The Register-Herald, Beckley, West Virginia

Life!

October 13, 2013

A focus on wellness for mental health patients

National Institute of Mental Health projections estimate as many as one quarter of American adults are diagnosable for some form of mental illness — and that’s the good news. The same are expected to die earlier than the general population, by 15 years on average and up to 25 years for patients with severe mental health issues. FMRS Associate Director Kathy Armentrout believes she knows why those with mental and emotional disorders are at such an overall health disadvantage. The health care community, she says, has for too long had diagnostic tunnel-vision, seeing only the mental illness and not the person. Now, Armentrout and a cadre of supporters are expanding their focus into total body wellness for their patients, leveraging a federal grant of $1.6 million over four years to change the dismal outlook for the population they serve.

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First opened as a comprehensive mental health center in 1969, FMRS launched a Beckley-based primary care clinic within its facility in March. The clinic is open 8 a.m. to 4:30 p.m. Monday through Friday for clients with problems ranging from colds to complications with undiagnosed diabetes. For many, it presents the opportunity to get beyond just their mental health diagnosis and into addressing life-threatening co-conditions, ones they are more prone to than the average person. The program has also proved critical to assisting the area’s notably large drug-addicted population, those recovering who have long neglected personal maintenance of any kind, including routine doctor’s visits. The SHARE (Sharing Health Alternatives Reflects Excellence) program, as it is called, is developing wellness groups along with its primary care evaluations to prevent diseases through education. In addition to regular medical check-ups and education, the program includes transportation to and from office visits, management of chronic conditions, medical liaison support, and the development of a recovery action plan for patients in dealing with their conditions.

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Denita Walker, SHARE project coordinator, has found most patients are very receptive to receiving primary care in the same building where their mental health issues have been addressed. To her, it is a way to keep patients safe from the dangers of communication gaps in rotating through multiple treatment facilities. “We may have prescribed a psychotropic medication in the past that increased blood pressure problems in a patient (because their condition) wasn’t communicated between providers. We are working hard to make this a culture shift in the treatment of mental health patients nationwide.”

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Culture changes, however, are hard to come by. Neglecting physical exams and lacking communication between care providers are among many hurdles mental health patients face, explains Armentrout. “The SHARE program removes barriers contributing to early death among those managing multiple illnesses. Individuals with emotional problems may find it difficult to communicate effectively with medical personnel. SHARE focuses on wellness, not the illness,” she explains. Part of the culture change for Armentrout and her group is in old methods well intentioned, but missing the mark of caring for the whole patient. Consider the past practice of giving out cigarettes to noncompliant mental health patients for keeping their appointments. “This was done all over the country,” she states. Now, under the new paradigm of total wellness, smoking cessation is a key component.

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Leah Kidd, the program’s Wellness Coordinator, believes this more health conscious, coordinated approach to patient care is critical for those with mental health issues. Her patients are excited about the sense of community developing within the various groups. “We have a nutrition class learning about food groups and concepts as simple as ‘what is a calorie?’ That knowledge is powerful in and of itself.” Kidd’s most popular group is a walking group, where participants meet and measure progress one literal benchmark at a time, as what started out 20 minutes of exercising at the YMCA Paul Cline Memorial Youth Sports Complex has turned into a friendly health competition. “Week to week, patients are seeing improvements. They’ll say ‘Today, I’m going to make it one more bench (around the track’), or ‘We made it to Bench Six this week.’” Another staff member, David Burgess, commented.

“There’s a lot more going on here than just walking,” Kidd agrees wholeheartedly. “There are friendship forming — bonds.”

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Beth Spade, RN and SHARE care manager, also believes there’s something more to gain than physical wellness from SHARE. “During reassessments, they’re asked if they have anyone to support them. A lot of times, their answer is SHARE — members of our staff, or peers from their groups.”

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Having a mental illness can detract from getting necessary routine primary care and the stigma attached to patients with depression and other conditions frequently fogs pathways to unbiased examination; accordingly, these patients are at a remarkable disadvantage. According to SAMHSA (Substance Abuse and Mental Health Services Administration) information, conditions more prevalent in patients with mental illness than in the general population include: high blood pressure, smoking, heart disease, diabetes, obesity; and asthma. The evaluations inside the two new SHARE exam rooms will diagnose these illnesses as early as possible for treatment in partnership with Beckley Appalachian Regional Hospital and Physician Assistant Brittany Addair. BARH is also in the process of establishing a lab at FMRS for better compliance and an immediate picture of what’s going on inside the bodies of mental health and recovery patients, many of whom have never seen a practitioner for more than treatment of their most obvious disorder.

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If diagnosed with concomitant conditions, the right medications and small health habit changes can make a big difference in the lives of mental health patients. Kidd describes a patient who began with her walking group, exercising just twice a week, and learning about better food options from nutrition group.  When he missed a few walking sessions, the clinic conceived a chart to illustrate the progress he’d made and of which he was yet unaware. Seeing a graphic representation of his 26-lb. weight loss, a two-point downshift in BMI and six inches off of his waist circumference reenergized him, Kidd explains. Now, he shows up for groups and brags to his therapists about his progress, folding and unfolding the paper to show as proof and inspiration to whoever will listen.

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Kim Pack, Program Director in charge of SHARE’s day-to-day operations, says, “We make the experience of primary care seamless for them.” Pack has found the structure of the program to be less rigid for patients who have trouble with keeping outside physician appointments or who have suffered in the past from being misunderstood.

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“This is one stop shopping for our patients. The clinic puts it all together. Before, our patients would go to other doctor’s offices and sit in waiting rooms a couple of hours. Our folks may not be able to tolerate this (emotionally). When they would leave, they’d be labeled as noncompliant.” Pack adds that everything SHARE is doing is new territory for FMRS, but the effort is paying big dividends in improving health. “We are stunned at how much of an impact even six months of being open has had on our patients.”

For more information on SHARE, call (304) 256-7129.

 

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