Author: Kayla Quesnel

In a previous blog, Moral Injury Part One, we discussed the differences between workplace burnout and moral injury. While often used interchangeably, the two are markedly different and require a differing approach to addressing and coping with them.

Burnout is the result of chronic workplace stress. It’s not a medical diagnosis, but if left unaddressed could potentially lead to physical and mental health concerns. For more information on burnout including common symptoms read Moral Injury Part One: Are You Experiencing Burnout or Moral Injury?

Moral injury, on the other hand, refers to psychological, behavioral, social and/or spiritual distress that is experienced by individuals who are performing, asked to perform, or exposed to actions that contradict their moral values and personal ethics. Moral injury is being recognized in frontline and healthcare workers of the COVID-19 pandemic.

Symptoms of moral injury could be acute or appear slowly months or years after the event. Symptoms can include:
• Feelings of guilt, shame, disgust, anger
• Self-blame, self-sabotage
• Feeling unworthy
• Feeling detached from sense of self

Note: If you’re feeling severe symptoms such as those related to PTSD, depression, anxiety or substance use issues, it’s important to see a behavioral healthcare provider as soon as you can.

Everyone has individual experiences and may require different strategies to cope with moral injury. What may work for one person may not work for another, and that’s okay. Consider the following:

Lean on existing support systems. Seek support from family, friends, colleagues, and spiritual leaders. Be vulnerable and express your feelings. Often, having a listener is helpful in relieving the burden of our feelings. Also consider reaching out to other support groups locally or even virtually for a place to share your thoughts, feelings, and help others by supporting them.

Create a stress management system. You know yourself best and know what strategies work for you. Common techniques include focusing on proper sleep, a consistent exercise routine, incorporating healthy foods, and a mindfulness practice. Would it be helpful to have an accountability partner? Ask someone from your support system if they will walk around the neighborhood with you a couple times a week. Or discover a new recipe with nutritious ingredients. Consider cooking the meal as a form of mindfulness and allow yourself to get lost in the process.

Slow down. Recognize that you may be in a vulnerable and raw emotional and spiritual place. Remind yourself that this is okay. We all go through traumatic events, witness unethical practices, or are asked to perform duties that go against our very nature. Allow yourself to slow down, feel and process your feelings. Take all the time you need. Healing yourself isn’t a race.

Attend therapy. If you don’t yet attend, we suggest that you start. As a behavioral healthcare provider, you know first-hand the benefits of scheduled therapy sessions. Additionally, it’s likely that your provider will be sympathetic to the effects of moral injury as they may have experienced it before themselves.

Take action. Experiencing moral injury has the potential to detract us from our sense of self. What we believe in, our ethics, our values. Reunite with your inner self by remembering what it is that you believe in. Take time to reflect inwardly on what strengthens your sense of self, your morals and your beliefs. Then take action! Maybe it’s in the form of activism for a cause you care deeply about or volunteering in your community. Determine what’s important to your deepest self, what reinforces your core beliefs, and then, reconnect with it.

 

 

 

Sources: hhs.gov, ncbi.nlm.nih.gov, drpaularedmond.com, mentalhealthfirstaid.com

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The holidays can be a time of perpetual joy, faith and connection. However, there are many ways our mental health can worsen during this time. There’s the stress of buying gifts and attending family gatherings. The feeling of loss and nostalgia for those who are no longer with us. And the last two years during the pandemic, a lot of us are feeling more isolated and distanced than ever. But there is hope. You can manage your mental health, stay connected, and lean into the holiday spirit with the following reminders.  

  1. Reset routine: Think about your daily routine. What’s working for you and where can you improve? Keep in mind that your health practices such as eating nutritious foods, exercising regularly, and getting restful sleep are all beneficial to your mental health.  
  2. Boost brain power: Have you ever wanted to learn something new? Maybe it’s yoga, cooking a gourmet meal, or learning a musical instrument. Even 5-10 minutes per day of practicing a new skill or hobby can boost your mental and emotional health and take your mind off any stresses of the season. 
  3. Slow down: The way we gather and celebrate may have changed, but it has also forced us to slow down and take stock of our lives. Allow yourself to move at a slower pace to be more present and mindful of the holiday season. What or who are you grateful for? What memories or events bring you joy this time of year? Writing these things out in a journal or on a notepad and seeing them will help. 
  4. Adjust traditions: The way we come together has changed, but it can be an opportunity to adapt rather than to be upset for how the holidays “should be.” How does this time of year make you feel? Share this with your family (along with their feelings) to see where new traditions can align.
  5. Reach out: We can still be connected while being apart. Keep connected to your loved ones by text, phone or video call, or writing a letter or holiday card. Let them know you’re thinking of them, share how you’re celebrating, and let them know you’ll always be there. 

 

It’s important to recognize that having a mixed bag of emotions during the holiday season is normal and that existent mental health issues can worsen due to holiday stresses. We all may need extra help this holiday season and that’s okay. The following are signs that professional guidance may be necessary:  

  • Fear and worry 
  • Self-isolation 
  • Fatigue, sleep changes 
  • Irritability, mood changes 
  • Impulsive or risky behavior 
  • Worsening chronic health issues 
  • Worsening mental health issues (such as anxiety and depression) • Increase in substance use (such as alcohol, drugs and smoking) 

Sources: hhs.gov, usatoday.com, mayoclinic.org, clevelandclinic.org, nm.org

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We know that your time is important to you, but are you using it to your advantage? When running your own practice, it’s easy to let time—and your ability to leverage it—get the better of you. To keep your business running smoothly, your clients’ appointments scheduled, and all your paperwork submitted on time, you need to incorporate a time management strategy.

Scheduling. Schedule your week so that each day has an equal (or nearly equal) amount of tasks and appointments that you can commit to. It’s also not realistic to schedule every hour of your work day to be productive. Plan some time each day for distractions, breaks, or small moments of whatever brings you joy. These moments of “non-productivity” can oftentimes be moments of great inspiration and renewal.

Boundaries. Although you want to “do it all” and often try, the effort most likely leaves you feeling defeated, stressed, and uninspired. In order to do your best work and serve the clients who depend on us, it’s necessary to work on creating boundaries. Create office hours and stick to them. Resist answering emails or phone calls immediately (and certainly not if you’re on vacation!). When you respect your time, others will too. 

Chunking or Grouping. It may be a silly name, but chunking or grouping is simply putting all of your tasks together by type of task or project. Then dedicate chunks of time on your calendar to work on that specific set of tasks. This helps to eliminate the dreaded multi-tasking that we all try to do (but which never truly works).

Incorporating self-care. Let’s nip this in the bud now—self-care isn’t selfish and it doesn’t “take up time.” Incorporating self-care into your schedule helps to create a work-life balance, clear your mind or make you feel better, which all ultimately helps you work more effectively and to a higher standard.

Task prioritization. During those times where it seems like you have a thousand things to do and not enough time to do them, task prioritization is the answer. There are several different methods out there, so finding which one works best for you may take some trial and error.

The ABCDE method is simple yet effective. Make a list of all your tasks and responsibilities. Then sort them using the parameters below. You can use this method for daily, weekly and monthly tasks.

  • A – highest priority tasks
  • B – medium priority tasks
  • C – low priority tasks
  • D – delegate tasks to another person
  • E – eliminate task

The GTD or “Getting Things Done” method is slightly more complex but worth the effort. After you have established all of your tasks, you then sort them using a “decision tree” to put them in their proper place.

With each task, ask yourself:

  • Is this task actionable?
    • No? Throw in the trash or file for later if it’s a reference or a resource
    • Yes? Determine which “pile” it should belong in.
      • Right away: If you can complete the task in under two minutes
      • Waiting for: if you’ve delegated the task to someone else
      • Next action: if you don’t have to finish actions with multiple tasks right away
      • Calendar: if your task has a deadline, always add it to the calendar

 

It may take a while to figure out which tools work best for you, but when it comes to running your own practice, efficient tools of time management are the secret key. As you manage your time within your business, remember that it’s all about balance and growth. Recognize what works for you today and realize that it may change as your business changes.

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This article originally appeared in Macaroni Kid on September 3, 2021, by Cindy Mailhot, LCSW, CCS, Assistant Director of the Outpatient Therapy Program, Health Affiliates Maine. 

Question:  My 13-year-old is struggling with mental health and starting to act out in concerning ways. How can I help and be supportive while also parenting and setting healthy boundaries with screens, dating, and outbursts toward younger siblings?

Answer:  First, I want to commend you on considering the two sides to every parent’s dilemma…how to be their biggest supporter and their disciplinarian at the same time. That is not an easy job! At thirteen years old you are on the starting line of those all-important teen years, so considering this now will help you set the tone for your relationship in the coming years. I think the answer lies in achieving a balance between these things. There are situations when you will be able to take on a stronger role as a supporter while offering gentle guidance and other times where you will need to fall heavier on the disciplinarian side. 

Being prepared can help alleviate stress for everyone in many situations. It is important to establish the rules and consequences for breaking those rules ahead of time (I.e. outbursts toward others). It helps both parents and children when navigating those emotionally charged moments. To ensure consistency, be sure to include anyone that might be significant in co-parenting (parents, stepparents, grandparents, etc.). Rules and consequences allow parents to remain levelheaded in these situations. Without them, heightened emotions can lead us to giving consequences (i.e., “you are grounded for a month”) and giving in later when the emotions are lower.   

Screen time is generally recommended to be no more than two hours per day.  That being said, you will want to determine what is right for your child and family. Once you establish that, set some clear rules around that. Does it need to be done after homework is complete? Do their grades factor in? What about chores? Do you want to change your Wi-Fi password daily and provide it after they meet your established boundaries? These are all things to consider before the issue arises.

Dating is another topic that you will want to consider before the need arises. When can they meet a date somewhere? What age will you have the date pick them up? Do you meet dates ahead of time?  What is the curfew and the consequence if broken? This is a great topic to have some discussion around so that your child understands your concerns. This is a great topic for safe dating discussions as well—internet safety, safety planning if a date if going poorly, red flags in choosing dating partners, etc. Allowing opportunities for your child to discuss this topic before and during their dating experiences will be important to you feeling comfortable with their plans and them feeling comfortable talking to you if challenges or questions arise.

The supportive parent may also incorporate several strategies to be sure that the relationship does not become defined as a series of arguments and punishments:

  • Incorporate time together to just have fun and talk.  Maybe take turns planning those “dates” or plan them together.  It is important to engage in activities that your child likes to do too (even if you do not).
  • Listen to your children about all topics. These are great times to teach them your family values but also how to think for themselves and make informed decisions. Listening also sends the message that they can talk to you—and even disagree with you—and it is okay. These are great skills for them to learn and will preserve your relationship for those harder times.
  • While very challenging, try to keep emotion level when disciplining. It is all too easy to fall into shaming and blaming when we are responding out of our own fear or anger. Those parenting behaviors may put a rift in your relationship, making the discipline times more challenging. Be firm about the discipline, acknowledge your emotions, and allow them to express theirs.   
  • Just like in adult relationships, talking when both parties are angry is probably not a great idea.  Come back to discipline and discussion later when you both have a chance to calm down.

In summary, know the rules and consequences for your family and be consistent with them but always leave communication lines open. 

If you notice anything concerning (you know your child best), reach out to a mental health specialist for assistance. Behavior changes could include a change in social activities, isolation, sadness, anger, acting out, or essentially any behavior that is outside the norm for your child.

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This article originally appeared in Macaroni Kid on August 15, 2021, by Marylena Chaisson, LCPC, Case Management Supervisor, Health Affiliates Maine. 

Question: My sister is six years older than me. Growing up, she was responsible for a lot of my care and was abusive both verbally and physically. We barely speak now which is fine by me. She has been living in another state but recently told us she is moving back to Maine. My parents live in Maine also. If it were not for them, I would have no relationship with my sister. However, I know that now I will see her at every holiday. I am dreading it. The only time I spoke to my mother about this (as an adult) she brushed me off as being dramatic. I am feeling a lot of anxiety around seeing my sister more (even though I know she can no longer hurt me). I’m struggling with the need to talk with my parents to let them know I may not be able to visit at the same time as my sister. I do not want to be hurt but nor do I want to be hurt. I know seeing my sister regularly will bring up many bad feelings. Am I best to avoid my sister, talk to my parents, or just try and suck it up?

Answer: I first want to express that your feelings about this are valid, and you are doing a fabulous job thinking about these potential changes ahead of time.  It is natural for you to want to protect yourself from a person who hurt you in the past. Your mother brushing off these concerns when you attempted to speak to her in the past about it does not invalidate your experiences or need to protect yourself in the slightest. I most certainly do not endorse the idea of you choosing to “suck it up” because that feels inauthentic and invalidating of the hurt you have experienced.

There is an array of paths you can take in this situation.  This is not an all-or-nothing, nor is it a one-time permanent decision for which path to take.  It is okay to decide that, for your own sense of emotional safety, you are not ready to have in-person contact (or any contact) with your sister.  You can choose to explain or not explain this to your parents in whatever level of detail you feel comfortable.  You do not owe anyone, including your parents or your sister, an explanation of what you are doing to make yourself feel safe and comfortable in the world.  You also reserve the right to change your mind in the future whenever you feel fit. This is a time where it is important to put your own emotional safety and needs ahead of your desire to please your parents or attempts to help them avoid feeling any discomfort.  They might experience uncomfortable feelings about what you say (or don’t say), but managing their feelings is their responsibility, not yours.  You must look out for your own best interest.

Here are some examples of explanations, varying from matter-of-fact statements with no detail, ideas for redirection, or all the way to including a more thorough, detailed explanation:

“I’m going to miss this family event.”  

“I want to start a new tradition of taking you [parents] out to dinner for holidays – just you and me.”

“I am not interested in seeing [sister] so I will not be attending events where she is present.”

“Remember I told you about the times that [sister] hurt me in the past.  I do not feel able to be in the same room as her right now.  That might be upsetting for you to hear and upsetting you is not my intent, but I need to do what I feel comfortable with. I am seeing a counselor with the hope that I might be able to attend events with her in the future, but I can’t right now.”

That last example leads me to my next thought: this is a perfect situation to bring to a counseling relationship if you have any interest in working through some of the stress you are experiencing related to this.  You have competing desires here—you want to participate in family events and see your parents during the holidays and you also want to avoid seeing your sister. These desires are coming into direct conflict, so something is going to have to give.  The only part of this dynamic you have control over is your own responses and decision-making.  There is room here, should you choose, to develop skills for distress tolerance and self-management while being physically present with her.  A counselor, especially one trained in family dynamics like a LMFT (Licensed Marriage & Family Therapist), could be helpful in supporting you to build skills for managing your reaction, memories, and stress related to the past abuse you experienced. With skills and support, you very well could find yourself able to attend family gatherings with her present without experiencing an unbearable level of distress.  This path is only recommended if you feel that she will not engage in further abusive behavior now that you are both adults—I would never encourage you to expose yourself to further abuse.  

Please remember, your path forward here should be focused on what feels emotionally safest to you, and not based on a misplaced sense of owing your parents contact with your sister. You can choose to work towards increasing your ability to be around her in the future—or not—again, that is totally up to you and may evolve over time.  Stay authentic to your truth and honor yourself and you will see the best path forward in this complicated situation.

Marylena Chaisson, LCPC is a clinical social worker and the Case Management Supervisor at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children, and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.” 

 

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This article originally appeared in Macaroni Kid on June 10, 2021, by Marylena Chaisson, LCPC, Case Management Clinical Supervisor, Health Affiliates Maine. 

Question: My son is a senior and will be going out of state for college next year. He has fairly high anxiety and lacks executive functioning skills. I am feeling very anxious about him being far from home. How do we both prepare for this big change?

Answer: Big changes ahead! Let me tell you that you’re already doing great just by thinking about these challenges ahead of time and acknowledging there might be a couple of bumps here and there for both of you, so first off, please give yourself a pat on the back for being a caring and nurturing parent! Changes like this can be stressful for the whole family. Please remember to take care of yourself and attend to your own anxiety and stress over this change by seeking the support of a counselor, even if just for a few short-term, solution-focused sessions. 

Here are some specific thoughts about your son and his transition to college life:

  • I would encourage him (maybe with a little support from you) to reach out to the college’s student counseling staff right away–even this summer. This could be something you can support him with. Counseling staff at college are well-versed in the array of transitional struggles that frequently occur with this population of young adults and can better support new college students if they know ahead of time what challenges might surface. I will be surprised if the college does not have a counseling option for their students. If they don’t, reaching out to the Dean for guidance towards locally available counselors might be the next thing I’d try.
  • Review with your young adult the various strategies that you’ve both been implementing already for him to keep up with his high school classes and helping out around the house–if he’s passed high school and been accepted to college, that tells me he has some capacity for executive functioning as long as there are some supports in place. Is he a list-maker? Does he use a planner? Does he have a calendar on his phone? Do you use a weekly chore chart in the house? Every family and every individual is different, and it’s very common for most of us to use one or more helpful strategies or tools to stay on track. You will want to encourage him to replicate these same tools/strategies in his new college environment as soon as he moves out of the house. 
  • Begin the transition to more independence early.  Sit down with your young adult and discuss what activities he will need to accomplish independently when at college–doing laundry, making it to the cafeteria during mealtime, waking up to an alarm so he can make it to his classes on time, being responsible about bedtime–and think of ways you can start promoting independence on these things this summer. Follow through with natural consequences. If he commits to waking up by himself to an alarm to get to a summer job, and then sleeps through the alarm and ends up getting in trouble at work–that’s a natural consequence that he might need to experience and learn from. It can be very hard as a parent of a transitional-age youth to avoid jumping in and “rescuing” them from poor decision-making or low responsibility, but that is part of your work as a parent right now to assure a smoother transition to independent living.
  • Look at the college schedule for the academic year and plan ahead about staying connected during the week through video chats or phone calls, and make a plan for his trips home so you both know what to expect. For the extended times he plans to remain on campus, make sure you come up with some fun activities to keep yourself occupied–have there been hobbies or activities you’ve been wanting to get back into or try that you haven’t had time for? This can be a great time of personal growth for you, too!

Remember that times like this are a great opportunity for growth for everyone in your family. Sometimes growth doesn’t feel good at first (remember growing pains as a kid?), but a little bit of discomfort isn’t necessarily a bad thing. Open and honest communication and great boundaries are some of the biggest stepping stones towards this transition being as smooth as possible!  I’m excited for you!

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Post-Traumatic Stress Disorder (PTSD) is caused by experiencing or witnessing an event such as an injury, death, war or combat, natural disaster, abuse or assault. Trauma is not rare—it’s estimated that 70% of Americans of all ages, genders, and ethnicities go through at least one trauma in their lifetime.

While not every trauma will result in PTSD, a traumatic event actually changes the cognition in the brain causing a person to continuously release stress hormones and always be on high alert. Constant, high stress and other symptoms of PTSD can have a negative impact on mental, physical and emotional health.

PTSD vs. Stress and ASD

A PTSD diagnosis is not the same as daily stress or Acute Stress Disorder (ASD). Daily stress is a normal part of life and something we all navigate in our own way. PTSD can develop if ASD (whether professionally diagnosed or not) wasn’t properly resolved or the person didn’t have access to appropriate coping tools. A PTSD diagnosis can occur months or years after a distressing event.

Acute Stress Disorder is usually diagnosed immediately after a traumatic event and can last for days or several weeks; however, it usually resolves naturally with healthy coping strategies or with counseling. If left untreated, ASD can develop into PTSD. This can lead to other serious conditions such as depression, anxiety disorders, eating disorders, or substance abuse.

The symptoms of ASD and PTSD are quite similar, but duration and timing of the diagnosis sets them apart. Signs and symptoms can include

  • Irritability or anger
  • depression or deep sadness
  • intense stress or anxiety
  • nightmares and trouble sleeping
  • feeling isolated
  • troubles controlling or expressing emotions
  • problems trusting others
  • difficulty maintaining relationships
  • flashbacks, pervasive negative thoughts and memories

 

 

Can PTSD be treated?

Psychotherapy, or talk therapy, is highly beneficial to those working through PTSD. Talk therapy helps to bring up feelings, memories and emotions associated with the traumatic event so that proper processing and management can occur. Some individuals will take medication in conjunction with talk therapy and/or group counseling.

In addition to counseling and medication, here are some examples of healthy coping strategies for living a content, fulfilled life.

Physical Health: By exercising, eating and sleeping well, and avoiding drugs and alcohol, you can relieve feelings of intense stress. Research shows that by setting goals and being consistent with your workout routine you can reduces stress.

Emotional Health: Practicing mindfulness, meditation or prayer keeps your mind in the moment. These practices allow for you to acknowledge feelings or memories and then “let them go.” Starting small with one or two minutes at a time can help limit stress, anxiety, depression and increase feelings of being grounded and present.

Community connections: Spending time with others especially understanding loved ones and people in a support group can help with feelings of isolation, avoidance or wanting to shut down.

Counseling: A professional counselor offers a comfortable, judgement-free safe space so that you can process your thoughts, feelings and memories in a healthy way. Be kind and patient with yourself. Consistent appointments allow for progress in your recovery.

Journaling: Writing your thoughts, feelings and memories rather than ignoring them or pushing them away allows you to work through them and also help to identify any triggers you may have. Remember that recognizing and processing emotions is a form of strength.

Be honest: If you’re ready, tell your loved ones that you’re living with PTSD—it’s nothing to be ashamed of. Maintain healthy boundaries and communication within your relationships can aid in your recovery.

Educate yourself: By learning about PTSD, it can help you and your loved ones better relate to one another. Let your loved ones know that even just listening to you and your experiences can helpful and is appreciated.

We all struggle at times, but help is here. If you’re unable to express your thoughts, feelings or have trouble with daily functions, consider reaching out to a friend or a healthcare professional.

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Jay Burrows, LCPC, LADC, CCS
Jay Burrows is a Licensed Professional Counselor, a Licensed Alcohol Drug Counselor and Certified Clinical Supervisor. In addition to providing counseling services to clients, Jay assists his colleagues and helps to develop their counseling skills.

Jay attended the University of Southern Maine for his undergraduate degree and for his Master of Science in Counseling with a Clinical Mental Health Concentration. Prior to graduation, Jay completed his internship at a residential program treating mental health disorders along with co-occurring substance use disorders. After graduation, Jay joined Catholic Charities Counseling Services in Portland as a clinical counselor providing outpatient services. He stayed with Catholic Charities for more than eight years. During this time, Jay worked with a co-occurring population who were often incarcerated or involved in the criminal justice system.

This experience led Jay to establish an Intensive Outpatient Group at Catholic Charities, which he facilitated for five years. Here he helped people gain more pro-social attitudes and behaviors, increasing their ability to successfully reintegrate into their communities and decrease their rates of recidivism.

In his role as clinical supervisor at HAM, Jay is dedicated to helping colleagues deliver quality services to their clients while also developing strong professional ethics. He also mentors clinical internship students, preparing them for a future in case work.

Outside work, Jay can be found reading a captivating book or volunteering with his community’s little league. He spends his summers traveling to Bar Harbor with his wife and four children.   

 

Lindsay McKeen, LCSW, CCS
Lindsay McKeen is a Licensed Clinical Social Worker and Certified Clinical Supervisor. In this role, Lindsay reviews client treatment plans, clinical records and the professional concerns and goals of other practitioners.

After attending the University of Maine Orono for her undergraduate degrees in social work and psychology, she then earned her Master of Social Work from the University of New England in Portland. Since then she has worked as a clinician at St. Mary’s Regional Medical Center in Lewiston in the Psych and Chemical Dependency Unit. While there, Lindsay used a strengths-based approach with her clients to identify their goals and treatment plans.

Lindsay received the “Service Star Employee” and “MVP” awards while at St. Mary’s. She is a lifelong learner, always looking to continue her education and professional career (ask her how quickly she can solve a Rubik’s cube)! She has completed many professional trainings including trauma-informed care in behavioral health, cognitive behavioral therapy certification, ethics in boundary setting, motivational interviewing, and art interventions for addiction, anxiety and chronic pain.

When away from work, Lindsay’s favorite place to disconnect is Rangeley, Maine, where she can rejuvenate and be one with nature. There you can find her hand-feeding chipmunks, watching birds and indulging her creative, artsy side.

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Studies have shown that adults with severe mental illness have a shorter lifespan than adults without a diagnosis by an average of 25 years. Additionally, 68% of adults with a mental health diagnosis have at least one chronic disease that limits their daily functioning.

Behavioral Health Home (BHH) programs are evidence-based care-coordination programs designed to reduce the impact of preventable diseases in people with mental health diagnoses by ensuring the coordination of medical and mental health treatment.

This coordination is done by BHH team members, including a wellness coordinator, peer/parent support person, nurse, consulting psychiatrist and primary care provider. The common goal is to address the gaps between physical health and mental health care plans.

BHH participation, when delivered with core principals, improves the outcomes of the individuals served—reducing emergency care visits and hospitalizations and increasing overall quality of life.

How can BHH help my client?

  • BHH creates treatment plans that address client life experiences, chronic stressors, poverty and isolation to reduce the risk of premature death.
  • A BHH team shows clients how to self-manage physical and mental health symptoms through education, coaching, forming support systems and connecting to community resources.
  • Emergency room use, appointment attendance and medication refills are monitored, and clients who have had two or more refills of antipsychotic medications have their blood sugars monitored.
  • Educational and peer support for adults in the program, and support to parents with children in the program, gives clients and their families the opportunity to learn from each other and to foster a sense of belonging and community engagement.

How does it benefit me as a healthcare provider to recommend BHH to my client?

  • Unlike other case management programs, BHH is an easier program to access. It does not require specific criteria relating to mental health diagnoses and you don’t need to write a section 17 letter.
  • The BHH team will ensure that the tools used during a client’s session encourage positive treatment outcomes, and that they continue to use the tools in their home and community.
  • Clients that struggle with chronic illness also struggle to attend appointments. As clients begin to feel better, they find it easier to attend sessions and take advantage of other resources available in the program.

Why HAM is the right BHH provider to partner with.

  • We don’t have a waitlist. We will assign your client within 24 hours and have a team member see them within 4-7 days.
  • We are not case management as usual. We worked with Maine Quality Counts to help design an effective program that adheres to the highest standards of BHH. We are fully committed to model fidelity.
  • We welcome client feedback and offer the ability to participate on an advisory board.
  • Our partnerships are important. We will be proactive in our collaboration with you and you can reach us at any time.
  • We collaborate with other case management programs. If we aren’t the right fit for your client, we will transfer them appropriately. (If your client would benefit from Section 13 or 17, they may still want to continue with BHH to work on self-management skills.)
  • We regularly consult with psychiatrists and primary care providers to ensure that we are educated and that we understand the impact of client treatment plans and interactions.

Do clients need to have a chronic illness to benefit from BHH?

No. If you have clients with mental health diagnoses and they are having challenges at school, work, home or community related environments, BHH can offer them help. The BHH program allows us to work on prevention activities that help with the overall well-being of your client such as nutrition, stress relief, physical activity and tobacco cessation.

Does my client need to have MaineCare?

Yes. A client must have full eligibility in MaineCare to qualify for BHH.

How do I refer a client?

We offer BHH services in Androscoggin County, and are accepting referrals for adults in Oxford and Southern Franklin County and surrounding communities.

Referrals can be made by calling us at (207) 333-3278 or (877) 888-4304. Click here for our online referral form. 

References:
Reisinger-Walker, E & Druss, B. (2011, February). Mental health disorders and medical co-morbidity. The Synthesis Project. Retrieved from: http://www.integration.samsha.gov/workforce

The Center for Integrated Health Solutions, SAMSHA-HRSA. (2012, May). Behavioral health homes for people with mental health and substance abuse conditions: The core clinical features. Retrieved at: http://www.integration.samsha.gov/workforce

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