heal
A publication of the Sheppard Pratt Health System • SUMMER 2015
PLUS UNDERSTANDING ADDICTION HELPING ADULTS WITH AUTISM A WORKSHOP IN AFRICA
Breaking New Ground After a $4 million renovation, the Steven S. Sharfstein, M.D. Integrated Health Care Center is completed.
In this issue.
SUMMER 2015
4
12
10
4 Breaking New Ground After a $4 million renovation, the Steven S. Sharfstein, M.D. Integrated Health Care Center is completed.
3
Helping Adults with Autism Spectrum Disorder
12
Philanthropy: You give. They heal.
6
Understanding Addiction
13
Raising Autism™: A Family Affair
7
Progress Report: Medication Management in the Dementia Population
15
Meet Our Team: Behavior Specialists Remy Chappell and Thomas Flis
8
In the News/Calendar
On the cover.
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Out of Africa
Steven S. Sharfstein, M.D., and Jeff Richardson cut the ribbon at the dedication of the new Steven S. Sharfstein, M.D. Integrated Health Care Center. Photo by David Stuck
This issue of heal. is dedicated to the late Czarina (Rina) Santos-Borja, M.D., director of geriatric services at Sheppard Pratt Health System who died in April of a sudden cranial aneurysm. She was a distinguished member of our medical staff and a long-standing part of the Sheppard Pratt family. We will never forget her determination, brilliant smile, and kind heart. CMYK / .eps
Connect with us.
facebook.com/SheppardPratt
heal. is published four times a year by the Marketing Department of the Sheppard Pratt Health System, one of the nation’s top mental health programs, providing compassionate solutions to help those suffering from mental illness and addiction recover and get back to their lives. Information provided is general in nature and should not be substituted for the medical advice of a physician. Please consult your health care provider for recommendations specific to your personal health, medical treatment, and medical conditions. If you wish to have your name removed from the list of those receiving communications from Sheppard Pratt Health System, please email the Marketing Department at marketing@sheppardpratt.org or call 410.938.3133.
@sheppardpratt
CMYK / .eps
CMYK / .eps
youtube.com/user/SheppardPrattHealth
Editor/Director of Marketing & PR
Jessica Kapustin
Outreach & Project Manager
Chelsea Soobitsky
Design, Production & Editorial
Mid-Atlantic Custom Media Cortney Geare, Jeni Mann, Geoffrey Melada, and Suzanne Pollak
Contributing Photographers
Brian Glock, Patti Prugh, and David Stuck
ADULT PSYCHIATRY
Helping Adults with Autism Spectrum Disorder RECOGNIZING AN URGENT NEED, SHEPPARD PRATT OPENS ADULT NEUROPSYCHIATRIC UNIT
SHEPPARD PRATT marked Autism Awareness Month this past April by reopening our seven-bed Adult Neuropsychiatric Unit, which provides inpatient treatment for adults with developmental and/or intellectual disabilities, including those diagnosed with Autism Spectrum Disorder (ASD) who are having an acute psychiatric emergency. This new unit, which I am privileged to lead, is the only inpatient unit of its kind in Maryland and one of only a handful in the country to specialize in treating patients with severe psychiatric and behavioral problems. It was filled to capacity in its first weekend of operation. Because some of the patients are nonverbal, diagnosing and treating mood disorders or other mental illnesses in this population can be difficult. Finding
ago, according to the U.S. Centers for
psychologists and nurses specially
Disease Control and Prevention.
trained to treat this patient population’s
As a result, programming and resources
needs is, admittedly, a challenge. But
must keep pace, or an enormous
meeting a need is the core of what we
burden falls on the caretakers. This
do at Sheppard Pratt.
need is particularly acute with the adult
To give you a better sense of that
population, as they age out of the
ROBERT WISNER-CARLSON, M.D.
need, one in every 68 children is
programs and services that were once
Robert Wisner-Carlson, M.D.,
diagnosed with ASD today, a number that
available to them when they were part
is service chief of the Adult
has increased from 1 in 88 just two years
of the educational system. Despite these challenges, it was critically important for us to move forward with this venture. And yet the opening of this new unit is just the beginning. In terms of securing state funding and program development to serve this adult population, there
Neuropsychiatric Unit and medical director of The Developmental Neuropsychiatry Clinic, part of the Neuropsychiatry Program at Sheppard Pratt. A graduate of University of Michigan Medical School, he trained in psychiatry at The Henry Phipps Psychiatric Clinic at Johns Hopkins Hospital and at Maudsley Hospital in London. He holds specialty certification in Behavioral Neurology and Neuropsychiatry from the United Council for Neurologic Subspecialties.
remains much work to be done.
sheppardpratt.org • heal.
3
FEATURE/SHEPPARD PRATT
Steven S. Sharfstein, M.D., and Jeff Richardson cut the ribbon to officially open the new center.
Breaking New Ground
BY SUZANNE POLLAK
AFTER A $4 MILLION RENOVATION, THE STEVEN S. SHARFSTEIN, M.D. INTEGRATED HEALTH CARE CENTER IS COMPLETED
W
hen Kelly Damon finished
Care Center is named for the president and CEO of Sheppard Pratt
rehabilitation program, she walked
psychiatry, addiction, primary care, and
Health System.
away with a certificate, a 30-day supply
pain management — in one facility,
of medicine, and nowhere to go.
making it easier for its clients to get the
his leadership position in July of 2016 but
Sharfstein, who will step down from
help they need,” said executive director
continue to be involved in clinical work,
someone talking about Mosaic
Jeff Richardson. That approach has
has presided over a period of exponential
Community Services. She went there
paved the way for Mosaic, part of the
that very day, beginning what became
Sheppard Pratt Health System since
an eight-year relationship that she
1995, to become Maryland’s largest
believes saved her life.
community-based behavioral health
Six months later, Damon overheard
The 51-year-old Baltimore native started using drugs when she was 19 and
4
“Mosaic’s integrated care combines a range of services — including
a year-long, state-run
services provider. Today, that growth continues,
soon became addicted to heroin. She
with the reopening of The Harry and
had attempted suicide six times. But
Jeannette Weinberg Building in May,
through Mosaic’s classes and therapies,
including a new $4 million integrated
she said she has learned to control her
health care center on North Charles
anger, better deal with her family, and
Street in Baltimore. The Steven S.
even lose 70 pounds.
Sharfstein, M.D. Integrated Health
heal. • Sheppard Pratt Health System
The writing’s on the wall: Community members gathered in May to dedicate the newly launched Steven S. Sharfstein, M.D. Integrated Health Care Center.
Mosaic treats a wide range of people, from those who need immediate hospitalization to others who can be best helped with short-term interventions. growth for Sheppard Pratt — from the
of the brain, he said. Removing
single hospital he joined in 1986 to
the societal stigma attached to
a health system today spawning
mental illness remains a critical
38 locations throughout Maryland.
priority. Increasing funding
When he started, Sheppard Pratt had 850 employees and a $40 million
is another. “We still struggle with
annual budget. It now has 2,700
these illnesses,” Sharfstein said.
employees and a $350 million annual
“They are poorly understood.
budget. The health system, which
We do a good job, but we can
had 1,000 admissions in his first year
do better.”
and extremely long lengths of stay,
The building opened in 1959
Kelly Damon uses Mosaic’s classes and therapies to help take charge of her life.
now provides services for 10,000
and was renovated to include the
admitted patients and another
brand new center that bears his
70,000 outpatients annually.
name in an effort to redesign its
with short-term interventions. It provides
space to accommodate the needs of the
medical and psychiatric services, as
clients by offering a variety of services
well as residential, vocational, and
About 27,000 people received assistance from Mosaic last year.
under one roof. Mosaic offers patients a
crisis services. “We will go to a bridge.
and medications designed to treat
team-based approach, coordinating care
We will go to a hospital. We go to
mental illness have been developed
for its clients among professionals in
where the people are, where they live,
since Sharfstein began his psychiatry
different fields.
wherever and whenever they need us,”
Although numerous therapies
career in Boston more than 40 years
Statistics show that, on average,
Richardson said.
ago, there is still much to learn in the
people with mental health problems
field, he said.
die 25 years earlier than the general
a discrete illness by guiding individuals
population largely due to treatable
back into society.
For one, scientists are only beginning to understand the workings
medical conditions. Mosaic is battling
Jeff Richardson, Mosaic’s executive director and Steven S. Sharfstein, M.D., Sheppard Pratt’s president and CEO.
The goal is to do more than treat
Damon said she has been clean
this early mortality rate
and sober for more than eight years
by embedding primary
now. She believes Mosaic is successful,
care into a behavioral
because “they actually take time out
health setting so that
to find out what’s wrong with you.
people coming in with
They talk to you, not at you.” She tried
mental health and
other programs and failed. Mosaic
addiction issues, for
was different.
instance, can access
“They don’t talk down to you,
services to help stop
and I never had a program that did that.”
smoking, lose weight,
Damon lives with her husband in
and make other
Mosaic housing and has a part-time job
behavioral changes.
helping a child with special needs learn
Mosaic treats
in an integrated classroom setting. She is
a wide range of
taking care of herself, too. Her weight
people, from those
loss has enabled her to control her blood
who need immediate
pressure. She is no longer suicidal.
hospitalization to
If not for Mosaic, she said, putting
others who can
it bluntly: “I don’t think that I’d be here
best be helped
right now.”
sheppardpratt.org • heal.
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THE RETREAT
Understanding Addiction WHAT sort of person do you picture
Addiction does not happen
when you think of a drug addict or an
overnight. It is a progressive
alcoholic? Film and television give us
disease. How quickly one becomes
caricatures — a homeless man, collapsed
an addict depends on a number
in an alley, clutching a bottle wrapped
of factors, both genetic and
in a brown paper bag.
environmental. No one signs up to
The truth is that most people who
be an addict or alcoholic. And once
suffer with drug addiction or alcoholism
the brain is altered from addiction,
cannot easily be spotted in a crowd.
recovery is not simply a matter
In fact, chances are good you know
of “Just Say No!” As a disease,
someone who has a substance use
addiction requires intervention
disorder. Addiction affects every ethnic
like any other.
group, gender, and tax bracket. Most people are introduced to alcohol or drugs by someone close to them, an influencer — a parent, sibling,
There is good news: Recovery from addiction is possible. Like addiction itself, though,
or friend. Some unwittingly become
recovery is a process — not a single
addicted after taking prescription
event. Inpatient, intensive outpatient,
medications lawfully prescribed by
and outpatient substance abuse
their doctors.
programs are first steps on that path.
The reasons people abuse drugs
In early recovery, medications are
and alcohol also vary. Some find
available to help patients combat
temporary relief from emotional and
powerful, physical urges to return to
it is important for family and friends
physical pain or from boredom and
substance abuse, while self-help
to educate themselves about addiction
loneliness. For others, they simply like
groups such as Alcoholics Anonymous,
and recovery. Al-Anon, Alateen, and
the way substances make them feel, at
Narcotics Anonymous, and SMART
Nar-Anon are self-help programs for
least until addiction takes hold.
Recovery provide emotional support.
people coping with someone else’s
When used in tandem, these treatment
addiction or alcoholism.
Addiction, which includes alcoholism, is a brain disease. It is not a
approaches work.
If you, or someone you know is
moral deficiency. The American Society
Because addiction is a process,
of Addiction Medicine defines addiction
some people will experience setbacks or
so is not a sign of weakness. It takes
as a chronic disease of the brain
even relapses along the way. People who
courage to pick up the phone, or to walk
characterized by impairment in behavior
have never experienced addiction or
into that first meeting. But you can do it.
control and an inability to consistently
seen it up close sometimes struggle to
And when you do, know this: You will find
abstain from cravings. Along with these
understand this. “Why can’t you just
an entire community of professionals and
symptoms, addicts experience significant
stop?!” they ask.
recovering individuals there who
problems with interpersonal relationships and dysfunctional emotional responses.
If only the solution were that simple. Because the reality is more complicated,
using substances, ask for help — doing
understand you, support you, and are ready and willing to help you.
DENISE CONNELLY, LCSW-C, CAC-AD Denise Connelly is a licensed clinical social worker and certified addictions counselor at The Retreat at Sheppard Pratt. She holds bachelor’s and master’s degrees in social work from the University of Maryland.
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heal. • Sheppard Pratt Health System
GERIATRIC PSYCHIATRY
Progress Report: Medication Management in the Dementia Population GERIATRIC SERVICES launched an
greatly improved communication among
initiative in 2013 to more safely and
staff deciphering records and created
effectively manage agitation on the
process efficiencies. An increased focus
Geriatric Neuropsychiatry Unit at
on documenting nonpharmacological
Sheppard Pratt. There is good
interventions — such as art, music, and
progress to report.
exercise therapies — also helped convey
During the course of an 11-month period, a 90 percent reduction in the frequency of agitation was shown in
the benefits of these activities, so they were used more often. The process improvements resulting
the rate of antipsychotic use for the
from this project continue to be in effect
management of behavioral and
at Sheppard Pratt.
psychological symptoms of dementia. How did we get there? Studies have
Ultimately, our hope is to advance findings and share them with the greater
During the course of an 11-month period, a 90 percent reduction in the rate of agitation was shown in the rate of antipsychotic use for the management of behavioral and psychological symptoms of dementia.
outpatient care, and off-site medical daycare services.
shown an increased risk of side effects
health care community to encourage
with uncertain benefits for some elderly
increased safety and effectiveness in
part of this project included myself,
patients with symptoms of dementia
managing medication among loved ones
Emily Draper, Rochel Friedman, Sheila
being treated with antipsychotic
in this elderly dementia population.
Harvey, Dr. Robert Roca, the late Dr. Rina
medication. In the face of that evidence,
Sheppard Pratt’s geriatric services
The staff members who were
Santos-Borja, Sheila Underwood, and
Centers for Medicare & Medicaid
serve older adults experiencing clinical
Susan Wolski-Vincenzes. This team was
Services launched a broad effort to
depression, anxiety, severe forgetfulness,
awarded a 2015 Minogue Award for
reduce the use of these medications
and other mental health problems. These
Patient Safety by the Maryland Patient
among this patient population.
services include two inpatient units,
Safety Center.
As part of our LEAN methodology program that focuses on continuously
Some of the staff from the Geriatric Neuropsychiatry Unit who participated in the project.
improving and eliminating waste, the geriatric services team at Sheppard Pratt first implemented a new process in the pharmacy order system calling for physicians and team members to re-evaluate the way they document behavioral symptoms and communicate with each other. For example, instead of recording a patient’s symptoms generally as “agitation,” the team began listing more specific symptoms such as exit-seeking, kicking, or insomnia. This
DR. JOSHANA GOGA Joshana Goga is a pharmacist and clinical specialist with Sheppard Pratt Health System. She is also an assistant professor at the University of Maryland School of Pharmacy.
sheppardpratt.org • heal.
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IN THE NEWS
Exemplary Physicians Honored THE SECOND RECIPIENTS of the Michael Edelstein, M.D., Physician Humanitarian Award were announced at Sheppard Pratt’s annual Doctor’s Day Luncheon on Thursday, April 2, 2015. More than Dr. Khizar Khan
Dr. Edward Zuzarte
80 nominations were received for
the award, which recognizes physicians who dedicate their time to fulfilling the needs of patients in a selfless and extraordinary way. Congratulations to Dr. Khizar
Please Join Us in Congratulating
Student Shows Poster at Annual Child and Adolescent Conference
• DR. STEVEN SHARFSTEIN, president and CEO of Sheppard Pratt Health System,
CONGRATULATIONS to Jenna Michelle
Khan and Dr. Edward Zuzarte for being recognized as this year’s winners.
for receiving a 2015 NAMI Exemplary Psychiatrist Award. • DR. HARRY BRANDT, co-director of The Center for Eating Disorders at Sheppard Pratt, for being selected by the readers of Chesapeake Family as one of their Family Favorite Doctors.
Jackson, a student at The Jefferson School at Finan Center, whose artwork was selected as the Maryland Coalition of Families for Children’s Mental Health Awareness Week poster for this year.
• BONNIE LINK, program coordinator and teacher at Hannah More School, and
The poster was unveiled at a reception
VERA ROTH, career and technology education director at The Forbush School at
on March 24 during the annual statewide
Glyndon, for being recognized as recipients of this year’s Unsung Hero Award
Child and Adolescent Conference.
by the Reisterstown/Owings Mills/Glyndon Chamber of Commerce.
Mark Your Calendar! For a complete listing of events, continuing education classes, and lectures, visit sheppardpratt.org/calendar-events.
Continuing Education: Wednesdays @ Sheppard Pratt A lecture series at The Conference Center at Sheppard Pratt most Wednesdays from noon to 1 p.m. to support continuing education of medical and mental health professionals. Visit sheppardpratt.org/education-training
EDUCATIONAL CLASSES
for more information.
PHILANTHROPIC EVENTS
Dick Prodey Lecture Series
2nd Annual Sheppard Pratt Stride
Sponsored jointly by The Kolmac Clinic,
Two Doctors, Two Generations: Medical Ethics Then and Now
Saturday, October 10, 2015
Sheppard Pratt Health System, and the
Save the date for this family-fun
National Council on Alcoholism and
event complete with music,
Drug Dependence of Maryland.
games, and more.
A FREE, eight-class series
stride 8
heal. • Sheppard Pratt Health System
held Wednesday evenings at The Conference Center at Sheppard Pratt from 7 p.m. to 9 p.m. Call 410.938.3900 for information.
July 8, 2015 Barron H. Lerner, M.D., Ph.D., professor, Department of Medicine and Population Health, Lagone Medical Center
IN THE NEWS
Sheppard Pratt Sponsors Art Exhibit to Promote Mental Health Awareness THIS MAY, Sheppard Pratt was a proud sponsor of the Maryland Coalition for Mental Health Awareness’s Third Annual Art Exhibit, which took place on May 7th at the American Visionary Art Museum. In addition to helping sponsor the event, which showcases artwork created by behavioral health consumers to eradicate stigma surrounding mental health, Sheppard Pratt also sponsored artwork created by a patient of The Neuropsychiatry Program at Sheppard Pratt.
The Mann Residential Treatment Center (RTC) Residents Lend Hands, Help the Hungry
Recognized Excellence
AS PART OF an initiative created by occupational therapy interns at Mann RTC,
SHEPPARD PRATT received
residents within this program have been spending time in the community helping
awards for both our logo
others. The girls units provided care packages
design and Heal magazine in the
to families at the Baltimore Ronald McDonald
2015 Aster Awards competition,
House, and the boys unit visited Moveable
which recognizes the nation’s
Feast, a local food pantry, and made more
most talented healthcare marketing
than 600 sandwiches for those in need. We are
professionals for outstanding
proud of the work this program is doing to give
excellence in advertising.
back and support our local community. Interns at Mann RTC.
Acceptance and Commitment Therapy July 22, 2015 Jesse M. Crosby, Ph.D., administrative director, Office of Clinical Assessment and Research, OCD Institute, McLean Hospital
Godfrey D. Pearlson, M.D., professor of psychiatry and neurobiology, Yale
NASW MD 10th Annual Clinical Conference
University School of Medicine
September 24-25, 2015 Linthicum Heights, Maryland
The Bad Mother in American Psychiatry: Where She Came From, Why Her Story Still Matters September 30, 2015
Diamonds in the Rough 2015 Conference for families, educators, and professionals working with students with special learning needs
Value in Mental Health Care: What Is It and Who Decides?
Anne Harrington, Ph.D., director of
August 5, 2015
of the History of Science,
Robert P. Roca, M.D., M.B.A., M.P.H.,
Harvard University
5th Biennial Trauma Conference Kennedy Krieger Institute
CONFERENCE EXHIBITING
October 1-2, 2015
Throughout the year, Sheppard Pratt
Timonium, Maryland
undergraduate studies, Department
vice president and medical director, Sheppard Pratt Health System How Can Biological Measures Help Guide Diagnostic Classification in Psychiatry? A Focus on Psychotic Illnesses September 9, 2015
Health System and its programs exhibit at a number of conferences and community events. Make sure to stop by our booth if you plan to be at any
September 26, 2015 Rockville, Maryland
ISTSS 31st Annual Meeting November 5-7, 2015 New Orleans, Louisiana
of these.
sheppardpratt.org • heal.
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SHEPPARD PRATT
Spray-painted mural by Juma Mkwela, Khayelitsha Township, South Africa.
at Sheppard Pratt. This was a chance to bring that knowledge someplace where they were willing to hear what we have to From left: David Pruitt, Tamara Maresky, Desmond Kaplan, Rene Nassen, Patti Prugh, and Eunice Dube.
out there, on a truly international level and show people what we stand for.
IN ORDER TO ADDRESS the mental health needs of those living in the underserved communities of the Western Cape of South Africa, a joint South African/U.S. child and adolescent mental health alliance was recently established among the University of Cape Town, Stellenbosch University, Columbia University, the University of Maryland, and Sheppard Pratt Health System. The inaugural project was a five-day child and adolescent mental health workshop that took place this past March, in which three Sheppard Pratt employees and two University of Maryland employees participated and led many of the lectures, workshops, and clinics. The workshop was free and open to all mental health and allied professionals. In their first debriefing with Sheppard Pratt since returning from the workshop, the participants reflect on their experiences in South Africa, the inspiration for this collaboration, and where they see it headed.
to South Africa? Desmond Kaplan: This trip was a further step in the work we’ve done with the Capetown community. We wanted to focus on what we felt were the real needs of the community. This wasn’t a
and international level. For the purposes of this project, we used our telemedicine equipment to video conference with those in South Africa, which helped us open the lines of communication and understand the needs of their community before we even arrived.
Eunice Dube: Having come from the region, and having worked there as a nurse, I have an idea of what health care services are like, so to be invited to participate in this really big, educational component of our health services, was inspiring. Desmond Kaplan: The issues in inner city Baltimore are not that different from what goes on in the shanty towns with drugs, alcoholism, and poverty. How is the mental health landscape different in South Africa from in the United States? Eunice Dube: There is a lack of enough qualified psychiatrists, and too many patients to care for. Desmond Kaplan: Just to give you some perspective, in South Africa there are
What inspired each of you to get
70 million people and approximately
conference that was sold out every day
involved with this project?
20 child psychiatrists. In the United
for five days.
Mark Rapaport: Look at it from the lens
States, we have 350 million people and
of what we do here. We forget how much
8,600 child psychiatrists. In South Africa
expertise we have in our own little world
they are producing just two child
fancy academic conference; it was a free
Telemedicine has allowed us to expand our reach on a local, national,
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for us and the participants. And it was a chance to get the Sheppard Pratt name
Out of Africa
What was the purpose of the trip
say, and, in the end, it was very beneficial
heal. • Sheppard Pratt Health System
sophisticated and really
What is your biggest take away
targeted at what we felt
from the trip?
were the important topics for this community. And while that disconnect is there within their a back door for addressing
appreciation of the universality of the
the issues through the
issues that we’re dealing with. The recent
without having spent time going to the presentations
psychiatrists a year, and, in the United
for domestic violence that were going on
States, we are producing 800 a year.
directly in these little community
several schools for children with autism and related disabilities. There were 27 children in a classroom with one teacher and then a couple of people who were not trained. In contrast, in our schools, we put a lot of time into training, even for the noncertified and non-disciplined staff. On the units, the modality and delivery
meaningful for others. Laurel Kiser: I walked away with an
I wouldn’t have known that
Mark Rapaport: On the trip, I went to
much that I could give that would be
system, there’s been
para-professionals. Monica “Momma” Duda conducting a frontline domestic violence workshop in Khayelitsha Township, South Africa.
Patti Prugh: I did not know that I had so
organizations, in the shacks. What happens next? Desmond Kaplan: One of the nurses from South Africa is coming in June to Sheppard Pratt to visit, and I’m going to South Africa in August to work on a project in Johannesburg, and one of the focuses will be telepsychiatry.
protests in Baltimore have made these parallels all the more real. The magnitude of the issues and the problems and how we can intervene to help people is just so critical at this point. One of the things I heard in South Africa was that it’s not very often that someone from the United States comes over and talks about poverty here and draws those parallels. David Pruitt: I took away the relationships, both internally and once we were in Cape Town. I really did feel I learned more than I taught which is remarkable. Because of those relationships, I think it’s sustainable. Mark Rapaport: The relationships.
of services was lacking.
Patti Prugh: People are asking us
As much as I think we gave, we were
David Pruitt: Their public health thinking
for help with grants writing, how to
able to receive. It was not a one-way
formulate their concept into something
process. The need to go back and do
ours here in the United States, because
they can convey to a funder. Teaching
more is another take-away.
they have to look at the whole and find
this skill isn’t something that has to happen in South Africa; it can be done
Desmond Kaplan: This get-together
the issues they want to intervene on. But there is a large gap between the private,
long distance using telemedicine.
create an institute of international child
public, and academic centers; they’re
David Pruitt: I would hope that, whatever
mental health through Sheppard Pratt
much more siloed there because of the
we do, we layer on to the good work
and the University of Maryland. There’s
lack of resources.
that’s already been created. Telemedicine
an enormous amount of work to be
Patti Prugh: When I was really on
is a remarkable technology, and it can
the ground, I found that the frontline
help us, but I still think the group coming
workers who do not have formal training,
together and creating the experience
the work that they would do was so
we had was key.
was actually more sophisticated than
has made me dream big. I’d love to
done, and the world is getting smaller through technology.
From Sheppard Pratt: Desmond Kaplan, M.D., service chief of the Child and Adolescent Neuropsychiatry unit and medical director of the Telepsychiatry Program; Patti Prugh, senior art therapist and rehabilitation services coordinator; Mark Rapaport, M. Ed., principal/education director at The Forbush School at Prince George’s County and special education teacher on the Child and Adolescent Neuropsychiatry unit. From the University of Maryland School of Medicine: Laurel Kiser, Ph. D., M.B.A., psychologist and associate professor in the Department of Psychiatry, University of Maryland School of Medicine; David Pruitt, M.D., child and adolescent psychiatrist, director of the Division of Child and Adolescent Psychiatry, and director of Telepsychiatry, University of Maryland, Baltimore. From the VA Baltimore: Eunice Dube, R.N. Also participating in the collaboration: From Columbia University: Christina Hoven, Ph.D.; From Hershey Medical Center: Fauzia Mahr, M.D.; From the Psychiatric Institute of Washington: Michael Bogrov, M.D; From Tel Aviv University: Alan Apter, M.D.
sheppardpratt.org • heal.
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SHEPPARD PRATT HEALTH SYSTEM PHILANTHROPY
You give. They heal. You make great things happen when you give to the Sheppard Pratt Health System.
stride
SAVE THE DATE for the 2nd Annual Sheppard Pratt Stride Saturday, October 10, 2015 Sheppard Pratt Health System’s Towson Campus Join us for a family-fun day to raise awareness and funds to support Sheppard Pratt programs that help patients and students, their families, and those affected by serious mental illness.
RECORD-BREAKING BENEFIT SHEPPARD PRATT HEALTH SYSTEM hosted its 23rd Annual Care for Kids Benefit on March 21 at the Four Seasons Hotel Baltimore. More than 400 donors and community members gathered at the disco-themed gala, which raised money to provide essential supplies and therapeutically beneficial activities to our 20,000 pediatric patients and students. It was the most successful event to date and raised over $300,000! To see more photos from the Care for Kids Benefit, please visit facebook.com/ SheppardPratt. You do not need an account to view the pictures. Save the date for next year’s event on April 2! QUESTIONS regarding the Sheppard Pratt Stride or the Care for Kids Benefit can be directed to the Office of Philanthropy at give@sheppardpratt.org or 410.938.4020.
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heal. • Sheppard Pratt Health System
SPECIAL EDUCATION
they have both life and social skills is key to establishing their independence. The Cherrys have also learned not to feel guilty about actively finding respite for the entire family, however they have to go about accomplishing this. Often, the family would break apart mealtime, sometimes feeding Matthew at a different time to avoid conflict. According to Jason, the family “has not been afraid to take breaks and to operate atypically as a family. We’ve looked past the commotion and frustration inherent to Raising Autism™ to find the humor in life.” Matthew and Jason Cherry.
Raising Autism™ : A Family Affair THE CHERRY FAMILY knows autism.
their advice on navigating family life
In 1996, Cathy and Michael Cherry
with a child with special needs.
traveled to Russia to meet Matthew for the first time. They quickly found themselves interacting with a 3-year-old whose actions could only be described
Disability is a household event According to Cathy, one of the greatest challenges to life with a child on the
Parents have no frame of reference when their first born is a child with special needs When Matthew was about 13 years old, he became more physically aggressive and had very poor judgment, especially as it came to safety. Cathy understood that Matthew never wanted to intentionally harm other children, but he had such poor judgment that she had concerns for the safety of the whole
as chaotic. Once in the states and old
autism spectrum or any other special
enough for a diagnosis around age 3,
need, is realizing that it impacts
Matthew was shown to have autism
everyone in the house. Says Cathy,
spectrum disorder (ASD), bipolar disorder,
“You don’t just raise a child with autism;
attention deficit hyperactivity disorder
you raise a family through autism.”
(ADHD), obsessive compulsive disorder
By the time Matthew was in second and
(OCD), and fetal alcohol syndrome.
third grade, home life was tumultuous.
Later, with two other children in the
It was a highly structured environment in
household, Jason, the middle child, and
school, but not at home, and things only
Samantha, the youngest, the Cherry
got worse as Matthew hit puberty.
adolescence, and what was just being
family began a lifelong journey to
In sixth grade, Matthew began attending
a boy.” Not until her second son,
understand autism and to raise a family
The Hannah More School in Reisterstown,
Jason, was 8 did she finally gain a better
with compassion, patience, and, most
Md., part of the Sheppard Pratt Health
understanding of what was neurotypical
importantly, humor.
System, where he progressed and did
development. During these early years,
well in the school setting for about
as Cathy was learning how to manage
five years.
Matthew’s challenges, her younger two
We recently sat down with Cathy, principal of Purposeful Architecture and Purple Cherry Architects, and her middle
family. Then conflict started happening among the siblings. “As a parent, when your first-born child has special needs, you have no frame of reference for what behaviors and social skills may be typically developing,” says Cathy. “Without any prior parenting experience, I could not determine what was autism, what was
Through this process, the family has
children experienced events that were
son, Jason, now 18 and the exclusive
learned that you must look at home and
scary to them. When Matthew pulled a
professional race car driver of the Autism
school settings together. Children with
knife on his aide, it created a year-long
Society of America (ASA), to find out a bit
special needs require more time to
fear in Jason, then about 7, which
more about their journey and to share
transition to adulthood. Ensuring that
manifested as anger and defense.
sheppardpratt.org • heal.
13
SPECIAL EDUCATION
Samantha, who was much younger,
everything that they’re going through, the
to marry her expertise in architecture
would deflect her feelings in response
good and the bad, so that they can
with her experience working with
to the fear. Jason went to private
receive the maximum support they need.
individuals with special needs. She can
counseling to learn how to cope with his
When Matthew was 17, the family
truly understand goals and provide
anger. And Cathy learned that she
knew it was time to seek residential
compassionate solutions to impact these
needed to take Matthew’s audience
treatment for him. He would throw huge
environments. “It’s what’s important to
away when he was becoming aggressive.
fits, running across the room and
me now,” she says.
“Sometimes I turned off the lights in the
slamming his entire body into the
house and other times, I honestly had to
window. He’d throw himself into shower
as a race car driver as a springboard to
place him outside on the lawn to remove
doors. Cathy says, “We fixed the wall 10
support ASA. Says Jason, “When I was
Jason chose to use his career
growing up with Matt as my brother, I was
“ Without any prior parenting experience, I could not determine what was autism, what was adolescence, and what was just being a boy.” — Cathy Cherry
embarrassed to have friends come over the house, and so I would ride my dirt bike a lot.” I then got into auto racing and began pro road racing. With 50,000 to 150,000 people in attendance at each race, and millions of viewers watching
him from a space where he could harm
times. He was hospitalized three times.
at home, Jason wondered, “What can
himself and others,” explains Cathy.
When it happens too much, you’re
I do with all of this attention? I saw an
overwhelmed.” And every member of
opportunity to speak as a sibling of
their support team needed to know what
autism, so I partnered with the Autism
was happening at home.
Society.” As the exclusive professional
Humor is the best remedy It took years for the younger siblings to get past their anger and resentment. But once they did, and once Matthew started
Now that Matthew is in a residential
its local affiliates to host families with
better and is more comfortable. He can
special needs at each of his races. He is
be home for two or three days at a time,
together. Matthew is usually the one
working to form an ASA sibling board for
and the family is able to enjoy that time
generating the humor, sometimes on
the next generation of leaders who will
together. According to Cathy, “When he
purpose and other times by accident.
eventually represent their autistic siblings.
got into residential treatment, it allowed
Cathy and Jason remember one time
the whole family time to begin healing.”
all three siblings is healed. A video on
because he picked it up. When they
Be proactive
Jason’s YouTube channel shows true
asked him why he would ever do
With the siblings now 15, 18, and 23, the
something like that, his response:
family, especially Cathy and Jason, has
“Because I wanted to see if I was
used the knowledge and patience
worthy of holding a bee.” Says Cathy,
they’ve learned from raising and growing
“Developing such a great sense of humor
up with Matthew, to help others with
has empowered all of us with a level
special needs. As principal of Purple
of patience that we would not have
Cherry Architects, Cathy started receiving
back on it, I can attribute a lot of my
developed otherwise.”
calls to work on special needs projects.
success to my brother and to dealing
She began creating living, learning, and
with the challenges and adversity.”
maturing, the family was left with humor to help piece the relationships back
when Matthew was stung by a bee
14
race car driver of ASA, Jason works with
environment, he composes himself
Today, the relationship among
love and friendship between the brothers. Jason’s best advice to other siblings is to “be patient, give it time, things will come full circle. In the moment, you don’t think anything will go right — I thought that for years. Looking
Full disclosure is vital
vocational environments locally, but
One of the biggest mistakes parents
knew she could do more. This led to the
make, in Cathy’s opinion, is to hide the
development of Purposeful Architecture,
realities of how difficult the situation is
a nonprofit arm of her firm dedicated to
Cherry’s Purposeful Architecture firm, visit
and to make it seem that everything is
creating spaces where children and
purposefularchitecture.com.
wonderful. For the Cherry family, it’s been
adults with special needs can thrive.
very important to fully disclose
Purposeful Architecture allows Cathy
heal. • Sheppard Pratt Health System
Jason Cherry can be reached through his website, jasoncherryracing.com, or through his Facebook page. To learn more about Cathy
MEET OUR TEAM
Get to Know Our Behavior Specialists CREATING POSITIVE BEHAVIORAL CHANGES IN OUR PATIENTS
Remy Chappell has worked since 2008 as a senior behavior specialist on 1H, the Child and Adolescent Neuropsychiatric Inpatient Unit. Her colleague, Thomas Flis, a 12-year veteran of Sheppard Pratt, serves as a senior behavior specialist on A7, the new Adult Neuropsychiatric Unit, having previously held the same position on 1H. The following are highlights from a conversation with these two professionals dedicated to achieving positive behavioral changes in our patients.
Q. What is a behavior specialist? A. Chappell: Behavior specialists look at behavior to determine why a person is doing what they are doing. There is a reason behind every behavior, and we try to figure that out by looking at environmental influences to determine the cause of the negative behaviors and to break the cycle and replace with and reinforce new, positive behaviors.
Flis: Remy and I are the only two behavior
in-home support, like an in-home
specialists at Sheppard Pratt. On A7,
therapist.
I work with adults with developmental disabilities, including ASD, genetic disorders, TBI, and intellectual disabilities. The adult population is different than the child population, because sometimes these adults have had problem behaviors for a long time, so it is much harder to break those behaviors.
Flis: For example, an individual who is
Q. How do you work with patients
unable to communicate verbally may be he has learned that every time he wants
once they leave to ensure they continue practicing the positive behaviors you have taught them?
or needs something, hitting himself in the
A. Chappell: Our biggest challenge
head has gotten the attention he wanted.
is our time limitations, as patients are
Our goal is to try to manage problem
only on our units for about two weeks,
behavior and to teach adaptive behaviors.
and we’re aiming to accomplish a lot
hitting his head against the wall because
in a short time.
Q. What types of patients do you work with?
Flis: Modifying behavior is a long-
A. Chappell: On 1H, we work with
our units. We perform numerous
children with neurodevelopmental issues,
assessments, work to create intensive
including autism spectrum disorder (ASD),
behavior plans, and determine
Down’s syndrome, traumatic brain
what works and what doesn’t
injury (TBI), and intellectual disabilities,
work for our patients.
among others. In addition to working with
It takes continuous
children, we also work with their families,
reinforcement to make
bringing them to team meetings, showing
a behavior stick.
them what has worked and what hasn’t;
Chappell: We also work
it’s the key to reinforcing the positive
to connect caretakers
behaviors once a child leaves the unit.
with outside resources for
CMYK / .eps
term process for people on and off
To learn more from our behavior specialists, visit our YouTube channel: youtube.com/user/SheppardPrattHealth
Q. What do you love most about your job? A. Flis: Many of our patients want to be able to express themselves, but because of their illness, they’re not able to. It’s amazingly rewarding when we’re able to manage a problem behavior and then teach a new, adaptive behavior that allows them to be more independent and express their feelings. Chappell: For me, it’s working with families who are really invested and want our help and accept our feedback. Those are the kids that get better and stay better and stay out of the hospital. That makes it all worth it.
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