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Department of Public Health Blog

Registered Dietitians Day was observed last month and DMH Connections is pleased to highlight the important work of dieticians throughout the Department. 

Patrice Levesque MSM, RD, LDN, has served as a registered dietician at Taunton State Hospital for 19 years. Patrice shared with us her typical day as a registered dietician.

My day begins with a check on patients newly admitted to Taunton State Hospital. My major responsibility is safety. As a clinical dietitian, I first check if the new person has any food allergies. I double-check with the assistant dietitian to see if this information has been conveyed in the correct manner and is noted for the kitchen staff.

Then it is off to the units to visit new patients and conduct nutritional assessments.  I first do a physical assessment, looking for obvious signs of nutritional health. I ask standard nutrition questions around cultural or religious preferences, swallowing difficulties, food allergies, dentition problems and previous dietary history. I also ask the person if they would like any nutritional help at all.

Patti Sylvia, also a registered dietician, and I lead two nutrition groups each week. The groups are educational and we discuss the latest news in nutrition topics. Diabetic education, lipid instruction and weight control are taught on an individual basis.

I also work on many hospital health and wellness projects and statewide committees such as the Healthy Changes Task Force, the Wellness Committee, the Going Green Task Force, the Massachusetts Board of Dietitians and Nutritionists and the Task Force for Executive Order 509, which is a mandate to lower sodium in foods supplied by state funds.

Menu writing is also part of my responsibilities. I have designed the menu so that it meets American Heart Association Guidelines. I meet with the cooks and food service supervisors to review the food satisfaction. In the recent past, I have served as a mentor to dietetic interns who have visited the hospital with the goal of ending the stigma of mental illness.

If you are looking for good and factual information about nutrition, ask a registered dietician! By experience and education we are your most reliable source. 

DMH salutes Patrice and all of the registered dieticians who serve in this valuable role at our facilities:

Margot Copeland - Corrigan Mental Health Center

Patti Sylvia - Taunton State Hospital

Sharon Dupont - Taunton State Hospital

Patti Sylvia - Taunton State Hospital

Sharon Dupont - Taunton State Hospital

Seva Panchomoorthy - Tewksbury Hospital

Terry Desrosiers - Tewksbury Hospital

Meridith Pellenz - Tewksbury Hospital

Pricilla Winn  - Tewksbury Hospital

Melissa McCormack - Tewksbury Hospital

Judy Donovan - Worcester State Hospital

Julia Rivers - Worcester State Hospital

Betty Rambarran - Worcester State Hospital

"Listen to your life.  See it for the fathomless mystery that it is.  In the boredom and pain of it no less than in the excitement and gladness: touch, taste, smell your way to the holy and hidden heart of it because in the last analysis all moments are key moments, and life itself is full of grace."

                        -- Frederick Buechner

The Healthy Changes Initiative took the first step towards incorporating mindfulness when members of the Statewide Healthy Changes Task Force met last month. The group heard presentations Carl Fulwiler, M.D., and Fernando deTorrijos, CTTS, of the University of Massachusetts Medical School Department of Psychiatry who specialize in mindfulness and health practices.  

Dr. Fulwiler, also Assistant Professor and Acting Director for the Center for Mental Health Services Research, discussed research-based evidence that Mindfulness Based Stress Reduction (MBSR) is proven to be highly effective for patients with pain, anxiety, depression and other conditions. Additional health benefits  include increased awareness of mind-body interaction (relationship between thoughts, feelings, actions) and awareness of thoughts as passing events in the mind, often conditioned and not necessarily "real" as well as emotional awareness and affect tolerance. Clinical trials also have shown reduced physiologic response to induced stress and when integrated with cognitive-behavioral therapies such as dialectical behavior therapy (DBT) and acceptance based cognitive therapy (ABCT) for general anxiety disorder (GAD).

He explained that holistic and strength-based mindfulness focuses on the whole person--physical, mental and spiritual. It encourages taking responsibility for one's own health and well being. This approach also promotes healthy behavior changes: exercise, nutritional awareness, and improved sleep as well as promoting changes in unhealthy behaviors that include smoking, emotional eating, alcohol and drug use.  A participatory approach to wellness supports a "culture of wellness" for all stakeholders involved in the person-centered planning partnership.  

Following Dr. Fulwiler's presentation, Task Force members learned and experienced a hands-on approach to mindfulness, guided by Fernando de Torrijos, pictured here. As the director of Mindfulness Programs in Psychiatry, stress reduction, and tobacco treatment specialist at UMass Medical School, de Torrijos teaches a series called "Breathing and your Health."

Unlike relaxation techniques, mindfulness is a skill that can be applied in any situation. "Mindfulness-based stress reduction is about kindness," de Torrijos said. "The teacher needs to recognize the strengths of individuals, not the weaknesses. It's about getting in touch with breath and physical sensations for example: attention, connection, regulation, order and ease." 

Leading the group in a three-minute mindfulness exercise, he gave members a great example of his work with his weekly mindfulness class for psychiatric patients and the incorporation of mindfulness-based training in the psychiatry residency curriculum. 

The presentations were a great beginning for the Health Changes Task Force to learn about mindfulness and how it can incorporated into the DMH Healthy CHANGES Initiative.

To learn more about mindfulness and the Mindfulness-Based Stress Reduction program at UMass visit http://www.umassmed.edu/content.aspx?id=41252

www.cultivatingemotionalbalance.org

Click here to read an article about Mindfulness written by Carl and Fernando.

May 21 will mark the 8th annual NAMIWalks, a day when walkers from across the state come together to show their support for the National Alliance on Mental Illness of Massachusetts and to celebrate hope, resiliency and recovery for consumers across the Commonwealth. Thousands of walkers join together to fight the stigma associated with mental illness at this much anticipated annual event.

Walkers come to celebrate triumphs of recovery, to support their peers, and to put a stop to the stigmatization of mental illness. One NAMIWalks participant described it this way: "Seeing that many people walking gives you hope; you know that you're not alone... no one is there judging you."

It is an empowering experience, allowing participants young and old to participate in this important cause. Among NAMI's good work are free educational programs for the general public and family members and friends of individuals living with mental illness as well as a telephone hotline.

Volunteers like the Recovery is Real walk team or the Northeast-Suburban Area DMH team are the heart of NAMIWalks Massachusetts. By participating, walkers join the thousands who take a stand for raising awareness of the stigma of mental illness. Last year's NAMIWalks drew more than 6,000 walkers and raised $360,000.

The 2011 NAMIWalks will be held Saturday, May 21, at Artesani Park in Boston.  Registration begins at 9 a.m., and walkers will step off at 11 a.m.  Registering is easy: visit www.nami.org/namiwalks/ma or contact Karen Gromis at kgromis@namimass.org or 781-938-4048.

The Department of Mental Health Task Force on Staff and Client Safety continues its series of public hearings this month as the group reviews and assesses current policies and practices relative to staff and client safety in the DMH community system of care.

Convened by Commissioner Leadholm, the Task Force is charged with reviewing a number of issues around safety and training related to the DMH community system and making recommendations to the Commissioner based on that review.

The Task Force will continue public hearings to receive comments. The remaining three forums will be held on the following dates and locations:

Western MA

Monday, April 11

4 p.m. to 6 p.m.

Springfield Technical Community College

Theater

Scibelli Hall

One Armory Square STE 1
Springfield, MA 01102

Southeastern MA

Wednesday, April 13

12 p.m. to 2 p.m.

New Bedford Public Library

613 Pleasant Street

New Bedford, MA 02740

Boston

Thursday, April 14

6 p.m. to 8 p.m.

Solomon Carter Fuller Mental Health Center

Auditorium

85 East Newton Street

Boston, MA 02118 

The deadline for receipt of written comments is Friday, April 22 by 4 p.m. Comments can be submitted electronically to SafetyTaskForce@umassmed.edu 

Hardcopy comments must be submitted to:

The Department of Mental Health Task Force on Staff and Client Safety

c/o Michelle Cormier

Department of Mental Health Central Office

25 Staniford Street

Boston, MA  02114

NOTE:  Written comments can be anonymous.

For Special Accommodations (e.g. deaf/hard of hearing interpreter services) at the hearing venues, please contact Michelle Cormier at 617-626-8118 or michelle.a.cormier@massmail.state.ma.us

Thursday April 28, 2011

Postponed from the January 27 snow storm

Screening of the DVD

Bullying: True Stories

and

Educational Forum on Bullying

9:30 to noon

Massachusetts State House

Gardner Auditorium

Presented by

Partners Healthcare: Massachusetts General Hospital and Brigham and Woman's Hospital

Co-Sponsored by

Massachusetts Department of Public Health

Massachusetts Department of Mental Health

The DVD is produced by BlakeWorks. Organizations attending the event will receive a DVD and companion booklet to use as educational tools.

Please RSVP

info@wordscanwork.com

By Michael Morton, Metrowest Daily News

U.S.has highest bipolar rate in 11-nation study

CNNHealth.com

Falmouthtakes steps to reduce suicide rate

Cynthia Mccormick, Cape Cod Times

Commissioner Barbara Leadholm will participate with leaders from across the state next month in a first-ever public engagement in Massachusetts on the needs of military-connected children called Living in the New Normal.  

She will join the Military Child Education Coalition, the Red Sox Foundation and Massachusetts General Hospital Home Base Program along with leaders from state government and the Massachusetts Congressional delegation, health care, child-serving organizations, education, business and the faith community in this initiative.  For two days in May, the group will use its collective insight, energy and creativity to identify and understand the unmet needs of military-connected children in Massachusetts and to develop a plan to address those needs as civilians, parents, neighbors and active community members. 

The need is great.  Currently, more than 13,000 children in Massachusetts have a parent who is serving in the United States military including the Massachusetts National Guard.  But thousands more Massachusetts children have a parent or sibling who has been deployed during the past 10 years in Iraq and Afghanistan. 

Because New England has a large contingency of National Guard and Reserve without a central base, military-connected children are often invisible in our communities. They may be having a tough time academically in school. They may not be able to participate in after-school activities because they can't get back and forth to practice or can't afford the school sports fee. They may be acting out, getting into fights at school or be the target of bullying.  Military-connected children may be deeply affected emotionally or physically by separation from a family member, death, injury, or illness of a loved one in service to our country. 

In January, President Obama announced a comprehensive Federal approach to supporting military families which called on all cabinet secretaries and other agency heads to support our military families. The agenda grew out of First Lady Michelle Obama and Dr. Jill Biden listening to service members and families and includes: enhancing the well-being and psychological health of the military family; ensuring excellence in military children's education and their development; developing career and educational opportunities for military spouses; increasing child care availability and quality for the Armed Forces.  

There is a saying in military families, that when one family member chooses to serve - the entire family serves.  Living in the New Normal is aimed at strengthening our communities and families, helping to supplement services provided by the military and the government, and doing what we can as a community to support the children of our men and women who serve.

In the coming months, DMH Connections will update you on the results of our public engagement and how DMH will be involved.  In the meantime, for more information on the Military Child Education Coalition and opportunities to address the needs of military connected children and services provided by the Home Base Program, visit

www.homebaseprogram.org or www.militarychild.org

Mark your calendars for Thursday, May 19 at 7 p.m. to join families, friends, educators, legislators and DMH Staff as they fill the Citi Performing Arts Wang Theatre for The 16th annual performance of the award-winning and nationally recognized Express Yourself.

This year's theme is "Here and Now: We are all here together to celebrate, be in the moment, and be here and now!"

The interactive event will feature:

• 150 amazing youth performers and beautiful props and set design 
• The always cool Stan Strickland Band 
• Latino sounds of the Ricardo Munzon orchestra
• Drum Line 
• Lorraine LeBlanc of STOMP 
• Hi energy performance artist Nancy Ostrovsky

 Special Guests:

• Boston Children's Chorus 
• Pingree School A Capella 
• ITM Dance Team

The DMH Citizens Legislative Breakfasts are an annual tradition with a growing attendance over the years. This year has been no exception with nearly standing room only for all of the events to date.

Area Director Cliff Robinson led two breakfast events as the Metro-Southeast Area highlighted the work done in both its Boston and Southeastern Massachusetts regions. The Boston breakfast was co-hosted by Senator Anthony Petrucelli and Representative Aaron Michlewitz. Commissioner Leadholm expressed her heartfelt gratitude to all DMH and provider staff who work on behalf of the adults, children, adolescents and families served by DMH and our partner providers.

Speakers included guardian/advocate Nancy Marks; Zohreh King, a Peer Specialist at North Suffolk Mental Health Association; and two young adults, Joshua Estrella and Shawnae Butler. A special recognition award was presented to Billy Higgins and Jim Duane, pictured here with the Friends of Metro Boston staff.  Among their achievements are organizing the annual Thanksgiving Dinner for DMH consumers and the consumer softball and basketball leagues which run throughout the year.

The Southeast breakfast was co-sponsored by Senator Michael Rodrigues and Representative Timothy Madden. Speakers included peer advocate Karen Sylvia; parent advocate Lynn Bosse; and Transitional Age Youth advocate Marissa Souza. Special recognition awards were presented to Phyllis Burns and Sandy Levine for their work and dedication to the mental health community.

Area Director Susan Wing gathered with the Suburban region of the Northeast-Suburban Area with a musical performance opening by Dan Martin and special emcees Alan Jensen and Nicole McMahon, two youth from the Wayside S.T.E.P.S. program, pictured here with their service coordinator Kim Anderson. Senator James Eldridge and Representative Jonathan Hect sponsored the event. Compelling stories were heard from speakers Hilary Cook, representing the Transitional Age Youth community, and parent Ronna Northrup. The audience was in rapt attention when Jilka Fitzpatrick told her story. Jilka lost her voice through injuries sustained in a fire. Despite her now soft voice, her amazing story of overcoming many obstacles in her recovery was heard by all in attendance. Click here to read her story.

Area Director Theodore Kirousis indrocuced the the Central region of the Central-West Area breakfast. The breakfast was sponsored by Senator Richard Moore and Representative Stephen DiNatale and held at Worcester Technical High School. President of the Central Mass. Area Board David Bunker, Esq. introduced the speakers. Consumers from several different programs shared powerful stories of their recovery including Rachel King, an artist from Alternatives, Inc. CBFS Program; Robert Boyden from Westwinds Clubhouse; Susan Lowell from Crossroads Clubhouse; and youth representative Zach Zella. A remarkable and poignant example of recovery from serious mental illness was shared by Donna Kelleher from the Central Mass. Recovery Learning Community who is proud to tell that after many hospitalizations, she is grateful to have received DMH services.

The West region of the Central-West area will hold the final breakfast event of the season on Friday April 8 at Springfield Technical Community College.  Click here to view photos from all the DMH Citizens Legislative Breakfasts.

Nearly 100 participants gathered for the annual 2011 DMH Research Centers for Excellence Conference in March at the Lemuel Shattuck Hospital. This is the third year that the Beth Israel Deaconess Medical Center (BIDMC) Harvard Medical School Commonwealth Research Center (CRC) and the University of Massachusetts Medical School Center for Mental Health Services Research (CMHSR) have held a one-day joint event and the first year the DMH Research Centers have collaborated on research projects.

Commissioner Barbara Leadholm welcomed attendees followed by introductory remarks and presentations by Gary Pastva, DMH Assistant Commissioner of Clinical and Professional Services; David Jimmerson, M.D., Acting Chair of Psychiatry at BIDMC Harvard Medical School; and Douglas Ziedonis, M.D., M.P.H., Chair of the Department of Psychiatry at UMass Medical School.

"By using DMH's research dollars as seed monies, the two Research Centers for Excellence bring substantial additional grants monies into Massachusetts to further our research agenda," Commissioner Leadholm said. "Every dollar spent by DMH for research resulted in almost eight dollars being returned to the Commonwealth to support new research, training and services."

Dr. Seidman presented on "Active Participation, Mindfulness and Cognitive Enhancement," which focused on how the brain responds to physical activity. Using images of the brain, He showed research-based evidence that activities such as aerobic exercise, music, mindfulness or even driving a London taxi stimulate brain activity and proving that "physical activity enhances cognitive and brain function and protects against the development of neurodegenerative diseases."

Carl Fulwiler, M.D., Ph.D., and 

Fernando deTorrijos, CTTS, of the University of Massachusetts Medical School Department of Psychiatry who specialize in mindfulness and health practices, presented an interactive talk on "Mindfullness Changes to the Brain: Pathways to Wellness."  

 Matcheri Keshavan, M.D., of Harvard/ BIDMC presented on "Harnessing Brain Plasticity: Neurocognitive Remeditation in Early Schizophrenia."  He used several visual examples in his talk such as how perceiving fragments of information as a whole can be difficult for individuals with schizophrenia, for example how the wristwatch is perceived, pictured left.  Research has proven that tasks like this show a decrease in brain activity in persons with schizophrenia. Dr. Keshavan says that cognitive impairments strongly predict functional outcome, but pharmacological treatment and cognitive rehabilitation programs may remedy this.

The DMH annual research conference continues to evolve and grow each year. This year's program featured afternoon break-out groups in which participants were able to discuss a variety of topics then return to the larger group for a spirited discussion. Response from the conference was positive and we look forward to seeing what unfolds for the DMH research centers at next year's gathering.

Last year, DMH Connections wrote about priorities for DMH research "Developing the DMH Research Agenda - Stakeholder Focus Groups" determined by focus groups of consumers, Transition Age Youth, parents of child consumers and community providers.  

The work of these groups helped develop important research priorities for the two DMH Centers of Excellence. At the 2011 Annual DMH Research Conference (see article above) an afternoon of participatory workgroups moved these priorities further along: consumer engagement in research; provider research priorities; and research dissemination strategies. Click here for a full description of the participatory workgroups. This summary can also be found on the Research Page on the DMH web site at www.mass.gov/dmh.

Here are some of the highlights of each priority:

Consumer Engagement in Research: Jonathan Delman, Consumer Quality Initiatives, Inc. (CQI); Mary Sharon Kaminski, CQI Inc.; Chuck Weinstein, Metro Boston Recovery Learning Community

A group of consumers, researchers and service providers met at the 2010 DMH research conference to consider and discuss key issues regarding consumer engagement in research. These main themes elicited enthusiastic discussion:

• The basics of research for consumers: In order to effectively participate in research, consumers need to understand basic research concepts.
• Create a culture of mutual respect and collaboration: Effective consumer engagement requires active collaboration, where both consumers and researchers aim to make research decisions together.
• How researchers can get technical support for consumer engagement: Researchers were interested in locating manuals or other sources of guidance on consumer engagement, research training, and research advisory councils.
• Consumer participation from the beginning research stages when possible: Consumer groups want ground-up collaboration with academics.
• Work with consumers to build capacity among the consumer community and mental health programs: Many consumer groups want to have research infrastructure available to them, such as researchers on grant applications capacity. 

Provider Research Priorities: Larry Seidman (CRC), Bruce Bird (Vinfen), Peter Evers (formerly of DMH)

At the 2010 DMH Research Day, a break-out group of about 40 providers shared a spirited discussion on provider research priorities, summarized here:

First, great interest in the use of data already collected by the DMH and for there to be good data available at the statewide level. Second, there was a recognition that any studies ought to attend to multicultural issues and ethnic minorities so that research is useful to all segments of the population. From a content area point of view, health and wellness interventions were considered important by many, and individual differences in response to interventions were considered to be informative if such data could be produced. A number of individual researchable questions were raised: Understanding adolescents' use of social media; the role of staff in residential housing; appropriate social-emotional communication; and the impact of hospital closings on individual outcomes.  The general tenor of the discussion suggested that the providers viewed research in a positive way and that it was a key element in providing information on the best possible strategies for mental health care.

Research Dissemination Strategies: Carl Fulwiler (CMHSR), Anna Chinappi (DMH), Tony Guiliano ( CRC)

This 2010 Research Day break-out discussion was positive and focused on a variety of creative strategies to facilitate better dissemination of information about research.  Group participants felt strongly that it was also important to educate stakeholders about what research is, how it is done, how it is funded and how it is different from quality improvement or program evaluation.

 

Vinfen will hold its 4th Annual Moving Images Film Festival on Saturday, April 16, at the Stuart Street Playhouse, 200 Stuart Street at the Radisson Hotel Boston, corner of Charles and Stuart Streets. The festival is free and open to the public. This year's films and panel discussions focus on autism and schizophrenia.

Accreditation and continuing education credits (CEUs) will be offered for social workers, psychologists, counselors and nurses. Register online or on-site at www.vinfen.org.

4TH ANNUAL MOVING IMAGES FILM SCHEDULE AND PANEL DISCUSSIONS

Feature Film: 12 to 2:30 p.m.
Temple Grandin, the HBO award-winning film starring Claire Danes is the story of a young woman's perseverance and determination while struggling with the isolating challenges of autism. The film chronicles Temple's early diagnosis; her turbulent growth and development during her school years; the enduring support she received from her mother and her science teacher and her emergence as a woman with an innate sensitivity and understanding of animal behavior.

Undaunted by education, social and professional roadblocks, Grandin turned her unique talent into a behavioral tool that revolutionized the cattle industry and laid the groundwork for her successful career as an author, lecturer and pioneering advocate for autism and autism spectrum disorder education.

Featured Short: 2:45 to 3:30 p.m.
When I'm Not Alone, is the story of Sam Durbin who was born female but raised as a male by his father, experienced unspeakable abuse, never learned to read or write and drifted in and out of institutions. Homeless and alone when he found the Clubhouse, Integrity House, Sam learned to read and write as well as advocate for himself.

Featured Documentary: 3:45 to 5:30 p.m.
Unlisted: A Story of Schizophrenia, a film made by Delaney Ruston, MD, is the story of her journey as the daughter of a father living with paranoid schizophrenia. The film examines the nature of responsibility of parents and children, of physicians and patients, and of society and citizens towards those afflicted with severe mental illness.

Lively interactive panel discussions with the audience will be held after the films are screened.