/ en Mon, 28 Apr 2025 03:10:33 -0500 Mon, 10 Mar 25 11:04:32 -0500 /role-hospitals-new-behavioral-health-center-offers-walk-mental-health-services-lancaster-general-hospital <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-6"><p><img src="/sites/default/files/2025-03/ths-penn-lancaster-behavioral-health-center-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Penn Lancaster. A female counselor holding a clibpoard and pen sits listening to a male patient" width="700" height="532"></p></div><p>People in need of immediate help with mental health issues have a new option for treatment with the opening of the <a href="https://www.lancastergeneralhealth.org/services-and-treatments/behavioral-health" target="_blank">Behavioral Health Center</a> at Lancaster General Hospital. Its Crisis Walk-In Center provides immediate behavioral health assessments and treatment, serving as a bridge to ongoing care.</p><p>The Interventional Psychiatry Program focuses on psychiatric conditions that don't respond well to first-line treatments. The center is expected to serve 900 patients annually for interventional psychiatry and 10,000 patients through the walk-in center, both in-person and by phone.</p><p>Patients visiting the walk-in center are greeted by a certified peer support specialist and connected with a registered nurse for a physical health assessment. If needed, they receive immediate counseling and are referred to the next level of service or scheduled for another appointment.</p><p>The center provides appointments and medication for up to 30 days before referring patients to longer-term services, aiming to reduce the boarding of low-risk behavioral health patients in the emergency department.</p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/community-benefit">Benefiting Communities</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 10 Mar 2025 11:04:32 -0500 Behavioral Health Intervention & Issues Prevention /role-hospitals-university-rochester-medical-center-researchers-uncover-possible-new-biomarker-psychosis-diagnosis <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-6"><p><img src="/sites/default/files/2025-03/ths-RochesterMedical-NY-MRI-700x532.jpg" data-entity-uuid data-entity-type="file" alt="University of Rochester Medical Center. Stock image of a series of brain scans displayed on a viewing board" width="700" height="532"></p></div><p>Researchers at the Del Monte Institute for Neuroscience at the University of Rochester in New York are investigating a potential biomarker in the brain that could diagnose psychosis before symptoms appear. Identified through MRI scans, this biomarker shows differences in brain connectivity, particularly in sensory regions and the thalamus.</p><p>“Establishing such biomarkers could provide a key step in changing how we care for, treat, and offer interventions to people with psychosis,” said researcher Brian Keane, Ph.D., assistant professor of Psychiatry, Center for Visual Science, and Neuroscience at the University of Rochester Medical Center.</p><p>The study involved 159 participants and found that these connectivity patterns could predict psychosis onset and help stratify patients for personalized treatment. Establishing such biomarkers could revolutionize how psychosis is treated, offering more timely and effective interventions.</p><p>A single five-minute MRI scan could potentially predict which at-risk individuals will develop psychosis, allowing for earlier and more targeted treatments. Future research aims to determine if this biomarker appears before or as psychosis begins.</p><p><a class="btn btn-primary" href="https://www.urmc.rochester.edu/news/publications/neuroscience/researchers-uncover-possible-new-biomarker-for-psychosis-diagnosis">LEARN MORE</a></p><p> </p></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 06 Mar 2025 13:51:56 -0600 Behavioral Health Intervention & Issues Prevention /role-hospitals-uvm-medical-center-mental-health-urgent-care-opens-vermont-addressing-critical-community-health-need <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><p><img src="/sites/default/files/2025-03/ths-uvm-mental-health-urgent-care-2-700x532.jpg" alt="UVM Medical Center. A female counselor in casual attire sits holding a tablet and listening intently to a female patient" width="700" height="532"></p></div><p>When individuals experience mental health distress, many will visit a hospital emergency department — a setting that may not be ideal for someone experiencing acute mental health illness. To provide a safe alternative to the ED and help people before they experience a mental health crisis, University of Vermont Medical Center in Burlington, Vt., and several other organizations worked together to open the <a href="https://www.uvmhealth.org/medcenter/location/mental-health-urgent-care" target="_blank">Mental Health Urgent Care</a> in October 2024.</p><p>Developed by UVM Medical Center, Howard Center, Pathways Vermont, Community Health Centers and the Vermont Department of Mental Health, the Mental Health Urgent Care offers mental health services, peer support and help accessing follow-up services to guests — intentionally called “guests,” not patients or clients. The urgent care team emphasizes it is a calming, welcoming environment for those experiencing trauma or struggling with thoughts of suicide. An onsite nurse also is available to address basic physical health issues.</p><p>People don’t need to have a referral from a provider or make an appointment beforehand to access these services, and currently there are no financial requirements or costs as services are fully funded for three years. The only requirement is that guests must be 18 years or older.</p><p>The collaborating organizations say the Mental Health Urgent Care is a welcome development in addressing a pressing community health need. “When we were thinking through this project, we wanted to build something that somebody could go to when they start to feel a crisis coming on, before they get to the point where they can’t stand it any longer,” said Maureen Leahy, administrative director of UVM Health Network’s psychiatry service.</p><p><a class="btn btn-primary" href="https://www.uvmhealth.org/healthsource/we-dont-want-people-have-jump-through-any-hoops" target="_blank">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/center/population-health">Improving Health and Wellness</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 03 Mar 2025 13:40:53 -0600 Behavioral Health Intervention & Issues Prevention <div class="container"><div class="row"><div class="col-md-8"><p>Behavioral health providers that are members of the ���������� Association add their voice and influence to the nation’s leading advocate for hospitals and health systems. The AHA provides its behavioral health members with valuable benefits, including <strong>advocacy, resources and initiatives designed to improve access to and strengthen the delivery of affordable, high-quality behavioral health care.</strong></p><h2><span>Advocacy</span></h2><p>We are working with Congress and the administration to enact policies to support behavioral health hospitals and service lines, and to solidify a policy environment that protects access to care, advances innovation and invests in behavioral health treatment.</p><h3><span>2024 Results</span></h3><h4><span>Legislation</span></h4><p>The AHA supports the <a href="/2024-11-12-aha-urges-congress-act-key-priorities-lame-duck-session" target="_blank"><strong>extension of Medicare telehealth programs</strong></a><strong> </strong>which have expanded access to care for patients and eliminates originating site restrictions. Congress included a 90-day extension of these flexibilities through March as part of a bill to fund the government passed at the end of 2024.</p><h4><span>Regulatory</span></h4><p>The Drug Enforcement Administration and Department of Health and Human Services responded favorably to the AHA’s request to extend telehealth flexibilities, which <a href="/special-bulletin/2024-11-18-dea-and-hhs-extend-waivers-prescribing-controlled-substances-through-telemedicine" target="_blank"><strong>will waive an in-person visit requirement prior to the prescribing of controlled substances virtually</strong></a> through 2025.</p><h4><span>The Administration</span></h4><ul><li>The Departments of the Treasury, Labor and Health and Human Services issued a final rule in 2024 implementing AHA-supported amendments to existing standards <a href="/special-bulletin/2024-09-10-administration-finalizes-enhanced-mental-health-parity-regulations?utm_source=newsletter&utm_medium=email&utm_campaign=bh-newsletter&mkt_tok=NzEwLVpMTC02NTEAAAGV8htmojsDNTwbod7zQq2dwKUPGI77ow9r7O2wAfG9sWn_1yy2QnT2LyJgiJg_Sj3aHa80ELdYu_N93tNiBNk2e9_FQgwY5_RnLpuKFb0XRKLTaA" target="_blank"><strong>that will support coverage parity</strong></a>, preventing insurance plans and issuers from placing greater limits on access to mental health and substance use disorder benefits as compared to medical and surgical benefits. </li><li>Following years of advocacy from the AHA, the Substance Abuse and Mental Health Services Administration in 2024 finally <a href="/special-bulletin/2024-02-09-hhs-finalizes-changes-information-sharing-requirements-addiction-treatment" target="_blank"><strong>issued</strong></a><strong> modifications of provisions of the law that governs sharing of patient records regarding treatment for substance use disorder</strong>, aligning requirements with those already in effect under the Health Insurance Portability and Accountability Act (HIPAA). </li><li>Upon AHA’s <a href="/lettercomment/2024-01-05-aha-comments-cms-proposed-medicare-advantage-policies-2025" target="_blank"><strong>urging</strong></a>, the Centers for Medicare and Medicaid Services (CMS) finalized provisions to address gaps in access to behavioral health services for Medicare Advantage beneficiaries. </li><li>As a direct result of AHA advocacy, CMS <a href="/news/headline/2024-10-22-cms-releases-final-guidance-hospital-respiratory-data-condition-participation-reporting-requirements" download="file" target="_blank"><strong>updated</strong></a> guidance detailing reporting requirements for the hospital respiratory data collection condition of participation and will allow psychiatric hospitals to report this data annually as opposed to weekly</li></ul><hr><h2><span>Sharing Solutions & Innovations from the Field</span></h2><p>In addition to a daily news bulletin and advocacy alerts on key issues, AHA members receive the <a href="/bibliographylink-page/2017-12-11-behavioral-health-updates" target="_blank"><strong>Behavioral Health News Update</strong></a> – a monthly communication on recent behavioral health advocacy initiatives, resources and educational offerings.</p><p> </p><h4><span>Grant-Supported Work</span></h4><p>The Centers for Disease Control and Prevention has awarded several grants to the AHA to support work in behavioral health, including a <a href="/suicideprevention/health-care-workforce" target="_blank"><strong>program to address health care worker suicide</strong></a>, and hospital and health system initiatives to address opioid and stimulant use disorder along with infection prevention and control.</p><h4><span>Health Care Worker Well-Being</span></h4><p>A wealth of resources on <a href="/physician-alliance-be-well" target="_blank"><strong>building and sustaining</strong></a> health care worker well-being programs are frequently being updated and shared with the field including <a href="/be-well-case-studies" target="_blank"><strong>case studies</strong></a> and podcasts. Information on a health system’s <a href="https://www.youtube.com/watch?v=qU1dwaAzh1E" target="_blank"><strong>peer support program</strong></a> and commentary on the importance of <a href="https://www.youtube.com/watch?v=ahEZfOS-4mk" target="_blank"><strong>stigma reduction</strong></a>among health care workers suffering from mental health challenges are among content recently released to the field.</p><p><span>AHA’s website for Behavioral Health is regularly updated with information and resources. These include:</span></p><ul><li><a href="/aha-search?search_api_fulltext=behavioral%20health&f%5B0%5D=type%3A5705" target="_blank"><strong>Podcasts </strong></a>featuring conversations with behavioral health professionals on innovations and solutions to challenges. </li><li><a href="/system/files/media/file/2024/12/integrating-physical-behavioral-resources-2024%20final.pdf" target="_blank"><strong>Insights on integrating behavioral health</strong></a> with physical care, including a new <a href="https://www.youtube.com/watch?v=Xv7-sxVKmzU" target="_blank"><strong>educational video</strong></a> aimed at trustees. </li><li>Best practices to <a href="/behavioral-health-community-partnerships" target="_blank"><strong>improve access to behavioral health care through community partnerships</strong></a>. Resources include an assessment checklist and an evidence-informed summary of effective partnerships. </li><li>Centralized resources to address the challenges of<a href="/child-and-adolescent-mental-health" target="_blank"><strong>youth</strong></a> and <a href="/maternal-mental-health" target="_blank"><strong>maternal</strong></a> behavioral health service delivery. </li><li>AHA’s <a href="/people-matter-words-matter" target="_blank"><strong>People Matter, Words Matter</strong></a> initiative – helping to reduce the stigma of mental health and addiction conditions and treatment, one word, one person at a time. </li><li>An AHA members-only <a href="https://membercommunity.aha.org/communities/community-home?CommunityKey=d8e79990-e8f4-4402-9239-e511752bab7b" target="_blank"><strong>professional online network</strong></a> for behavioral health leaders. </li><li>Curated resources to enhance your organization’s participation in <a href="/mental-health-awareness-month" target="_blank"><strong>Mental Health Awareness Month.</strong></a></li></ul><p> </p></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/02/2025_WeareAHA_Behavioral_Health_Final.pdf" target="_blank"><img src="/sites/default/files/2025-02/weareaha-bh-2025-cover.png" data-entity-uuid data-entity-type="file" alt="We are AHA Behavioral Health Cover." width="691" height="893"></a></p></div></div></div> Wed, 26 Feb 2025 12:20:53 -0600 Behavioral Health Intervention & Issues Prevention /role-hospitals-rose-medical-center-trained-dogs-working-inside-hospitals-help-ease-burnout-among-health-care-staff <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><p><img src="/sites/default/files/2025-02/ths-rose-med-ctr-therapy-dogs-700x532.jpg" alt="Rose Medical Center. A golden retriever sniffs a smiling female health worker wearing scrubs" width="700" height="532"></p></div><p>At HCA HealthONE Rose Medical Center in Denver, two wagging tails, belonging to therapy dogs, bring smiles and a sense of peace to the hardworking staff.</p><p>These dogs aren't just visitors; they're part of the team, providing much-needed emotional support to the medical staff. Dr. Susan Ryan, an emergency medicine physician, knows firsthand the benefits of having a canine companion at work. After experiencing PTSD from her years in the ER, she found solace in a Labrador named Peppi. The presence of these dogs helps staff decompress and take a breather from their high-stress environment, proving that a wagging tail can be the best medicine.</p><p>"A dog can be that calming influence," Ryan told NPR. "You can get down on the ground, pet them, and you just get calm."</p><p>The dogs are kept away from allergic patients and washed regularly to prevent germs from spreading, and people must wash their hands before and after petting them.</p><p>The hospital's CEO, Casey Guber, is such a fan of the canine connection that he even has his own dog, Ralphie, who holds the title of Chief Dog Officer. Ralphie and the other therapy dogs have become beloved members of the hospital community, bringing joy and comfort to everyone they meet.</p><p>Whether it's a surgeon rolling on the ground with Ralphie or a nurse taking him for a walk, these dogs are making a pawsitive impact on the mental health and morale of the hospital staff.</p><p><a class="btn btn-primary" href="https://www.npr.org/sections/shots-health-news/2025/01/24/nx-s1-5271595/hospital-trained-dogs-medical-burnout-doctors-nurses-suicide-risk-stress-denver">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/center/population-health">Improving Health and Wellness</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Fri, 21 Feb 2025 13:14:30 -0600 Behavioral Health Intervention & Issues Prevention /role-hospitals-mercy-hospital-oklahoma-city-introduces-new-training-better-serve-patients-autism <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-5"><p><img src="/sites/default/files/2024-09/ths-mercy-ok-autism-ed-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Mercy Hospital. A doctor offers a teddy bear to a little girl and her parents" width="700" height="532" class="align-left"></p></div><p>A trip to the hospital emergency department can be overwhelming for anyone, but for individuals with autism, the stress can be significantly heightened.</p><p>Mercy Hospital has recently begun training its ED staff to enhance their ability to care for patients with autism. The training focuses on understanding sensory overload and implementing effective interventions, including the use of sensory kits, according to Chandee Kott, program director at the Autism Foundation of Oklahoma.</p><p>Recognizing that sensory overload can be a significant issue for individuals with autism, the staff at Mercy are now better equipped to offer appropriate interventions and support. "We discuss how to identify sensory overload and effectively use a sensory kit to assist patients," explained Chandee Kott, program director at the Autism Foundation of Oklahoma.</p><p>Kott emphasized the importance of recognizing sensory sensitivities in patients with autism, whether it is due to loud noises, crowded spaces or harsh lighting. "If a patient comes in experiencing these challenges, it's vital for health care staff to notice and take steps to alleviate their discomfort," Kott said.</p><p>This new training initiative aims to make ED visits less daunting for patients with autism. Mercy Hospital is leading the way as the first hospital in Oklahoma to implement this specialized training for its staff.</p><p>The Autism Foundation of Oklahoma spearheaded the training, which was inspired by a nurse at Mercy who is also the mother of a 6-year-old autistic boy.</p><p>"As a parent, I know how stressful even a routine doctor's appointment can be for my son. An emergency room visit is exponentially more difficult because we can’t take the time to calm him down," said Shannon Montgomery, an ED nurse at Mercy Hospital.</p><p>Montgomery hopes that increasing awareness and understanding of autism within the health care system will make a significant difference for children like her son. She emphasized the importance of expanding this knowledge across the health care field to better support patients with autism and their families.</p><p><a class="btn btn-primary" href="https://www.koco.com/article/oklahoma-mercy-autism-foundation-partnership/46873493">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 05 Sep 2024 11:16:08 -0500 Behavioral Health Intervention & Issues Prevention /advancing-health-podcast/2024-08-12-youth-crisis-how-innovative-program-addressing-pediatric-mental-health <p>Nationwide, there is a critical shortage of trained care providers to meet the needs of kids struggling with mental health issues, and the problem is especially acute in rural areas. In this conversation, three experts from Dartmouth Health discuss their five-part virtual behavioral health training program, "Keeping Students Safe: Supporting Youth in Mental Health Distress." Backed by a federal grant, the program offers tools for care providers to help guide young people through their mental health challenges.</p><p><a href="https://video.dartmouth-hitchcock.org/playlist/dedicated/1_3g66mb6m/1_pvvjilri" target="_blank" title="Dartmouth Health—Project ECHO: Student Safety: Accessing Suicide Risk in Students video.">Learn more about Dartmouth Health's innovative program.</a></p><hr><div></div><hr><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00:00:00:18 - 00:00:20:26<br> Tom Haederle<br> Experts say at least one in five children or adolescents in a pediatric waiting room is dealing with a significant mental health problem — everything from serious eating disorders to suicide attempts. Nationwide, there has long been a critical shortage of trained care providers to meet the needs of kids struggling with these issues. And the problem is especially acute in rural areas. </p> <p> 00:00:20:29 - 00:00:42:06<br> Tom Haederle<br> So it's encouraging to see that the most rural academic health system in the U.S., New Hampshire's Dartmouth Health, has created one of the most innovative and effective programs anywhere to provide the tools to help. </p> <p> 00:00:42:09 - 00:01:09:27<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA Communications. Sitting near the border with Vermont, Dartmouth Health serves a population of nearly two million people across many small towns in northern New England. Backed with a federal grant, Dartmouth has created a five-part virtual behavioral health training program for children and adolescents that offers care providers effective tools to engage and help guide young people through their challenges. </p> <p> 00:01:09:29 - 00:01:37:00<br> Tom Haederle<br> The program is called Keeping Students Safe: Supporting Youth in Mental Health Distress. In dialogue about the program with Jordan Steiger, AHA senior program manager for clinical affairs and workforce, are three experts from Dartmouth Health. Dr. Julie Balaban, child psychiatrist, Jackie Pogue, research project manager with the Dartmouth Institute for Health Policy and Clinical Practice, and Barbara Dieckman, director of Knowledge Map and patient education. </p> <p> 0:01:37:02 - 00:01:53:18<br> Jordan Steiger<br> Julie, I'm wondering if you can kick this off being that you are a child and adolescent psychiatrist, but we know it's been all over the news that since the start of the pandemic, a lot of children and adolescents are really struggling with their mental health. So could you kind of just paint the picture for us of what that's looking like right now? </p> <p> 00:01:53:25 - 00:02:21:09<br> Julie Balaban, M.D.<br> Yeah, I think there's actually been a problem with meeting the needs of children and adolescent mental health for a long time, because there's always been a critical shortage of mental health providers in general, and specifically for children and adolescents in that area of specialty. And then the pandemic really highlighted that the kids that were coming into the emergency room were seriously ill. </p> <p> 0:02:21:11 - 00:02:43:17<br> Julie Balaban, M.D.<br> Significant eating disorders, very serious suicide attempts. That's what was showing up during that time. And I think that really brought to light that this was an area of great need for a long time. So it's been well known that historically, that one in five kids in a pediatric waiting room, for example, will have a significant mental health problem. </p> <p> 00:02:43:17 - 00:03:10:14<br> Julie Balaban, M.D.<br> That number may now be higher, maybe one in four. And depending on what region you live in of course. The other piece that the pandemic played into is of course the general workforce shortage. So nursing shortage, for example, is a problem that's been affecting things like inpatient beds for kids who might need a psychiatric hospitalization. So hospitals have had to decrease their bed size. </p> <p> 00:03:10:14 - 00:03:34:05<br> Julie Balaban, M.D.<br> And so that led to a backlog for kids who were seriously ill, having to be in emergency rooms or even waiting at home. At Dartmouth, we had the luxury of being able to put some of those kids, at least up on a pediatrics unit, so they were around other kids and not in a general emergency department, which can be a scary place for a kid. </p> <p> 00:03:34:07 - 00:03:58:09<br> Jordan Steiger<br> Absolutely. And I mean, I know that this is a problem that is affecting communities, hospitals, health systems across the country. We hear it all the time at AHA. You know, we need to provide support to children and adolescents. I know you mentioned some pretty severe things like suicidal ideation, you know, severe and persistent mental illness that we know can continue to get worse when they are not treated. </p> <p> 00:03:58:11 - 00:04:14:27<br> Jordan Steiger<br> What I love about the work that you all are doing is that you're not just sitting back and saying, this is bad, what are we going to do? You've taken the steps to do something about it, and kind of brought your entire community and state along for the ride with you. So I would love to hear kind of what you're doing. </p> <p> 00:04:14:27 - 00:04:25:11<br> Jordan Steiger<br> I know that you have a virtual behavioral health training program for children and adolescents, and teaching people how to respond. Is that correct? Jackie? Can you tell us a little bit more about it? </p> <p> 00:04:25:11 - 00:04:49:09<br> Jackie Pogue<br> Sure. So we received a grant from HRSA around training rural behavioral health workers, very broadly defined. And we knew we wanted to focus on youth mental health. But, you know, we can't, like, grow a bunch of new psychiatrists in three years or, you know, things like that, we're trying to think creatively about where might be points of intervention that could have a bigger impact. </p> <p> 00:04:49:12 - 00:05:32:04<br> Jackie Pogue<br> So we met with a lot of different stakeholder groups, a lot of people from schools. So school counselors, school principals, other folks hearing about how youth mental health was impacting kids at school. So it could be things like really disruptive classroom behavior, kids who are kind of languishing, like just showing up but not thriving, right. A lot of kids wandering the hallways and hearing some of those stories, and also educators and people on the school staff, like really trying to work together for the increased severity and number of kids who were in having mental health challenges. </p> <p> 0:05:32:05 - 00:05:55:22<br> Jackie Pogue<br> So through those conversations, we developed, five-series training called Keeping Students Safe: Supporting Youth and Mental Health Distress. And we designed the program so that way to kind of fill some of these gaps that we heard from the schools. So they're like, well, they said they're very sick, but they went to the hospital and they sent them home. </p> <p> 00:05:55:24 - 00:06:17:06<br> Jackie Pogue<br> Like, why didn't they admit them? They're still so sick, or, oh, they went to the hospital and they came back and they're still really having problems, like what's going on. And so we realized there were, there are these kind of siloed systems, and to be able to share information and, you know, sort of promote more collaboration and give people more tools. </p> <p> 00:06:17:09 - 00:06:45:11<br> Jackie Pogue<br> What's been interesting is sort of helping people learn about all the skills they already do have, you know. I think there's a lot of fear from people that they're gonna say the wrong thing or that they don't have the tools, and not everybody is going to administer like a Columbia scale around suicide severity, right. But like especially school staff, I mean, they're amazing, you know, they're like, yeah, I talk to this kid every day. </p> <p> 00:06:45:11 - 00:06:55:27<br> Jackie Pogue<br> We do a check-in. We do these things like so just helping them feel more confident and that there's more details on it left out. Julie or Barb, what what else would you add? </p> <p> 00:06:56:00 - 00:07:26:16<br> Julie Balaban, M.D.<br> I think you did a great job, Jackie, of describing. I think what I would add is each time that we do the program, we learn from what our experience is, so that we can fine tune the content to better address what's coming up from the participants as what their needs are. And I think the other really nice aspect of the way the program runs through the I ECHO format is this all teach, all learn model. </p> <p> 00:07:26:19 - 00:07:55:04<br> Julie Balaban, M.D.<br> So not only, as Jackie said to people already innately have a lot of skills that they can bring. They just don't realize that it's useful. But they also all have a lot of help and support for each other and very practical resources. You know, we'll hear schools from the northern part of the state talking about something that they're doing, and then someone in the southern part of the state will connect with them offline to find out how they could implement the same thing in their school. </p> <p> 00:07:55:10 - 00:08:17:04<br> Julie Balaban, M.D.<br> So it's just been a wonderful way to build connections and networks that otherwise would never have happened, and all in the name of supporting youth in their schools. And our hope being that with those added resources and support, that kids will do better sooner and won't get to that severe level where they need to go to the emergency room or need to access things. </p> <p> 00:08:17:12 - 00:08:23:21<br> Julie Balaban, M.D.<br> But we also tell them how to handle that and what they have available to support them if they should need to. </p> <p> 00:08:23:23 - 00:08:52:06<br> Barbara Dieckman<br> I would agree with both of you. You know, I think that the ability to intervene in a kid's life earlier or in their where are you beginning to see some problems at school and having people that have those natural relationships with kids actually do something or be able to reach out and touch them is really helpful. I think just to decrease the demand on the whole acute care system. </p> <p> 0:08:52:08 - 00:09:17:26<br> Jordan Steiger<br> Absolutely. And I love, you know, through this program, you've kind of addressed some of those workforce issues that we hear about, maybe not directly, you know, but bringing people in like a coach, like a school nurse, like a principal, people like you said, Barb, that have contact with these children every day, that know them, that know their lives and can intervene, I think, takes so much stress off of the local health care system, as you all have mentioned. </p> <p> 00:09:17:29 - 00:09:37:07<br> Jordan Steiger<br> And I think that's so important because as you said, Jackie, we can't grow psychiatrists on trees. That's going to take a little time to build the workforce. So this is, I think, just such a great example that others can emulate and really implement in their own states. But I'd love to hear a little bit, maybe about some of the positive outcomes that you've seen. </p> <p> 00:09:37:15 - 00:10:21:23<br> Jackie Pogue<br> So we've done this five, it's a five-session one hour Zoom like every couple weeks. Usually. So we've run that five times. We've probably had 500 total people participate. It's been very, very popular. And some of the outcomes that we've heard, we do a pre/post course survey and we do a follow-up three months later. So things that people talked about are feeling more confident that they could intervene with a student in distress, that they knew the resources that were available and that they felt more confident interacting with youth's families as a resource and also other community resources. </p> <p> 00:10:21:26 - 00:10:57:29<br> Jackie Pogue<br> One outcome that we're really proud of is that, like 100% in every session, people talk about having a decreased sense of professional isolation. And so that is really powerful for us, knowing that people are, you know, just like in health care, school staff are very stressed. They've had a really hard time from the pandemic and now, and to be able to provide an opportunity for people to connect, to not feel so alone, right, that there's resources and there's hope has been really very meaningful I think for our team. </p> <p> 00:10:58:01 - 00:11:15:28<br> Jordan Steiger<br> That's great. I think, you know, sometimes we all get in our own bubbles and lanes and think, oh, we are the hospital. We can only solve problems for patients and families once they walk through the doors. But I think this proves that there are a lot of ways to partner with your community and to really improve the way that we respond as a whole. </p> <p> 00:11:15:28 - 00:11:28:20<br> Jordan Steiger<br> And I think that's really, really powerful, especially when we're talking about maybe smaller rural communities that we do know have some issues sometimes with workforce, with access, with things like that. I think this is just such a great example. </p> <p> 00:11:28:23 - 00:11:56:13<br> Jackie Pogue<br> Yeah. With youth mental health, it's just, it's such a crisis, right. And it's really an all hands on deck situation. And there's so many areas where people can act. And so that's really you know, when I think about the stats, it's really sobering. And then I think about all the caring school staff and community youth supporters and other folks that I have, that we've met through our Project ECHO. </p> <p> 00:11:56:15 - 00:11:58:09<br> Jackie Pogue<br> It really gives me a lot of hope. </p> <p> 00:11:58:11 - 00:12:19:09<br> Julie Balaban, M.D.<br> Yeah, I think one of the things that was an unexpected outcome for me, anyway, was hearing from the community, you know, we know this is a crisis and I come at it particularly from a clinical perspective. And what are we doing and how are we seeing these kids, and what kinds of things can we do to increase access to specialty care and all of that? </p> <p> 00:12:19:12 - 00:12:45:19<br> Julie Balaban, M.D.<br> And then talking to not just the schools, but particularly when we did the community programs, town libraries, we had a lot of librarians participate, and the stories that they tell about what they're doing and how they're trying to hold these kids together and what they have to manage in their setting with even less support than a school setting would have </p> <p> 00:12:45:21 - 00:13:09:21<br> Julie Balaban, M.D.<br> for example, it really opened my eyes to how this problem is just not just pervasive, but is really affecting people in the community so strongly, even if it's not the family member of the kid or the school trying to educate the kid. Like everybody is experiencing it, everybody is struggling. It was really something. </p> <p> 00:13:09:24 - 00:13:16:22<br> Jordan Steiger<br> That is. What other types of professionals were involved in that community ECHO that you ran? </p> <p> 00:13:16:24 - 00:13:57:03<br> Julie Balaban, M.D.<br> So we had some faith leaders from the community. We particularly ended up with our panel trying to include more of the community members for that reason, because we previously had had a lot of school people because we were dealing with school. And then of course, the hospital psychologists and myself and the typical sort of providers for kids. But we've very much have learned that if we're doing a program for a particular group of stakeholders, you need to have representation from that group on your panel, or you'll miss the boat in a number of things, even if it's just like when to schedule the sessions. </p> <p> 00:13:57:05 - 00:14:12:07<br> Julie Balaban, M.D.<br> So we had faith leaders, we had the coaches, we had rec department people, we had a daycare provider participate. People from some of the like, family support centers throughout the region. Those kinds of people. </p> <p> 00:14:12:09 - 00:14:37:15<br> Barbara Dieckman<br> You know, I would add to that, what is so good about doing this in a virtual way is that people didn't have to come to a meeting, central location. We've got mountains and you know everything else, right? And like every other rural community, there's distance, right? And there is hardship in terms of transportation and getting time off. None of that had to happen. </p> <p> 00:14:37:23 - 00:14:53:13<br> Barbara Dieckman<br> I mean, what we were able to do is to bring these people together from very disparate areas geographically to talk about something that they all cared about, and they all had very similar themes of need and solutions for each other. </p> <p> 00:14:53:15 - 00:15:12:10<br> Jordan Steiger<br> I think that's really powerful and especially like you mentioned, just, you know, addressing some of those, you know, transportation, some, you know, that distance between people, I think is something that I think many people will resonate with that are listening, you know, finding easier ways to connect people. And I think you guys have done that really, really well. </p> <p> 00:15:12:12 - 00:15:22:20<br> Jordan Steiger<br> As we wrap up, if you maybe have inspired somebody that is listening to, you know, implement something like this at their own hospital or health system, what advice would you give them? </p> <p> 00:15:22:23 - 00:15:49:00<br> Julie Balaban, M.D.<br> I would say do it. You know, we used a particular program that I ECHO program because Dartmouth has joined that group. But you can do this without any sort of a formal program. In our presentation, in our handouts, we particularly put a lot of that information because we want people to be able to emulate it within their own setting with whatever they can do and whatever resources they have, and it doesn't have to be costly at all. </p> <p> 00:15:49:03 - 00:16:14:16<br> Julie Balaban, M.D.<br> So I would say just jump in and do it. And I think, again, I think the important pieces are to go to the group you're trying to reach and hear from them. As Jackie talked about what they see as their needs, because we had guesses about things. But I think we did a better program because we worked from their perspective and what they were telling us. </p> <p> 00:16:14:19 - 00:16:24:18<br> Julie Balaban, M.D.<br> And then also to keep that good representation on your planning committee and on your panel so that you're really keeping a nice, well-rounded group going. </p> <p> 00:16:24:20 - 00:16:29:12<br> Jordan Steiger<br> Great, thanks Julie. Barb, Jackie, any advice you'd want to share? </p> <p> 00:16:29:14 - 00:16:43:01<br> Barbara Dieckman<br> Know that you can make a difference. Know that you can make a difference and just keep keep doing it. Keep improving. Keep looking for ways to hear from the people that are your audience. You can do it. </p> <p> 00:16:43:04 - 00:17:05:29<br> Jackie Pogue<br> I would add, you know, I think Project ECHO is a really great training platform and format, but like Julie said, you don't need to do Project ECHO to do a good program. And the things that I really value about ECHO and what we've been doing is you don't need to have a bunch of fancy experts like talking, talking, talking, right? </p> <p> 00:17:05:29 - 00:17:33:11<br> Jackie Pogue<br> The beauty of a more interactive, all teach, all learn there is the sense that you're relinquishing some control over your program, but it ends up providing space and being more powerful, I think. And that is, that's just how adults learn, right? Like giving each other advice and ideas and stuff that you can apply right away. So, you know, I've facilitated all the sessions. </p> <p> 00:17:33:11 - 00:17:52:11<br> Jackie Pogue<br> It's super fun for me to just, you know, don't know what people are going to say. And, in that way, yeah, it's just it's really rewarding. So I would say even if you're not going to use Project ECHO, I would encourage you to if you're going to do a session, have half of it be something where the audiences interacting and sharing with each other. </p> <p> 00:17:52:14 - 00:18:10:20<br> Jordan Steiger<br> I love that all teach, all learn model. I think that is so effective and just want to thank all of you again for joining us. I think the work that you're doing across your state is truly phenomenal. And like I said, something that others can really learn from. So we appreciate you sharing. And Julie, I know you mentioned you put some notes in your presentation. </p> <p> 00:18:10:20 - 00:18:17:03<br> Jordan Steiger<br> We can make sure maybe to add those to the podcast description so others can also learn from that. As long as that's okay. </p> <p> 00:18:17:03 - 00:18:18:01<br> Julie Balaban, M.D.<br> That would be great. </p> <p> 00:18:18:01 - 00:18:21:12<br> Jordan Steiger<br> Wonderful. So thank you so much again. </p> <p> 00:18:21:15 - 00:18:29:23<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Mon, 12 Aug 2024 06:00:00 -0500 Behavioral Health Intervention & Issues Prevention /news/chairpersons-file/2024-07-29-chair-file-leadership-dialogue-recognizing-and-addressing-anxiety-robert-brady-dartmouth <p>In this episode, I talk with my colleague Robert Brady, who leads the Anxiety Disorders Service at Dartmouth Health. He specializes in assessing and treating patients with anxiety and other disorders to help them overcome emotional and behavioral patterns that prevent them from being their most effective and engaged selves.</p><p>This discussion is especially important given our current environment, when events from national news to personal challenges can ratchet up our individual anxiety. Robert shares that more than 30% of Americans have diagnosed anxiety disorders and almost all of us will suffer from anxiety at some point in our lives. That makes it critically important for our communities, patients, families and workforce to have tools they need to reduce stress and anxiety — to improve both their psychological and physical health.</p><p>In our conversation, Robert and I talk about young adults and the pressures they are facing that can lead to increased levels of anxiety. We also discuss how older adults, who may begin to suffer from anxiety and depression as they age, can manage those difficult emotions. Robert also offers his thoughts and expertise about working with caregivers and shares some suggestions to help decrease uncertainty and anxiety.</p><p>I hope you find these conversations valuable. Look for them once a month as part of the Chair File.</p><p><a href="https://www.youtube.com/watch?v=T-queynyeLE&t=25s" target="_blank" title="YouTube: https://www.youtube.com/watch?v=T-queynyeLE&t=25s">Watch the episode on YouTube.</a></p><hr><p> </p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00;00;00;14 - 00;00;26;05<br> Tom Haederle<br> Money worries. The job. A personal relationship. The daily news headlines. All of these things and many more can cause anxiety and stress. In fact, experts note that anxiety and stress are 100% common, in that everyone - from all walks of life - feel some level of these things practically every day. Managing stress is more important than ever. But these emotions can gain the upper hand for many people </p> <p> 00;00;26;09 - 00;00;38;27<br> Tom Haederle<br> and that's when it's time to reach out for help. </p> <p> 00;00;38;29 - 00;01;15;08<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA communications. In this month's Leadership Dialogue series podcast, Dr. Joanne Conroy, CEO and president of Dartmouth Health and the 2024 Board Chair of the ���������� Association, invites an expert colleague from Dartmouth Health to discuss ways to manage stress. They talk about how to tell the difference between the normal, garden-variety anxieties of everyday life, and the kinds of stress and anxiety levels that affect roughly one-third of the US population and limit enjoyment of life. </p> <p> 00;01;15;10 - 00;01;43;24<br> Joanne M. Conroy, M.D.<br> Thank you for joining us today for another AHA Leadership Dialogue discussion. It's great to be with you. I'm Joanne Conroy, CEO and president of Dartmouth Health and currently the chair of the ���������� Association Board of Trustees. I look forward to our conversation today, and I'm delighted to have my colleague, Dr. Robert Brady, join us. Robert leads our anxiety disorder service at Dartmouth-Hitchcock Medical Center. </p> <p> 00;01;43;27 - 00;02;01;11<br> Joanne M. Conroy, M.D.<br> He originally trained at the University of Arkansas, where he earned his doctorate in clinical psychology, later doing some post-doctoral work with the VA, and has now been at Dartmouth here for almost ten years. Robert, thank you for joining us. </p> <p> 00;02;01;13 - 00;02;01;28<br> Robert Brady<br> Good to be with you, Joanne. </p> <p> 00;02;01;28 - 00;02;38;09<br> Joanne M. Conroy, M.D.<br> Our health system along with many others across the country, is deeply committed to ensuring that our patients and our communities have access to the full range of behavioral health services. This is especially important given our current environment, when events from national news to personal challenges can really ratchet up an individual's anxiety. Coverage of wars, the recent assassination attempt of a candidate running for office, and various other headlines create anxiety for people across the country. </p> <p> 00;02;38;12 - 00;03;09;29<br> Joanne M. Conroy, M.D.<br> That on top of everyday stress that people are trying to manage makes it all more important for our communities, our patients, our families and our workforce to have the tools they need to identify and reduce stress and anxiety. We know anxiety is actually quite common, and it's an issue for many people in all walks of life. Robert is going to answer a lot of questions for us about anxiety and the incidents and how we actually manage it as an individual and a community. </p> <p> 00;03;10;01 - 00;03;22;00<br> Joanne M. Conroy, M.D.<br> But what I'd love to do is have Robert tell us a little bit about himself and how he actually got into this line of work, which for many people could be anxiety provoking in itself. </p> <p> 00;03;22;03 - 00;03;45;12<br> Robert Brady<br> Yeah, sure. Thanks, Joanne. And you know, as you mentioned earlier, I am a clinical psychologist by training. And here at Dartmouth Health, I lead a specialty team in our anxiety disorder service that's focused on the treatment and assessment of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias, along with OCD and PTSD. </p> <p> 00;03;45;14 - 00;04;04;22<br> Robert Brady<br> Now my research goes a bit further than anxiety, so I'm really focused on applying implementation science methods to develop and evaluate brief psychosocial interventions that are delivered in nontraditional mental health settings so that we're trying to increase access to care overall. But in terms of how I got more focused on the anxiety disorders, it is a little personal. </p> <p> 00;04;04;22 - 00;04;28;16<br> Robert Brady<br> And I like sharing this because it normalizes anxiety. But, I remember being an extraordinarily socially anxious, socially fearful kid. And it wasn't until I learned through my own experience of kind of approaching the scary thing, seeing that nothing bad happened, that I really started kind of coming out of that shell and being less worried about embarrassing myself and really having a fuller life. </p> <p> 00;04;28;17 - 00;04;42;14<br> Robert Brady<br> So I'm a big believer in the value of exposure-based therapies. That's really what I specializes in, in my intervention. And ultimately I just found anxiety to be, and still do, to be a fascinating problem to people that a lot of people struggle with. </p> <p> 00;04;42;16 - 00;05;08;23<br> Joanne M. Conroy, M.D.<br> You know, that's interesting as something that a lot of people can relate to. You're not the only one that gets anxious, you know, before a social situation or before giving a talk or presentation that sometimes can be disabling. We used to do oral board exam practice sessions with our residents, and some of my brightest residents -they were so anxious they couldn't talk and breathe at the same time. </p> <p> 00;05;08;26 - 00;05;30;29<br> Joanne M. Conroy, M.D.<br> And, you know, actually the practice sessions really helped them actually overcome their anxiety. So it was really less about their knowledge and more about how to really manage their own anxiety in this situation. Well, how prevalent is anxiety, anyway, across the general public? How many people would self-identify as having a challenge with it? </p> <p> 00;05;31;01 - 00;05;50;05<br> Robert Brady<br> Sure. Well, I always like the question how common is anxiety? Because if we just mean anxiety, the answer is it's 100% common. And I always tell people, everybody is going to experience some level of anxiety on a daily or at the very least a weekly basis. And I would say anyone says they're never anxious is not telling the truth. </p> <p> 00;05;50;07 - 00;06;12;13<br> Robert Brady<br> But if what you mean, is what's the prevalence of people who will go on to have really problematic anxiety, the sort that's kind of been seeking care or getting in the way of their life, then we're looking at approximately 30 to 35% of the of the U.S. based population at least, meeting criteria for some anxiety disorder at some point </p> <p> 00;06;12;16 - 00;06;14;02<br> Robert Brady<br> over the course of life. </p> <p> 00;06;14;04 - 00;06;23;20<br> Joanne M. Conroy, M.D.<br> What are the criteria for deciding whether you have just garden variety or human anxiety and anxiety that probably needs to be addressed. </p> <p> 00;06;23;22 - 00;06;55;28<br> Robert Brady<br> So, you know, without getting in the weeds of all the individual criteria for each anxiety disorder, we would say there are two kind of main, defining features. Either the problem - the anxiety is interfering in the person's life, or it's substantially distressing personally to them. Either it's a problematic symptom or it's a painful symptom. But really, any time that the anxiety has gotten so big that it's limiting life or limiting enjoyment of life, I think it's worthy of being treated at that point. </p> <p> 00;06;56;00 - 00;07;10;25<br> Joanne M. Conroy, M.D.<br> You know, a lot of people would equate that to having a panic attack, but that's probably just one symptom that people experience and probably a kind of an extreme one. You don't want to get it to the point where you actually experience that. </p> <p> 00;07;10;27 - 00;07;48;12<br> Robert Brady<br> Right. And so panic attacks are very common to have over the course of life. And that's going to be different than panic disorder. When we have someone with a panic disorder, it means they're having recurrent panic attacks. And maybe most importantly they're changing their life in some meaningful way. That is, they're stopping doing the things that give them pleasure, or they're not going to places that are important for them to complete their activities of daily living. That is not the panic attack, but it's the anxious apprehension of panic and the change in life, all to prevent what is otherwise an unpleasant but actually harmless experience. </p> <p> 00;07;48;15 - 00;08;07;13<br> Joanne M. Conroy, M.D.<br> Now, the certain segments that you've seen a significant increase in anxiety. I think we all kind of are worried about young adults and teenagers, but there are probably other segments of the population that are experiencing rising anxiety that we need to be aware of. </p> <p> 00;08;07;16 - 00;08;26;07<br> Robert Brady<br> It's a good question. What are the prevalence differences by segment or age group? You know, I don't know. That's the kind of research we're looking back on in some ways. But I can say that two of the areas that we're, kind of particularly concerned about as you mentioned, are young adults. I'm not a young adult anymore, </p> <p> 00;08;26;10 - 00;08;45;21<br> Robert Brady<br> and I think it would be really tough to be one these days. We think about anxiety as a perception of threat somewhere in space and time, that's how I think about anxiety, that the danger is not there, but it might be in the future. I mean, kids right now, they're kind of drinking through a firehose of cues for anxiety. </p> <p> 00;08;45;29 - 00;09;14;20<br> Robert Brady<br> They have a constant flow of information and they can't predict anything. One day, you know, some part of themselves is acceptable and appreciated and the next day it's not. It's something that has changed. And they can't be that aspect of self anymore. So that would be a really hard place to be in. And certainly anyone who's a parent or knows other young folks is understandably concerned about the risk of increased anxiety in that population. </p> <p> 00;09;14;23 - 00;09;41;02<br> Robert Brady<br> The other end of that spectrum is our older adults. And so some folks, listening to this may be aware of or familiar with the term anxious depression and older adults. Anxious depression is a sort of milling about presence of just discomfort. We've got end of life issues that we're starting to think about. We're having fewer folks in our lives because a fact of life is as you get older, there's an increased likelihood of losing folks that are close to you. </p> <p> 00;09;41;05 - 00;09;58;09<br> Robert Brady<br> And so all those things compile, along with trying to maintain that quality of life they're used to while also going through the substantial change of retirement and changes in your living. So that results in a lot more of that anxious apprehension. And that's another population we're particularly focused on. </p> <p> 00;09;58;12 - 00;10;19;06<br> Joanne M. Conroy, M.D.<br> You know, a topic that a lot of people talk about is the role of social media. And I can tell you that there are times that I just don't want to open up my newsfeed because I don't think it's going to be good. But we know that a lot of our younger patients are very tied into social media. </p> <p> 00;10;19;09 - 00;10;48;11<br> Joanne M. Conroy, M.D.<br> And frankly, for some of our older patients, that is sometimes the only contact or stimulation they may have if they don't actually get out of their apartment or their home frequently enough to interact with others. So I know you probably have written many papers on the impact of social media, but, you know, how should we approach it? As, you know, aunts and uncles and parents with these younger kids who I think are significantly affected by it? </p> <p> 00;10;48;13 - 00;11;14;21<br> Robert Brady<br> So a simple question we might ask someone in our clinic is: is this behavior helpful to you? On balance, is this thing - whatever it is you're doing, maybe it's accessing social media - is it making life better? Or is it actually perhaps causing some problems? And sometimes we'll hold up the mirror, you know, kind of figuratively, to say, this is what I heard you describing about your use of social media, and you said, this is how it makes you feel, but I notice you're continuing it. </p> <p> 00;11;14;23 - 00;11;37;01<br> Robert Brady<br> Maybe this is functioning more as a habit or an effort to avoid something else. Maybe it's repeatedly trying to look for reassurance in the social media and not being able to learn to tolerate the uncertainty. So a there's a lot - it's a very complex subject. It's not it is not my content expertise, certainly. But it shows up, almost ubiquitously in our population. </p> <p> 00;11;37;04 - 00;11;55;21<br> Joanne M. Conroy, M.D.<br> Yeah. It feels like sometimes a national event can actually get amplified by the number of times it actually shows up on social media and all the social media venues, and it almost makes it feel more impending for people that they could be affected by that. </p> <p> 00;11;55;24 - 00;12;16;14<br> Robert Brady<br> Yeah. And so in some ways, it becomes a numbers game, right? It's so omnipresent, it's so constant that you kind of say, well, it has to be important if they're putting it on the website this many times, right? Failing to remember that the normal stuff of life doesn't make social media, right? The normal stuff of life doesn't make the news. </p> <p> 00;12;16;14 - 00;12;23;11<br> Robert Brady<br> It's the scary stuff. And the more you see it, the more you start to say, oh, it must be. This is something I have to be worried about. </p> <p> 00;12;23;13 - 00;12;48;19<br> Joanne M. Conroy, M.D.<br> Let's shift a little bit and talk about anxiety in health care workers. You know, we have a lot of uncertainty and violence in the world that gets amplified by social media. But health care workers are often on the front line, either treating victims who are affected by violence. But also we have more violence within the health care setting. </p> <p> 00;12;48;22 - 00;13;13;10<br> Joanne M. Conroy, M.D.<br> You know, people are angrier. And you know, we can use the example of the active shooter that we had here almost seven years ago that created a lot of anxiety within the organization. It felt like our safe little bubble of the upper valley had actually been popped, and people realize that we could be vulnerable. </p> <p> 00;13;13;12 - 00;13;40;05<br> Robert Brady<br> Right. And we oftentimes are the most anxious about the things that we can't predict. Right? If anxiety, as I said before, is the perception of threat somewhere over the horizon, ideally the salve, the balm for anxiety would be able to predict things and those unpredictable events and the idea that they might happen. That's what provokes that anxious, that anxious response. I mentioned at the top that I've been here for about ten years. </p> <p> 00;13;40;08 - 00;14;00;04<br> Robert Brady<br> And so I've been able to work with a lot of health care providers, both as colleagues of course, but also sometimes in my clinical work. And health care providers come across as superheroes sometimes, and I think sometimes we also think of ourselves as superheroes, forgetting that if anxiety is a normal human response, we're going to have it too. </p> <p> 00;14;00;07 - 00;14;20;29<br> Robert Brady<br> We try to kind of push that part away, instead of kind of welcoming or accepting it and acknowledging it. The pandemic also certainly heightened that sense of anxiety, because here is an unpredictable event, and we're being asked to do things where we don't feel like we have the same sense of control and that that starts to impact our resilience. </p> <p> 00;14;21;01 - 00;14;31;29<br> Robert Brady<br> We are not superheroes, but we have the training and ideally, we have the support necessary to remind us that we can deal with even the unpredictable parts of the work. </p> <p> 00;14;32;01 - 00;14;58;13<br> Joanne M. Conroy, M.D.<br> Was really fascinating after the active shooter here that people surfaced with experiences before they came here. We found out we had three people that used to live in Sandy Hook and our incident actually stirred up a lot of that kind of trauma that they were still kind of dealing with, being proximate to that event. </p> <p> 00;14;58;15 - 00;15;20;28<br> Joanne M. Conroy, M.D.<br> And it was fascinating that you would think that how proximate you were to the event had something to do with your anxiety level. But it had nothing to do with your anxiety level. It felt like it was almost a reflection of the other trauma you'd had in your life. You know, how common is that? I was struck by that. </p> <p> 00;15;21;01 - 00;15;52;08<br> Robert Brady<br> Sure. So we think about those as kind of trauma reminders. So, you know, oftentimes someone goes through a terrible event and they say, I don't want to think about that anymore. They try to put it in a box and put it in the back of their mind. but all it takes is a little reminder to cause that to come back, to be thinking about that more. A lot of the work that we do in the anxiety disorder service at Dartmouth Health is with PTSD specifically, trying to help people understand and process the things that happened before. </p> <p> 00;15;52;10 - 00;16;09;08<br> Robert Brady<br> And we think, you know, when you have something bad happen, if you say, I'm going to put that away, I'm not going to think about it anymore, you better hope that the way you were thinking about it when you locked it away, that that was an effective way of thinking about it. That was adaptive. Because if you don't think about it anymore, you put it aside to, I'm just not going to deal with that. </p> <p> 00;16;09;10 - 00;16;23;20<br> Robert Brady<br> Well, you're kind of stuck with whatever thoughts and beliefs you had about it at the time. So then when someone a similar event, happens, they didn't deal with the first one. And it makes understanding how this could happen again all the much more difficult. </p> <p> 00;16;23;23 - 00;16;55;05<br> Joanne M. Conroy, M.D.<br> What should we be doing as leaders of hospitals and health care systems to actually support our staff? You know, at some point in my career, I thought everybody would benefit from sitting with psychologists at least twice a year, almost check ins. And I think we've actually even talked about that. We do that with our residents and we have a psychologist that's hired to support the residents, but that's probably undoable for some of our health systems. </p> <p> 00;16;55;05 - 00;17;02;02<br> Joanne M. Conroy, M.D.<br> And we have 18,000 employees across the health system. But what else should we be doing to help support our staff? </p> <p> 00;17;02;05 - 00;17;25;19<br> Robert Brady<br> So I think this is a good point to note that most of our colleagues manage anxiety quite well. In fact, we actually did a study during Covid of health care workers in the resilience, and specifically with anxiety. And we found that the overwhelming majority of health care workers did not report anxiety that would be concerning, that would be in kind of the clinical range. </p> <p> 00;17;25;19 - 00;17;50;18<br> Robert Brady<br> Or if they had high anxiety, it went away within a year. But what that also showed is that almost a fifth of our colleagues do have, you know, problematic anxiety. What we want to be able to do is help to identify the folks that are most at risk, because we don't want them to suffer in silence. We want to be able to promote normality of anxiety and to be able to talk about it. </p> <p> 00;17;50;20 - 00;18;29;11<br> Robert Brady<br> And one of the other things we learned from that study was when the health care workers can't predict day to day what's going to happen, or when they're asked to do services and tasks outside of their usual sense of what I can control, control and predict, their anxiety was much higher. So as leaders, I think what folks in health care want to be able to do is both encourage people by reminding them you have the training and skill set to do amazing things, and you can cope even with uncertainty, while at the same time trying to give them the most predictable working environment that they can. Not unnecessarily inserting uncertainty, even if </p> <p> 00;18;29;11 - 00;18;54;05<br> Robert Brady<br> sometimes that's part of the job, trying to smooth out those rough edges of unpredictability. You know, we talk a lot about encouraging psychological safety, and then other times we will talk about brave spaces. I want to encourage people to create predictable spaces so that the person knows what to expect as much as possible from day to day. </p> <p> 00;18;54;08 - 00;19;15;10<br> Joanne M. Conroy, M.D.<br> That's probably the key to my success, because the same Joanne Conroy shows up every single day. I'm boring, but the same person shows up. I want to thank you for joining me today Robert, and I appreciate you sharing some of your valuable expertise and insight, and certainly some of your own personal insights in terms of managing anxiety. </p> <p> 00;19;15;10 - 00;19;36;29<br> Joanne M. Conroy, M.D.<br> And I encourage all of our viewers to reflect on some of the advice that Dr. Brady has shared, whether managing individual anxiety or helping somebody get the assistance they need. Until next time, I want to thank everybody, and I look forward to seeing you next month and our Leadership Dialogue. Have a wonderful day. </p> <p> 00;19;37;02 - 00;19;45;12<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Mon, 29 Jul 2024 11:03:10 -0500 Behavioral Health Intervention & Issues Prevention /advancing-health-podcast/2024-07-29-leadership-dialogue-series-anxiety-disorders-and-ways-support-mental-health <p>In this conversation, Joanne M. Conroy, M.D., CEO and president of Dartmouth Health and 2024 AHA board chair, speaks with her colleague Robert E. Brady, director of Anxiety Disorders Service at Dartmouth Health, about different types of anxieties and their prevalence in today’s culture. The two also discuss how the health care community is being acutely affected by the rise in anxiety disorders.</p><p>This is an edited conversation. <a href="https://www.youtube.com/watch?v=T-queynyeLE&t=25s" target="_blank" title="YouTube: Leadership Dialogue Series: Anxiety Disorders and Ways to Support Mental Health with Robert Brady">Watch the full version on YouTube.</a></p><hr><div></div><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00;00;00;14 - 00;00;26;05<br> Tom Haederle<br> Money worries. The job. A personal relationship. The daily news headlines. All of these things and many more can cause anxiety and stress. In fact, experts note that anxiety and stress are 100% common, in that everyone - from all walks of life - feel some level of these things practically every day. Managing stress is more important than ever. But these emotions can gain the upper hand for many people </p> <p> 00;00;26;09 - 00;00;38;27<br> Tom Haederle<br> and that's when it's time to reach out for help. </p> <p> 00;00;38;29 - 00;01;15;08<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA communications. In this month's Leadership Dialogue series podcast, Dr. Joanne Conroy, CEO and president of Dartmouth Health and the 2024 Board Chair of the ���������� Association, invites an expert colleague from Dartmouth Health to discuss ways to manage stress. They talk about how to tell the difference between the normal, garden-variety anxieties of everyday life, and the kinds of stress and anxiety levels that affect roughly one-third of the US population and limit enjoyment of life. </p> <p> 00;01;15;10 - 00;01;43;24<br> Joanne M. Conroy, M.D.<br> Thank you for joining us today for another AHA Leadership Dialogue discussion. It's great to be with you. I'm Joanne Conroy, CEO and president of Dartmouth Health and currently the chair of the ���������� Association Board of Trustees. I look forward to our conversation today, and I'm delighted to have my colleague, Dr. Robert Brady, join us. Robert leads our anxiety disorder service at Dartmouth-Hitchcock Medical Center. </p> <p> 00;01;43;27 - 00;02;01;11<br> Joanne M. Conroy, M.D.<br> He originally trained at the University of Arkansas, where he earned his doctorate in clinical psychology, later doing some post-doctoral work with the VA, and has now been at Dartmouth here for almost ten years. Robert, thank you for joining us. </p> <p> 00;02;01;13 - 00;02;01;28<br> Robert Brady<br> Good to be with you, Joanne. </p> <p> 00;02;01;28 - 00;02;38;09<br> Joanne M. Conroy, M.D.<br> Our health system along with many others across the country, is deeply committed to ensuring that our patients and our communities have access to the full range of behavioral health services. This is especially important given our current environment, when events from national news to personal challenges can really ratchet up an individual's anxiety. Coverage of wars, the recent assassination attempt of a candidate running for office, and various other headlines create anxiety for people across the country. </p> <p> 00;02;38;12 - 00;03;09;29<br> Joanne M. Conroy, M.D.<br> That on top of everyday stress that people are trying to manage makes it all more important for our communities, our patients, our families and our workforce to have the tools they need to identify and reduce stress and anxiety. We know anxiety is actually quite common, and it's an issue for many people in all walks of life. Robert is going to answer a lot of questions for us about anxiety and the incidents and how we actually manage it as an individual and a community. </p> <p> 00;03;10;01 - 00;03;22;00<br> Joanne M. Conroy, M.D.<br> But what I'd love to do is have Robert tell us a little bit about himself and how he actually got into this line of work, which for many people could be anxiety provoking in itself. </p> <p> 00;03;22;03 - 00;03;45;12<br> Robert Brady<br> Yeah, sure. Thanks, Joanne. And you know, as you mentioned earlier, I am a clinical psychologist by training. And here at Dartmouth Health, I lead a specialty team in our anxiety disorder service that's focused on the treatment and assessment of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias, along with OCD and PTSD. </p> <p> 00;03;45;14 - 00;04;04;22<br> Robert Brady<br> Now my research goes a bit further than anxiety, so I'm really focused on applying implementation science methods to develop and evaluate brief psychosocial interventions that are delivered in nontraditional mental health settings so that we're trying to increase access to care overall. But in terms of how I got more focused on the anxiety disorders, it is a little personal. </p> <p> 00;04;04;22 - 00;04;28;16<br> Robert Brady<br> And I like sharing this because it normalizes anxiety. But, I remember being an extraordinarily socially anxious, socially fearful kid. And it wasn't until I learned through my own experience of kind of approaching the scary thing, seeing that nothing bad happened, that I really started kind of coming out of that shell and being less worried about embarrassing myself and really having a fuller life. </p> <p> 00;04;28;17 - 00;04;42;14<br> Robert Brady<br> So I'm a big believer in the value of exposure-based therapies. That's really what I specializes in, in my intervention. And ultimately I just found anxiety to be, and still do, to be a fascinating problem to people that a lot of people struggle with. </p> <p> 00;04;42;16 - 00;05;08;23<br> Joanne M. Conroy, M.D.<br> You know, that's interesting as something that a lot of people can relate to. You're not the only one that gets anxious, you know, before a social situation or before giving a talk or presentation that sometimes can be disabling. We used to do oral board exam practice sessions with our residents, and some of my brightest residents -they were so anxious they couldn't talk and breathe at the same time. </p> <p> 00;05;08;26 - 00;05;30;29<br> Joanne M. Conroy, M.D.<br> And, you know, actually the practice sessions really helped them actually overcome their anxiety. So it was really less about their knowledge and more about how to really manage their own anxiety in this situation. Well, how prevalent is anxiety, anyway, across the general public? How many people would self-identify as having a challenge with it? </p> <p> 00;05;31;01 - 00;05;50;05<br> Robert Brady<br> Sure. Well, I always like the question how common is anxiety? Because if we just mean anxiety, the answer is it's 100% common. And I always tell people, everybody is going to experience some level of anxiety on a daily or at the very least a weekly basis. And I would say anyone says they're never anxious is not telling the truth. </p> <p> 00;05;50;07 - 00;06;12;13<br> Robert Brady<br> But if what you mean, is what's the prevalence of people who will go on to have really problematic anxiety, the sort that's kind of been seeking care or getting in the way of their life, then we're looking at approximately 30 to 35% of the of the U.S. based population at least, meeting criteria for some anxiety disorder at some point </p> <p> 00;06;12;16 - 00;06;14;02<br> Robert Brady<br> over the course of life. </p> <p> 00;06;14;04 - 00;06;23;20<br> Joanne M. Conroy, M.D.<br> What are the criteria for deciding whether you have just garden variety or human anxiety and anxiety that probably needs to be addressed. </p> <p> 00;06;23;22 - 00;06;55;28<br> Robert Brady<br> So, you know, without getting in the weeds of all the individual criteria for each anxiety disorder, we would say there are two kind of main, defining features. Either the problem - the anxiety is interfering in the person's life, or it's substantially distressing personally to them. Either it's a problematic symptom or it's a painful symptom. But really, any time that the anxiety has gotten so big that it's limiting life or limiting enjoyment of life, I think it's worthy of being treated at that point. </p> <p> 00;06;56;00 - 00;07;10;25<br> Joanne M. Conroy, M.D.<br> You know, a lot of people would equate that to having a panic attack, but that's probably just one symptom that people experience and probably a kind of an extreme one. You don't want to get it to the point where you actually experience that. </p> <p> 00;07;10;27 - 00;07;48;12<br> Robert Brady<br> Right. And so panic attacks are very common to have over the course of life. And that's going to be different than panic disorder. When we have someone with a panic disorder, it means they're having recurrent panic attacks. And maybe most importantly they're changing their life in some meaningful way. That is, they're stopping doing the things that give them pleasure, or they're not going to places that are important for them to complete their activities of daily living. That is not the panic attack, but it's the anxious apprehension of panic and the change in life, all to prevent what is otherwise an unpleasant but actually harmless experience. </p> <p> 00;07;48;15 - 00;08;07;13<br> Joanne M. Conroy, M.D.<br> Now, the certain segments that you've seen a significant increase in anxiety. I think we all kind of are worried about young adults and teenagers, but there are probably other segments of the population that are experiencing rising anxiety that we need to be aware of. </p> <p> 00;08;07;16 - 00;08;26;07<br> Robert Brady<br> It's a good question. What are the prevalence differences by segment or age group? You know, I don't know. That's the kind of research we're looking back on in some ways. But I can say that two of the areas that we're, kind of particularly concerned about as you mentioned, are young adults. I'm not a young adult anymore, </p> <p> 00;08;26;10 - 00;08;45;21<br> Robert Brady<br> and I think it would be really tough to be one these days. We think about anxiety as a perception of threat somewhere in space and time, that's how I think about anxiety, that the danger is not there, but it might be in the future. I mean, kids right now, they're kind of drinking through a firehose of cues for anxiety. </p> <p> 00;08;45;29 - 00;09;14;20<br> Robert Brady<br> They have a constant flow of information and they can't predict anything. One day, you know, some part of themselves is acceptable and appreciated and the next day it's not. It's something that has changed. And they can't be that aspect of self anymore. So that would be a really hard place to be in. And certainly anyone who's a parent or knows other young folks is understandably concerned about the risk of increased anxiety in that population. </p> <p> 00;09;14;23 - 00;09;41;02<br> Robert Brady<br> The other end of that spectrum is our older adults. And so some folks, listening to this may be aware of or familiar with the term anxious depression and older adults. Anxious depression is a sort of milling about presence of just discomfort. We've got end of life issues that we're starting to think about. We're having fewer folks in our lives because a fact of life is as you get older, there's an increased likelihood of losing folks that are close to you. </p> <p> 00;09;41;05 - 00;09;58;09<br> Robert Brady<br> And so all those things compile, along with trying to maintain that quality of life they're used to while also going through the substantial change of retirement and changes in your living. So that results in a lot more of that anxious apprehension. And that's another population we're particularly focused on. </p> <p> 00;09;58;12 - 00;10;19;06<br> Joanne M. Conroy, M.D.<br> You know, a topic that a lot of people talk about is the role of social media. And I can tell you that there are times that I just don't want to open up my newsfeed because I don't think it's going to be good. But we know that a lot of our younger patients are very tied into social media. </p> <p> 00;10;19;09 - 00;10;48;11<br> Joanne M. Conroy, M.D.<br> And frankly, for some of our older patients, that is sometimes the only contact or stimulation they may have if they don't actually get out of their apartment or their home frequently enough to interact with others. So I know you probably have written many papers on the impact of social media, but, you know, how should we approach it? As, you know, aunts and uncles and parents with these younger kids who I think are significantly affected by it? </p> <p> 00;10;48;13 - 00;11;14;21<br> Robert Brady<br> So a simple question we might ask someone in our clinic is: is this behavior helpful to you? On balance, is this thing - whatever it is you're doing, maybe it's accessing social media - is it making life better? Or is it actually perhaps causing some problems? And sometimes we'll hold up the mirror, you know, kind of figuratively, to say, this is what I heard you describing about your use of social media, and you said, this is how it makes you feel, but I notice you're continuing it. </p> <p> 00;11;14;23 - 00;11;37;01<br> Robert Brady<br> Maybe this is functioning more as a habit or an effort to avoid something else. Maybe it's repeatedly trying to look for reassurance in the social media and not being able to learn to tolerate the uncertainty. So a there's a lot - it's a very complex subject. It's not it is not my content expertise, certainly. But it shows up, almost ubiquitously in our population. </p> <p> 00;11;37;04 - 00;11;55;21<br> Joanne M. Conroy, M.D.<br> Yeah. It feels like sometimes a national event can actually get amplified by the number of times it actually shows up on social media and all the social media venues, and it almost makes it feel more impending for people that they could be affected by that. </p> <p> 00;11;55;24 - 00;12;16;14<br> Robert Brady<br> Yeah. And so in some ways, it becomes a numbers game, right? It's so omnipresent, it's so constant that you kind of say, well, it has to be important if they're putting it on the website this many times, right? Failing to remember that the normal stuff of life doesn't make social media, right? The normal stuff of life doesn't make the news. </p> <p> 00;12;16;14 - 00;12;23;11<br> Robert Brady<br> It's the scary stuff. And the more you see it, the more you start to say, oh, it must be. This is something I have to be worried about. </p> <p> 00;12;23;13 - 00;12;48;19<br> Joanne M. Conroy, M.D.<br> Let's shift a little bit and talk about anxiety in health care workers. You know, we have a lot of uncertainty and violence in the world that gets amplified by social media. But health care workers are often on the front line, either treating victims who are affected by violence. But also we have more violence within the health care setting. </p> <p> 00;12;48;22 - 00;13;13;10<br> Joanne M. Conroy, M.D.<br> You know, people are angrier. And you know, we can use the example of the active shooter that we had here almost seven years ago that created a lot of anxiety within the organization. It felt like our safe little bubble of the upper valley had actually been popped, and people realize that we could be vulnerable. </p> <p> 00;13;13;12 - 00;13;40;05<br> Robert Brady<br> Right. And we oftentimes are the most anxious about the things that we can't predict. Right? If anxiety, as I said before, is the perception of threat somewhere over the horizon, ideally the salve, the balm for anxiety would be able to predict things and those unpredictable events and the idea that they might happen. That's what provokes that anxious, that anxious response. I mentioned at the top that I've been here for about ten years. </p> <p> 00;13;40;08 - 00;14;00;04<br> Robert Brady<br> And so I've been able to work with a lot of health care providers, both as colleagues of course, but also sometimes in my clinical work. And health care providers come across as superheroes sometimes, and I think sometimes we also think of ourselves as superheroes, forgetting that if anxiety is a normal human response, we're going to have it too. </p> <p> 00;14;00;07 - 00;14;20;29<br> Robert Brady<br> We try to kind of push that part away, instead of kind of welcoming or accepting it and acknowledging it. The pandemic also certainly heightened that sense of anxiety, because here is an unpredictable event, and we're being asked to do things where we don't feel like we have the same sense of control and that that starts to impact our resilience. </p> <p> 00;14;21;01 - 00;14;31;29<br> Robert Brady<br> We are not superheroes, but we have the training and ideally, we have the support necessary to remind us that we can deal with even the unpredictable parts of the work. </p> <p> 00;14;32;01 - 00;14;58;13<br> Joanne M. Conroy, M.D.<br> Was really fascinating after the active shooter here that people surfaced with experiences before they came here. We found out we had three people that used to live in Sandy Hook and our incident actually stirred up a lot of that kind of trauma that they were still kind of dealing with, being proximate to that event. </p> <p> 00;14;58;15 - 00;15;20;28<br> Joanne M. Conroy, M.D.<br> And it was fascinating that you would think that how proximate you were to the event had something to do with your anxiety level. But it had nothing to do with your anxiety level. It felt like it was almost a reflection of the other trauma you'd had in your life. You know, how common is that? I was struck by that. </p> <p> 00;15;21;01 - 00;15;52;08<br> Robert Brady<br> Sure. So we think about those as kind of trauma reminders. So, you know, oftentimes someone goes through a terrible event and they say, I don't want to think about that anymore. They try to put it in a box and put it in the back of their mind. but all it takes is a little reminder to cause that to come back, to be thinking about that more. A lot of the work that we do in the anxiety disorder service at Dartmouth Health is with PTSD specifically, trying to help people understand and process the things that happened before. </p> <p> 00;15;52;10 - 00;16;09;08<br> Robert Brady<br> And we think, you know, when you have something bad happen, if you say, I'm going to put that away, I'm not going to think about it anymore, you better hope that the way you were thinking about it when you locked it away, that that was an effective way of thinking about it. That was adaptive. Because if you don't think about it anymore, you put it aside to, I'm just not going to deal with that. </p> <p> 00;16;09;10 - 00;16;23;20<br> Robert Brady<br> Well, you're kind of stuck with whatever thoughts and beliefs you had about it at the time. So then when someone a similar event, happens, they didn't deal with the first one. And it makes understanding how this could happen again all the much more difficult. </p> <p> 00;16;23;23 - 00;16;55;05<br> Joanne M. Conroy, M.D.<br> What should we be doing as leaders of hospitals and health care systems to actually support our staff? You know, at some point in my career, I thought everybody would benefit from sitting with psychologists at least twice a year, almost check ins. And I think we've actually even talked about that. We do that with our residents and we have a psychologist that's hired to support the residents, but that's probably undoable for some of our health systems. </p> <p> 00;16;55;05 - 00;17;02;02<br> Joanne M. Conroy, M.D.<br> And we have 18,000 employees across the health system. But what else should we be doing to help support our staff? </p> <p> 00;17;02;05 - 00;17;25;19<br> Robert Brady<br> So I think this is a good point to note that most of our colleagues manage anxiety quite well. In fact, we actually did a study during Covid of health care workers in the resilience, and specifically with anxiety. And we found that the overwhelming majority of health care workers did not report anxiety that would be concerning, that would be in kind of the clinical range. </p> <p> 00;17;25;19 - 00;17;50;18<br> Robert Brady<br> Or if they had high anxiety, it went away within a year. But what that also showed is that almost a fifth of our colleagues do have, you know, problematic anxiety. What we want to be able to do is help to identify the folks that are most at risk, because we don't want them to suffer in silence. We want to be able to promote normality of anxiety and to be able to talk about it. </p> <p> 00;17;50;20 - 00;18;29;11<br> Robert Brady<br> And one of the other things we learned from that study was when the health care workers can't predict day to day what's going to happen, or when they're asked to do services and tasks outside of their usual sense of what I can control, control and predict, their anxiety was much higher. So as leaders, I think what folks in health care want to be able to do is both encourage people by reminding them you have the training and skill set to do amazing things, and you can cope even with uncertainty, while at the same time trying to give them the most predictable working environment that they can. Not unnecessarily inserting uncertainty, even if </p> <p> 00;18;29;11 - 00;18;54;05<br> Robert Brady<br> sometimes that's part of the job, trying to smooth out those rough edges of unpredictability. You know, we talk a lot about encouraging psychological safety, and then other times we will talk about brave spaces. I want to encourage people to create predictable spaces so that the person knows what to expect as much as possible from day to day. </p> <p> 00;18;54;08 - 00;19;15;10<br> Joanne M. Conroy, M.D.<br> That's probably the key to my success, because the same Joanne Conroy shows up every single day. I'm boring, but the same person shows up. I want to thank you for joining me today Robert, and I appreciate you sharing some of your valuable expertise and insight, and certainly some of your own personal insights in terms of managing anxiety. </p> <p> 00;19;15;10 - 00;19;36;29<br> Joanne M. Conroy, M.D.<br> And I encourage all of our viewers to reflect on some of the advice that Dr. Brady has shared, whether managing individual anxiety or helping somebody get the assistance they need. Until next time, I want to thank everybody, and I look forward to seeing you next month and our Leadership Dialogue. Have a wonderful day. </p> <p> 00;19;37;02 - 00;19;45;12<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Mon, 29 Jul 2024 08:29:07 -0500 Behavioral Health Intervention & Issues Prevention /rural-behavioral-health <div class="row"><div class="col-md-8 col-sm-8"><p>According to a 2022 policy brief from the <a href="https://www.ruralhealth.us/getmedia/cf3c3922-25cb-49a0-bb04-0bad81d634f9/NRHA-Mental-health-in-rural-areas-policy-brief-2022.pdf">National Rural Health Association</a>, rural areas can experience a severe lack of access to and availability of the full range of behavioral health care services, challenges with mental health workforce recruitment and retention, and technology barriers impacting telehealth visits. These challenges, combined with additional social challenges like stigma, a potential lack of anonymity when seeking care, geographic isolation from services, and cost, can deter patients and families in rural communities from getting the care they need.</p><p>Hospitals are the cornerstones of their communities, serving as principal access points to care for the nearly 60 million people or 20 percent of Americans who live in rural areas and may need behavioral health services. The AHA is committed supporting its members as they strive to provide high quality, accessible behavioral health services in America’s rural communities through the following advocacy priorities:</p><p><strong>Telehealth.</strong> The pandemic demonstrated telehealth services are a crucial access point for many patients. AHA supports legislation to make permanent coverage of certain telehealth services made possible during the pandemic, including lifting geographic and originating site restrictions, allowing Rural Health Clinics and Federally Qualified Health Centers to serve as distant sites, expanding practitioners who can provide telehealth, and allowing hospital outpatient billing for virtual services, among others (S. 2016 / H.R. 4189).</p><p><strong>Graduate Medical Education</strong>. We urge Congress to pass additional legislation to increase the number of Medicare-funded residency slots, which would expand training opportunities in rural settings and help address health professional shortages <strong>(S. 1302 / H.R. 2389)</strong></p><p><strong>Loan Repayment Programs</strong>. We urge Congress to pass legislation to provide incentives for clinicians to practice in rural HPSAs. We support expanding the National Health Service Corps and the National Nurse Corps, which incentivize health care graduates to provide health care services in underserved areas <strong>(S. 862 / S. 940 / H.R. 1711).</strong></p><p>A number of <strong>behavioral health</strong> <strong>policies</strong> that authorize, expand, and better integrate behavioral health programs in rural communities.</p> For more information, visit <a href="/rural-advocacy-agenda">AHA’s 2024 Rural Advocacy Agenda</a>. </p> --><h4><span>Latest Behavioral Health Podcasts</span></h4><div></div></div><div class="col-md-4 col-sm-4"><div><div><h4 class="text-align-center">Rural Behavioral Health Infographic</h4><p class="text-align-center"><a href="/infographic-realities-behavioral-health-rural-communities" title="Click to open The Realities of Behavioral Health in Rural Communities infographic in a new window"><img src="/sites/default/files/2024-11/rural-behavioral-health-infographic-cover.png" data-entity-uuid data-entity-type="file" alt="2023 Behavioral Health Fast Facts Infographic. The Realities of Behavioral Health in Rural Communities" width="250" height="325"></a></p><p class="text-align-center"><a class="btn btn-primary btn-wide" href="/system/files/media/file/2024/11/rural-behavioral-health-infographic.pdf" title="click here to download Infographic: The Realities of Behavioral Health in Rural Communities">Download Infographic</a></p></div></div><h4> </h4><div class="panel module-typeC"><div class="panel-heading"><h4><span>Featured Resource</span></h4></div><div class="panel-body"><ul><li><a href="/news/blog/2024-11-04-aha-committee-chairs-come-together-increasing-access-behavioral-health-services-rural-communities"><strong>Blog: AHA Committee Chairs Come Together for Increasing Access to Behavioral Health Services in Rural Communities</strong></a></li></ul></div></div><h4> </h4><div class="panel module-typeC"><div class="panel-heading"><h4><span>For More Information</span></h4></div><div class="panel-body"><ul><li><a href="https://www.ruralhealth.us/">National Rural Health Association</a></li><li><a href="https://www.ruralhealthinfo.org/topics/mental-health">Rural Health Information Hub</a></li></ul></div></div></div></div> Wed, 03 Jul 2024 13:25:26 -0500 Behavioral Health Intervention & Issues Prevention