It's Where I Am with Zandra Polard

Kevin Krall 0:00
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Unknown Speaker 0:38
Good morning Las Vegas, it's Zondra Polare with it's where I am. Today we have women empowerment 2022 Part two. So now we have our panel of mental health professionals. So we have Dr. Deepa Sesia, Dr. Gwendolyn green, and Dr. Althea cook. So they answer questions from the audience. And they give us a deeper understanding into the intake process. They also talk about employment assistant program, they talk about inpatient intensive. In US, they talk about intensive inpatient and outpatient therapy. We also discuss how to understand if your loved one or yourself needs professional help. And we also want to make sure that we are acknowledging, slugging the magazine who is our proud sponsor, here's part two. Women Empowerment 2022. We have a second panel here today, a women who are actually experts in the field of mental health. We have a psychiatrist and we have two doctors of psychology. So please be prepared to ask them some questions. Because I know a lot of us are having a hard time getting through. We do have telehealth, which has made major accomplishments OR, or NOT accomplishments, but has given opportunity to people who have not been able to get help before. It has also gotten people who need help, they have a difficult time getting out the door to get help, because that's an issue to get therapy right at home. However, it's made it very difficult for the professionals to keep up with all of the demand. Okay, so that's why I brought these women here, who has spent most of their day here with us. So please make sure you ask. Ask, ask ask. Okay. Thank you. So ladies, can you come up, please, we have option when Dylan green Doctor diva anesthesia. And we have Dr. Joe Smith.

Unknown Speaker 3:12
Hello, I want to thank you, thanks so much for being here. And being patient with us. As we've gone as we're going through our first women, empowerment. 2022. Focus is obviously mental health because my show concentrates on mental health and wellness. So if you've ever been here, as a clinician,

Unknown Speaker 3:34
that is the first thing I want to know a little bit more about your family dynamic. So what's going on in the home has something changed, you know, reach out and find a provider as covered so that you can go and get services. Most insurances will provide you with a provider data directory that will give you names and locations of child psychiatrists, child psychologists, and people who can actually help you to give the appropriate assessments and such done. Then at that point, once they come in, and they see like myself or Dr. Cook, we might decide, okay, this kiddo has a little bit more going on there, what we would normally treat with just, you know, individual therapy or family therapy. And at that point, that's when we make referrals to doctors, or psychiatrists who can further assess and determine a pharmacological

Unknown Speaker 4:27
approach.

Unknown Speaker 4:30
After the seizure, how we talk to parents about understanding that it's okay, if they need a little bit of help, because we can put on a better day. If our legs broken, we can get it passed. But we just won't accept that when our brain needs help. We need a little bit of medication. It will take a time. If I have a hang around from time to time, you're getting into drugs that we don't know about. So that can be scary. So how do you open that conversation of appearance for them to understand that it's something necessary for the child?

Unknown Speaker 5:08
So I, first I'm gonna say that, you know, most people have this perception that psychiatrists are child psychiatrists, or they're just to start medications right off the bat, which is actually not true child, psychiatrist pacifically. Our goal is to first talk to the child, talk to the parent, and understand what's going on. Medication is absolutely a last resort for us. So when the child comes to see me, I usually say, okay, is this a school issue? First, this is a family issue, we go back to me refer to the school first, schools have counselors, actually the first line, when kids go to school, there's their grad school majority of the day. So the teachers are seeing a lot of his behaviors firsthand. When they come home, they spend party time there. So the parents are noticing things, we have to get a holistic view of things, what happened with them as terms of are they sleeping, okay? If something changed in their diet, it something happened with grandma or something happened with dad that's kind of changing the system. So good history is very important this and the only way to get input history is to listen to different different parts of the team, which is the parents, the teacher, the child is the most important if you sit and talk to the child and think about things from the child's perspective. A lot of your answers are right there. So when they come to me, we actually take a step back and say, let's listen first, let's listen as recorded therapy. First, we'll refer to therapy for 12 weeks, we'll coordinate with therapists and get feedback what is going on with this kid before we even consider medications. As far as files, that guy is concerned, we do have to do that first in order to even say, you know, or recommend kind of using this medication is a last resort. Nobody wants to put any child on medication. Sleep is very important. Sleep is a big question we asked about how is your child sleeping? Sleep, if adults don't sleep? Well, we don't act right. So we can surely expect kids to act right? If they're not sleeping well. Or if they're not even eating? Well, that's a big part of it. And then feedback from the teachers is extremely important how the kids behaving in school versus how it is in home, a lot of the story will come right from there. If someone does need medication, I'm not saying we won't start it. In some situations where the child is acting completely different, like weeks have gone, they're not eating, they're not sleeping, we will refer to the pediatrician first we'll get blood work done because he is something's going on before we come to psychiatry. So things have to be ruled out absolutely before they come to psychiatry, if something is needed, or if it is hurting themselves, or hurting other people, or doing something dangerous, for example, like a seven year old is so hyper that when the mom says the car, please look on both sides, and the kids not able to do it, it was just running into traffic doing something that dangerous. We wouldn't treat something like that, you know, we obviously don't want any child to get hurt.

Unknown Speaker 8:58
So I'm gonna let you guys have questions now, because we're gonna talk about the children. But as I'm understanding you guys deal with adults as well. And so I want to try get some of my therapy questions. Children, any questions about children?

Unknown Speaker 9:18
On the child welfare services for our kids? And I'm just wondering, what are some of the challenges that you guys find when you have repeat kids that keep coming back? You know, these parents don't have maybe the right insurance or anything else like that? What kind of advice do you give a parent who has struggled with how do we find insurance and not having the right supportive services like access to that because I know that in our in our city we don't really have about mental health services to really support our kids. So what are some advice you should give those parents? So

Unknown Speaker 9:50
I work for DCFS as well and they do offer for kids who are not insured. They do offer mobile crisis services they also or when some of it is in home service, as well as therapy, we do have telehealth for them, even medication management is actually covered. Hospitals does. So educating the community on that, that we do have this resource.

Unknown Speaker 10:16
And I'm going to add to that, because he was saying, I like to work with DFS, as well. And one of the challenges that I see with kiddos that come into our residential treatment, and you know, they spend six to nine months with us working on behaviors, working on their psychiatric concerns, and then we discharge them and go home, one of the biggest challenges that we see is that there's no continuity in the home. So a lot of the things that the child has learned while they've gone through treatment kind of starts to fall off when they get home, because you know, maybe mom and dad are too busy to, you know, do the redirections that we teach or to hold you accountable or to actually go in and make sure that they made up their day, their dads and vendor chores and everything like that. So one of the things I always try to impress upon the families, as we discharge you back into the home, I try to give them things and tools that they can use in their home, so that they can continue to see those behaviors that we saw on treatment, what the youth when they get back into the home, it feels more familiar for the youth, right? Because they've spent six to nine months learning these skills, learning how to be responsible, learning how to be respectful, learning how to learn coping skills, so that maybe they're not self harming when they get upset, or they get really sad. And so, you know, one of the things we want to make sure happens is that the parents have those tools that they can use with their youth in the home.

Unknown Speaker 11:51
In the younger ages, elementary level, a lot of things down ADHD, on the older levels as a lot of awesome suicide, how to look out for the signs of suicide, the question is someone is cutting if they have marks on them. So the systems, the papers are more aware now and they are more trained on it. I'm not sure how many hours a two or a year that I know for sure why they are trained on behavioral issues and depression and anxiety, how to look out for signs of suicide, or there's a very significant change in behavior, they do reach out to the parents and see what's going on. As far as psychiatry is concerned child psychiatry, if a parent signs or release of information, we do contact the school and the school counselor does give us information on how the kid is doing in school. We also there's also IEP programs where you can say I want a therapist to go to the school, I want them to observe the behavior in the school, and also observe a behavior at home. And some agencies are doing that.

Unknown Speaker 13:05
They will question over here.

Unknown Speaker 13:08
What would you suggest for the tired parent who has who has exercised, talking to the medical doctor has gone to a therapy referral husband, their child and with a therapist. And then they turned out to be the kind of therapist that just listening and doesn't have any suggestion. And you don't realize until you sit here the women's empowerment panel that that's what you're experiencing. And there is no help from the school because the meter user was through school. And a counselor that you asked to speak with never called you back and not only child's home school, where would you suggest that residency to start?

Unknown Speaker 13:53
I would say that, you know, that's an extremely hard position to be in. And to be honest, I hear that a lot from a lot of parents. So we did dig a little deeper. And the issue is our community is strained for resources. The school is also extremely overwhelmed. And teachers have a lot of responsibility. And teachers like a lot of them are extremely good. The counselors have good but they're spread too thin. And if someone is tired, you know, it's an issue that's become more prevalent right now especially with cold at times because of child is at home. The parent, the single parents can't really go to work if the child is very young. Someone has to monitor that kid. So a lot of single fans have actually had to quit work and be home just so that their kid can attend the online classes. So I think I'm In general, all of us, everyone is struggling. It's just, it's a very bad situation. I would say, you know, friends, family, people who can be positive and support you, you know, reach out for that help, I'm struggling, but I'll reach out to your family member and family struggling. And they might say, Well, I'm struggling to, I can't help you. Find someone that you can get together with, I have realized, especially in this pandemic, that people do want to help, because everyone's come into the same boat, almost, you know, we're needing each other as humans, we realize we are vulnerable during this time, and we need each other. So to reach out for that help. And if you do need to take it to a level where someone is really needing help, you know, take it to psychiatry, like that kid, talk to somebody. Unfortunately, the resources in this community are limited. You know, I do realize that working in this community, talk to friends. I will say there are people out there, you just have to tell them, I'm really out.

Unknown Speaker 16:12
Can you describe from the person Yeah, referred and come there, do the assessment. And then they got in the program. And then normally sometime in their discharge in the after three days, normally this week. Right now, they don't really go much longer week. That's, of course, you can explain why well is that reason could be clinical could be insurance. And also I will not like to understand our how our program runs what resources, integrate it into the program. Once you do this alternators plenary team collaborate together. And once the patient discharged from the residential treatment, someone to the partial hospital program, right. Some may refer to IOP. Some may refer to the community outpatient program like us for continue their therapy and their medication if they have a medication art party started. So can you just give a little description of the procedure? So our public may know a little more about right how.

Unknown Speaker 17:33
Thank you. And I can explain a little bit about that. So when a patient comes to us, from our fusion clinic, like ours versus desert behavioral health problems, come on, tease me, at my clinic, Satori, behavioral health, is there's an issue going on, which cannot be handled at home, which means the kid is actively suicidal, they have a plan to go home and overdose on pills have their risks, something extremely serious, we will refer them to the hospital. When they get to the hospital, they go through a process called intake, there is a person there that will assess the kid. Is this an issue that really needs hospitalization? Or is it something that can be handled at home, if it's a safety issue, where the parent has to constantly monitor the child 24/7 And they're saying, I'm not going to sleep tonight, because I'm afraid what think is going to do? That's when they need a face like this, or the child is threatening them. Like, you know, when you go to sleep, I'm going to beat you up or I'm going to hurt the younger child and you don't feel safe. That's the reason why someone shouldn't be in the hospital. Or if they're using drugs, they're hearing voices, not they're talking to themselves. Those are reasons for hospitalization. When they go through the intake process intake will be like, okay, this person really needs this criteria. They will admit them to the inpatient psychiatric for inpatient psychiatry is someone staying at the hospital, just like you would go to the medical hospital. If you are not breathing well, or someone had a stroke, it would have been there. Same thing with a hospital like this, except it's for psychiatric reasons. We're trying to maintain safety for that kid or the adult. First they will rule out any medical causes of this once a medical causes ruled out. They will determine okay, this was purely SEC Yeah. The floor on the floor suite, this monitor and eating habits gotten voted over groups are started. They teach again coping skills. A psychiatrist is there to see does this require medication management is the sum is going to get better just by helping with my patients now will be determined in the hospital. Usually kids who come and stay at the hospital it's takes about three to seven days to stabilize. Depending on the child, some may take less, some needs eight more. But after they're stabilized from a program like this, we stuffed them down, which means it could the parent could say, well, I just want outpatient services, which is once a month, or once a week therapy, which range are some parents may think I need a little bit more, because this kid is not currently suicidal, but still thinks about, maybe I should cut myself to relieve some anxiety. Those kinds of his will refer to the partial hospitalization program, which is usually in this town is about 10 days, so two weeks, where the child will go there from like nine to three, and the therapists will be there, help them with group therapy, also engage the family to establish a routine for this kid at home and have a dialogue back and forth. Is this treatment working or trying to teach your kid? What are their coping skills to use in a difficult time or identify your trigger? Or what's your trigger are loud noises your trigger are yelling, screaming your trigger, identifying the trigger to see, okay, what coping skill can I build on to use when I have going on get triggered. So we will teach them that in that kind of program. Once they graduate from that program, they might decide, okay, I do want to still do this but maybe three times a week, which is intensive outpatient. So I'll do this few hours in the morning or a few hours after school. I have this available to me. And if someone wants them, they can continue with that if they don't want that when we stepped on down to outpatient, which is like Hydrae once a month or psychiatry, once in three months, depending on how that person they recommended. Medication management alone on trade, most situations, therapy is needed or this is comfortable.

Unknown Speaker 22:16
There's a top like LGBTQ Resource Centers here in Las Vegas. And if you don't have insurance, they will in therapy once a week, you may have different therapists on the basis, but they do provide this service.

Unknown Speaker 22:33
And I think someone was saying before to those Okay, he moves on who will say journaling. You know, that's a good way to start your process as well. That's an cathartic process to get your headspace, right, until you can get some help. If we're going to say when when we know that versus just reading a referral. And what is the what is that?

Unknown Speaker 22:58
Yeah, I'm sorry. Yeah, that gave he's an employee assistance program that a lot of employers offer. And it gives you access to a number of mental health sessions, therapy sessions were actually covered by your employer. So it doesn't even have anything to do necessarily with your insurance. But generally, what I have seen happen, at least for me is just like you said, I'll get that email from Cigna, oh, we have this person, they want to use our EAP plan. You know, she's 18 years old, she's suffering from depression, let us know when your next available slot is right. And so our response and then normally what happens is if they have signals approving it, and you know, I say I have a spot open and say signals, okay with it, they'll normally provide me with a billing code that I utilize I put into their system where I put it on there, the CTF team hungry, which the CMS 1500, which has a paper form that we used to reverse back, and I'll put that over there, and the dates of the session, how long those sessions ran. Sometimes they'll come back and ask for just kind of a clinical update, like, are they doing better? Do you think you're gonna need more sessions, so that they can give an additional approval? But generally, yeah, everything's uploaded, usually with insurance. And so, you know, we're not going to write code and we don't get paid as clinicians but you know, you got your service. And so that's an important piece, right? Did you get what you needed? When you came in to see

Unknown Speaker 24:30
any questions about relationships?

Unknown Speaker 24:39
What's the best way to approach your spouse, my kids, my wife, if I know that we need therapy would offend her if I say

Unknown Speaker 24:50
we have to go

Unknown Speaker 24:54
slowly, go kind of ever.

Unknown Speaker 24:58
That's my question. Oh, gee. is saying that we need to go to therapy?

Unknown Speaker 25:04
was a great question.

Unknown Speaker 25:07
Of course, say, the assault in kind, when it has timing is everything. You know, timing is everything. And then to have a conversation. I don't think there's one or will one because that's not really one way that he can do that just like highly and places everything. Remember you want to therapy, although you're a clinical, you still want to get them for yourself. Okay, that's a good approach to take. Because last times, couples will start therapy together, but they won't finish. Right? So the ultimate goal is that you're coming to therapy, you want to share the whole experience of working on issues with another person, but you're ultimately there for it. So that way that you gain insight and awareness to how you relate to the other person, not how the other person necessarily relates to you. You can do get it to that point. But just remember, you're going for yourself.

Unknown Speaker 26:12
I want to thank you ladies again for being here. Dr. Linda green Dagara Sesia at Dr. Look out here could give a special thanks to Mark Thomas of slugging the magazine, who is our proud sponsor of this event. And it's where I am also a special shout out to Kelly. I don't know her last name, but she is a part of magazine as well. That was anchor for being here personally, to attend this conference. On Friday, shout out to family and friends who are in support of this. And I also want to give a special special superduper thanks to all of the supporters from all across the nation for this women empowerment conference. So thank you, 91.5 Jazz and more for tuning in to it's where I am. I'm here every second Saturday of the month at 8:30am. And don't forget, stay tuned for our women empowerment conference, part two on my website. It's where I am.com

Transcribed by https://otter.ai