Riverbend Community Mental Health: CURRENTS Summer 2020 by RiverbendCMH

aren’t alone. LOVED. Everyone has mental health. JOY. Self-care. Need to Talk? Be kind to your mind. STRONG. HOPEFUL. Happiness. You are enough. Mindful. Every

OVE yourself. Strength through change. Need to Talk? You are brave. POWERFUL. BE KIND TO YOUR MIND STRONG. BOLD. HOPEFUL. You are brave. YOU ARE E

CURRENTS

ental health. JOY. Self-care. Need to Talk? Be kind to your mind. STRONG. HOPEFUL. Happiness. You are enough. Mindful. Everyone has mental health. ENOUGH. You

Need to Talk? You are brave. POWERFUL. BE KIND TO YOUR MIND STRONG. BOLD. HOPEFUL. You are brave. YOU ARE ENOUGH. You aren’t alone. LOVED. Ev

e kind to your mind. STRONG. HOPEFUL. Happiness. You are enough. Mindful. Everyone has mental health. ENOUGH. You aren’t alone. LOVE yourself. Strength throu

E KIND TO YOUR MIND STRONG. BOLD. HOPEFUL. You are brave. YOU ARE ENOUGH. You aren’t alone. LOVED. Everyone has mental health. JOY. Self-care. Need

piness. You are enough. Mindful. Everyone has mental health. ENOUGH. You aren’t alone. LOVE yourself. Strength through change. Need to Talk? You are brave. POWE

D. HOPEFUL. You are brave. YOU ARE ENOUGH. You aren’t alone. LOVED. Everyone has mental health. JOY. Self-care. Need to Talk? Be kind to your mind. STRONG

one has mental health. ENOUGH. You aren’t alone. LOVE yourself. Strength through change. Need to Talk? You are brave. POWERFUL. BE KIND TO YOUR MIND STR

SUMMER 2020

OUGH. You aren’t alone. LOVED. Everyone has mental health. JOY. Self-care. Need to Talk? Be kind to your mind. STRONG. HOPEFUL. Happiness. You are enough. Min

aren’t alone. LOVE yourself. Strength through change. Need to Talk? You are brave. POWERFUL. BE KIND TO YOUR MIND STRONG. BOLD. HOPEFUL. You are brav

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h change. Need to Talk? You are brave. POWERFUL. BE KIND TO YOUR MIND STRONG. BOLD. HOPEFUL. You are brave. YOU ARE ENOUGH. You aren’t alone. LO

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l. Everyone has mental health. ENOUGH. You aren’t alone. LOVE yourself. Strength through change. Need to Talk? You are brave. POWERFUL. BE KIND TO YOUR MI

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Changing Trends ENOUGH. You aren’t alone. LOVED. Everyone has mental health. in Substance Use

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Isolation Wellness

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brave. POWERFUL. BE KIND TO YOUR MIND STRONG. BOLD. HOPEFUL. You are brave. YOU ARE ENOUGH. You aren’t alone. LOVED. Everyone has mental health.

ONG. HOPEFUL. Happiness. You are enough. Mindful. Everyone has mental health. ENOUGH. You aren’t alone. LOVE yourself. Strength through change. Need to Talk?

D STRONG. BOLD.

HOPEFUL. You are brave. YOU ARE ENOUGH. You aren’t alone. LOVED. Everyone has mental health. JOY. Self-care. Need to Talk? Be kind to y

OF You RIVERBEND COMMUNITY MENTAL HEALTH, INC.You are brave. POWERFUL. BE are enough. Mindful. EveryoneAhasPUBLICATION mental health. ENOUGH. aren’t alone. LOVE yourself. Strength through change. Need to Talk?

A letter from Lisa Madden

TEAMWORK, ADAPTABILITY, AND RESILIENCY DURING UNCERTAINTY Greetings! I am honored to be writing this as the new President and CEO of Riverbend. I will admit to being a bit apprehensive joining the team in the throes of a pandemic, but my fears were short lived. What I have seen is inspiring and impressive. Riverbend staff, Board and a vast network of community partners are dedicated to their missions and determined to provide exceptional services to all of those who seek care. Everyoneâ&#x20AC;&#x2122;s genuine kindness, their obvious compassion for our clients and the investment in their recovery is remarkable. The teams at Riverbend have demonstrated tremendous adaptability and resilience during uncertain and unpredictable times. Riverbend Incident Command, Senior Leadership and Management teams continue to work tirelessly to coordinate resources so we remain open and accessible throughout this experience. There are many examples of their efforts: Personal Protection Equipment (PPE) was secured; cleaning and air filtration at our facilities was upgraded to meet safety standards; and technology to support telehealth and working remotely was implemented within days of the Emergency Order issued by Governor Sununu.

CURRENTS IN THIS ISSUE...

01 A Letter From Lisa Madden Teamwork, Adaptability, and Resiliency During Uncertainty 02 Thinking Outside the Box Telehealth During a Pandemic

06 Changing Trends in Substance Use During the COVID-19 Pandemic How Isolation is Fueling a Spike in Alcoholism 08 Mission Isolation Wellness Tips From Mental Health Experts, an Astronaut, and a Navy SEAL

10 Becoming Color A Quartet of Poems by Cara Haley 14 How to Protect Your Mental Health During Uncertainty

C U R R E N T S I S G E N E R O U S LY B R O U G H T T O Y O U B Y : B O R I S L O W I N S U R A N C E A N D D A R T M O U T H - H I T C H C O C K

From April 1 through June 30 we provided 8,584 telehealth video visits and another 23,625 telehealth appointments over the phone. These services provided clients the skills and supports to manage their mental health and addiction symptoms, to reduce the need for a higher level of care, to reduce the probability of exposure or infection. The New Hampshire Community Behavioral Health Association has been a strong supporter of legislation that will assure ongoing access to services via telehealth. On July 21, 2020 Governor Sununu signed into law House Bill 1623 which ensures coverage and compensation at the same level as face to face services. Telehealth has provided access to behavioral health services for many and it has undoubtedly saved lives. Now, it will be a permanent modality for treatment. Most importantly, Riverbend employees continue to work, every day. They work in our offices, their home offices, our

CURRENTS

Lisa Madden, CEO, Riverbend Community Mental Health

residential programs, consult with our partners, and work in the community. They provide crisis services 24/7 as part of our Mobile Crisis Team, at the Behavioral Health Crisis Treatment Center, and at the Doorway. They provide psychiatric support at Concord Hospital in the emergency department and on the voluntary in-patient unit. Thank you to the numerous businesses, organizations and individuals whose gifts and in-kind donations of cloth masks, gowns, food and personal products for our clients have had a deep and meaningful impact in our ability to remain operational while keeping our staff and clients safe. We are so grateful for your thoughtfulness and support. Every day the professionals at Riverbend demonstrate their skills, strength and commitment to service. I am very proud to be here, I promise to bring the same energy and enthusiasm to my work as I see in all of the staff in this organization! With gratitude,

Lisa Madden CEO - Riverbend Community Mental Health

TELEHEALTH DURING A PANDEMIC

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THINKING OUTSIDE THE BOX

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When daily routines came to a screeching halt in the hopes of slowing the spread of COVID-19, there was little that felt normal. For businesses, families, schools, and healthcare providers there was one common thread: redefining the new way of going about life. Mental health providers have been working tirelessly to meet the standard of care while practicing social distancing. “There was a lot of fear at the beginning that we would have no one show up and no one would want to do treatment online. But I was proven wrong, which was great,” said Shanna Large, Director of Substance Use Disorders at Riverbend. The results of telehealth are promising but for providers uncharted territory remains ahead. On the national and state level, task forces had to quickly figure out how to meet the needs of mental health providers and the population they serve. Organizations like Riverbend needed to figure out how to be accessible to new and existing clients and how to deal with the changing

needs during a pandemic. The solution was making telehealth a successful, available option for those who need it. As part of a series of emergency orders announced in March by Governor Chris Sununu, telehealth services were expanded, allowing health care providers to be reimbursed for socially distant services. Now, it appears telehealth is here to stay. On July 21, Governor Sununu signed a bill into law that allows providers to continue to be reimbursed for services via audio, video, or a combination of both at the same rate as in-office visits. While the insurance barrier has been lowered for most, other hurdles to seek treatment remain a concern.

“In the first few weeks of the pandemic the number of people awaiting psychiatric care in the emergency room was at historically low levels despite our knowing now from various surveys that have been done that anxiety levels were sky high,” said Dr. Jeffrey Fetter, MD.

“Clients have done well and really opened up through telehealth. They feel protected and safe in their home.” that they can access services.” - Shanna Large

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PRE-HOSPITAL INCIDENT REPORTS’ JANUARY 1 THRU APRIL 30, 2020 (COMPARED TO THE SAME TIME PERIOD IN 2019): ANXIETY

400%

DEPRESSION

21%

Source: NH EMS

From January 1 through April 30, 2020, NH EMS data on pre-hospital incident reports show that the top complaints were calls for anxiety, an increase of 400 percent for that time period compared to 2019. The second was depression, increasing 21 percent. “For our clients that have symptoms of anxiety, everything around us is anxiety-provoking right now, people wearing masks, being fearful of catching the virus. All of those pieces that are part of our community are adding to people’s depression and anxiety,” said Sarah Gagnon, VP of Clinical Operations at Riverbend. Many people are finding themselves overwhelmed by the unknown. Is it safe to go to the grocery store? Will my kids return to school in the fall? When can I see my family and friends? What will happen to my job?

increase in the number of crisis calls that we have been getting at the agency because people haven’t been paying attention to their mental health. They haven’t addressed issues that they’ve been dealing with they’ve let it get worse so now the crisis calls are starting to increase,” Gagnon said.

At the end of May, some inperson group meetings began.

The good news is Riverbend has spent the last few months preparing and testing technology to meet the needs of the community.

In some cases, Riverbend is conducting socially-distant home visits for those in need.

“Clinicians got creative and really had to think outside the box to reach clients and to keep them engaged in this new setting,” Large said. Early on, a survey was sent to clients to determine who needed help connecting virtually. “There were a handful that didn’t know how to use the technology and so we launched a peer group to help them get set up. Some clients were able to access a phone via Medicaid and that helped them get connected,” Large said. From April 1st to June 30th, Riverbend provided more than 8,000 telehealth video visits and nearly 24,000 phone appointments.

2020 RIVERBEND TELEHEALTH APPOINTMENTS: APRIL - JUNE

These concerns can lead to a person pushing aside their mental health, which then exacerbates the situation. “We are a few months into the ‘new normal’ and we’re seeing a slow

“Across the agency wherever we have the ability to do functional support services outdoors and get people out of their houses in a safe way we are doing that,” Dr. Fetter said.

“It is so important that we continue to provide services to the client in our community so that they feel supported and so they have the education about PPE use, sixfoot distancing, what’s going on in the community right now with COVID-19 and how Riverbend is responding to that,” Gagnon said. While it’s hard to speculate about the future, experts know that as the pandemic continues, the need for mental health services will increase. “All the staff at Riverbend have put a lot of time and thought and care into making our services safe to deliver. I want people to feel confident that they can access services.” -Dr. Fetter

ONSITE VISITS “All the staff at Riverbend have put a lot of time and thought and care into making our services safe to deliver. I want people to feel confident that they can access services.” - Dr. Fetter

AT RIVERBEND What to expect during and onsite visit at any one of our locations: • Temperature Check • Health Screening Questions • Social Distancing, 6ft • Group Meetings of 10 or less • Client & Staff Wear Masks

HAVE AN EMERGENCY ? 1-844-743-5748

We make it as easy as possible all you have to do is click on a link and you’ll be able to see your clinicians face. If you don’t want to do video that’s ok. We have audio options which are basically us giving you a phone call. This is a service that we’re providing and it’s as easy as logging in and checking your email or picking up your phone,” Gagnon said.

Start seeking help today, dial 211 or visit riverbendcmhc.org. Video Appointments

8,584

Phone Appointments

23,625

WATCH. Practicing “welcome hands” when you feel anxious.

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“We are seeing the beginnings of it now and it will continue to grow over the next six months or so after the pandemic threat subsides,” Fetter said. Over the last few months, alcohol purchases in New Hampshire have increased dramatically. According to a recent NH Crisis Standards of Care meeting, alcohol sales are up 43%, exclusively among New Hampshire residents. “We are really concerned about the amount of alcohol that people are consuming. We’re seeing a lot of new clients, ones who are realizing they are alcoholics,” Large said. Peer Living Room at Riverbend’s Behavioral Health Crisis Treatment Center

CHANGING TRENDS IN SUBSTANCE USE DURING THE COVID-19 PANDEMIC How isolation is fueling a spike in alcoholism While predictions are based on relatively short data, experts said the impacts of the COVID-19 pandemic and stayat-home orders are resulting in substance relapses and calls from those who have never received treatment in the past. “It’s hard to speculate about the future, but we are seeing changes in the number of people seeking treatment and what they are struggling with,” said Shanna Large, Director of Substance Use Disorders at Riverbend. Historically, alcohol abuse and dependency tend to spike following traumatic events. That happened following 9/11 and previous economic crises, said Dr. Jeffrey Fetter, MD.

In Concord, medical calls for acute alcohol poisoning and drug overdoses increased 40 percent from March 1 to May 25, according to Jeffrey Stewart, a Concord paramedic. Additionally, there has been an uptick in connections through The Doorway program, which provides 24/7 support for those seeking services. “Every new person that comes in seems to have alcohol or meth in their system,” Large said. The impact of the pandemic is taking a toll across the United States. According to a recent report, upwards of 75,000 Americans could die by drugs, suicide, or alcohol abuse as a result of COVID-19 restrictions. “It’s terrifying because we know that something could happen to our clients because they’re trying to cope with all of this. These clients

really need people around,” Large said. Traditionally, clinicians encourage face-to-face and group meetings for clients dealing with substance use disorders. During the pandemic, those expectations have changed. For the last few months, there was a focus on video and audio telehealth. More recently, Riverbend began conducting small, socially distant group meetings that are often held outside.

for improving depression and substance misuse problems,” Fetter said. Outcomes are consistently better when substance use and mental health care are integrated into the primary care offices. “There should be no wrong door for people, whatever they feel comfortable with, just get started, reach out,” Fetter said.

It hasn’t been without hurdles, but clinicians realized the importance of making meetings available and keeping clients engaged to avoid a relapse. “When clients are in recovery they do well with structure,” Large said. Clinicians have seen progress with the telehealth program and there has been camaraderie among members who encourage participation with their peers.

GET HELP TODAY Call The Doorway: 2-1-1 (24/7) OR visit: RiverbendCMHC.org

For those in the beginning stages of seeking help with substance use, there is no wrong way to get started. Integrated care programs like Riverbend’s collaboration with Concord Hospital Medical Group will be key to the initial response. “People are likely to go to their primary care physician (PCP) before calling a treatment provider directly. Those PCP’s are screening for mental health, alcohol, and drug use. Integration is one of the most powerful evidence-based models

WATCH. Curious about This is My BRAVE - Concord, NH? Watch this video to learn more.

CURRENTS “Outer space and your own living room might be drastically different physically, but emotionally the stressors can be the same,” Dr. Jay Buckey, a professor at Dartmouth College’s Geisel School of Medicine, said in a statement. Buckey spent more than two weeks orbiting Earth on the space shuttle Columbia in 1998.

Jay Buckley, Former Astronaut

Photo courtesy of NASA

MISSION: ISOLATION WELLNESS Tips from mental health experts, an astronaut, and a Navy SEAL

“The fact that you did not leave your house means that a virus did not get from person A to person B through you, you have moved us closer to the end of the pandemic.” - Dr. Jeffrey Fetter There is no precedence, no historical parallel, no manual or handbook to tell us what to do or how to feel during a global pandemic of this nature. That’s why it’s OK to feel anxious, overwhelmed, or uneasy. You aren’t alone. Nearly half of Americans (48%) are anxious about the possibility of getting coronavirus (COVID-19). More than one third 36% agree that coronavirus is having a serious impact on their mental health. “Part of the problem is that people are afraid to reach out for help. People are afraid to leave their

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house and people are afraid to expose themselves and their family to the virus,” said Dr. Jeffrey Fetter, MD. So how do you strike a balance between staying safe and staying mentally well? 1. Follow the recommendations of health officials. 2. Don’t avoid seeking medical help and consider telehealth when possible. 3. See your personal proactive measures as steps made for the greater good.

“Every single person who does their best to follow public health recommendations is helping themselves and their family and their neighbors and their whole country get closer to the end of the pandemic,” said Dr. Fetter. By changing how we view our sacrifices, we open the door to a sense of accomplishment. This has been shown true in studies about human isolation during times of high stress which previously focused on astronauts, submariners, military personnel, and people in extreme environments such as Antarctica.

“When people feel like they are doing something that really matters they are able to tolerate the stress of isolation much better,” said Dr. Fetter. “People who look at the experience and say ‘it is uncomfortable but by my doing part in this, I’m making the world better by contributing to science or by defending my country,’ those people tend to do pretty well. But they need reminders of the meaning of the ordeal that they’re going through,” Fetter said. A recent article by Andrew Huberman, a professor of neurobiology at Stanford University School of Medicine, and Pat Dossett, a former Navy SEAL suggests three steps: move the finish line, take action, and serve others. Move the finish line: It isn’t about how much you do, but that you do something specific you are certain you can complete. Focus on what you can accomplish in the next few minutes, not the entire day. Take action: When you feel powerless, you must, instead, move forward. By taking action, you train your brain to repeatedly release dopamine, enhancing your energy levels and creating an outsized effect on your thinking, mood, and

ultimate sense of what you can control. Do one small task and then look for the next. This will encourage a positive mindset. Support someone else: Supporting others rebalances the weight of attention we pay to our inner self to the outer world. Focus on meeting the needs of others to make the group more effective and reduce the perceived sense of stress any single teammate feels. “It is absolutely normal to be scared. If you’re not a little scared you’re not paying attention,” Dr. Fetter said. “But if you’re a lot scared so it’s keeping you from being what you would consider your best self then the first step is doing things that are creative and connecting. Whatever you consider creative in your own personality whether it’s gardening, music, writing, the things that express who you really are. Make sure you make time to do that and to do things that are connecting to the people that you care about, the people you consider your most important community around you, that may be people distant or people far. Do things that are creative and connecting and if those things don’t feel like enough or if you’re doing things that make you feel more anxious or depressed, whether its substance use or cutting down on activities that are important to your wellness because you’re so depressed or anxious, if that’s where you are that’s when you should give a call to a mental health professional or a healthcare professional.”

COVID-19 Pandemic Involkes Anxiety Amoung Americans A nationwide online survey of 1,004 Americans conducted for APA queried respondents about their reactions to the worldwide COVID-19 pandemic. below are the percentages of respondents who agreed with the following statements: I am anxious about getting the virus

48.0% I am anxious about family/loved ones getting the virus

50.8% I am anxious about spreading the virus to loved ones

44.1% I am afraid of becoming very ill or dying from the virus

39.8% The pandemic is having a serious impact on my mental health

36.1% I’m worried about running out of food/medicine/supplies

47.0% Source: Porter Novell for American Psychiatric Association, March 2020

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My name is Cara Haley and I am here to share with you the story of my life coping with dual diagnoses: schizoaffective disorder and autism. The autism part is pretty socially acceptable these days but the mental illness part is still scary to many people. Especially when the prefix “schizo” is mentioned. People tend to back away. Even my parents spent a lot of time encouraging me not to talk about those voices I was hearing and visions I was subject to. It was like they were scared of my reality and who I was becoming. I felt like I was a disappointment to them and I began to think this whole thing was my fault. What had I done wrong? For a long time, I thought I was doing everything wrong. And that when people looked at me they saw an ugly nonhuman. I could barely look anyone in the eye. Along with some good talk therapy and eventually getting on the right meds, my artistic nature has saved me from myself. Painting, weaving and writing have allowed me to see myself as someone who has something to say that other people need to hear. I am beginning to walk in the world in such a way that I have started to look people in the eye, to smile and say hello. Sometimes they say hello back and if they don’t I am working hard to think It’s them not me. So here are a quartet of poems that chart my journey toward love and light. I call them Becoming Color.

BECOMING COLOR CURRENTS

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A quartet of poems by Cara Haley

And the third poem is called: The first poem of my quartet I call:

TAKEN OVER The dvd inside my head clicks on. I watch my life pass before my eyes. No moment is left unexamined. No mistake goes uncondemned. How could I be so stupid, so envious, so lazy, so hateful? I freeze my face. I tremble. I sweat. Vertigo takes me over. I build a wall between worthless me and the world.

Poem 2, I call:

THE WORST Like a gun punched in my passion, I see them coming in my brain. The Instructions: I see them and I hear them. They tell me what to do.

BIRTHDAY As I turn into the next year of my life, I think back to the confusing years of my adolescence. So much required. Conformity a necessity. Yet for me an impossibility.

And the fourth poem in my quartet I call:

Mental Illness = Difference.

TODAY

Sometimes you know you are.

Colors swirl all around me.

Sometimes you don’t know.

My hair paints the air.

All of it equals pain.

Bright, life lessons decorate my arms.

But I can endure.

Inside me though, live gray

I can be different without shame.

And black.

I can communicate, I can be useful.

Colors I must blend and balance every day.

Some pieces of the puzzle fall into place.

I struggle and I create

And the gaps become part of the picture.

I am an artist. I am the art.

Walking the road I’m on, takes energy. It takes community. It requires love. I am getting there.

Hungry for my blood, I become the evil vampire. But then the light comes, always the light. My people who love me, holding out their open arms. I will not die of suicide

Cara Haley just recently turned 32 years old. She has lived in the Concord area her whole life, except for attending Riverview School in East Sandwich, MA. She is a visual and fiber artist. She enjoys music, reading, and writing poetry.

HOW TO

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Protect Your Mental Health

RIVERBEND READS AN IMPOSSIBLE LIFE, BY SONJA WASDEN& RACHEL SIDDOWAY

AN IMPOSSIBLE LIFE Life chronicles the real-life story of Sonja Wasden who appears to have the ideal life: Married, mother of three, and living in suburbia. Then, at the age of thirty-five she is involuntarily admitted to a psychiatric hospital. In this compelling true story, Sonja shares her struggles with marriage, raising a family, and living with mental illness.

DURING UNCERTAINTY

Riverbend will be hosting several author talks and book discussions with Sonja, and her co-author and daughter Rachel Siddoway during the Month of October (dates and times to be announced later).

seperate what you can and CANNOT CONTROL

We look forward to you joining us – Happy Reading!

do what helps you feel a sense of safety

exercise find ways to relax new g n thi e m so

find joy at home

ld ist an ce

k lo ts o wate f r

cia

drin

eat well

ty ou rv ita mi ns

limit media exposure

LEARN MORE about Sonja and her journey, visit: www.animpossiblelife.com

ABOUT RIVERBEND COMMUNITY MENTAL HEALTH Founded in 1963, Riverbend Community Mental Health is a private, nonprofit organization providing specialized behavioral health services in central New Hampshire. Core programs include:

be present

sleep well

get outside

BOARD OF DIRECTORS

EX OFFICIO

John Barthelmes, Chair

Lisa K. Madden, MSW Chief Executive Officer Riverbend Community Mental Health

Jim Doremus, Vice Chair Annmarie Timmins, Secretary Frank Boucher

SENIOR LEADERSHIP

Ross Cunningham

Lisa K. Madden,MSW Chief Executive Officer

• Addiction Treatment and Recovery • Counseling & Mental Health Services for Children and Adults

Nicholas Larochelle, MD

• Residential Programs for Adults • Wellness Education Currents is a publication of Riverbend Community Mental Health, PO Box 2032, Concord NH, 03302-2032. All Rights reserved. Mailed free of charge to friends and supporters, Currents is also available at riverbendcmhc.org.

Aaron McIntire Rabbi Robin Nafshi Bradley Osgood Paul Quitadamo Glenn Shepherd James Snodgrass, MEd Carol Sobelson, LICSW Leslie Walker Cinde Warmington

think positive

LET’S GET SOCIAL:

Robert P. Steigmeyer Chief Executive Officer Capital Region Health Care

Leslie Combs Lucy Hodder, JD

• Psychiatric Emergency Services

protect the vulnerable

Jennifer Griffey Chief Financial Officer Chris Mumford, LICSW Chief operating Officer Jaime Corwin VP of Human Resources Sarah Gagnon, LICSW VP of Clinical Operations Karen Jantzen, CFRE VP of Community Affairs Sheryl Putney VP of Quality Assurance

are brave. YOU ARE ENOUGH. You aren’t alone. LOVED. Everyone has mental health. JOY. Self-care. Need to Talk? Be kind to your mind. STRONG. HOPEFUL. Happiness.

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