ARC Innovation and Sheba Medical Center, Israel’s largest medical center and a Newsweek ranked world’s best hospital for the last five years, announced today the integration of technology developed by two startups, Cognishine and Kemtai, to augment healthcare in the hospital’s newly expanded rehabilitation ward.

Sheba Medical Center is home to Israel’s largest rehabilitation hospital. Amid the Israel-Hamas war, Sheba expanded the hospital with the addition of a new state-of-the-art 36-bed ward to treat wounded soldiers. The new ward leverages a range of innovative digital medical technologies to augment medical staff capabilities and improve overall quality of care. 

“Now is the time to innovate. During the COVID pandemic, Sheba created innovative solutions to save lives and helped set the health protocols for the rest of the world,” said Prof. Eyal Zimlichman, Chief Transformation Officer and Chief Innovation Officer at Sheba Medical Center and Director and Founder of ARC Innovation. “Times of crisis present an opportunity to accelerate innovation and transformation in care. And this is exactly what we are setting out to do, given the immense need for rehabilitation in Israel at this time.”

To maximize the effectiveness of the new ward, Sheba called upon Israel’s startup ecosystem, inviting health tech companies to submit solutions for potential use in the rehab hospital. Out of 82 companies that applied to the project, eight were selected to pitch their solutions to a panel of Sheba clinicians and industry leaders. Out of these eight companies, Cognishine and Kemtai were selected to begin a pilot program at Sheba, with the aim of incorporating the solutions into day-to-day rehab treatment.

Cognishine’s digital platform supports therapists in providing effective care for cognitive, emotional, speech and language disorders. Digitizing traditional therapeutic processes, the company offers a wide range of activities based on real-world scenarios to help patients to regain cognitive, speech and social-emotional capabilities.

“Cognishine extends the reach of medical professionals, enabling them to continue providing care through digitized therapeutic activities aiding cognitive abilities,” said Nimrod Zilkha, Co-Founder & CEO of Cognishine. “We are honored to play a role alongside Sheba helping soldiers recover from the war and get back to their daily lives.”

Kemtai is an AI-powered exercise platform for physical therapy and rehab, compatible with most phones and computers. The app provides real-time feedback and corrective guidance during exercise, enabling patients to improve their performance and accelerate recovery.

“Kemtai is enabling patients to fully adhere to their rehabilitation exercises with AI-guided, real-time guidance, helping achieve the best possible outcomes,” said Dr. Mor Amitai, CEO of Kemtai. “Our pilot at Sheba will see even more patients with physical limitations recover through augmented exercise.”

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About Sheba Medical Center

The largest and most comprehensive medical center in the Middle East, Sheba Medical Center, Tel Hashomer is generating global impact through its medical care, research and healthcare transformation. Sheba’s City of Health boasts acute-care, rehabilitation, children’s, cancer and geriatric hospitals, research and innovation hubs, medical simulation center and center for disaster response on one comprehensive campus in the center of Israel. Sheba serves as a true hospital without borders, welcoming patients and healthcare professionals from all over the world and consistently providing the highest-level medical care to all in need. Sheba has been ranked a World’s Best Hospital by Newsweek five years in a row (2019, 2020, 2021, 2022, 2023). For more information, visit: https://sheba-global.com/

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Iowa State University (USA) researchers set out to see if exercise improved depression symptoms in the short term. Today, we look at the prevalence of depression in the general population before turning to the positive results from the new studies.

Depression prevalence

Syndromes of depression are pretty prevalent among adults worldwide. An examination of 21 countries discovered a 12-month prevalence of unipolar depression to be five percent.

The lifetime prevalence of depression is about 12 percent, according to surveys from 14 countries. There appears to be a striking difference in the incidence of depression when we stratify it by income:

• In developed countries (for example, the United States and Europe), the lifetime prevalence of depression is about 18 percent.
• In developing countries (for example, China, Mexico, and Brazil), the lifetime prevalence of depression is nine percent.

The significant differences in depression risk may be secondary to sampling errors, challenges with applying diagnostic criteria in all locations, or genetic and cultural factors.

Depression risk factors

Several factors are associated with an individual having a higher chance of suffering from depression. Here are some of them:

• Age. Major depression, at least in the United States, is more common among younger adults than older individuals. One community survey of adults 55 years and older showed that the one-year prevalence of major depression decreased with increasing age. However, depression appears more frequently among those with more medical challenges and assisted living or skilled nursing facilities residents.
• Income. There appears to be a slightly higher probability of suffering from depression among those with a lower household income than those making US $70,000 or more.
• Marital status. The lifetime prevalence of depression among those who are married (or cohabitating) is around 8 percent in the USA, compared with 13 to 14 percent for the never married, divorced, separated, or widowed.
• Race/ethnicity — In the United States, the highest prevalence of major depression is among Native Americans, with the lowest rates in Asians/Pacific Islanders. The lifetime prevalences of depression are 12 percent for Asians, 15 percent for Blacks, 16 percent for Hispanics, 28 percent for Native Americans, and 23 percent for whites.
• Sex — In the USA and elsewhere, the prevalence of depressive syndromes is about twice as high among females as males.

Depression and exercise

For the study, researchers recruited 30 adults experiencing major depressive episodes.

The subjects completed electronic surveys about depression symptoms before, in the middle, and after 30 minutes of moderate-intensity cycling. The participants also completed surveys afterward at the 25-, 50-, and 75-minute marks.

The subjects returned a week later. Those who had cycled during the first lab visit repeated the activity, but only after sitting for 30 minutes first. The other group reversed the exercise and rest order.

Depression symptoms better for up to 75 minutes

The surveys examined changes in three main features of depression, including depressed mood state, challenges experiencing pleasure from activities previously enjoyed (anhedonia), and decreased cognitive function.

Here are the findings:

During the cycling experiment, participants’ depressed mood state improved over the 30 minutes of exercise and up to 75 minutes afterward.

In terms of the ability to feel pleasure, the benefits of exercise began to wear off after about 75 minutes. Still, the exercise group scored better on this measure than the non-exercisers.

A single session can improve a depressed mood for at least 75 minutes, with drops in anhedonia (not experiencing pleasure) not lasting as long.

Cognitive behavior therapy

After the eight-week program, both groups showed improvement. Those who did an exercise program before cognitive behavior therapy had the most impressive drop in depressive symptoms.

Participants who exercised also reported a quicker, more robust connection with their therapists. The study authors suggest that exercise may prime the brain to engage in more emotionally challenging work with a therapist.

Thank you for joining me. If you have symptoms of depression, please let your health care provider know right away.

The post The Power of Exercise to Fight Depression appeared first on Medika Life.

Recently, a young woman living in New York City returned to her apartment, and a homeless man slipped through the locked entrance before it closed behind her. Following her up the stairs, he would murder her with a knife from her own kitchen.

Exhibiting a lack of escape plan, he barricaded himself in her apartment, forcing the police to break down the door. Calls to 911 by neighbors hearing a woman’s screams alerted them to the situation. The man was arrested and taken into custody, and he may be charged with a hate crime; the woman was Asian-American. Sources investigating the case found the man had multiple instances of criminal behavior and was released on his own recognizance.

This man is one of many who have fallen through the cracks in a mental health system in tatters and created by the well-meaning but inadequately managed deinstitutionalization movement after 1955, which picked up steam in the 1970s.

Unfortunately, it’s not the first time an individual in dire long-term need for care and treatment was left wandering the streets to assault and, in one case, murder a therapist in her office in New York City. The trial and that man’s insanity defense failed to place him in a hospital, and he went to prison.

With the closing of large, self-contained psychiatric hospitals that functioned much like small towns, many patients were sent to live in supervised housing or apartments or with their families. Promises of ongoing care and careful follow-up never materialized to the extent needed, and patients became homeless.

In some cases, repeated incidents of street or subway attacks never resulted in long-term care under strict supervision. Prisons became the “hospitals” for these patients who were now criminals. However, press coverage can lead the public to believe that all patients with a psychiatric illness are potential criminals or murderers, not so.

If the system is failing both the patients and the public, what possible solutions might there be that would meet the needs of both? One, of course, would be a return to the former hospital system where patients could live out their lives. I’m not sure the bucolic moral treatment existence related to me by old-time hospital staff was accurate, but it may have been better than our current state of affairs. Unfortunately, that wasn’t a time of intense data collection, so we have nothing to go on regarding incidents of criminality by the mentally ill.

I’ve worked in these hospitals, I’ve seen patients who could be safely returned to the community and ones that might never recover a rational ability to function outside the institution. One patient who was delusional and had killed his mother kept muttering that all women must die.

Patients on wards where I’ve worked had received treatment from insulin coma therapy, ECT, lobotomy, psychotropics, and behavioral therapies of many types.

Management at the hospitals wasn’t akin to anything resulting from an MBA. Some patients were “treated” with questionable psychotherapeutic techniques as they cycled through the wards. Therapists were unlicensed, physicians weren’t necessarily psychiatrists, and some were pediatricians in a hospital for adults.

The diagnoses ranged from mental developmental disorders, drug-induced delusions, to paranoid schizophrenia. And some of them had murdered one or many people. I worked with those patients, and I know some, who killed their entire families, did so by psychotic reasoning brought on by severe, extended stress. One wanted to die so he could join his family in heaven.

Today, I’m sure many of them live in communities near or far from the hospitals. I am not sure whether some of them would not have another break in their reality testing ability. Often, taking prescribed medication requires a level of care that is either lacking or there is resistance and discontinuance.

Do the mentally ill have constitutional rights regarding psychotropic medications and hospitalization, and how should these individuals be protected? One significant case brought before the US Supreme Court was a clever test of the issue of involuntary detention in a psychiatric hospital.

The case of Kenneth Donaldson was simple. Donaldson refused to take psychotropic medication, and because the hospital was not treating him, he argued he should have been discharged.

After the case was decided in his favor and the court agreed that Donaldson could sue those who took his freedom from him, he would write a book and be interviewed for a podcast. Today, in hospitals, we have legal procedures where psychiatrists decide whether a resistant patient needs meds, and they may then be forcibly administered.

Involuntary hospitalization remains one means of protecting those with mental disturbances from harm to themselves or others, but the question of competence remains. The statutes for obtaining orders to forcibly detain them vary by state, and they are known by many names. In Florida, it’s “Bakering” or the Baker Act. Most provide for several days of hospitalization before a person may request discharge if the medical staff agrees the current need for stabilization is over.

Where do we go from here? One aspect of this serious dilemma remains questionable; funding. If inadequate funds are authorized or poorly utilized when authorized, who will protect both patients and the public? Who is responsible for deaths and destruction of property when a patient is left to wander the streets and had been discharged to a community residential facility?

How much supervision do they receive in those residential housing units? I know of some places where staff leaves at 4 pm each day. There is no overnight coverage in the residence.

I remember a hospital worker once commenting on the excessive discharges of patients unready for release. “She’ll discharge them to a crate in the middle of the street.”

Civil rights and mental health issues clash frequently, and the outcomes are not precisely what is needed unless knowledgeable, caring, and prolonged planning is created. I once offered training for judges hearing mental health disability cases and never received a response. What type of training do judges receive in this area? I question whether they receive any.

The current state of affairs ensures that people will wander, people will be seriously injured or die, and the media will howl each time. But who will step up and attempt to fix the broken system? Anyone who presents themselves must be prepared for a rain of ire and accusations. It is not a pretty picture.

The post Senseless Murder Mandates Prison or a Psychiatric Hospital Admission? appeared first on Medika Life.

Am I blind to the fact that the nosology of psychiatry/psychology requires this distinction? I don’t think so, and I question using a word that appears to have evidence of its biological or “unconscious” base.

Yes, biology is often seen as the cause of so many mental disturbances, but we are still walking in a dark room with our eyes shut on that one. For every “discovery” about a gene connection, we find it’s a dead-end where treatments fail, yet we continue with the treatments as though they will provide a cure. Some of the treatments bring on more symptoms that then require another treatment. Consider the rash of TD (tardive dyskinesia) medications we’re now seeing on TV. It is an iatrogenic disorder.

Today, my substack is prompted by reading about play therapy, its effectiveness, and where it originated. I believe it has a place in treatment for children, but I am also aware of the warped history that came before it.

One of the significant forces that sparked interest in this form of treatment was the Virginia Axline book “Dibs in Search of Self….” Greeted enthusiastically by the public and professionals alike, I don’t believe many looked critically at Axline’s portrayal of her treatment and the boy. I think it’s similar to the case of the Sybil books. Authors can take some liberties with their books, but not when people’s lives are at stake.

I’ll give one example of a problem with Axline’s book. Axline stated the therapeutic intervention lasted six months. I understand it took much longer than that, possibly years, and I have to ask if Axline or her editors made that change in the book. The second point is Axline’s theoretical basis for her interventions, both of which she fails to outline in her book. It’s more of a diary than anything else.

What prompted her to conceive her approach? The critical readers of her book have pointed out that she subscribed to the original idea of the “refrigerator mother.” Cold, emotionally distant mothers were the genesis of the syndrome. One of the strong proponents of this orientation was Bruno Bettelheim, a man discredited for plagiarism after his death when research regarding his book on fairy tales and, allegedly, brutal therapeutic treatments came to light. His book, “The Empty Fortress..” lays the blame for autism squarely on mothers.

Bettelheim appears to have had no training or credentialing in the techniques he espoused and may have given himself a c.v. that was replete with falsehoods. The image he created has been repeatedly questioned, and it is astonishing. Despite all of this, too many hold him in high regard.

Of course, the journal he wrote while in a German prison camp is something we should read. But, considering his slipping into unverified rhetoric, we have to question that, too.

Aside from Freud, Bettelheim, and Axline, we need to, as is being done now, begin the work of repair on theory and treatment of mental disorders. If they are illnesses, let’s say what causes them and, if they are more dependent on environmental issues, okay. More likely, any disturbance is multi-factorial, and many treatments will still not hit the mark solidly enough to “cure” these illnesses. As one patient told me, relief from his auditory hallucinations was what he wanted.

The future is bright and promising in terms of neurobiology and psychological treatments and, for that, we should be grateful. One instance of a book where I believe we can take comfort in parents’ ability to help autistic children is “Son Rise,” written many years ago. I recommend you read how dedication and consistent hard work with a child can have incredible results.

Remember that we create “gods” in medicine and psychology, and too many of them have feet of clay. Psychology has a few presently running around beating their chests like prominent warriors in the war for mental health treatments. But they may provide a crumb of an idea that can be extended to something worthwhile. Worshipping them without recognizing their humanity takes the wrong road on a dangerous highway.

The post Old Theories, Questionable Experts, and Mental Disturbances Need to Be Deconstructed appeared first on Medika Life.

Ethic pride in some homes, my grandparents being one of them, meant no English was spoken in the house, no English newspapers, and no radio programs for English-language anything. My mother bristled against it but had no choice but to speak the native tongue, not English.

Despite this home mandate, she did speak English without any hint of an accent and determined that none of her children would speak anything but English. A second language was verboten for us.

My requests to learn my grandmother and my mother’s foreign language went unheeded. There was a strong refusal to teach me anything but a few words, and that was the extent of it. So, I had a grandmother with whom I could not communicate and a mother who refused to help with this roadblock to connection.

I don’t blame my mother. I understand that it must have been complicated living under those conditions and then going into a world outside the home where she spoke only English. In addition, her home was targeted by people against her parents’ native country. They threw rocks and spit at the house.

Now research into language, specifically second languages, is casting new light on why learning a new language would be beneficial. It’s probably going to mean big business surges for Babbel, Rosetta Stone, Pimsleur, Duolingo (my preference), and others.

There used to be a fantastic Japanese program (sorry, I forgot the name) that taught you about the culture and how to write in the language, but it’s gone now. Really a shame because explaining how sentences are created offered insight into the economy of expression in Japanese. If you do want to learn Japanese, there are free online programs.

Second Language and Dementia

A concept with great potential in terms of dementia and warding off its ravages is now being investigated with more zeal in the professional literature. The cognitive reserve concept refers to the maintenance of cognitive functions in instances where we would expect cognitive decline.

Several factors have been tapped to delve into what might be responsible for the most robust ways to maintain healthy cognition. One promising area is that of bilingualism. The conclusion of one study was, “In all cases, bilinguals revealed patterns that were consistent with the interpretation of protection for cognitive reserve when compared with modeling goals.” We also know that bilingualism may also contribute to developing more robust brain areas. Therefore, the benefits begin quite early in life with children.

Cognitive reserve is also called neurocognitive maintenance, neurocognitive compensation, brain reserve, and brain maintenance. All of us understand the importance of maintenance, and, indeed, maintaining our brains at optimal levels would seem prudent. If bilingualism, whether by birth or through efforts at learning a second language later in life, could contribute to this cognitive reserve, the question would be, why isn’t everyone doing it?

In fact, why are schools eliminating foreign language course requirements? Yes, computer programming is a language of sorts (Python, Java, Cocoa, Fortran, C++, Cobol, SQL), but does it have the same effect as linguistics? Foreign language may be as crucial as cursive writing, and we see where that’s going.

I would assume people aren’t signing up in record numbers for foreign language classes because they don’t know about the research, and sufficient attention is not being paid to it by the mainstream media. As one researcher put it, the answer to some forms of dementia may be hiding in plain sight.

According to some estimates, half the world will be suffering from dementia by 2050. The cost for caring for these individuals will be in the billions, if not the trillions of dollars; the pressure should be mounting now for forms of cognitive maintenance.

We are being told about diet, exercise, healthy behaviors, and activities, assuredly, but a straightforward action, learning a new foreign language, hasn’t been mentioned anywhere I have seen it. Have you?

Want to be shocked a bit more? The same research that I’ve been reading provides a rather startling fact regarding instances of dementia in an aging population. If we could put the symptoms of cognitive decline off for merely one year, this researcher estimated that by 2050 that would mean 9 million fewer cases of dementia and or Alzheimer’s disease.

If we put cognitive decline off for two years, the projection is that 22 million will be spared from dementia for that period. But these are only somewhat enlightened guesstimates. Sadly, Alzheimer’s remains a significant mystery and a disorder that medical science has yet to be effectively combated.

Excruciatingly small steps, in terms of cognitive improvement, are shown in some Alzheimer’s protocols. Still, they are not long-lived, nor do they bring the person a return to a somewhat everyday existence. I was in an Alzheimer’s protocol, and the best the patients could do was to say “good morning” to someone.

Unfortunately, although researchers are pointing to bilingualism as an essential element in maintaining brain health, they also admit that this is an area where the mechanism is poorly understood, and further brain research is required.

The research thus far, however, has indicated that the “bilingual experience stimulates crucial attentional processes, fortifying them for other purposes, and potentially creating a foundation for cognitive reserve.”

Multilingualism, therefore, builds a foundation for the future, and just as we contribute to our retirement funds, shouldn’t we be contributing to this critical reserve? If one language is good, how about more than one new foreign language?

In the famous nun’s study, a nun made it her yearly resolution to learn a new language. If I’m correct, she lived to be about 103 and was lucid until the day she died.

If we wanted to learn a foreign language after completing our educational efforts, we would have had to pay hundreds of dollars to go to specialized schools where we would immerse ourselves in a second language. Most people know the famous Berlitz school, where many international corporations enrolled their executives before assignments at foreign offices.

Today, the Internet has provided a yellow brick road at little cost and at our convenience to learn a second language. How much would it take each day for you to utilize one of those online programs? You might devote an hour or so, and within several weeks you would have at least a working vocabulary and be familiar with sentence structure. Then you can build on that by using your new skills on native speakers in your area, and each word is like more cement to protect your brain.

With each bit of language that you accumulate, you will be assisting your brain to fortify itself in those mysterious ways that scientists still don’t understand. But, understanding is not the important thing here. Brain health is what we are attempting to maintain and how the mysteries of the brain accomplish this isn’t necessarily something for us to understand.

Indeed, we’re not going to become neuroscientists because we don’t have all the years required. But we can, in a short time, do some marvelous things for ourselves, our families, and our societies. We can learn a second language.

What will you do?

The post A Second Language May Be Your Defense to Ward Off Dementia in Your Life appeared first on Medika Life.

In the very beginning, I must admit, there was a small bit of a thrill inside me: “I’m joining the war against SARS CoV-2…I’m part of the fight in this global pandemic.” People all across the world stood up to thank us, whether banging pots and pans from their windows, or sending us cards, posters, and treats. While we are not in it for the praise, the praise was nice nonetheless.

Almost two years into this pandemic, I must say that thrill is gone.

In my entire career, I have never experienced the scale of death and destruction by one condition. I was in practice during the 2009 H1N1 pandemic; I have worked many bad influenza seasons. All of those pale in comparison to the SARS CoV-2 pandemic. It has been horrific.

There are scenes in my head that can never be unseen. Patient after patient after patient has died – many times alone in the ICU with their families screaming in anguish on an iPad. We are exhausted, physically, mentally, and emotionally.

We had thought that, with the advent of vaccines, it would be the beginning of the end. Indeed, tens of millions of us have gotten vaccinated, and in the beginning of the summer of 2021, it seemed like it was over.

But there were also tens of millions of us who didn’t want to get vaccinated, even though the vaccines are incredibly safe, incredibly effective, widely available, and free of charge to boot. And when Delta hit our shores, the anguish started all over again.

Hospitals and ICUs were, once again, overwhelmed with COVID-19 patients. Once again, tents were erected outside of Emergency Rooms. Once again, resources were running thin. In one of my hospitals, we came dangerously close to running out of ventilators. In some parts of our country, fellow colleagues had to choose which patient would live or die. I never though it would be like this – again – in the summer of 2021. But, it was, and we are exhausted.

And now, way more than before, the patients coming in with COVID-19 – the overwhelming majority of whom are not vaccinated – are younger. And, they are dying.

What’s more, many of them are angry and belligerent towards us. What did we do? Why are you taking our your frustrations out on us? We are angry, too, but we would never take it out on our patients, who come to us seeking our help to relieve their suffering. It’s been a terrible road, and we are exhausted.

And, like I said, the virus is not yet done with us. I genuinely fear this winter, where we may very well have “Revenge of the Flu” along with a steady stream of new COVID-19 patients. It may very well get worse before it gets better. But, we don’t have much left to give. We are done with this virus, and we are exhausted.

And so, as we soldier on, all I can say is, “Thank You.”

From the very bottom of my heart and soul, I say “Thank You.” Thank you, my sisters and brothers on the front lines, for all you have done. Thank you, my sisters and brothers, for your fatigue. Thank you, my sisters and brothers, for your exhaustion. Thank you, my sisters and brothers, for your exasperation.

This pandemic has tested us to our very cores, and I pray that we will come out of it much better caregivers and much better people, our emotional scars notwithstanding.

If I said “Thank You,” my sisters and brothers, for eternity it would not be enough. But still, let me say, one more time, “Thank You.” You are all so special to me, and you will always be in my heart and my prayers.

The post Sisters And Brothers On The Front Lines appeared first on Medika Life.

AHRQ, a branch of the U.S. Department of Health and Human Services, issued a challenge during the summer of 2020 for hospitals to present evidence-based plans to address the needs of women and families after having a baby. Helena’s St. Peter’s Health and Birmingham, Alabama’s Pack Health were the winners of a $50,000 award for their innovations.

St. Peter’s team implemented universal screening programs to identify at-risk mothers. The hospital screened patients for risk factors such as alcohol, substance use, depression, and anxiety. The health team connected patients and families with community resources.

Birmingham’s Pack Health program leveraged a digital health platform to connect new mothers to coaches and health advisors.

Photo: kieferpix Istock/Getty Images

Postpartum depression is an inaccurate term. Perinatal mood and anxiety disorders can occur anytime after conception up to one year after delivering a baby. One in seven women suffers from a mood disorder related to pregnancy and childbirth.

Risk Factors for Perinatal Mood Disorders include:

• Stressful live events.
• Low social support.
• Previous history of depression.
• Family history of depression.
• Difficulty getting pregnant.
• Being a mom to multiples, like twins, or triplets.
• Being a teen mom.
• Preterm (before 37 weeks) labor and delivery.
• Pregnancy and birth complications.
• Having a baby who has been hospitalized.

Perinatal depression can be dark and debilitating, leaving mothers unable to function or adequately care for themself or their baby. Symptoms vary from person to person but include crying spells, sadness, hopelessness, and guilty. Some may express a lack of happiness or feel the absence of bonding with the baby. Some may have thoughts of self-harm or of hurting the baby.

Shame, guilt, and feelings of inadequacy prevent moms from reaching out for help. Moms fear judgment. They wonder “what is wrong with me” for not feeling blissful over the birth of their child. They fear their family will judge them. Others fear they may lose their baby if they express their true feelings out loud.

Some moms have intrusive thoughts causing fear and anxiety. Negative thoughts do not necessarily equal behavior. Help is available to manage these thoughts.

These symptoms indicate a new mom requires medical attention. The first step in treating perinatal mood disorders is recognizing the problem. Patients are often relunctant to share these feelings. Health providers may not be comfortable in screening for peripartum mood disorders.

Treatment options vary from person to person. Some women may only need to expand their social support network. Others benefit from group or individualized therapy. Pharmaceutical interventions may be needed for others.

The Agency for Healthcare Research and Quality recognized the increased challenges facing postpartum mental health care in the rural setting. Access to care, cost, transportation, and internet access all create barriers to identifying and treating those at risk for perinatal mood disorders.

The federal agency’s mission is “to make health care safer, higher quality, more accessible, equitable, and affordable,” The stated goals are to “keep patients safe, help doctors and nurses improve quality, and to develop data to track changes in the health care system.”

The AHRQ competition brought together digital health and other nontraditional health partners to find unique and innovative solutions to help rural families receive the help they need. Perinatal depression and anxiety universal screening programs for perinatal depression and anxiety along with patient and provider education programs help these women come out of the shadows.

Women need to know they should never feel ashamed to speak up about postpartum depression. These award-winning programs help patients and doctors learn to ask the right questions to get the help they deserve. 

The post Helena Hospital Awarded $50,000 for Helping Women with Postpartum Mental Health appeared first on Medika Life.

The Steven A. Cohen Military Family Clinic at Metrocare is a non-profit mental health clinic serving veterans and their families throughout North Texas. The Addison clinic previously offered couples and group therapy to active duty servicemen and women. This expansion of services announcement opens the door for any active-duty personnel to seek individual treatment.

Veterans and active-duty members face a variety of potential mental health challenges. Like civilians, Covid-19 has exacerbated these life stressors.

Metrocare providers have been offering North Texan veterans evidence-based care since 2016 for a wide range of mental health challenges. Help is available for depression, anxiety, and post-traumatic stress. Other families seek help for adjustment issues, anger management, and grief counseling. The clinic also provides therapy for service members struggling with family issues and relationship problems. The family-friendly environment also provides care for children.

The Cohen Clinic at Metrocare also offers case management services to connect veteran families to community resources and services.

The Addison clinic is nearing its fifth anniversary serving the community. This office is one of the original sites of the now nationwide Cohen Veterans Network (CVN). Military families now can get the help they need at one of the 19 Steven A. Cohen Military Family Clinics across the country.

Clinic Director Dr. Amy M. Williams highlights the need to provide mental health care throughout the continuum of military service, stating, “By including the individual active duty service members, we can begin to address problems closer to their onset instead of waiting until after service discharge. Providing timely and effective mental health care strengthens our military and, ultimately, our veteran population.”

The Cohen Clinic is partnered locally with Metrocare, the largest behavioral health services provider in Dallas County. Together, they have served over 2,000 North Texas veterans and family members.

To reach more people in need, The Cohen clinic builds on existing partnerships with the Department of Defense, the VA, and veteran service organizations (VSOs) throughout North Texas. The VA offers specific tools to help veterans cope with the challenges of the Covid-19 pandemic. They acknowledge making the transition to civilian life was already difficult. The pandemic adds to the stress and mental toll.

The 2020 National Defense Authorization Act authorized the Department of Defense to find community-based care for veterans if DoD could not arrange an internal referral. The Cohen clinic fills the void for our service members making the transition to civilian life.

The Covid-19 did not stop the Cohen Clinic at Metrocare from providing mental health treatment access. Telehealth and virtual care access continued through the CVN Telehealth platform. Virtual therapy options expanded access for service members in various military installations across the Dallas Fort Worth Metroplex.

As in-person visits resume the clinic plans to restart its Military Family Clinic Classes to help provide holistic and comprehensive care to the entire family.

Improving access is an essential step in caring for those who serve in the Us military. Data from 2012 showed veterans reported severe psychological distress more often than nonveterans, but less than 5% report the distress. Public health experts now prioritize the well-being of military personnel and their families.

Any active-duty service member is eligible for care with a Tricare referral.

For more information, check the company website: Cohen Veterans Network news release.

Learn more about the Cohen clinic’s mission and values here.

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It is increasingly difficult, if not bordering on impossible, in today’s America to find decent mental health care. Therapists are in short supply and spoilt for choice. They can cherry-pick patients from the long waiting lists of people requiring their help and insurers are reticent to pay for care.

In my colleague’s case, she had the added burden of wanting to find a Korean-speaking therapist who would not only be able to speak her native tongue but more importantly, would understand the dynamic of an Asian family.

She turned to the Employee Assistance Program (EAP) offered by her employer to try and secure the services of a therapist. Although she has now established contact with one, the process was onerous, time-consuming and a far cry from ideal.

The therapist she found isn’t Asian and doesnt speak Korean — according to the American Psychology Association, only 5% of psychologists in America are Asian. He also isn’t covered by her insurer but she is left with no other choice and has decided to commit.

Not everyone does. Providing family therapy is a complex process and it requires a clear understanding of the interpersonal dynamics at play. Asian families differ from Mexican families in the same way that White American families differ from African-American families or European families. It’s a cultural thing.

To provide effective treatment the therapist has to be intimately versed in the family’s culture and traditions. Jewish people look for Jewish therapists, Irish Americans look for therapists with Irish backgrounds, and so on. This raises the question, what happens when you are presented with a system like her EAP that doesn’t have the flexibility to address these elements? The answer is simple.

You are provided sub-standard levels of care or at worst, no care at all as the recommendations are not suited to the patient. This is a system that works partially, but that is built to enforce racial and cultural biases, not intentionally, but consequentially. Before you go off on the racial bandwagon, it is very doubtful that the creators of this system purposely designed it this way.

It merely suffers from a poor or inadequate design that is further restricted by an inability to evolve or adapt to the fluid landscape it inhabits.

The issue here, in terms of the systems we deploy in healthcare, is primarily a discriminatory one, based on cultural ignorance or a conscious decision to focus on the predominantly white American patient model for developing solutions.

This raises another question. Which other systems do we currently use that have been developed using white middle-class American patients as a baseline? Which products are currently being developed that will further enforce this systemic bias? New technology-based solutions that promote cultural disparities in healthcare and reduce access to care?

I can assure you these are in development as we speak, with most developers blithely unaware of the consequences of their chosen data set or model.

The Rainbow Society of Modern Day America

America is a melting pot of cultures, colors, and religions. A human stew, each ingredient having contributed to the growth of the country and each one as deserving of proper medical care as the other. To ignore this is to ignore the very fabric of what once made America great. Diversity is a strength, shared under one flag. That’s the theory.

In practice, things look bleak. Racism and cultural discrimination permeate American healthcare, in much the same way they permeate American society. Healthcare is, arguably, simply an extension of the society it serves, so this shouldn’t come as a surprise to anyone.

Don’t take my word for it, speak to someone of color if you’re white, or read one of the many excellent articles on the topic from people that experience health disparities first hand. This week, Asian-Americans experienced the brunt of this evil, next week the Hispanic community may be up.

This ugly undercurrent flows continuously through modern-day America, thinly disguised beneath an increasingly tenuous veneer of civility. I dislike the term “racism”, but for the purposes of this article, it will suffice and I raise this point for one simple reason.

If we have inherent racism and bias being exhibited by providers, unintentional or otherwise,, and we then add the burden of racially or culturally biased systems to the equation, what chance do these groups stand of accessing fair and equitable care?

Systems and people are not the same things. Systems are easily fixed if the desire and motivation exist. We can easily begin assessing software and digital health solutions for inbuilt biases that may inadvertently discriminate against certain communities. We can examine entrenched systems and develop guidelines for new systems.

Well-built, robust systems are designed to evolve and expand beyond their original parameters. Staid, old, and inflexible solutions will simply fall by the wayside. For instance, simply broadening the societal scope under which products are developed to account for cultural differences would directly and immediately benefit patient outcomes.

It’s a complicated world, where solutions cannot be everything to everyone. Issues around race and culture have to be considered alongside age, sex, and other complex criteria that affect our ability to deliver care. Where patient-facing technology is deployed, inclusivity must be maximized and where certain demographics are left incapable of accessing these solutions, alternatives must be provided.

We no longer have the excuse of ignorance on our side. Healthcare is aware of its failings and it is aware of the steps needed to address these issues. The problem, as I see it, is that this is not the only ill that hangs over American Healthcare. Other issues, equally pressing and equally as important to the delivery of effective care, also need to be addressed.

It is a question of priorities, of repairing other systems that are not fit for purpose. Where the issues of addressing cultural and racial disparities fit into the jigsaw puzzle of an industry barely holding together under the stresses of a pandemic and logistical demands, remains to be seen.

But address them we must. The mechanisms I refer to can and do result in death. Take the simple, but terrible example of mortality rates among black American women in childbirth. Racism and discrimination have no place in our house, and it’s time to draw a line and rid the industry of biases.

Perhaps the most important thing we can do for future generations of patients is to screen healthcare students for racial bias. A purge, forced on us by our current inability to respond to the underrepresented voices clamoring for care and basic dignity.

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As an Asian American healthcare worker and a caregiver, it is tough to balance work and personal life and the pandemic has made it worse.

We have experienced a different level of racism in the US after Covid-19, which has been stressful for my family and me. What was just a distressing event before Covid-19 is now something that drains everyone’s energy. I have found myself exhausted from the challenges at work and now face the challenges of finding mental health help for my family and myself.

Many healthcare organizations like mine offer an Employee Assistance Program (EAP). Essentially, an employee assistance program is an employee benefit program that assists employees with personal problems and/or work-related problems that may impact their job performance, health, mental and emotional well-being. In theory, they’re a great idea.

Practically though, for me, the EAP has proved far from a solution right now. I contacted the program, and I received an email with a list of providers’ phone numbers. I called all ten practices listed during breaks, through the drives, and between taking care of kids. None, except one, would take EAP patients because of high demand.

It’s a pandemic and we’ve ramped up all the other medical services, but one of the most critical, mental health, has been left behind.

Some asked if I wanted to be waitlisted. I also inquired about bilingual practitioners who could speak Korean as an option while searching because of my family’s ethnicity and cultural sensitivity. The EAP representative contacted me back with bad news after five days. She could not find anyone that matched my preferences, but she said she would keep looking since telehealth would also be an option to consider.

I appreciated her gesture. It is hard to find someone who will spend that much time in healthcare nowadays. I asked her why they did not provide emails to me? I could send one email to all providers to inquire about the service rather than calling each practice, leaving a voicemail, waiting for them to call back during my work hours, and calling them back again to leave a message and repeat.

She agreed how frustrating the process was for someone in my position to find suitable help with my needs. This process alone took me at least a week to figure out I could only see one specific therapist. I needed someone my insurer would cover as I suspected our family would need more than the six sessions provided under EAP coverage to see any progress. I have been there and done that. 

The therapist told me I would need to drive to a more distant location among his insured offices to cover me after the EAP sessions or when my insurance elected to stop paying for virtual visits. Since I am determined to make progress in healing, I have moved forward with him and will be seeing him next week through a virtual visit.

From the point of inception, this entire process till we eventually see a family therapist will take us three weeks. I don’t even know if he will be a good fit. I am hopeful he is, as he sounded very caring. He is not bilingual or from my ethnic background, but I have no choice. I can pay out of pocket towards my deductible and get mental care that way, but I don’t want to waste resources provided to me when I don’t know whether he/she will be a good fit for our family.

I have already spent more than $12,000+ on mental health and am exhausted from trying to find a solution that works for my family. This is my last hope.

I wonder what families of other healthcare workers that need mental health care are going through, especially those like me who may have specific needs. What about people who don’t even have resources like me? What do they do? Healthcare workers get to work in the emotional turmoil of patients and caregivers. They are expected to provide the best care possible while dealing with their own well-being.

Referring health care workers to an EAP is not enough. Employers need to assume more responsibility for the wellbeing of frontline healthcare. Healthcare leadership needs to be aware of healthcare workers’ mental health needs, a priority that affects their ability to provide the best care for patients. This has less to do with race/cultural differences and more to do with basic care for employees.

We ALL suffer to varying degrees from mental health challenges, and the pandemic has amplified our need for qualified and effective care.

The aspects of race and culture add dimension to the challenge of securing proper care and cannot be ignored. Cases like my own should be seen as opportunities to assess and improve care access, not as problems that exist outside of the system.

The dangerous and rampant racism experienced by Asian Americans deserves attention as well.

There are solutions

There are many simple and effective solutions that we can apply to improve the current workflow of EAP’s.

• Organizations can assist in the process by providing an onsite therapist healthcare workers can see and who can, in turn, refer for longer care.
• Maybe reach out to volunteer organizations or mental health organizations to see if retired therapists can help. They are often eager to assist voluntarily.
• EAP’s need to be more flexible and upgrade old analog systems to fit patients’ needs.
• Phone numbers are not enough in this digital era of the internet, where texts and emails are now how we communicate.
• Correctly qualifying the patient’s needs before providing a list of names can significantly improve matching patients with providers.
• An awareness of the culture and language of the employees and patients before providing a list of providers is not only important but essential. If not available, having the flexibility and options to expand the network of providers should be considered.

For everyone to move forward with this pandemic, we need to work together to make changes now. And it has to start with caring for healthcare workers so that we can care properly for our patients. Healing in this era of Covid-19 is possible only when we are open to changes in healthcare.

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