking problem, Aurora Behavioral Health Services offers treatment programs that can help.

If you or someone you know is battling addiction, contact Aurora Behavioral Health Services us — online or by phone at 1-877-666-7223 — as soon as possible.

 

Celebrating our caregivers: March is Social Worker Month

The National Association of Social Workers (NASW) recognizes March as Social Worker Month. This year’s theme, “Weaving Threads of Resilience and Advocacy,” emphasizes the value of using personal strengths and self-advocacy to manage serious life challenges.

Social work is currently one of the fastest growing professions in the United States;

social work month 2013They are employed in many different organizations and industries, including private and public agencies, hospices, hospitals, and health care organizations, schools and universities, businesses and foundations, military branches and veterans centers, as well as national and local public elected offices.

There are currently more than 650,000 professionally trained social workers in the United States, and the Bureau of Labor Statistics predicts job growth to 800,000 by the year 2020.

Social workers help millions of people function better in their environments. The primary mission of Social Work is to enhance human well-being and help meet the basic needs of all people, especially the most vulnerable. As therapists, social workers accomplish this mission in many ways:

  • Social Workers help patients develop treatment plans that use their strengths, resilience, and self-advocacy to navigate life challenges.
  • Social Workers help patients function better in their environments, improve their relationships with others, and solve personal and family problems through a wide range of interventions.
  • Social Workers assist patients in every stage of life, from all communities, through individual, group and family therapy.
Pete Carlson is the president of Aurora Behavioral Health Services.

Pete Carlson is the president of Aurora Behavioral Health Services.

“ABHS utilizes social workers at all levels of care. They are invaluable in delivering effective, quality behavioral health and substance abuse treatment.” says Pete Carlson, President of Aurora Behavioral Health Services. “Social workers play a vital role in our inpatient, residential, partial hospital, intensive outpatient and outpatient treatment programs. I extend a warm and sincere “Thank You” to all our clinical social workers.”

For a list of social workers at Aurora Behavioral Health Services, or to search for a social worker visit our web site.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

 

What does “eating well” mean to a person with an eating disorder?

The Academy of Nutrition and Dietetics recognizes March 9, 2016 as Registered Dietitian Day. This event, started in 2008, was created to increase the awareness of the vital part registered dietitians provide for patients regarding food and nutrition services and to recognize RDs for their commitment to helping people enjoy healthy lives.

The importance of the registered dietitian is extremely evident in the area of Eating Disorder treatment.

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Sandy Blaies

“Dietitians are an essential part of our program at Aurora Psychiatric Hospital” says Sandy Blaies, Eating Disorders program supervisor. “Eating disorders have both psychological and physiological elements and require treatment providers with expertise in both.

“The extreme dieting behaviors, severe weight loss and symptoms of semi-starvation, binge-eating behaviors, and the patient’s distorted beliefs about nutrition and dietary requirements all support the need for the expertise provided by dietitians.”

“Dietitians have an essential role within the multidisciplinary assessment and treatment programs for all three major eating disorders.”

The main aim is to provide sound nutritional knowledge for the patient, the caregivers and other members of the treatment team. The focus of treatment should be on the establishment of a balanced dietary intake which will restore nutritional status and body weight.

Anne Sprenger

Anne Sprenger

Ann Sprenger, RD, a registered dietitian in the Aurora Psychiatric Hospital Eating Disorder Program describes how she works with patients. “I meet with every patient to provide nutrition information, describe how nutrition affects their mental and physical health, and to develop a diet plan in partnership with the patient.

“We monitor food intake every day and identify barriers to healthy eating habits. It is important for the patients to practice healthy eating habits while in the treatment program.”

Dr. Dinshah Gagrat, MD is the Medical Director of the Aurora Psychiatric Hospital Eating Disorder Program. “Professionals who treat patients with an eating disorder need to have knowledge of the nutritional effects and physiological consequences of the illness. This is rare within a predominantly mental health setting and this is the importance of including a registered dietitian in the treatment team.”

How do registered dietitians help people live well? Check out the top 10 ways from the Academy of Nutrition and Dietetics.

Dr. Dinshah Gagrat

Dr. Dinshah Gagrat

If you or someone you know may be experiencing an eating disorder please contact us at 877-666-7223 or visit our web site at Aurora Behavioral Health Services or check out these resources:

Do you always need to be hospitalized for mental health care?

Partial Hospitalization Program offers alternative to inpatient mental health care

For people who do not need to be hospitalized for behavioral health issues like anxiety, depression, bipolar or post traumatic stress disorder, but who have serious symptoms that are impacting their ability to cope with a daily routine, we offer Partial Hospitalization.

Partial Hospitalization is a great alternative to inpatient care, with a more flexible schedule, and is also more cost-effective. Yet, many people are still unaware that this program exists. It’s a fairly new concept in mental health care, having become available within the last 10-15 years.

mother daughters kids children family outdoors summer heroPartial Hospitalization provides clinically equivalent mental healthcare at a much lower cost than inpatient treatment. According to the Association for Ambulatory Behavioral Healthcare, direct cost savings over inpatient benefits are usually 40 to 60 percent — and more than 60 percent in some instances.

There are additional benefits because an employee involved in partial hospitalization treatment may be able to work on at least a limited basis, thus maintaining productivity.

Partial hospitalization dates back to the 1960s, when a small group of clinicians believed that individuals with acute mental illness would have a better chance of recovery and healthy functioning if they were allowed to pursue their treatment in the same communities where they worked, went to school, or maintained their family relationships.

“Our program provides the resources available to an inpatient without being completely isolated from your life” explains Marlyene Pfeiffer, LCSW, CSAC, and program psychotherapist at Aurora Psychiatric Hospital. “It’s an alternative to inpatient care, or a nice transition toward home for those ready to be discharged from the hospital.”

Partial Hospital programs help individuals develop and strengthen coping and healthy living skills – from healthy eating and regular exercise, to better sleep habits. Patients come in during the day and go home to their families in the evening. This allows them to practice the new skills they’ve learned, while also promoting their new-found confidence and independence.

Aurora Behavioral Health Services offers several Partial Hospitalization Programs.

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

How do you perceive people with psychiatric issues?

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What if you were to ask a group of friends or colleagues “How many of you have ever broken a bone?”

I’m sure they would not have thought twice about raising their hands if that were the case. Then I would have asked “How many of you have ever been diagnosed and treated for some form of mental or emotional disturbance?” I suspect none would have raised their hands, and there would have been an awkward silence.

Perhaps the stigma which continues to linger in our modern age is because the field of psychiatry is relatively young, compared to other sciences. Or perhaps it is because there tends to be an unrealistic expectation that anyone who is “competent” should not incur such types of problems.

The truth of the matter is: man, by his very nature, is imperfect, and mental health conditions can be inherited, just like so many other illnesses. Mental health conditions can also develop easily enough based on our ever-changing sets of life circumstances. Chemical imbalances stemming from a variety of bodily changes, such as hormonal, or thyroid, or a wide variety of other factors, can also bring on a range of psychiatric symptoms. All of these can happen to any of us at any time, whether we like it or not.

Why is it we don’t hesitate to contact our doctor when we have a physical problem, but hesitate to contact them when the problem is of an emotional nature? This is where the stigma comes in; that fear of what others might think of us. And that fear is based on a sense of shame, as if for some reason we are automatically buying into the negative stereotype of whatever label our symptoms might suggest.

As individuals we are far more than one or two labels might suggest. If we suffer from symptoms of anxiety or depression or a myriad of other potential psychiatric symptoms, does that make up the whole of who we are? Does that mean we are to automatically assume feelings of shame, inadequacy, or worse yet, label ourselves as a victim? If we break a leg do we not place our focus on the steps we need to take to heal, as opposed to just laying there as if nothing can be done?

Some progress has been made regarding the unfortunate stigma which has been placed on mental health or emotional problems, but we still have a long way to go. Every day we see the kinds of shortcomings each of us too often display, whether they can be labeled as a legitimate psychiatric condition or not.

The fact is, we have all exhibited unhealthy behaviors toward each other, and the challenge to improve our condition is always by degrees. We live in a world with a million shades of gray, and it does none of us any good to think strictly in polarized terms, as if everything should be black or white, all or nothing. We would all be wise to daily practice a greater degree of compassion to those in the world around us.

For more about mental health treatment, please contact Aurora Behavioral Health Services at 877-666-7223 or visit our web site at Aurora Behavioral Health Services

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.

How can art therapy be used to treat eating disorder?

Art therapy is part of the holistic treatment approach applied to treat eating disorders at Aurora Psychiatric Hospital. Patients can develop self-awareness, adopt better coping mechanisms, improve cognitive functions, and find pleasure in art making.

The purpose of art therapy is fundamentally on healing.  Art therapy helps patients creatively express emotions they may be having difficulty expressing verbally.

It is vital that patients express their emotions. Many times abusive or deadly behaviors are used to numb the pain of not speaking up and out. Obsessions with food and weight are often attempts to cope with unresolved emotional issues such as depression, rage, powerlessness, and loss.

Art therapy is a special tool that can help provide access to those hidden feelings in a safe and non-threatening way. Patients in the Eating Disorder Program at Aurora Psychiatric Hospital participate in both guided art and open art studios in an effort to strengthen and apply their inner resources towards recovery. Art therapy techniques are used to explore the issues that have led to compulsive eating, binging, purging, starving, over-exercising, laxative abuse, etc. Art Therapy is offered as a creative source and an outlet for patients to overcome blocked feelings. Emphasis is on discovering new ways to nurture oneself.

Art therapy is often intimidating to people. Many patients think they’re not artists or they can’t draw or they’re not creative. But art therapy is about the creative process, not the creative product. Patients connect with their inner experiences and find a way to express something that they may not be able to do easily with words. That’s one reason art therapy is a natural fit for eating disorders. It takes away the shame and helps people feel empowered.

A range of materials and mediums can be used, including pencils, watercolors, clay, collages and more. If someone is feeling anxious, overwhelmed, or out of control they might prefer markers or pencils, which help foster a sense of control. Someone who is feeling “stuck” or needing to break out might try a more fluid media, like watercolor paint. And someone who doesn’t want to draw at all can use collage, for example.

Looking at the visual representation of a particular issue provides helpful understanding of the emotions involved. So a person can examine how they feel and behave currently vs. how they want to feel or behave and explore what’s keeping them from functioning the way they want to in a situation or relationship. It’s a skill that can continue to be used at home after treatment as well. Art can be used as a positive coping skill to incorporate into a long term recovery plan.

If you or someone you know is struggling with an eating disorder contact Aurora Psychiatric Hospital Eating Disorders Program

Aurora Behavioral Health Services offers complete mental health treatment options, provided by highly trained professionals in a caring, confidential manner to meet individual and family needs.  If you or someone you know needs help, contact us — online or by phone at 1-877-666-7223 — as soon as possible.