Here are the key steps I would take to develop a health reentry program in my clinic:
1. Assess the needs of the returning population in my community through surveys and focus groups to understand barriers to care.
2. Build partnerships with local reentry organizations, parole/probation, and community groups to identify and engage potential participants.
3. Enlist administrative support for the program from my clinic's leadership and identify a medical champion.
4. Develop core program components like group medical visits, health education, care coordination, and linkages to social services.
5. Train medical providers, case managers, and other staff on the unique needs of those with criminal justice involvement.
6. Pil
Social support through positive, health-promoting relationships can have a significant impact on motivation and long-term success. Otherwise, the health risk can increase dramatically. For example, when someone close to a participant becomes overweight, their chances of becoming overweight increase 45%-171% (depending on the nature of the relationship).
This paper focuses on the advantages of social support, with ideas for your organization to take advantage of these findings.
This document discusses doctor suicide and provides strategies for prevention. It begins with introductions of the speakers, Dr. Louise and Dr. Walton. Statistics are then presented showing doctors have high rates of suicide, with female doctors at even greater risk. Common issues contributing to suicide include depression, substance abuse, stress from long work hours and demands of the job. The document recommends hospitals and medical practices implement wellness committees, confidential support programs, and policies to promote healthy work-life balance and easier access to mental health support to help reduce suicide rates among physicians.
Supporting Wellness for Adults with Intellectual and Developmental DisabilitiesHouse of New Hope
This document discusses supporting wellness for adults with intellectual and developmental disabilities. It presents wellness as touching on physical, social, vocational, spiritual, emotional and psychological areas of life. The document offers ways that disability service providers, health professionals, community programs, employers, advocates and families can help ensure opportunities for wellness activities are available to those with disabilities. It shares examples of programs and individuals leading the way in supporting attention to areas essential for well-being, such as healthy activity, social connections, pleasure, meaningful relationships and healthcare participation.
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
1. The document discusses unwed mothers and issues they face, including social stigma, lack of family support, and health and economic problems.
2. Counseling is a key part of supporting unwed mothers and includes helping them deal with mental health issues, make decisions about their pregnancy, and establish a plan for their future.
3. Rehabilitating unwed mothers involves addressing mental, physical and emotional trauma as well as reuniting some with families or helping them start new lives on their own.
Social support through positive, health-promoting relationships can have a significant impact on motivation and long-term success. Otherwise, the health risk can increase dramatically. For example, when someone close to a participant becomes overweight, their chances of becoming overweight increase 45%-171% (depending on the nature of the relationship).
This paper focuses on the advantages of social support, with ideas for your organization to take advantage of these findings.
This document discusses doctor suicide and provides strategies for prevention. It begins with introductions of the speakers, Dr. Louise and Dr. Walton. Statistics are then presented showing doctors have high rates of suicide, with female doctors at even greater risk. Common issues contributing to suicide include depression, substance abuse, stress from long work hours and demands of the job. The document recommends hospitals and medical practices implement wellness committees, confidential support programs, and policies to promote healthy work-life balance and easier access to mental health support to help reduce suicide rates among physicians.
Supporting Wellness for Adults with Intellectual and Developmental DisabilitiesHouse of New Hope
This document discusses supporting wellness for adults with intellectual and developmental disabilities. It presents wellness as touching on physical, social, vocational, spiritual, emotional and psychological areas of life. The document offers ways that disability service providers, health professionals, community programs, employers, advocates and families can help ensure opportunities for wellness activities are available to those with disabilities. It shares examples of programs and individuals leading the way in supporting attention to areas essential for well-being, such as healthy activity, social connections, pleasure, meaningful relationships and healthcare participation.
This is a presentation that I give to medical professionals educating them on the role and potential use of social work in the hospital setting. I presented this on May 22, 2009 to the Trauma Education & Research Committee.
1. The document discusses unwed mothers and issues they face, including social stigma, lack of family support, and health and economic problems.
2. Counseling is a key part of supporting unwed mothers and includes helping them deal with mental health issues, make decisions about their pregnancy, and establish a plan for their future.
3. Rehabilitating unwed mothers involves addressing mental, physical and emotional trauma as well as reuniting some with families or helping them start new lives on their own.
The document discusses the need for behavioral health services in Nueces County, Texas. It provides statistics on mental illnesses like bipolar disorder and major depressive disorder treated in the county. Suicide rates are also discussed both locally and nationally. The nursing implications are early detection, education on risk factors, and management of disorders. Nurses play a role in comprehensive assessment, advocacy, and linking patients to support services. Barriers to mental healthcare include stigma, lack of perceived need, and cost of treatment. Community education and support can help address these barriers.
Aacc 2017 become a more trauma informed addiction counselorDenice Colson
The document provides an overview of trauma-informed care and the links between childhood trauma and addiction. It discusses research from the Adverse Childhood Experiences (ACE) Study which found strong associations between adverse childhood experiences and negative health and behavioral outcomes later in life, including increased risks of addiction. The document then outlines four levels of developing trauma-informed care and provides examples of trauma-informed approaches, assessments, interventions and theoretical models for understanding the development of trauma survivors.
This document discusses the challenges of implementing trauma-informed care. It suggests that trauma-informed care could make a difference for those with mental health problems by addressing their adverse experiences. However, achieving trauma-informed care will require building an evidence base through translational research, engaging stakeholders, developing systems to support the approach, and addressing challenges around complexity, costs, and politics. Ongoing translational research integrated with service development may be needed to optimally address adversities, build strengths, and enhance capacity for those affected by trauma.
Cancer is one of the most common diseases in the world. Stress is a common experience among cancer patients.
National Comprehensive Cancer Network (2017) defines cancer-related psychological distress as an:
“ unpleasant emotional experience of a Mental, Physical, Social, or Spiritual nature. It can affect the way you think, feel, or act. Distress may make it harder to cope with having cancer, its symptoms, or its treatment. ”
Attendees will gain insight and understanding into the unique challenges and needs of families who have a relative with a mental illness from a family system’s perspective. With this knowledge those in attendance will learn ways to help family members to get the knowledge and supports they need to help themselves and their ill relative.
This document discusses mental health risk assessment and management. It notes that clinicians have poor ability to predict suicide or homicide. It identifies static risk factors like previous self-harm and dynamic factors like suicidal ideation. Guidelines are provided for asking patients about suicidal thoughts and developing safety plans. Involuntary referral criteria and processes are outlined when significant short-term risk is present.
Religion and Social Innovation Conference presentation at St Michael s College the Platinum Rule goes beyond the golden rule and focuses on ‘treating others how they want to be treated’.
Restoring balance through cultural safety & the medicine wheel WNRCASNgriehl
North American culture sees health as an individual problem, but we live in dynamic, intercultural communities. Health is multifaceted with issues related to mental, spiritual, emotional, and physical health. Our culture can be a barrier to caring for our clients.
Each area of the medicine wheel needs to be balanced for wholistic health for the client, where the client is the person, family, group, or community. Indigenous teachings support addressing all areas of the person to achieve balance.
Through literature reviews and interviews with elders, it is clear health care providers can serve clients better with knowledge related to the medicine wheel. Cultural safety stresses the importance of reflection and acceptance of differences. As health care providers, and teachers, we should not treat everyone the same, but we do need to recognize and acknowledge our blind spots. Increasing awareness of Medicine Wheel teachings will support health care workers to care effectively for their clients.
Moving beyond our own and into the culture or the ‘other’ is required to provide care, treatment, and support to clients, and students, from diverse backgrounds and experiences. The culture of Western medicine places diagnosis as a central goal, whereas other approaches, including Aboriginal medicine, see diagnoses and the physical aspects of health as less central and pay more attention to finding a safe environment in which the patient may recover.
Religion, Spirituality, And Health In Medically Ill Hospitalized Older ...Masa Nakata
This document summarizes a study examining the relationships between religion, spirituality, and health in older hospitalized patients. The study found that religious activities, attitudes, and spiritual experiences were common in older hospitalized patients. Greater religiousness and spirituality were associated with greater social support, less depressive symptoms, better cognitive functioning, and greater cooperation. Relationships with physical health were weaker but followed a similar pattern. Those who considered themselves both religious and spiritual had the best psychological and physical health outcomes.
The influence of religion and culture on female health- a review of BangladeshRishad Choudhury Robin
This document provides a literature review on the influence of religion and culture on female health in Bangladesh. It begins with an introduction and country profile of Bangladesh. It then discusses several cultural and religious influences that impact female health, such as the preference for sons, child marriage, dowry practices, traditional healing methods, nutrition practices, and views on infertility. These influences can increase health risks for females such as maternal complications, malnutrition, and mental health issues. The document concludes that religious and cultural beliefs significantly impact female health in Bangladesh and that interventions require addressing both individual and community factors.
The document discusses understanding families in the context of health care. It outlines characteristics of Filipino families, types of families, and Filipino cultural values related to family. It emphasizes the importance of understanding a patient's family dynamics to provide holistic care and discusses various family assessment models and interview techniques that take a family-oriented approach.
Becoming a Trauma Informed Addictions Counselor using a Source-Focused Model Denice Colson
The document discusses the links between childhood trauma and various negative health outcomes in adulthood. Some key points:
- 65% of alcoholism and 78% of IV drug use are attributable to unaddressed childhood trauma. 58% of suicide attempts also link to childhood trauma.
- Over 60% of men and over 50% of women report experiencing at least one trauma in their lifetime. Rates are higher (71%) among those in substance abuse treatment.
- However, most addiction treatment programs do not take a trauma-informed approach and do not provide trauma-specific treatment. The document advocates shifting to a trauma-informed model that addresses the root causes of trauma rather than just the surface-level symptoms.
The document summarizes an evaluation of an early intervention outreach mental health clinic for young people experiencing homelessness. It finds that the clinic facilitated improved access to mental health services by providing assessments and brief interventions on-site at a youth homelessness service. The clinic adopted a youth-friendly approach and built connections with clients by meeting them in their living environment and addressing their fears about traditional mental health services. However, engaging with clients was challenging due to the high mobility and turnover of young people experiencing homelessness. The consistent presence of the clinic and its flexibility helped to create safety and trust with clients.
The document summarizes theories of psychological development that have traditionally focused on male subjects and standards, and how this excluded or viewed women as deficient. It then discusses more recent relational models of development that emphasize women's sense of identity being strongly tied to their relationships with others. Finally, it outlines sociocultural influences and life skills that can impact women's emotional well-being and mental health issues such as depression.
This document discusses trauma informed care and practice, with a focus on childhood trauma. It notes that while trauma is a core issue for many consumers, current mental health services seldom identify or address trauma. Childhood trauma can have widespread impacts and coping strategies adopted in childhood often persist into adulthood. The document calls for a trauma informed approach that recognizes a person's traumatic life experiences rather than just focusing on diagnoses. It outlines some key principles of trauma informed care including safety, choice, and empowerment.
This document provides an overview and goals of a training on trauma-informed care (TIC). It discusses recognizing the impact of adverse childhood experiences and how unresolved trauma relates to long-term health outcomes. It emphasizes the importance of identifying and addressing trauma, reducing re-traumatization in services, and understanding secondary trauma for workers. The training aims to provide resources for staff to learn about working in a TIC system.
The document discusses wellness counseling and different models used in counseling clients. It summarizes Bronfenbrenner's bioecological model and Sweeney/Myers' indivisible self model for understanding clients in relation to others, their community, and social context rather than primarily as individuals with pathologies. A hypothetical wellness intervention example is provided that targets physical health to improve overall wellness by targeting exercise, nutrition, and sleep to positively impact emotional, intellectual, and other areas of wellness according to these models.
This document discusses caregiver burnout and provides strategies to mitigate it. It defines burnout as physical, emotional, and mental exhaustion resulting from prolonged stress. Both professional and unpaid caregivers can experience burnout. Risk factors include social isolation, depression, financial difficulties, and lack of self-care. Warning signs include withdrawing from others and changes in sleep and health. Assessment tools can identify burnout levels. The document recommends caregivers schedule personal time, seek help, and participate in self-care activities to prevent burnout.
Este documento describe una línea de investigación sobre cómo las redes sociales pueden promover el trabajo colaborativo entre estudiantes. Explica que la web 2.0 se caracteriza por la colaboración y compartir información entre usuarios. También señala que las redes sociales se están incorporando rápidamente a las instituciones educativas y que los estudiantes tienen una actitud positiva hacia el trabajo en grupo. La línea de investigación concluye que el impacto de las redes sociales y su uso común entre los usuarios las benefician como herramienta para foment
The document discusses the need for behavioral health services in Nueces County, Texas. It provides statistics on mental illnesses like bipolar disorder and major depressive disorder treated in the county. Suicide rates are also discussed both locally and nationally. The nursing implications are early detection, education on risk factors, and management of disorders. Nurses play a role in comprehensive assessment, advocacy, and linking patients to support services. Barriers to mental healthcare include stigma, lack of perceived need, and cost of treatment. Community education and support can help address these barriers.
Aacc 2017 become a more trauma informed addiction counselorDenice Colson
The document provides an overview of trauma-informed care and the links between childhood trauma and addiction. It discusses research from the Adverse Childhood Experiences (ACE) Study which found strong associations between adverse childhood experiences and negative health and behavioral outcomes later in life, including increased risks of addiction. The document then outlines four levels of developing trauma-informed care and provides examples of trauma-informed approaches, assessments, interventions and theoretical models for understanding the development of trauma survivors.
This document discusses the challenges of implementing trauma-informed care. It suggests that trauma-informed care could make a difference for those with mental health problems by addressing their adverse experiences. However, achieving trauma-informed care will require building an evidence base through translational research, engaging stakeholders, developing systems to support the approach, and addressing challenges around complexity, costs, and politics. Ongoing translational research integrated with service development may be needed to optimally address adversities, build strengths, and enhance capacity for those affected by trauma.
Cancer is one of the most common diseases in the world. Stress is a common experience among cancer patients.
National Comprehensive Cancer Network (2017) defines cancer-related psychological distress as an:
“ unpleasant emotional experience of a Mental, Physical, Social, or Spiritual nature. It can affect the way you think, feel, or act. Distress may make it harder to cope with having cancer, its symptoms, or its treatment. ”
Attendees will gain insight and understanding into the unique challenges and needs of families who have a relative with a mental illness from a family system’s perspective. With this knowledge those in attendance will learn ways to help family members to get the knowledge and supports they need to help themselves and their ill relative.
This document discusses mental health risk assessment and management. It notes that clinicians have poor ability to predict suicide or homicide. It identifies static risk factors like previous self-harm and dynamic factors like suicidal ideation. Guidelines are provided for asking patients about suicidal thoughts and developing safety plans. Involuntary referral criteria and processes are outlined when significant short-term risk is present.
Religion and Social Innovation Conference presentation at St Michael s College the Platinum Rule goes beyond the golden rule and focuses on ‘treating others how they want to be treated’.
Restoring balance through cultural safety & the medicine wheel WNRCASNgriehl
North American culture sees health as an individual problem, but we live in dynamic, intercultural communities. Health is multifaceted with issues related to mental, spiritual, emotional, and physical health. Our culture can be a barrier to caring for our clients.
Each area of the medicine wheel needs to be balanced for wholistic health for the client, where the client is the person, family, group, or community. Indigenous teachings support addressing all areas of the person to achieve balance.
Through literature reviews and interviews with elders, it is clear health care providers can serve clients better with knowledge related to the medicine wheel. Cultural safety stresses the importance of reflection and acceptance of differences. As health care providers, and teachers, we should not treat everyone the same, but we do need to recognize and acknowledge our blind spots. Increasing awareness of Medicine Wheel teachings will support health care workers to care effectively for their clients.
Moving beyond our own and into the culture or the ‘other’ is required to provide care, treatment, and support to clients, and students, from diverse backgrounds and experiences. The culture of Western medicine places diagnosis as a central goal, whereas other approaches, including Aboriginal medicine, see diagnoses and the physical aspects of health as less central and pay more attention to finding a safe environment in which the patient may recover.
Religion, Spirituality, And Health In Medically Ill Hospitalized Older ...Masa Nakata
This document summarizes a study examining the relationships between religion, spirituality, and health in older hospitalized patients. The study found that religious activities, attitudes, and spiritual experiences were common in older hospitalized patients. Greater religiousness and spirituality were associated with greater social support, less depressive symptoms, better cognitive functioning, and greater cooperation. Relationships with physical health were weaker but followed a similar pattern. Those who considered themselves both religious and spiritual had the best psychological and physical health outcomes.
The influence of religion and culture on female health- a review of BangladeshRishad Choudhury Robin
This document provides a literature review on the influence of religion and culture on female health in Bangladesh. It begins with an introduction and country profile of Bangladesh. It then discusses several cultural and religious influences that impact female health, such as the preference for sons, child marriage, dowry practices, traditional healing methods, nutrition practices, and views on infertility. These influences can increase health risks for females such as maternal complications, malnutrition, and mental health issues. The document concludes that religious and cultural beliefs significantly impact female health in Bangladesh and that interventions require addressing both individual and community factors.
The document discusses understanding families in the context of health care. It outlines characteristics of Filipino families, types of families, and Filipino cultural values related to family. It emphasizes the importance of understanding a patient's family dynamics to provide holistic care and discusses various family assessment models and interview techniques that take a family-oriented approach.
Becoming a Trauma Informed Addictions Counselor using a Source-Focused Model Denice Colson
The document discusses the links between childhood trauma and various negative health outcomes in adulthood. Some key points:
- 65% of alcoholism and 78% of IV drug use are attributable to unaddressed childhood trauma. 58% of suicide attempts also link to childhood trauma.
- Over 60% of men and over 50% of women report experiencing at least one trauma in their lifetime. Rates are higher (71%) among those in substance abuse treatment.
- However, most addiction treatment programs do not take a trauma-informed approach and do not provide trauma-specific treatment. The document advocates shifting to a trauma-informed model that addresses the root causes of trauma rather than just the surface-level symptoms.
The document summarizes an evaluation of an early intervention outreach mental health clinic for young people experiencing homelessness. It finds that the clinic facilitated improved access to mental health services by providing assessments and brief interventions on-site at a youth homelessness service. The clinic adopted a youth-friendly approach and built connections with clients by meeting them in their living environment and addressing their fears about traditional mental health services. However, engaging with clients was challenging due to the high mobility and turnover of young people experiencing homelessness. The consistent presence of the clinic and its flexibility helped to create safety and trust with clients.
The document summarizes theories of psychological development that have traditionally focused on male subjects and standards, and how this excluded or viewed women as deficient. It then discusses more recent relational models of development that emphasize women's sense of identity being strongly tied to their relationships with others. Finally, it outlines sociocultural influences and life skills that can impact women's emotional well-being and mental health issues such as depression.
This document discusses trauma informed care and practice, with a focus on childhood trauma. It notes that while trauma is a core issue for many consumers, current mental health services seldom identify or address trauma. Childhood trauma can have widespread impacts and coping strategies adopted in childhood often persist into adulthood. The document calls for a trauma informed approach that recognizes a person's traumatic life experiences rather than just focusing on diagnoses. It outlines some key principles of trauma informed care including safety, choice, and empowerment.
This document provides an overview and goals of a training on trauma-informed care (TIC). It discusses recognizing the impact of adverse childhood experiences and how unresolved trauma relates to long-term health outcomes. It emphasizes the importance of identifying and addressing trauma, reducing re-traumatization in services, and understanding secondary trauma for workers. The training aims to provide resources for staff to learn about working in a TIC system.
The document discusses wellness counseling and different models used in counseling clients. It summarizes Bronfenbrenner's bioecological model and Sweeney/Myers' indivisible self model for understanding clients in relation to others, their community, and social context rather than primarily as individuals with pathologies. A hypothetical wellness intervention example is provided that targets physical health to improve overall wellness by targeting exercise, nutrition, and sleep to positively impact emotional, intellectual, and other areas of wellness according to these models.
This document discusses caregiver burnout and provides strategies to mitigate it. It defines burnout as physical, emotional, and mental exhaustion resulting from prolonged stress. Both professional and unpaid caregivers can experience burnout. Risk factors include social isolation, depression, financial difficulties, and lack of self-care. Warning signs include withdrawing from others and changes in sleep and health. Assessment tools can identify burnout levels. The document recommends caregivers schedule personal time, seek help, and participate in self-care activities to prevent burnout.
Este documento describe una línea de investigación sobre cómo las redes sociales pueden promover el trabajo colaborativo entre estudiantes. Explica que la web 2.0 se caracteriza por la colaboración y compartir información entre usuarios. También señala que las redes sociales se están incorporando rápidamente a las instituciones educativas y que los estudiantes tienen una actitud positiva hacia el trabajo en grupo. La línea de investigación concluye que el impacto de las redes sociales y su uso común entre los usuarios las benefician como herramienta para foment
This document discusses bioburden testing, which quantifies the number of microorganisms present on a medical device or pharmaceutical product. It outlines the purposes of bioburden testing such as acting as a quality control measure and determining necessary sterilization doses. The key steps of bioburden testing include sampling techniques, extraction methods, enumeration procedures like plate counting, and incubation. Regulations like CFR 21 and ISO 11737 provide standards for bioburden testing to ensure product quality and safety.
The document provides specifications for a Revotorq 1.05L diesel engine vehicle, including engine details like 1.05L 3-cylinder diesel engine producing 70PS and 140Nm of torque. Safety features include driver and front passenger airbags, ABS with EBD. Interior features include an 8-speaker audio system with Bluetooth and smartphone navigation. Exterior dimensions include a 3992mm length, 1677mm width, 2450mm wheelbase and 170mm of ground clearance.
The document provides key specifications for the Revotron 1.2L engine, including a 1199cc, 3-cylinder petrol engine producing 85PS and 114Nm, housed in the Tata Tiago. Dimensions include a 3992mm length and 2450mm wheelbase. Safety features include dual front airbags, ABS with EBD, rear parking sensors, and vehicle stability control.
The Neurobiology of Touch and Trauma Somatic Experiencing from Dysregulation ...Michael Changaris
This paper explores the role of touch in treatment. It explores the neurobiological impact of touch with a focus on the main neurological systems activated in touch. The paper attempts to outline tools to reduce symptoms of trauma through touch.
The document discusses how adverse childhood experiences can lead to autonomic dysregulation and increased allostatic load. This causes changes in cell markers related to cell health and apoptosis regulators, resulting in the removal of healthy cells. It also leads to neuroplastic and immunofunction changes, rapid tissue loss, reduced cell repair cycles, and metabolic changes. The net effect is a decrease in the balance between cell replacement and reduced cell health, which can serve as a model for multiple sclerosis when combined with genetic and other factors.
Brochure General de RFID Peru. Descubre qué podemos hacer para mejorar tus procesos, aumentar tus ventas y reducir tus costos; usando la tecnología de identificación por radiofrecuencia.
Trauma informed care a national healthcare movement: Treating the Health Epid...Michael Changaris
This slide show explored trauma informed care and how to apply trauma informed care to primary care treatment settings. It also explores some national movements in increasing trauma informed approaches to treatment.
The Connectted Heart: Biopsychosocial Approaches to Cardiac Disease Presenta...Michael Changaris
This presentation explores the risk factors of heart disease and developing skills to address those risk factors. The presentation connects from biology to psychology and addresses life time risk.
The document compares the mainstream British artist Adele to the indie artist Lucy Rose. Adele has achieved massive commercial success with her albums 19, 21 and 25, selling over 30 million albums worldwide. She also received a songwriting Oscar. In contrast, Lucy Rose is an indie singer-songwriter from Warwickshire whose albums have achieved more modest success. While Adele appeals to an older demographic and has over 1 billion video views, Lucy Rose has a younger target audience and only 3 million video views, highlighting the major differences in their levels of recognition and popularity.
El estudiante aprendió sobre los diferentes documentos investigativos y sus partes a través del taller 2 del curso. El Anejo N fue útil para ver cada parte de un trabajo de investigación de forma individual, lo que facilitó el análisis y la preparación de un resumen. El estudiante espera aplicar este conocimiento en su propio trabajo de investigación. Le gustaría repasar más el proceso narrativo del problema o pregunta de investigación. Los conceptos sobre la investigación podrían ayudarlo a mejorar su propia investigación, facilitar la lectura de otros trabajos, y
This document discusses conventions used in pop rock music videos and albums. It analyzes the document writer's media product and compares it to conventions seen in other pop rock media. Specifically, it examines conventions related to: 1) Performance lighting and shots in music videos, 2) Costumes in music videos balancing pop and rock styles, 3) Using the same actor for performance and narrative in music videos, 4) Black borders and color use in magazine advertisements, and 5) Medium shots of artists on album digipaks. The document evaluates how the writer's media product used, developed, or challenged these common pop rock conventions.
The document contains a series of unrelated math problems involving trigonometric functions such as tangent, sine, and angles and sides of triangles. It provides multiple choice answers but no explanations connecting the problems or answers.
Contemporary Social Issues - Mental Health Powerpointjessdettman
This document discusses mental health and mental illness. It defines mental health as successful mental functioning and relationships, while being able to cope with change and adversity. Mental illness and mental disorder are also defined. Several common mental illnesses are listed such as depression, bipolar disorder, and anxiety disorders. Facts about the prevalence of mental illnesses are provided, showing they affect about 20% of Canadians and are more common among youth and those who die by suicide. The stigma of mental illness is discussed, showing many are unwilling to be in relationships with or socialize with those who have a mental illness. A story is also provided about a woman who recovered from depression. Overall causes, impacts, and solutions for mental health issues are examined.
This document provides an overview of health, wellness, and community-based care. It defines health, wellness, and their components. It discusses the health-illness continuum and how illness can impact individuals and families. Key factors influencing health and illness behaviors are explored. The document outlines criteria for an ideal community-based health care system and integrated delivery models. It also discusses the role of community-based nursing.
This document discusses the importance of mental health and wellness. It defines mental health as a sense of well-being, ability to cope with stress, and ability to develop relationships. The document notes that mental health affects how people think, feel and act. It discusses factors that impact mental health like biology, life experiences, and family history. The document aims to promote mental wellness by discussing stress, anxiety, myths and facts about mental health, prevention, recovery, and early warning signs of mental health issues. It emphasizes that mental health is important for everyone and recovery is possible with treatment and social support.
Lessons-from-Social-Epidemiology-in-Health-Care_Norman-Ponce-Gonzalez-WestKristen West
The documents discuss the importance of addressing social determinants of health and equity in order to improve health outcomes. Charity focuses only on immediate needs while social justice aims to end the underlying causes of inequity. Equality means giving everyone the same things while equity means ensuring fair access to opportunities. Health is determined more by social and environmental factors than healthcare, yet less funding is allocated to social services. True health reform requires a focus on population health and social determinants alongside clinical care. Health equity requires understanding how policies and environments influence health behaviors and outcomes. The documents provide examples of how policies can address social determinants to improve health conditions like diabetes among vulnerable populations like migrants.
The document provides information about Adverse Childhood Experiences (ACEs) including:
1) It summarizes the objectives of raising awareness about ACE research and prevention frameworks like Essentials for Childhood.
2) It describes the original ACE study which found associations between childhood trauma and later health outcomes, and notes that 64% of participants experienced at least one ACE.
3) It shows that higher ACE scores correlate with increased risks of health problems like smoking, alcoholism, suicide attempts, and teen pregnancy.
4) Data from the Kansas BRFSS survey found rates of ACEs in Kansas similar to national data, with certain groups like women and low-income residents
This document provides information about Adverse Childhood Experiences (ACEs). It begins with the objectives of raising awareness about ACE research and prevention frameworks. It then defines ACEs as childhood experiences of abuse, neglect, and family dysfunction that harm development. The landmark ACE Study found associations between early life stressors and negative health outcomes later in life. It also summarizes findings that higher ACE scores correlate with increased risks of health problems, demonstrating the lifelong impacts of ACEs. The document concludes by discussing prevention approaches like building resilience and utilizing collective impact frameworks.
Why do some individuals develop addictive disorders while others don’t? The relationship between trauma and addiction can provide valuable insight. The adverse childhood experiences (ACES) study helped define and shape our understanding of this complex issue and research demonstrates that higher ACE scores are linked with higher rates of future substance use. It is critical that the health care workforce understand the impact of trauma on addiction and how this relationship impacts treatment and recovery. Explore what it means to be trauma-informed and how providers can integrate trauma-informed care into recovery services and other work with individuals who experience addictive disorders.
This document summarizes a presentation on social determinants of health (SDoH) given by April Recher. It discusses how SDoH, such as poverty, education, neighborhood/environment, and employment, can impact an individual's health risks and outcomes. It provides a framework that outlines structural determinants like socioeconomic/political context, intermediary determinants like behavior/biology, and how these influence health and inequities. The presentation also gives examples of how hospitals and community services can collaborate to address patients' SDoH needs after discharge through screening, referrals, and tracking progress.
- Clifford Beers is a mental health organization founded in 1913 that offers various programs and services to support children's mental health and wellness, including clinic, community, and home-based care.
- The document discusses how adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction can lead to long-term negative health outcomes through impacts on brain development, attachment, and health risk behaviors.
- Having supportive relationships, emotional regulation skills, safe communities, and meeting basic needs can promote resilience to trauma and build protective factors against both physical and mental health problems later in life.
Mental health includes our emotional, psychological, and social well-being. I...AkashBhagatsingYadav
This document discusses mental health, including its definition by the World Health Organization, its history of treatment, characteristics of mentally healthy individuals, types of mental illnesses, causes of mental illness, and methods of prevention. It notes that historically, mentally ill individuals were considered possessed and locked away without treatment. Today, psychiatry takes a more scientific approach. The document also outlines some early warning signs of poor mental health and stresses the importance of upholding human rights for those with mental illness.
The document discusses recovery from mental illness, specifically schizophrenia. It provides statistics on the prevalence and outcomes of schizophrenia. Despite advances in treatment, outcomes have not significantly improved, with only 13.5% meeting recovery criteria. The recovery program described aims to facilitate personal growth and transformation beyond acute symptoms through a collaborative, strengths-based approach focused on self-directed goal setting. It emphasizes hope, well-being, social inclusion and meaning rather than just treating illness. One patient's story of improving life through the program is shared.
Prelim PDHPE-Core 1: Better Health for IndividualsVasiti Ratusau
The document discusses different conceptions of health and factors that influence individual health. It begins by explaining early definitions of health as merely the absence of disease but notes this view is too narrow. The document then outlines four dimensions of health - physical, social, mental/emotional, and spiritual. It describes health as a dynamic process influenced by both objective and subjective factors. Key determinants of individual health are identified as including genetics, environment, socioeconomic status, culture and behaviors.
The document discusses wellness counseling and different models used in counseling clients. It summarizes Bronfenbrenner's bioecological model and Sweeney/Myers' indivisible self model for understanding clients in relation to others, their community, and social context rather than primarily as individuals with pathologies. A hypothetical wellness intervention example is provided that targets physical health to improve overall wellness by targeting exercise, nutrition, and sleep to positively impact emotional, intellectual, and other areas of wellness.
Integrated Behavioral Health Care: Biopsychosocial Approach to Treatment Inte...Michael Changaris
This slide share explores the biopsychosocial determinents of health, developing an integrated care team and supporting the role of the health psychologists to be a high functionng member of the health care treatment team.
Weaving Health Activation into the communitymichaelrlevin
1. The document discusses strategies for improving health literacy and activation in communities. It focuses on empowering individuals to better manage their own health and recovery.
2. A major barrier is that people often feel passive and overwhelmed by their health, lacking understanding of how to manage it. The strategies aim to build knowledge, skills, and confidence.
3. Activating recovery requires trust between community organizations and those they serve. When people trust the resources available, success in managing health and recovery is more likely.
Health Education - Meaning, Definition, Concept, Factors Influencing HealthRabiya Husain
The document covers topics such as health, health education, their meanings, definitions, importance, concepts, factors influencing health, and types of health. It will be beneficial for students studying health education, particularly those enrolled in the DNHE (Diploma in Health Education) program or BSc. Physical Education students. The material was compiled by Ms. Rabiya Husain, a lecturer at IGIPESS, University of Delhi.
This document discusses family health care nursing. It defines family and family health. Family is considered the basic unit of society and health care. Family health nursing aims to promote the health of the entire family. It involves assessing family health needs, making nursing diagnoses, planning and implementing care, and evaluating outcomes. The document outlines the nursing process for family health. It also discusses types of families, factors influencing family health, and services provided like maternal, child, and family planning care. The overall goal of family health nursing is to help families develop self-care abilities to maintain health.
This document discusses the effects of lifestyle on health. It defines health using both the medical model and positive health models. The medical model views health as a normal state like a well-adjusted machine, while positive health defines it in terms of physical, mental, social and emotional well-being. Lifestyle factors like diet, smoking, drinking and socioeconomic status directly impact health and influence behaviors. The document also presents a scenario of a nurse dealing with alcohol-related emergencies and discusses the health promotion role of practitioners in addressing lifestyle-related issues at the individual and community levels through education, policy changes and collaborating with other agencies.
This presentation is helpful for MBBS 1st year students to have basic Ideas on family health. This can be used by Masters in Public Health (MPH) students as well.
Mental health continues to be an important issue affecting so many Canadians. I wrote three stories for the series for the Canadian Nurses Association in partnership with the Mental Health Commission of Canada. The stories were: Reducing Stigma in Health-Care Settings; Suicide Prevention and Postvention Initiatives; and When Mental Illness and the Justice System Intersect.
Similar to Returning from Prison - Building Health, Purpose and Community (20)
Primary Care and Behavioral Health Integration – Leveraging psychologists’ ro...Michael Changaris
Background and Importance: Violence stands as a significant cause of death in the United States, contributing to various health and mental health issues. The role of psychologists has evolved into an essential component of healthcare.
Despite a decrease over several decades, rates of violence have begun to rise again. However, the prevailing approach often focuses on managing the aftermath of violence rather than tackling its underlying causes. Each community possesses its own distinct profile of factors that either elevate or mitigate the risk of violence.
Primary Care Behavioral Health Integration presents a broadly applicable method for preventing violence, offering a hyper-local approach that targets the specific health needs of individuals, families, and communities. By adapting established evidence-based strategies for healthcare improvement, primary prevention can significantly reduce violence.
Methods and Description: This presentation will provide practical tools and general measures to effectively merge behavioral healthcare with primary care systems, fostering violence reduction at the levels of the community, healthcare facility, and healthcare providers. The implementation of universal precautions for violence reduction will be outlined, along with a structured approach to establish violence reduction advocates and teams. These teams will be equipped to assess the unique local risks, manifestations, and impacts of violence within the community they serve.
Outcomes: Through the incorporation of a 7-factor violence risk reduction strategy within primary care behavioral health, collaborative multidisciplinary teams can effectively diminish instances of interpersonal, individual, and community violence. The application of the "four Ts" model (Training, Triage, Treatment, Team Care) empowers primary care clinicians and integrated healthcare settings to enhance individual clinical outcomes, overall clinic population health, and actively champion community-wide violence reduction.
Geriatric Pharmacotherapy Addressing SDOH and Reducing Disparities.pdfMichael Changaris
This slideshow explores skills for addressing pharmacotherapy in an integrated behavioral health setting. It develops the SEA model for addressing medication management in team based care. The SEA model considers medication SAFETY, medication EFFICACY, and medication ADHERENCE. It explores some of the impacts of social determinents of health on clinical outcomes for elders.
Safety: Medication safety changes as we age. Older adults are are not just young adults with added years. Their bodies, brains, since of self and social systems have changed.
Efficacy: Aging changes medication efficacy. Medications are involved in two main effects. These are the effect of the medication on the body (pharmacokinetics) and the effect of the body on the medication (pharmacodynamics). These are both changed as people age.
Adherence: Adherence is a challenge at all ages. Adherence is impact by age related changes in body, cognitive capacity, social supports, and systems of care. Having an adherence plan can change health as we age.
Health Psychology: Transforming social determinants of health to build health...Michael Changaris
This document provides an overview for a health psychology class that addresses social determinants of health (SDOH). The class includes a student presentation, a small group discussion on epigenetics and SDOH, a lecture on SDOH, and an exercise to address SDOH in clinical care. It also outlines skills practices involving visualization, checking-in with needs, and committed action planning to support students' well-being.
This lecture explores clinical tools to interrupt sustain talk to support change talk. Interrupting sustain talk is one of the core factors that predicts change in motivational interviewing sessions.
Motivational Interviewing: Change Talk moving to authentic wholeness (Lecture...Michael Changaris
This lecture explores how authenticity in motivational interviewing supports person-centered change, how to support the change process of self-discovery, how to change talk moves an individual closer to their authentic self, and how that authentic self supports building a life that matters for people.
Motivational Interviewing: Foundational Relationships for Building Change (Le...Michael Changaris
This lecture explores the centrality of relationship in clinical change, how motivational interviewing is rooted in relationship, and how to develop a clinical relationship that supports people to discover the change that matters to them.
Motivational Interviewing: Introduction to Motivational Interviewing (Lecture...Michael Changaris
This is the second lecture and introduction to Motivational Interviewing Skills. It explores the continued development of core understanding, and reviews key processes from lecture 1 and the spirit of MI.
Motivational Interviewing: Engaging the Stages of Change (Lecture 8).pptxMichael Changaris
This class explores how to build motivational interviewing into case formulation, using stages of change, adapting for the impact of cultural factors on sessions, and building person-centered culturally responsive interventions.
The class explores a model for integrated treatment plan development that uses three core factors: a) Culturally Grounded Understanding of Individual, b) Theory Based Grounded Understanding of the Problem a person faces, and c) Motivation Grounded Empowerment for patient-centered care.
The presentation explores a five factor model for adapting interventions to the impact of culture on clinical work. Cultural factors affect: 1) Clinical symptoms and diagnosis, 2) Experiences of self, 3) Biological Impacts (Stress and Health), 4) Relationships, and 5) Access to Cultural Support Structures.
This lecture explores stages of change, the core hallmark of each stage of change, and how to adapt clinical interventions for those stages.
This document is a self-evaluation checklist for clinicians to assess their skills and experience with various cognitive behavioral therapy (CBT) techniques and tools. It includes over 50 specific CBT skills, techniques, and tools and asks clinicians to indicate how often they have used each one, ranging from never to using it weekly with most clients. Some examples of CBT skills and tools listed include establishing a collaborative therapeutic relationship, cultural self-awareness, case conceptualization, psychoeducation, thought monitoring, cognitive restructuring, exposure therapy, and relapse prevention planning. References are provided for where the checklist was developed.
The document discusses disenfranchised grief and ambiguous loss. It then outlines the five invitations of loss according to Frank Ostaseski: don't wait, welcome everything and push away nothing, bring your whole self to the experience, find a place of rest in the middle of things, and cultivate a "don't know" mind. These invitations encourage embracing life's precariousness, being open without judgment, including all parts of oneself, finding inner stillness amid activity, and letting go of certainty.
Team Based Care for Hypertension Management a biopsychosocial approachMichael Changaris
This presentation is an overview of the collaborative care model of hypertension management for behavioral health providers, primary care doctors and health care teams. It explored social determinants of health, complex interaction of adverse childhood experiences and treatment and provides a map for integrated care.
Somatic Experiencing - Academic and Research References Michael Changaris
This document provides an overview of quantitative and qualitative research on Somatic Experiencing from 2005 to 2021. It summarizes 16 quantitative studies that measured outcomes of SE treatment for conditions like PTSD, anxiety, depression, and physical pain. It also summarizes 18 reviews, books, and qualitative studies that explored SE's biopsychosocial theory and clinical applications for issues like trauma, dissociation, eating disorders, and relationships. The document indicates that research on SE has grown significantly in the past decade and involved populations from multiple countries.
Slides for Living Well with Difficult Emotions Online GroupMichael Changaris
These slides are two groups in the living well with difficult emotions group. They focus on thoughts skills, exercise, wise mind, and other ways to help fight depression.
Understanding Bipolar Disorder: Biopsychosocial Approaches to Mind Body HealthMichael Changaris
Explores psychological, medical and primary care treatment and self-care for bipolar disorder from the biological bases of brain function and medication management to the psychological integrated care and treatment plan for health complexity and bipolar treatment needs.
This document provides information on treating psychotic spectrum disorders in primary care psychology. It discusses the risks of psychosis across the lifespan and describes types of psychotic disorders like schizophrenia and their symptoms. It also summarizes guidelines for treating schizophrenia, the neurobiology of psychosis, and rationales for using cognitive behavioral therapy to treat psychosis symptoms. Key points covered include the roles of dopamine and serotonin in positive and negative symptoms, considerations in pharmacotherapy, relationships between trauma and psychosis, and approaches to CBT for psychosis.
Seeking Safety Zoom Group Materials - Post-Traumatic Growth COVID-19Michael Changaris
This document discusses building resilience during difficult times like the COVID-19 pandemic. It emphasizes the importance of self-compassion, self-care, and connection to reduce stress. Specific strategies mentioned include prioritizing rest, reflecting on one's needs, and finding "blue sky moments" even amid stress. While stress can't always be avoided, the "3 C's" of self-compassion, self-care, and connection can help turn stress into a source of power and growth instead of burnout. The document also notes signs of stress and provides a resilience exercise focused on relationships, identity, and work-life balance.
Integrated Primary Care Assessment SBIRT (Substance Use) and Mental and Refer...Michael Changaris
This is an overview of triage pathway for those with mental health and substance use conditions with clinical cutoffs and referral options based on screening.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Returning from Prison - Building Health, Purpose and Community
1. REDUCING HEALTH DISPARITIES
THROUGH RETURNING MEDICAL HOME
Addressing adversity in multiple
forms can reduce rates of
individuals who are returning
from prison going back to prison.
4. PRESENTERS
Arlinda Timmons-Love, ELE
• REMEDY Program Development Team and Group Leader
• West Contra Costa County African American Re-entry Health Conductor CCCounty Health Svc Division Office of The
Director Reducing Health Disparities Partnering With Center For Human Department
Roosevelt Terry, ELE
• REMEDY Program Development Team and Group Leader
• East Contra Costa County African American Re-entry Health Conductor
CCCounty Health Svc Division Office of The Director Reducing Health Disparities Partnering With Center For Human
Department
Tiombe Mashama, H.Ed., MPA
• Program Coordinator for the African American Health Conductors/Transitions Clinic for the formerly incarcerated
• Contra Costa Health Services, Reducing Health Disparities Hospital and Health Centers
Joseph Mega, MD, MPH
• Medical Director, Health Care for the Homeless- Contra Costa County
• Physician Transitions Care Network and REMEDY program Contra Costa County
Michael Changaris, PsyD
• Health Psychologist – CCRMC Health Psychology Groups Program Lead
• Training Coordinator – Integrated Health Psychology Training Program Partnership Between CCRMC and Wright Institute
6. PRESENTATION GOALS
q Develop an understanding of key research findings on health
and behavioral health factors impacting successful re-entry
q Recognize core components in integrated systems of care
q Understand the core road map for developing integrated
health care partnerships for returning population
q Report on key outcomes and findings on pilot integrated
medical home program
q Recognize signposts on the way to transition success
7. WORKSHOP OVERVIEW
5 Min Panel Introductions and
Introduction to TCN – REMEDY
5 Min Addressing Health Disparities:
Risk, Resilience, Returning Health
10 Min Braking the Cycle Through Collaboration, Empowerment
and Consumer Driven Interventions.
10 Min Experiential Exercise: Developing a reentry health
program in your clinic
5 Min Provider Perspective – Relationships that change
5 Min TCN – REMEDY Outcomes Data
5 Min Question and Answer
8. INTRODUCTION - TCN AND REMEDY
REMEDY GROUP STATEMENT: The REMEDY group is a community
home for people who are reentering from prison. We believe each
of us has strength, wisdom and is worth full respect. Each member
of the community is a vital strength. Each of us carry our struggles
and together the struggles are lighter. Like iron that sharpens iron
we support each other to build our personal health, community
strength and group vitality. Through our connection and action we
build healthy minds, healthy bodies and healthy spirits.
13. HEALTH DISPARITIES – FORMERLY INCARCERATED
q Even when controlling for access to care and insurance status formerly
incarcerated individuals receive less care.
q Perceived experiences of bias in medical system in other research has
lead to less health care utilization.
q In the first year Post-release there is an increased mortality rate (up to
3.5 fold increase) for formerly incarcerated individuals. Health related
issues leading to mortality were HIV, Cancer and HTN.
q The first year after release is highly vulnerable for mortality.
q There are multiple barriers to receiving mental health and substance
abuse treatment. These barriers impact access to care.
14. q Those returning from prison often come back with a
higher disease burden of health, mental health and
substance abuse disorders. These three factors are a
core part of what leads to recidivism.
q If one considers the social determinants of health there
are many other key social factors that become part of
the story of why people are incarcerated to why
people return to incarceration.
q Many of our program participants have said at times
to one of our team members ‘I don’t think I can do it.
Maybe I will just go back (meaning prison).’
q Some the factors that have triggered that statement
were housing/work crisis, challenges with family,
mental health/SUD and health/disease process.
HEALTH AND CHRONIC DISEASE IMPACTS RECIDIVISM
15. Image from the web @ https://www.rehabcenterforwomen.org/recovery-blog/mental-disorder-highly-common-among-women-prison
16. Image pulled from web @ http://cdonohue.com/incarcerationinamerica/mental-health/
17. EXPERIENTIAL KNOWING – STORIES OF HEALTH
Jill a 54 year old Latina woman arrived to the REMEDY group 60 min late. She sat
down and asked to meet with the health psychologist. When she and the health
psychologist met she described intense feelings of pain in her feet, like she was
walking on broken glass.
She explored her depression, housing insecurity and the need for pain medication.
The health psychologist helped her identify the relationship between pain, depression
stress and diabetes.
She reported that she had stopped taking her medication and due to housing
insecurity was eating more poorly. She made a plan to secure her housing, improve
her eating and was re-connected with her medical provider to have her metformin
addressed. Her A1Cs were above 11.
In the next months her AC1 levels normalized < 8, she found stable housing and
began working a full time position.
18. BRAKING THE RECIDIVISM CYCLE Developing Healthy Minds,
Bodies, Spirits, family and
community
19. RISKS OF RECIDIVISM
q There are two main classes of factors that lead to recidivism: Static factors
that can not change (e.g. number of years incarcerated) and dynamic factors
that can be effected (e.g. mental health, SUDs, Access to Housing, Health
Care, Values, and Cognitions).
q Of the dynamic factors (factors that change) there are factors that are
behaviorally influenced and factors that are more impacted by systems and
environment. There are bidirectional relationships between environmental and
behavioral factors
q Environmental Factors: Problems with housing, lack of available work and
economic challenges all increase risk.
q Behavioral/Internal Factors: Mental health, substance use disorders, stress,
health behaviors.
20. ADVERSE CHILD EXPERIENCES AND INCARCERATION
q Adverse Childhood Events – Is a hidden epidemic
leading to increase risk of health, mental health and
social impacts.
q Adults with incarceration hx treated in San Diego
Kaiser were 4X the rate of ACEs compared w/
Kaiser normative sample.
q Sex offenders treated in Kaiser system had higher
rates of sexual abuse as children.
q Two main targets: Addressing late life impacts of
childhood adversity and reducing risk of childhood
adversity.
Reavis, J. A., Looman, J., Franco, K. A., & Rojas, B. (2013). Adverse childhood experiences and adult criminality: How long must we live before we possess our own lives?. The Permanente Journal, 17(2), 44.
Baglivio, M. T., Epps, N., Swartz, K., Huq, M. S., Sheer, A., & Hardt, N. S. (2014). The prevalence of adverse childhood experiences (ACE) in the lives of juvenile offenders. Journal of juvenile justice, 3(2), 1.
It is hard to get enough of
something that almost works.
Vince Felitti, MD
21. FROM ADVERSITY TO COMMUNITY
ADDRESSING ACES THROUGH TRANSITION HEALTH
Prison to Life of Purpose Pipeline
Adverse Childhood Experiences
REMEDY: Trauma Informed Tx and Group
Social, Emotional and Cognitive Impairment
REMEDY: CBT, Emotion Reg., Social Skill/Support
Adoption Health Risk Behaviors
REMEDY: Health Literacy, MI, CBT
Disease, Disability, and Soc. Prob.
REMEDY: Medical Care & Health Conductors
22. COMMUNITY IMPACTS OF INCARCERATION
Increased family
poverty and associated
health and mental
health risks.
Returning creates
challenges with
adjustment and impact
family wealth.
Disrupted family
relationships impacts a
child’s ability to bond
with returning family
member
Grandparents in
parenting role and
taking care of young
children.
Children w/ incarcerated
parents have > risk of
chronic illness, depression
and beh problems.
Disrupts the family system
and increases risk children
in foster care and need
for multiple health and
mental health services.
23. WHAT WORKS – EBP FOR REDUCING RECIDIVISM
q Education and Training: More then 30 years of data indicate that increased access
to education and training reduce rates of recidivism
q Mental Health Treatment: Studies have shown for individuals with significant mental
health issues addressing those needs can reduce recidivism by >60%
q CBT and Cognitive Interventions: Developing skills for self-regulation, challenging
beliefs that lead to criminal actions and increasing positive coping all reduce
relapse rates.
q Responsive Health Care: Poor health care, difficulty with attending treatments and
health disparities all lead to increased risk of some one returning to prison. A
provider trained on building relationships with formerly incarcerated individuals
helps increase attendance and adherence.
q Substance Abuse Treatment: Access to solid SUD treatment can reduce significantly
the likelihood some one with engage in criminal behaviors.
24. SIGNPOSTS TO RETURNEE REENTRY SUCCESS
#1 Asking for help.
People in our group
report often having to
go it alone. It takes
trust to ask and
confidence to accept
support.
#2 Training
People seeking
training and
getting support
are more likely
to succeed.
#3 Connection
Being willing to
open up and
connect with others
in the treatment
team and the
group.
#4 Visions
Actions towards
visions. Reconnecting
to personal values
and allowing oneself
to take the risk of
success
#5 Giving Back
Supporting other
group members
helps deepen
learning and leads
to empowering the
REMEDY member.
25. REENTRY HEALTH PROGRAM
INTEGRATED HEALTH CARE
Integrated health programs meet
people where they are, reduce
barriers to care and improve
outcomes
26. HEALTH DISPARITIES AND BARRIERS ARE COMMON…
People returning
from prison have
multiple chronic
health conditions
and high mortality
in the first year.
Individuals from
lower SES receive
worse care on
47% of quality
metrics
African Americans
and Latino(a)s
receive worse care
on 41% and 39%
of quality metrics
respectively
Biases in health
health system, low
health literacy,
post-incarceration
have worse health
and less utilization
Health Disparities are
common and being
formerly incarcerated
leads to multiple
barriers to care. Those
reentering come home
with multiple health
conditions and the first
year is a high risk of
mortality.
27. TCN REMEDY – ADDRESSING TRANSITIONS CARE
Trained health
coordinators
with returning
experience
Providers
committed to
returning
health
Access to
support for
training,
education,
jobs and
housing
Support from
group tx and
increased
coping skills
Mental health
treatment and
referrals
Medical Home
Pathway to Medical Home
28. RETURNING PROGRAM THAT PROMOTES HEALTH
REMEDY Group
The REMEDY group provides health education,
CBT and emotion regulation skills, peer
support, coordination with medical team and
health conductor support.
Integrated Transitions Clinic
The integrated transitions clinic model has
four components a. trained medical team,
b. health conductor/consumer, c. REMEDY
group, d. health psychologist.
Support Service
Reentry programs need a web of
support services like day programs,
job training/skills, education, SUD
Tx, Housing, Transportation etc.
Trained Primary Care Provider
Providers who are committed to returning
health and have training on some of the key
barriers can improve health care attendance,
medication adherence and patient health.
Health Conductors
Health conductors are trained professions
who understand needs of a community
and play a central role in health, mental
health and care coordination
Health Psychologist
Health psychologist/BHC provide
warm handoffs for crisis & health
education, referral SUD/MH
services, group Tx and individual Tx
29. STEPS TO BUILDING INTEGRATED
REENTRY SYSTEM OF CARE FOR REENTRY MEDICAL HOME
q Assess services
q Build support
q Identify Medical
Champion
q Enlist Admin
Support
q Make list of
reentry services
list available
q Develop services
q Reentry clinic
q REMEDY Group
q Provider ed/tr.
q Behavioral
Health education
q Reentry health
conductors
q Build on success
q Improve current
programs
q Develop new
program(s)
q Address care
coordination
need
q Collaborative
care teams
q Care team dev.
q Int. key services
q Challenging PTs
QI for system dev
q Develop
Standard Work
q Trained medical
providers
q Trained mental
health providers
q Standard work
developed
q Regular QI with
consumer input
Seed Team
Beginning
Change
Building On
Success
Integrated
System of
Care
Reentry
Medical
Home
30. Signposts Reentry Development Next Actions
Level 1:
Reentry Siloes
q Reentry programs are separate
q Mental health and PCP not reentry focused
Develop a seed team, build support with in
program, identify medical champion, enlist
administrative support, list community
referrals
Level 2: Reentry
coordination
q Periodic communication between programs
q Care coordination provider initiated
q No regular access to trained care teams
Develop change plan, start with core
change, health conductors, re-entry group,
collaborative clinic, provider education,
mental health/BHC training. PDSA Cycles
Level 3: Co-located
Re-entry Services
q Regular reentry clinics
q Trained Mental Health, SUD Tx & PCPs
q Periodic case conferences
Take successes and build one them. Improve
newly developed programs, develop
additional program/services/ trainings.
Level 4: Integrated
Reentry Services
q Coordination/MOUs with housing, job sites and
education/training programs
q Integrated Share the Care TCN and Mental Health Tx
(Group, MH Warm Handoff, Psychiatry, SUD Tx, Indiv. Tx)
Develop clear referral pathways, trained
primary care providers, specialized
transitions clinics paired with REMEDY group,
develop standard work and case
collaboration.
Level 5: Reentry
Medical Home
q Returning health systems notified when people released.
q Pre-Release medical assessment and coordination with
medical program
q Well trained reentry specialists and clinics focused on
reentry care.
Training medical team on referral pathways,
Develop coordinated medical programs
connecting from with in prison to reentry
care, Dedicated quality improvement for
reentry integration.
31. REMEDY PROGRAM DEVELOPMENT – SLIDE A
q The REMEDY program first started with a collaboration between
our African American Health conductor team and primary care.
These conversations lead to pulling in behavioral health. The initial
conversations sparked the creation of a group that supported
clinical services.
q Initially we had speedbumps. There were challenges with filling
clinics. There were challenges with keeping PCP appointments
saved. The group initially filled up but then became very slow.
q Addressing these challenges lead to a program that works.
Through Regular Focus on Improving Care the Program Grew…
… As it Grew the Patients we Serve Made a Medical Home
32. REMEDY PROGRAM DEVELOPMENT – SLIDE B
1. We developed clear referral pathways and had regular meetings with primary care team to
address challenges.
2. The model for the group needed a higher level of collaboration from people with insight into
the experience. The academic knowledge was not enough. But collaboration between the
health conductors who were also returning and behavioral health provider allowed for the
development of a solid group.
3. We moved the clinic near the group. The physical space matters. Having the clinic near the
group space increased group attendance and increased collaboration for the team.
4. Human connection and person care are the heart of the group. Members feel cared for. They
know some one, often multiple someone’s are tracking them and caring for them.
Through Regular Focus on Improving Care the Program Grew…
… As it Grew the Patients we Serve Made a Medical Home
33. EXPERIENTIAL EXERCISE DEVELOPING
A HEALTH REENTRY PROGRAM
Starting from where you are you
can develop a responsive
reentry health program
34.
35. EXERCISE FOR DEVELOPING REENTRY
HEALTH PROGRAM IN YOUR COMMUNITY
Instructions:
Brake into groups of 4-6 with people who’s programs are close
to the same stage of development as yours choose a note taker.
Answer these questions as a group:
1. What motivates you to build a re-entry health program?
2. What are some ideas for next step improvements in your
organization?
3. As a group choose an idea to work on and develop a
Plan-Do-Study-Act outline.
36. REENTRY HEALTH PROGRAM
MEDICAL TEAM CARE
Relationship with providers
matter. It increases rates of
adherence and health outcomes.
37. MY HISTORY WITH TRANSITIONS CLINIC
Passion is essential (and palpable!)
Relationships matter
Health conductors
Patients
Community connections – HCH, MDF, ED
You have to be informed, not just medically
38. STRATEGIES/ESSENTIALS IN THE CLINIC
Trust is essential
Don’t make promises you can’t keep
Be knowledgeable, be honest
No egos- this is your time to listen. You DON’T know what folks are going through
Trauma-Informed Care
No agenda in your first few visits
Recognize discrimination, barriers as real
Patient buy-in/understanding- evaluate health literacy and work within patient’s level
My philosophies:
There is no last chance
The buck stops here
The door is always open
39. INITIAL VISIT
My initial intake visit discussion
I ask lots of questions, give lots of time, have no agenda; do a lot of listening.
EXPLAIN everything you are doing and why!
Be action-oriented; people are tired of waiting. Offer SOLUTIONS!
Move past criminal background- this is none of your business and better not to know!
Be aware of your population and their major issues/barriers.
E.g yoga might not be the best option for LBP in someone with no job, sleeping in their car
Building trust may require a carrot
40. REMEDY PROGRAM OUTCOMES DATA
Exploring the data related to
health, mental health and
treatment outcomes.
41. MAJOR ISSUES I’M SEEING
Chronic Pain- 41%
Strategies for addressing:
Trigger point injections
FB removals/GSWs; remove the bullet remove some reminder of the trauma
PT
Address trauma
Flexibility with chronic pain management
Substance use disorders (35%) = coping. Ask what happened to you, not what’s wrong with you
Alcohol
opioids
Methamphetamines
Offer TREATMENTS
Mental Illness (32%)- remove barriers inherent in the siloed system
Know your PTSD screening questions and how to treat (PCL5)
Prazosin, propranolol
Homelessness (54%)- especially with paroles with sex offender status
43. HEALTH OUTCOMES DATA 2014-2016
Report of all patients seen at least once in our “Transitions Clinic”
N = 74
Metrics included:
Number of scheduled visits
No show rates
Diabetes and A1c values
GFR
Lipids
Hypertension
Cancer screening
ER Visits
Recidivism
50. CANCER SCREENING
Breast Cancer Screening
Eligible patients = 9
Percentage of patients with up to date screening = 56%
Cervical Cancer Screening
Eligible patients = 11
Percentage with up to date screening = 64%
Colon Cancer Screening
Eligible patients = 26
Percentage with up to date screening = 54%
51. FUTURE VISIONS
Direct referrals from county detention/work together to develop treatment plans
Medi-cal waiver resources- expanded case management
Integrated psychiatry
Expand wrap-around services available
Jobs
Vocational training resources
Peer support
52. REMEDY Q&A DISCUSSION CONSUMER
ROLE IN PROGRAM DEVELOPMENT
Program development rooted in
real human needs makes
meaningful change in people’s
lives.