Let's talk about mental health

T U O B A K !

L H A T T L S ’ A T E H LE L A T N E M

PROGRAMS&PEOPLE

Bert Nash Programs: Dialectical Behavior Therapy: ‘A Miracle Program’ ...................................................................Pg. 3 Adult Services: Helping Thousands....................................Pg. 5 Family Services: Meeting the Needs of Local Families ..................................Pg. 7 Bert Nash and HCHC: Integrating a Partnership .........................................................Pg. 9 Homeless Outreach: Reaching Out.................................Pg. 11 Jail Team: Inmates Have Added Needs ............................Pg. 14 WRAP: Schools are WRAPped Up .......................................Pg. 16

Bert Nash People: Lorraine Cannistra: Client has Write Stuff ...........................................Pg. 19 Bill Beedles: Using Knowledge to Help ............................Pg. 21 Elizabeth Sheils: In Her Own Words................................Pg. 22 Kathleen Boyd: Making a Positive Difference ...............Pg. 23 Debra Chapin: Providing Peer Support ...........................Pg. 25 Ron Fowler: Writing Positive Poetry .................................Pg. 26 BERT NASH COMMUNITY HEALTH CENTER

❘ 200 MAINE STREET ❘ LAWRENCE, KS 66044 ❘ (785) 843-9192 ❘ www.bertnash.org

Let’s talk about mental health!

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DBT is ‘A Miracle Program’ Acronyms are big at Bert Nash.

There’s CFS, CSS, IDDT, IOP, SEED and WRAP, to name a few.

But there’s none bigger than DBT, which stands for dialectical behavior therapy.

Bert Nash Community Mental Health Center CEO David Johnson has another name for it.

“I call it a miracle program,” Johnson said.

DBT combines the best of different cognitive-behavioral models, which are integrated into a comprehensive treatment program.

Developed by University of Washington psychologist Marsha Linehan, DBT, in its initial form, targeted women with suicidal and self-harming behaviors.

Linehan, as she revealed publicly in 2011, had been one of those women.

“The idea behind DBT was to figure out a more Members of the Bert Nash DBT team include, from left: Heidi effective way to treat this Pritchard, Leigh Jordan, team leader Juliet Nelson, Marty Rus and population,” said Juliet Merrill Evans.

Nelson, who is the DBT team leader at Bert Nash. life worth living.”

Nelson, like Johnson, believes DBT is nothing short In the DBT model, the most high-risk behaviors, of a life-saving program. Even more, it is a lifesuch as self-injury and chronic self-destructive urges, changing program. are treated first.

“It’s not an overstatement to say DBT saves lives.

“You kind of ignore the other stuff so you don’t I’ve definitely seen that,” Nelson said. “But it get overwhelmed by trying to treat everything at doesn’t just save lives. It helps people live a life that once,” Nelson said. “You deal with the more serious is not misery.” stuff, and then you address the other things. KeepNelson calls DBT an empowerment program. ing that hierarchy in mind gives you a structure in “It helps people have the kind of life that they should have,” Nelson said. “It helps them create a See DBT PROGRAM on Next Page

DBT Program Continued from Page 3 what to do as a therapist.”

In the past, when therapists tried to deal with all of a person’s problems — many people with severe mental illness have more than one diagnosis — at one time it could lead to burnout and frustration, both on the part of the client and the therapist. DBT takes a different approach.

“When you add another diagnosis to an already serious diagnosis, it complicates things and exponentially grows the difficulty to treat that person,” Nelson said. “With DBT, it really helps you stay balanced so that you treat things in order of priority.”

Nelson, who has been at Bert Nash for 18 years, has been involved with the center’s DBT program since it was started in 1997.

“Sandra Shaw, our CEO at the time, and Ronda Reitz, adult outpatient team leader, were the driving force in us getting started with DBT,” Nelson said.

“When Ronda and I went to the executive team to make a case for getting intensive training in DBT, Sandra said, ‘We have to do this.’ It was such a vote of confidence, not in us so much, but that we have to do new and innovative things.”

And it wasn’t cheap.

“The training was expensive,” Nelson said. "But Sandra saw how this was integral to the vision of the Bert Nash Center."

Current administrators at Bert Nash have continued to support DBT. “We’re really fortunate to have an administration that has supported us having a comprehensive DBT program,” Nelson said. “It says a lot about their dedication to empirically supported treatment.”

There are four primary components of a comprehensive DBT treatment program: individual and/or family therapy, group skills training classes, coaching calls provided by a therapist, and a consultation team made up of a group of DBT therapists.

“It’s really a different way of looking at things,” Nelson said of DBT. “So you create a treatment team of people who are helping each other apply this model.”

In the DBT model, therapy consists of two hours or 90 minutes of group therapy and one hour of individual therapy a week. DBT can be used to treat both adults and children. Bert Nash’s DBT program for adolescents is for ages 12 to 18.

“The parents are included in the skills training

DBT: (DIALECTICAL BEHAVIOR THERAPY): ■ Bert Nash program started: 1997 ■ No. of staff members: 9 ■ No. of student interns: 2 ■ No. of people involved in the program at any given As of 2012 time: 80 group, so they learn right along with the kids,” Nelson said.

There are currently 11 families in the Bert Nash Adolescent DBT program.

‘When you get the families around the table in a group that can be 20-25 people in the room,” Nelson said. “This is the biggest our adolescent program has ever been. But that’s good.”

In the adult program, there are about 80 people actively engaged in DBT services. Many others have graduated from the program and either are no longer Bert Nash clients or have stepped down to less intensive services.

In the past, people with severe mental illness who were chronically suicidal would likely have been in and out of hospitals, which was expensive and didn’t help them cope with their lives and the emotional pain. DBT teaches people skills to regulate their emotions more effectively. For members of the Bert Nash DBT team — eight staff and five students — the work is both rewarding and demanding.

“It’s hard work,” Nelson said. “You have to keep in mind these are some of the most acute cases being seen at the Bert Nash Center at any given time. My whole team is a really wonderful team, and everybody pitches in and everybody tries to do as much as they can. There are enormous amounts of support for each other within the team.”

DBT is also beneficial and applicable in the personal lives of members of the Bert Nash team.

“Learning the skills yourself is a preventative measure for your own good mental health,” Nelson said.

“The treatment is so effective that you’re helping yourself as you’re doing it. It’s a wonderful outcome to know how to stay mentally healthy yourself.”

Which is the ultimate goal of DBT. “We want to help people create a life worth living,” Nelson said.

Let’s talk about mental health!

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Team leaders on the Adult Services staff include, from left, Sharon Zehr, Amy Warren, George Wanke, Juliet Nelson, director Eunice Ruttinger, Linda Davis and Carla Helm.

Adult Services Helps Thousands

Bert Nash offers an array of mental health services for adults.

The programs focus on a variety of issues, from depression and anxiety to post-traumatic stress disorder to severe and persistent mental illness.

But they all have the same goal.

“We want to try and help people move forward in their lives and their recovery,” said Eunice Ruttinger, adult services director.

Each year, about 4,000 Douglas County adults use the services offered at Bert Nash to do exactly that.

“As far as the range of services, I love the things that we’re doing,” said Ruttinger, who is in her 10th year at Bert Nash and who has nearly 40 years of experience in the mental health field.

Adult services range from brief-solution-focused therapy, which involves three to five sessions, to ongoing therapy for those with severe and persistent mental illness.

Community Support Services is designed to help adults with severe and persistent mental illness, such as schizophrenia or bipolar disorder.

It used to be people who were schizophrenic or had borderline personality disorder or severe mental illnesses were more likely to be hospitalized. But in

Kansas there have been significant deinstitutionalization efforts. The focus now is to get people the outpatient services they need and help them move forward in their recovery.

Case management is an important component of Community Support Services.

“This is a core service that provides outreach and practical assistant to people who qualify for the services,” Ruttinger said.

In adult services at Bert Nash, there are 33 case managers and 10 psychosocial workers. They work with clients in a variety of areas, including housing, finances and helping with their individual recovery.

Helping clients maintain housing is essential, said Carla Helm, residential housing team leader. The team works in partnership with the Lawrence Douglas County Housing Authority.

About 40 percent of people with a major mental illness also have a substance abuse problem. That’s where Bert Nash’s Integrated Dual Diagnosis Treatment program can help.

“The team of 10 professionals provides more than 10,000 hours of service to more than 140 people See ADULT SERVICES on Next Page

Adult Services Continued from Page 5 each year,” said George Wanke, the IDDT team leader. “Specialized training in harm reduction therapy techniques allows the team to address both serious mental illness and addiction problems.”

IDDT is what is called an evidence-based practice.

“What that means is there are specific protocols to provide the service,” said adult services director Ruttinger. “The practices are shaped for each individual person and his or her needs.”

Among other evidence-based practices offered at Bert Nash is dialectical behavior therapy. Known as DBT. DBT is a program for those who are in crisis. People who are struggling with mood disorder, impulse control, eating disorder, anger management, addictions, self-injury or suicidal thoughts can benefit from DBT. Juliet Nelson is the team leader for DBT, which can be used to treat adults as well as children who are severely emotionally disturbed.

Another evidence-based practice is the Strengths Approach Case Management team, led by Linda Davis.

Davis also supervises SOAR, an outreach, access and recovery team, which assists people who are in homeless and have serious mental illness in accessing their disability and medical services.

“We started this program about three years ago and have had significant success in getting clients on disability and Medicaid,” adult services director Ruttinger said. “Before this program it would take up to a couple of years for people to get their disability.

This program helps put all the documentation together and assist clients through the process.”

With assistance from the SOAR team, 100 percent of clients have received approval for disability benefits within 90 days. In the past, the process could take years.

“The average time it has taken to get approval for benefits from the time our team started with our clients is 75 days,” Davis said. “Thirty percent are approved within 60 days and 70 percent are approved in 90 days. This is compared to the two to three years — or even more – it can take to get approved without SOAR assistance.”

Adult services at Bert Nash can include individual as well as group therapy.

“The research shows groups are just as effective as

ADULT SERVICES:

■ Staff: 33 case managers and

10 psychosocial workers ■ No. of adults served: 4,000 ■ No. of clients who use adult services on any given day: 300 As of 2012 individual therapy,” Ruttinger said. “Groups are also cost-effective for the client.”

Individual and group meetings are part of the Anxiety Disorders Clinic at Bert Nash, which helps people who suffer from anxiety, panic disorder or social phobia. Individual and group counseling are also part of the Successful Aging Program, which provides services for those age 60 and over who are dealing with anxiety, depression, and other aging and mental health issues. Amy Warren oversees both programs.

Through another program called Peer Support Services, certified peer support specialists share their personal stories of recovery with others who are going through similar struggles. Clients may be more likely to confide in someone who has been there, done that.

“People will share things with the peer support specialists that they haven’t shared with anyone in their life before, because they have had similar experiences,” said Peer Support Services team leader Chris Ford.

People with severe mental illness can have difficulty finding work or holding down a job. Bert Nash, through its Support Employment Services, provides clients with job coaching, job placement and on-thejob support for people.

“As soon as a person wants to work, we want to help them work,” Ruttinger said. “The client may still be having problems, but working can be helpful to their recovery.”

On a typical day, more than 300 clients will use one or more of the adult services provided at Bert Nash.

Bert Nash also has a couple of adult outreach programs, one at the Douglas County Jail and one that targets the homeless and those at risk of being homeless. Team leader Sharon Zehr oversees both programs.

“They are amazing,” Ruttinger said of her staff.

“That's why we have great services, because of our team.”

Let’s talk about mental health!

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Child and Family Services team leaders, from left: Julie Boydston, Charlie Kuszmaul, Kala Bhana, former director Janice Storey, Becky Cheek-King and Kristen Brown.

Bert Nash Serves Local Families

There has actually been a decrease in the number of children using services at the Bert Nash Community Mental Health Center.

But that’s not necessarily a good thing.

“We’re seeing about a 20 percent decrease in the number of kids coming in for services,” said Janice Storey, former director of Child and Family Services at Bert Nash. “But the acuity is much higher. They are in a much higher level of crisis when they get here. Sometimes our first point of contact with kids is a screening for the hospital.”

So while the numbers of children using services is on the decline, the severity of cases is on the rise.

“That’s disturbing,” Storey said. “Because the earlier you can intervene, the more successful those kids will be.”

One reason for this trend is the loss of on-site mental health clinicians in the schools, Storey said.

At one time, through the program Working to Rec-

ognize Alternative Possibilities (WRAP), there was a Bert Nash clinician assigned to every Lawrence school. The clinicians worked in collaboration with school counselors and officials. But due to the loss of funding, the program has been scaled back. Currently, there is a WRAP worker in both high schools and two of the four middle schools, but none of the Lawrence elementary schools.

“We were getting kids in services quicker when we had a WRAP worker in all of the Lawrence schools,” Storey said.

Bert Nash has a partnership with the Eudora School District, where there is a WRAP worker in all three schools. Funding for those positions is through a federal grant. There is also a Bert Nash child and family therapist assigned to Eudora. In addition, Bert Nash is a partner with the Baldwin, Eudora and See FAMILY SERVICES on Next Page

Family Services Continued from Page 7 Wellsville schools in a program for secondary students with behavioral disorders.

Economic pressures are another factor in the severity of cases the child and family services staff is seeing.

“We’re seeing a lot of kids who are pretty unstable,” Storey said. “We have always had those kinds of kids, but it seems we’re seeing more of them because of the economy and the pressure that puts on families and there are fewer resources in the community, so it’s taking them longer to find their way into services.”

When they do find their way to Bert Nash, they will find a range of services available for children and their families.

“We have a range of community-based services,” Storey said. “We do individual therapy and family therapy and we have a variety of psychosocial groups that are targeted on skill building.”

Bert Nash offers an array of services for children who are chronically mentally ill.

“We have services specifically developed for that population,” Storey said.

Storey is proud of the work her staff does, and it’s not easy work when dealing with cases involving children.

“We see a lot of abuse and neglect, which has always been present, but there are worse cases now and there are more of them,” Storey said. “Some of the things that have been done to kids who come in here for services, I think people would be shocked to know what kinds of things go on in the community.”

Joining Storey on the leadership team for child and family services are Kala Bhana, Julie Boydston, Kristen Brown, Becky Cheek-King and Charlie Kuszmaul.

“I have a great team and staff,” Storey said.

Internally, child and family services has a partnership with the center’s adult dialectical behavior team to offer DBT, which is a skills-based program, for adolescents.

“That has been a great collaboration,” Storey said of the DBT program for adolescents. “It’s been very successful.”

Bert Nash’s Child and Family Services also has a longstanding partnership with the Lawrence School District to provide a secondary therapeutic class-

CHILD AND FAMILY SERVICES: ■ Staff: 44 case managers and psychosocial workers ■ No. of children and families served: 1,948 ■ No. of clients who use services on any given day: 260 As of 2012 room, which is housed at the center.

“The school is on our property, but the teachers, paraprofessionals and the program are through the school district,” Storey said. “What we do is supply the mental health therapist in the classroom.”

Bert Nash also has a contract with the school district to provide mental health interventions for children at the juvenile detention center.

Bringing mental health out of the shadows is important, said Patricia Roach Smith, Bert Nash chief operating officer.

“The prevalence of mental health disorders in children and youth is about 20 percent in any given year, making this a fairly common problem,” Roach Smith said. “It is important for us to normalize talking about behaviors and feelings that can significantly impact our life. If our children have asthma or a broken leg, we address it promptly. Let's talk about mental health and treatment in the same way. The work done by child and family services to focus not only on treatment but also on promotion, prevention, early intervention and education to improve the health of our county's children is impressive.”

And as always, early prevention is the key.

“The earlier you can intervene the better outcomes you will have,” Storey said. “To have a healthy community, the more you can build kids who have a high level of confidence and feel safe and are successful, then they are not going to keep developing more and more problems. That’s why prevention can be very helpful. What you’re trying to do is stop that generational growth. So, you’re kind of paying it forward.”

Let’s talk about mental health!

Integrating a Partnership Karin Denes-Collar is employed by one agency, but works at a different agency.

And everyone involved agrees that’s a good thing.

Denes-Collar is a behavioral health consultant on staff at the Bert Nash Community Mental Health Center. But she spends her days working at Heartland Community Health Center, which provides affordable health care to the community. The two agencies have a partnership to provide integrated services.

“I always joke about having dual citizenship,” Denes-Collar said of the arrangement.

She feels equally at home at both places.

“Having worked at Bert Nash for so long, there’s a certain allegiance there, because I’ve been part of that team for so long, but this is where I work dayto-day. These are my people. From the first day I was here, I was welcomed with open arms,” DenesCollar said.

That’s not always the case in such arrangements, she said.

“A lot of people who do the job that I do find some resistance when they get to the community health center,” Denes-Collar said. “They can be like we don’t want this interloper coming in and telling us what to do. But from the beginning, integrated care was seen as an important part of how we want to practice here. I always hope everybody here at HCHC sees me as much a part of the team as I feel like I am.”

This is Denes-Collar’s second year in the shared role, which is funded through a grant by the Sunflower Foundation.

“I think the partnership has worked well,” she said. “People are starting to learn that I’m here.”

The biggest beneficiary of the partnership is the community.

“Working to meet the primary care needs of the community is a significant challenge. Bert Nash is already doing a great job of meeting needs in mental health,” said Jon Stewart, Heartland CEO. “By sharing resources and utilizing this unconventional model that repositions the expertise into a new setting, we are really leveraging the impact the re-

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Bert Nash behavioral health consultant Karin Denes-Collar is in her second year of working with clients and medical providers at Heartland Community Health Center. sources will have.”

Having a behavioral health consultant on site makes it easier and faster for HCHC patients to see a therapist. Sort of like one-stop shopping when it comes to health care.

See BERT NASH-HEARFLAND on Next Page

Bert Nash-Heartland Partnership Continued from Page 9 “Anybody who comes here for a primary care appointment or is one of our patients has the ability to see me,” Denes-Collar said. “The really great thing about it is it doesn’t require a referral from a doctor.

It is super easy.”

There is a national push toward integrated care, and Bert Nash and Heartland are at the forefront of that movement. And Denes Collar was the right person for the job.

“When I began searching for the perfect behavioral health consultant, I realized this position needed to be a marketing professional, an outstanding clinician, have a shining personality that instilled trust, and present as non-threatening, while standing his or her ground,” Patricia Roach Smith, Bert Nash chief operating officer, said. “We hit the jackpot with Karin. She is all those things, while being flexible and grounded. Of course, the team at Heartland Community Health Center was a dream to work with, but without those qualities in the individual we put forth, things could have been slow and more challenging. The marketing skill is important for a number of reasons. We want to convince the consumers at Bert Nash that physical health is as important as their mental health, while convincing those at HCHC that their mental health is fundamental to their physical health. The behavioral health consultant is in sales and marketing with patients, consumers and staff. That is not a role everyone can play.”

Which makes Denes-Collar a good fit.

“I’m convinced that this position is not for everyone. The key to Karin’s success is adaptability and flexibility,” said Heartland CEO Stewart. “She always has lots of plates spinning. She’s able to move fast when she needs to and she can slow down when the situation calls for it. She’s good at helping patients in areas that they want help, and she’s good at supporting providers in ways that they want support.”

Besides addressing people’s mental and physical needs, part of the mission at Heartland is to also serve people’s spiritual needs.

“That is an important part of what we do at HCHC,” Denes-Collar said.

The partnership between Bert Nash and Heartland also helps reduce the stigma for those needing mental health services.

“We know the rate of people following through on referrals is low. Part of that is the stigma of going to the mental health center,” Denes-Collar said.

“But we know if we can catch things early and we can see somebody when they are a little depressed and not a lot depressed, then we can help them get back into their lives faster.”

On the flip side, the partnership between Bert Nash and Heartland benefits those who have mental disorders as well as physical stressors.

“On the average, people with severe and persistent mental illness die about 25 years earlier than the general population, which is startling. Cigarette smoking is a big factor in that,” Denes-Collar said.

“So helping them to eat healthy and getting them to the doctor when they need to and getting them to think about quitting smoking, it’s a great benefit for people, and probably keeps some out of a more serious crisis.”

As part of the ongoing partnership between the two agencies, a nurse practitioner from Heartland will be available at Bert Nash one day a week, starting in September.

“We’re hoping she will be able to capture some of those folks at Bert Nash who don’t have a primary care provider,” Denes-Collar said. “Just like we may have some people at Heartland who may be reluctant to seek care at the mental health center, there are people at the mental health center who are reluctant to go to HCHC.” As yet another way to expand health care integration, a psychiatric nurse from Bert Nash will be available at Heartland one day a week, also starting in September, to offer consultation to HCHC’s primary care providers.

“We’ll be able to manage all of their prescribing right here in house,” Denes-Collar said. “There’s a lot of continuity in services that makes that a really good idea.”

For her role, Denes-Collar sees around six or eight patients a day on average, and on top of that she may visit with the doctors at Heartland about a handful of other patients.

“This is a little bit different from traditional mental health,” she said. “It tends to be what I call briefer therapy, but it’s very efficient. It’s all very seamless.

There’s no referral process needed. The way we see it here, talking to a therapist is just a normal thing to do.”

Let’s talk about mental health!

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Reaching Out to the Homeless With their long hair and long beards, they look The one common denominator, though, is they don’t have a place to call home. like rock stars.

“We work with pretty much anybody, as long as But they don’t act like it. they are homeless, or at risk of becoming homeless, No limos or five-star hotels for this band. But aland they have a need for service and we can help most any day of the week them,” said Brad Cook, you can find them at the the senior member of the Lawrence Community Bert Nash homeless outShelter, or along the reach team. banks of the Kansas River, Cook has been involved or in the downtown diswith the homeless outtrict. reach team since the beOr wherever the homeginning. He has had a less are. passion for working with Since 2006, a team of the homeless since he trained case managers was a student in social from Bert Nash Commuwelfare at the University nity Mental Health Cenof Kansas. ter, through a partnership “It’s a worthy cause,” with the city of Lawrence Cook said of his chosen and a federal grant, has profession.

“The homebeen reaching out to the less is a population that is city’s homeless populaalways marginalized by tion. the world, and I think “The ultimate goal is to they need the help.” help people obtain and Other members of the maintain housing,” said team — Mathew Faulk Bert Nash’s Sharon Zehr, David Tucker is a member of the Bert Nash and Namaste Manney — who supervises the team. homeless outreach team. He also works at the are in it for similar rea“To do that, you have to Lawrence Community Shelter. sons. help them get jobs, deal “The world needs more people doing this kind of with their substance abuse, deal with mental illness, work,” Faulk said. or deal with domestic violence, or whatever assisManney, the newest member of the team, said, “I tance they need.” have had experience being a low-income mother The city provides about $165,000 annually to help and a single mom myself, so I really enjoy being fund the homeless outreach team. able to help families and single moms connect with “Bert Nash’s programs, including the homeless services and try to keep their heads above water.” outreach team, provide a beneficial resource to our Another member of the team — technically, he’s community,” said City Manager David Corliss. “The his own team — is David Tucker, or Tuck, as he is city has supported Bert Nash and its various procalled. Funding for his position is paid through a grams for many years because we see the value in federal grant called PATH (Projects for Assistance in physical and mental health services."

Transition from Homelessness), and targets the Homelessness is not a single-issue problem. There homeless who are mentally ill. are typically other factors involved when people find themselves on the street.

See HELPING HOMELESS on Next Page

Helping Homeless

HOMELESS OUTREACH TEAM: ■ Full-time staff: 4

Continued from Page 11

■ No. of people worked with:

Tucker’s motivation for being involved in homeless outreach is simple.

“I feel like everybody deserves a fair chance,” Tucker said. “To me, it is a social justice issue. Someone who is having trouble in their life should be treated as a human being and still given respect.”

What is Tucker’s least favorite part of the job?

“Taking people to jail,” Tucker said after providing transportation for a homeless man who was ordered to report to the Douglas County Jail. “At least I’m not the one arresting them. I’m just trying to get them to where they need to be.”

Transportation is a challenge for many homeless people. Getting them from Point A to Point B is an important part of the job description for the homeless outreach team.

“Getting people to their appointments, getting them out looking for jobs, we just try to get people where they need to go,” Tucker said.

“We do a lot of driving,” Cook said. “We rack up a lot of miles.”

Members of the team are always on the lookout for homeless people.

“Outreach is a big part of the job,” Tucker said.

“We’ll spend a lot of time just walking on Massachusetts Street.”

One of the people who members of the homeless team reached out to was Troy Frank.

When Frank was on the street, members of the homeless team brought him food or gift cards for a local grocery store or took him to a food pantry.

“They would come and find me,” Frank said.

“Otherwise, I wouldn’t have known anybody.”

For Frank, the Bert Nash services were a lifeline.

“You find that there are good people who care,” Frank said. “That there’s support out there.”

As of April 9, 2012, the 51-year-old Frank has a place he can call home.

With help from the Bert Nash housing assistance program — a cooperative effort with the Lawrence Housing Authority — Frank now lives independently in a one-bedroom duplex. The program allows people who have a mental disorder to live on their own in the community. Bert Nash case manager Eddie Velez provides ongoing support for Frank.

“It’s been good,” Frank said. “Having a roof over your head and a place you can call your own. You start to feel like a person again.”

250 ■ No. of people helped to go from homeless to housed: 70 individuals, 17 families ■ No. of people each member of the team is working with at any given time: 40 As of 2012 Mass Street and the busy downtown district are areas frequented by the homeless, though not as much as when the former homeless shelter used to be located near downtown. The popular downtown district is an area frequented by the homeless because of the crowds of people, which mean opportunities for panhandling, even though the city has an ordinance against “aggressive panhandling.”

While many downtown shoppers try to avoid panhandlers, members of the homeless outreach team seek them out.

“We’re always on the lookout for homeless people,” Tucker said. “That’s a big part of the job is networking inside the homeless community.”

One thing members of the homeless outreach team don’t do is judge. The people they work with are in the situation they are in oftentimes because of circumstances out of their control.

“They didn’t choose to be homeless,” Cook said.

“I don’t think anybody wakes up and says, oh, I want to be homeless. It’s just the path they have gone down.”

And it is a hard road.

“Probably five or six people die a year who we work with,” Cook said. “People who are homeless have a higher rate of mortality than other people.

Poverty kills you.”

Mental illness or substance abuse or both can go hand-in-hand with homelessness.

“We deal with substance abuse and mental health problems all the time,” Cook said.

“Not only are we dealing with, say, someone who had a drug problem, but the reason it is so exacerSee HELPING HOMELESS on Next Page

Helping Homeless Continued from Page 12 bated is because there are also these other social issues going on,” Faulk added.

The team’s connection to Bert Nash offers homeless clients access to the center’s mental health services.

“Having the homeless team employed by the Bert Nash Center helps facilitate access to services for clients and provide available professional consultation as needed,” said Eunice Ruttinger, Bert Nash adult services director.

For members of the homeless outreach team, it’s important to gain the trust of the people they work with. They do that by showing genuine concern and with small acts of kindness.

“When I meet someone, I’ll bring them food or coffee and just hang out with them,” said Tucker, who regularly gets food from a food pantry, like Lawrence-based Just Food, and takes it to places where homeless people are staying. “You have to let them know you can be trusted and let them know you are not here to harm them in any way. I am just the guy who brings them food. Eventually, it helps them open up so we can work on things like their medication or housing.”

It also helps that members of the homeless outreach team look the part. Tucker describes his beard as his people filter.

“It allows people to say, hey, there’s a guy with a long beard. I have a long beard. We have something in common,” Tucker said. “This is a job you can’t do dressed in business casual.”

“I think it absolutely helps,” Cook said of the appearance of the male members of the homeless outreach team.

“I think it makes us much more approachable,” Faulk said.

With their long hair and beards, the male members of the team receive stares when walking the streets of Lawrence.

“We have people ask us all the time if we are in a band,” Cook said.

“They like to pretend they are in a band,” Manney, the only female member of the team, said.

Members of the homeless outreach team are available during walk-in hours from 8-10 a.m. each weekday at the Bert Nash Center, 200 Maine St. The walk-in clinic, which opened in 2012, increased accessibility for those requesting help.

“Anyone can show up,” Tucker said.

Members of the team also spend considerable time at the new community shelter, located next to the Douglas County Jail, and regularly make the 15minute drive back and forth between the shelter and the Bert Nash Center.

Besides being part of the homeless outreach team, Tucker works at the shelter three nights a week, and Cook works at the shelter on Saturdays and Sundays.

The new shelter, opened in November 2012, is double the square footage of the old one and increased the number of beds from 75 to 125.

But there are never enough beds for everyone who needs one.

“The last two to three years, we’ve had 200 to 300 homeless people,” Tucker said. “They’re camping, they’re doubling up, they’re staying with family or friends, and they’re sleeping in cars.”

In 2011, the Bert Nash homeless outreach team worked with 106 people. The number increased to 195 in 2012.

Last year, the team helped 70 individuals and 17 families find housing.

“We do the best we can with the resources that are available to us,” Cook said.

Team leader Zehr is proud of the work the team members do for some of the least fortunate in the community.

“I love the team,” Zehr said. “They have been doing this a long time, and to work with this population for that long can be really difficult. The burnout can be really high. But they are very passionate.”

Team members provide a support system for each other.

“We talk a lot among ourselves, and that helps a lot,” Manney said.

“We try to be as supportive of each other as we can,” Faulk added.

Working with the homeless can be emotionally draining. It can even be hazardous duty.

“Oh, yeah, absolutely, I’ve had people get upset with me sometimes,” Tucker said. “I’ve had knives pulled on me. I’ve had bottles thrown at my head.

I’ve had a gun pointed at me. It happens.”

But members of the Bert Nash team do what they do because they believe everyone deserves a helping hand, especially those who may be considered outcasts.

“Everyone is deserving of respect,” Tucker said.

“You have to be able to approach someone no matter their circumstances. I feel that’s all this job really takes.”

Let’s talk about mental health!

14

Inmates Have Added Needs When someone is an inmate at the Douglas County Jail, they are locked up because they are charged with violating the law.

Chances are they may also have a substance abuse problem or a mental health disorder.

Or both.

“It’s very common for inmates to have mental health issues,” said Cindy Naff, a therapist who is a member of the Bert Nash staff that works with inmates at the jail. “We’ve noticed it’s increasing.”

Inmates with drug or alcohol problems are also common.

“A high number of inSharon Zehr, team leader of the Bert Nash staff at the Douglas mates have substance abuse issues,” said Madison County jail, and Steve Hornberger, Douglas County undersheriff, Husman, a member of the who oversees the jail. “Bert Nash is an integral part of this facility and provides a great service,” Hornberger said.

Bert Nash team at the jail.

Mental health issues are a valuable asset.” not a new problem among inmates.

When someone is booked into the county jail, part “It’s been a long issue with us,” said Ken McGovof the intake process includes a series of questions to ern, who has been Douglas County sheriff since try and assess the person’s mental health. The ques2004 and began his law enforcement career with tions include: Do you have a history of mental illthe sheriff’s office in 1982. ness? Have you ever been hospitalized for a mental The sheriff’s office has a long-standing relationship illness? Are you receiving mental health counseling? with Bert Nash to provide mental health services for Have you ever thought about suicide? Are you thinkinmates as well as for law enforcement personnel ing about suicide now? who are going through a mental health crisis.

Members of the on-site Bert Nash staff review the A Bert Nash team of therapists started working at inmates’ answers and respond accordingly. the jail in 2000.

“A yes answer to any one of those mental health “I think we’re good partners,” said McGovern, questions and the person is put on our daily list and who is a member of Bert Nash’s Governing Board of we go see them,” said Sharon Zehr, leader of the Directors. “Not only on the corrections side, but on Bert Nash jail team. “Our role is to provide mental the operations and patrol side. Bert Nash therapists services to the inmates.” have come in and done support groups after we’ve A recent example of a point-in-time count, which had a major incident, or officers who are going through a crisis can reach out to them. I see them as See JAIL OUTREACH on Next Page

Jail Outreach Continued from Page 14 is based on the intake responses at the time of booking, showed almost 30 percent of inmates were identified as having mental health issues; 9 percent were identified as having severe mental health issues; and 20 percent were on medications for mental health issues.

Those numbers are typical.

“It used to be, mental health was a secondary issue,” said Sheriff McGovern. “Now we see it as much as an issue as physical health.”

Bert Nash team leader Zehr credits the Douglas County sheriff with recognizing the importance of addressing the mental health issues among inmates.

“What’s the reason for the difference? I think the sheriff, because he really believes in the whole concept of helping people,” Zehr said. “I think he’s really the driving force.”

Members of the Bert Nash team view inmates as people who, yes, have violated the law, but may also have mental health issues that contributed to their legal problems.

“We see somebody who has had a really messed up life and who needs some help and guidance,” Bert Nash team member Naff said. “Even when I get frustrated, and we all do, I always think there is one who is going to make a change.”

Steve Hornberger, Douglas County undersheriff, who oversees the correctional officers at the jail, appreciates the work the Bert Nash therapists do for inmates.

“Bert Nash is an integral part of this facility and provides a great service,” Hornberger said. “We appreciate everything they do.”

Some inmates, while incarcerated, can become depressed or reach the point of being suicidal.

“Sometimes there will be an inmate who goes to court and they get bad news and they say they’re going to kill themselves,” Naff said. “The jail staff will call us to assess them to see if they are just upset or if they really have a plan to attempt suicide. Our job is to decide whether to put them on suicide watch, close observation, or sometimes we do send someone to a psychiatric hospital from here.”

Oftentimes, the Bert Nash staff sees inmates who are repeat offenders.

“We have frequent fliers, we call them, who come in and out a lot and we deal with them each time,” said team member Naff.

BERT NASH JAIL TEAM:

■ Average no. of inmates the jail

team saw per month: 50 ■ Average no. of inmates the jail team saw on a daily basis: 10 As of 2012 An inmate can make a request to see one of the Bert Nash therapists.

“We encourage them to let us know if they need anything, and they can be put on the list,” said team leader Zehr.

Besides meeting one-on-one with inmates, the Bert Nash therapists conduct group sessions on topics such as life skills, anger management, relapse prevention, substance abuse and dialectical behavioral therapy.

“Most inmates just really want someone to listen to them,” Husman said. “So most of them are very willing to have a conversation with us.”

Another role the Bert Nash therapists provide is to help prepare inmates for reentry, in advance of their release from jail.

“Where before, when we let inmates out, they’d go out and then they’d come right back in. It can be a vicious cycle and clog up the system,” Sheriff McGovern said. “We try to take a proactive stance with identifying and working with Bert Nash.”

The presence of the Bert Nash team can have a positive effect on reducing the cycle of repeat offenders.

“We’re trying to put stopgaps in there to help inmates when they get out of jail,” McGovern said.

Those stopgaps include having Bert Nash therapists work with inmates who have mental health issues and help them put together a plan for when they get out of jail.

“We meet with them and we talk about their goals and what support systems they might need when they get out,” Bert Nash therapist Husman said. “So they have a plan in place when they are released and we work together to achieve those goals.”

While not every inmate who is released from jail will stay out of trouble or turn his or her life around, that’s always the goal.

“As long as I’ve been in mental health, I still have that hope that people want to change and can change,” Bert Nash team member Naff said. “I want to be here to help them do that.”

Let’s talk about mental health!

16

Schools are WRAPped Up When Charlie Kuszmaul heard about the shooting at Sandy Hook Elementary School in Newtown, Conn., like everyone, he was appalled.

But he wasn’t surprised.

He knew the possibility existed for the same horrible act to occur at any school in the country. Including here.

“When Columbine happened I was at Lawrence High School and everyone there was aware that it just as easily could have happened in Lawrence, or anywhere,” said Kuszmaul, who is coordinator of WRAP (Working to Recognize Alternative PossibiliApril Ramos, WRAP worker at Free State High School, talks with a ties).

Twelve students and one student. teacher were killed in the rent to students succeeding in the classroom. shooting at Columbine (Colo.) High School in 1999.

“What we’re trying to deal with are those kids who Two years earlier, WRAP was started in Lawrence’s have significant problems with emotional and psytwo high schools. chological functioning,” Kuszmaul said. “Because WRAP is a Bert Nash Community Mental Health how they function at school will be an indicator of Center program that currently operates in two of the how they will function in life.” city’s four middle schools — Liberty Memorial CenThe WRAP program was set up to place mental tral and South — both Lawrence high schools and health clinicians in the schools, because that is where three Eudora schools. kids spend the majority of their time.

“The mission of the program is to make students “Teachers aren’t trained to deal with mental health as effective as they can be at school,” Kuszmaul said. issues, like depression and anxiety, which can get in WRAP workers, who are master’s-level clinicians, a student’s way of learning,” said April Ramos, the are available to help with the behavioral, emotional, WRAP worker at Free State High School. “So, we are familial and psychological problems students can here to help students with whatever is getting in the have. In other words, the kinds of issues schools may way of them being successful students, which later not be prepared to handle. translates into being productive, contributing society “Schools are not well equipped to deal with those members.” problems,” Kuszmaul said. “Schools are equipped to Having WRAP workers on site helps to avoid the educate children. We’re asking our school system to stigma often associated with mental health issues. do something it was not set up to do.”

Emotional and psychological issues can be a deterSee WRAP IN SCHOOLS on Next Page

WRAP in Schools Continued from Page 16 “Kids don’t want to go to the mental health center, because that’s where the ‘crazy’ people go,” Kuszmaul said. “So bringing the WRAP workers to the schools is of vital importance. They become more integrated in the kid’s life, and when you do that, it’s much more reasonable to do an intervention, because you’re there and you’re available.”

WRAP workers work in concert with school counselors, teachers and administrators.

“WRAP is in the schools to serve an unmet need,” said Amy Brown, WRAP worker at Eudora High School. “The schools provide a great forum for identification, prevention and intervention.”

Anna Stubblefield, human resources director for the Lawrence School District and former principal at Liberty Memorial Central Middle School, said the WRAP program was a huge benefit to the school.

“Bert Nash would make sure there were no drops (in services for students),” said Stubblefield, who was principal at Liberty Memorial Central Middle School from 2008 to 2012. “It fills that gap. There are certain things where the school has our limits. I really appreciate that Bert Nash filled in the gap where we didn’t have those resources. When some of the kids needed more support, Bert Nash could provide those one-on-one resources. That was a life-saver.”

Especially in those situations when the school’s resources are limited.

“She (WRAP worker Deb Keary) would step in and fill the gap,” Stubblefield said. “Deb was very good about sharing information (with the appropriate school personnel), but she gave the students a safe place to go. From the students I interacted with, they felt like it was a safe haven.”

School personnel and WRAP workers may have different areas of expertise, but they desire the same end result — healthy, functioning students.

“Is behavior getting in the way of learning? That’s what teachers are interested in,” said Valerie Giedinghagen, WRAP worker at South Middle School.

“We have the clinical perspective to say (to a teacher) what they could do to help a student.”

In the beginning, a WRAP worker was assigned to both Lawrence high schools, and eventually every Lawrence school.

“WRAP began as a program to help with kids who were truant,” said Giedinghagen, WRAP worker at South Middle School. “Truancy is a pretty good pre-

WRAP: Started in 1997 ■ No. of new clients: 399 ■ No. of ongoing clients:

366 As of 2012

dictor of family stress and the WRAP program naturally evolved from there, because truancy is not the only predictor. In my school, free and reduced lunches have doubled over the past few years. That is another good predictor of stress for families and students.”

Because of the loss of funding since the program’s inception, WRAP had to be scaled back. There is no longer a WRAP worker in the Lawrence elementary schools and two of the middle schools. Nor are there WRAP workers in the Baldwin schools, like there used to be.

The hope is to restore funding so WRAP can be available in all Douglas County schools.

Shannon Jones, a member of the 2013 Leadership Lawrence class, is working with Bert Nash CEO Dave Johnson to find sustainable funding for the WRAP program. She said the benefits of WRAP and finding funding to sustain the program are a “no-brainer.”

“I first heard about WRAP when Dave came and spoke to our Leadership Lawrence class on wellness day. That was my first exposure to WRAP,” Jones said. “When I heard about WRAP and heard that funding had gone away, there were some of us in the class who wondered what we could do to start the conversation of what we can do to get this back in the schools.”

Then Jones attended a Discover Bert Nash session, which is a one-hour virtual tour about the programs and services offered by Bert Nash and the impact they have on people’s lives.

“That’s when Charlie (Kuszmaul, WRAP coordinator) did his presentation,” Jones said of the Discover Bert Nash session. “I walked out of that meeting saying the loss of funding for the WRAP program couldn’t be allowed to happen.”

For Jones, the mother of two elementary students, the Newtown shooting was heartbreaking and alarming.

“With Newtown just happening, it’s obviously on all our minds,” Jones said. “My youngest is in kindergarten and that guy would have walked right down See WRAP IN SCHOOLS on Next Page

WRAP in Schools Continued from Page 17 her hall and things would be very different for our family right now.”

Jones joined forces with fellow Leadership Lawrence class member Leslie Soden and made a presentation to the rest of the class about finding long-term, sustainable funding for the WRAP program.

“That’s our goal, so that we never have to be at risk of it going away again,” Jones said.

The WRAP program is available to all students and there is no charge for the services.

But it takes money to operate.

Many of the students who participate in the WRAP program come from low-income families. The ability to pay can be a hindrance to finding help from other sources.

With the WRAP program, there are no obstacles.

“We don’t put any barriers on the way we see kids,” Kuszmaul said.

Students can be referred to a WRAP worker by a parent, teacher, administrator, therapist, or they can self-refer. WRAP is a preventative program designed to reach students as early as possible and give them necessary life skills.

“This is a way of paying it forward,” said Janice Storey, Bert Nash child family services director.

The down-the-line costs of troubled students who don’t get help can show up in the form of teen pregnancy, substance abuse or incarceration, all of which are a financial drain on the system.

“We don’t cost money; we save money,” Kuszmaul said of the WRAP program.

Former Liberty Memorial Central Middle School principal Stubblefield said WRAP provides another layer of emotional and psychological support in the schools, and she would hate to see the program go away.

“Students know the Bert Nash people,” Stubblefield said. “Bert Nash was the consistent component in their lives. If that were removed, it would mean there would be a chance some students may not come up on our radar, because we always go to the students with the greater need. So to lose that connection, some borderline kids could slip through the cracks.”

While it is sad it took the Newtown shooting to shift attention on the importance of mental health services, it has focused awareness on the need for

preventative programs like WRAP. While decreases in funding forced the program to be scaled back, the behavioral, emotional and psychological needs among students haven’t diminished.

In fact, the need may be greater than ever.

The Newtown school shooting in December was the second deadliest in U.S. history, after the 2007 shooting at Virginia Tech University. Twenty schoolchildren and six adults were killed at Newtown. In the shooting at Virginia Tech, 32 people were shot and killed and 17 wounded.

Thankfully, there have been no such school shootings in Douglas County. But no school is immune from the possibility of a Newtown or a Columbine.

WRAP workers deal with a range of issues, from anxiety and depression to substance and sexual abuse and even suicide.

“The WRAP worker does a whole range of interventions,” WRAP coordinator Kuszmaul said. “It’s just about as heavy a lifting as you can do as a therapist.

We’re talking about developing a relationship with someone so that they will tell you about things, like whether they are considering killing themselves or someone else.”

Which has happened.

However, the student didn’t follow through on the suicidal or violent thoughts. Instead, the student confided in a WRAP worker first, and the clinician was able to diffuse the life-threatening situation.

The situation was resolved without anyone being harmed and without most people even being aware of the student’s plans.

A student who is contemplating suicide or even murder is an extreme case, but there are countless examples where a WRAP worker has helped a student who was dealing with a serious emotional or psychological issue.

“We don’t discharge people out of the WRAP program,” program coordinator Kuszmaul said. “We don’t have an end date. We have kids who started in the first grade and are still involved in the program in high school, which is great.”

Students who stay in school, who stay out of trouble and who stay on the path to become functioning adults can be a measuring stick of the WRAP program’s success.

But perhaps the ultimate benchmark is the lives that are changed … and saved.

“We can check grades and things like that, but the real question is, ‘How are you doing?’ What about the kid who was suicidal and is still alive?” Kuszmaul said. “We might consider that a fairly significant success.”

Let’s talk about mental health!

19

Client has the Write Stuff

She’s a blogger, a ballroom dancer, a motivational speaker and a pageant titleholder.

Now she can add another achievement to her résumé — published author.

Lorraine Cannistra wrote a personal story that was included in a new “Chicken Soup for the Soul” book released in August.

Cannistra, a client at the Bert Nash Community Mental Health Center, was surprised when she was notified her submission had made the final cut.

“I couldn’t believe it,” she said. “I didn’t tell very many people at first, because I didn’t know if it was going to make it in the Bert Nash client Lorraine Cannistra had one of her stories published book.”

Cannistra has long been a in the newest "Chicken Soup for the Soul" book. She will also have a fan of the “Chicken Soup” story included in a "Chicken Soup" Christmas book, due out in October. books.

“I love reading them,” struggles, so helping her find ways to not have that she said. “I like the concept; stories that make you be as big a barrier and to live as full of life as she can, feel better and brighten your day a little.” it’s been a joy for me,” Wanke said. “She’s been a The theme of the new “Chicken Soup for the Soul” delight to work with. She’s motivated and she’s articbook is “From Lemons to Lemonade: Positive, Practiulate. She takes what we talk about in sessions and cal, and Powerful Stories about Making the Best of a tries to integrate them. She’s done that in all areas of Bad Situation.” her life. She’s run the gamut of personal developA subject Cannistra knows all about. ment in a wide variety of areas.”

Cannistra was born with cerebral palsy. Then when Cannistra’s submission in the "Chicken Soup" book she was in her mid 20s, she was diagnosed with boris almost painful to read. Without spoiling the story, derline personality disorder. She’s had her share of suffice it to say she found herself in an embarrassing lemons in life. situation. The incident took place in front of a crowd But she’s made the best of bad situations, thanks in of people during her graduation from Emporia State part to services she has received at Bert Nash.

University in May 1990.

George Wanke, integrated dual diagnosis treat“For a few minutes, it was horrible,” Cannistra said. ment team leader at Bert Nash, has worked with “I couldn’t believe this was happening. I wanted to Cannistra since 2004.

“She has this combination of mental and physical See THE WRITE STUFF on Next Page

The Write Stuff Continued from Page 19 pretend I wasn’t there.”

But then she realized the embarrassing moment wasn’t the end of the world. She decided to laugh about it.

“Actually, that particular experience has taught me a whole lot,” Cannistra said. “It challenged me to look at a situation that may seem horrible, but if you look at it differently, you can see the humor or the silver lining in it.”

Cannistra, who has a bachelor’s degree in English and creative writing and a master’s in rehabilitation counseling, first wrote about her graduation experience in a blog. When she decided to submit the story to be included in the “Chicken Soup” book, she shared her work with the Great Plains Writers Group, an organization of local writers who support and critique each other’s work.

“I read the story to them and asked what they thought,” Cannistra said. “I got great feedback on what was good about it and how I could make it better. In particular, I got some help from a woman in the group, Nicole Muchmore, who is a professional editor. She graciously edited the whole thing and told me I could take what I wanted from her suggestions, but she made it really clear that it was still my story.”

Cannistra has been writing a blog, called Health on Wheels (healthonwheels.wordpress.com), for a little more than a year. Her former Bert Nash case manager, Kristin Hoffman, a blogger herself, encouraged Cannistra to give it a try.

“I found I just loved it,” Cannistra said of blogging.

“I started out writing anonymously, so I could pour out my heart and it became a way that I could explain how I was feeling or the lessons I’ve learned. It has been a really good way to process things that have been going on in my life.”

Despite her physical and mental challenges, Cannistra has had a lot going on in her life. Besides writing, she’s a wheelchair ballroom dancer, she was crowned Miss Wheelchair Kansas in 2007, she qualified for the U.S. Paralympic team in 1986, and she’s an advocate and motivational speaker on behalf of people with disabilities.

Cannistra enjoys dispelling stereotypes about people with disabilities.

“I have learned so much having my physical disability. If someone offered me a pill to take away my

physical disability, I don’t think I would trade the experiences I’ve had, because those kinds of things have helped make up who I am,” Cannistra said.

“My psychiatric disability, even though it is also part of who I am, it interferes with everything I do. Given the choice, if somebody offered me a pill, that’s what I would get rid of in a heartbeat.”

Cannistra didn’t always believe it was possible to do the things she has done. It took some prodding.

That’s where Bert Nash team leader Wanke came in.

“She always had the skills to do these things, she just didn’t believe it,” Wanke said. “If I offered her anything as a therapist, it was encouragement to act on these ideas and put together a plan on how she could actually get those things done. She does the work. I’m just lucky enough to have her as a client.”

For Cannistra, the feeling is mutual. She credits the team she has worked with at Bert Nash, including Wanke, Hoffman, psychiatric support and treatment case manager Kaley Silva, and SEED (Supported Employment Education Development) case manager Wendy Karpowitz for encouraging her to pursue her dreams.

“The encouragement from them has played a big part in my being able to be published,” Cannistra said.

She submitted her story to “Chicken Soup for the Soul” in February. She was notified April 30 that her story had been selected. The book is scheduled for release Aug. 13.

Cannistra was paid $200 for her submission and received 10 free copies of the book. But having her story published — in the hopes it will inspire other people — meant far more to her than a check.

“It feels pretty darn amazing,” Cannistra said. “I’ve always known what my writing has meant to me, but to think my writing means something to other people is just incredible to me.”

In more good news, Cannistra recently received word a second submission was accepted for publication in a “Chicken Soup for the Soul” Christmas book, due out Oct. 8.

“Pretty cool, huh?” she said.

No, very cool.

Cannistra credits the team she has worked with at Bert Nash for encouraging her to pursue her dreams.

Let’s talk about mental health!

21

Using Knowledge to Help

When Bill Beedles took a enforcement personnel, UniMental Health First Aid class in versity of Kansas faculty and the fall of 2011, it changed his staff, and the Leadership life.

Lawrence class.

It could also change the life “It gives people the skills and of someone he knows. information they need to know “The biggest change is I now when a person is developing a have enough knowledge so problem, how to deal with a that I have the courage to incrisis a person may be having tervene if the situation is seriand how to get them the apous enough that I need to be propriate professional help,” proactive,” said Beedles, a Unisaid Bert Nash CEO David versity of Kansas business proJohnson, who is a certified fessor. “Where I just wasn’t Mental Health First Aid instrucinclined to do so in the past.” tor. “People who have taken Mental Health First Aid is an Mental Health First Aid will tell eight-hour certification course you they use the training.” that helps people identify, unBeedles, a member of the derstand and respond to signs Bert Nash Endowment Board of mental illness. of Trustees, has not had to ask In 2008, the Bert Nash Comthe big question since taking KU business professor and Bert Nash munity Mental Health Center Mental Health First Aid. But he Endowment Board of Trustee Bill was one of seven pilot sites in can’t help but wonder if he Beedles is an advocate for the training the nation to begin offering had had this training years ago course Mental Health First Aid. Mental Health First Aid. Bert how life might have been difNash also has instructors ferent. trained to teach Youth Mental Health First Aid, which “Would I have had the insight to intervene with my is new this year. The class, for adults who work with adolescent daughter with her eating disorder that young people, provides a basic knowledge in recogshe had in junior high?” Beedles said. “Would I have nizing the signs and symptoms of a variety of mental been able to get her help more quickly? I think I health challenges and disorders in young people and would have.” how to respond appropriately.

Another what-if question involves Beedles’ fatherSince 2008, more than 900 Douglas County resiin-law. dents have been trained in Mental Health First Aid, “Would I have had the courage to look him in the including Beedles. eye and ask, ‘Are you thinking about killing yourself?’

The program starts with asking the big question.

If I had asked that question would he have been alive “Could you look someone in the eye, and with for the raising of my children and grandchildren? I compassion, ask, ‘Are you thinking about killing yourdon’t know the answer to that,” Beedles said. “But self?’” Beedles said. “Depending on the answer, I also now I know I have the knowledge and the courage have the knowledge to ask the follow-up questions to to ask that question.” find out if the situation is serious enough that I need to be proactive and get the person the professional MENTAL HEALTH FIRST AID help they need.”

■ No. of people in Douglas County trained Bert Nash’s certified instructors in Mental Health in MHFA: More than 900 As of 2013 First Aid have trained, for example, church staff, law

Let’s talk about mental health!

22

Elizabeth,inHerOwnWords Starting in 1982, I had been my own. She wrote that down. in and out of hospitals. When I She then asked me what else I first was diagnosed with menwanted to do, and I said I tal illness, I was a graduate stuwould like to do some kind of dent at the University of work. Again, she wrote that Kansas. During the first phase down. My case manager reof my illness, I was teaching at ferred me to a job support speKU and had won a Fulbright to cialist at Bert Nash. go to Mexico to collect data Soon my case manager also for my degree. I had earned became my therapist. I began two master’s degrees and was to receive all my services at working on my dissertation Bert Nash. The community when my illness made it imsupport services gave me an possible for me to continue in outlet to socialize and I made the program. I was lost and friends. My new psychiatrist at went to private practitioners.

Bert Nash took me off the My illness was overcoming me. many medications I had been I felt isolated. taking for years. I began to feel At the time, the “medical” alive again. I became a part of model was widely in use. What my treatment plan. I was told this means is that I was not of possible side effects before I part of my treatment plan. I decided to take a medication For Elizabeth Sheils, serving on the took several medications, some or not. What was important Bert Nash Governing Board of to counteract the side effects Directors is a way to give back to the was that the doctor at Bert of other medicines. I was a Nash listened to me, and community. zombie. The doctors and helped me feel better. nurses at the hospitals told me I would never live on My case manager/therapist became a team leader. I my own. I would live in a nursing home or state instilike the team approach at Bert Nash because other tution. I was going down after having had a successtherapists and case managers offer suggestions for ful career. my recovery.

With much reluctance and warnings from my outAt Bert Nash, all bases are covered. I have a theraside practitioners, who claimed I would fall through pist, case manager and job specialist and attend the cracks, I entered the program at Bert Nash Comweekly groups. Now it is up to me to make a go of munity Mental Health Center. I continued to see a this. I worked for the School of Social Welfare at KU psychologist and psychiatrist in private practice, but I as an independent contractor, which meant I was a now had a case manager at Bert Nash. This was the co-trainer for evidence-based practices, such as supturning point in my life. ported employment specialist and case management My case manager talked to me for a few visits and training. Currently, I am self-employed as a consultthen asked me to fill out a strengths assessment ant/speaker/advocate. I am also on the Governing (which looks at your strengths rather than the Board of Directors at Bert Nash. deficits) with her. This was the first time anyone had I am enjoying my jobs. I feel much better about asked me what I wanted to do with the rest of my myself and my involvement in the community. And life. I was cautious and a bit bewildered because I thanks to Bert Nash, I now have a better quality of thought the course of my life had already been deterlife. mined. First, I said that I wanted to continue living on — Elizabeth Sheils

Let’s talk about mental health!

23

MakingaPositiveDifference When Kathleen Boyd sees a child having trouble in school, she sees more than a student struggling with grades.

She sees beyond the classroom.

She sees a boy or girl who is part of a school, a family and a larger community who needs support.

“I look at each child in terms of his or her world,” said Boyd, who is a Bert Nash child and family therapist in Eudora. “Life happens to all of us and can often be overwhelming.

Kids struggle as well as adults when there is loss, a family illness, divorce, change of schools or financial pressures, to name a few.

“These stressors can make concentrating at school, navigating relation- Kathleen Boyd is a Bert Nash child and family therapist in Eudora. ships and staying on track difficult. When someone is “The partnership with Bert Nash opens the door struggling with constant for community members to have easier access to stress, anger or sadness, it can come across as chronic services that improve their quality of life. When irritability, apathy, sudden people who live in Eudora have easy access to menrage or withdrawal,” Boyd said. “Learning, homework tal health services, it helps create safe schools and and grades typically suffer a healthy community.” as well as relationships.”

— Don Grosdidier, Eudora school superintendent Accessing supports during those difficult times can make a positive difference.

Nash also offers groups to help a child and their par“Many people still do not realize that community ents learn skills to better manage moods, problemmental health centers offer more than therapy and solve, increase self-control and to be more successful medication,” Boyd said. “Bert Nash offers a range of in relationships.” wraparound services in the home, school and community for qualified kids as well as their parents. Bert See BN IN EUDORA on Next Page

BN in Eudora Continued from Page 23 Boyd’s position originally was funded through a federal grant, Safe Schools/Healthy Students, which Eudora received in 2008. But her position now is self-sufficient.

Boyd works collaboratively with teachers, school counselors, administrators and WRAP workers at each of the three Eudora schools. WRAP (Working to Recognize Alternative Possibilities) is a Bert Nash program that places a master-level clinician where the students are — in the schools.

“We strive to work as a team,” Boyd said. “The collaboration here is remarkable. We share the same goal — to help kids succeed academically, socially and emotionally.”

Boyd knows problems in school can lead to even bigger problems down the line. Lack of success in school often results in lower self-esteem and increases a student’s chances of giving up, dropping out and getting into drugs, alcohol and legal problems.

“If they don’t succeed in school, it could be an indicator that the rest of their lives will be tough financially and relationally,” Boyd said.

Which makes it important to reach kids as soon as possible once problems surface.

“If we could intervene earlier, a child’s chance for success is greater,” Boyd said. “The last thing we want is for a kid to fail in life because they didn’t get the support they needed.”

In her role in Eudora, Boyd works with a wide range of students with varying needs. Typically referrals from the school are for those needing more intense mental health supports.

“I work with WRAP to address students who may benefit from more consistent individual or family therapy and possibly wraparound services,” Boyd said. “We often take on the more acute cases addressing mental health and life issues.”

Boyd’s office is in a large classroom at the West Resource Center in Eudora, formerly West Elementary School. The space is donated by the school district.

“The Eudora School District has been incredibly supportive,” Boyd said. “They have made it possible for Bert Nash to have a satellite office providing mental health services for Eudora kids and families.”

Eudora Superintendent Don Grosdidier said the collaboration with Bert Nash is unique for the community.

BERT NASH EUDORA OFFICE Kathleen Boyd, child and family therapist ■ No. of clients seen: 1,742 ■ No. of unduplicated clients

seen: 266 As of 2012

“The partnership with Bert Nash opens the door for community members to have easier access to services that improve their quality of life,” Grosdidier said. “When people who live in Eudora have easy access to mental health services, it helps create safe schools and a healthy community.

“This is the first time in Eudora’s history that residents could receive mental health services without leaving town,” Grosdidier said. “That is a huge positive impact for our community and the families who live here.”

Transportation was a barrier if people had to travel to receive mental health services, especially for lowincome families.

“Transportation between Eudora and Lawrence is not easy for those without cars or whose budgets are tight,” Boyd said. “Many high-need kids come from families that have financial limitations. Providing services locally permits them to access services they otherwise might not have considered.”

Living in a small town can have other barriers.

“There’s often more stigma about seeking mental health services in a rural community,” Boyd said. “It’s a pull-yourself-up-by-your-bootstraps way of thinking that is part of our strong American heritage. It can also discourage people from asking for help, seeing it as weakness rather than an opportunity for life to become better.”

Through relationship building and networking within the community, Boyd said it is important to let people know help is available.

It’s her job to tell them.

And it’s a role she takes seriously.

“It has truly been a privilege to work with the schools, the students and their families, working collaboratively to help these kids become more successful,” she said.

Let’s talk about mental health!

25

Providing Peer Support

June was an anniversary for Debra Chapin.

That’s when she celebrated her first year as a peer support specialist at the Bert Nash Center.

“I knew this program existed,” Chapin said. “I thought what they did was really cool. I thought this is exactly where I want to be.”

In January, that’s exactly what happened. Chapin was notified she had passed the certification to become a peer support specialist.

In her role, she provides support and shares her personal story of recovery with others who are suffering from a mental illness and working on their own recovery.

“This seemed like the perfect thing for me, where I could share my story and use my skills to help peoAs one of the peer support specialists at the Bert Nash Center, ple,” Chapin said. “That’s Debra Chapin shares her personal recovery story and offers always been something I encouragement to others who are going through similar struggles. wanted to do.”

Chapin has a bachelor’s “I had become kind of a shut-in,” Chapin said. “I degree in addictions counseling and a master’s in wasn’t able to drive out of town. I wasn’t able to go counseling. But the counselor needed counseling. to stores.”

“With my mental health difficulties, I found it diffiNow Chapin works with people who are going cult to hold a job for very long,” Chapin said. through similar struggles with fear and anxiety.

She was diagnosed with depression when she was “I work with a lot of people who have anxiety,” she 19 and suffered panic attacks. She took medication said. “It is a huge issue.” for depression, but she also self-medicated with alcoBesides therapy, there were other supports that hol. That went on for years. were important factors in Chapin’s recovery.

Finally, in 2006, Chapin came to Bert Nash as a “We call it personal medicine,” she said. “They are client. It changed her life. things you do outside of the mental health program “That was when I really started to get it,” she said. that make you feel good, things that you do on a “I had to face my fears.” daily basis to feel better.”

Chapin attended a therapy group for anxiety. The group helped her address her fears and anxieties.

See PEER SUPPORT on Page 27

Let’s talk about mental health!

26

Writing Powerful Poetry

Bert Nash client Ron Fowler likes to express his thoughts and feelings by writing poetry.

“I love to share my story,” he said. “If I can help anybody along the way, I'm glad to do it.”

Ron Fowler may not be comfortable speaking in front of a group.

He prefers to express his thoughts and feelings in a different way.

Writing poetry.

Fowler was asked by Heidi Pritchard, a community support services case manager at Bert Nash, to share his experiences. He agreed, with one condition.

“I told her I would do it, but I told her I don’t speak very well, so maybe I would write a poem. I put things down better in poetry,” Fowler said. “She said that would be great.”

Pritchard had helped Fowler through the Ticket to Work program, which assists people who are disabled in finding employment. Social Security’s Ticket to Work Program is a free and voluntary program See RON FOWLER on Next Page

It’s been a rough five years, Since I became ill.

Though time kept rolling, My life came to a standstill.

The bills kept coming, There seemed to be no end.

Until I came to Bert Nash, Where I found a good friend.

I was talked to and asked, About things I might need.

I didn’t have a real clue, So Heidi* took the lead.

She looked and worked, Helping me find a place.

To help me feel again, Like part of the human race.

The time we spent looking, For a place I would fit.

Filling out apps, Waiting for the right place to submit.

On my first interview, My life started taking a turn.

I was given a job, Which really helped all my concerns.

Now I can say that my life is better, And I won’t crash.

Yes, I’m working full time, Thanks to Heidi and Bert Nash. *Bert Nash therapist Heidi Pritchard was Ron's case manager

Peer Support

Ron Fowler

Continued from Page 25

Continued from Page 26

For Chapin, one of those things was art. She took a pottery class at the Lawrence Arts Center.

“In IOP (Intensive Outpatient Program), I was encouraged to utilize community resources such as the pottery classes at the Lawrence Arts Center,” Chapin said. “I took that risk we talk about in the stages of recovery, where we try something new. That’s been a huge part of my recovery. It’s something that has been very important in improving my self-esteem.”

Chapin now has her own pottery wheel and she continues to take classes at the art center.

Chapin also attended Alcoholics Anonymous meetings, something she still does.

“I go to 12-step meetings,” Chapin said. “I’m very active in AA. Because I am an addict and an alcoholic, that is something I need.”

Chapin celebrated five years of sobriety on May 7.

As a Bert Nash peer support specialist and through AA, she shares her story of recovery with others who are dealing with addiction issues.

“Often, a dual diagnosis (alcoholism or drug addiction) is part of mental illness,” Chapin said. “If they’re self-medicating, which is what I did for a lot years, I feel that by sharing my story that’s another way I am able to help people.”

Spirituality was another important piece of Chapin’s recovery.

“A higher power is a big part of the recovery program,” Chapin said. “That’s a big part of my everyday life now.”

Sticking with the program was important to Chapin’s recovery story, and it’s something she stresses to others who are pursuing their own recovery.

“It’s a one-day-at-a-time thing,” she said. “It’s a process. It takes time and it takes persistence and willingness. But I’m proud to say, I’ve always been willing to do whatever is necessary to get better, and I encourage other people to do the same thing.”

available to people ages 18 through 64 who have a disability and who receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

“Heidi was my advocate,” Fowler said.

In his poem, Fowler thanked Heidi and Bert Nash for helping him.

Fowler, who grew up in Lawrence — he was in the class of 1978 at Lawrence High School — went through a rough period prior to coming to Bert Nash.

He was diagnosed with non-small cell lung cancer in 2006 and hadn’t been able to work.

His wife of 35 years, Joan, was with him at the doctor’s office when he was given the news.

“We broke down crying,” Fowler said. “She was crying because she didn’t want to lose me. I was crying because I didn’t want to hurt her.”

Fowler credits the medical care he received, support from his family and his faith for helping him survive cancer. He underwent two years of chemotherapy.

“My life belongs to God,” Fowler said. “I figured I was in good hands.”

For therapy, Fowler, who has a book of poems he has written, would express himself through verse.

“I write during times in my life when I feel like I need to put my thoughts and feelings down on paper,” he said.

Fowler wrote the poem about Heidi and Bert Nash in 2011. He is back at work now. He works with facilities services at the University of Kansas.

“Heidi helped me get back on at KU,” said Fowler, who has worked different maintenance jobs at KU in the past.

Despite battling cancer and going through a time when he wasn’t able to work, Fowler has maintained a positive outlook.

“I’ve had my ups and downs, but it’s been a great life. I wouldn’t trade it for anything,” he said. “I’ve had nothing but blessings since this whole ordeal started.”

Fowler’s life experiences are the inspiration behind his poetry.

“I love to share my story,” he said. “If I can help anybody along the way, I’m glad to do it.”

PEER SUPPORT TEAM

Started in 2006 4 part-time staff 40 peer support clients receive services at any given time ■ Another 100 go through the Decision Support Center per month As of 2012 ■ ■ ■