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Behavioral Health

Feb 23 2020
Love1

Peer Support: Patience and Kindness

By Advocate, ePatient, Podcasts

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Everybody possesses innate wisdom about themselves. I don’t know the answer to your question, but I believe that you know the answer to your question. I’m here to provide you with any information you need, support to access resources in the community, or just to be patient and listen. Interview about Peer Support with Keith Scott from Advocates, Inc.

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Nov 05 2017
Love0

From the Inside Looking Out

By Caregiver, Clinician, Consumer, ePatient, Family man

At the #PCORI2017 Annual Meeting, Alan Alda showed us a simple mirror improv exercise (remember Groucho and Chico Marx in Duck Soup?). Alan first showed us him mirroring an audience member, then the audience member mirroring him, and finally, them mirroring each other at the same time. It was an exercise in empathy.  Afterwards, someone at my table said,

From the outside looking in, it’s hard to understand. From the inside looking out, it’s hard to explain.

I first heard these words many years ago from a peer support professional describing the experience of depression and addiction. I understand this better now that I’m a person with a chronic illness. I work hard to explain what’s inside to my family and other members of my health team.  Often I don’t know or I don’t have words. Mindful meditation helps tremendously – deciding to become friends with what ails me. It’s all me and I love me. I’m not sure if it helps me explain, but it helps me know myself. And for sure, it increases my empathy when I’m on the outside looking in. Thanks, Alan, for reminding us.

See also other posts about Improv and

Patient-Centered Outcomes Research Institute

Learning from What Doesn’t Work

Jan 16 2017
Love0

Health Hats – 2016 in Review

By Advocate, Caregiver, Clinician, ePatient, Family man, Informaticist, Leader, Researcher

I’ve been feeling my oats in 2016 as an advocate and catalyst for Empowering people as they travel together toward best health. As my dear friend, Mary Sue said, Danny, you’ve found your calling! Wearing my many hats, I often feel like I know enough to be dangerous about much of healthcare. When I walk into a room of experts in their fields – clinicians, researchers, policy makers, techies, insurers, executives, I think, What am I doing here? I’m way over my head. It takes two minutes to understand that I’m the connector of their considerable expertise to the workflow and life flow of patients, clinicians, caregivers, and staff. I’m also the translator among their jargons. I can shift the conversation by offering a voice for some experiences of patients, caregivers, and clinicians.

I’ve refined my work this year as a connector, translator, and advisor while working as a technical expert in patient-centered research, behavioral health information technology, community health, and health payment innovation. I’ve benefited from the warm embrace of Wellesley Partners during this transition year after leaving my 40+ years as an employee and boss.  I am grateful that they believed in me and helped me polish a few rough edges of inexperience. I also appreciate the counsel of many – Doug, Geri, Pat(s), Juhan, Bevin, Eve, Jarred, Keren, Jonathan, Sarah, and Lauren to name a few. You all know who you are. Thanks. I’m grateful for the many inspiring people in the patient/caregiver/clinician experience space. Thanks for all you do. You keep my embers glowing. Read More

May 29 2016
Love0

Fractured Communication in Crises

By Advocate, Caregiver, Clinician, ePatient, Informaticist, Leader

This week two of my readers described experiences of fractured communication with their clinicians.  One reader, a person in acute treatment for overwhelming anxiety, found himself watching and feeling the effects of dueling clinicians with widely differing diagnoses, medication regimens, and styles of communication. A collaborative, listening, empathetic physician versus a paternalistic, blameful, arrogant physician. Both physicians practiced in the same organization but in adjacent levels of care (one inpatient and the other outpatient). They didn’t coordinate care – they didn’t even speak to each other. The person with acute anxiety had to muster energy to advocate for himself and seek help from his partner. To little effect.  The other reader experienced a sickle-cell crisis in a hospital without a sickle-cell specialist.  She couldn’t get pain medication known to work for her.  She was classified as a drug seeker.  The treating physician wouldn’t communicate with the specialist who had treated this reader successfully many times and managed her long-term care.

So many levels of outrage here. How is it that institutions, practices, and people working in these two programs don’t know about disrespect, poor communication skills and lack of coordination within? Does nobody raise a red flag?  Where was the medical record? Where were the leaders? Read More

May 01 2016
Love0

I’m So Discouraged

By Caregiver, Clinician, ePatient, Family man, Musician

Several times this week I heard a variation on: I’m so discouraged, I thought I was doing better. I just keep sliding back. I really suck at this. The topics: meditating every day, losing weight, managing anxiety, soloing, recovering from surgery. I heard each from more than one person. Several people said it about multiple things. One person, me, said it about losing weight and soloing. Two things strike me here. First, sucking and second sliding back. Can’t we give ourselves a break and celebrate that we’re trying? I’m trying to meditate every day, lose weight, improve my mental health, solo on my sax!!!! Yippee for me. Yippee for us!!! Recovering, healing, learning, changing habits doesn’t happen in a straight upward line, steadily better. It’s two steps forward, one step back. It’s up and down, first wildly so, then smaller cycles of up and down, over time with forward progress. Looking at just 2 data points only frustrates us, since we tend to recognize the down after the up, rather than the up after the down. In each of the scenarios someone heard the other and provided a good job, way to go, keep it up, keep me posted, call me anytime

I honor you’re work of healing, learning, recovering. Good job, way to go, keep me posted, call me anytime.

Oct 13 2013
Love0

A Powerful Union: Relationships within Health Teams

By Advocate, Caregiver, Clinician, Consumer, ePatient, Leader
The relationship between health team members, especially people and their clinicians and caregivers, frequently arises as a topic of this blog. Let me share with you one of the values of Advocates.  I work for Advocates as VP of Quality.  We express our values in Advocates Way. Advocates provides person-centered, community-based support services to individuals and families with mental illness, addictions, developmental disabilities, brain injury, and other challenges in living.

A Powerful Union

We strive to foster relationships in which the person feels understood, is respected as an expert about his or her own life, and takes a leading role in all decision-making and planning that could affect that person’s life.
 
We see each person we serve as a “guide” whose experience, wisdom and perspective are unique and vital to our mutual success.  When a person’s expertise about her or his own life is combined with our knowledge and resources in an atmosphere of hope, collaboration and mutual respect, truly marvelous things can happen.
 
We encourage and support people to take charge of their own lives. We do this even when the path a person chooses includes an element of risk and decisions which may cause us concern.  We believe that all experiences – successes and challenges alike – result in growth, learning, and change.
 
Isn’t that sweet! A constant challenge to live.
Oct 20 2012
Love1

Patient Adherence – Lessons from Recovery

By Consumer, ePatient, Leader
I attended a planning meeting of the #PatientAdherence Working Group in Newark, NJ on Thursday. The group dedicates itself to patients & health teams members developing an adherence plan for best health outcomes. I began discussion of adherence in a previous post:  Developing and adhering to a health plan involves studying population health; evidence-based best practice; collaborative relationships, behaviors, language, and alignment of the health team; standardized work flows with on-the-spot improvisation; electronic and non-electronic tools; leadership; and management of cultural and social habits and challenges.

I was educated about the complexity of adherence under the tutelage of Bob Doherty while working at St. Peter’s Addiction Recovery Center in Albany, NY. Bob taught me that recovery (adherence) involves the whole person and all their social systems – personal health, family relationships, housing, diet, spirit, etc. That relapse is not failure but a milestone in a journey to best health. Relapse is an opportunity to learn and recalibrate. Such lessons! The medical side of health has much to learn from addiction treatment. An inspired example of technology contributing to adherence comes from The Recovery Engagement Center. Check it out.
Oct 10 2012
Love0

World Mental Health Day

By Caregiver, Family man
My heart aches – I have loved two people with serious mental health disease. I am a caregiver, I want to be a contributing part of my loved ones’ health journeys. Heck, I became a nurse because I find fulfillment in being an intimate part of people’s health journey. I felt gnawing  inadequacy living with my loved ones with serious depression. It killed me that they didn’t appreciate themselves as much as I valued them. We couldn’t figure out how to let me in to be part of their team. They were so alone, I got so angry. I honor this day to honor them. Lillie and Peggy, you made life rich. Thanks.