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Wednesday, October 23, 2013

Featured:Next Door Neighbors Health

Pavilion Medical Director, Dr. Avtar Dhillon, describes how physical symptoms can be a sign of behavioral health issues.


Saturday, November 24, 2012
American Foundation of Suicide Prevention

Do what you think will be comfortable for you. Remember, you can always choose to do things differently next time.

  • Think about your family's holiday traditions. Consider whether you want to continue them or create some new ones.
  • Remember that family members may feel differently about continuing to do things the way they've been done in the past. Try to talk openly with each other about your expectations.
  • Consider whether you want to be with your family and friends for the holiday, or whether it would be more healing for you to be by yourself or go away (this year).
  • Keep in mind that sometimes the anticipation of an event can be more difficult than the event itself.
  • If you find it comforting to talk about your loved one, let your family and friends know that; tell them not to be afraid to mention your loved one's name.
  • Some survivors find it comforting to acknowledge the birthday of their loved ones by gathering with his/her friends and family; others prefer to spend it privately.
  • Some survivors have found the following ritual helpful for a variety of occasions:

Light two candles, and then blow one out. Explain that the extinguished candle represents those we've lost, while the one that continues to burn represents those of us who go on despite our loss and pain.
Simply leave the one candle burning (you can put it off to one side) for the duration of the holiday meal or event. The glowing flame acts as a quiet reminder of those who are missing.

Above all, bear in mind that there is no "right" way to handle holidays, anniversaries, or birthdays. You and your family may decide to try several different approaches before finding one that feels best for you.

Excerpted from Surviving Suicide Loss: A Resource and Healing Guide.


Sunday, September 30, 2012

The recent media accounts of Joe Giarrusso Jr.'s life -- my dad -- suggested that he had it all. First, he was a retired attorney and magistrate who helped create a domestic violence section at Criminal Court. Second, he was related to former and current public officials. Third, he taught theology classes. Fourth, he had a wonderfully loving family.
There was no fairy tale ending, however. Dad died of a self-inflicted gunshot wound on Sept. 12.
After reading the media accounts, many have asked, "What was wrong?" "Did he have a substance abuse problem?" No, though he had a few beers now and then. "Was he near financial ruin?" No, he blossomed in his new career as a mediator and provided for his family. "Maybe, there were marital problems?" No, Dad often said in his own colorful way that being married to him was the best 37 years of Mom's life.
He turned 60 in July and was diagnosed with diabetes a few months earlier. The former is an expected milestone and the latter is a regularly treated chronic medical condition. But neither one was immediately life threatening.

If my dad's death can teach us anything, it is the need for heightened sensitivity to mental health issues.
It is now self-evident that Dad was suffering from depression, a serious mental illness, the severity of which was lost on his family, friends and colleagues.
We do not profess to be mental health experts after two weeks, but we are trying to learn what we can about mental health issues. And the evidence is surprising and disturbing.
According to Kay Jamison's 2011 book "Night Falls Fast: Understanding Suicide," suicide was "the third leading cause of death in young people in the United States and the second for college students." Based on the National Institute of Mental Health's findings in 2007, suicide was the fourth-leading cause of death in the United States among adults ages 18-65.
Mental health issues affect the New Orleans metropolitan area. On July 13 -- which ironically was Dad's birthday --- The Times-Picayune reported on the state's cuts to Louisiana's Medicaid program. That article highlighted massive cuts to hospitals and clinics throughout Louisiana, including the closure of the inpatient mental health facility Southeast Louisiana Hospital in Mandeville. Closing Southeast Louisiana Hospital means the loss of 176 beds to treat patients with mental illness.
Mental illness is not a geographical problem. It is not a socioeconomic problem. It is not a racial problem. This is a problem affecting all of us. Put differently, this is not a "their" problem. It is an "our" problem.
If my dad's death can teach us anything, it is the need for heightened sensitivity to mental health issues. Mental illness and suicide are stigmatized largely because of a historical misunderstanding of these diseases and their processes. Two things have resulted from such misunderstanding.
First, mental health issues are often either discussed behind closed doors or swept under the rug entirely. Second, the failure to discuss these problems undermines awareness resulting in the delay of treatment. Awareness of mental health issues can only be achieved through greater education.
In turn, greater education should lead to increased public discourse and the understanding that mental illness must be addressed and combatted in the same way as cancer, Alzheimer's, or any other illness. We would not let family or friends delay or avoid treatment of those conditions. Why should mental illness be treated any differently?
As tragic as this is for my mom, our family and friends, my dad's passing is a teachable moment, a moment to focus on increased awareness, education, dialogue and treatment. Let's not allow that moment to slip away. We won't.
Joseph I. Giarrusso III is a New Orleans attorney.
Wednesday, September 19, 2012
Psych Central

New research from the University of Michigan suggests that veterans battling post-traumatic stress (PTSD) and substance abuse disorders face a greater risk of death.
The study, which includes findings from veterans returning from conflicts in Iraq and Afghanistan, is the first to assess the combined impact of drug or alcohol use disorders in association with PTSD.
Kipling Bohnert, Ph.D., the study’s lead author, says the research sheds new light on the importance of treating both substance use and post-traumatic stress disorders in veterans.
“Attention needs to be paid to veteran patients with PTSD, with an emphasis on identifying those who might also have a problem with drug or alcohol use,” Bohnert said. “This study highlights the potential importance of effective treatment for both conditions in helping veterans after they’ve returned from conflict.”
Prior studies have linked an increased risk of death among veterans with PTSD, but this study is the first to highlight the association between substance use disorders, PTSD and mortality.
The study was published online in the journal Drug and Alcohol Dependence.
Young veterans, those 45 and under, appear especially vulnerable to both injury and non-injury-related death when PTSD is combined with substance abuse.
Injury-related death included homicides, suicides and accidents, while non-injury related deaths included heart disease, cancer and other health problems.
Bohnert said more research is necessary to figure out why younger veterans exhibit a stronger tie between substance use disorders and death.
Federic C. Blow, Ph.D., the paper’s senior author, believes the research might be helpful for physicians in deciding the best way to treat their patients.
“In theory, a treatment program that addresses both issues – substance use and PTSD – should reduce the risk of death from all causes, and this may be especially true for the nation’s youngest veterans,” Blow said.
Source: University of Michigan


Wednesday, August 22, 2012
8/16/12 (Williamsburg, Virginia) – The Pavilion at Williamsburg Place earned The Joint Commission’s Gold Seal of Approval™ for accreditation by demonstrating compliance with The Joint Commission’s national standards for health care quality and safety in behavioral health care. The accreditation award recognizes The Pavilion’s dedication to continuous compliance with The Joint Commission’s state-of-the-art standards of high quality behavioral healthcare.
The Pavilion underwent a rigorous on-site survey in July 2012. A team of Joint Commission expert surveyors evaluated The Pavilion for compliance with standards of care specific to the needs of individuals served and families, including infection prevention and control, leadership and medication management.
"With Joint Commission accreditation, we are making a significant investment in quality on a day-to-day basis from the top down. Joint Commission accreditation provides us a framework to take our organization to the next level and helps create a culture of excellence,” says Marsha Obremski, Executive Director.  “Achieving Joint Commission accreditation, for our organization, is a major step toward maintaining excellence and continually improving the care we provide.”
This recent accreditation has provided the ability for The Pavilion to seek contractual relationships with all major Insurance Companies (to include Medicare, Tricare, Blue Cross, Optima, Cigna, Value Options, Southern Health, and many others). This accomplishment further allows The Pavilion at Williamsburg Place the ability to serve more patients and families in need to include older adults and active duty military and dependents.  We are very excited about our ability to serve our region more fully.
“The Pavilion is a highly valued resource in our region. The Pavilion is one of a very few psychiatric hospitals with a program for the treatment of our geriatric population. A contract with Medicare is essential to The Pavilion’s ability to provide psychiatric services to this population,.” says Dr. Sarah Bisconner, Director of Emergency Services for Colonial Behavioral Health.



Tuesday, July 10, 2012
American Hospital Association

The Institute of Medicine today called for a national effort to boost the number of mental health and substance abuse providers to meet the needs of the nation’s aging baby boomers. The report estimates that between 5.6 million and 8 million Americans age 65 and older have mental health conditions or substance abuse problems. Among other actions, the IOM committee calls for a redesign of Medicare and Medicaid payment rules to guarantee coverage of counseling, care management and other mental health/substance abuse services. Following a 2008 IOM report on building the health care workforce to meet the needs of the nation’s growing elderly population, Congress mandated that IOM conduct a complementary study focused on mental health/substance abuse workforce needs for this population.  To read the entire study visit /sites/default/files/MH%20and%20older%20adults.pdf



Thursday, September 1, 2011

Addiction is a chronic brain disorder and not simply a behavior problem involving alcohol, drugs, gambling or sex, experts contend in a new definition of addiction, one that is not solely related to problematic substance abuse.

The American Society of Addiction Medicine (ASAM) just released this new definition of addiction after a four-year process involving more than 80 experts.

"At its core, addiction isn't just a social problem or a moral problem or a criminal problem. It's a brain problem whose behaviors manifest in all these other areas," said Dr. Michael Miller, past president of ASAM who oversaw the development of the new definition. "Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It's about underlying neurology, not outward actions."

The new definition also describes addiction as a primary disease, meaning that it's not the result of other causes, such as emotional or psychiatric problems. And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored over a person's lifetime, the researchers say.

Read More on MSNBC

Tuesday, November 22, 2011

By Genevra Pittman



NEW YORK | Tue Nov 22, 2011 4:14pm EST


Surgeons were also no different from non-surgeons in the proportion who relapsed after treatment, or the number who had their medical licenses revoked.

Researchers wrote Monday in the Archives of Surgery that they had expected surgeons might make a stronger turn-around than other doctors, in part because of the expectation of "perfection" in everything they do.

"Being a safety-sensitive specialty, they receive greater scrutiny when returning to practice following chemical dependence treatment," said Amanda Buhl from the Washington Physicians Health Program, who worked on the study. "We actually hypothesized that they would have more favorable outcomes following treatment."

While that turned out not to be the case, the majority of surgeons and non-surgeons were able to return to practice within a few years of treatment.

The study included 144 surgeons and 636 other physicians, including family practice doctors and anesthesiologists, who were treated for a substance abuse disorder in 16 different state physician health programs from 1995 to 2001.

Physician health programs allow doctors to be treated for drug abuse and addiction without repercussions as long as they complete program contracts, including random testing, and recover before returning to practice.

The participating doctors, mostly men, and in their mid-40s, on average, were followed for five years after treatment to see how many of them fulfilled the contracts and if they went back to work.

Alcohol abuse was the most common reason for enrolling in the physician health programs, and was more prevalent in surgeons than non-surgeons. Other reasons for treatment included opioid, stimulant and sedative abuse.

About one in five surgeons and non-surgeons had a positive alcohol or drug test result after treatment, and the same number were reported to state licensing boards because of relapses or non-compliance with the programs.

Still, after five years, 60 to 65 percent of all doctors had completed post-treatment monitoring contracts, and as many as 75 percent had their licenses restored and were practicing medicine again.

Slightly more surgeons than non-surgeons didn't return to medicine for a variety of reasons, including having a license revoked, leaving voluntarily or dying.

The findings "certainly demonstrate favorable outcomes following successful treatment for a substance use disorder," Buhl told Reuters Health.

Studies have estimated that about ten percent of doctors will abuse drugs or alcohol at some point during their careers -- similar to figures in the general population.

But if they do get treatment, they tend to do better than the average non-doctor, possibly because they have a lot to lose, said Dr. Keith Berge, an anesthesiologist from the Mayo Clinic in Rochester, Minnesota, who has studied drug dependence in physicians.

Although physician health programs have helped address addiction by emphasizing treatment over punishment, there's still a long way to go in terms of getting doctors the help they need in a timely fashion, added Berge, who wasn't involved in the new research.

"There's a huge barrier to physicians admitting to these problems, and often they're pretty far gone in their addictive illness by the time they come to the attention of (other) physicians or state medical boards," he told Reuters Health.

"The medical community -- families, colleagues -- need to remain vigilant to not only the signs and symptoms of substance use disorders, but to stress and burnout, those conditions that can lend themselves to drug and alcohol abuse," Buhl agreed.

Berge said that the question of drug and alcohol addiction in doctors is increasingly being seen as an important patient safety issue -- but the safest thing isn't necessarily to remove doctors from the operating room or bedside for good.

"There is a scarcity of physicians, so the goal is not to basically take good physicians that can have a useful, safe career out of practice," he said. "The goal is to have a valuable societal resource fixed and put back into place to provide safe, competent patient care."


NEW YORK (Reuters Health) - Surgeons and other types of doctors were equally likely to return to medical practice after being treated for drug or alcohol addiction, in a new study.

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