heal. Winter 2015

heal

A publication of the Sheppard Pratt Health System • WINTER 2015

Learning to Cope For 12-year-old Bryce Greenberg and his family, The Frost School has been a ‘special’ gift.

PLUS CONCUSSIONS: A SERIOUS CONCERN NEW LEADERS AT THE RETREAT FINDING SUPPORT FOR EATING DISORDERS

In this issue.

WINTER 2015

4

13 4

3 Road to Recovery from Eating Disorders Is Shorter with Family Involvement

Learning to Cope For Bryce Greenberg and his family, The Frost School has been a ‘special’ gift.

12 12

Philanthropy: You give. They heal.

14

Informing Ourselves About E-cigarettes

15

eet Our Doctor: M Edward Zuzarte, M.D.

7

Calendar

8

In The News

10

Questions for Our Medical 3 Director of the Trauma Disorders Program

On the cover.

Concussions: A Serious Concern

Photo by David Stuck

11

Bryce Greenberg, 12, is now thriving, thanks to the comfort of The Frost School and his constant companion, Griffin.

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heal. is published four times a year by the Marketing Department of the Sheppard Pratt Health System, a private, nonprofit health system with one of the nation’s leading mental health programs. 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.

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Editor/Director of Marketing

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Design & Production

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Jeni Mann and Cortney Geare

Contributing Photographers

Brian Glock and David Stuck

EATING DISORDERS

Road to Recovery from Eating Disorders Is Shorter with Family Involvement WHEN A FAMILY MEMBER DEVELOPS AN EATING DISORDER, THERE ARE MANY VARIED REACTIONS How did this happen? Where did I go wrong?

Why won’t you just eat?

These questions, while quite common, have no simple answers and can easily distract from the ultimate goal of recovery.

When questions have no easy answers, many family members find themselves bewildered by the illness and frustrated with the afflicted individual. As an alternative, families are often encouraged to ask a new set of questions: How do eating disorders affect the body and the brain?

What can I do to support you in recovery?

Family involvement in the treatment of eating disorders can play a critical role in an individual’s recovery and is considered absolutely essential for children and adolescents. Family-based treatment (FBT) is a type of family outpatient therapy in which parents are coached to help their child to eat normally, end unhealthy behaviors, and regain weight. FBT helps parents understand what an eating disorder is and how it affects their child, both emotionally and physically. It views parents as the best experts in the refeeding of their son or daughter. The focus is on behavioral change, nutritional rehabilitation, and weight restoration. FBT is a “no blame” approach. During weekly sessions, the therapist serves as a coach to the family, and assists the family in supporting their child to eat what they need to in order to meet the body’s nutritional requirements. While the therapist may be quite active in treatment, most decisions are left to the parents. It is firmly believed that most families CAN help their child recover.

A key principle in FBT is a therapeutic technique known as externalization of the illness in which the child and the illness are viewed as two separate entities.

For example, when a child is struggling and resisting a meal, parents learn to direct their frustration at the anorexia and not at the child. This allows parents to remain aligned with their child, working together as a team against a common enemy, the eating disorder, instead of battling each other.

Family-Based Treatment Promotes Success The Center for Eating Disorders at Sheppard Pratt (CED) recently participated in a multisite NIH-funded study to assess the efficacy of family-based treatment (FBT). This five-year, international study found that parental involvement promotes success in treatment and recovery.

CED offers FBT as a first-line approach for families of children and adolescents with eating disorders. Because FBT is an outpatient therapy, the individual needs to be medically stable to utilize this approach. At times, an individual may require hospitalization to ensure safety during the beginning stages of recovery. Family involvement remains critically important at these higher levels of care as well.

The benefits of family support for recovery are not just for children. Changing deeply ingrained eating disorder behaviors is very difficult for individuals at any age. During treatment, adult patients are encouraged to identify people who are supportive and can help them while they work toward recovery.

Support People Need Support, Too The process of recovery is difficult for an individual as well as for his or her support network. To assist support people and families, CED offers free Collaborative Care Workshops for families and friends of individuals with an eating disorder. These workshops are tailored to address the needs of care providers, offering education and therapeutic communication techniques.

They provide a space for caregivers to seek

STEVEN CRAWFORD, M.D., co-director, The Center for Eating Disorders Dr. Crawford has been in a leadership role at The Center for Eating Disorders for more than 20 years. He also serves on the faculty of the University of Maryland School of Medicine, where he teaches how to

support while also learning self-care strategies for themselves.

For more information on The Center for Eating

identify eating disorders, and is also a lead investigator in federally

Disorders, visit eatingdisorder.org or call

funded research grants.

410-938-5252. sheppardpratt.org • heal

3

FEATURE/SPECIAL EDUCATION

Learning to Cope

BY DAVID HOLZEL

FOR THIS 12-YEAR-OLD AND HIS FAMILY, THE FROST SCHOOL HAS BEEN A ‘SPECIAL’ GIFT

N

ot so long ago, Tracy Greenberg

“Everything was driven by what

than not, Tracy was the victim of Bryce’s

often looked like a battered wife.

Bryce’s moods were going to be,” Tracy

fury. “With children like Bryce, they tend

said. “Even going out to dinner or to a

to take out their aggression on their

She was a battered mother.

friend’s house — I didn’t want to push him

mother,” she said.

Her son Bryce, now 12, was often

because I didn’t know what his reaction

She wasn’t one though.

It hadn’t always been that way.

uncontrollably violent. Diagnosed with

would be. We had to cancel a vacation

Bryce was “a fabulous baby,”

attention deficit hyperactivity disorder

because he had to be hospitalized.”

remembered Tracy, who with her

(ADHD) at age 5, and later with bipolar

Something as seemingly innocuous

disorder and anxiety, Bryce’s rages, prior

as being asked to do his homework

to treatment, controlled family life.

could lead to an outburst. More often

husband Terry adopted Bryce at birth. “He hit all his milestones.”

The couple knew that the birth parents struggled with drugs and mental illness. “But when you want a baby, words

Bryce Greenberg, with his pet dog Griffin.

like bipolar and schizophrenia mean nothing,” she said. She hoped nurture would overcome nature.

But when Bryce was 18 months old, Tracy and Terry “started to notice things weren’t right. He had night terrors.

They were like nightmares on steroids,” Tracy said.

In the following years, Bryce developed new, violent behaviors.

When it was time for kindergarten, the Greenbergs enrolled Bryce in a public school. “For the next four years, our life was awful,” Tracy said.

“In kindergarten and first grade he was restrained more than 10 times. He had

i 4

Taking Action

of the Sheppard Pratt ED day school programs.

Emotional disability (ED) is not so much an illness as it is

“It overlaps with the child’s medical definition such as

a diagnosis category that allows patients to access

depression, anxiety, psychosis.”

benefits available through the Individuals with Disabilities

The bottom line is that emotional disability

Education Act (IDEA). It governs how states and public

“impairs the child’s ability to get an education. It impairs

agencies provide early intervention, special education,

their ability to engage in satisfying interpersonal

and related services to more than 6.5 million eligible

relationships,” she said.

infants, toddlers, children, and youth with disabilities.

That was certainly true in Bryce Greenberg’s case.

“Emotional disability defines what a child is entitled

There were long periods before he began attending The

to in services. It defines the parents’ rights in requesting

Frost School when “he wasn’t learning at all,” his mother

evaluations,” said Ayanna Cooke-Chen, medical director

Tracy said.

heal • Sheppard Pratt Health System

Bryce Greenberg, shown here with father Terry, mother Tracy, and brother Cole, has made tremendous progress at The Frost School.

“He’s no longer violent.

I can challenge him now.

I can discipline him.

He knows how to use his coping skills, and he comes out of [an episode] quicker.”

— Tracy Greenberg

fits. He was violent. He was aggressive

again had to be restrained at school.

toward the staff and himself.” That’s when

“He was banging his head for an hour

Bryce was hospitalized for the first time.

on cement walls,” Tracy said.

The Greenbergs had an

The extent of Bryce’s illness isn’t

At The Frost School, which Bryce began attending in the middle of fourth grade, he is reminded every day of the

apparent on a recent fall afternoon at

Individualized Education Program (IEP)

coping skills he has learned. It has made

the family’s home in the Maryland

for Bryce beginning in second grade;

a difference. “He’s no longer violent.

suburbs of Washington, D.C. Bryce,

however, it did not cover the level of

That’s the hugest thing,” Tracy said. “I can

is eager to show off his bedroom,

services Bryce needed to be successful

challenge him now. I can discipline him.

where his pet gecko, Echo, has run of

in school. Eventually, the Greenbergs

He knows how to use his coping skills,

the place. He rough houses with the

were able to get another IEP for Bryce,

and he comes out of [an episode]

Greenbergs’ good-natured golden

where it was recommended that he

quicker. He recognizes it.”

retriever, Griffin.

attend The Frost School, one of

“We found out Bryce is sensory seeking,” Tracy said. “He wants to feel

Rather than explode in anger,

14 special education schools in the

Bryce is more likely to tell his mom,

Sheppard Pratt Health System.

“I have homework. I need a break first.”

With small classes, individual

“Frost has a way of holding the

support, daily therapy where he learns

students accountable, but it also allows

hospitalized at the Sheppard Pratt Health

coping skills, and the freedom to take

them to know that if they need support,

System during fourth grade when, after

a break when he needs one, Bryce “is

the support is there for them,” she said.

making some behavioral progress, Bryce

doing fine,” Tracy said.

everything all over him.”

The family learned this when he was

The process for requesting testing and evaluation typically begins with a letter to the school principal.

“If you suspect a psychological issue or emotional

Continued on page 6.

such as Frost. Donor contributions make it possible.

Since mental illness touches almost everyone in some way, “people are hopefully beginning to recognize that

disturbance, go to your general practitioner and get

we need to have these resources for young people,”

a referral to a psychiatrist and get it documented,”

Cooke-Chen said.

she said. “Documentation gives you a basis for talking to schools and what the next step is for getting special education in the current school or finding a place like The Frost School.”

Success for children like Bryce comes through

For information regarding giving to the Sheppard Pratt Health System, including our Special Education Fund, contact Marguerite Kelley, director of philanthropy, at mkelley@sheppardpratt.org or 410.938.4018.

the heavy investment Sheppard Pratt makes in schools sheppardpratt.org • heal

5

FEATURE/SPECIAL EDUCATION

Bryce even tolerated the school’s

would have been out of the question.

tie and dress slacks when he breaks the

So would have been the sight of

rules. “For a kid with sensory issues, this is

his younger brother Cole bringing

not easy,” Tracy said. “But he did it.”

his friends over to play, now a

Bryce’s progress has allowed the Greenbergs to live more like a family. But Bryce still has a long way to go.

“His moods fluctuate constantly, and

b. This is a 10- to 14-week study.

As she watched Bryce and Griffin playing tug of war with a chew toy, Tracy said she “used to sit waiting for that phone call every day” from school saying that

live in the same world that we all live in all

Bryce had had another violent episode.

and struggles in groups.”

Major Depressive Disorder Study (NCT02153502, NCT02158533) a. Adults 18-plus with unresolved symptoms of depression.

common occurrence.

he is sad, confused, and doesn’t really of the time,” Tracy said. “He doesn’t sit still

Volunteers needed for research studies at Sheppard Pratt Health System.

synagogue. Only two years ago, it

“dress code consequence” — putting on a

Bryce made it through three swim

Now Bryce is doing so well at The Frost School that he made the honor roll.

After receiving the award, Bryce told

practices last summer. “Next year, we

his therapist that he needed to talk to him

hope for five.”

“because he had never won anything

Tracy and Terry are discussing whether they want Bryce to begin preparing for his bar mitzvah, the

before,” Tracy said. Bryce cried, telling the therapist that they were “happy tears.”

“It’s important for people to know

Jewish rite of passage celebrated at age

how hard it was,” she said, “and how much

13 that draws family and friends to the

better it’s gotten.”

c. We will evaluate an investigational medication designed to work with antidepressants to help address unresolved symptoms of depression.

Unipolar & Bipolar Depression Study (NCT01562184) a. Adults 18-plus who are currently experiencing an episode of depression. b. This study will last up to 12 weeks. c. This study will evaluate the safety and effectiveness of transcranial direct current stimulation (tDCS) versus sham stimulation as an antidepressant treatment.

Tardive Dyskinesia Study (NCT02274558) a. Adults 18 to 85 who suffer from schizophrenia, schizoaffective disorder, bipolar disorder, or mood disorder and are experiencing involuntary movements in their face or other parts of their body. b. This study will last up to 46 weeks. c. The purpose of this clinical research study is to evaluate the effectiveness, safety, and tolerability of an investigational oral medication for tardive dyskinesia.

FOR MORE INFORMATION OR TO VOLUNTEER FOR ANY OF THESE STUDIES, PLEASE CONTACT:

Jennifer Sklar, study coordinator, at 410-938-3136 or jsklar@sheppardpratt.org Principal investigator, Scott T. Aaronson, M.D.

6

heal • Sheppard Pratt Health System

Making Education Accessible BRYCE GREENBERG is in a class of four kids. That’s the kind of student-teacher ratio The Frost School in Rockville, Md., employs to successfully educate its students.

Frost is one of the Sheppard Pratt Health System’s 14 special education residential and day schools located throughout Maryland.

Sheppard Pratt’s Special Education Program provides compassionate, nurturing care and individualized attention to children with autism, as well as emotional and behavioral disorders, to help them lead successful lives.

The Special Education Program is recognized as the largest provider of nonpublic, special education programming in Maryland and serves nearly 700 students with special needs from the state and surrounding areas, more than 50 percent of whom have been diagnosed with autism.

“Our purpose is to provide an educational environment that gives students the opportunity to access tools to make education accessible for them,” said Ayanna Cooke-Chen, medical director of the Sheppard Pratt ED day school programs.

For more information about Sheppard Pratt’s Special Education Program, visit sheppardpratt.org/special-education-services or contact Jim Truscello, director of day school programs, at 410.938.4747.

Mark Your Calendar!

For a complete listing of events, continuing education classes, and lectures, visit sheppardpratt.org/calendar-events.

PHILANTHROPY

Upcoming Wednesday Lectures:

Annual Care for Kids Benefit This year’s Care for Kids Benefit will

The Pathetic Past But Hopeful Future of Schizophrenia

be held on Saturday, March 21, at the

January 7

Four Seasons Hotel Baltimore. Presented

Fuller Torrey, M.D., executive

by Morgan-Keller Construction, it will

director, The Stanley Medical

feature a ‘70s disco theme, with all

Research Institute; professor of

proceeds benefiting Sheppard Pratt’s

psychiatry, Uniformed Services University

pediatric patients and students.

of the Health Sciences

Call 410-938-4020 for tickets and information.

Historical Trauma, Losses, and Separations: A Pilot Study to Evaluate the Psychological Problems of Exiles January 21 Eugenio M. Rothe, M.D., professor of psychiatry, Herbert Wertheim College of Medicine, Florida International University; professor, Robert Stempel

EDUCATION Dick Prodey Lecture Series Sponsored jointly by The Kolmac Clinic, the Sheppard Pratt Health System, and

School of Public Health, Florida International University; adjunct professor, Cuban Research Institute, Florida International University

Culturally Competent Assessment and Treatment of Abused, Suicidal African-American Women March 4 Nadine J. Kaslow, Ph.D., professor, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences Sleep Disturbances in PTSD: Rational Use of Prazosin and Other Treatment Modalities March 25 Murray A. Raskind, M.D., professor, vice chair, director, Mental Health Services, VAPSHCS

COMMUNITY National Eating Disorders Awareness Week February 23-March 1 Please stay tuned for events hosted by The Center for Eating Disorders at Sheppard Pratt, including a community

the National Council on Alcoholism

The Changing Face of Autism

art exhibit featuring student artwork from

and Drug Dependence of Maryland

February 4

the annual Love Your Tree Campaign.

(NCADD-Maryland).

Fred R. Volkmar, M.D., director, Child

Learn more at loveyourtree.org.

A FREE, eight-class series held Wednesday

Study Center, Yale University School

evenings at The Conference Center at

of Medicine; chief of child psychiatry,

Sheppard Pratt from 7 p.m. to 9 p.m.

Yale New Haven Hospital; Irving B. Harris

Call 410.938.3900 for more information.

professor of child psychiatry, psychiatry, pediatrics, and psychology, Yale University

Continuing Education: Wednesday Lectures at Sheppard Pratt We offer a lecture series at The

National Drug Abuse Treatment Clinical Trials Network: Research and Dissemination Accomplishments

Conference Center at Sheppard Pratt

February 18

most Wednesdays from noon to 1 p.m. to

Maxine L. Stitzer, Ph.D., professor of

support continuing education of medical

behavioral biology, Department of

and mental health professionals. Visit

Psychiatry and Behavioral Sciences, Johns

sheppardpratt.org/education-training

Hopkins University School of Medicine

CONFERENCE EXHIBITING American Psychoanalytic Association 2015 National Meeting January 14-18 New York City Psychotherapy Networker March 26-29 Washington, D.C.

for more information.

sheppardpratt.org • heal

7

IN THE NEWS

Neuropsychiatry Program Welcomes 3 New Clinic Heads HELP US WELCOME three new faces to the Neuropsychiatry Program at

Robert

Sheppard Pratt, an outpatient program that treats patients with developmental

Wisner-Carlson,

disabilities, traumatic brain injury, age-associated cognitive impairments, and

M.D., director of

related mental health problems.

The Developmental Neuropsychiatry

Margo Lauterbach,

Crystal Watkins,

M.D., director of

M.D., Ph.D., director

offers specialty care for adults with

The Concussion

of The Memory

intellectual disabilities, autism spectrum

Clinic, which treats

Clinic, which treats

disorder, and genetic conditions who

individuals who

individuals who

are also experiencing behavioral

have sustained

have started

and/or neuropsychiatric problems.

Clinic, which

a concussion or multiple concussions

experiencing mild memory problems,

Dr. Wisner-Carlson trained in psychiatry

and have been impacted by the

as well as those who have memory loss

at The Henry Phipps Psychiatric Clinic

neuropsychiatric consequences.

and/or confusion related to medical

at Johns Hopkins Hospital and at

Dr. Lauterbach completed a residency

conditions, and those suffering from

Maudsley Hospital in London.

in psychiatry and fellowship training in

dementia. Dr. Watkins completed her

He is also service chief for the

neuropsychiatry at the University of

psychiatric training as well as a geriatric

Adult Inpatient Neuropsychiatry

Massachusetts Medical School.

fellowship at Johns Hopkins University.

Program at Sheppard Pratt.

For more information on the Neuropsychiatry Program at Sheppard Pratt, call 410.938.4981.

Trauma Disorders Unit Staff Nurse Receives Caul Grant JOIN US in congratulating Briana Snyder, MSN, RN-BC, CNE, a registered nurse on the Trauma Disorders Unit, for being selected for a David Caul Research Grant at the International Society of Trauma and Dissociation’s 31st annual meeting for her ongoing research study, “Views of Women with Dissociative Identity Disorder on Intimate Partner Violence.”

Dickerson: A Doctor on the Move

Autism Research Collaborative

FAITH DICKERSON, PH.D., director of psychology and the program

THE SHEPPARD PRATT HEALTH SYSTEM’S Child and

been traveling the world presenting research updates. Among

Adolescent Neuropsychiatric Inpatient Unit is one of six

other talks, she has presented “Infections, Inflammatory Markers,

inpatient sites in the country to join the Autism &

and Schizophrenia” at several conferences this year, including the

Developmental Disorders Inpatient Research Collaborative

PsychoNeuroImmunology Research Society’s (PNIRS) 21st Annual

(ADDIRC) in an effort to characterize the severely affected

scientific meeting in Philadelphia, the 21st Multidisciplinary

autism population. The goal of this collaborative is to develop

International Neuroscience and Biological Psychiatry Stress and

a comprehensive registry of clinical and biological data on

Behavior Conference in Russia, the Fourth Biennial Schizophrenia

severely affected children and adolescents with autism.

International Research Society Conference in Italy, and the 12th

director for the Stanley Research Program at Sheppard Pratt, has

Psychoimmunology Expert Meeting in Germany.

8

heal • Sheppard Pratt Health System

Meet the New Leaders of The Retreat at Sheppard Pratt Thomas Franklin,

candidate at the Washington Center

M.D., was recently

for Psychoanalysis. He is board

appointed the new

certified in Addiction Medicine

medical director

and Psychiatry and has extensive

of The Retreat at

experience in psychotherapy,

Sheppard Pratt, a

psychopharmacology, addictions,

premier residential

and co-occurring disorders.

treatment program on Sheppard Pratt‘s Towson campus. Dr. Franklin previously

We also welcome Miles

served as medical director of Ruxton

Quaytman, M.D.,

House, The Retreat’s transitional living

as the new

program designed for residents who

associate medical

need more time before transitioning

director for

back into the community.

The Retreat and

Dr. Franklin is also a clinical

the medical director of Ruxton House.

assistant professor of psychiatry at

Dr. Quaytman has been an integral part

the University of Maryland School

of The Retreat’s treatment team for

of Medicine and an advanced

eight years.

Visit our YouTube channel at youtube.com/user/SheppardPrattHealth to watch our Q&A session with Dr. Thomas Franklin.

About The Retreat WITH JUST 16 LUXURIOUS BEDROOM SUITES, The Retreat is a private-pay program that is host to a select group of patients from all over the world. The treatment team has extensive expertise in working with professionals at a crossroads, young adults desiring increased independence and personal responsibility, and adults facing retirement and loss, problems in marriage, and other interpersonal difficulties.

It treats the full spectrum of mental health disorders including depression and treatment-resistant depression, addictive disorders, anxiety disorders, and borderline

Expert Psychiatric Care in a Residential Setting The Retreat at Sheppard Pratt, our premier residential unit, offers patients seeking a private-pay, intensive, and highly personalized assessment and treatment program, a chance to make meaningful progress toward recovery.

We offer an intermediate length of stay of three weeks to several months in a therapeutic milieu and provide nationally renowned expert care for depression, anxiety, personality, and addictive disorders. Our 12-year anniversary marks a new era for The Retreat with a new medical director, Thomas Franklin, M.D., a more intensive co-occurring disorders treatment track, and a recently renovated facility that provides unrivaled comfort.

• Experienced psychiatrists lead treatment teams and are involved in patient care.

• Our expertise is in working with professionals at a crossroads, young adults, and adults facing life-changing events.

• Residential treatment takes place in an open, unlocked setting.

personality disorder.

For more information about The Retreat, call our program director at 410.938.3891.

6501 N. Charles Street Baltimore, MD 21204 410.938.3891 • retreatatsp.org

sheppardpratt.org • heal

9

TRAUMA DISORDERS

3 Questions for Our Medical Director of the Trauma Disorders Program

2.

What is unique about the Trauma Disorders Program at Sheppard Pratt?

Our Trauma Disorders Program is unique in that it is designed to treat individuals with the types of complex trauma and complex trauma reactions described in Question 1.

Our program emphasizes highly intensive individual and group psychotherapy. All of our psychiatrists, psychologists, social workers, rehabilitation services, and nurses are specifically trained to work with individuals with trauma symptoms.

We have success in treating patients who have failed treatment in community settings or have not responded to treatment at other trauma treatment programs.

1.

3.

What is a complex trauma disorder, and when is it considered complex vs. non-complex?

What is the single most pressing need facing mental health care today?

The single most pressing need is the shocking and

“Complex” trauma is a term that means that an individual has experienced multiple traumatic events, and/or types of

scandalous lack of resources and funding for treatment of

traumatic events over multiple developmental periods, usually

psychiatric disorders. Because of this, there are more than

childhood maltreatment and/or exposure to domestic violence.

10 times the number of mentally ill individuals in prison cells

In general, these traumas also involve a betrayal at the hands of

than in state hospital beds. This was the condition of American

someone who should be trustworthy and on whom the person

mental health “care” in the 1830s, when the movement for

depends: parents, teachers, clergy, coaches, et al. However,

humane mental health treatment began, exemplified by our

complex trauma may also describe multiple adult traumas

founder, Moses Sheppard.

under conditions of captivity and imprisonment such as victims

These imprisoned individuals receive virtually no

of sexual trafficking and political torture and prisoners of war,

treatment. Many other severely mentally ill individuals spend

as well as soldiers subjected to multiple combat experiences,

days in emergency departments because no psychiatric beds

particularly if they involve committing or witnessing atrocities.

are available for them. Additionally, large numbers of mentally ill children are unable to find services due to a lack of child

Complex trauma reactions cut across diagnostic categories and describe individuals who have problems with

mental health providers, the lack of funding for adequate child

attachment and relationships or regulation of their mood and

mental health at the state level, and insurance companies’

emotions; have a damaged sense of self or identity; have a

policies that prioritize profits over mental health treatment.

sense of alienation from their bodies; or have a core set of

Similarly, most public and private insurance does not provide

beliefs that see the world as dangerous and untrustworthy.

reasonable reimbursement even for adult inpatient and

But also these individuals see themselves as blameworthy for

outpatient services.

the traumas they have suffered and frequently have problems with reckless behavior, suicidal and/or self-harmful behavior, anger and aggression, and substance and/or alcohol abuse.

For more information on the Trauma Disorders Program at Sheppard Pratt, call 410.938.3584.

RICHARD J. LOEWENSTEIN, M.D., medical director, Trauma Disorders Program Dr. Loewenstein is a senior psychiatrist and founder of the Trauma Disorders Program. He lectures frequently and has received numerous awards for his contributions to clinical studies of trauma and dissociation. He is a clinical professor of psychiatry at the University of Maryland School of Medicine.

10

heal • Sheppard Pratt Health System

NEUROPSYCHIATRY

Concussions: A Serious Concern

Studies have shown that sadness or depression, irritability, and mood swings may follow a concussion and that concussions may also be linked to difficulty concentrating, recalling, or absorbing information.

THANKS TO a settlement with the

and fatigue. You don’t need to be

National Football League, every football

playing sports to suffer one; car

player today knows about the dangers of

accidents, assaults, falls, and being

a concussion, an all-too-common brain

struck by a hard object can also lead to

injury that can result any time the head

a concussion or traumatic brain injury.

is subjected to a sudden acceleration of

Concussions have been linked to sleep

forces. Untreated or repetitively inflicted,

disturbances such as too much or too

concussions can even result in death as

little sleep or difficulty falling asleep. But

in the high-profile tragedies suffered by

when emotional symptoms or difficulty

several high school football players in

thinking or remembering things are also

problems that result after brain

the past couple of years.

present, recovering from a concussion

injury, illness, or disease.

All of the media attention is helpful, but because reporters tend to focus on

may be even more challenging.

Studies have shown that sadness

The Concussion Clinic at Sheppard Pratt embraces a team-based

the consequences, too few people can

or depression, irritability, and mood

approach to care for patients who have

recognize the signs and symptoms of a

swings may follow a concussion and

sustained brain injuries and are suffering

condition that, according to Centers for

that concussions may also be linked

emotionally and/or physically. The clinic

Disease Control statistics on sports and

to difficulty concentrating, recalling, or

is available to patients at all stages of

recreation-related injury, affects millions

absorbing information, which can cause

healing from a brain injury or concussion,

each year. The sooner a concussion or

serious issues for people in a school

whether the concussion was a recent

head injury is diagnosed, the better the

or work environment.

occurrence or was incurred several

person’s chances of recovery, so it’s

Who can help someone recover

weeks, months, or even years prior to

important to know what a concussion is

from a concussion after the immediate

seeking treatment. The clinic also

and what to look for should you suspect

trauma or emergency has passed?

collaborates with other medical providers

that you or someone you know may be

While physicians of varying specialties

in an effort to facilitate rehabilitation from

suffering from a concussion.

may be helpful, you may also want

a concussion in a way that works best

to consider seeking treatment from

for the patient.

A concussion is a type of brain injury broadly defined as a bump, blow, or jolt

a neuropsychiatrist who specializes in

to the head that can lead to a variety

the assessment and treatment of

MARGO LAUTERBACH, M.D.,

of physical symptoms, including

patients with emotional or cognitive

neuropsychiatrist and

headaches, dizziness,

director of The Concussion Clinic, part of the Neuropsychiatry Program

To make an appointment at The Concussion Clinic, contact the Neuropsychiatry Program at 410.938.4762.

sheppardpratt.org • heal

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You give. They heal.

You make great things happen when you give to the Sheppard Pratt Health System.

Our Largest Individual Donation Ever to Benefit Child, Adolescent Programs THE SHEPPARD PRATT HEALTH SYSTEM recently received a donation of $2 million from Mildred Kern of Baltimore, the largest individual donation to the health system since its doors opened in 1891. For more than a century, the largest donation to mental health and the health system came from benefactor Enoch Pratt, a well-known American businessman and philanthropist from Baltimore who donated $1.6 million in 1896.

Mildred, a Baltimore resident and New York native, was six days shy of her 105th birthday when she died on June 9, 2013. Her donation will support child and adolescent programs at Sheppard Pratt, with the intent to improve To honor and commemorate Mildred’s generosity, a plaque was dedicated in the lobby of the Weinberg Building on Sheppard Pratt’s Towson campus on September 17, 2014.

From left: Dr. Steven Sharfstein, president and CEO of the Sheppard Pratt Health System, joins Morris Roseman, Mildred Kern’s friend and representative, Marguerite Kelley, director of philanthropy, and Byron Forbush, chairman of the board of trustees, at the Weinberg Building to honor Mildred’s generous gift.

Thank You for Your Generosity DR. STEVEN SHARFSTEIN, president and chief executive officer of Sheppard Pratt Health System, hosted

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opportunities for education and care for children in need.

Sheppard Pratt’s annual donor reception at the picturesque Sagamore Farm House on October 15. More than 70 of Sheppard Pratt’s most generous donors enjoyed networking, refreshments, and a short program at the historic Vanderbilt family farmhouse now owned by Kevin Plank, CEO and founder of Under Armour.

For more information on supporting Sheppard Pratt, contact Marguerite Kelley, director of philanthropy, Dr. Steven Sharfstein (center) thanks honored donors, from left: Stan Goldman of the Weinberg Foundation; Hosanna Asfaw-Means of CareFirst BlueCross BlueShield; Donn Weinberg of the Weinberg Foundation; and Pedie Killebrew of the Women’s Hospital Foundation who is also a Sheppard Pratt trustee.

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heal • Sheppard Pratt Health System

at mkelley@sheppardpratt.org or 410.938.4018.

PHILANTHROPY

Sheppard Pratt Stride Debuts as Family-friendly Fundraiser more than 350 participants, many of whom were Sheppard Pratt employees and friends. More than $40,000 was raised. Additionally, as a result of the Stride, Sheppard Pratt connected with more than 500 new donors.

In addition to the one-mile walk around Sheppard Pratt’s main campus in Towson, there were many familyfriendly activities, including moon

Tracy Greenberg, the top fundraiser, and her family attended the Stride.

ON SEPTEMBER 27, the Sheppard Pratt

“The first Sheppard Pratt Stride

bounces, face painting, balloon animals,

united our employees, patients, and

a pre-walk warm-up routine, and zumba

Sheppard Pratt donors and reinforced

lessons. Musical entertainment for the

support for mental health in Baltimore,”

day was provided by four Sheppard

said Dr. Steven Sharfstein, president

Pratt employees.

and chief executive officer of the

The Stride’s top fundraiser was Tracy

Sheppard Pratt Health System. “It is

Health System held its first Sheppard

Greenberg, a member of the Sheppard

with great eagerness that we look

Pratt Stride, a one-mile walk and family

Pratt Health System’s Consumer Council

forward to hosting the Stride next year

fun day that raised awareness and

who raised more than $4,000. A former

on October 3.”

funds to support the many Sheppard

Dallas attorney, she moved to Maryland,

Pratt programs that help patients and

so that her son, Bryce, could receive

students, their families, and those

better care. Bryce is a fifth-grade student

affected by serious mental illness. The

at The Frost School, which is part of the

event surpassed all expectations, with

Sheppard Pratt Health System.

Special thanks to Sodexo, the 1st Sheppard Pratt Stride presenting sponsor.

Walkers of all ages helped raise more than $40,000 in the first-ever Sheppard Pratt Stride.

sheppardpratt.org • heal

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ADDICTIONS

Informing Ourselves About E-cigarettes WHAT ARE THE BENEFITS? WHAT ARE THE RISKS?

refers to the part of the e-cigarette that heats the e-liquid for vaporization.

E-cigarettes either use refillable cartridges or a refillable tank. (Adding more e-liquid is called “dripping.”)

Proponents of e-cigarettes feel that they are a viable harm-reduction strategy, which can reduce morbidity and mortality. This reduction, if achieved, could be vital, as our existing methods have yielded limited success. They also feel that the amount of toxicants found in CIGARETTES cause more than 480,000

larger and sport different colors;

e-cigarettes is significantly lower than

deaths annually in the U.S. Seventy

while others look very different from

in cigarettes. Opponents, however, are

percent of smokers say that they

traditional cigarettes.

not convinced of their safety. They

would like to stop smoking, yet only

The e-cigarette market has

4 to 7 percent of people are able to

expanded exponentially to the point

evidence-based strategies. They

actually quit. E-cigarettes have now

where it has become a $2 billion industry.

also think that e-cigarettes will act as a

emerged in the market, bringing with

There are now close to 500 brands of

“gateway” and that youth can get hooked

them new promises and questions.

e-cigarettes and 8,000 unique flavors.

on nicotine from their use. Poison centers

Time will tell, however, whether they

There are substantial differences among

have received more than 200 calls a

will actually be able to break the

these varieties, so one needs to be

month this year for nicotine-related

stronghold of combustible tobacco

cognizant before one chooses to use

poisoning, and more than half of these

products and become a true

them or advise others to use them.

cases involve children in accidental

“breakthrough technology.”

They are highly variable in quality,

poisoning. Both proponents and

appeal, and efficiency.

opponents, however, agree that there

E-cigarettes are designed to emulate the experience of smoking

They have also added some new

argue that smokers should use current

is a need for better regulations.

and usually deliver a certain amount

terms to our lexicon. “Vaping” denotes

of nicotine but without exposing the

the inhalation of the vaporized solution.

writes, “We have to accept that it will

user to the highly carcinogenic tar and

“E-liquid” or “juice” is the liquid solution

probably be more than 30 years before

harmful carbon monoxide gas that

vaporized by e-cigarettes; it usually

we would have a chance of being able

cigarettes emit. Many of them look

contains water, propylene glycol or

to use epidemiology to quantify risks

very similar to cigarettes but are often

glycerin, nicotine, or flavorings. “Atomizer”

from e-cigarette use.”

Robert West, an epidemiologist,

SUNIL KHUSHALANI, M.D., service chief of the co-occurring disorders inpatient unit and the adult day hospital Dr. Khushalani is a clinical assistant professor at the University of Maryland School of Medicine and serves as a physician adviser to the Stanley Research Program at Sheppard Pratt. He has co-moderated a monthly “Addiction Forum” at Sheppard Pratt since 2010.

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heal • Sheppard Pratt Health System

MEET OUR DOCTOR

Catching Up with Dr. Edward Zuzarte PROVIDING COMPASSIONATE CARE IN A SAFE ENVIRONMENT

Dr. Edward Zuzarte, service chief of the Psychotic Disorders Unit, has worked at Sheppard Pratt for more than 15 years, specializing in helping those with psychotic disorders, such as schizophrenia and bipolar disorder, heal and recover. He also offers outpatient services through Mosaic Community Services, Inc., and is NAMI Metropolitan Baltimore’s 2014 Frances J. Lentz Mental Health Professional of the Year.

Q. What is a psychotic disorder?

Q. What is unique about the

A. A psychotic disorder is when a person

Psychotic Disorders Unit?

starts to lose touch with reality and loses

A. For our patients, we’re not just a unit,

the ability to function. They may believe

we’re a setting where they can receive

things that aren’t true or have unusual

innovative treatment in a safe, effective

sensations such as hearing things or

environment. The continuum of care

seeing things that impact their behavior.

we are able to provide our patients is

We don’t know why it happens, but it

unique to Maryland. On our unit, we

is a medical problem in the brain.

provide 24/7 intensive and acute care.

These types of mental illnesses

Once a patient is stabilized, they are

usually manifest in a person in their late

able to move directly into Sullivan

teens and 20s. Because there is such a

Day Hospital and can reside at night

strong hereditary component, people

in a halfway house run by Mosaic,

should be particularly cognizant of any

one of our affiliates, also on our

changes in behavior among family

campus. Our nurses and doctors

members in this age group who have a

are all extremely dedicated to the

history of mental illness in their family.

work we do and have been

Frequently, early symptoms such as the

providing compassionate care to

person starting to smile to themselves

our patients for a very long time.

or mumbling under their breath are overlooked by family and friends — but

Q. If you could spend a day

these symptoms should not be ignored.

with any influential person, who would it be?

Q. What should someone do if they are concerned about a loved one?

A. That’s easy: Steve Jobs. My favorite [Jobs] quote: “The only way to do great

A. The earlier a person is diagnosed

work is to love what you do.” This is what

and receives treatment, the better the

I always remember as life throws me

person’s prognosis. You don’t want to wait

hurdles — I love what I do, my colleagues

until a person experiences a nervous

love what they do, and we come here

breakdown to seek help. If you suspect

each day to treat our patients and help

that something might be wrong, the best

them get well.

thing you can do is talk to a health care professional, whether a primary care

Visit our YouTube channel to hear more

doctor, pediatrician, or school counselor.

from our interview with Dr. Zuzarte:

You can also reach out to a reputable

youtube.com/user/SheppardPrattHealth

mental health organization, like NAMI [the National Alliance on Mental Illness].

6501 N. Charles Street Baltimore, MD 21204 410.938.3000

GARRETT

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ALLEGANY

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WASHINGTO

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FREDERICK

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CARROLL

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BALTIMORE

HOWARD MONTGOM

ERY

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CECIL

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BALTIMORE CITY

KENT

ANNE ARUNDEL

PRINCE GEORGE’S

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QUEEN ANNE’S

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TALBOT CHARLES

CAROLINE

CALVERT

THESE FOUR SHORT, SIMPLE WORDS succinctly and powerfully sum up exactly what we try to do for each and every person we touch and can be applied to all programs and departments that comprise our vast health system throughout Maryland.

HARFORD

DORCHEST

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ST. MARY’S

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WICOMICO

SOMERSET

focused on helping you sheppardpratt.org

★ WORCHESTER