It's Where I Am with Zandra Polard

Wesley Knight 0:00
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Zandra Polard 0:44
Good morning Las Vegas. It's Sondra Pollard, and the show is it's where I am, right here on 91.5 jazz and more. So this show focuses on mental health and wellness, and today we're gonna get a really good conversation going with a previous guest, Dr canard is back from Sun arch, is it? Sun arch,

Dr. Julia Kannard 1:12
yes. Sun arch, Academy,

Zandra Polard 1:14
Academy, that's it? Yeah, yeah. So you may remember her from a previous show she was on with a good friend of ours, Danielle, who is a yoga instructor. Yeah. So shout out to Danielle. I hope all is well, but let's get into mental health. So the place where the facility you work at, what's your title is, what clinical director, the Clinical Director of Sun arch Academy, you guys deal with primary mental health. And primary mental health would be things like PTSD, depression. What else am I missing? There's a couple more we

Dr. Julia Kannard 1:53
do, depression, anxiety, PTSD, a lot of mood disorders. So bipolar, borderline, we because our age range is 12 to 17, we see kiddos with Oppositional Defiant Disorder, a little bit of conduct disorder. Every once in a while, we get some kiddos with psychosis and schizophrenia. So I think the list of what we see is a lot longer than what we don't see.

Zandra Polard 2:17
Oh, my goodness. Well, so you guys do partial hospitalization, and you also do the

Dr. Julia Kannard 2:26
acute so we actually just do residential. Oh yeah, okay, yeah, we have, we have plans to do PHP and IOP. My plans next year is my goal. We already have a building set aside for it and everything. Oh no, so right now we're just doing residential

Zandra Polard 2:42
All righty, okay, so then the next question would be, how many beds Do you have?

Dr. Julia Kannard 2:48
We have if we were to be at max capacity, we would have 58 beds. Oh, that's a lot, yeah, but we try to reserve a few open beds that way, if we have kiddos who maybe can't have a roommate for various reasons, then we can have a room for them by themselves. So we would probably try to top out at 53

Zandra Polard 3:11
okay, yeah, so let me walk me through what like your therapy sessions are like. So if you are covering that many different diagnoses, are they all in the same therapy? Or how does that work?

Dr. Julia Kannard 3:29
So we're on average 90 day program, and it really depends on the progress that the kiddo makes while they're with us. So if we have them for about 90 days, we're really looking at what's realistic to accomplish while they're with us. So they might have three four diagnoses, but it may not be realistic to accomplish everything that we need to with all of those. So we really look at what are the ones that are contributing to them needing to be with us, which a lot of time, is safety concerns.

Zandra Polard 3:59
Okay, so suicide rates have increased. It's a major recent CDC data show elevated rates of anxiety and depressive symptoms among adolescents, which is your the group that you work with, right? Right? So that's between ages 12 to 19 and high end, rising suicide burden. Suicide deaths exceed 49,000 in 2023 and remain a major public health concern, with 53 beds in Nevada, you guys are constantly busy, right?

Dr. Julia Kannard 4:43
We are, and I think it's really a blessing for us to have so many beds, because I know that for us, we're a level six facility, because we're secured, and there's not that many facilities like us in Las Vegas, much less the state. So I think it's really a blessing to be. Able to operate and to offer so many beds for people that need it, because, like you said, the need is exponential, yes,

Zandra Polard 5:06
and then three months at a time, minimum, or it

Dr. Julia Kannard 5:12
that's like the average length of stay. And we say from the beginning, when they admit to us, we are estimating 90 days, because that's shown to have better outcomes post discharge. And not every residential is like that. Some do 35 day or 30 days or 45 days. So we try to be a little bit different and do 90s, so that way kiddos don't have to come back to us, hopefully, as much as we love them or like we don't want you to come back right, or they don't have to go to emergency rooms or acute facilities.

Zandra Polard 5:41
You should have really good wraparound services on exit Absolutely. That is so important. Now I wanted to also ask you about all of the different I kind of touched on it, but I'd like for you to continue explaining those therapy sessions. So what are the average group size and like? Because if someone has PTSD and then another person has oppositional defiance disorder, are they in the same therapy?

Dr. Julia Kannard 6:16
So the way that we have our units split up, we have five units right now we have two boys units and three girls units, just because we have more incoming need for girls at this time. And so the units are going to be, on average, 10 to 11 kids. So not too big. And so when you're looking at the group sessions, it'll be about 10 to 11 kids plus or minus one. You know, if someone gets taken out for a therapy session, or if they need to go see their psychiatrist, it'll be still a small and intimate group setting our group topics. So every day, we do two clinical groups. In the mornings, we're doing process groups, so we're just kind of looking at where the need is for the milieu at the time. So we might talk about boundaries, we might talk about respect. The kiddos might have something they want to talk about. So it's not going to be curriculum based for those groups. But in the afternoons, we do psych ed, and that's going to be curriculum based, and it'll be different day to day. So Mondays, they might have a mindfulness group. Tuesdays, they might have an anger management group. Wednesdays, they might have a healthy relationships group, okay? So we're keeping it broad, so that way, regardless of your diagnosis, you're going to be able to take something away from

Zandra Polard 7:27
it. Okay? I understand that makes sense. So that's kind of like because I'm in the educational system, and social, immersive, social, emotional learning is a big thing right now. So after covid, or during covid, people were isolated and dealing with bereavement, things like that. And so we're having issues with and also, like, just like with the video games and all that stuff, kind of put together the curriculum with education, adding that Sel is so important. And so it sounds like you guys use some of that stuff too,

Dr. Julia Kannard 8:03
absolutely, yeah, because there is a big social component to being in a residential setting, because they're with us for so long, they're with, you know, if they don't change units, they're with more or less the same group of kids for an extended amount of time, which can be really difficult when you're on a unit with 10, 910 people. It's like having nine or 10 roommates at one time. And I feel like having one roommate is hard enough. So we talk a lot about those social dynamics, because our milieus operate like many communities, almost. So we're teaching them the things that they need to be able to take with them, to go back into the community once they leave us, and then,

Zandra Polard 8:41
so is there, like, a wait list? And how long do people have to wait?

Dr. Julia Kannard 8:45
We don't have wait lists too often, which is really nice. I know we've had wait lists from time to time, so I think that's a good thing about us too, is we have a lot of beds to offer, and we can usually get people in

Zandra Polard 8:57
pretty quickly. Oh, nice. So then say there's a concerned family, and they want some and they need an assessment. How do they do that?

Dr. Julia Kannard 9:06
So they would just contact our admissions department, and they would say, hey, I'm interested in seeing if my kiddo is a good fit. They have X, Y and Z needs, or if, if it's not, the family directly reaching out. Sometimes we'll get referrals from acute hospitals or other programs, and so they might reach out on the family's behalf and say, We have someone we want to consider sending to your program. They'll send us a referral packet. I do the reviews for clinical and then our director of nursing reviews for any medical concerns, and then together, we kind of look at the whole big picture to make sure we're going to be a good fit for them. Now, what

Zandra Polard 9:44
if there's a potential patient, and let's say the parent is not sure if there's a diagnosis, they need an assessment. What is that like, if they when they go down the. There. How long does that assessment take? Is it like a series of questions on paper? Is it a personal interview? What is an assessment

Dr. Julia Kannard 10:09
like? It's pretty thorough. So our admissions team will ask questions to get an idea of the mental health concerns, substance use concerns, trauma concerns, any educational concerns or community concerns like maybe legal involvement. So she has a whole assessment that she goes through, so we get a really good snapshot of what the concerns are that would lead someone to come to us just to make sure we're the right fit in the right setting. Because if they're not, if they maybe need a PHP program instead of residential, we're doing our assessment to make sure we're not just we're not going to bring you in just because we have an open bed. We want to make sure we're going to bring you in because you need our help and we can meet your needs, right?

Zandra Polard 10:50
That is a great fit. So in terms of family supports and peer supports and those type of group settings outside of a hospital, they're known to work very well for a lot of people. However, it's better to have a therapist, right, a professional to lead a group, right? What is the difference between peer led and having an actual professional in the room to lead those groups

Dr. Julia Kannard 11:23
versus a peer led group? Yes, yeah. So with the the therapist led groups, you know, obviously you have a trained professional who has the background and the education to, you know, speak to certain topics. I feel like they have the insight to, you know, make connections about what's being discussed, and if it's appropriate, they can challenge clients to go a little bit deeper on things. And to be fair, when I have run groups in the past, like process groups, for example, my favorite, my favorite dynamic at a process group is when the kids are invested in it to the point where they start to ask each other questions and challenge each other, and maybe not to the level that a therapist would, but you see them start to ask each other about you know, if someone brings up a concern about a family member, you see a peer kind of challenge them on some things about how they contribute to that relationship dynamic and sometimes like, that's a good question. I would ask that too. But you see them, you see the wheels turning in them drawing connections, which with our setting and our age range. You know, you will see that they're at that age where social connection is really important. So you can get different answers when it's peer led, where they may be more willing to share some things with a peer versus a therapist, but you also see them making the connections to help them in the healing journey too. So it's not like they're just they're saying it to say it for show. It's they're actually connecting and understanding how behaviors lead to different outcomes, and that's what we want them to take away, is understanding what led you to this point, and what can you take away so you don't have to come back to this point either, right? And then

Zandra Polard 13:08
sometimes people don't realize that they actually need the help. You know, I've seen where the parent is pulling their hair out trying to explain to the child, what's wrong? And the kid is just not getting it. It's not connected. So when they're around more peers that are maybe going through some of those same things, you know, I can see how maybe a light bulb would come on, right? But what if it doesn't? How do you get someone to know they really need the help.

Dr. Julia Kannard 13:43
Yeah, and I think we see that a lot in the beginning of treatment for residential setting, at least, you have kids who really don't want to be there. Not that anyone wants to be in residential for the most part. But in the beginning, there's a lot more unwillingness and a lot less motivation. The kids are really fixated on discharging and going home or just not being in residential and I think that's the time where they have the most need, which can be really hard for them to take a look at themselves and say, I have all these things that I need to work on. And, you know, feeling some sort of way about it, like, know what's wrong with me? I think parents feel kind of similar to like you're saying they're sitting there pulling their hair out, because not only is their child at wit's end, but the parents like, I've exhausted all my tools too. So I it's like, hands up. I'm hoping your facility can, you know, bring us something that we don't know about, give us the tools because we've used them all and they're not working. So I think there's a lot of that parallel that we see between the kids and the parents. When they come in, there's frustration, because they're like, I don't know, I don't know how to fix this because I've tried everything. Or they're like, nothing's wrong with me, and I'm fine. I just need to leave, which we get a fair amount of that. So when we get the kids who are like, You know what? There's. Nothing wrong with me. I don't know why I'm here, even though we may know it's a process of kind of walking side by side with them to help them make that connection themselves,

Zandra Polard 15:09
too. And then, you know, parents can't think, Oh, they're gonna be gone for a couple months.

Dr. Julia Kannard 15:14
Really, it is respite for the parents sometimes and then,

Zandra Polard 15:18
but they think sometimes they'll come back and it's all fixed. No parents have to be involved. They do. Yeah, so before they're discharged, is there like groups, when you start meeting with the parents and the child, and how does that

Dr. Julia Kannard 15:35
go? So from the very beginning, we're starting family therapy. Oh, because realistically with it, if they're here for 90 days, they're going to get 12 family sessions, which isn't a whole lot, so they get it once a week for an hour. So we really encourage that from the very beginning, we do an initial call with the parents, just to see what the concerns are from their perspective. And then we bring the family together to start really digging into that family work, and I think within those sessions, the therapist is able to model a lot of things for the parents too. So and we can do a lot within the family sessions, the therapists, like I said, Can model for the parents different ways of interacting with the child. We can do sessions with just the parents, if we need a little bit more parent coaching or a little bit more study, more psych Ed, just for the parents, we can do different dynamics of families, like if we have a divorce situation, we can do a session one week with dad, one week with mom, or we could do blended sessions. So it's really just whatever that family need is we want to be flexible and try to meet that as much as possible within those sessions.

Zandra Polard 16:43
Awesome. That sounds wonderful. Now I wanted to ask you, what is the difference between oppositional defiance disorder and personality? What is it person, personality, mood disorder, is that it Yes, okay. What is the difference between those two?

Dr. Julia Kannard 17:04
Yeah. So with a lot of the mood or personality disorders that you're gonna see, things like bipolar, borderline personality disorder, narcissistic personality disorder, which is, you know, kind of a small portion of all the diagnoses that are out there, because the DSM five, I think we're on, has hundreds and hundreds of diagnoses. So with other diagnoses, and all of them, they're based on symptomology and different behaviors and presentations. So the symptomology is just going to look a little bit different, where, like with Oppositional Defiant Disorder, primarily that is seen with kids, and so you're seeing a lot of the opposition, the resistance, you know, not being willing to follow rules, whereas with some of the mood disorders like bipolar, we see things like mania, for example, where it kind of ties into some of the personality, but still is the behavioral component.

Zandra Polard 18:08
So so they're similar, but one we're going to see like maybe depression, and then the opposite of that, yeah, grandiose,

Dr. Julia Kannard 18:18
yeah, yeah. And with, and I feel like there's so much crossover with symptomology too, where you know someone, if they have a mood disorder, there probably is some component of depression or anxiety mixed in there. But you know, with bipolar, you might see the mania, or with borderline personality disorder, you might see some of that, like hot and cold. I love you, I hate you, sort of a

Zandra Polard 18:40
presentation. Okay, so do not self diagnose.

Dr. Julia Kannard 18:44
Oh my gosh, we would all have everything.

Zandra Polard 18:48
Let someone who is trained and who understands that DSM five very well to assess you know what's happening with you or your child.

Dr. Julia Kannard 19:00
And our providers do a really good job of diagnosing too, because I I know with a personality disorder, for example, it can be, I've seen it in the past where someone's given a diagnosis of borderline, for example, and then that just follows them throughout Life. And we really want to make sure if you have that, we are 100% sure you have that. So our providers take a lot of time of doing rollouts too. So we might start with, you know, major depressive or an unspecified mood disorder, and really take time to figure out all the symptoms and comparing that with the DSM to make sure you know, if I'm giving you a bipolar diagnosis, I feel very confident that you have that

Zandra Polard 19:47
right. Or is it true that someone can have a diagnosis, let's say at age 12, but by the time they're age 16, they don't have that anymore. They have some. Else, right? That's pretty much, I think, what you were

Dr. Julia Kannard 20:02
saying, yeah. And I mean, with with kids and kind of the old way of thinking, and I'm not sure how it is currently, but I know back in the day, you had to be 18 to get a diagnosis of a mood disorder. So I'm not sure if that's still the case, because I know at our current facility, our psychiatrists are primarily doing the diagnosing, but if you think about it, how much development is going on for a child, cognitively and physically, it makes a lot of sense why we would be hesitant to give such a hefty diagnosis when there's so much already happening within that child. Not that it stops at 18, but I think within those you know, adolescent years, there's so much development happening. Is it, is it truly a mood disorder, or are we just seeing things that are kind of intertwined with their development at that

Zandra Polard 20:53
stage too? Yes, absolutely. That is a great point. Yeah, because, you know, I've seen people who were diagnosed, as, you know, on the spectrum of certain things, I won't say. And then later on, either some of those people things got worse or things got better, you know, and then also, with the the med management, right? So we'll see also, people feel like, Oh, I'm better. I don't need my medication anymore. Yes, and there, here comes the revolving door, right? Yeah, they end up back in the hospital. Yeah, yeah.

Dr. Julia Kannard 21:33
I feel like that's a really common conversation I have had with people for the entire time I've been in the field, especially when I was working outpatient, they feel like, Oh, well, you know, I'm feeling better. I haven't taken my meds in three days. I'm like, okay, not only is that dangerous physically for your body, but how are you feeling emotionally now? And it's not, you know, I kind of compare it to, you know, physical medications. I think someone gave me a great example one time of diabetes medication. So if you're you have diabetes, and you're taking metformin and you feel better, and your a 1c is coming down. That means that you're responding well to the meds, but if you stop taking it, your a 1c is probably going to shoot back up. So and I know it's a little bit different from like diabetes versus major depressive disorder, but I think being able to like my goal for someone, if possible, would be, you know, you come in at residential and that's when your needs the highest. So we have this high need for coping skills, because we have a low set of them. So meds usually are, you know, a big part of that. So that way we can stabilize some things while we're equipping you with the coping skills. So that kind of balances out where it's like, we don't need meds as much because we have more coping skills. And maybe you don't need medications forever, but in this time of really high need, it's going to help you so you have the headspace to do the work and it and I will say, if you're on meds forever, not going to judge that either, because some people, you know, maintenance meds, cool, if that works for you, awesome. But I know that's not everyone's path, but being able to get to a point where you have enough skills to not need the meds is going to be important too. We're not just like, Oh, I feel better. I'm going to toss out the window and then, like you said the revolving door, yeah.

Zandra Polard 23:21
And I just want to put that out there, because I always say, you know, never, ever stop taking your medication without consulting your doctor, because that psycho psychiatrist is going to slowly wean you off if that is to happen for Right, right? Yeah. So what I wanted to ask you also, I was thinking about so much so my mind went back to covid, and I was thinking about how telehealth has improved, and it's become so accessible, but we're back to the same situation. There's so many people who need help, it's difficult to get those appointments too now. Yeah, it is. Yeah. Do you guys offer telehealth at all?

Dr. Julia Kannard 24:10
Or so we do telehealth for our therapy sessions. If a family isn't local to Nevada, okay, so let's say a family's from Arizona. The kid comes to us for treatment, for those family sessions, we would try to offer telehealth that way. It's as as much in person as it can be, but on video. Because, kind of like we were talking about earlier, that family components really important, and just because you're not in the state to come do an in person session doesn't mean that you shouldn't get a session. So I think there's a lot that you can still get from telehealth,

Zandra Polard 24:42
okay, and that's how you guys implement it, yep, yeah. But what do you think? And this is aside from where you work, what do you think about telehealth? Now, doesn't it seem like are there enough therapists? Is what I'm getting at like, come. Come on, let's be real. People are still challenged with getting care.

Dr. Julia Kannard 25:05
Yeah, yeah. I think one of the good things about covid, like you said, is that it kind of opened up the world of telehealth and made it, I don't know, just more of a known option. And I think a lot of people, because we had to go virtual during covid. It kind of forced people into telehealth. And then I think some people just stayed there because they're like, Oh, this is great. Like, I can, you know, do my sessions from wherever I'm able to reach a lot more people. So I think that it's, it's been really helpful in that aspect. But I, I find myself saying, Where are all the therapists in Las Vegas? Because I feel like there are none. They come out of the woodworks. Every once in a while. I'm like, Where have you been for the last two years? Yeah, so I think, and you know, I did teletherapy during covid too, because I just, I'm one of those therapists that thinks therapy is good for me too. And I was, I was kind of challenged in finding someone, because I don't think people always know where to look. So I was like, Oh, I just call my insurance. I don't know what else to do, but I think there's so many different options now with, like, better help and like other places that, like, all they do is telehealth therapy, where I think over the years, it's just like I said, it's gotten more prominent. So I think it's just become more accessible and better known to people,

Zandra Polard 26:28
yeah, and but you know what I want to say? There's a lot of people who don't know where to begin. And so you mentioned that insurance, you call your insurance look on the back of your insurance card and call the number for therapy or mental health services, okay, and see what is offered for you. Anyhow, I want to thank you again for coming back. You're such a professional now. Thank you the first time you were so nervous, and now it's like nothing. Yeah. So anyhow, this is Sandra Pollard, and that, ladies and gentlemen, was Dr canard from Sun arch Academy. Let's give him a phone number.

Dr. Julia Kannard 27:13
Our phone number is 702-982-7060 01. More time, 702-982-7060 702-982-7600,

Zandra Polard 27:23
alright, and this is Sondra polar. It's where I am. Is on 91.5 jazz and more every Saturday at 7:30am I'm here today, and I'll be back next week. Have a good one. Bye. You.

Music 27:39
You.

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