RN&R Health Guide 2019

pa g e 4

n

2

m e d i tat i o

9 1 0

living wi a n x i e t yt h pa g e 7

n av i g at t h e s y s tien g m pa g e 9

how to help

pa g e 11

Making Sense of

Mental Health

a special supplement to the reno news & review

Reno Behavioral Healthcare Hospital A New Community Resource for Mental Health and Substance Use Treatment

Reno Behavioral Healthcare Hospital opened its doors a little over a year ago with the promise to elevate the standard of care for mental health and addiction treatment. The new, 124-bed, 80,000 square foot state-of-the-art hospital is the first facility of its kind to open in the area in more than 35 years.

“Reno Behavioral Healthcare Hospital represents a new day for mental health

and addiction services. People have been seeking additional alternatives for their treatment that has been lacking for many years,” said hospital CEO Steve Shell. “We are proud to be able to help people who have previously had few places to turn.

Rather than being forced to look outside Reno for assistance, residents can now stay close to home while getting the help they need.”

Courage, Respect and Dignity Reno Behavioral Healthcare Hospital recognizes it takes courage to seek help. Every patient is treated with respect and dignity in a comfortable, safe and therapeutic environment.

Comprehensive Inpatient and Outpatient Services for Patients of all Ages: • Adult Inpatient Behavioral Health Treatment • Detox and Chemical Dependency • Specialized Programs for Youth • Transitions: Behavioral Health for Older Adults • Center for Eating Disorders • Outpatient programs addressing mental health and/or addiction for both adults and adolescents

If you or a loved one is struggling with mental health and/or addiction, call 775-393-2200 for a free and confidential assessment.

775-393-2200

www.renobehavioral.com 6940 Sierra Center Pkwy Reno, NV 89511

2

RN&R Health Guide

09.19.19

A speciAl supplemeNt to ReNo News & Review

1

20

9

It’s all in your head

W

elcome to the Reno News & Review’s 2019 Health Guide. The above statement, “It’s all in your head,” might be a familiar chorus for anyone living with mental health issues—or even just negative thoughts from time to time. Maybe it was said by a loved one, someone you opened up to in hopes they could relate.

Maybe you said it to yourself, hoping to assuage the panic that sets in when considering the idea that your thoughts are not your own. Or maybe, if you’ve been spectacularly let down—as many have—by our country’s public and private health care systems, you’ve even heard it from a health care professional.

But simply because a disease manifests “in your head” doesn’t make it imaginary— the real world effects of PTSD, anxiety and depression, psychosis and trauma are all too real for too many Americans. That’s why this guide tackles issues that are familiar to many but never seem to be discussed.

Coping with the everyday stresses of our chaotic world are enough of a challenge to even “healthy” minds, let alone those with a diagnosable issue. To both, however, help can be found in the emerging science behind meditation’s effects on the physical structure of our brains. Check out Andrea Heerdt’s piece on page 4 for a primer on this theory and some advice on how to start meditating yourself.

Of course, to those affected by a mental condition, the best advice comes from those who can relate personally. To that

end, contributor Ashley Warren details her own struggles with Generalized Anxiety Disorder on page 7.

To many who need help, however, diagnosis and treatment can be a long, painful process—one made worse by the numerous barriers to finding care in a model that puts profits before patients. On page 9, Editor in Chief Brad Bynum spoke with a mental health professional about navigating the system’s many pitfalls.

Finally, if you’ve been lucky enough to be unaffected by the issues listed above, it’s almost certain that you know someone who has. Whether its a friend or complete stranger experiencing a psychotic episode or just not being themselves, offering help can be complicated—but sometimes necessary. Temi Durojaiye spoke with the experts and lists some resources on how to find the care needed for a mental health crises on page 11.

In the past decade specifically, study after study has come to a similar conclusion: Americans are not well. The current administration touts mental health care as a priority for curbing tragedies like veteran suicide, youth depression and the epidemic of mass shootings—while simultaneously cutting funding for these services. Until systemic issues are addressed, knowledge will be our community’s first-aid, and I hope that’s what you’ll find here.

Best regards, Matt Bieker Special Projects Editor 09.19.19

RN&R Health Guide

3

H e a LT H G U i D e

Finding

oM How meditiation changes your brain

by AndreA Heerdt

M

editation to reduce stress and anxiety has become an increasingly popular mental exercise practiced in the United States in recent years.

Perhaps you’ve observed someone meditating on TV or have seen a tranquil looking yogi with her eyes closed in a publication (like this one) with her hands in a prayer posture and thought, “That’s nice, but meditation just isn’t for me.”

The reality of meditation is that it isn’t just for a hippies or seekers of enlightenment, and when practiced regularly, meditation has been found to change brain activity and brain structure, according to a Harvard University study.

Associate Researcher in Psychiatry at Massachusetts General Hospital and Assistant Professor in Psychology at Harvard Medical School, Dr. Sara Lazar. has been documenting the effects of meditation in the human brain since 2014.

During a TEDx Talk, Lazar talked about her first experience with yoga and meditation. She remembers going to a yoga class for the first time simply to stretch and exercise when the instructor began to speak about how a yoga and meditation practice will increase compassion and open up your heart.

Initially, Lazar disregarded her teacher’s claims until a few weeks later when Lazar began to notice the effects of her practice in her daily life. She felt calmer and better able to handle stressful

4

RN&R Health Guide

09.19.19

situations, yet Lazar still didn’t know if these feelings were simply a placebo based on what her teacher said.

Lazar discovered previous research that found meditation decreases stress, reduces symptoms of depression, anxiety, pain and insomnia, increases the ability to pay attention and increases overall quality of life.

Lazar found these changes from meditating were linked to “It essentially neuroplasticity: feels like a doing something over and over returning to home again to create when I meditate—a changes in the place where I don’t have brain. When something is to do anything. I am repeated over simply just allowed to and over again, be.” the neurons became change how they Kelly aguilera larger, talk to each other, YoGa inSTrUcTor including she said. These the left hippochanges are not only campus, which evident from feedback is responsible for stated from test subjects, emotional regulation, but changes in neuroplasticity learning and memory. can also be observed with a Magnetic In the temporo-parietal junction, the Resonance Imaging scan (MRI), accordpart of the brain responsible for perspecing to Lazar. tive taking, empathy and compassion, PUT To THe TeST there was also an increase.

In the amygdala, the area of the To conduct a study for herself, Lazar brain responsible for the fight or flight found a group of people who had never response, there was a decrease in grey meditated before and scanned their brains matter, which Lazar believes directly with an MRI machine. She then enrolled correlated with a decrease in stress. her subjects in an eight-week stress “The more stress reduction people reduction program where they were told reported, the smaller the amygdala to meditate for 30-40 minutes every day. became,” she said.

At the end of the eight weeks, Lazar The study subjects didn’t undergo conducted the brain scans again and any other changes in their environments found that several areas of the brain

A speciAl supplemeNt to ReNo News & Review

during their eight-week trial, meaning they continued to experience the same stressful situations at work and with family that they had before.

Lazar’s concluded that changes to the amygdala were instead due to changes in how people learned to react to their environments and manage stress internally, specifically through meditation.

G e n e r aT i n G z e n Holly Hazlett-Stevens, Ph.D., is an associate professor of psychology at the University of Nevada, Reno. Her current research includes identifying specific brain mechanisms responsible for observed meditation effects, as well as developing “mindfulness” training programs that enhance the well-being of service professionals.

“Mindfulness” as defined by the American Psychological Association

Making Sense of Mental Health

P r ac t i c e M a k e S Perfect

Kelly Aguilera practices meditation at The Studio where she teaches yoga and mindfulness.

Courtesy/Kelly AguilerA

is “a moment-to-moment awareness of one’s experience without judgment. In this sense, mindfulness is a state and not a trait ...” meaning that it can be achieved through practice and people are not born inherently “mindful” or otherwise.

In a recent article titled “Dispositional Mindfulness and Neural Correlates of Affect Regulation” Hazlett-Stevens cited studies conducted by neuroscientists that showed practicing mindfulness leads to decreased negative emotion when faced with negative self-beliefs.

“A growing body of psychological research links dispositional mindfulness to increased emotional well-being and happiness coupled with lower levels of perceived stress, depression, and anxiety,” she wrote in her conclusion.

Linda Marie

Preliminary science supports the benefits of meditation on an emotional level, yet learning how to practice meditation can be confusing or even intimidating to some.

Kelly Aguilera has been a yoga teacher in Reno for seven years. She teaches a variety of classes, including yin yoga (a style of yoga involving holding postures for long periods of time), breathwork and meditation, and vinyasa flow, focusing on the movement of the body through a sequence of postures.

She’s also a yogi’s yogi, teaching classes for those training to receive their instructor certification as well.

Aguilera describes meditation as the act of quieting the mind and tuning in to the present moment, and when teaching meditation to new students, she said it can be overwhelming to some because they worry they may not be meditating correctly.

“It can be very difficult for beginners to quiet the mind, and for some it can lead to some anxiety, or even sitting alone with your thoughts can be very intimidating,” she said.

In order to not get overwhelmed, Aguilera recommends starting small.

“First, just a simple awareness of the breath,” she said. “Notice the inhale and exhale, and see if you can deepen and lengthen each, working on filling and emptying the lungs, but we aren’t forcing breath in or out.”

From the initial breathing sequence, Aguilera said different techniques resonate with different students. She said repeating a mantra like “inhale, exhale,” is nice for some, while others might prefer to count the number of seconds it takes to inhale or exhale. For beginners looking for a more structured practice, Aguilera said square breathing—which is inhaling, retaining the inhale, exhaling and retaining the exhale for the same number of seconds—is also helpful.

Focusing on the sensation of your breath gives you something to concentrate on instead of trying to think about absolutely nothing. If your mind begins to wander during your meditation, it’s important not to beat yourself up over it as it’s a natural reaction at first. Gently guide

Urban LOtUs PrOject Presents

Teen Chill Lounge

Massage Therapy

By Appointment Only NVMT#6457

at Midtown Community Yoga 600 s. Virginia street

SunDaYS at 3pM Relax, unwind and prepare for the week ahead.

Teen Chill Lounge is a mellow 60-minute yoga and meditation class for teenagers.

No experience necessary.

Free - Donation optional

Mention this ad & receive 20% off

775.525.7077

142 Bell St. Ste. 2D, Reno

your mind back to your breathing and repeat if necessary.

Aguilera said there are many apps out there that keep time while you’re meditating, or even lead guided meditations.

However, she recommends placing your phone more than an arm’s reach away from where you are sitting or lying so it’s not a distraction.

“It essentially feels like a returning to home when I meditate—a place where I don’t have to do anything. I am simply just allowed to be,” Aguilera said When it comes to how often you should practice, Aguilera said every day is ideal but, of course, not always possible. If extended, 30-40 minute sessions aren’t feasible—or even useful to everyone—Aguilera recommends just making a daily habit of checking in, taking a moment of silence and a few intentional breaths. Even a few minutes a day can jumpstart the neuroplasticity mentioned in Lazar’s work, and whether it’s half an hour in a candle lit yoga studio, or just a few minutes at your office desk, a few moments to yourself are always in reach. □

+ www.urbanlotusproject.org | www.midtowncommunity.yoga

• Essential Oils • Bulk Herbs & Teas • Herbal Extracts • Homeopathics • Supplements • Special Ordering • Medical Bottles Knowledgeable Staff Serving You Since 1982

Your complete Source of Quality Herbal Products 786-8814 • 1170 S. Wells Ave. • Reno 09.19.19

RN&R Health Guide

5

6

RN&R Health Guide

09.19.19

A speciAl supplemeNt to ReNo News & Review

H e a lt H G U i d e

Calm

Living with Generalized Anxiety Disorder b y A S h L e y WA r r e n

or stomach aches are additional symptoms of anxiety. At 30 years old, I have a proper diagnosis from my doctor, although it took me years to get it because I didn’t know I had to ask for it.

For years, I thought my anxiety was just who I was. As a child, I was very self-motivated, hardworking, often called “Type A.” I assumed that feeling a mild level of panic at all times was the cost of being an ambitious girl. I ome mornings, my heart starts was also a fearful child: dogs barking made me to race before I even open my flinch, and I detested rollercoasters for the way eyes. My brain begins to whir like they made my stomach feel like I had missed a an engine revving, cycling through step walking down stairs. I hated anything that thoughts and stimuli, reacting to made me feel “out of control.” I glommed onto the routine of academia, of structured activities and balking at each one no matter like Girl Scouts. I was weird, introspective and the actual importance. My alarm on edge all the time from elementary school goes off, and I brace myself for the to high school. That’s just who I was, and I torrent. resigned myself to accepting it.

When I was in college, I finally realized that maybe it wasn’t “just me.” I had my first panic attack “Sometimes I one day while walking envision my anxiety back to my dorm room and thought I was like an egg, lodged in dying. A panic attack my chest next to my is terrifying when you heart. It’s delicate and don’t know what it is, because all of the sympeasy to crack.” toms are physical and mirror others like asthma attacks or heart attacks.

A formal diagnosis was a relief, because it affirmed that anxiety is indeed a medical condition with physical symptoms and that I wasn’t “crazy” or just high strung—or other euphemisms that don’t address the underlying medical issues at play. Those who deal with mental illness struggle to convey what they experience and others assume that because they can’t see our illness on the outside it can simply be “willed away.”

Living with Generalized Anxiety Sometimes I envision my anxiety like an Disorder (GAD) means that mornings and egg, lodged in my chest next to my heart. It’s nights, waking up and going to sleep, are delicate and easy to crack. Sometimes when times I dread. These are the times when it breaks, its a relief from the tension; other my mind is most vulnerable to anxiety and times, it breaks wide open and feels like it’s when I’m least capable of addressing the releasing poison, seeping through my body symptoms with a healthy mindset. According and rendering me paralyzed. An anxiety to the Anxiety and Depression Association “attack” is catalyzed by seemingly innocuous of America, GAD is characterized primarily stimuli: the sound of a motorcycle backfiring as “excessive worry.” There’s a bit more to makes me breathless and jittery. But most of it than that: trouble concentrating, sleeping the time, it’s just an ever-present hum. poorly and experiencing frequent headaches

in the storm

S

Learn more about the author at her website, ashleywarrenwrites.com

Making Sense of Mental Health

Living with anxiety has given me some positive traits. I’m perceptive and thoughtful, because the dread of the unknown forces me to adapt quickly to changing circumstances.

I’ve also had to become my own advocate and find ways to manage anxiety so that I can fulfill my goals and survive day-to-day life. The routine I’ve crafted is just what works for me, but I encourage anyone who faces a similar struggle to make time to craft their own regimen. As a disclaimer, though, none of this should be considered formal medical advice.

M e d i tat i o n Deep breathing with my eyes closed invokes an almost instant feeling of calm and control.

My go-to trick for preventing a panic attack is to breathe in and out, counting to four with each breath. I’ve learned this from mindfulness experts, and it really does make a difference.

M e d i C at i o n Taking medication for mental illness is OK, and the societal stigma around it needs to end. I take a low dosage of a medication called Lexapro, prescribed by my doctor, and it helps the anxiety from spiraling into a panic attack. Lexapro is a Selective Serotonin Reuptake Inhibitor (SSRI) and prescribed to patients with anxiety or depression (sometimes both).

Sleep When I’m tired, I’m much more likely to feel anxious and unequipped to handle it. Sleep helps repair my mind and body, and I try my best to get a restful eight hours a night.

exerCiSe Keeping my body busy and active can release some of the jitters and stop me from ruminating, which means obsessing over the same thoughts or worries.

I often go to the gym just to feel less anxious, but the physical benefits are well worth it.

Anxiety is common, diagnosable and treatable. Living with GAD is scary and sometimes overwhelming, but we always have our breath to return to, a reliable constant: one, two, three, four.

09.19.19

□

RN&R Health Guide

7

8

RN&R Health Guide

09.19.19

A speciAl supplemeNt to ReNo News & Review

H E A LT H G U I D E

Insurance, availability and awareness are all barriers to finding help

by Brad Bynum bradb @ n ew s r ev i ew . com

I

t shouldn’t be harder to find a therapist than a dentist or an optometrist, but somehow it is. Most Americans value the importance of mental health care but, according to a 2015 survey conducted by the Anxiety and Depression Association of America, the American Foundation for Suicide Prevention and the National Action Alliance for Suicide Prevention, only about 38 percent of Americans have seen a mental health professional, and about one-third consider mental health care inaccessible, mostly because it’s expensive and not supported by insurance.

Caitlyn Wallace is a licensed clinical social worker at the Renown Behavioral Health. She specializes in maternal mental health care.

“There are access issues within mental health because insurance carved out mental health,” she said. “For a lot of people, it’s not included in their standard insurance.”

This problem is especially acute in Nevada, a state that attracted national headlines in 2013 when the Sacramento Bee broke the story that the state’s largest mental hospital, Rawson-Neal Psychiatric Hospital in Las Vegas, approached the problem of mental health care by putting more than 1,500 patients on Greyhound buses and sending them to other states. And things haven’t gotten much better since then.

“Nevada is hard because other states have a lot more public funding for those sorts of things, whereas Nevada doesn’t have public funding,” Wallace said.

The federal government has laws, like the 2008 Mental Health Parity and Addiction Equity Act, that require parity among insurance companies for covering mental health alongside physical health. And the 2010 Affordable Care Act required small-group and individual health plans sold on insurance marketplaces to cover mental health services at levels comparable with medical services.

But these laws have been difficult to manage at state, county and municipal levels.

For patients with Medicare or Medicaid, it can be difficult to find a provider because many clinics—especially privately owned ones—won’t accept their insurance.

“A lot of private practice therapists don’t take either because the reimbursement rates are not sustainable,” Wallace said.

Making Sense of Mental Health

Access

denied But it can be just as difficult to find a therapist with private insurance. In March, a federal judge in Northern California ruled that the insurance company UnitedHealth Group “had created internal policies aimed at effectively discriminating against patients with mental health and substance abuse disorders to save money,” according to the New York Times.

According to the Times, D. Brian Hufford, an attorney representing the plaintiffs said, “When the federal parity law prevented insurers from placing sharp limits on behavioral health coverage, the companies ‘came up with an even more insidious approach,’ ... by developing internal rules that focused on providing expensive outpatient and residential care only when patients were acutely ill. … Once the acute condition was treated, the companies would reduce or deny services, he said. The care ‘wasn’t addressing the underlying issue or the chronic condition.’”

The insurance company is expected to appeal the decision.

Apart from insurance woes, many therapists aren’t taking new clients because their schedules are full. This is especially true in places like Reno, where the population is growing faster than the infrastructure can handle.

Some therapists will petition insurance companies directly for coverage for a single-case agreement on an individual basis, but that creates a lot of extra work for the clinician.

“In maternal mental health, for example, there’s no one who regularly takes Medicaid right now—they’re both out on maternity leave,” Wallace said. “And no one who takes UHC. And in terms of Cigna and Aetna, I’m the only one who takes them. But it’s a two-and-a-half-month wait list for me, and for a postpartum mom, that doesn’t work.

They need help immediately because they’re at high risk. So there’s a therapist in town who doesn’t normally take those but because they’re at-risk, high-need postpartum moms, she will write up the case agreement and submit it.”

Family counseling has other challenges.

Insurance companies only want to pay for what they deem “medically necessary” treatment, which doesn’t usually include couples’

therapy. So therapists either won’t take insurance at all or are “forced to do something slightly unethical,” according to Wallace.

The therapist needs to identify a diagnosis in order to bill insurance. One of the clients, usually whomever is the primary insurance holder, gets diagnosed with an issue that then becomes the focus point of treatment. In other words, the billing needs of the insurance companies dictate the focus point of treatment—not the needs of the patients or the assessment of the therapist.

And insurance companies don’t place any value on the mental health care equivalent of preventative care.

Wallace thinks the long-term solution could be an insurance plan that allows for eight-to-12 mental health sessions annually without requiring a diagnosis. “Get rid of the syndrome-based reimbursement system that insurance companies work under for mental health,” she said.

This would benefit people who suffer from some of the symptoms of a disorder—like PTSD—but don’t quite fit the full requirements for a diagnosis.

And a patient wouldn’t have to attempt to selfdiagnosis before seeing a therapist that “specializes” in whatever problem they think they might be suffering from.

When looking for a therapist, Wallace recommends using the websites Good Therapy and Psychology Today to find professionals in your area, and then cross-checking those results with your insurance company’s website. And still, if, after that two-step process, you’re not satisfied with your therapist, don’t be willing to settle. A personal connection can be important.

“The number-one thing—and it’s hard to tell if you don’t know them—is how comfortable you feel with them,” Wallace said. “The biggest thing that makes people successful in therapy is how safe and comfortable they feel with their therapist.” Ω

09.19.19

RN&R Health Guide

9

The Dogter Will See You Now: How Pets Contribute to an Improved Sense of Overall Wellbeing

By Amanda Williamson Marketing Director, Nevada Humane Society Imagine glancing down at your prescription to see that, instead of your normal medication, the paper said: “Lots of dog kisses and the purring sound of a cat. Enjoy twice daily. Refill as necessary.” You’d probably be a bit surprised, to say the least! Science says you shouldn’t be. More than 97 percent of doctors believe there are health benefits to owning a pet, according to habri, the Human Animal Bond Research Institute. Researchers are so certain of this they’ve even named the slew of mind and body improvements individuals enjoy when they interact with animals. Enter “the Pet Effect.” Here at Nevada Humane Society, we didn’t need these scientists to tell us what we already know from the hundreds and thousands of happy pet owners that come through our doors, but it doesn’t hurt.

Guard Against Depression

“Petey and PJ put a smile on my face every day when I get home as they run, tails wagging, to snuggle and slather me in kisses,” said Kristen Saibini, a Nevada Humane Society board member, volunteer and adopter. “It’s an instant mood booster, for sure.” How exactly does this work? When we hug or pet our animals, the chemical in our brain tied to happiness increases — and as a result, we see improved changes in mental health. After all, unconditional love and support goes a long way to ease worry, distress and loneliness. That means a dog or cat in the home can help combat some of the major contributors to depression. Kristen knows that all too well. Her wife, Katelyn Floyd, works in the military, which forces her to travel often. When Katelyn is away, Kristen says it helps to have her furbabies in the home, especially since nothing beats the joy of coming home to a dog’s wagging tail and a cat’s purr.

But, there’s more to it than that. Habri notes pets provide a sense of purpose to their owner’s lives, which is something we hear often from our team members and volunteers. “In all my struggles with mental health, the reminder that I am the one person my animals truly rely on is what kept me here and kept me strong,” said Pryce Scott, TNR Coordinator with Nevada Humane Society. “By intimately knowing that experience, we are able to see the life-saving bond between humans and animals — and know that we help save more lives than our adoption statistics can possibly count.” After all, there’s nothing quite like releasing all those bottled emotions to your pet, knowing that they will provide a constant shoulder and a non-judgmental ear.

Goodbye to Anxiety

It is no mystery exercise can help reduce feelings of stress, but how does your pet help? Studies show dog owners are more likely to meet daily exercise goals because they strive to keep their pet fit and healthy, as well. Michigan State University found dog owners are 34 percent more likely to fit in 150 minutes of walking per week than non-dog owners, and a similar study by the University of Missouri saw a 28 percent increase in walking speed when walking with a four-legged buddy instead of a human buddy. Exercise produces endorphins in the brain, which act as natural painkillers and also improve your ability to sleep. Both, in turn, contribute to decrease stress.

Additionally, exercising your dog often leads to conversations with other dog owners, helping to create connections and friendships that didn’t exist previously. People who have more social relationships tend to be mentally healthier. But reducing anxiety isn’t just for the dogs. It turns out that just hearing the sound of a cat’s purr can reduce stress responses in humans, says Bonney Brown, the president of Humane Network. Pets of all varieties provide perks, no matter what age we are, which could explain why more than 60 percent of households in the United States already have one. Pets lower stress, connect you to a community, provide a constant exercise buddy and offer a source of comfort. That explains why the University Of Michigan School of Public Health found that 88 percent of people surveyed believed the benefits of pet ownership included helping them to enjoy life. After all, with dog and cat by our sides, we truly learn to live in the moment.

Kristen Saibini and Katelyn Floyd know their rescue dog, Petey, brings so much joy into their daily life. Petey encourages them to get out to the parks and is doesn’t hesitate to be a fellow couch potato.

10

RN&R Health Guide

09.19.19

A speciAl supplemeNt to ReNo News & Review

H E A LT H G U I D E

Making Sense of Mental Health

reaching How to help someone experiencing a crisis

by Temi Durojaiye

E

very day, thousands of people walk Reno’s streets, often uneventfully. Yet, sometimes, pedestrians might witness someone shouting at no one in particular or moving erratically—even in and out of traffic. Other times, it might seem like someone is confused or perhaps lost, their behavior much more timid, but still out-of-place. These people could potentially be suffering a psychotic episode or other mental health crisis, and, to concerned members of the public, it might seem responsible or even necessary to intervene in some way.

According to Danica Pierce, a behavioral health provider at Northern Nevada HOPES hospital, it’s important to trust your instincts about what’s happening, especially if you’re untrained.

“The only checklist is [your gut],” Pierce said. “If you’re noticing like, ‘this seems odd,’ then it’s probably odd.”

“Some of it is really intuitive,” added Brandon Cassinelli, an embedded resource officer in the Reno Police Department, about identifying a mental health crisis in public. “You can almost feel that something is going on.”

Both stress the importance of prioritizing safety first before offering any assistance. Pierce suggests asking if they’re OK from a safe distance as a good first step. They said to pay attention and note as much detail about the incident as possible in order to help you better assess what to do next, as well as provide a comprehensive report to any intervening law enforcement or medical help that might follow.

Pierce and Cassinelli are both in key positions within the architecture of mental health care in Reno.

At HOPES, Pierce coordinates the Medicated Assisted Treatment program for people addicted to alcohol and opiates, which prescribes medication to help them achieve stability. It’s important work as alcohol and opiates are two of the three most abused

out substances in Reno, according to the Washoe County Health District.

Meanwhile, Cassinelli recently pitched his bosses on integrating the management of community behavioral health and the police department’s internal mental well-being—an offshoot of his graduate studies in psychotherapy at the University of Nevada, Reno.

His bosses, agreed and for the past month, he has been working with Pierce to ensure that law-enforcement is fully aware of the available mental health resources that they can deploy in managing mental health crises in public, but also in taking care of themselves.

So far, it’s working out—internally and externally.

The experts said that providing help to people experiencing a crisis—whether it’s a stranger or a friend—should affirm their autonomy and right to refuse help as long as they do not pose a danger to themselves or others.

Although one can feel obligated to help a friend who is struggling, Cassinelli cautions that imposing mental health resources on a friend is guaranteed to change your relationship—for better or worse—and can be counterproductive if the friend is not invested enough to help themselves. In addition, it’s necessary to provide specific resources for each situation rather than just a general appeal to seek help.

HOPES, Community Health Alliance, and Northern Nevada Adult Mental Health Services all offer free to affordable behavioral health services—from therapy to medication—for all patients, including the uninsured.

Pierce reports that 33 percent of the clients at HOPES are uninsured, and over 70 percent are on Medicare or Medicaid.

The Crisis Support Services of Nevada also operates a 24/7 call center that people can call anonymously for critical support in dire moments, which can sometimes be the difference between a tragedy and recovery.

Additionally, the Mobile Crisis Response Team, a crisis intervention service across Nevada for adolescents, can be on-site for individuals who need immediate intervention.

No matter the case, the key to providing good care is inquiry, compassion and attentiveness.

It’s necessary to provide specific resources for each situation rather than just a general appeal to seek help.

NorTHErN N E vA DA H o P E S 580 W. Fifth St. 786-4673 nnhopes.org There’s no such support service for adults, though, and Pierce and Cassinelli recognize that it is one of the many gaps in behavioral health services that the city still has to fill in order to provide robust care.

Of course, Emergency Services, or more commonly 9-1-1, remains an invaluable resource in crisis situations—even mental health. Although it’s synonymous with police, Cassinelli clarifies that there will usually be a mental health care provider riding with the responding officers, who will advise and sometimes take lead on handling the situation.

As of now, this ride-along service is available seven days a week but not round the clock (there’s no one during graveyard shifts) and providers in the area are limited, but it’s a marked difference from the previous systems.

“Before, [a resource] might have gone completely under our radar, [that we could refer people to], as opposed to the old revolving door of incarceration: arrest and release, arrest and release,” Cassinelli said.

Sometimes, depending on the situation, dispatch may also send a medical response team instead.

No matter the case, the key to providing good care is inquiry, compassion and attentiveness. The best response usually starts with being circumspect in assessing what’s happening. Then, inquiring from the affected party if there’s any way they’d like you to help. Finally, informing the owners or representatives of the relevant establishment before involving law enforcement or emergency services—at all stages, reinforcing their humanity.

“No one is immune, any demographic, any job, any socioeconomic status, [to] struggle,” Cassinelli said. □

CoMMUNIT y H E A LT H A L L I A N C E 330 Crampton St. 336-3700 3915 Neil Road 870-4333 chanevada.org

rENo PoLICE D E PA r T M E N T Non emergency number 334-2115

NorTHErN N E vA DA A D U LT M E N TA L H E A LT H SE rvICE S: 480 Galetti Way, Sparks 688-2001 dpbh.nv.gov/About/Overview/ NNAMHS_Overview/

CrISIS SUPPorT SE rvICE S of N E vA DA 1-800-273-8255 or text CARE to 839863. cssnv.org

MobILE CrISIS rESPoNSE TEAM 688-1670 knowcrisis.org

r E N o b E H Av I o r A L H E A LT H C A r E H o S P I TA L 6940 Sierra Center Pkwy.

393-2200 09.19.19

RN&R Health Guide

11