It's Where I Am with Zandra Polard

Unknown Speaker 0:00
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Unknown Speaker 0:45
Good morning Las Vegas listeners. This is Dr. G. And it's time for it's where I am on K u and v 91.5. FM. This is David JENICE, clinical and public relations director at great minds counseling and Wellness Center. And I'm guest hosting for Zondra pollara So we have a special guest today on it's where I am. And I'm very excited to introduce this guest that because I get to call her my personal friend. On the show this morning with us is Dr Deepa has Sesia who is a board certified child and adolescent psychiatrist. And she, in my humble opinion is one of our most valued providers here within our system of care in the city of Las Vegas. So without further ado, I'd like to say good morning to my friend Dr. Sesia.

Unknown Speaker 1:43
Good morning, David. Good morning.

Unknown Speaker 1:47
So Dr. Has Setia and I have known each other for a long time. Actually, I've had the privilege to work alongside her when she was working on her residency hours prior to becoming a fully licensed medical doctor. So I've had the privilege, the honor to collaborate with her in in supporting young children and their families through the therapeutic process. So we would come together and collaborate because I would be the therapy provider and Dr. H would be the psychiatry provider. So Dr. seizure is a provider at her own practice called Satori behavioral health. And Dr. H would you like to kind of share a little bit about what you provide to our community at Satori, behavioral health.

Unknown Speaker 2:40
So Satori behavioral health, this clinic, I opened this clinic in 2019. And it was purely opened, as I saw the lack of services in the Las Vegas area, I used to see patients at the hospital. And when we were discharging the patients, I didn't know which providers would actually have a child psychiatrist available at their clinic to see these patients. We have few child psychiatrist in the community, but very few that take insurance or very few that even have the availability to take on more new patients. So with this in mind, I open up the clinic to service this needs specifically. So the clinic was opened in 2019. I started seeing children, we would evaluate them to see if they needed medication, we try our best not to put children on medications unless absolutely needed. So we would prefer they go to therapy if the therapy doesn't work, or we refer them to the pediatrician to rule out any medical issues that would cause the psychiatric issues. After all those considerations, then I would say, Okay, this kid needs to be on a medication to help better their life or even temporarily be on a medication until things calm down or get better. I started seeing children and this progressed into me treating the whole family system. It seemed like it wasn't just the child who needed the help. It's also the parents taking care of these children also are stressed out and also need that kind of attention.

Unknown Speaker 4:38
So I love I love that through working initially with the identified patient, which typically is the child or the adolescent that is being referred for psychiatric services. You identified the stress within the family system and how that's impacting the whole family and really started working more so with the family and also providing that psychiatric oversight and that support for the adults, the caregivers that are involved in caring for the child. So, so you provide or can provide to our community psychiatric services for both children, adolescents and adults. Correct. So, so, you know, you and I have participated in and many what is referred to child and family team meetings, where we would come together and assess the strengths of the Child, Adolescent and the family, and identify opportunities where potentially we could come in and assist the family and hopefully moving forward in a positive way, helping them get to a space of functioning where they're having, hopefully less, less challenges, less barriers in their lives and experiencing more days of fulfillment and joy and happiness. So, you know, one of the areas that you identified is that, you know, there are not many board certified child and adolescent psychiatrists within our system of care. And you happen to be one of them, though. And so I refer to you all the time, just because of your expertise in treating young children. And that's one of the areas that I am very passionate about, because I completed a two year postdoc certification at the Harris infant mental health institute in Phoenix, Arizona. And so for me, you know, being a resource and allowing our helping families who have young children that start presenting with some developmental challenges, to be assessed and to have, you know, different options in terms of who they seek out for support. Part of you know us on the show, it's where I am, is really a being able to introduce different resources to the community and to our community members so that they know what's available, and how to go about the process of accessing care, accessing support, and, and hopefully not feeling any stigma associated with reaching out and wanting to ask for help, and to have support, formal support come into their life for a period of time, until you know, the heaviness or, you know, the waves associated with certain needs or behaviors start start coming down a little bit, and that ripple effect becomes lesser, and in regards to, you know, the family needing formal services or accessing formal services. And so I think about sustainability. You know, for children, you you you shared with our listeners that your experience a little bit of working in the hospital setting, and your challenges or difficulties linking those patients to services that were in the community. That is really where a lot of the work happens at the outpatient level of care, where families have the opportunity to learn new skills, practice new skills, and hopefully work towards being able to transition having less formal providers within within or involved in their family system. You know, you want to speak to any of that, as far as you know what you've seen some of the gaps in regards to service gaps that we may have here in Southern Nevada.

Unknown Speaker 8:49
Yes. So first, I want to let the listeners know that mental health is still a big stigma in our society. And when anyone in our society experiences any kind of mental health issue, most people tend to hide from it or want to hide it, they don't want to share it as they feel it might be mocked by other people. So they tend not to share it and it keeps building up or it goes to a point where it's not controllable anymore, and most people reach out to primary care, or they will go to the pediatrician for their child to get screened to see if help is needed. Most referrals we get are from primary care right now primary care is screening pretty heavily for depression, anxiety, suicidality. That referral usually goes to a psychiatrist. Or if a child psychiatrist is available through the person's insurance will go to child psychiatry. We Get to referrals both from psychiatry as well as child psychiatry. Now, most people are still hesitant like to go to a psychiatrist, they feel like there's still a stigma around that. And that's what I want to talk about specifically. So there is still a stigma around this. However, it's very important part in someone getting services for their child or themselves. So when someone comes to a psychiatrist, it's not necessary that the psychiatrists or the child, psychiatrists will immediately start medications. And that's what most people fear that I'm on a medication, I'm gonna get addicted to this medication. And in the future, this might cause other issues. For me, it's important to go to a psychiatrist, as they can tell you whether you need to be on medications or you don't, most of the time, the guidelines state that you try therapy, if the therapy fails, then you resort to the medication. But if you don't go to a psychiatrist, we wouldn't know what direction to go to. So we can even have referrals such as for children, for example, I will refer for therapy for family therapy for sensory testing for autism testing for occupational therapy, testing. So I make referrals to all sorts of different ways where someone can get help, it's not necessary that we're always saying, we're going to medicate this person. So

Unknown Speaker 11:43
I love that that part of your training, in that you're very mindful that when I make a referral to you specifically, I say to a family that, you know, let's let's just get Dr. has seizures, opinion, you know, be honest with her, and let's really inform her some of our challenges that are roadblocks walls that we might be hitting in therapy, and that we've gotten to a place where the family and I are discussing alternative interventions, which in this case, or an auxiliary intervention to couple with therapy would be psychiatry, and we're talking about the utilization of potential medicine. And so, when discussing medicine, though, with a lot of my families, they do present to me some initial fear, and fears that are related to everything that you just said, and regards to maybe having a family history of addiction, and having their child be prescribed medicine that could potentially be addictive. That's certainly one of the fears and one of the conversations that that I have with families. Now, I've been working in the field for 24 years, if you can believe that. And I've had the privilege of being a clinical director over every level of care. So I've worked with a lot of individuals, a lot of children, a lot of families, and I've trained a lot of therapists that then have helped a lot of families. And so I've seen the benefit, though of psychotropic medication over time really be efficacious for an individual in learning how to slow down, learning how to think in a more clear headed way, being less impulsive, and having more success at emotional regulation, due to taking some type of medication that's specific to treating something and so, you know, I do believe in psychiatry, and that's one of the reasons why Dr. Has Sesia is here this morning on our show, it's where I am, because I want to hopefully reduce the fear and the stigma associated with accessing psychiatry as a potential service or a potential intervention and helping an individual and you know, I love the fact that Dr. Has Sesia also recognizes and holds in mind that when she is contemplating or thinking about recommending the use of a medication you know, we think about it from a temporary perspective. How we talk about this is that this is not something necessarily that an individual may take forever. It's it's sometimes really an aid though to couple with their A B to couple with the extracurricular activities that a child or youth may be involved in the family therapy and all those other things that may be involved that we may wrap a family with psychiatry is just one additional intervention, if you will. Do you have any thoughts regarding that? Dr. seizure?

Unknown Speaker 15:22
I think that was really well said, and pretty accurate of how I view it.

Unknown Speaker 15:30
Well, I mean, you and I have collaborated in regards to working with many families. And so we both have a really good understanding in terms of how we view therapy, we how we manage and oversee the therapeutic process, you know, our views and our oversight and implementation of Clinical Services is very similar. And, you know, we I'd like to just highlight though, because, you know, Doctor has Sesia is a practicing provider, that that embraces, though family voice and choice, and embraces the values associated with the child and family team process and wraparound principles, which are very dear to both of us. Because, you know, we're here to to not create any other barriers or challenges for families as they overcome sometimes their fear, to reach out and ask for help, and to formally access services. I think for some families, it's, that's a hard pill to swallow sometimes in accessing mental health services because of the fear of how they may be perceived by others, by their family members, by their neighbors, by their work colleagues. And so I really hope that, you know, on, it's where I am, I hope that I'm doing a good job to decrease the stigma, as I invite guests on to speak about different services that we offer here in our system of care of Southern Nevada, in Southern Nevada, in Las Vegas. And that people are, I hope, becoming more open minded, to want to utilize formal services.

Unknown Speaker 17:28
I really hope that people are becoming more open minded, especially with everything that we've seen recently in the news. I think if people had sought help much sooner, we could have reduced to the outcomes in our community that have been so devastating in the news recently. Yeah,

Unknown Speaker 17:52
yeah. So, you know, in our society, unfortunately, you know, we have had some shootings, that certainly, you know, how I view that you when, when there is that level of devastation, what I think about what drives an individual to get to that point, to be so destructive towards others, and so hurtful, and that, clearly, there is opportunity for us to provide, I think, within our daily living, you know, are these are these dinner table conversations, you know, is this something that we learned in our school environments, I'm not really certain what the appropriate forum is. And that certainly is open for discussion as far as how we talk about maybe identifying the service gaps in in Southern Nevada and throughout the state of Nevada, as far as access to mental health services. But, you know, I think talking about mental health, like what we do are what I do every week, it's a privilege to be able to highlight different people and different resources throughout the community that all of us have access to, and that there should I hopefully, believe that hopefully others are feeling less of a stigma associated with accessing mental health services.

Unknown Speaker 19:31
And now, I think this is a great spot to talk about mental health and how it affects our community. I think these shows, especially you being involved with this show is really great for the community and educating the community of what's available and to reduce the stigma.

Unknown Speaker 19:54
So I want to talk a little bit more about Satori behavioral health. This Is Dr. has seizures third? Baby? So, so Okay, let's say if if some of our listeners identified that, you know psychiatry might be an intervention that that they'd like to access. And if they were interested in contacting Satori, behavioral health, how would they go about to do that?

Unknown Speaker 20:24
They can Google and under Satori, behavioral health, the number will pop up. But I can also say the phone number over here, it's seven, zero to 7806200.

Unknown Speaker 20:42
Okay, so you heard that listeners that if you are in need of psychiatric services in Southern Nevada, you have different ways in which you can contact doctor has seizure at Satori, behavioral health. And you know, how I think about mental health services is that it's not uncommon, where we make a recommendation for an individual to receive a referral to a different type of provider that specializes in something outside from what each of us does, where we want to rule out something. So as Dr. Has Sesia alluded to, I send out referrals to different entities to rule out sometimes different diagnoses. Because I want to have a better concrete understanding of symptomology. Or, you know, working with young children, sometimes I want to rule out, for example, sensory integration issues. So, you know, doctor or seizure, and I would utilize an occupational therapist, that would complete an OT assessment on a young child, to help us understand this sensory regulation may be challenges. And so we really do utilize other providers in this assessment process, to help us sometimes narrow down really the needs and understanding the needs of an individual. And so I like listeners to know that, you know, if you were to go visit Dr. H, at Satori, behavioral health, you know, might not be like a one stop visit, you know, you're going to establish a relationship with with Satori, behavioral health, and Dr. Sesia. And she's going to start formulating in her head, an understanding of how she can or her team support you appropriately. And and through that initial assessment process. You know, there may be a recommendation for different things such as maybe participation in therapy, if you already are not linked to a therapist or participating in family therapy. And or, you know, there might be other assessments recommended to rule out any other potential medical stuff that could be on setting some of the behaviors that we may be seeing in in a child or or an adult even. Is that a good a good understanding of, of maybe things that people may hold in mind as far as what the process as far as initiating psychiatric services? Which story behavioral health?

Unknown Speaker 23:39
Yes, no, that sounds pretty accurate. We also have therapists at our facility that are able to provide therapy, even if the person does not need psychiatric medication management. Oh,

Unknown Speaker 23:54
I love that. So so, you know, when I make a referral to Dr. H, I always say, you know, let's just hear what what Dr. Has Setia has to say, let's just let's see, you know, let's gain her interpretation from her lens from being a psychiatrist. And let's just go from there. And so I love the fact that you are not even intending on recommending medicine at the onset of a new assessment because an individual might not really need medicine. Yes.

Unknown Speaker 24:27
So that's why the assessments really important. And the reduction in the stigma in society is very important because they view a psychiatrist as purely just prescribing medication, and they tend to not come for a visit, which leads to other issues and inaccurate referrals.

Unknown Speaker 24:51
So I know that we always want to recommend services. That is least restrictive, so least restrictive and at the lowest level of care. And so I believe in our system of care, the intervention of psychiatry falls a little bit above therapy in in that's a higher level intervention. And so, you know, I love, though, that you hold that in mind, and that if medicine is really not needed, if it's not appropriate, you say that, and I know sometimes for parents, for caregivers that may be involved in caring for a child that, you know, presents with some high needs behaviors, hearing from a psychiatrists telling them that, you know, you think medication is really not going to be needed or helpful, can sometimes be devastating for a caregiver. You know, what's been your experience when you have told caregivers that, you know, let's hold off on medication right now, because I don't think it's really necessary or needed? How have you been able to kind of help help caregivers understand that.

Unknown Speaker 26:08
So sometimes I have said that, but it's typically when I think there's some other screening that needs to be done, for example, medical screening, a lot of times patients come to me and they haven't seen primary care for years or even gotten bloodwork done. A lot of the times abnormalities in their blood work and be presenting a psychiatric symptoms. And if I didn't do my due diligence and refer them to get their blood work done, we would never find out what the root causes for this illness. So I do think a psychiatrist visit isn't sensual in terms of determining the treatment plan. Now the treatment plan can be therapy, medication, follow up with medical and come back on but either way I would, I would highly recommend if someone is struggling, definitely see a psychiatrist or child psychiatrists first, and see what they recommend in terms of your next steps.

Unknown Speaker 27:18
Yes, yes. So, you know, I value from treatment plan perspective, as well as, you know, conceptualizing care from a wraparound perspective, that, you know, we want to rule out any other medical things that may be coming up, that could be impacting a child or an individual's level of functioning and their behaviors. And so, you know, it's really working from a perspective of ruling out different things that could be really contributing to how an individual is presenting and functioning on a daily basis. And I appreciate what you said about you know, sending a referral out for bloodwork. And as well as I know that you've also asked sometimes individuals to get an EKG. And so I appreciate the level of due diligence that you are taking into consideration in regards to looking at overall the individual's health from your lens as being a psychiatrist. So, you know, this conversation I think, is really relevant to our listeners at K U N, V 91.5. FM, because we are presenting and discussing mental health and looking at the resources that we have access to and available to within our system of care. So listeners, until next time, it's Dr. G for it's where I am on 91.5k You envy. Till next time, I'm Dr. G.

Transcribed by https://otter.ai