In many communities, mental health issues fester in the shadows. Not here on the Cape where enlightened concern is more the rule than the exception…and where recent new developments have further brightened a too-often bleak landscape.
With an eye toward providing Cape and Islands youth and their families with comprehensive behavioral health assessments, treatment plans, and connections to appropriate services, several community groups have collaborated on a new Kids and Teens Behavioral Health Assessment Center on Potter Avenue in Hyannis.
The new Assessment Center will offer families a central point of contact, a point person to help coordinate referrals for specialized assessments and a central place to receive information and support related to parenting a child with behavioral health issues. This service will be available to all families, regardless of ability to pay. All children in Massachusetts under age 19 are eligible for health insurance under state programs, meaning most assessments are reimbursable.
“The Assessment Center will provide culturally competent and comprehensive behavioral health assessments, family driven treatment plans, and community-based care management services,” said Peggy Meenan, LICSW, the director of the Center. “We will serve as a clearinghouse in which to locate behavioral health services, arrange for referrals, and obtain a comprehensive diagnostic picture of a child.”
The Assessment Center will work with a variety of children and families and will assist parents who need some guidance through the behavioral health system in finding services for their children. The Center also will work with those children and families that have more complex needs and questions on diagnoses, medications and connections to services.
The Assessment Center is governed by an Advisory Board comprised of community members with various levels of expertise in the area of child and adolescent behavioral health. Its creation has been funded through grants from The Bilezikian Family Foundation, The Cape and Islands United Way, The Cape Cod Foundation, The Kelley Foundation and Cape Cod Healthcare’s Community Benefits Program.
Doreen Bilezekian, who runs the Bilezikian Family Foundation, and Richard Brothers, President of the Cape and Islands United Way, are two of 18 Advisory Board members.
Cape Cod Healthcare’s Behavioral Health Services group will operate The Assessment Center during the first year of operation. CCHC will provide clinical, administrative and regulatory oversight in the initial operational phase of The Assessment Center to ensure a singular focus on service delivery from the onset.
The Advisory Board intends to obtain independent licensure and operational status for the Center at the earliest possible date.
“There are gaps in the current mental health system statewide, as well as here on the Cape and Islands,” Ms. Meenan added. “The Assessment Center intends to try to close some of those gaps.”
He has seen the worst during a four-month tour in Iraq, including helping to clean up some of the emotional detritus from Abu Ghraib Prison. For more than six years, including nearly three years since his return, Dr. Tony Dingmann has been Medical Director and child psychiatrist with Child and Family Services in New Bedford.
Now, Dr. Dingmann, a resident of Pocasset, now has taken on double duty on the Cape as Medical Director for the State Department of Mental Health Cape and Islands site in Hyannis and as a child psychiatrist with the new Kids and Teens Behavioral Health Assessment Center on Potter Avenue in Hyannis.
He’s also in the process of setting up in a private practice as well.
A busy man, Dr. Dingmann, and he still has time to work with the local Boy Scouts and to keep up his military obligations as a newly-promoted lieutenant colonel in the Massachusetts National Guard with weekend training stints at Hanscomb Air Force Base.
A recall to active duty remains a possibility for Dr. Dingmann, although he knows it would be short. “The military knows that when physicians are called up for an extended period of time, their practices can disintegrate. And so you’d end up with no doctors joining the Guard or reserves,” Dr. Dingmann explained. “That’s why they only call us up for four-month tours.”
Dr. Dingmann came to Abu Ghraib, the notorious Iraq prison camp after the abuses had ended and the recovery period had begun. Now, in his military capacity, he counsels soldiers before their overseas tour of duty and also on their return.
Dr. Dingmann is from North Dakota and attended that state’s medical school before coming east to Brown for two years of psychiatric training. That’s where he met his wife, a psychiatric nurse from Bourne, which led to the Cape connection. They’ve been here since 1997 and have three children, 15, 19 and 22.
He specializes as a child psychiatrist, but points out that the younger the patient, the more important the family relationships, and so that becomes part of his practice as well.
Behavioral Health Services of Cape Cod, the mental health arm of Cape Cod Healthcare (CCHC), has named Dr. Shannon Scarry as medical director. In addition to these responsibilities, Dr. Scarry will maintain her outpatient psychiatric practice at Cape Cod Hospital.
The appointment was announced by Carol Plotkin, MSW, LICSW, Executive Director of Behavioral Health Services who had been named to that position herself only in the past year.
Dr. Scarry brings 25 years of clinical and administrative experience to her new position. A graduate of Radcliff College of Harvard University and Rush Medical University of Chicago, she is board-certified in both Child Adolescent Psychiatry and Adult Psychiatry. Prior to returning to the Cape where she grew up and attended Nauset schools, Dr. Scarry established psychiatric emergency and admission centers in two Philadelphia hospitals.
Electroconvulsive Therapy (ECT) may be a relatively new tool in the on-going struggle against mental illness, but Cape Codders received a moving lesson in its effectiveness recently from Kitty Dukakis, wife of the former Massachusetts governor and presidential candidate.
Mrs. Dukakis has been troubled with depression, alcoholism and prescription drug addiction over a 20-year period. She has discovered ECT to be an effective treatment and has written a book on her experiences, SHOCK: The Healing Power of Electroconvulsive Therapy. She and her co-author, Larry Tye, delivered the annual Dykens Guest Lecture at the Four Points by Sheraton Hyannis Resort under the co-sponsorship of Behavioral Health Services of Cape Cod Healthcare (CCHC) and the Southeastern Massachusetts Psychiatric Society.
“It’s not a cure, but it is a treatment and it works more quickly than anti-depressant drugs,” Mrs. Dukakis pointed out.
It’s particularly useful, she said, for pregnant women who cannot be taking these drugs and is “extraordinarily effective” for the elderly.
“I hope a program here can help the many elderly on Cape Cod who suffer from depression so they can enjoy the years they have left,” Mrs. Dukakis said.
(A spokesman said CCHC has been “looking at establishing an ECT program for a while,” and had even recruited a specialist in that procedure. “This book did bring it to the forefront and I’m glad we were able to bring them down (to speak),” he added.)
Mrs. Dukakis said the usual regimen is six to 12 treatments over a two or three-week period and after four or five treatments the patient can begin to see some results.
However, it is not a permanent cure and continued maintenance may be required. “It used to be an in-patient procedure, but now you’re in and out in hours,” she added.
There can be some memory problems and while ECT can be used for schizophrenia and bi-polar problems, it is most effective in treating depression.
The treatments are expensive, she warned—$2,000 to $3,000 per treatment and up to $16,000 for a full course. However, she said, Medicare will cover the cost as will most private insurance companies. “They like it,” she said, “because it works and because it’s
September 11th. Will we ever forget that date?
Where were you when you heard the news? If you were at work, did you start crying or shaking? Were you unable to perform your duties because you couldn't stop thinking about what had happened or what yet might occur?
If so, you weren't alone. Many people felt the same way after the 9/11 terrorist attacks. And those are just a few of the symptoms that people experience after a tragedy, even one that didn't happen right in their own office.
We can't imagine a tragedy of that magnitude happening where we work. Yet every day Americans in the workplace are affected by some kind of traumatic incident. Recent reports have shown that each year:
l More than 10,000 people are killed in accident-related events at work
Employees experience critical incidentsat work as traumatic, whether or not they are directly affected by the tragedy and even if they did not personally know anyone involved. Events that impact workers range from armed robbery, physical assault by a co-worker, and natural disasters, to medical emergencies such as a heart attack or stroke, sudden death of a company VIP, or family violence that spills over into the workplace.
Trauma in the workplace has wide-ranging impacts on employees, both practical and psychological. Depending on the nature of the incident, employees may be thrust into new roles, be given additional responsibilities, and generally have more demands on their time. They may be worried about losing their jobs, or wonder where they fit in a changed hierarchy in the office. All the while, they are continually reminded of their losses.
The psychological impact of the loss and the additional stress cannot be overlooked. It is normal to exhibit signs and symptoms of a stress reaction.
These can include:
Usually these symptoms last for a few days or weeks. However, depending on the severity of the traumatic event and the individual's coping skills, a stress reaction could go on for months or even longer. Occasionally, the traumatic event is so painful that professional assistance may be necessary.
This does not imply that a person is abnormal or weak; it simply indicates that the particular event was just too powerful for some people to manage by themselves.
When a traumatic incident occurs at a workplace, it is often helpful to call in professional help. If you have an employee assistance program, it can provide a variety of supportive interventions. Many mental health organizations on Cape Cod also have trained practitioners who can provide support and consultation.
One supportive intervention called Critical Incident Stress Debriefing has been found to be effective in mitigating the impact of traumatic events. Debriefing is not psychotherapy; it is a group intervention, usually led by a mental health professional trained in this process. The goal is to facilitate the natural healing process.
Having professional consultation enables managers as well as the employees themselves to identify when someone is having trouble and may need some extra help. It provides the resources to seek out the help they need. It is important to remember to attend to the psychological impact of any critical incident that occurs at work to help employees get back to their normal functioning and productivity as soon as possible.
(The above article was prepared by staff at Bayview Associates, a program of South Shore Mental Health, in Hyannis, 508-862-0514).
By Diane J. Kovanda, M.Ed.
Stress is an unavoidable part of life. The demands of jobs and family, along with financial, health and time pressures can at times become overwhelming.
Fortunately, we all have within us natural ways of reducing stress and recharging ourselves. Exploring the sources of stress and transforming our reactions are important steps on the path to well-being.
Following are some initial actions one might take toward a less stressful, healthier life, although professional assistance may be helpful:
Here are some useful techniques for calming and renewing your body and mind:
(Ms. Kovanda provides individual stress-reducing counseling. She can be reached at 508-428-8635 or Kovanda@comcast.net.)
By Barbara M. Maurer, L.M.F.T.
Marriage and Family Therapy is based on the research and theory that mental illness and family problems are best treated in a family context.
Marriage and Family Therapists (MFTs) concentrate on understanding their clients’ symptoms and interaction patterns within their existing home environment, although they will treat individuals in addition to couples and families.
Our research has indicated that family interventions can be equally or even more effective (and often less costly) than other methods. This can include family involvement in dealing with medical as well as mental problems.
MFTs also take what is considered a unique approach toward marriage counseling and this year established The National Registry of Marriage Friendly Therapists, LLC.
Starting with the premise that many therapists “are often neutral about whether a troubled marriage ends or endures,” the Registry has assembled a group of therapists whose guiding principle is that “while sometimes divorce is unavoidable…the first effort is to see if the marriage can be preserved.”
The inspiration for this theory was a 1995 book, Soul Searching, by William J. Doherty, Ph.D. Dr. Doherty, a marriage therapist, criticized many of his colleagues for taking what he termed “an individualistic approach to commitment: how is it working for you now, and what will make you happiest in the future?”
His goal and that of Marriage Friendly Therapists is to “help couples stay together unless there are compelling reasons not to.”
(The Registry is available at www.marriagefriendlytherapists.com. Ms. Maurer is a state-licensed Marriage and Family therapist practicing in Osterville, 508-428-5849.)