CURRENTS: Winter 2022

CURRENTS WINTER 2022

A Consideration of Stigma Mental Health and the Holidays: Fending Off the Seasonal Blues Riverbend Kids Special Edition

Special

A PUBLICATION OF RIVERBEND COMMUNITY MENTAL HEALTH, INC.

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SAY PROUDLY WHAT YOU DO

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A letter from Lisa K. Madden

IN THIS SPECIAL ISSUE...

Greetings, The end of the year 2022 brings with it a sense of — dare I say it — a return to a ‘normal’ holiday season. We’ve all spent a long two and a half years mired in a COVID reality which isolated us, frustrated us, and made us adapt in ways we could never have imagined back in 2019. While we remain vigilant we should all also be very proud of what we have accomplished together!

We are thrilled to share with you a special edition of CURRENTS this holiday season.

It includes information about mental health care along with celebrations of the achievements of Riverbend employees, supporters, and friends. This edition also offers a kids entertainment section with puzzles created by our own Riverbend staff!

We have a strong strategic plan at Riverbend. It speaks to integration, workforce investment, technology, and community education. And every facet of our plan centers on improving the client experience, which is core to our mission. To stay on course, Riverbend’s programs and teams have all demonstrated two key, and at times competing, characteristics: being dependable and being flexible. To a person, we have continued to be present for our clients and community. Despite all of the obstacles and imposed limitations, staff members answered an epic call with grace, kindness, and optimism.

For those who don’t regularly receive CURRENTS, please enjoy this edition. And if you would like to subscribe, just write us at: CURRENTS, Riverbend Community Mental Health, Inc., 278 Pleasant St., Concord, NH 03301.

01 Say Proudly What You Do A letter from Lisa K. Madden 02 Stigma A Consideration

03 Praising Mobile Crisis and Emergency Services Heather Gaylord, MS, LCMHC 04 Learning to Breathe. Again.

(And again, and again…)

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And the need for care hasn’t been put on hold. In fact, it has grown exponentially. This increased need has bumped up against a nation-wide shortfall in providers. In the midst of this, our recruitment and retention efforts have reduced our professional openings by half. And Riverbend Management and Board remain committed to continued workforce enhancement strategies.

06 The Holiday Blues... ... And How to Deal with Them 12 An Overdue Recognition By: Paul Brown, MD

When our providers’ schedules were full and the pressures of community needs continued to grow, staff didn’t fall victim to discouragement. They carried on, striving each day to make things better. Riverbend professionals in every

Lisa K. Madden, CEO, Riverbend Community Mental Health

department worked as a team to bring hope and healing to so many people in our community.

I want to recognize and thank, too, our corporate and community supporters. You have been instrumental in promoting the important work we do. My sincere wish is that you all enjoy a warm holiday season shared with those you love. And to the team at Riverbend, when visiting friends and family, if you get the opportunity to speak about your work, I hope you proudly state, “I work at Riverbend. I help people live their best lives. I help people move forward in their recovery.”

Say proudly what you do.

Best,

Lisa K. Madden CEO - Riverbend Community Mental Health

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PRAISING MOBILE CRISIS AND EMERGENCY SERVICES

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STIGMA A Consideration

Negative terms about mental illness are still entrenched in our everyday language. Words like: crazy, mad, lunatic, insane add to the stigma for those living with mental illness. They represent cruel and unfair generalizations. Over the past 10 years there have been great advancements in how we have educated our families, friend and communities about the truths of living with mental illness. It is a medical condition; people are in pain and they deserve relief.

Treatment is effective, recovery is possible.

The tendency to generalize is very human and can be helpful. But it can also be distorting and lead to prejudice. When we think about people as individuals and consider their personal experiences it becomes easier to recognize and let go of the unfair, inaccurate conceptions which may still frame our fears. This is a big step toward eliminating stigma.

Mental illness symptoms vary; often the cause for

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Heather Gaylord, MS, LCMHC

One of Riverbend’s primary goals in 2022 was to draw ever closer to the dissolution of the stigma often associated with mental illness. Indeed, addressing stigma is one of the cornerstone challenges of mental health care.

Consider what our own impressions of a psychiatric crisis might have been 20 years ago. If a friend or family member needed mental health care, how would we have reacted? Without any clinical or personal experience, we might have been swayed by images in books and other media. We may have found ourselves uncomfortable, even frightened, and withdraw from our friend. Stigma would have created distance right when compassionate support was what was needed.

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Despite operating at a fraction of staffing capacity during the COVID era, Riverbend’s Psychiatric Emergency Services Department steadfastly provided critically needed interventions to our community, as well as to others in New Hampshire. In the first 11 months of 2022, Riverbend’s Mobile Crisis Team provided 773 community-based crisis assessments for 627 individuals. During the same period Emergency Services completed 1,432 crisis assessments for 1,018 people. These teams have worked countless hours responding to adults and children in dire need. And the Department has continued to expand and evolve its services.

the disruption can be related to a personal trauma.

Consider just a few traumatic experiences that may impact our mental health: Members of the military returning from wartime deployments in far-away countries, their experiences incomprehensible to those of us who, enjoying the freedom provided by their service, chose civilian careers.

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Veterans returning from wartime deployments.

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First Responders who are frequently exposed to tragic situations as they work to save lives.

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Seniors who lose friends, partners, and spouses.

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Young people bullied simply for being themselves.

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Survivors of abuse or tragedy.

These are all members of our community who can use our support and our respect as they bravely work toward living fully and engaging in recovery. So this holiday season, remember to aware of the words you use and join us in our mission to eliminate stigma!

PATH – Projects for Assistance in Transition from Homelessness – is one such offering. PATH provides community-based care management services to individuals experiencing homelessness. With Morgan Stevens at the helm, PATH has developed strong relationships with local agencies such as the Community Action Program, Easter Seals, the Homeless Resource Center, McKenna House and City Welfare. The program has aided in numerous successful placements for housing and voucher programs.

In another innovation, Shannan Dufour and Kelsey Harriman have established a two-person team under the auspices of the NH Rapid Response COVID Grant. Through a close relationship with Concord Hospital and 5-West, this team has helped many adults and youth connect to services and resources. The goal of this program is to prevent and ameliorate crises and help people overcome barriers such as limited resources and insufficient insurance.

2022 also saw the launch of our CTI (Critical Time Intervention) Program.

This is a no-cost, intensive, nine-month program that serves individuals during the critical time when they are transitioning from inpatient care to community integration. CTI is led by Sarah Richdale, alongside coaches Sampson Davis and JoAnn Brown.

I am forever grateful for the dedication and service of the phenomenal human beings who serve our community in Riverbend’s Psychiatric Emergency Services Department!

People in photos, in order of appearence: Haley Emery, Melaney Schmertzler, Sharday Boyd, Kate McClain, Ericca Chappell, Aurelia Hutchison, Shannan Dufour, Morgan Stevens, Melaney Schmertzler, Melissa Stephens, Sam King, Cheryl Donlon, Sarah Richdale, Aurelia Hutchison, Heather Gaylord, Erin Balestrieri, Cheryl Donlon, Sarah Miner, Deb Green, Cheryl Donlon, and Amanda Miller Johnson.

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(And again, and again…)

LEARNING TO BREATHE. AGAIN.

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inside our little raised ranch were glowing. I could hear my wife singing and laughing with our two young children at bath and bedtime. Suddenly I was slammed with a bonedeep fatigue. I lay on the cold grass and watched the steam of my body and my breath rise up into the moonlight. I thought, “I want to disappear. What if I disappeared like this vapor? What if I put everything down and just died?”

Suddenly I saw no point in going on though on the surface there were so many reasons to go on: Love. Purpose. Truth.

Faith. Family. Community. God. All the things I had spent my youth and young adulthood pursuing, studying, embracing suddenly amounted to nothing — like my breath evaporating in the frigid darkness. Somehow, I got up and went inside.

myself in a psychiatrist’s office. We talked for about a half an hour or so, he asking me questions that I didn’t really want to answer. But he needed to get to a picture of my emotional state. At the end of that session he said, “Your friend is right.

You are very sick, and you need help. I think I can help you feel better.” Then he described the kind of therapy he did: a combination of talk and medication.

Later that week, the same feeling came over me as I drove home from work. It was dark. We lived off a twisting country road in Connecticut, and there was an immense oak tree on a sharp turn. I’d just come from a fraught meeting, about nothing really, and wasn’t feeling very effective, and suddenly it was all I could do to keep myself from plunging my Toyota Corolla head-on into the tree.

I still see that same psychiatrist periodically, and I have a team of people I’ve managed to assemble through the years. I have colleagues, a therapist, a spiritual director, a prayer partner, a coach.

Why? Little things made me irritable, impatient. I could often feel a tingling in my scalp that seemed to come from within my skull. A weight. A need to cry but an absolute inability to make tears. A sigh deeper than words.

You know those LEGO sets where you get all these pieces in a kit and you can make virtually anything?

In my 20s I did my best to build my life’s LEGO set and it seemed to be the best of times. My “kit” was for a happily married pastor and father. Sure, I had a couple of unhappy false starts, but as I realized something was not fitting, I’d return to the LEGO set and start again. I was lucky to have the luxury of multiple chances to restart, having been born with advantages many don’t have. So eventually I found myself with a small, growing family and a vocation that gave me ample opportunity to grow, be creative, build community, and live the values of dignity, justice, peace, and love.

The outward struggles and strivings were pretty much resolved. But there was something not right within me. It had crept up in such a way that I didn’t see it coming. They say, “A fish doesn’t know it’s wet.” And when you’re depressed, it can hurt in ways that you grow so accustomed to that you can experience damage that you’re either not aware of or you deny, until you just can’t anymore.

One night that seemed to be just like any other, I felt a kind of sadness and fatigue. I forced myself to go for a run. It was mid-November. I ran hard.

And I thought I could push through the block I was feeling. I made it home and noticed the lights

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It went on that way for months. I felt separated from everything and everyone. Not only did I not feel pleasure, I felt compelled to eradicate pleasure, laughter, beauty, and lightness from my inner life. I was, and still am, so driven by duty, obligation, and honor that I faked it for the sake of my family and career. I kept up appearances, but the inner, twisting weight of my depression was deadening everything that was me.

One day a friend said, “Rob, Listen. You’re not well. You’re becoming less than who you are. I’m worried, and I’m going to find you some help.” I think someone else noticing what I was spending so much energy trying to hide finally gave me permission to accept what I needed, which was help. I needed help. I still need help.

Even back then, there was help around, and soon I found

As he handed me a card with his phone number he said, “And my therapy works much better if you’re alive.” Though that statement had a tinge of humor, it went through me like a shock. I was indeed in trouble, and I needed help. And it was coming right toward me.

My work brings me close to all sorts of pain in this world, and much of it brings deep and troubling sorrow. The world is often not conducive to mental or spiritual happiness. So, I have what I call a pit crew that leaps into action when I need to stop and get help.

My secret power is saying often to myself, “I don’t know.

I need help.” I have gone from wanting to disappear with my breath into the void to learning how to breathe again, moment by moment, day by day. Again. And again, and again.

I have ample resources, and it’s tragic — even sinful — that our society, our culture, our health care delivery system is so underfunded, under-resourced and over-stressed that what’s available to me isn’t available to everyone who needs it.

When I am in a gathering and I ask, as I do sometimes, who among those present has been touched by mental illness, either personally or in their circle of friends or family, everyone — that’s everyone — raises their hand. Everyone.

That breaks my heart. And it helped me decide to share my story for the sake of all those who are striving to live the life that I believe God yearns for us all to enjoy. I am Rob Hirschfeld, and this is my brave.

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THE HOLIDAY BLUES… ... And How to Deal with Them

For generations, Thanksgiving has meant the beginning of the holiday season. For some kids, it has meant that the Advent calendar was ready to divulge its first chocolates or the menorah was soon to be lit. For adults, the Black Friday specials fliers were spread upon the kitchen table, ready to inform the ideal shopping strategies. In recent memory, however, festive decorations, Christmas advertising, holiday advertising, and television specials seem to begin appearing before summer even officially concludes. For many, this phenomenon alone incites the first measure of holiday stress.

And there are many different types of holiday emotional stress. Seasonal affective disorder, a form of depression caused by limited access to natural light and changing sleep patterns due to daylight saving time, is suffered annually by more than 6% of Americans. The American Psychological Association (APA) recently reported that 38% of all people suffer increased stress levels in December due to additional tasks, family gathering anxiety, financial worries, travel stress, loneliness, and changes in diet.

The excitement of the upcoming holidays coupled with the expectation that everything will be as perfect as a greeting card, often leads to some level of disappointment. The expectations of families of various levels of income can be overwhelming.

So, we encourage you to slow things down, sit in a comfortable chair, take a deep breath and think about some of the suggestions below.

1. Stay in touch with friends and family. The simple act of reaching out to a loved one lets them know that they are being thought about. And those moments of contact, in person, over the phone, or on Zoom, provide a warm break.

2. Practice self-care. Consider going outside for a quick stretch. Reconnecting with nature for a few minutes on a regular basis can provide great benefits, from anxiety reduction to recognizing your own self-worth. And your diet and sleep schedule are vital to maintaining your energy!

3. Know your limits. Don’t put the weight of the holiday world on your shoulders. If you wouldn’t expect someone else to achieve the things you expect of yourself, it is probably time to slow down a bit. It’s okay to say “no” once in a while.

4. Don’t read the comments! Of course, this is advice associated with social media. Especially in December, it’s good to avoid measuring yourself or your holidays against what others might be doing. Step away from electronics and connect personally with people.

5. Be empathetic with others and with your own inner voice. Be aware of how others might be feeling and maintain that same vigilance with yourself.

6. If you or someone else is already feeling down, connect them or yourself with some support. Don’t wait.

These practices are useful not just during the holidays. They work year round! Remember to take the time to step away from the business of your day, take some deep breaths and be gentle with yourself. You deserve it!

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This holiday season, CURRENTS is expanding upon a new section intended for the enjoyment of young people (and the young at heart!). We share puzzles created by Riverbend employees as a way of celebrating and saying ‘thank you’ to our youthful readers.

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A RIVERBEND WORD SEARCH

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COLOR ME IN

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KWANZAA, HANUKKAH, CHRISTMAS AND THE HOLIDAYS!

2022 YEAR-END GIVING Before you hang your new 2023 wall calendars or declare your New Year’s Resolutions, please consider a taxdeductible year-end gift to Riverbend. It’s a gift which, in so many ways, gives back directly to your communities.

Our amazing team cares for the behavioral health of every neighborhood, welcoming everyone who seeks professional services. Working side by side with educators, physicians, first responders, and outreach workers, our goal is to make sure that every person who needs behavioral health services has access to them.

Thank you for your tireless support of Riverbend.

Please use the enclosed envelope to send your check (made payable to Riverbend Community Mental Health, Inc.) or scan this QR code to go to our website and make a secure gift online:

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Your support provides employment services for adults with chronic mental health issues, scholarships for individuals seeking addiction treatment, and crisis intervention for anyone experiencing a psychiatric emergency.

HAPPY HOLIDAYS AND A SAFE AND JOYOUS NEW YEAR!

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Your gifts will provide holiday meals to residents of Mill House, Twitchell, and Fayette, help children attend vacation camp, and support parenting education programs. There is no such thing as a “small gift,” and joining our 365 Club by becoming an automatic monthly recurring donor provides assistance throughout the year in the most manageable of ways!

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WE CAN’T DO IT WITHOUT YOU! 80%

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the process for team transfers within CSP by improving communication and prescriber involvement. She was always available to support her fellow providers and was especially helpful in orienting new prescribers. In her ‘free time,’ Leanne worked on developing policies for the implementation of telemedicine and documentation for prescribers.

Leanne worked with the nurse leader to set up guidelines for nursing appointments and helped initiate the policy that nursing appointments with medication reconciliation occur before every psychiatric evaluation. She helped pioneer formalized provider training for all CSP staff and ran the CSP prescriber meeting to assist with follow-through on these initiatives. Leanne also worked with Concord Hospital staff to enhance communication with clients needing admission to or discharge from the behavioral health unit in the hospital, often referred to as 5-West. In addition, Leanne was able to utilize her vast experience in residential services to help provide support for clients and staff in those settings. She attended Medical Practices Committee meetings and helped develop new initiatives pertaining to nursing practice.

As the incoming CMO, it made my role so much easier having her precede me in many of the administrative roles I have since assumed. Leanne accomplished all of the above and more while keeping a full caseload and delivering excellent care to her clients. I believe the dedication and energy she showed during a difficult time was largely a selfless gesture. She demonstrated all that is good about Riverbend including our commitment to continuous quality improvement.

It is emblematic of a good team relationship when you make others better by your presence. Leanne did just that in her time as Associate Medical Director and I believe she is one of many unsung heroes within our Riverbend community. I’m grateful to be in an organization that can build upon the achievements of staff such as Leanne Booth going forward.

AN OVERDUE RECOGNITION Leanne Booth, APRN By: Paul Brown, MD

When I was asked to submit an article for Currents, my mind went immediately to all of the gratitude I feel for those who provided a welcoming atmosphere as I transitioned to my new role as Chief Medical Officer at Riverbend. There are so many superstars within this organization, and I am happy to say I have met many of them in the past six months.

I am grateful for the skills, warmth, and compassionate tolerance so many people offered as I settled into my position.

There are so many examples of employees who go above and beyond for the sake of clients, staff, and the mission of the agency that it may seem wrong to single out anyone in particular; however, I should start somewhere. So, while so many exceed expectations regularly, I choose today to recognize one exemplary clinician and leader.

In August of 2021, Leanne Booth, APRN accepted the role of Associate Medical Director for the Community Support Program (CSP), a position she held until my arrival in June of 2022. CSP is a very large program working with adults living with severe mental illness. These clients often benefit from a team-based approach including therapists, case managers, community outreach professionals and medication prescribers. During her tenure, Leanne attended clinical meetings, provided support and guidance to the treatment teams, and continued to see her clients. She strengthened

ABOUT RIVERBEND COMMUNITY MENTAL HEALTH Founded in 1963, Riverbend Community Mental Health is a private, nonprofit organization providing specialized behavioral health services in central New Hampshire. Core programs include: • Addiction Treatment and Recovery • Counseling & Mental Health Services for Children and Adults • Psychiatric Emergency Services • Residential Programs for Adults • Wellness Education CURRENTS is a publication of Riverbend Community Mental Health, PO Box 2032, Concord NH, 03302-2032. All Rights reserved. Mailed free of charge to friends and supporters, Currents is also available at riverbendcmhc.org.

LET’S GET SOCIAL:

BOARD OF DIRECTORS James Doremus, Chair Frank Boucher, Vice Chair John Barthelmes Mark Broth, Esq. John Chisholm Leslie Combs Christopher Eddy Benjamin Hodges Nicholas Larochelle, MD Rabbi Robin Nafshi Bradley Osgood James Snodgrass Carol Sobelson Johane Telgener Kara Wyman

SENIOR LEADERSHIP Lisa K. Madden, MSW Chief Executive Officer Chris Mumford, LICSW Chief Operating Officer Crystal Welch, BS Chief Financial Officer Jaime Corwin, BA, PHR, SHRM-CP VP of Human Resources Sarah Gagnon, LICSW VP of Clinical Operations Brian Asselin VP of Information Services Sheryl Putney, BS VP of Quality Assurance

Andrea Beaudoin, AS Senior Executive Assistant EX OFFICIO Lisa K. Madden, MSW Chief Executive Officer Riverbend Community Mental Health Robert P. Steigmeyer Chief Executive Officer Concord Hospital

PO BOX 2032 CONCORD, NH 03302-2032

NON PROFIT ORG. U.S. POSTAGE PAID Concord, N.H. Permit No. 763