Page 1

Mental Health Matters


Fall 2016

The Mind Body Connection The Value of Integrated Care Meet some of our mental health providers dedicated to integrated care

The Emotional Side of Pregnancy


During the past decade, healthcare professionals and organizations have begun to recognize the value of addressing their patients’ physical and mental health needs in one location. Many family medicine offices now offer therapy and/or medication management with a professional counselor, psychiatric nurse practitioner or even a psychiatrist. Specialty practices are also making it easier for their patients to receive mental health treatment in the same place that they receive cancer, cardiac or other specialty care.

the Value of

Integrated Care Patient benefits from this integration include accessibility, convenience, compliance and better outcomes as discussed by five Centra providers in the next few pages. (click on the provider’s photo for more information)


Mental Health Matters

The mind/body connection The brain and body have a significant and important connection. The body sends the brain signals in order to influence decision making and the brain sends the body signals to respond. When a person experiences a stressor, it is a natural and normal response for the parasympathetic nervous system to get triggered. When this happens, the heart beats faster and breathing becomes more shallow and rapid. Adrenaline and cortisol are released in the brain, and the body prepares to give a response such as to run away (flight), fight or freeze. These responses are meant to protect us and to keep us alive. Interestingly, there are medical conditions that create similar body responses such as heart

Bailey Evans Licensed Professional Counselor Bridges Treatment Center


rate increase and rapid and shallow breathing. It is not unusual for the brain to become confused by these symptoms and create a low level of anxiety for a person. As the body works to communicate its experience to the brain, the brain is also working to make sense of the body’s experience. For example, when a person receives a diagnosis of a chronic, serious, and possible terminal disease, such as multiple sclerosis or cancer, it is well documented that there is a high correlation of signs and symptoms of anxiety and depression. This reaction may be due in part to the activation of the cycle of grief. Ultimately, one must grieve the loss of the future they believed they would have, the way their body would function, and come to some acceptance of his or her situation. Seeking help for the emotional distress associated with chronic illness is crucial to healing the body and the mind.

Mental Heallth Matters


IntegratedCare Michele Donoghue Certified Family Nurse Practitioner Centra Farmville Medical Center In my eight years as a primary care provider, I have found that patients in rural areas in need of mental health evaluation and treatment see their primary care provider first. In my practice, I often hear “why do I feel this way?” Or more troubling, “I know I need help, but I cannot find anyone who knows how to help me.” I see a comparable number of patients for mental health issues as I do for diabetes. Mental instability has a significant impact on every aspect of a patient’s health and well-being, so it is im-


perative to integrate mental health care into the primary care setting. This integration can help promote adherence to mental health treatment by mitigating the negative effects of social stigma associated with mental illness. It is crucial that primary care provid-

Maria Almond, MD Adult Psychiatrist CMGroup Piedmont Psychiatric Center at Farmville Medical Center When I was opening my psychiatric practice two years ago, I learned that a new primary care center under Centra leadership was in the works. I knew right away that I wanted to be there working with primary care providers whose patients often present with mental health issues. Being embedded in the center allows me to be part of the primary care team. It automatically signals to our patients that we are practicing whole person medicine—mind and body. For our patients, this means that mental health care is just a step away in a familiar place. We begin to decrease stigma when we treat mental health disease just like any other illness.


Mental Health Matters

ers, like myself, collaborate with mental health providers to promote optimal outcomes for our patients.


Chelsea St. Clair Licensed Clinical Social Worker CMGroup Piedmont Psychiatric Center Centra Stroobants Cardiovascular Center Research has shown that immediate access to mental health services in outpatient clinics significantly reduc-


es symptoms of anxiety and depression. As a provider for Centra Medical Group Piedmont Psychiatric Center, I am on site full-time at Centra Stroobants Heart Center and available for consultation with the heart specialists throughout the day. I also provide outpatient therapy in

Lakshman Gandham, MD Psychiatrist CMG Piedmont Psychiatric Center

the same location when needed. The goal is to improve overall quality of life for our patients.

Last year, I began providing psychiatric evaluations for individuals who would potentially undergo bariatric surgery for weight reduction. Obesity is a medical condition that has multifactorial etiology. In some patients, emotional


and psychological factors play a major role in behavioral patterns around their eating habits and distorted perceptions about food. My role is to assess individuals at the Centra Weight Loss Clinic for any underlying mental health/emotional issues that can impact their ability to progress and follow through with lifestyle changes. I also assess whether substance use disorder may be a factor. I provide assessments two days a week with feedback sent to the treatment team. I also participate in team meetings to provide input about how best to help patients with psychological issues. My involvement with bariatric patients has helped me learn about their challenges and the various ways to deal with weight issues. This knowledge benefits my psychiatric patients because I now know when to refer them to nutrition education or other programs focused on weight control.

Mental Heallth Matters



Centering CenteringPregnancy®, a group healthcare model designed to enhance prenatal care and education, has been shown to result in a wide range of benefits, including decreased preterm labor, increased birth weight and positive psychosocial effects. A voluntary program, CenteringPregnancy blends educational sessions with monthly exams. A group of eight to 12 moms-to-be with similar due dates meets for 10 two hour sessions, giving patients more time with certified nurse-midwives. After private, individual check-ups, the group members gather to discuss various aspects of pregnancy such as nutrition, exercise, common discom-

support for each other during their pregnancies and af-

forts, breastfeeding, staying safe, labor options, time

ter their babies are born.

management, balancing work with family responsibilities, difficulty adjusting to their new roles, and other fac-

“We primarily look at the physical benefits from Center-

tors that may contribute to depression and anxiety. Fa-

ing, but we are also finding that the psychosocial bene-

thers-to-be are also encouraged to attend the sessions.

fits are significant,” said Peggy Karpenske, RN, manager of Centra Medical Group Women’s Center. “Recent stud-

Being involved in Centering groups encourages rapport

ies have shown that women who participate in Centering

and strong relationships between the nurse-midwives

are more informed and less anxious,” she said, pointing

and their patients because they get to know each other

to a study by the Oregon Health & Science University

on a highly personal level, creating a bond that may not

School of Medicine. The certified nurse-midwives at Cen-

typically develop in the office setting. Women in the Cen-

tra Medical Group Women’s Center have been providing

tering groups create new friendships and provide

Centering groups for almost two years and recently


Mental Health Matters

earned site approval for model fidelity and quality assurance from the Centering Healthcare Institute in Boston. Nicole, a participant in one of Centra’s Centering groups, was diagnosed with depression when she was 17. Soon after, she became a teen mom. Fortunately, she had her mother to help out, but she was scared about her pregnancy and childbirth. She felt alone and needed to start taking antidepressants to help with her sadness and fear. During her latest pregnancy, Nicole became involved in the Centering group where she learned that she was not the only one who was afraid of what was to come.


Listening to other moms-tobe helped me with my fear and anxiety. We have fun and provide strong support for each other. (Nicole)

Mental Heallth Matters



Things that previously made me depressed do not do that any longer. I can cope better and have a much more positive attitude. (Nicole) They stay connected on Facebook where they post photos of their children and discuss issues. At their recent

reunion, the moms and dads talked about planning a family cookout in the park. And they always have the option of more reunions at the midwifery practice.

Nicole is dealing well with her depression these days. She attributes that change, at least partially, to the support she receives from the other members of the group.

“My family practice doctor said I was doing so well I could stop taking anti-depressants,” she added. “I now see the brighter side of everything.”


Mental Health Matters

Nicole and the other moms stressed the importance of the dads-to-be to also be involved in Centering. Not only can they relate to the other dads in the group, but it helps them to appreciate what their partners are going through. One new dad said, “It helped me to understand her perspective and what she needed from me.�

To learn more about Centering, click here or call 434.385.8948 Photo Credit: Foster & Asher

Mental Heallth Matters


CENTRAL VIRGINIA AUTISM RESOURCE FAIR Children's activities Resource and information booths Child Care Refreshments Free & open to the public Saturday, April 29, 2017 10am-1pm

To register or for more information 434-200-4447

Sponsored by

Centra Alan B. Pearson Regional Cancer Center 1701 Thomson Drive Lynchburg, VA 24501

Centra Mental Health Click on the photos for more information about our programs. For referrals or admissions, call the Mental Health Intake & Resource Center, 434.200.4444, 24 hours a day.

MENTAL HEALTH MATTERS Centra Mental Health Marketing 3300 Rivermont Avenue Lynchburg, VA 24503

About Produced by Centra Mental Health Services and Communications/ Marketing Department.

ADDICTION & RECOVERY Pathways Services offer comprehensive services for substance use disorders.

BRIDGES RESIDENTIAL Residential psychiatric treatment and educational services for boys and girls ages 6-17.

Adult ages 18-64

AUTISM & DEVELOPMENTAL Pathways Services offer comprehensive services for substance use disorders.

CMG PIEDMONT PSYCHIATRIC Outpatient practice with full spectrum of providers and services for people of all ages.

Child & Adolescent ages 5-18

For more information about the Mental Health Services division, please email or call 434.200.4447.

RIVERMONT SCHOOLS A therapeutic educational program for students, ages 5-22, with special needs, including autism.

Seniors ages 65+

ACUTE UNITS Short term inpatient care for those in crisis including deep depression, severe anxiety and suicidal tendencies and in need of immediate stabilization

Mental Heallth Matters


Profile for Centra - Mental Health Marketing

Mental Health Matters - Fall 2016