Arkansas Hospitals, Fall 2024

Fall 2024

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MENTAL HEALTH FEATURES

12 America’s Mental Health Crisis 18 Health Worker Mental Health 22 Mental/Behavioral Health Resources 26 Mental Health in Arkansas 29 Integrating Peer Support Services 40 Community Outreach 46 Healing the Healers

ARKANSAS

HOSPITALS Arkansas Hospitals is published by The Arkansas Hospital Association

419 Natural Resources Drive | Little Rock, AR 72205

IN EVERY ISSUE

5 President’s Letter 7 Editor’s Letter 8 Event Calendar 10 Hospital Newsmakers 34 Leader Profile: Courtney Bishop 39 AHA Services Presents 44 Coach’s Playbook 48 Where We Stand: Mental Health in America

To advertise, please contact Brooke Wallace magazine@arkhospitals.org Ashley Warren, Editor in Chief Nancy Robertson, Senior Editor & Contributing Writer Katie Hassell, Graphic Designer Roland R. Gladden, Advertising Traffic Manager

BOARD OF DIRECTORS

Larry Shackelford, Fayetteville / Chairman Greg Crain, Little Rock / Chairman-Elect Michelle Krause, Little Rock / Treasurer Ron Peterson, Mountain Home / Past-Chairman Ryan Gehrig, Rogers / At-Large Chris Barber, Jonesboro David Deaton, Clinton Phil Gilmore, Crossett Michael Givens, Jonesboro James Magee, Piggott Guy Patteson, Jonesboro Eric Pianalto, Rogers Douglas Ross, Hot Springs Neta Sue Stamps, Berryville Brian Thomas, Pine Bluff

EXECUTIVE TEAM

Robert “Bo” Ryall / President and CEO Jodiane Tritt / Executive Vice President Tina Creel / President of AHA Services, Inc. Pam Brown / Vice President of Quality and Patient Safety Lyndsey Dumas / Vice President of Education Debbie Love / CFO

Fall 2024

DISTRIBUTION: Arkansas Hospitals is distributed quarterly to hospital executives, managers and trustees throughout the United States; to physicians, state legislators, the congressional delegation, and other friends of the hospitals of Arkansas. Arkansas Hospitals is produced quarterly by Central Arkansas Media. Periodicals postage paid at Little Rock, AR and additional mailing offices. The contents of Arkansas Hospitals are copyrighted, and material contained herein may not be copied or reproduced in any manner without the written permission of the Arkansas Hospital Association.

Articles in Arkansas Hospitals should not be considered specific advice, as individual circumstances vary. Products and services advertised in the magazine are not necessarily endorsed by the Arkansas Hospital Association. To advertise, email magazine@arkhospitals.org.

ARKANSAS HOSPITALS | FALL 2024 3

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PRESIDENT’S MESSAGE

In Our Care

G

ood health – both mental and physical – is essential for every Arkansan. The Arkansas Hospital Association works every day to safeguard hospitals’ operational effectiveness in advancing the health and well-being of their communities.

As such, we support our hospitals in their efforts to improve the mental and behavioral health of their communities, of their patients, and of the thousands of health care employees that serve hospitals across the state.

We know that, particularly postCOVID-19, mental and behavioral health is more tenuous in America than ever before. That’s why we’re dedicating this edition of Arkansas Hospitals to the issue of mental health.

Our hospitals are making concerted efforts to support health care workers in the areas of mental and behavioral health. We all know that it’s imperative for everyone who works in the hospital to come to work clear-minded, focused, and as free as possible from mental and behavioral health challenges.

Besides doing all they can to provide a healthy working environment, many of our hospitals are providing on-site counseling services to help employees address mental health concerns and even behavioral health issues, including substance use disorder. Throughout the state, hospitals are focusing

caregiving not only on patients but also on their own employees, by providing counseling services and other resources to help health care workers deal with the extreme daily stress they encounter. This helps to build healthier communities.

In this issue of the magazine, we are providing a number of resources hospitals can use as they meet the needs of today’s workers, patients, and community members.

Speaking of resources, the AHA is hosting its Annual Meeting October 3031 in Little Rock. We hope you will join us as, together, we learn from experts in the field and tackle the everyday challenges hospitals across the state and the nation are now facing.

A one-day workshop presenting leadership tenets employed by the U.S. military will be presented by Patrick Houlahan, a former United States Marine Corps TOPGUN pilot. Our keynote address will focus on recognizing

the purpose in our work and will be presented by Mike Massimino, former NASA astronaut and Senior Advisor for Space Programs at the Intrepid Sea, Air, and Space Museum.

We’ll also feature a panel discussion by Arkansas hospital leaders addressing the financial sustainability of health care organizations, including actionable ideas and methods.

Other notable sessions will address health equity, communications, unconscious bias, and leadership techniques that can be utilized across the health care management spectrum.

The Annual Meeting always provides cutting edge ideas that can be taken back to and implemented by our local hospitals. We believe this year’s offerings will be especially useful to our hospitals as you seek to advance both care and culture throughout your organizations.

My hope is that everyone who attends benefits profoundly from the networking opportunities, sessions, resources, and celebrations of achievements; I also hope the time away allows you to return with a renewed sense of purpose and clarity of vision.

I also hope to see you there, and I will be glad to visit with you about what the AHA can do to further help your organization as we work together to meet challenging times head-on.

Bo Ryall

President and CEO Arkansas Hospital Association

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EDITOR’S LETTER

Stigma = Barrier

I

am trying to think of one person I know well who has not experienced a mental health struggle or been impacted by someone close to them who has … and I simply can’t do it.

The very real stigma that persists around mental illness makes it likely that people you and I know well do not feel comfortable sharing how severe their symptoms are – or were – even with a close friend. The reverberations of a personal mental health crisis can damage relationships and careers, and many people are trying to face mental health challenges alone – or, worse, they are both alone and mired in shame about what they are experiencing.

I’m simply lucky that, when I faced my own crisis after the birth of my first child, I was surrounded by others who recognized my symptoms – and that I had immediate access to medical care. Because, let me tell you, I am an “I’m ok-er.” I’m a suffer-in-silenceer. I’m a recovering perfectionist, overthinker, and self-critic.

So, 15 years ago, when I gave birth for the first time and a few months later saw all the color and joy drain out of life – despite the fact that I had a beautiful little butterball of a baby to love on – I didn’t even want to admit these changes to myself, much less discuss them with anyone else.

The walls were closing in on me, and I believed it was because I wasn’t a good mom.

The shame I was feeling only snowballed my depression and anxiety, and my mom and husband both expressed their concerns. I felt like I was disappointing everyone, and I started having intrusive anxious thoughts and imagining catastrophes that were just as terrifying as they were highly unlikely. During a followup appointment with my obstetrician, he goo-gooed over my daughter while he asked me how it was going.

It was like a dam inside me broke, and I told him what I was experiencing. He listened carefully, and he suggested a treatment plan which I followed, and the clouds lifted.

During my subsequent post-partum periods, I knew what symptoms to

notice first, and I took the same steps to treat them with the help of a professional, without ever letting shame enter the chat.

Every day, health care workers face excruciating challenges. Some of these involve their own mental and/or behavioral health. Some are facing unbelievable stress. Some are battling substance use. They face the ugly reality of stigma and too many are afraid to seek help.

As you read every mental health article in this issue of Arkansas Hospitals, you’ll see that word, “stigma,” pop out. Every time you see it, please remember that stigmas are barriers to people seeking and receiving the mental health care they need. As you apply many of the resources supplied in these articles to your hospitals, please keep in mind the importance of erasing the stigma around impaired mental health.

No one should feel ashamed of the effects of their own brain chemical soup. No one should feel they are totally alone or believe that their struggles separate them from the health care community. Mental health care is health care, the same as care for our physical bodies. Erasing the stigma surrounding the need for mental health care is something we can all embrace.

Ashley Warren Editor in Chief

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2024 Fall Calendar OCTOBER

October 2

Reimagine Your Work Design Webinar

October 2

Before Run, Hide, Fight: A Proactive Approach to Active Shooter Threats AHASI Webinar, hosted by HSS

October 3-4

Arkansas Healthcare Human Resources Association (AHHRA) 2024 Fall Conference The Capital Hotel, Little Rock

October 7

Safeguarding Our Future: Battling Syphilis and Congenital Syphilis in Arkansas Webinar

October 10-11

Arkansas Association for Healthcare Engineering, Inc. (AAHE) Fall Conference Embassy Suites Northwest Arkansas, Rogers

October 10

careLearning’s Premier Learning Management System Overview AHASI Webinar, hosted by careLearning

October 11

Society for Arkansas Healthcare Purchasing and Materials Management (SAHPMM) Conference Unity Health, Searcy

October 11

Arkansas Association for Healthcare Quality (AAHQ) Conference St. Vincent Infirmary, Little Rock

October 15

340B Quarterly Meeting Virtual Event

October 17

Healthcare Financial Management Association (HFMA) Payor Summit Embassy Suites, Little Rock

October 18

Fall Patient Experience Collaborative Unity Health-White County Medical Center, Searcy

October 23

How to Create a Selective Medicare Advantage Program for Your Organization AHASI Webinar, hosted by Vizient Managed Care

October 30-31

AHA 2024 Annual Meeting Little Rock Marriott

October 30

AHA Board Meeting Little Rock Marriott

October 30

AHAA Board Meeting Embassy Suites, Little Rock

NOVEMBER

November 1

AAHE Scholarship Trust Trap Shooting Tournament Arkansas Game and Fish Foundation, Jacksonville

November 6

Challenges & Winning Practices for Behavioral Health Management Webinar

November 6

AHA Healthcare Cybersecurity Alliance AHA Classroom

November 6

SunRx Presentation AHASI Webinar, hosted by SUNRx

November 19

Cyber Tabletop Exercise: A Consequence Management Event Virtual Event

DECEMBER

December 4

Improving Health Outcomes Through Effective Operations Webinar

Register for AHA Events Online!

Employees of AHA member hospitals can now log in to www.arkhospitals.org and register for events online.

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Join Us!

Arkansas Hospital Association

2024 Annual Meeting OCTOBER 30-31 Little Rock Marriott

HOT TOPICS:

LEADERSHIP WORKSHOP

• Health Equity Belongs to Everybody

(4.5 Continuing Education Hours Applied for) Patrick Houlahan, Founder and CEO of Strategic Leadership Consultants, LLC, Former United States Marine Corps “Top Gun” Fighter Pilot

• When Good Isn’t Good Enough:

Arkansas Hospital Association

2024 Annual Meeting

How Unconscious Bias Harms Patients…Despite Our Good Intentions

Learn how to apply TOPGUN October 30-31Patrick pilot tools and techniques Houlahan Little Rock when leading your ownMarriott high- • 3 Statehouse Plaza performance teams.

• Consumer Behavior in a World of Memes, GIFs, and Trends • It’s All in the Delivery

KEYNOTE ADDRESS

(Communications Training)

Mike Massimino, Professor of Mechanical Engineering, Columbia University; Senior Advisor for Space Programs at the Intrepid Sea, Air & Space Museum; Former NASA Astronaut

How to remember that we are making the world a better place through our work.

• Leading Like Taylor Swift

Mike Massimino

Approval is pending for continuing education credits for ACHE, Legal, Nursing, Quality, and Risk Management.

Meeting Brochure and Online Registration Available Now!

Scan here to learn more!

ARKANSAS HOSPITALS | FALL 2024 9

HOSPITAL NEWSMAKERS Arkansas has seven hospitals identified among America’s Top 100 Critical Access Hospitals in a 2024 designation by the Chartis organization. Earning this distinction are Baptist Health Medical Center – Arkadelphia, CHI St. Vincent Morrilton, Howard Memorial Hospital, Mercy Hospital Berryville, Mercy Hospital Booneville, Mercy Hospital Paris, and Mercy Hospital Waldron.

The Arkansas Hospital Association’s new Economic Impact Report is now available. This report identifies and measures the direct impact of hospitals on the state’s economy, and it demonstrates the “ripple” effect of the dollars the health care sector brings into Arkansas communities and the jobs it helps create. In addition, the report illustrates the benefit hospitals provide in building safe, stable, and healthy communities. You can download your copy from arkhospitals.org.

Scan here to access the new Economic Impact Report at arkhospitals.org.

Unity Health is partnering with Bernhard to install an array of Earth Mount solar panels that will produce power for its rural hospitals in Searcy, Jacksonville, and Newton, upgrading existing power sources and providing sustainability into the future.

An expansion is underway at Arkansas Children's Northwest.

A four-story addition will include 15 new patient beds, a pharmacy, an expanded infusion center, and is expected to draw about 40 new physicians to the complex over the next several years.

Arkansas Children’s Northwest is currently undergoing a 72,000 square foot expansion.

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Richard “Harley” Smith, MBA, has been named CEO of Izard Regional Hospital. He holds both an MBA in health care management and a master’s degree in human resource management. He previously served as a hospital CEO in Texas, Mississippi, Tennessee, and North Carolina.

Lyon College and UAMS are collaborating on the creation of Arkansas’s first dental college. The institutions recently broke ground on the Little Rock construction site for the Lyon College School of Dental Medicine. Applications for admission are now being accepted, and the school will open when it receives accreditation.

Arkansas Children's Research Institute is receiving $3.3 million from the National Institutes of Health to run a fiveyear study that will clarify which viral and host factors lead to severe disease among children infected with the virus that causes COVID-19. The study will identify common features in children with multiple respiratory viruses, including SARS-CoV-2.

Jay Quebedeaux, MBA, FACHE, has been named President of Regional Hospitals for Baptist Health. He will now have operational responsibility for Baptist hospitals in Arkadelphia, Heber Springs, Malvern, Monticello, and Stuttgart, working directly with their leadership teams. He continues to serve as President for Baptist Health Medical Center-Hot Spring County and Baptist Health Medical Center-Arkadelphia.

CHRISTUS St. Michael Health System held a ribbon cutting ceremony in mid-July for its new Emergency Center in Texarkana.

The $17 million, 12,000-square-foot facility houses 12 treatment rooms, advanced full-service imaging, and on-site lab services.

CHRISTUS St. Michael Health System holds a ribbon-cutting and blessing for its new Emergency Center in Texarkana.

The University of Arkansas for Medical Sciences (UAMS) is one of 60 research institutions nationwide to receive the Clinical and Translational Science Award from the National Institutes of Health. The $31.7 million grant will allow clinical trials to develop treatments for diseases like Parkinson’s and Huntington’s and continuation of a program to address health disparities among rural and minority communities.

LaDonna Johnston, MSN, BSN, has been named President and CEO of Unity Health. She previously served as Interim President and CEO, and she brings more than 30 years of experience and health care leadership within the Unity Health system to her new position.

Pamela Brown, RN, BSN, CPHQ, Vice President of Quality and Patient Safety for the Arkansas Hospital Association, has been named one of Arkansas’s 2024 Great 100 Nurses by the Great 100 Nurses Foundation.

Aaron Hilton, MSHA, has been named the new President of Lawrence Healthcare. He previously served in various roles with St. Bernards Healthcare, leading projects to improve patient care and system operations. Lawrence Healthcare partners with St. Bernards Healthcare for some services.

National Park Medical Center recently honored employees who are current members of the military or are military veterans. The event included a luncheon and participation by the Lake Hamilton Junior ROTC.

St. Bernards Medical Center’s Emergency Department has been approved for Pediatric Readiness Recognition at the Gold tier by the Arkansas Emergency Department Pediatric Readiness Recognition Program.

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America’s

MENTAL HEALTH CRISIS

By Thomas Insel, MD

Young people are contending with anxiety, jails have become de facto mental health centers, and deaths are rising from drug overdoses – but we know the way forward, if we have the will.

O

ur nation is facing a new public health threat.

Accelerated but not solely caused by the COVID-19 pandemic, feelings of anxiety and depression have grown to levels where virtually no one can ignore what is happening. A CNN/Kaiser Family Foundation poll put a number to it: 90% of Americans feel we are in a mental health crisis.

They are right.

A report in JAMA Health Forum notes that 38% more people are in need of mental health care since the onset of the pandemic than before. And an unprecedented White House report from earlier this year begins, “Our nation is facing a mental health crisis among people of all ages, and the

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COVID-19 pandemic has only made these problems worse.”

In truth, we are facing three distinct crises, which partially overlap. There is the youth mental health crisis, highlighted in an advisory from the surgeon general. There is a crisis around serious mental illnesses, such as schizophrenia and bipolar disorder, contributing to social problems including homelessness and incarceration. And there is the ongoing substance use disorder (SUD) or addiction crisis, fueled by prescription opiates such as oxycontin but complicated by new, lethal drugs such as fentanyl.

These three crises have somewhat different drivers, but the remarkable and hopeful truth is that we have solutions to resolve each of them if we have the will to embrace them.

THE PROBLEM YOUTH MENTAL HEALTH

Over the past 60 years, U.S. surgeons general have released advisories for major public health threats: smoking (1964), AIDS (1986), and obesity (2001). Surgeon General Vivek Murthy’s advisory on youth mental health (2021) states, “The pandemic era’s unfathomable number of deaths, pervasive sense of fear, economic instability, and forced physical distancing from loved ones, friends, and communities have exacerbated the unprecedented stresses young people already faced. It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place.”

The Centers for Disease Control and Prevention (CDC) monitors mental health and substance abuse through the Youth Mental Health Survey, a poll of high school students collected as questionnaires every two years since 2011. The most recent data, from 2021, is stunning: 42% “experienced persistent feelings of sadness or hopelessness,” up from 28% in 2011. And 22% “seriously considered attempting suicide,” up from 16% in 2011. While the 2021 data might reflect some of the most difficult months of the pandemic, the trends were apparent before 2021.

Historically, youth have had low rates of suicide mortality, but that began changing about a decade ago. Today, youth and young adults (ages 10-24) account for 15% of all suicides, an increase of 52.2% since 2000. Suicide has become the

second-leading cause of death for this age group.

The highest rates are found among non-Hispanic American Indian or Alaska Native youth, with a suicide rate three times greater than the general population. Youth who identified as sexual minorities (LGBTQ+) had a fivefold higher rate of attempting suicide.

SERIOUS MENTAL ILLNESS

While there is no clear boundary between serious mental illness (SMI) and mild or moderate mental illness, the term generally refers to disorders that are disabling.

Psychotic disorders, such as schizophrenia and bipolar disorder, and severe mood and anxiety disorders (including depression and PTSD) are in the SMI category. In contrast to the increased prevalence of youth mental health problems, the SMI crisis is a crisis of care. While we have effective medications, psychological treatments, and, most importantly, rehabilitative care (such as supportive housing and supported employment), less than half of the people with SMI are getting care.

Many receive treatment only in jails or prisons, which have become the de facto institutions for people with SMI because we no longer have sufficient public hospital beds for them. Many have become homeless because of the shredded safety net for people with disabilities.

And very few receive the range of rehabilitative services that are essential for recovery.

The statistics are grim. Life expectancy for people with SMI is about 20-25 years shorter than that of the general population. While 70% say they want to work, less than 20% are employed. People with SMI are 10 times more likely to be incarcerated than hospitalized and, relative to the general population, are 16 times more likely to be killed by police. Considered as a minority group, people with SMI would be the most disenfranchised and marginalized segment of our society, literally our untouchables.

SUBSTANCE USE DISORDER

Addiction is not a new problem in America, but it has become a crisis largely because of its new lethality.

The advent of powerful opiates, especially fentanyl, has driven mortality rates to unprecedented levels. The CDC reported 105,452 drug overdose deaths for 2022, more than a fivefold increase from 2002 and double the number from 2015. The highest death rates are in males ages 35-44. For context, there were roughly 43,000 auto fatalities in 2022. Lung and bronchial cancers, which cause the most deaths of any form of cancer, accounted for 127,070 deaths in 2022, mostly people over age 50.

Recognizing that some overdoses and alcohol-related deaths may be intentional, public health officials now describe drug overdoses, alcohol-related deaths, and suicide mortality as “deaths of despair.”

Combined, these deaths of despair were posited to be reducing life

ARKANSAS HOSPITALS | FALL 2024 13

These three crises - youth mental health, serious

mental illness, and substance use disorder - frequently overlap. Perhaps more important, these three crises share some common solutions.

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before the pandemic. Today, the number surpasses 264,000, a figure that would no doubt be considered the public health crisis of the century had we not just lost over 1.1 million lives to COVID-19.

These three crises – youth mental health, serious mental illness, and substance use disorder – frequently overlap. Roughly three-quarters of people with SMI report onset before age 25. And approximately half of the over 20 million people in the U.S. with a substance use disorder (SUD) also experience a mental health disorder. Roughly one-third of the 50 million adults with a mental health disorder experience a co-occurring SUD. Perhaps more important, these three crises share some common solutions.

SOLUTIONS ENGAGEMENT

One of the great challenges for solving these mental health crises is engagement. As noted above, we have effective treatments, yet relatively few people receive them.

Why? A common answer is the lack of capacity: too few therapists for youth, too few hospital beds and intensive outpatient programs for people with SMI, and too little access to medication-assisted treatment programs for people with opiate addiction. There is some truth to the deficit explanation – we need more capacity – but investing in more care centers may not solve the engagement problem, because the problem runs deeper than access.

In contrast to people with physical health disorders, especially those involving pain, people suffering with the emotional pain of mental disorders often avoid care, and those with the most severe illnesses are the least likely to engage. This is not an indictment of the people with these illnesses; it’s a recognition that these illnesses often preclude their own treatment. Depression creates hopelessness, anxiety creates avoidance, and psychosis creates denial, including denial of illness.

Solving for engagement requires intervening early (before

For those seeking mental health care,

the experience is too often delayed, fragmented, and frustrating.

hopelessness, avoidance, and denial set in), meeting people where they are (not asking someone to wait six weeks for a clinic appointment), and building trust by offering something of value (not simply a diagnosis) at the first meeting.

But that’s not how our health care system works. Health care has been built for payers and providers who need a diagnosis for reimbursement.

It has not been built for patients and families looking for efficient and effective care.

The revolution in digital mental health has helped by democratizing care, giving patients a choice of providers and often delivering care within hours instead of weeks.

This has increased the number of people in care, but it has not yet solved the issue of engagement.

That solution requires a proactive and preemptive approach: moving youth mental health care from clinics to schools, building community teams of coaches for people with SMI, and creating a harm reduction approach to addiction.

QUALITY

For those who seek mental health care, the experience is too often delayed, fragmented, and frustrating.

Most antidepressant and antianxiety prescriptions are written by primary care physicians who are not able to provide psychotherapy. Most psychotherapists have not been trained in the skill-based treatments, such as cognitive behavior therapy or dialectical behavior therapy, that evidence shows have the greatest

ARKANSAS HOSPITALS | FALL 2024 15

benefit. And very few providers of mental health care measure outcomes with standard metrics.

This lack of fidelity to scientific evidence and neglect of measurement would be unimaginable in other areas of medicine, but it has been endemic to mental health care. While both public and private insurance might require standards of care, few mental health specialists accept insurance, often because insurance reimbursement

does not match what they can receive as direct out-of-pocket payment.

The remedies for lack of quality are not complicated. Training of providers in skill-based psychotherapy, as is done across the United Kingdom, is essential for improving quality and has been shown to improve population health. Measuring outcomes and ultimately tying payment to outcomes, a strategy known as valuebased care, can improve quality.

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Mental health parity, which requires reimbursement for mental health care on par with physical health care, incentivizes better care through better reimbursement.

RECOVERY

While parity argues for the equality of mental health and physical health care, we need to consider that people with mental health disorders require more than medical care.

Perhaps one of the greatest drivers of the current mental health crises has been this fundamental misunderstanding.

Mental health requires much more than mental health care. More clinics, more medication, and even more psychotherapy may not reduce the morbidity, mortality, and costs of mental illness. While it is true that the current costs are driven more by lack of care than by care itself, we will bend the curve only when we move from a focus on reducing symptoms (as we do in a clinic) to a focus on recovery.

What is recovery? It is more than a reduction in symptoms or even remission of illness. Recovery requires a focus on the 3 P’s: people, place, and purpose.

When we can build a care system that ensures social support, a safe and nurturing environment, and a reason or mission to recover, then we will see the current mental health crises resolve.

Seem impossible? California’s new Medicaid waiver allows providers to write a prescription for food or rent. A clubhouse, a community where people with SMI can get all 3 P’s every day, is now covered as a Medicaid benefit in California. These are inexpensive interventions, especially in comparison with emergency room visits and incarcerations. But they require a shift in mindset from a medical model that focuses only on diagnosis and treatment to a recovery model that focuses on the 3 P’s.

Of course, the medical model is necessary. It is simply insufficient for resolving the crisis.

THE WAY FORWARD

It's tempting to compare the mental health crisis to the COVID-19 pandemic. Both have been massive killers, reducing life expectancy in the U.S. for the first time in a century.

But the differences are instructive: Mental illness decimates young people (roughly 8,000 people under age 34 died of COVID-19; over 140,000 died of deaths of despair during the pandemic). Mental illness is usually chronic or relapsing, and, in contrast to where we were early in the pandemic with COVID-19, for virtually every mental illness we have an effective treatment.

This is perhaps the greatest tragedy of the national mental health crisis. We know what to do, we have effective interventions, we have innovations to scale those interventions, and yet we have been unable to marshal the collective will to end this crisis.

But that lack of will is changing. In a nation torn apart by political polarization and culture wars, mental health remains a personal problem, not a political cause. The

Bipartisan Safer Communities Act of 2022 was arguably the biggest federal commitment to mental health since President John F. Kennedy’s Community Mental Health Act of 1963. It committed $8.5 billion to fund a network of clinics dedicated to recovery for people with SMI and SUD in all 50 states.

In 2021, Congress mandated a new national approach to the mental health crisis, designating 988 as a single phone number across the nation ensuring that those in crisis have someone to call, offering someone to come, and providing someplace to go for those who need immediate help.

Several states have taken on the youth mental health crisis, with California launching a $4.7 billion program to support a new workforce in schools, virtual platforms for youth, care for new families, and a telehealth network linking pediatricians to child psychiatrists.

The crisis is indeed personal, not political. There are, in fact, only two kinds of families in America: families struggling with a mental illness and those not struggling with a mental illness yet. The prevalence is that high – 50% of us will be affected at some point. And we now find ourselves facing this trifecta of youth mental health, SMI, and SUD challenges.

But the solutions – engagement, quality, and recovery – are neither complicated nor expensive. Digital innovation will help. New policies and enforcement of old policies, like parity, will help. But most of all, we need a clear vision that the current public health crisis is not inevitable. With what we know today, we can, as a nation, resolve this crisis.

THE TAKEAWAY

Anxiety and depression have become a new public health threat for Americans of all ages, but we have the tools to resolve this crisis through better engagement, quality care, and a focus on people and recovery.

Thomas Insel, MD, is a psychiatrist and neuroscientist, the former director of the National Institute of Mental Health, and author of Healing: Our Path From Mental Illness to Mental Health. This article originally appeared in TREND magazine, a production of The Pew Charitable Trusts, and is used with permission.

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Health Worker Mental Health

The National Institute for Occupational Safety and Health (NIOSH) presents this article to bring attention to and encourage steps toward improving health worker mental health.

BUILDING WORKPLACES WHERE HEALTH WORKERS CAN THRIVE

Challenging work conditions today put more than 20 million U.S. health workers at risk for mental health issues, but supportive work environments can help protect their well-being.

Health workers include everyone working in patient care, including nurses, physicians, home health aides, and medical assistants. It also includes many others who serve in critical support roles as well as public health workers. The challenges today’s health workers face in the workplace include long hours, staffing shortages, and exposure to violence and harassment.1 Mental health concerns among health workers include stress, burnout, depression, anxiety, substance use disorders, and suicidal behavior. Burnout and poor mental health outcomes are longstanding concerns made worse by the unique challenges of the pandemic.

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A recent CDC Vital Signs, authored by NIOSH, compared data in 2018, before the pandemic, with data in 2022, after the onset of the pandemic. It found that health workers are, indeed, facing a mental health crisis2: • More than double the number of health workers reported harassment at work in 2022 than in 2018.

• Nearly half of health workers (46%) reported often feeling burned out in 2022, up from 32% in 2018.

• Nearly half of health workers (44%) intended to look for a new job in 2022, up from 33% in 2018. Other research has shown the top reasons for leaving included insufficient staffing, intensity of workload, and the emotional toll of the job.3

POLICIES AND PRACTICES TO PROMOTE WELL-BEING

While these findings are concerning, the Vital Signs study also showed that certain workplace policies and practices can promote well-being. Health workers reported fewer mental health issues when they said they work in a supportive environment.

Aspects of a support environment include: • Participation in workplace decisions.

• Trust between management and workers.

• Proactive and helpful supervisors who promote: º Stress prevention. º Psychological health. º Support for productivity. º A harassment-free workplace. º Enough time to complete tasks.

NIOSH RESOURCES CAN HELP IMPROVE HEALTH WORKER MENTAL HEALTH

This free resource provides hospital leaders with evidence-informed solutions to reduce health care worker burnout, sustain well-being, and build a system where health care workers thrive.

NIOSH is actively working to help address this issue through its Impact Wellbeing™ campaign4.

This free resource provides hospital leaders with evidence-informed solutions to reduce health care worker burnout, sustain well-being, and build a system where health care workers thrive. It is designed to help hospital leaders go beyond encouraging self-care and individual resilience to focus on operational improvements that can support well-being.

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On March 18, 2024, the inaugural Health Workforce Well-Being Day, NIOSH expanded this well-being campaign to include an additional set of resources. The Impact Wellbeing™ Guide: Taking Action to Improve Healthcare Worker Wellbeing 5 was developed in partnership with the Dr. Lorna Breen Heroes’ Foundation. The Guide has six evidence-informed actions designed to improve the professional well-being of health care workers and strengthen hospital operations. It was realworld tested for usability by six hospitals across the United States within the CommonSpirit Health system, and it is available free-of charge to health care organizations.

In addition to the guide, Impact Wellbeing™ offers several web resources: For hospital leaders – NIOSH offers tips on how to effectively communicate with staff. This resource includes how to establish two-way communication, use inclusive and stigma-free language, and presents general communication best practices.6 For health care workers – NIOSH offers communication tips for health care workers, specifically on how to talk about burnout, moral injury, and mental health at work. 7 Another page for workers includes recommendations on how to advocate for the use of the guide in their workplaces. 8

original research, and perspectives from organizations taking action to improve health worker mental health.

Finally, NIOSH offers a new, free-of-charge online training resource, Understanding and Preventing Burnout among Public Health Workers: Guidance for Public Health Leaders.10 It helps managers and supervisors prevent personal burnout and burnout in the public health workers they lead. This free online training is built in a modular format to best fit busy supervisors’ schedules. Participants learn about demands that contribute to burnout and resources that can protect workers from burnout. The course also uses a multilevel framework for choosing among evidence-based interventions.

Mental health concerns for health workers are REAL.

UPDATING THE SCIENCE

NIOSH is helping to update the science around health worker mental health through a supplemental issue of the American Journal of Public Health.9 Sponsored and edited

by NIOSH, the issue focuses on the theme Addressing the Current Crisis and Building a Sustainable Future. The 15 articles included in the supplement provide updated data,

HOW YOUR ORGANIZATION CAN BENEFIT

Learn more about Impact Wellbeing™, health workers and mental health, and about mental health in general by accessing NIOSH resources. Visit the NIOSH Total Worker Health® Program11 and the Healthy Work Design and Well-Being Program12 to learn more about how work conditions and work design impact worker well-being.

NIOSH also offers training and resources for health workers on stress, fatigue, burnout, substance use, and suicide prevention. You can access these resources through the CDC’s NIOSH website, cdc.gov/niosh.

Mental health concerns for health workers are real. If you or someone you know needs suicide prevention support now, call or text 988 or chat 988lifeline.org. 988 connects you with a trained crisis counselor who can help. If you or someone you know needs assistance (in English or Spanish) with mental health concerns and/or substance use disorders, prevention, and recovery, please contact SAMHSA’s National Helpline at 1-800-662-HELP (4357) or visit https://www. samhsa.gov/find-help.

References 1. National Academies of Sciences, Engineering, and Medicine [2019]. Taking action against clinician burnout: A systems approach to professional well-being. Washington, DC: The National Academies Press.

2. Nigam JA, Barker RM, Cunningham TR, Swanson NG, Chosewood LC. Vital Signs: Health Worker–Perceived Working Conditions and Symptoms of Poor Mental Health — Quality of Worklife Survey, United States, 2018–2022. MMWR Morb Mortal Wkly Rep 2023;72:1197–1205, dx.doi.org/10.15585/mmwr.mm7244e1 3. Berlin G, Lapointe M, Murphy M [2022]. Surveyed nurses consider leaving direct patient care at elevated rates. McKinsey & Company, February 17, mckinsey.com/industries/healthcare-systems-andservices/our-insights/surveyed-nurses-consider-leaving-direct-patient-care-at-elevated-rates 4. cdc.gov/niosh/healthcare/impactwellbeing/?CDC_AAref_Val=https://www.cdc.gov/niosh/impactwellbeing/ 5. cdc.gov/niosh/healthcare/impactwellbeingguide/?CDC_AAref_Val=https://www.cdc.gov/niosh/impactwellbeing/guide/ 6. cdc.gov/niosh/healthcare/communication-resources/?CDC_AAref_Val=https://www.cdc.gov/niosh/impactwellbeing/leaders/ 7. cdc.gov/niosh/healthcare/impactwellbeing/talking.html?CDC_AAref_Val=https://www.cdc.gov/niosh/impactwellbeing/talking.html 8. cdc.gov/niosh/healthcare/impactwellbeing/advocating.html?CDC_AAref_Val=https://www.cdc.gov/niosh/impactwellbeing/advocating.html 9. blogs.cdc.gov/niosh-science-blog/2024/02/15/ajph-hwmh/ 10. cdc.gov/niosh/learning/publichealthburnoutprevention/default.html 11. cdc.gov/niosh/twh/programs/?CDC_AAref_Val=https://www.cdc.gov/niosh/twh/default.html 12. cdc.gov/niosh/research-programs/portfolio/hwd.html?CDC_AAref_Val=https://www.cdc.gov/niosh/programs/hwd/default.html

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Behavioral Health Strategic Priorities 2024 Resources for Hospitals from the American Hospital Association

T

he American Hospital Association (AHA) has a long-standing commitment to support member efforts to deliver high-quality, accessible behavioral health services. Consistent with that commitment, these 2024 Behavioral Health Strategic Priorities and resources are offered to provide easy access to information and tools that will assist hospitals in navigating the changing behavioral health care system and understanding national, state, and local activities affecting behavioral health.

The 2024 Behavioral Health Strategic Priorities are Integration, Community Partnerships, Stigma Reduction, and Suicide Prevention. What follows are short descriptions of each segment of the strategies, along with downloadable and accessible resources your hospital can use in its own behavioral health journey.

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COMMUNITY PARTNERSHIPS

INTEGRATION

Goal: Increase hospitals’ and health systems’ integration of physical and behavioral health services in acute inpatient settings, emergency departments, and primary care.

Integrating behavioral and physical health services can improve patient outcomes, reduce the total cost of care, and improve workforce satisfaction. Integration also reduces stigma and disparities, while improving access to behavioral health care. Visit aha.org/behavioral-health-physical-behavioralhealth-integration-resources to find evidence-informed examples of hospitals and health systems successfully integrating behavioral and physical health services, as well as research and thought leadership on the impacts of integrated care.

Unparalleled workforce shortages, negative margins, and increasing labor expenses are creating multiple challenges for hospitals and health systems – but integrating physical and behavioral health services can reduce the total cost of care, improve outcomes, and improve workforce satisfaction.

Integrated care can decrease the impact of these and other challenges. There are at least six positive impacts of integrated care, including: • Improved patient outcomes.

• Reduced total cost of care.

• Increased access to behavioral health services.

• Enhanced patient satisfaction.

• Better workforce productivity and satisfaction.

• Reduced health care disparities and stigma.

The push for integrated care is not new, but the time to act is now. Government and commercial payers are increasing coverage and consumers are demanding more timely access to behavioral health care.

The AHA’s vision is of a just society of healthy communities, where all individuals reach their highest potential for health.

Integration of physical and behavioral health services can help us move closer to achieving this vision.

For more, download the Issue Brief at aha.org/system/ files/media/file/2023/09/AHA-BH-Integration-TimeisNowwhitepaper-september-2023.pdf.

Goal: Inspire and further initiatives by hospitals and health systems, community partners, social service agencies, and others to expand access to a continuum of behavioral health services in a region.

The resources in this section showcase stories and the steps to achieving successful behavioral health community partnerships and expand access to behavioral health services at the right time, place, and level of care.

The AHA Hospital Community Collaborative (HCC) provides proven ideas, insights, and resources for creating effective, sustainable collaborations between hospitals and community organizations across sectors to accelerate health equity.

The Hospital Community Collaborative online program aims to make it easier for hospitals and community organizations to develop and lead grassroots interventions that advance health equity. The program coaches community partners to effectively work together and develop initiatives that transform the conditions and outcomes that matter to their communities.

HCC’s learning lab approach informs and nurtures the development of hospital-community partnerships, encourages peer-to-peer knowledge exchanges, and sets the foundation for success.

Delivered in an online platform, users can progress through the complimentary six-module program at their own pace, engage with peers in an online community, and participate in live virtual coaching sessions throughout the year.

Case Studies and Solutions are offered in these areas: • Emergency Departments.

• Integration of Physical and Behavioral Health.

• Maternal & Child Health.

• Opioids.

• Rural Solutions.

• Substance Use Disorder.

• Suicide Prevention.

• Stigma.

• Value of Behavioral Health.

Access these resources at: https://ams.aha.org/ and search for the AHA Community Health Improvement Hospital Community Collaborative Online Program.

Scan here to download

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STIGMA REDUCTION

Goal: Reduce stigma and deaths of despair, while addressing the unique stigmas of specific age groups, cultures, and other demographics.

The AHA is providing tools and insights toward this goal. To immediately access these resources, go to aha.org/stigma.

Words can transmit stigma. Studies have shown that people with psychiatric and/or substance use disorders often feel judged, both outside and inside the health care system. This can lead them to avoid, delay, or stop seeking treatment.

The way we talk about people with a behavioral disorder can change lives – in either a positive or negative manner. A series of downloadable posters, created by the AHA, together with behavioral health and language experts from member hospitals and partner organizations, are designed to help your employees adopt patient-centered, respectful language.

This educational poster series, “People Matter, Words Matter,” addresses a variety of topics, through posters including: • Using caring and compassionate language regarding people with disabilities.

• Using caring and compassionate language about eating disorders.

• Using the right actions and words to support colleagues after they experience an adverse event or distressing situation.

• Using caring and supporting language about maternal mental health.

• Using caring and concerned language about child and adolescent behavioral health.

• Using supportive language that makes a person feel safe and heard.

• Using destigmatizing language about suicide.

• Using culturally/racially aware language.

• Using compassionate language to discuss mental health conditions.

• Using people-first language.

• Using compassionate substance use disorder language.

Access these free, downloadable posters at aha.org/ people-matter-words-matter

SUICIDE PREVENTION

Goal: Prevent suicide through behavioral health initiatives, awareness, and intervention.

September is Suicide Prevention Awareness Month. All month long, the AHA is shining a national spotlight on suicide as a national public health issue and how hospitals and health systems are finding solutions to ensure that people at risk feel supported and connected.

When you visit aha.org/suicideprevention, you’ll find resources to prevent suicide by helping people become better informed, support those who are at risk and create hope through action.

To address the specific needs of health care workers in the area of suicide prevention, visit aha.org/suicideprevention/healthcare-workforce.

Health care professionals confront daily challenges impacting their wellScan here for more information. being, which was intensified by the COVID-19 pandemic.

Prioritizing mental health is crucial, as seen in AHA's guide "Suicide Prevention: Evidence-Informed Interventions for the Health Care Workforce." Access the guide for immediate steps to safeguard your health care teams' wellness amidst these challenges.

Words can transmit stigma [...] People with psychiatric and/or substance use disorders often feel judged, both outside and inside the health care system.

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The Cedar Stone Building at The BridgeWay houses the Admissions Department and Administrative Offices.

The Post-Pandemic

Landscape of Mental Health in Arkansas

By Megan Miller

F

or many people across the globe, COVID-19 may seem like a catastrophe that’s now in the rearview mirror, but mental health practitioners still operate every day in its wake.

We have seen a global surge in both mental illness and psychological distress since early 2020, when the pandemic began. A scientific brief released by the World Health Organization in March 2022 cited a 25% global increase in anxiety and depression in the first year of the pandemic alone.

We can all remember the urgent demand for both increased mental health services and for solutions to care for existing and new patients in the behavioral health field. Care

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providers in Arkansas showed innovation and flexibility during that stressful time, introducing mental telehealth services while working through challenges related to access and equity of internet availability.

We built healthy support networks by improving peer support mechanisms, crisis intervention skills, and low-contact methods of delivering community-based care. Inpatient mental health facilities adapted to social distancing and made a path for patients to get help. These efforts were made on the fly while everyone touched by the pandemic was in the throes of isolation and confusion; they didn’t yield perfect solutions, but they heralded steady progress.

THE CURRENT STATE OF MENTAL HEALTH IN ARKANSAS

Mental Health America uses 15 measures to rank the United States and the District of Columbia in its annual report, “State of Mental Health in America.” Arkansas’s overall ranking was 33 in 2020; it has progressed to 31 in 2024. While this is not an astronomical improvement, it does indicate that Arkansas is focusing on improvement of our citizens’ mental health.

Yet, some of COVID-19’s lingering effects are still evident. What follows is a breakdown of the pandemic’s impact by age group.

CHILDREN, ADOLESCENTS, AND YOUNG ADULTS

Children and adolescents in Arkansas and around the world suffered deep psychological impacts of the pandemic and the social isolation it fostered. There was already a national crisis in adolescent mental health, and it was only exacerbated by the pandemic. Emergency rooms noted an overwhelming rise of Arkansas youth appearing with thoughts of suicide, indications of substance use, symptoms of depression, uncontrolled anxiety, and destructive behaviors.

These symptoms seemed to be spurred by social isolation, loneliness, disrupted education, family stress, and financial instability.

Physical attendance in our nation’s schools has, of course, now resumed, allowing for structure, social and emotional development, and academic engagement. Yet we note that the influence of social media, which rose alarmingly during the pandemic, still plays a strong part in weakening young people’s mental resilience.

Social media use was front and center during the social isolation of COVID-19, as students necessarily lived within the confines of limited in-person contact. It seemed like a natural progression to use online tools to increase connection with the outside world. But reliance on social media can have negative consequences.

We know now that media overload changes a person’s mood, exacerbates social anxiety, and increases our tendency toward comparison and perfectionism. The overuse of social media creates a real problem for the mental health of today’s youth.

When discussing the mental health of young people, it must be noted that we have also not reached our goal of zero suicides. In Arkansas, suicide is still the third leading cause of death for those between the ages of 1024. Mental Health America notes that 35,000 (14.03%) of our youth had serious thoughts of suicide this past year. Access to quality mental health care in every corner of the state is critical.

There are also growing numbers of young people with substance use disorder. In Arkansas, youth are less likely to be enrolled in college, more likely to suffer motor vehicle fatalities, more likely to be victims of violent crimes, and more likely to be arrested for drug-related offenses than their national counterparts (Young

Adult State of Wellbeing: Arkansas State Epidemiological Outcomes Workgroup, 2021).

The state has noted these rising rates and has stepped up efforts in its “roadmap to success” to ensure that adolescent substance use treatment is available.

ADULTS

Adults were not immune to rising mental health stressors during the pandemic. They were often crippled by financial and work-related pressures from job loss or the transition to remote work. Many had difficulty balancing work and home life, in addition to fears of contracting the virus and managing relationship strains created by quarantines and lockdowns.

Some members of The BridgeWay's staff, representing nursing professionals, dietary staff, administrators, therapists, mental health techs, maintenance professionals, human resources staff, business office staff, IT staff, and medical records staff members.

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Today it is estimated that 546,000 (23.86%) adults in Arkansas have a mental illness. Of those, 40,000 (7.8%) are estimated to be uninsured, a circumstance that severely limits access to life-saving care (Mental Health America, 2024). Substance use disorders among Arkansas adults also remain high. A disproportionate number of those with substance use disorders are not receiving the treatment they need.

OLDER ADULTS

Younger generations reported more anxiety and depression during the pandemic than older adults, yet many older adults did suffer with these symptoms as long-term care facilities and nursing homes restricted in-person visits, churches temporarily closed their doors, and family gatherings were cancelled. Like many of us, older adults worked through feelings of loneliness and increased worry over contracting the virus. They also had to mitigate limited access to mental health services and medical care caused by pandemic shutdowns. Some have noticed a decline in cognition from the lack of mental stimulation during the pandemic years.

LOOKING AHEAD

A R C H I T E C T S

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E N G I N E E R S

The long-term impacts of the pandemic are still unfolding, but it is clear today that varied causes of symptoms for each age group are still increasing the demand for mental health care. We can help navigate this new landscape by promoting efforts that increase funding and coverage for mental health and substance use services. On a personal level, if your mental health hasn’t rebounded, please reach out to a mental health professional. If you are healthy, be aware of those who aren’t.

Rebuild connections to help break down loneliness, do what you can to reduce the stigma around mental health that prevents people from asking for help, and take time away from electronics to enjoy the beautiful Arkansas outdoors.

Integrating Peer Support Services into Hospital Care

By Jenny Post

T

he Arkansas Behavioral Health Integration Network (ABHIN) works with health care organizations and partners around the state to promote enhanced behavioral health care. We are currently working specifically with hospitals to address the need for stronger overdose response programs across northern Arkansas.

ABHIN is helping hospitals integrate peer recovery support (PRS) specialists into hospital service areas including Emergency Departments and clinical support areas. These specialists, each of whom has personal, lived experience with Substance Use Disorder (SUD), offer a perspective that is proving helpful in hospitals’ overdose response and treatment.

We are currently introducing these specialists into the overdose response protocols in several of Arkansas’s more rural hospitals, and we are hoping to make the program available to more hospitals in the state in the coming year.

The official name of the overdose response program is the Arkansas Rural Opioid Use Team Education Overdose

Response program (AROUTE-OR). Developed in response to the overwhelming need for evidence-based treatment of substance use disorder in rural northern Arkansas, this program is funded by the Health Resources and Services Administration (HRSA). It is centered on integrating PRS specialists into rural health care organizations (hospitals, primary care clinics, etc.) to help expand services and address the ongoing needs of patients with SUD. ABHIN works directly with hospitals adopting the AROUTE-OR program. We spend a year helping build their overdose response capacity, training care teams on integrating PRS specialists into their existing services, and then placing these specialists into those settings part-time.

Our team is halfway through the trainings with this first group of hospital care teams. Though it is still early, we already see promising outcomes that we believe will interest any health care team looking to build a stronger overdose response program within its organization.

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BREAKING DOWN BARRIERS AND BUSTING STIGMA

Bringing PRS specialists into hospitals to assist patients with SUD is backed by solid evidence.

Research shows that these specialists, through their lived experience with SUD, can connect with patients on a very deep level, helping to build trust and support recovery. Their involvement has been linked to improved outcomes, such as increased engagement in treatment, reduced relapse rates, and overall better patient satisfaction. 1-3 Beyond that, by sharing their own stories and experiences, PRS specialists help break down the stigma surrounding SUDs. This is a crucial element in creating a more compassionate and effective health care environment, and it encourages patients to seek help without fear of judgment.

“There’s a large part of the population that stigmatizes substance use or mental health struggles,” says Frank Frenzel, a PRS specialist working with North Arkansas Regional Medical Center in Harrison through the AROUTE-OR program. “That stigma keeps people from opening up, keeps people from mentioning their difficulties to their doctors [or other caregivers they might see on a regular basis.] The notion of stigma really keeps people to themselves, and it perpetuates substance use.”

PRS specialists can break through those tough barriers that may have formed over years or decades due to the stigma people with SUD experience. Yet despite their professional training and experience, these specialists can themselves suffer from a form of stigma when working as peers within the health care setting.

In a recent podcast produced

by ABHIN, peer supervisor Megan Copeland stated it clearly: “Instead of viewing SUD as a moral failing, let's recognize it for what it is. It's a medical condition, and it requires compassion and support.”

St. Bernards Five Rivers in Pocahontas is sharing preliminary results of the Peer Support programming.

Additional results are included throughout this article.

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CONNECTING RESOURCES AND ADDRESSING SOCIAL DETERMINANTS OF MENTAL HEALTH

“I met with a lady yesterday who is in her 60s,” said Nicole Hanners, a PRS specialist on a recent weekly supervision call. “She experienced childhood trauma and has been a heroin addict since the age of 11. She is now living in a nursing home and asked if I would come to the nursing home one night a week to facilitate a recovery meeting for those in recovery. I told her I would love to!”

PRS specialists like Nicole can play a vital role in helping patients with SUDs throughout their recovery journey.

They use their shared life experiences to build trust, offer emotional support, and suggest practical advice. They offer hope by sharing their experiences along their own recovery journeys, providing inspiration and living proof that a better future is possible.

Beyond providing encouragement, peer specialists help patients navigate and overcome social determinants of mental health, such as housing instability, unemployment, domestic abuse situations, legal challenges, and more.

Ashley Sanders is a PRS supervisor-in-training who works in Batesville, Mountain Home, and Mountain View – an area of the state with very limited resources for the treatment of SUD. “To get people the help they actually need is a bit of a struggle,” she says. “But that’s the great thing about peer recovery: we can reach out to a network of people all over the state and connect people with the resources they need.” By locating and connecting patients with community resources, advocating for their needs, and helping them develop healthy coping strategies, PRS specialists empower people to tackle challenges that could otherwise trip up their recovery and hurt their overall well-being.

DETECTING SUD AND MAKING REFERRALS TO PEERS

Kim Shuler presents an overview of the AROUTE-OR program to primary care, behavioral health, hospital staff, peer specialists, and students at CHI St. Vincent.

Engage a Peer Recovery Specialist for Your Overdose Response Program

Your hospital can utilize Peer Recovery Specialists, too! Join these Arkansas hospitals and emergency departments that are currently participating in the AROUTE-OR program: • North Arkansas Regional Medical Center, Harrison.

• Piggott Community Hospital, Piggott.

• White River Health Emergency Department, Cherokee Village.

• White River Health Emergency Department, Batesville.

• St. Bernards Five Rivers Medical Center, Pocahontas.

• Lawrence Memorial Hospital, Walnut Ridge.

• Primary care clinics located in Batesville, Mountain Home, and Marked Tree.

While AROUTE-OR is ending soon, we would love to help your team build stronger overdose response workflows.

Contact ABHIN’s CEO Kim Shuler for more information. You may reach Kim at kim.shuler@abhinetwork.org.

Screening for SUD in hospitals is straightforward and can be seamlessly integrated into routine patient assessments. Many hospitals use brief, evidence-based screening tools that quickly identify patients who may need support. Once a potential SUD is detected, making a referral to a

ARKANSAS HOSPITALS | FALL 2024 31

Scan here to find PRS specialists in your county, at arpeers.org/peer-directory

PRS specialist can be quick and efficient. With established protocols in place, hospital staff can immediately connect patients to a PRS specialist who is trained to provide the necessary support and resources.

This streamlined process can ensure that patients get the help they need right away, improving their chances of successful recovery. There are currently 441 PRS specialists operating throughout most of Arkansas’s 75 counties. To find PRS specialists in your county, visit arpeers.org/peer-directory/.

TRAINING TEAMS AND EVALUATING IMPACT

“We know that training hospital staff is crucial for the launch and sustainability of peer support programs,” says Kim Shuler, Project Director for the program and CEO of ABHIN. “Studies have shown that it is essential for ED and hospital staff to fully understand the role, scope, and value of peer support workers.”

This basic understanding forms a foundation that fosters teamwork and empowers staff to effectively utilize PRS specialists to improve patient outcomes. Shuler says another significant benefit of staff training is that it reduces bias against individuals with SUD. “The trainings we have developed help hospital staff see SUD as a chronic disease,” she explains. “The trainings, as well as working day-to-day alongside a peer specialist, often have a huge positive impact on the care teams’ perceptions of patients struggling with SUD. Working together helps re-form the way we think about and respond to individuals struggling with SUD.”

Above: ABHIN sends the monthly 'Peer'iodical newsletter to interested hospitals each month.

Right: St. Bernards Five Rivers program data.

32 FALL 2024 | ARKANSAS HOSPITALS

St. Bernards Five Rivers program data.

Shuler and the ABHIN team have developed a training curriculum with recorded modules that offer seven CEUs/CMEs. The training is available free-of-charge to anyone, and CEUs/CMEs are available through January 2025. You can access the recorded training at linktr.ee/peersinheathcare.

The ABHIN team has also prioritized collecting data from the PRS program to help hospital staff, administrators, and the state understand the profound impact integrating PRS services can have on individuals and the community. “It is our hope that these health care teams will see this pilot data and then use it to secure funding that makes peer support a more permanent part of their overdose response strategies,” Shuler says.

Scan here for access tp the CEUs/CMEs recorded training, at linktr.ee/peersinheathcare.

LEARN MORE ABOUT PRS AND GET CONNECTED WITH ABHIN

To learn more about the work peers are doing in rural Arkansas, check out the peer spotlight videos developed by ABHIN.4 They are powerful illustrations of the importance of PRS work.

“I have not found anything that brings me as much joy as watching people come out of the funk you get into in addiction,” Frenzel says. “We get to see people absolutely evolve into empowered, self-directed individuals who are solving their own problems and attaining goals.”

PRS specialists participating in the AROUTE-OR program include: Megan Copeland, Advanced Peer Recovery Support Specialist (APR); Bryttney Joslin, Peer Recovery Support Specialist (PR); Nicole Hanners, PR; Shalinda Woolbright, Peer Recovery Support Specialist Peer Supervisor (PRPS); Telly Roberts, APR; Michael Manley, Peer Recovery Support Specialist in Training (PIT); Ashley Sanders, APR; Rodney Beaver, PR; and Frank Frenzel, PIT. ABHIN will continue looking for opportunities to partner with Arkansas health care organizations interested in integrating behavioral health services into their overdose recovery protocols. If your organization needs support and resources as you move toward behavioral health integration, be sure to reach out to Kim Shuler at ABHIN (kim.shuler@abhinetwork.org).

Source 1. Stack E, Et. Al (2022). Peer Recovery Support Services Across the Continuum: In Community, Hospital, Corrections, and Treatment and Recovery Agency Settings – A narrative review. J Addict Med. 2022 Jan-Feb:16(1)93-100. doi: 10.1097/ ADM.0000000000000810 2. Collins D, Alla J, Nicolaidis C, et al. “If It Wasn’t for Him, I Wouldn’t Have Talked to Them”: Qualitative Study of Addiction Peer Mentorship in the Hospital. J Gen Intern Med. 2019.

3. Richardson, J, Rosenberg L. (2019) Peer Support Workers in Emergency Departments: Engaging Individuals Surviving Opioid Overdoses – Qualitative Assessment. The National Council for Behavioral Health.

4. youtube.com/playlist?list=PL19JiRKsWgQamwDd3cmJKgLal-jQ88TyH

Jenny Post, MA (Sociology) serves as Project Manager for the Arkansas Behavioral Health Integration Network (ABHIN). ABHIN is a nonprofit organization headquartered in Eureka Springs.

ARKANSAS HOSPITALS | FALL 2024 33

LEADER PROFILE

MENTAL HEALTH LEADERSHIP

FOCUSING ON ARKANSAS'S CHILDREN AND YOUTH

C

ourtney Bishop Ed.S., LPC, is a mental health professional with a proven track record of serving children and adults in Arkansas. In her current role as Chief Executive Officer of Pinnacle Pointe Behavioral Healthcare in Little Rock, she and her staff offer inpatient pediatric psychiatry programs for youth aged 5-17, aiming to treat mental and behavioral health issues including depression, anxiety, mood swings, grief or loss, attempts to harm the self or others, and other high-risk behaviors.

Knowing that children’s behavioral health can affect a child’s success, she and the Pinnacle Pointe staff are dedicated to helping families find a pathway toward hope and healing.

Arkansas Hospitals sat down with Bishop to discuss the mental health landscape in Arkansas post-COVID, and to find out more about her individual journey toward health care leadership.

34 FALL 2024 | ARKANSAS HOSPITALS

AH: When did you know that health care, specifically the field of mental health, was your chosen career path?

CB: I knew from an early age that I wanted to be a helper.

My Mom was a lab and x-ray technician, and I used to visit her at her work in various doctor’s offices. Observing the importance of her work made me realize that I, too, wanted to help others.

AH: Were there role models along the way that helped you discover your passion?

CB: I had a great high school psychology teacher who helped cement my decision to pursue a career in the mental health field. I thought, at first, that medical school was my most likely path, but soon realized that counseling was a better fit for me. I attended Ouachita Baptist University, where I earned my undergraduate degree, then earned a master’s in counseling psychology from the University of

Today's youth - and even adults feel an intense need for remaining connected, and the anxiety that results when they're not constantly checking their phones and social media is real.

Central Arkansas, and finally my Ed.S. from The George Washington University. One of my courses was in servant leadership – the art of leading by helping others – and that helped define the career path I wanted to pursue. From there, it was as if my career journey opened up and blossomed.

AH: Where are some of your most memorable stops along your career path?

CB: I worked full-time as a counselor for chronically mentally ill adults while teaching part-time at my alma mater – Ouachita Baptist University. I absolutely love both teaching and learning, and I would probably be teaching at the university level had I not pursued my career in mental health care.

I was asked to run a school-based program in Hot Springs with youth who needed help with their mental health. This was at a time that I still carried a small caseload of patients.

But it was my family’s move to Little Rock that put me squarely on the path I’m on today. I worked as a mobile assessor at Methodist Behavioral Hospital for five years when Shane Frazier approached me regarding a position as Pinnacle Pointe’s Director of Assessment and Referral. That was in 2017. I served in that position for three years, then as Chief Operating Officer in the CEO-in-Training program for two years. In September of 2023 I was promoted to my current role as CEO at Pinnacle Pointe.

AH: You currently serve kids and teens with mental health needs. Do you see a change in our youths’ mental health trends post-COVID? CB: We see a lot more anxiety, and a deeper level of anxiety, than we did before the COVID pandemic. Kids’ access to and use of phones and social media pre-COVID was a problem, but now it is becoming a crisis. During COVID, use of phones, the internet, and social media became not just a means for providing kids’ educational needs, it became their social lifeline, the norm for their communication with friends and distant family members.

Today’s youth – and even adults – feel an intense need for remaining connected, and the anxiety that results when they’re not constantly checking their phones and social media is real. Why is this? They’re afraid they’re missing something, afraid they are being left out if they don’t check constantly for messages and updates.

This need for constant “checking in” is leading kids – and adults – to suffer anxiety attacks. They can become distraught if they are disconnected from their social media outlets, whether on a phone or computer.

This is anxiety added to what we used to consider to be the “normal” challenges from social media: bullying, comparing the self to others, confidence-building, self-esteem. Kids, postCOVID, have a palpable “need” for social media connection.

ARKANSAS HOSPITALS | FALL 2024 35

Courtney Bishop and her husband, Brian Carney, with their children: Audrey and Jackson Bishop.

36 FALL 2024 | ARKANSAS HOSPITALS

AH: How do parents and guardians fit into this picture?

CB: Kids’ need for social media connections can cause parental distress, too. It’s hard to gauge what sites are safe, how much screen time is healthy, what each individual child’s needs may be. It’s hard to experience their children’s distress when, say, a parent blocks or restricts access. “But all my friends are on Snapchat, and I’m left out if I don’t have it…”

Dealing with social media access is a new side of parenting that brings with it stresses for both parents and children.

AH: What are some practices you see that parents can put into place to reduce their children’s social media addictions and resulting anxieties?

CB: Setting screen time limits is a big factor. Not allowing screen time for several hours before bedtime helps. Phones should charge overnight in a room away from the child’s access, and parents should constantly monitor their children’s internet activity. This can be hard. Even if you make use of parental control apps that alert you to sites your child is visiting – and I mean apps above and beyond those that are built into today’s phones – your children can still have exposure to inappropriate material if their friends gain access.

There’s a current campaign called “Wait Until 8th” that urges parents to wait until a child is in the eighth grade to provide them with their own phones and social media access.

But many parents provide phones to their children at much earlier ages. Phones are pervasive.

One thing we can unequivocally state: When phones are removed completely, as they are in the clinical setting, kids often display a sense of relief when they are not constantly checking social media.

LEADERSHIP Q/A WITH

COURTNEY BISHOP

Pinnacle Pointe Behavioral Healthcare is located in Little Rock. Its welcoming lobby with child-friendly murals seeks to instantly put young patients at ease.

What is the best advice you were ever given?

Leadership is not a position or a title, it is action and example.

What do you like to do in your down time?

Walk my dogs, listen to audio books, and travel – I believe that traveling and seeing the world is the greatest way to learn and grow.

Who is someone you greatly admire, and why?

Our patients. A lot of the kids that we see have had to grow up too quickly or have learned unhealthy ways to cope. But they keep trying to make connections, they are resilient, and they are all able to learn and grow.

It may take time, but they are all smarter and stronger than they realize.

What would you be doing if you weren’t in health care?

Teaching, most likely on the college level. I taught as an adjunct professor at Ouachita Baptist University for a few semesters in the psychology department. I love learning and I love sharing knowledge with others. One of the things I loved best about the graduate program at George Washington University was the opportunity to mentor or work with students in the Master’s of Counseling program. I really enjoy teaching and helping others to find ways to grow.

What’s on your desk right now?

Way too much paper and always about 4-5 cups and water bottles.

Where would you travel if you could go anywhere?

I cannot possibly narrow it down to just one place. I want to travel everywhere. The beach is always a favorite destination for relaxation, but I love places that are rich with history and art also.

What is the most valuable lesson COVID taught you?

How to adapt quickly. I think that we would all agree that the information and protocols were changing as fast as we could implement them. We had to be resourceful and flexible.

AH: What are some of the other trends you are noticing, post-COVID? CB: Symptomologies are more severe. The LEVELS of anxiety, acting out and anger are much higher. Parents are hesitant to admit their children for mental health treatment because of the stigma they feel this may create. But they need to realize that their kids will not be labeled as bad kids, they are simply kids who have medical needs, and that treatment can help them live better, happier lives.

AH: How well do the physical health and mental health communities work together for kids in Arkansas?

CB: I think the behavioral health community is tightly knit and that mental health providers throughout the state work well together. Hospitals collaborate with mental health providers, too. This is a bond that certainly strengthened during the pandemic. That was a time when we all helped one another as we begged, borrowed, and shared resources across normal boundaries. Today, hospitals and mental health providers focus on information sharing and relationship building. We used to be more siloed and competitive by nature; now, the attitude is, “Let’s work together to help our patients get what they need.”

AH: What self-care practices does Pinnacle Pointe provide to help its employees maintain optimal mental health? What are some self-care practices you would suggest that the hospitals of Arkansas provide for their employees?

CB: A lot of hospitals are trying hard to provide flexible scheduling for their staff members, which can be difficult when you are scheduling 24/7. This can be a particularly helpful practice for our employees, resulting in a big improvement in morale. When people have a

ARKANSAS HOSPITALS | FALL 2024 37

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variety of shifts to choose from, they can schedule their work around other responsibilities – taking care of children, older relatives, the normal business of daily life – this helps them take better care of themselves. We also really try to work with our employees when their life circumstances change in order to retain them. This is not always possible, but our leaders go above and beyond to make it work when we can.

Hospitals, including Pinnacle Pointe, also offer Employee Assistance Programs, or EAPs. Through these programs, mental and behavioral health counseling are offered, sometimes on-site.

At Pinnacle Pointe, we also offer hospital-wide training in TraumaInformed Care. This is training provided to every person who works in the hospital, from food service and maintenance to office and professional staff. This helps each of us provide the best of care to our patients, and gives us training in mental health self-care, as well. We offer guidance in how to move forward and address trauma in our lives, moving from the old model of “What’s wrong with you?” to the model of asking, “What happened to you?” It’s a paradigm shift that is necessary and so helpful. We need to make this shift in thinking in society in general as well, to offer one another grace and understanding and a move toward improved mental health.

AH: What is your greatest hope for those serving in the health care field today?

CB: As a CEO, my biggest goal is to help others – a goal most people in health care share. But I would challenge us to remember that each of us has the ability, every day, to bring positive change to the lives of our patients, coworkers, and those in the community whose lives we touch. We should remember this every day, and not take this responsibility lightly.

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COMMUNITY OUTREACH:

Arkansas Hospitals Share Their Successes

The AMMC Health Fair team at the Paragould Municipal Utilities Family Health Fair.

Arkansas Methodist Medical Center HOSTING INDUSTRY AND BUSINESS HEALTH FAIRS

Arkansas Methodist Medical Center (AMMC) is a leader in community health. Every year the AMMC health fair team provides free, on-site health fairs to local industries and businesses. Each year, around 8 – 10 industries hold annual health fairs hosted by AMMC and more than 2,000 industry and business employees attend these gatherings.

AMMC features 15 booths that showcase services, clinics, and providers. Attendees are able to speak with providers, make appointments at any of our clinics, and have the opportunity to receive free lab work. Some of the services featured at the AMMC Health Fairs are physical therapy, neurology, surgery, family practice, urgent care, women’s clinic, dermatology, stroke awareness, infection prevention, plastic surgery, inpatient rehab, social services, infusion services, diabetes awareness, mammography, and Alzheimer’s treatment. Attendees are able to speak with providers and make appointments on location. Lab work is provided at no charge to businesses, thanks to local grants.

The AMMC Health Fair team is proud to support our local community and help promote health care. Every year many lives are saved because of the testing and health care access provided by the hospital’s hosting of community health fairs.

40 FALL 2024 | ARKANSAS HOSPITALS

Lunch & Learn: Dr. Ron South, Neurologist at AMMC Neurology Associates, makes a presentation to community members regarding the differences between Alzheimer’s, other types of dementia, and how LEQEMBI is being used to slow the progression of Alzheimer’s.

Above: Bonnie Barnes and Jessica Nutt represent AMMC Neurology Associates at the Allen Engineering Health Fair.

Right: Kayla Coates and Yong Ko work the Cardiopulmonary booth at Paragould Municipal Utilities Employee Health Fair.

PROVIDING CUTTING-EDGE ALZHEIMER’S OUTREACH

Arkansas Methodist Medical Center (AMMC) is proud to introduce LEQEMBI (Lecanemab), a groundbreaking FDAapproved medication designed to slow the progression of Alzheimer's disease and improve the quality of life for patients and their caregivers.

AMMC is honored to be the first, and currently one in six hospitals in Arkansas to offer a comprehensive LEQEMBI program, distinguishing itself as a leader in advanced Alzheimer's care within the region. This program emphasizes our dedication to provide not only enhancements in patient care but also hope and support to those dealing with Alzheimer’s, positioning AMMC at the forefront of neurological health care services.

AMMC hosted an Alzheimer’s/Dementia Community Lunch & Learn in the spring with more than 75 people in attendance.

Dr. Ron South, AMMC Neurology Associates, presented on the difference on Alzheimer’s and Dementia and treatment options.

AMMC has also collaborated with the Arkansas Alzheimer’s Association to create a support group for caregivers. This support group is open to our community and is held on a monthly basis. AMMC is proud to offer this service to the community we serve.

"LEQEMBI is a significant step forward in Alzheimer's treatment, but it shouldn't detract from the importance of early detection and preventive measures," says Dr. Ron South, Neurologist at AMMC Neurology Associates. "Our comprehensive evaluation process helps us determine eligibility for LEQEMBI treatment, ensuring we can provide this innovative therapy to those who will benefit most."

For more information regarding AMMC and the LEQEMBI program, visit myammc.org. These articles on AMMC’s community outreach were provided by Tiffany Lidisky, Marketing Coordinator, and Tori Thompson, Director of The Foundation & Marketing.

Above: This photo was taken January 2, 2024 at the first LEQEMBI infusion to take place at AMMC. Pictured are some of the team members who were involved in the development of the LEQEMBI program. From left to right: Michelle Kemmett (RN for Dr. South), Brandi Hyde (APRN at AMMC Neurology Associates), Dr. Ron South (Neurologist at AMMC Neurology Associates), Jessica Nutt (APRN at AMMC Neurology Associates), Bonnie Barnes (RN at AMMC Neurology Associates), Stan Carmack (PharmD, Director of Pharmacy at Arkansas Methodist Medical Center), Sarah Newberry (PharmD, Assistant Director of Pharmacy at Arkansas Methodist Medical Center), Grace McKenzie (RN, Director of Infusion Services at Arkansas Methodist Medical Center), Justin Davis (CRNA), and Tiffany Lidisky (Marketing Coordinator at Arkansas Methodist Medical Center).

ARKANSAS HOSPITALS | FALL 2024 41

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Mercy co-workers volunteer at the Community Rescue Mission in Fort Smith.

Mercy Awards Outreach Grants in Arkansas

M

ercy, one of the 20 largest health systems in the United States and which operates seven hospitals and two rehabilitation facilities in Arkansas, is providing half a million dollars in grants to nearly 30 organizations serving children and elderly, homeless and uninsured people across five states, including several in Arkansas.

The purpose of Mercy’s grants is to provide support for community-based programs consistent with Mercy’s mission and vision that are aligned with an identified community health need. Mercy Caritas (Latin for “charity”) is in its 36th year. In Arkansas, nonprofit programs in Fort Smith, Rogers, and Springdale received funds through Mercy Caritas, as did programs in Conway and Hot Springs.

“This year, there was a special emphasis in each community to align Mercy’s strategic partnerships with those organizations that assisted in a particular manner to meet the social determinants of health,” says Kevin Minder, Mercy senior vice president of mission and community health and Caritas committee chairperson. “As we know, we find much value for our patients most in need when we can meet their non-clinical needs in addition to their traditional health care experience.”

Of the $500,000 being awarded, $450,000 are in Mercy Caritas grants, while $50,000 in grants were awarded to Sisters of Mercy working directly to serve people in poverty.

This funding will impact more than 200,000 people.

“Health care starts with a person’s basic needs, including routine access to food and shelter,” says Father Paul Fetsko, vice president of mission for Mercy Arkansas Communities. “These grants will help those who are underserved continue to find the support they need through local organizations that work to meet their immediate needs while helping them create goals toward a more self-sufficient lifestyle.”

Organizations receiving outreach grants in Arkansas include: • Community Rescue Mission (Fort Smith) – The mission fosters healing and resilience within homeless families by addressing their unique mental health challenges in a safe and supportive environment. Through a team of dedicated therapists and counselors, the mission provides group, individual and family personalized therapy sessions.

• The Next Step Homeless Services (Fort Smith) – Next Step provides safe housing and case management services for homeless women and children in coordination with an existing housing program in a group home.

• Riverview Hope Campus (Fort Smith) – Riverview Hope is a structured program meeting the immediate needs of area residents and the unhoused in the community. The program meets individuals right where they are and works to lower the immediate barriers they are facing that prevent them from becoming self-sufficient.

• Samaritan House Community Center (Rogers) – The house’s focus on health, hunger, and hope centers on the understanding of the social determinants of health and their impact on marginalized, low-income Northwest Arkansas families. Identifying barriers to success and creating pathways for equitable access to services is critical for helping these families experience lasting positive change.

• Children’s Safety Center (Springdale) – The center provides financial assistance, when necessary, for items such as rent, utilities, groceries, gas cards, and personal needs, as well as emotional support for child abuse victims and their non-offending family members.

Other funding in Arkansas will support The Free Store Storefront in Conway, along with the Cooper-Anthony Mercy Child Advocacy Center and St. John’s Catholic School, both in Hot Springs.

ARKANSAS HOSPITALS | FALL 2024 43

COACH'S PLAYBOOK

Creating a Culture of Continuous Improvement

and Innovation Through Leadership

By Kay Kendall

W

hen you walk into your organization, what do you feel? Do you feel a sense of energy, or do you feel a sense of “same old, same old?”

What accounts for the difference in these two cultural atmospheres?

Put simply, it is employee engagement and work that has meaning.

Having mentored 24 Baldrige Award recipients and even more Gold Award recipients (through the Baldrige-based award AHCA/NCAL National Quality Award Program for long-term care), we at BaldrigeCoach can attest to the palpable, energetic cultures these nationally recognized organizations emanate.

LEADERSHIP THAT MAKES A DIFFERENCE

Aside from achieving exceptional results in the areas of quality and beyond, what makes these organizations stand out? They have in place a visionary leader with a relentless focus on excellence.

Some of these leaders are charismatic, and some are introverts, so 44 FALL 2024 | ARKANSAS HOSPITALS

it isn’t an issue of personality as it relates to leadership style. Excellencefocused leaders are role models whose behaviors reinforce the mission, vision, and values of their organization, and they constantly inspire their employees to bring their hearts, minds, and hands to work.

Some concrete ways of promoting excellence may seem simple: Invest in your workforce by providing training on quality improvement and problemsolving tools and methodologies. Encourage staff members to offer ideas, take intelligent risks, and improve the way that work is done. As lifelong learners themselves, these leaders promote the personal and professional development of others. They encourage continuous improvement and innovation by making data available for use in fact-based decision making.

They also use rewards and recognition to reinforce a focus on excellence.

Are you employing these techniques as you lead your health care organization today? What would happen if you committed to one or all of these?

ROUNDING WITH PURPOSE

Another practice employed by many dynamic leaders, even those not in health care, is rounding (with your employees) with purpose. You can up your rounding process by adding one (or all) of these three questions to your own rounding: Are you able to perform your job 100% of the time with no errors or rework? If not, what gets in the way? (And how can I help you remove those barriers?)

How much of your job is value-added? (The customer cares about it, it changes the product or service, and is consistently done right the first time?) How could you eliminate or significantly reduce the non-value-added portion of your work?

What would your “customers” – those impacted by or receiving the benefits of your expertise – say about the quality of your services or products?

As a leader in the health care field, are you committed to pursuing excellence? What can you do to bring your employees along on the performance excellence journey?

The team at BaldrigeCoach would be glad to help guide your hospital’s quest for process improvement.

As CEO and Principal of BaldrigeCoach, Kay Kendall coaches organizations on their paths to performance excellence using the Malcolm Baldrige National Quality Award Criteria as a framework. Her team, working with health care and other organizations, has mentored 24 National Quality Award recipients. In each edition of Arkansas Hospitals, Kay offers readers quality improvement tips from her coaching playbook.

Contact Kay at 972.489.3611 or Kay@Baldrige-Coach.com.

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Join us at the upcoming Baldrige Fall Conference.

You’ll discover best practices and lessons learned from recipients of the Baldrige National Quality Award. And, you will have an eye-opening experience with lots of networking opportunities.

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Scan here to learn more.

ARKANSAS HOSPITALS | FALL 2024 45

HEALING THE HEALERS:

Arkansas Medical Foundation's Support for Health Care Professionals

T

hroughout their training and practice, health care professionals learn to set aside personal challenges and focus on patient care. While this approach helps them prioritize patients, it can also lead to neglect of their own wellbeing and affect their ability to care for others.

The simple truth: Health care professionals must take care of themselves in order to effectively care for their patients. This need highlights the importance of support programs that help physicians, nurses, and other caregivers deal with personal challenges while continuing to provide high-quality health care to their patients.

The Arkansas Medical Foundation (AMF) provides a specific health program to ensure the safety and well-being of Arkansas health care professionals and the patients they

46 FALL 2024 | ARKANSAS HOSPITALS

By Alex Joseph and Eldrina Easterly serve. While the program was originally focused mainly on physicians, AMF now extends its services to all health care professionals.

AMF offers assistance to health care professionals struggling with: • Substance abuse.

• Stress and burnout.

• Boundary problems.

• Self-destructive behavior.

• Mental or emotional illness.

AMF is led by medical director Dr. Brad Diner, a psychiatrist with 35 years of experience. Dr. Diner is boardcertified in forensic psychiatry, and, in that capacity, he has been called upon to perform fitness of duty evaluations for professionals. That led to his employment as medical director for AMF roughly 15 years ago.

AMF is dedicated to supporting health care professionals and striving to overcome the stigma of reaching out for assistance by providing a

confidential, safe space for seeking help. “We understand the unique health concerns faced by health care professionals and the intense pressure they face when providing patient care – where errors are not an option,” Diner says. “AMF is here to help them access the confidential support they need while safeguarding the health and safety of the patients they serve.”

VOLUNTARY AND NON-VOLUNTARY REFERRALS

Health care professionals can access resources through the AMF to address concerns related to substance use disorders, mental health, and other behavioral issues that may affect their ability to practice safely. According to the American Addiction Centers, 1015% of doctors will develop a problem with substance abuse at some point in their careers.

The Arkansas Medical Practices Act enables AMF to provide confidential assistance to struggling health care professionals without notifying the medical board. As long as the provider follows the specifications of their care plan and AMF can guarantee their fitness to practice through ongoing monitoring and evaluation, that provider will not face disciplinary action with the board.

"Only about 50% of those who come to us for help do so voluntarily,” Diner explains. “The rest are sent to us through referrals by hospitals, physician partners, nurses, clinical staff, or even spouses."

Every hospital in Arkansas is required to have a physician health program, and AMF fulfills this requirement.

Unfortunately, some hospitals in rural Arkansas may hesitate to refer out of fear of losing a practicing physician, but the consequences of allowing an impaired physician to continue practicing far outweigh the loss of a physician’s availability. Dr. Diner estimates there are around 700 health care professionals in Arkansas who struggle with substance abuse.

Health care professionals monitored

by AMF are significantly less likely to face malpractice lawsuits due to the pressure and scrutiny they endure.

Dr. Diner highlights the importance of referring impaired doctors to the appropriate channels for assistance to ensure their ability to practice responsibly, thus minimizing potential liabilities for their hospitals.

PERSONALIZED CARE PLAN FOR EACH PROFESSIONAL

When a professional agrees to get help, an independent evaluation is recommended and the individual meets with Dr. Diner. “I make my initial recommendations and then may request a more comprehensive assessment from a specialized physician evaluation and treatment facility outside of Arkansas,” he explains.

These outside facilities perform multi-day assessments, including psychiatric, medical, and addiction evaluations, collateral interviews, and lab and neurological testing. They then provide AMF with a report including recommendations and a treatment plan for the professional to follow.

The treatment plan may require outpatient or inpatient treatment for the individual. “Three-month

inpatient treatment is not unusual for a significantly impaired, alcoholdependent physician, for example,” Dr. Diner said.

Once the individual has completed their treatment plan, they enter a contract with AMF for monitoring their practice. Standard contracts typically last for five years and may include a variety of required guidelines.

According to Dr. Diner, “As long as an individual follows our monitoring guidelines, and most do, there is very little relapse. Practice is only limited if the personalized plan recommends inpatient treatment.”

Upon completion of the contract, many physicians express gratitude to AMF for safeguarding their careers and even saving their lives. Dr. Diner encourages health care professionals in need to reach out for assistance. AMF is available around the clock. The foundation's work has the power to positively change a health care professional's trajectory and confidentiality is always paramount.

Alex Joseph is a Technical Writer and Eldrina Easterly serves as Vice President, Communications and Strategy, with the Arkansas Foundation for Medical Care. To reach the Arkansas Medical Foundation, you may call 501-224-9911, email director@ arkmedfoundation.org, or visit the AMF website: www.arkmedfoundation.org.

ARKANSAS HOSPITALS | FALL 2024 47

ADULTS

YOUTH

nearly

MENTAL HEALTH IN 50,000,000 TAL HEALTH MENTAL IN HEALTH AMERICA IN AMERICA 2,700,000 MENTAL HEALTH IN AMERICA AMERICA

youth are experiencing severe major depression

are experiencing a mental illness

ADULTS 2,720,000 ADULTS ADULTS ADULTS

YOUTH 16.39%YOUTH YOUTH YOUTH

of youth (age 12-17) report suffering from at least one major depressive episode (MDE) in the past year

are experiencing a severe mental illness nearly nearly

2,700,000 2,700,000 youth are experiencing youth are experiencing

nearly 50,000,000 report a substance 0,000,00050,000,000 50,000,000

arly

youth are experiencing youth are experiencing severe major depression severe major depression

2,700,000 2,700,000 During the COVID-19 Pandemic

15.3%2,720,000 2,720,000 ,720,000 2,720,000 6.82% 10.96% are experiencing a mental illness are experiencing a mental illness

severe major depression severe major depressio

useexperiencing disorder e experiencing a mental are illness a mental illness

16.39% of youth

ofyouth youth of (age 12-17) 2020 - 2022 (age 12-17) of youth report suffering from atleast leastone one major report suffering from at major depressive episode (MDE) in the past year (age 12-17) (age 12-17) depressive episode (MDE) in the past year

16.39%

are areexperiencing experiencingaasevere severemental mentalillness illness

e experiencing a severe are experiencing mental illness a severe mental illness have an alcohol use have an illicit report reportaasubstance substance disorder drug use disorder

15.3% 15.3%

use usedisorder disorder

15.3%

15.3% 10.96% 10.96%

report a substance report a substance use disorder use disorder

6.82% 6.82%

12,100,000 adults 10.96% 10.96% 6.82% 6.82% have haveananalcohol alcoholuse use disorder disorder

16.39% 67%

55%

report suffering fromreport at least suffering one major from at least one major depressive U.S. episode (MDE) depressive in the episode past (MDE) experienced in the past year high school students year some reported schoolwork emotional abuse in During the COVID-19 Pandemic During the COVID-19 Pandemic 2020 2022 was more difficult the home 2020 - 2022

During the COVID-19 During Pandemic the COVID-19 Pandemic

67%2020 - 2022

have havean anillicit illicit drug druguse usedisorder disorder

24%

U.S. high high school schoolstudents students U.S. reported schoolwork reported schoolwork reported they did not was more moredifficult difficult was

67%

report serious thoughts of suicide

55% 55%

11%

2020 - 2022

experiencedsome some experienced emotionalabuse abuse emotional inin experienced thehome home the

67% 55%

55%

have enough food to eat physical abuse ave an alcohol use have an alcohol have an useillicit have an illicit U.S. high school students U.S. high school experienced students some experienced s disorder disorder drug use disorder drug use disorder reported schoolworkreported schoolwork emotional abuse in emotional abu adults adults was more difficult was more difficult the home the home

12,1100,000 00,000 12,

24%

reported reportedthey theydid didnot not have have enough enoughfood foodto toeat eat

28,000,000 5,500,000 12,100,000 adults 12,100,000 adults reportserious seriousthoughts thoughtsof ofsuicide suicide report

11% 11%

experienced experienced physical physicalabuse abuse

24%6.34% 24% 11%

report a substance individuals with mental with a mental illness use disorder illness receive no treatment are uninsured experienced not report serious thoughts report of suicide serious thoughts of suicide reported they did notreported they did report aasubstance have enough food to have eat enough food physical to eat abuse report substance

28,000,000 28,000,000

5,500,000 5,500,000

6.34% 2.85%

11%

experience physical abu

4.85% 28% 2.85% 4.85% 4.85% 28% 8,000,000 28,000,000 5,500,000 5,500,000 28% 6.34% 6.34% 1,200,000 2.85% 2.85%4.85% 4.85% 1,200,000 1,200,000 28%350 3501 1 350 1 60% 60% 60% individualswith withmental mental withaamental mental illness illness individuals with of allillness adults with no ano mental illness report that they illnessreceive receive treatment are uninsured treatment are uninsured

use usedisorder disorder

were not able to receive the treatment they need

adultswith withaamental mentalillness illnessreport reportthat that they they ofofallalladults were not able to receive the treatment they need were not able to receive the treatment they need

have an alcohol use disorder

viduals with mental individuals with with mental a mental illness with a mental illness ess receive no treatment illness receive are no treatment uninsured are uninsured Individuals needing treatment for a mental illness outnumber mental health providers

have an illicit drug use disorder

have an alcohol use haveaan illicit a substance report have report an alcohol use have substance an illicit disorder drug use disorder use disorder use disorder disorder drug use disorder

youth with private insurance do not have coverage for mental or emotional difficultie youth with private insurance do not have

Individuals needing treatment for a mental illness Individuals needing treatment for a mental illness outnumber mental health providers of all adults with a mental of all adults illness with report a mental that they illness report that they outnumber health providers tomental

youth with private insurance do not have coverage for mental or emotional difficulties

mental oran emotional were not able to receive were the not treatment ableto to receive they need the treatment they have need an alcohol use coverage have anfor alcohol have use illicit difficulties have an illicit to disorder disorder drug use disorder drug use disord of youth with major depression do not of youth with major depression do not receive mental health treatment of youth with major receive mental healthdepression treatment do not

dividuals needing treatment Individuals forneeding a mentaltreatment illness for a mental illness outnumber mental health outnumber providers mental health providers

350 1 to

350 1 to

receive mental health treatment

1,200,000 1,200,000

youth with private insurance youthdepression with do private not have insurance do no Only 28% of youth with severe Only 28% of youth with severe depression coverage for mental or coverage emotional for mental difficulties or emotional d Only 28% of youth with severe depression receive some consistent treatment (7-25+ visits in a year) receive some consistent treatment (7-25+ visits in a year) receive some consistent treatment (7-25+ visits in a year)

60%

60%

All information is from the 2023 State of Mental Health in America Report by Mental Health America, www.mhanational.org

of youth with major depression of youth with do major not depressio

All information is from the 2023 of Mental HealthininAmerica America Report Mental Health America, www.mhanational.org All information is from the 2023 StateState of Mental Health Reportbyby Mental Health America, www.mhanational.org receive mental health receive treatment mental health treatme

48 FALL 2024 | ARKANSAS HOSPITALS

Only 28% of youth with Only severe 28%depression of youth with severe depression

What does it mean to be taken care of?

At Arkansas Blue Cross and Blue Shield, it means providing peace of mind. We’ve been taking care of Arkansans for over 75 years, providing affordable, reliable health insurance … to keep Arkansans healthy and to help them heal. We’re investing in communities to keep this diverse and wonderful state strong. We’re committed to a whole person approach to health, including physical and behavioral well-being. And we recognize that total health is influenced by many factors, including medical history, genetics, lifestyle, environment, nutrition, safety and physical activity. We also realize that it will take all healthcare providers working together to ensure future generations of Arkansans can live their best life their whole life long. Let’s take good care, Arkansas.

00845.01.02-1123

ARKANSAS HOSPITALS | FALL 2024 49

LOOKING FORWARD TO THE NEXT 75 YEARS OF

building places for healing

For 75 years, Nabholz has upheld our purpose: Grow our people. Serve our clients. Build our communities.

Our extensive work on healthcare facility projects aligns with just that by giving medical professionals and the surrounding communities the tools they need to succeed.

LOOKING FORWARD SINCE 1949 1.877.NABHOLZ | nabholz.com