“Psychiatric Rehabilitation Wellness Programs” are fairly recent concepts.   It is recognized that many people lack the skills or lack the words to explain what they are experiencing, causing behaviors, as they try to cope with their personal misperceptions in life, that may seem ‘weird’ to observers.  Often with schizophrenia, there are sensory distortions, input is skewed.  Dr. Moller shared the story of a lady who smeared lipstick between her nose and chin before she ate, then always sat in front of a glass water pitcher.  Staff laughed at her strange behavior, often taking away her lipstick and water pitcher saying “she’ll eat when she gets hungry enough”. A nurse who was new to the unit asked the lady directly why she used the lipstick that way, and always wanted a water pitcher in front of her, to which the lady replied, “It’s the only way I can be sure I find where my mouth is supposed to be when I eat.”  She was simply trying, as best she could, to solve a problem arising from incorrect sensory information.  At Not Alone, we are grateful to the medical staff, therapists, peer support specialists, and family and friends who care and who patiently encourage the healing process, but we’d like to say a special Thank You to the nurses who see the patients as people trying to adjust to a collection of symptoms that wax and wane, and find creative ways to help the patient understand, process, and adjust to those symptoms accordingly.   It’s called healing.

To hear more about Dr. Mary Moller and the role of nursing in mental health care, listen to the June 11 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.

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June 11, 2013 – Dr. Mary Moller

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

Dr. Mary Moller, a professor in Yale University’s Graduate Nursing Program, was a guest on this broadcast of Not Alone.   Dr. Moller is especially interested in research and education for individuals and families experiencing the effects of schizophrenia and how improved or changed nursing care can increase patient recovery.  Questions that Dr. Moller has researched include:

• How does the nurse or other professionals help the patient accept their illness and gain mastery over the illness? 
• How can the healing team help someone successfully emerge from their experience while creating a positive, new sense of life meaning?

Dr. Moller spoke of her nursing experience on a neurology ward, where education for patient and family were primary goals for the nursing staff.  Helping the patient, never leaving them alone during crisis, checking for even the most subtle change in the way a patient was thinking or interacting with others, changes in perceptual or cognitive functioning, encouraging the patient’s ability to make psychological adjustments after head trauma were all nursing priorities.   However, when she was moved to a psychiatric unit, patients exhibiting exactly the same kinds of behaviors she witnessed in the neuro unit, were ‘corrected’ for their behavior, were isolated or restrained, or their ‘weird’ behavior was laughed at and misunderstood.  The greatest pain she felt as a nurse, however, was that nobody was expected to help the patients or the families understand the course of the disorder, develop a plan for coping with the symptoms, or initiate a wellness plan.  The educational component, which nurses can provide so well, was missing.

Our visit with Dr. Moller was of such interest, that we invited her to join Not Alone again on June 11, to continue the conversation regarding nursing care for people with mental health needs and especially for those with schizophrenia.

To hear more about Dr. Mary Moller and the role of nursing in mental health care, listen to the June 4 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.
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June 4, 2013 – Dr. Mary Moller

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

Dr. Duffy also introduced us to “pharmacogenomics” which essentially utilizes a mouth swab to measure a person’s unique genetic composition and then predict how that individual might metabolize or respond to medication.  This procedure helps doctors and patients decrease side effects and promote drug efficacy.  We talked about treatment resistant depression and the use of Transcranial Magnetic Stimulation or TMS, where magnetic fields are used specifically to alter brain activity. This magnetic stimulation is focused on the prefrontal cortex, which is underactive in depression. TMS stimulates that area to more normal function, lifting depression.  Our friend, Wendy, who has taken advantage of TMS treatments, said the treatments make a ‘funny noise,’ but she is fully awake during the treatment. When the treatment is completed (about 40 minutes) Wendy hops back in her car and continues her schedule for that day. TMS is not to be confused with the electro-shock treatments as they are different procedures.   Whether these treatments are right for everyone is undecided. However, the option is there to learn more and consider the opportunity.

To hear more about Premier Psychiatric Group, listen to the May 28 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.

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May 28, 2013 – Premier Psychiatric Services of Lincoln Nebraska

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

How does a parent get someone within ‘the system’ to listen?   Is there a Well of Courage to draw from when parents are blamed and seen as the failures?   MaryAnn spoke of the isolation a parent feels when their child is perceived by others as ‘less than perfect.’  People you thought were friends begin excluding you, often because they simply do not know what to say or how to respond to the constant turmoil your child can cause.   Ann reflected on the pain she as a mom experiences as she realizes how much her other children and other family members need her time, her smile, her love, and some days she is just so tired of ‘coping’ she simply doesn’t have one more smile or one more hug to give.   Tom talked about the true fear parents feel when their child legally becomes an adult, but lacks the emotional stability to make ‘adult’ decisions and assume ‘adult’ responsibilities.

The Center for Disease Control (CDC) issued a report in May, (for the first time ever) recognizing that children have mental health disorders and tracking those mental health disorders.  The CDC reported that 13 to 20 percent of U.S. children experience a mental disorder in any given year, including major depression, anxiety, ADHD, autism spectrum disorders, and a host of other mental health challenges.  Suicide, which the CDC reported can result from the interaction of mental disorders and other factors, was the second leading cause of death among adolescents age 12 to 17 in the year 2010.  And yet, what happens when parents try to access an assessment, a diagnosis, a treatment plan, a recovery plan for the child they love before a crisis develops?   

Ann, Mary Ann and Tom were impressive; this broadcast is one we personally will re-visit many times.

To hear more about Parent Voices, listen to the May 21 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.

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May 21, 2013 – Parent Voices

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

Nebraska Families Collaborative was formed in 2009 to address the safety, permanency, and well-being for children who have been removed from their homes and placed in foster care.  NFC was created to improve outcomes for children and families in foster care and is a partnership with Boys Town, Heartland Family Service, OMNI Behavioral Health, Child Saving Institute, and Nebraska Family Support Network.  Recognizing that many families simply need extra support or encouragement in order to better care for their children, NFC tries, in most instances, to connect families to appropriate support teams.   When the safety of the child or youth is in question and children must be removed from their home, Nebraska Families Collaborative makes every attempt to place youngsters with someone who already knows and cares about them, or with experienced foster families.     

We learned about the need for special training when dealing with emotional and behavioral struggles that a youngster might be facing and the criteria and background checks that must be met when applying to become foster parents. Some of the licensing requirements can be waived or postponed when Kinship Care is utilized which involves placing a young person with a relative, or perhaps someone like a special teacher or neighbor who has a strong relationship with the youth in question. 

Help us celebrate this month of May, National Foster Care, Month and recognize how foster families are very special people.  Thank you for the generosity of your love!   We hope others will give thought to also becoming foster parents.

To hear more about the Nebraska Families Collaborative, listen to the May 14 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.

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May 14, 2013 – Nebraska Families Collaborative

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

I told the staff that one day we would look back and question these practices, just as we now reject ice baths, straightjackets, and lobotomies. We have come a long way in our treatments and the progress is due to the recovery movement. I took the opportunity to translate recovery concepts into practice by changing our use of seclusion and restraint.

Collaborating with a peer specialist, patient advocate, and three nurses, I taught the changes in seclusion and restraint to the staff. My goal was to influence change at three levels: organizational, staff, and patient.

At the organizational level, we aimed to create an environment with no tolerance for violence. I wanted to convey the message that physically containing a patient and using seclusion or restraint are violent acts. I also wanted people to understand the use of seclusion and restraint represented treatment failure, not successful intervention.

The staff needed tools to help patients deal with crises and distress. One strategy was to assist patients in developing individual safety plans so staff could use them at times of crisis. The safety plans would help staff coach patients in using self-selected skills during stressful times. Some examples are listening to music, taking a warm bath, talking to someone, or finding a comfort room to sit in silence.

The next step was to teach the staff about trauma-informed care. They had received training on the topic, but we did something unique to bring that training to life. Elaine Alberti, a clinical nurse specialist, worked with a group of patients on a photovoice project. The patients took pictures and created a narrative interpretation of messages they wanted to convey to staff regarding trauma, recovery, and stigma. They turned their pictures and narrative into a slideshow with music. The project sent a powerful message to the staff and many heard the patients’ voices in a new and different way.

We also reinforced the use of de-escalation tools. Our goal was to prevent crises from occurring by listening to patients, helping them problem solve, and encouraging the use of skills they had been learning in therapy groups.

The last strategy was to amplify the patient’s voice by working with a peer specialist and patient advocate—both of whom had experienced containment, restraint, and seclusion. It was the first time the peer specialist and patient advocate talked openly about their experience in a public forum. They spoke with conviction and passion and their message was raw but clear: this was not a way to treat a human being. Peer specialists ended their talks by saying “I may be deranged and psychotic, but remember I am a human being and need to be treated with dignity and respect.”

Since this initiative began, we have seen incredible results. Our seclusion and restraint hours have been reduced by 90 percent. In the past, patients had commonly stayed in seclusion for weeks, especially in our forensic unit. Our current goal is to release people from seclusion within 2 hours. We are meeting this benchmark 85 to 90 percent of the time and when we don’t, it is usually because a person required seclusion for 3 or fewer hours. The days are gone when a patient would remain in seclusion for days or weeks.

On the whole, staff are also more accepting of patients’ behaviors. When a patient expresses anger, staff are more willing to process feelings together, instead of engaging in a power struggle. Once the patient is heard, he or she feels validated and knows we care, thereby lessening the tension and conflict. We try to remember that so many patients have experienced trauma, and understand their behaviors are at times only best efforts at telling us “I need help.”

The most significant accomplishment we have made thus far was proving to staff that using less seclusion and restraint is possible. As a caring profession, when we listen and focus on each patient’s needs, we can and do make a difference. My aim was to be creative and strategic, to make training as powerful as possible, and to inform and complement the necessary bureaucratic changes with the voices of our patients. Our presentation viscerally moved people. I saw staff with tears in their eyes and many said it was the best training the hospital had ever offered. I think of recovery as bringing the voices of patients to the people who provide care and treatment. Once we hear their cries, we can, will, and do make a difference.

About the Author Jeffery Ramirez, PhD, PMHNP
Dr. Ramirez is an Assistant Professor at Gonzaga University in Spokane, Washington, and a Clinical Nurse Specialist at Eastern State Hospital in Medical Lake, Washington.

(Source: Recovery to Practice Highlights, SAMHSA)

Dr. Kevin Riley, Superintendent of School District #37 in Gretna, Nebraska, Board Chair of GOALS, the Honorable Elizabeth Crnkovich, judge of the Douglas County Juvenile Court, and Treva Haugaard, the Executive Director of the GOALS Center, showed us how GOALS helps families recognize the barriers that might prevent a youngster’s success in school. Then, they assist the family in finding the community resources available to help overcome those barriers. Dr. Riley reminded us that each child comes to school with their own special strengths and gifts, and their education will help young people develop those unique gifts.   When youngsters are missing school, they are also missing opportunities to develop those very gifts and strengths that will lead to success in their future endeavors.

GOALS is a voluntary program designed to overcome chronic absenteeism, help youngsters achieve learning goals, and find value in completing their education.  Many students do live in less than stable environments, attending school each day presents physical, emotional, and social challenges. However, already the positive influence of GOALS is helping to change the absenteeism rates in our community.

To hear more about GOALS, listen to the May 7 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.

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April 7, 2013 – GOALS

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

The Nebraska Family Collaborative representing Boys Town, Child Saving Institute,  Heartland Family Services, Nebraska Family Support Network, and Omni Behavioral Health, strives to unite family and community strengths on behalf of troubled children and youth, so that every child is safe, healthy, and in a forever family.   Becoming part of the welfare or juvenile justice system is traumatic for each member of the family, especially the youngsters; the Nebraska Family Collaborative develops teams that include family members, community resources, and the professionals needed to help children be safely reunited with family, or to quickly find a forever family so that youngsters can experience success as part of a family, achievement in school, and see themselves as valued members of society.  Dave will not only assist other national leaders in emulating the success of NFC, but he will also be bringing the vision of other worthwhile programs back to Nebraska.    Congratulations, Dave! Your invitation is a well-deserved honor for you and for Nebraska.

We were especially impressed to learn that included within Mary Lanning Healthcare is a comprehensive mental health treatment program, including a commitment to providing individualized, therapeutic treatment plus behavioral health education opportunities for individuals and families. 

Mary Lanning Healthcare not only offers traditional inpatient and outpatient care opportunities, but also provides a specialized geriatric outreach, with an APRN visiting assisted living and skilled care facilities on a regular basis.  What a blessing to those rural and frontier counties they serve!   

Mary Lanning Healthcare will be celebrating their 4^th annual Mental Health Awareness Dinner on Tuesday, May 7, at the Hastings City Auditorium.  Dr. Warner and Ms. Kern both stressed their personal appreciation for the interest and support local residents provide for Behavioral Services, and particularly the community enthusiasm for Relapse Prevention. 

We especially remind our readers and Not Alone listeners that Mary Lanning Healthcare provides a crisis referral telephone number, staffed 24 hours each day, by licensed mental health professionals.   That telephone number is 402-463-7711.

To hear more about Mary Lanning Healthcare, listen to the April 30 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.

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April 30, 2013 – Mary Lanning HealthCare Center

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Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.

A recent article in Careers in Aging reported that today one in eight Americans are over the age 65, while the age group growing fastest in our society is identified as “the very old” or people over age 85.  There will be 15 to 18 million Americans over the age of 85 within the next 15 years.  These facts present us with amazing opportunities to encourage young people to consider emerging careers in Gerontology, and of course Not Alone wants to see increases in professional numbers who can assist seniors experiencing mental health challenges to find Hope, Help and Healing. 

Professor Lyn Holley, Dr. Priscilla Quinn, and Paul Falkowski joined Not Alone from the prestigious Department of Gerontology at the University of Nebraska-Omaha campus sharing the excitement as, with increasing regularity, new careers and opportunities in the field of Gerontology become available.  This is a time when innovative ideas and new programs in Gerontology evolve with amazing regularity. Dr. Holley laughingly told us that in every career field, about the only profession that has not yet identified an emerging need to expand proficiency addressing provisions for the aging population has been the study of rocks. In addition to psychiatrists, nurses, and physical and occupational therapists who might specialize in Gerontology, consider the architects, the construction engineers, the transportation industries, the economists who might require a background in service or accommodation for older populations.  Not Alone, of course, is particularly concerned about the common misconception that “depression is a normal part of aging”, a concept which prevents many seniors for being healthy and experiencing joy in life.  Studies in Gerontology are helping to dispel this myth and creating opportunities for seniors to make life more meaningful.

We recognize and appreciate the leadership the Department of Gerontology at UNO continues to provide and offer our congratulations on the national respect and prominence the UNO Department of Gerontology inspires during this period of rapid growth relating to a healthier life for seniors.

To hear more about the field of Gerontology,  listen to the April 23 Not Alone radio program by clicking on the play button below, or downloading the file to listen later. Visit The Kim Foundation Not Alone podcast page to listen to any past Not Alone broadcast.
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April 23, 2013 – UNO Department of Gerontology

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 Airing every Tuesday from 4 p.m. to 5 p.m. (CST on station KCRO, channel 660 AM based out of Omaha, Neb.), Not Alone is a live talk radio program focused on behavioral health and recovery. Developed by The Kim Foundation through the support of C&A Industries, Inc., Not Alone works to reduce the stigma often associated with mental illness. The show seeks to assure individuals, families, and communities that they are not alone, mental illness affects us all, hosting a variety of guests from across the country.