By Jennifer Dozer, RN, Patient Care Coordinator, Behavioral Health

I remember my first day as a student nurse on the psychiatric unit. We had each been assigned a patient, and were supposed to spend a few minutes talking with them and assessing their psychiatric symptoms.

My assignment was easy. I had been given a 20-something woman, who had experienced the devastating loss of a child and was severely depressed. She was actually pleasant and very forthcoming about her troubles, and I finished my interview fairly quickly.

My classmate Sharon was another story. Her patient was a man in his 40s who had had a rough night. Shortly before we started our clinical shift, he had been escorted to the seclusion room, medicated, and placed in restraints. Her assignment was to assess his symptoms and provide the constant monitoring and checking required when a patient is restrained for his own safety.

He was very upset. He frequently screamed at the voices he heard -voices that were saying terrible, scary things to him. He truly believed the people around him wished him harm, and that he was fighting for his life.

Not only was he frightened, but Sharon was frightened as well. After an hour, her time with her patient was done, and we all huddled in the break room talking about our experiences.

“My Grandma used to say people like this had demons inside them”, she said. “And now I believe it is true. He had to be talking to demons.”

“But you attended lectures just like the rest of us,” I challenged. “This is a disorder of the brain.”

“Well”, she hedged. “Maybe the brain disorder just makes him more susceptible to a demon’s influence?”

It’s shocking to think anyone can still hold this belief even in the 21^st century, especially someone training to be a health care professional, but she was not the only one nodding in agreement that day.

Fear is an incredible motivator. It can motivate us to ignore the evidence of reason. It can motivate us to avoid seeking the help we need when we are ill.

Psychiatric disorders often carry the extra burden of stigmatization while, at the same time, getting enough social and community support can be integral to achieving recovery.

Educating yourself about the facts, so that you too can help educate others, is one way to chip away at the misconceptions we all may have about mental illness.

A year or so after this incident, I was working in a community outreach program. My clients were all adults with serious mental health diagnoses. Part of my role was helping people form social bonds and re-integrate into the community after hospitalization. I took one of my clients, Sue, to a social club that was organized by other people with mental health diagnoses.

As we walked in, the leader for the day walked up to us and introduced himself. He asked me which center I went to, and it suddenly occurred to me that he was assuming that I, like Sue, was also a mental health consumer. There was a heartbeat of a second when I had to decide whether to correct him or just go with the flow, and wear that label for the next few hours.

What would you decide? If you find the idea of wearing that label uncomfortable for even a short period of time, imagine how someone who must carry that label for a lifetime must feel. The truth is, the way we speak about and act socially towards people with psychiatric illnesses can discourage people from seeking help, in order to avoid that socially unacceptable label.

What did I choose to do? I went with the flow and acted as Sue’s wing-woman for the night. No stigma allowed.

For updates on the fight against mental health stigma, subscribe to the National Alliance on Mental Illness (NAMI) Stigmabuster Alerts.

May is Mental Health Awareness Month

Lisa is a Registered Nurse at CareSource and has worked in behavioral health most of her career.

“I just fell in to it. It was a natural transition for me,” explains Lisa. “Some people gravitate towards maternity and babies; I gravitated towards mental health.”

You might think that’s strange, but Lisa doesn’t. She has a passion for helping people that have mental illnesses. In fact, mental illness hits close to home.

Lisa has two teenage sons – 19 and 17 – that struggle with schizophrenia, depression, anxiety and bi-polar disorder.

“Mental illness runs in our family; both my father and my husband struggle with it.”

When her oldest son was 3 years old, she took him to the doctor because she knew something just wasn’t right.

“He was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). My doctor told me to socialize him and involve him in activities. That seemed to help, but there were still other things going on that we weren’t yet aware of.”

Both sons were diagnosed at early ages and will probably be on medication the rest of their lives. However, there have certainly been bright spots along the way.

Her 17 year old son recently received his GED and will be attending college this summer.

Lisa’s 19 year old is attending college and involved with Goodwill Easter Seals to help him with housing and employment. Even his college professors are aware of his struggles and reach out to help when things get a bit overwhelming.  Recently he had to take a break from school and work due to feelings of “losing control” but he is receiving the support and services he needs to get back on track.  This is very common in people who try to manage their mental illness.

“A person with a mental illness can become easily overwhelmed. It’s important for people to have a support system to help them take a step back and put things in to perspective.” ”

Despite their daily struggles, Lisa is hopeful that people with mental illnesses can lead healthy, productive lives.

“The good news is mental illness is a disease you can live with if you are willing to work hard, accept help, allow support and recognize the ‘triggers’.”

Twenty years ago, mental illness was never discussed or addressed but simply swept under the rug. Today, education and communication are key. There are resources available but, the person has to be ready and willing to accept help. 

Mental illness is more common than you might think. In fact, in Ohio there are approximately 418,000 adults and 124,000 children living with serious mental illnesses.

Some people think those who are mentally ill can just snap out of it, take some medicine and get better. That’s not the case. It’s a lifelong challenge, but it can be done with proper support and hard work.

“Mental illness is hard for people to talk about and admit. But the silence must be broken if we truly want to get people the help they need and deserve.”

If you or someone you know needs help, talk to your doctor or contact the National Alliance on Mental Illness (NAMI) at 1-800-950-6264. You can also follow NAMI’s updates on Facebook and Twitter.

Resource: National Alliance on Mental Illness

Bullies and mean girls have been on playgrounds and schools forever, but the Internet and cell phones have opened up a whole new world. Kids use technology different than their parents. Many spend a lot of time on social networking sites like Facebook and send hundreds of text messages and instant messages (IMs) to their friends. Their knowledge of technology can be intimidating, but they still need parental supervision.

What Is It?
Cyberbullying is the use of technology – e-mail, text messages and social media sites – to harass, threaten, embarrass or target another person. In a 2006 poll from the national organization Fight Crime: Invest in Kids found that 1 in 3 teens and 1 in 6 preteens have been the victims of cyberbullying. Severe cyberbullying can leave victims at greater risk for anxiety, depression and other stress-related disorders. Some kids have even turned to suicide.
 

Know the Signs 
Kids who are cyberbullied are often reluctant to tell a teacher or parent because they feel ashamed or are afraid their computer and cell phone privileges may be taken away. The signs that a child is being cyberbullied vary, but a few things to look for are:

1. Emotional distress during or after using the Internet
2. Withdrawal from friends and activities
3. Avoidance of school or group gatherings
4. Slipping grades and “acting out” in anger at home
5. Changes in mood, behavior, sleep or appetite
6. Wanting to stop using the computer or cell phone
7. Appearing nervous or jumpy when getting an instant message, text message or e-mail
8. Avoiding discussions about computer or cell phone activities

What You Should Do
Here are some suggestions on what to do if online bullying has become part of your child’s life.

1. Talk to your child. Listen to how they feel about being bullied and talk about ways you can approach the situation.
2. Know your kids’ online world. Check their postings and the websites they visit. Be aware of how they spend their time online. Talk to them about the importance of privacy and why it’s a bad idea to share personal information online, even with friends.
3. Limit access. Keep the computer in a public place in the house and limit the use of cell phones and games.
   Block the bully. Most devices have settings that allow you to electronically block e-mails, instant messages (IMs), or text messages from specific people.
4. Get involved. Talk to your child’s school counselor, principal or teacher about what is going on. However, before you do that, tell your child what your plan is. He or she may think you are “tattling” and prefer the situation be handled at home.
5. Keep record. Threatening messages, pictures and texts can be used as evidence with the bully’s parents, school, employer or even the police.

Cyberbulling should be taken seriously. Talk to your kids about respecting others even through technology.  It’s a lot easier to send a hateful text message than to say it to someone’s face.

Source: KidsHealth.org

By Silvia Llacera, Associate Learning Consultant, CareSource University

I joined Pinterest earlier this year because I wanted to find out what everyone was talking about. I was instantly taken by the visual appeal of the site and the endless opportunities for inspiration and idea sharing. Pinterest is a social network – a virtual pinboard that helps you organize the things you find online that interest you. It’s different from other social sites because it is richly visual, while others are text heavy.

Pinterest is a great tool in so many aspects. I am always looking for inspirational quotes, recipes, craft ideas, DIY projects and of course a few fashion tips. My 13 year old daughter has even created her own board in my account and pins her favorite things. She finds it fun and has even put some ideas to work.

My 7 year old son enjoys helping me with recipes we find. He helps me gather the ingredients, and more than once, he got his hands dirty in the kitchen. I have even encouraged my husband to get involved since I’ve found a few DIY home improvement projects for us to work on now that spring is here. I also started purposefully taking pictures of the things I do to share on Pinterest so that I can also contribute my ideas. 

I even use Pinterest for my job. As a Learning Consultant at CareSource University, I always search for things that are worth sharing in the classroom. My job is to train our employees and help them increase their passion for our mission and our company culture. I also help my co-workers apply concepts of what they learn to their professional and personal lives.  I created a board titled “Do What You Love” where I pin anything that I think is relevant for the training room. The most impactful thing I found so far was a flow chart that starts with the question, “Are you happy?” Another image I found is called “The Cup is Always Full”. I am always looking for new ways to bring inspiration and a positive outlook into my classes. 

I was excited to find CareSource on Pinterest. We have several boards of interest – some are inspiring and educational, others are funny. Overall, there are a lot of great tips on health and wellness and things to do with the family. I encourage you to follow our boards and tell us what you would like to see.

Now it’s time for you to build your own collection of resources, share your ideas, follow those in your own community or around the world. You’ll definitely learn about others through what they pin – a picture is worth a thousand words.

How are you using Pinterest?

We are honored to be recognized for a third year in a row as one of Training magazine’s Top 125 companies that excel at staff development and training.

Listed at #14 on the Top 125 list, we join the ranks of some of the nation’s largest and most successful organizations including Farmers Insurance, the United States Navy and Coldwell Banker. The past two years, we have been ranked in the top 15.

“We are honored and extremely excited to be recognized again,” said Pamela Morris, President and CEO. “This is a testament to our exceptional training and development programs that continue to evolve and grow.”

With choices from more than 500 curriculum offerings, CareSource University provides career planning and development resources to all employees, including clinical licensure programs, new employee training, leadership and career development and coaching.

“Our organization is unique in that we place a high emphasis on learning and career development,” stated Jackie Smith, Vice President of CareSource University. “I believe successful organizations, like CareSource, realize the importance of training their employees as well as offering ongoing coaching and development programs. I am honored to be a part of an organization that places such a high value on employee development.”     

Two CareSource employees know the the importance of ongoing training and development firsthand.

“Over the years I have had the privilege of working for several large Fortune 500 companies, but none of them had a training program as relevant and accessible as CareSource’s,” Mark Quick, Business Analyst, stated.

“I am grateful for the opportunities I have been given to learn and grow,” said Heather Boehmer, Grievance and Appeals Specialist. “The skills I have gained through the development classes have not only helped me earn a promotion and grow professionally, but have led me to take a far more active role in my own destiny.”

 Training magazine selects 125 global and national organizations annually that exhibit best training practices, evaluation methods and outstanding training initiatives. Honorees range in size from Fortune 500 companies to smaller organizations of 100 plus employees. Judging is based upon elements such as scope of development programs, financial investment in employee development, and how closely training efforts are linked to business goals and objectives.

“We are honored to be recognized again and to be in the same category with nationally known organizations,” Smith added. “We look forward to continuing to train our employees in a way that is innovative, personalized and immediately applicable to our organizational objectives.”

What’s called the “silent killer,” the number one risk for heart disease and one in three adults have it?

High blood pressure, also known as hypertension.

Surprised?

Even more disturbing – most people don’t even know they have high blood pressure which is why it’s called the “silent killer.” It can lead to stroke, heart attack, kidney failure and even heart failure. 

The American Heart Association has introduced Life’s Simple 7™ – seven steps to a healthier heart.

1. Mange your blood pressure.  Know your numbers – normal blood pressure is less than 120 over 80 (120/80). Keep your blood pressure down by eating a heart-healthy diet which includes reducing salt, enjoying regular physical activity, maintaining a healthy weight, managing stress, limiting alcohol and avoiding tobacco smoke.

2. Eat better. A healthy diet and lifestyle are your best methods to fight heart disease. Choose foods like:

• Vegetables and fruits – high in vitamins, minerals and fiber; low in calories
• Whole grains – wheat bread, brown rice, oatmeal, popcorn or whole wheat pasta. Whole grains help lower your cholesterol and help you feel full, which may help manage your weight.
• Lean meat and fish – salmon, trout and herring have omega-3 fatty acids that may help lower your risk of heart disease.
• Low-fat dairy products – skim milk, low-fat cheese and yogurt are great sources of calcium, protein and Vitamin D which help build stronger bones, lower blood pressure and maintain weight. 

3. Get active. By exercising for as little as 30 minutes a day you can reduce your risk of heart disease. Without regular physical activity, the body slowly loses its strength and ability to function well.

To increase physical activity try:

• Parking farther away from your destination
• Take short walks throughout the workday
• Use the stairs instead of the elevator
• Participate in active-play video games with your friends and family like Wii Fit Plus™

The simplest, positive change you can make to improve your heart health is to start walking.

4. Control cholesterol. Cholesterol comes from two sources: your body and food. Your liver and other cells in your body make about 75% of blood cholesterol. The other 25% comes from the foods you eat. LDL cholesterol is the “bad” cholesterol. When too much of it circulates in the blood, it can clog arteries, increasing your risk of heart attack and stroke. To keep your cholesterol under control The American Heart Association recommends that you:

• Schedule a cholesterol screening
• Eat foods low in cholesterol and saturated fat and free of trans fat
• Maintain a healthy weight
• Stay active

5. Lose weight. Obesity is now recognized as a major risk factor for heart disease. If you have too much fat — especially a lot around your waist — you’re at higher risk for high blood pressure, high cholesterol and diabetes. Eating healthy and being active is the key to managing a healthy weight.

6. Reduce blood sugar. The American Heart Association considers diabetes one of the six major controllable risk factors for heart disease. In fact, adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without diabetes. When diabetes is diagnosed, a doctor may prescribe changes in eating habits, weight control, exercise programs and medication to keep it in check. It’s very important for people with diabetes to have regular check-ups. Work closely with your doctor to manage your diabetes.

7. Stop smoking. Smoking increases the risk of heart disease, but when it is combined with other factors like being overweight and having diabetes for example, it can double or triple your risk of heart disease. You don’t have to quit alone. Ask your family, friends, and doctor to help you. Quitting is hard, but it can be done.

• Get ready. If you’re ready to quit right now, go ahead. But if you want to plan ahead, set a date to quit. Pick a time when you won’t have a lot of stress in your life. Get rid of ashtrays and lighters before you quit. Don’t let people smoke in your house.
• Change your routine. For example, if you smoke after eating, take a walk instead.
• Use medicine. It can help with cravings and stress, and it doubles your chances of quitting smoking. You can buy nicotine gum, lozenges, or patches without a prescription. Your doctor may also prescribe medicine.
• Get support. Seek help from the national tobacco Quit Line (1-800-784-8669), stop-smoking programs like the American Lung Association’s Freedom from Smoking program or contact your doctor.

Remember, Life’s Simple 7™-  it’s the small steps that make a big difference.

 Resources: American Heart Association, WebMD

We are honored to be named 1 of 60 organizations on the Dayton Daily News’ Top Work Places list. We placed #8 out of 10 in the large business category.

This is a testament to all of our employees not just in the Dayton office, but in Columbus, Cleveland and Lansing, Michigan. It reminds us of the outstanding culture and professional environment we have cultivated. 

Join our team. We are hiring! View our jobs and apply online.

Top 10: Large Business Category  

1. Coldwell Banker Heritage Realtors 
2. MacAulay-Brown Inc.
3. The Hospice of Dayton Inc.
4. Miami Valley Career Technology Center
5. Gem City Homecare
6. St. Leonard
7. Hillsboro City Schools
8. CareSource
9. Comfort Keepers Miami Valley
10. Dayton Children’s Medical Center

Guest post by Jessica Bertolo, Credentialing

While most birth defects cannot be prevented because their causes are not known, women can take a number of steps before and during pregnancy to reduce their risk. These steps include taking a multivitamin containing 400 micrograms of folic acid daily starting before pregnancy and in early pregnancy. This helps to prevent serious birth defects of the brain and spinal cord, including spina bifida, and may also help prevent heart defects. Another step is getting a pre-pregnancy check-up and making sure that the medications you are taking are safe to use during pregnancy.

The March of Dimes is a great resource to pregnant women, especially those at risk for birth defects.

Since the late 1950’s, The March of Dimes has developed and promoted numerous initiatives to advance this field as part of their mission to improve the health of babies by preventing birth defects, premature birth and infant mortality. March of Dimes also awards research grants aimed at understanding the causes of birth defects and advocacy priorities focus on authorization and funding for birth defects surveillance, research and prevention at the federal and state level.

Many families walk and raise dollars to support the work that the March of Dimes conducts targeting birth defects. The Cornell Family of Dayton reached out to the March of Dimes following the birth of their son, Carter, in January, 2011. At twenty, parents Blair and Kat found out that their new baby would be a boy. That same day, they also received news that their baby appeared to have multiple birth defects. After additional testing, it was confirmed that their baby would be born with clubbed feet and that his brain had multiple signs of developmental abnormalities. Eventually, their baby was diagnosed with a birth defect called Dandy-Walker Malformation, a brain malformation that occurs during embryonic development and leads to abnormally high pressure within the skull and swelling of the head that can lead to neurological impairment. Doctors prepared Blair and Kat for a baby with moderate to severe physical and/or mental disabilities in the event he would even survive. With these brain abnormalities it was highly likely that their baby would also be born preterm creating additional health concerns.

Carter Thompson Cornell was born full term, just one week before his due date, miraculously eating and breathing on his own. He had a shunt placed to drain excess fluid off of his brain when he was just six days old. Over the past year, Carter has had many medical appointments as his team of doctors attempt to diagnose and meet his medical needs. He is currently undergoing treatment for his clubbed feet and is receiving occupational and physical therapy on a regular basis. Although, Carter is developmentally delayed he is gaining strength and making continual progress. In his spare time, Carter loves to laugh and play with his big sister Caitlin. He recently reached his one year goal of sitting up on his own. He is one special boy! 

In 2011, employees and clients of UBS Financial Services, Inc., Blair’s employer, raised $10,000 to support the March of Dimes work to fight birth defects. This April, the Cornell Family along with the UBS

Financial Services Team will once again be walking at the Miami Valley March for Babies. For more information on the Dayton March of Dimes chapter, log on to  http://www.marchofdimes.com/ohio.

If you are a CareSource member, join our new iConnect program and share your ideas with us. Your point of view helps us design medical benefits, customer service and wellness programs. iConnect will let you choose how you want to communicate with us. You can text or email us or join us on Facebook and Twitter.

We’ll also give you the chance to come to face-to-face meetings. Some members will be picked
to join our CareSource ambassador program.

This is your time to be heard. To join, call (888) 882-3613, email iConnect@CareSource.com or fill out our web form at www.caresource.com/iconnect. As a thank you, we will send you an iConnect t-shirt.

Now’s your time to be heard.

What happened to last year’s resolutions? Around February 1, you probably forgot what your resolutions even were. This year, set goals that are realistic and can be achieved.

Get Active
You don’t have to run a marathon or climb Mt. Everest to be active. Making small changes can add up to big results.

• Take the stairs instead of the elevator
• Park farther out and walk
• Bring your lunch to work instead of eating out
• Take your dog for a walk instead of watching TV
• Play with your kids outside for 30 minutes a day

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For more tips, go to www.smallstep.gov. 

Manage Stress
Stress can be caused by changes in life such as losing your job, your child leaving or returning home, the death of your spouse, divorce or marriage, an illness, an injury, a job promotion, money problems, moving or having a baby. Stress can cause health problems or make health problems worse. Here some tips for dealing with stress. 

• Don’t worry about the things you can’t control
• Prepare for events that you know may be stressful, like a job interview
• Talk with a trusted friend, family member or counselor
• Eat well-balanced meals
• Get enough sleep
• Look at change as a positive challenge, not as a threat
• Get involved in activities and hobbies you don’t find stressful

Eat Better
Being overweight puts you at risk for developing diseases like heart disease, stroke, diabetes and cancer. Lowering your weight helps prevent and control these diseases. Make better food choices by doing the following things:

• Drinking skim milk instead of 2%
• Choosing whole grain bread and pastas instead of white
• Drinking water or 100% juice instead of soda
• Eating baked or grilled foods instead of fried
• Cooking at home instead of eating out

We wish you and your family a happy and healthy 2012.

Sources: smallstep.gov and American Academy of Family Physicians