2: Mental Health Matters

The Vedala Brothers bring in their first guests to the podcast in this episode! Farhan Jawed, MD, Collyn Campbell, MSW, LCSW, CCTP and Lynn Mayes, RN, Clinic Care Coordinator, join the brothers to speak about mental health. They engage in meaningful discussions with Dr. Krishna and Dr. Veer, emphasizing the important role of mental health services within comprehensive healthcare, seamlessly bridging patients’ journeys from primary care to necessary in-patient services and beyond. This compelling episode will leave you better after listening. This episode’s guests give us words of wisdom and hope for the future through their advice and experiences.

Guest Bios:
Farhan Jawed, MD, formally served as the Chief of Staff for Norman Regional Health System. He is the medical director for Norman Regional’s inpatient Behavioral Medicine Services in Norman. Dr. Jawed specializes is psychiatry and behavioral health. His certification is from the American Board of Psychiatry and Neurology, studied medicine at King Edward Medical College and completed residency with Michigan State University, Kalamazoo Center for Medical Studies.

Dr. Jawed is a diplomat of the American Board of Psychiatry and Neurology. He also has an outpatient practice where he treats adult mental health patients. 
Dr. Jawed specializes in psychiatric illness and substance abuse disorders and helps persons experiencing suicidal ideation, danger to self or others, depression, mania, anxiety, hallucinations, delusions, self mutilative behavior, insomnia, disorientation, catatonia, substance abuse and withdrawal symptoms from substance abuse. 

Collyn Campbell, MSW, LCSW, CCTP has bachelor’s and master’s degrees in Social Work from the University of Oklahoma. She has been a Licensed Clinical Social Worker (LCSW) since 2004, a board approved supervisor since 2011, EMDR (Eye Movement Desensitization and Reprocessing therapy) trained since 2021 and a CCTP (Certified Clinical Trauma Professional) since 2022.

Collyn has experience in forensic interviewing, private practice and working as a psychotherapist with various populations including children, at-risk youth, sex offenders in a juvenile detention center, adults, families and couples. Collyn has also been involved with the Oklahoma Arts Council and has acted as a group facilitator for Intro to Art Therapy at the University of Oklahoma. Her primary areas of specialty are in trauma and somatic psychotherapies. Collyn has been with Norman Regional Health System since 2011.

Lynn Mayes, RN, BSN has been a nurse for 27 years. She has a passion for helping others and has found her job as clinic care coordinator to be one of the most rewarding of her career. She has experience in providing care in a school system and as a nurse in the PACU. Lynn has been with Primary Care - South OKC since October, 2022.

Links:
Farhan Jawed, MD
Norman Regional In-patient Behavioral Medicine
Blog - Norman Regional. Oceans to Build Behavioral Health Center

This podcast is for educational purposes only. The information in this show is not to be used as medical advice. If you are needing medical care, please consult with your physician.

Norman Regional is hiring! See all our open opportunities here: https://careers.normanregional.com/careers-home/

Transcript

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Welcome, friends.

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This is DR’s Krishna and Veer Vadala.

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And we are Vedala Bros.

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We are delighted to bring you our brand new podcast, Vital Visions.

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So in this podcast, we'll be discussing important medical topics

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that affect your community.

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We'll be looking into medical research Health and wellness tips

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and also available health

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care resources brought to you by the Norman Regional Health System.

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That's right.

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And in each episode, we'll also be joined by medical

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professionals, local community leaders and even some of our friendly neighbors

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as we talk through various issues that are affecting our community.

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So if you want to lead healthy lives or learn about the new healthy trends,

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we want this podcast to be your go to resource.

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Mental health is very important because it impacts our overall

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wellbeing, physical health, productivity,

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relationships and even the ability to cope with challenges.

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Prioritizing mental health promotes a happier life, better

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functioning, and reduces the risk of mental health disorders.

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It also helps reduce stigma and encourages seeking support when needed.

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Mental health is so important because it affects our overall wellbeing.

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And to talk with us today regarding this very important subject

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is the following guests.

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So today here with us we have Dr.

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Farhan Jawed, a um, psychiatrist who is the chief of Behavioral Health

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and Medical director for the Norman Regional Inpatient Behavioral Services.

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Ms. Collyn Campbell, um, social worker who specializes in behavioral health.

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And also Ms.

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Lynn Mayes, who is our clinic's clinical care coordinator.

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Dr. Jawed, Ms. Collyn, Ms. Lynn.

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Thank you so much for joining us today.

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If you could tell our listeners a little bit about yourself.

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Um, my name is Lynn.

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I'm a clinical care coordinator for the Primary Care - South OKC Waterview office.

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Um, I've been in nursing

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quite a few years, and this is my first job

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as a clinical care coordinator with Norman Regional and, um, enjoying

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being here and getting to know 
the providers in the patients.

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Hi, I'm Dr.

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Farhan Jawed.

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I'm currently serving

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as the chair of the Behavioral Medicine Unit at Norman Regional Health Systems

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for the last 12 years,

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and I'm in charge of all of our behavior

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medicine services, the inpatient service, the consultation service,

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um, and anything else that has to do with behavior medicine.

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And my name is Collyn Campbell.

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I am an LCSW and I work with Dr.

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Jawed for 12 years also.

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We started around the same time, so

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I'm one of the psychiatric social workers up there

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and we do therapy and case management and it's a privilege to work here.

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So my gosh, we are so lucky to have such wonderful people here

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joining us today.

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You just wanna get right to it, Krishna? 

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Yeah, sure, might as well.

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So, um, Dr.

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Jawed, uh, what do you think are some promising new treatments

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or therapies for mental health conditions?

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So for the mental health treatments, we always,

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uh, encourage people that it has to be a comprehensive approach

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with your life and your daily activities.

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Um, there are many medicines that come, and there are some newer ones as well.

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There are newer technique techniques as well.

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If you talk about traditional treatments,

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we have psychotropic medication managements, but they don't work alone.

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You have to have counseling services along with it.

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The medicines can help with the modification of, um,

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your brain chemistry, neurotransmitters that can help with overall symptoms.

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But if you want to change or help alleviate symptoms to

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to changing somebody's behavior, then you need counseling for them.

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And we have a multitude of counseling therapies.

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We have the basic ones, including cognitive

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behavioral therapies and psychodynamic psychotherapies.

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There are newer therapies,

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relatively new therapies like EMDR for trauma based therapies.

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So there are multiple different therapies that can be used,

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but it all depends upon the clinical diagnosis.

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And depending upon that, we pick and choose which therapy would go with which

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psychotropic medication management treatment.

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Yeah.

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So there are some other techniques as well

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An age old technique of, uh, electroconvulsive therapy.

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Then we had transcranial magnetic stimulation.

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Um, and then there was newer treatments

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where there's some ketamine infusion therapies as well.

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So we are coming up with newer ways of treating our patients.

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Some of them are beneficial in some and not in others.

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So depending upon the patient's situation and risk benefit side effects,

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we pick and choose which therapy would work for an individual.

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Yeah, so

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longitudinal scale of multiple therapies,

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but I sort of like rewind a little bit and a question for all three of you guys

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is I think, you know, mental health is very important

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and especially after the wake of the COVID 19 pandemic,

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um, us in primary care see it more often, but sometimes I don't feel

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like our patients grasp even what what mental health is.

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So if each of you could like in your own way, define

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what you think mental health is, you know,

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to the patient and yourself as well.

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Kind of give an explanation of why it's important.

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You know, in overall health would be great.

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Ms. Collyn you want on to go first? 

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Why Mental health is important?

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I mean, we're all humans and we all have stories and we all struggles.

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And COVID has affected everyone.

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Myself and all of us.

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So we have to, like Dr.

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Jawed said,

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have a comprehensive approach and we have to see

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what each individual's needs are and what we need to do to tackle

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that for that individual.

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And there are like he said, doing the holistic approach,

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you know, mind, body, spirit approach and different psychotherapies.

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So it's it's

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just critical to stay on top of that and have a good line of communication

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open with your PCP or with a counselor or someone that you can trust

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that can get you the referrals to the necessary treatment if needed.

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Yeah,

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And speaking of referrals,

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when you, when you call, our patients Ms. Lynn,

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how do you approach that mental health topic with them?

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I think it's it's to get to know that

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patient

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you know as a go between between the PCP and then we kind of

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build a relationship with them and say you know we're here to help you.

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I think one thing people don't realize is that I always say it's

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okay to not be okay.

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You know, people

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I don't know if it's just maybe pride or maybe an embarrassment or, you know,

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whatever they think other people might think of them.

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But like you said,

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we all have things that we're dealing with on a daily basis,

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and we just want patients to know that we're here.

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We always give them my contact number directly to my line,

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you know,

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and then they at least

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have that one contact that they know, Hey, I can reach out to my clinic care

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coordinator if I can't get that referral or I'm having issues or the insurance

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doesn't cover.

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So it it builds a relationship between us

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and that patient to help the providers do what's best for the patient.

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Mm hmm. Wow.

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You know, I always help and educate people

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that you cannot separate mental health from medical health.

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Yeah, mental health is a part of global, complete physical health.

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You cannot read a patient's medical health

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alone and expecting that their mental health will get better.

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So in order to provide a complete comprehensive medical health care,

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you have to address the mental health issues.

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And these mental health issues,

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vise versa, affect your physical health as well.

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You guys

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have seen in your clinical practices, when people have cardiovascular issues

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and other problems, it comes along with lots of depression, anxiety and these issues.

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So most of my referrals are from physicians

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whose patients are having medical health

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problems and then those are affecting their mental health issues.

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So it has to be treated combined. Yeah.

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Right.

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Thank you so much for that.

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I think that's a full-fledged answer

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from hearing from each of you and your individual roles.

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What else you got, Krishna?

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Well, you know, um, one of the things that, that I've always kind of dealt

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with in the primary care field is this hesitancy towards

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taking or being placed on medications.

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And, um, you know, at the end of the day,

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Veer is a family medicine doctor.

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I'm an internal medicine doctor,

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and I'll be the first to admit

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we do not necessarily have a sufficient training in psychiatry,

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but we do have, you know, the knowledge to be able to manage

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mild and moderate levels of any mental health illness.

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So I have always encouraged patients

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that they have to look at their mental health medicines exactly like they're,

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looking at their medical health medicines, for example, if somebody has

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diabetes, thwy're on diabetic medicines, depending upon the stress of their day,

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your sleep, your appetite, your routine, your blood sugar can go up and down.

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Same way

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When you have depression or anxiety, you take your medicine

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regularly depending upon the day, it may go up and down.

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But that does not mean you stop your medicines

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because both are for maintenance of your medical health or your mental health.

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But the compliance has to be there.

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Without compliance, it's very difficult for people to get better.

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So you just have to make that connection and then bridge that.

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There. They have to be treated equally.

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my next question.

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Oh, perfect.

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This next question.

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Actually, um is for Dr. Jawed and Ms. Collyn, uh we've been hearing

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a lot about Norman Regional's, new partnership with Oceans.

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And we would just love to tell our listeners

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more about this and the resources Norman Regioanl has to offer.

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So this is a very exciting thing and exciting times for all of us.

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Once we decided to expand

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our hospital system and started the Inspire Health Project,

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where we will be moving from our older campus to our newer campus

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and the health plex will have ambulatory services. Uh, one of our,

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A main factor was to enhance the mental health services.

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So we already have a 20 bed inpatient unit

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which is within the hospital at Norman Regional Porter campus.

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As the time is moving forward,

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you know, the growth is exponential.

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We have more patients, there are more needs.

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So we decided it was time for us to expand now.

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And so we partnered with Oceans.

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Oceans is a very well known mental health provider company in the South.

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They have 18 plus units

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in Alabama, Texas area,

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and we decided we will be building 48 bed unit

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on the campus of our Porter Street campus.

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It would be 24 beds adults and 24 geriatric beds.

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It would be a complete full service psychiatric hospital

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on the ground floor, very modern, 
very new.

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It will have courtyards and other facilities

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that you don't find in other mental health facilities,

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because most of them are within the hospitals and those which are not,

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They're all kind of localized


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and people don't have the access to go out in the sunlight and all that.

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So we are making it so that we can provide

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the best possible services to all the psychiatric patients.

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And it's going to be a very nice, very modern, very beautiful.

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So I always tell people will be providing the same great service,

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but in a much nicer, bigger, prettier place.

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That's amazing. Ms. Collyn,

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do you have anything to add to that?

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We just are really, as therapists, we're trying to expand so we can broaden

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our knowledge base so we can really help touch everyone

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and be a be able to help everyone specifically in trauma.

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So I think that this new Oceans opportunity is going to give us

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a chance to really get some therapists in that

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that have some new knowledge and some new skills.

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And it's just an exciting time in so many ways for us to move towards this.

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That's amazing.

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Dr. Jawed was telling us like,

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you're incorporating more like physical therapy too,

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with like yoga therapy and things like that.

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So trauma informed yoga is huge or somatic

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psychotherapy or somatic experiencing, tapping.

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I use EFT emotional freedom technique with my patients when I do it.

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There's internal family systems and EMDR.

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These are all the therapies that I do with the patients right now.

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CBT Cognitive Behavioral Therapy is obviously what every therapist does.

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That's what you guys do.

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When you talk to your patients, right? Right.

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How are you feeling and how do we want to change that?

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Yeah, but there are so many other cutting edge

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therapies for physicians and other providers to be aware of.

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I would recommend every provider

00:12:49:20 - 00:12:52:25
read The Body Keeps the Score by Bessel van der Kolk.

00:12:53:07 - 00:12:54:24
You got to write this down. We're sorry.

00:12:54:24 - 00:12:58:24
It is it it's just and that's just scratching the surface.

00:12:58:24 - 00:13:01:25
But it is such a great book just to kind of

00:13:02:05 - 00:13:05:13
look at all the different things that are going on with the body.

00:13:05:13 - 00:13:07:22
We have to include the body in healing.

00:13:07:22 - 00:13:09:00
This is great. Thank you so much.

00:13:09:00 - 00:13:11:12
Because part of our goal of this podcast is to learn.

00:13:11:12 - 00:13:12:03
And, you know,

00:13:12:03 - 00:13:14:04
we think some of our listeners are going to be like residents and students.

00:13:14:04 - 00:13:16:22
So this up and coming therapy they need to know about, right?

00:13:16:22 - 00:13:18:01
They don't teach this in medical school very often.

00:13:19:06 - 00:13:20:22
Or even in training residency.

00:13:20:22 - 00:13:23:12
Yeah, we don't if we get exposure, we can.

00:13:23:12 - 00:13:25:01
But otherwise it's mostly just, you know, work

00:13:25:01 - 00:13:27:09
80 hours a week and, you know, come back the next day.

00:13:27:09 - 00:13:29:17
You don't even learn about it in grad school as a therapist,

00:13:29:17 - 00:13:30:27
these are things that you have to go learn

00:13:30:27 - 00:13:33:08
and get certified on your own and get trained in.

00:13:33:08 - 00:13:37:11
EMDR is tons of hours and money, but you will get certified in it

00:13:37:11 - 00:13:38:24
and it changes lives.

00:13:38:24 - 00:13:41:20
So it's you have to be committed to that as a professional.

00:13:41:20 - 00:13:42:18
That's great.

00:13:42:18 - 00:13:45:17
So on our current unit, we are already doing

00:13:45:17 - 00:13:49:16
individual therapies group therapies, craft therapies, meditation therapies,

00:13:49:24 - 00:13:53:10
spin therapies, yoga therapies, exercise therapies.

00:13:54:13 - 00:13:56:01
So there's a lot that already goes on.

00:13:56:01 - 00:13:59:02
But like I said, it will be on a much larger scale

00:13:59:05 - 00:14:00:17
in a newer facility,

00:14:00:17 - 00:14:03:18
and it would be very beneficial for the patients who will come.

00:14:03:26 - 00:14:05:04
That's amazing.

00:14:05:04 - 00:14:06:28
Thank you both for that answer. That's great.

00:14:06:28 - 00:14:08:04
Good info for us to have.

00:14:09:08 - 00:14:12:01
What do you think are some of the barriers

00:14:12:01 - 00:14:15:02
for patients receiving mental health care in our community?

00:14:15:21 - 00:14:18:25
So generally I would say the biggest barrier

00:14:18:25 - 00:14:22:25
is access to care and availability of the providers.

00:14:23:14 - 00:14:26:25
We do not have enough providers

00:14:27:04 - 00:14:30:05
or enough mental health care facilities

00:14:30:19 - 00:14:33:14
where people can get access to.

00:14:33:14 - 00:14:37:08
Obviously there's a financial component to it as well.

00:14:37:18 - 00:14:40:24
There's a resource component to it as well training.

00:14:40:24 - 00:14:44:03
So we are behind, to be very honest, in Oklahoma

00:14:44:10 - 00:14:47:19
and we need to do a lot of work so that we can have more providers,

00:14:48:11 - 00:14:51:27
more staff, more nursing, more training, more facilities

00:14:52:15 - 00:14:55:16
so that the appropriate help can be provided to our patients.

00:14:56:05 - 00:14:58:06
Ms. Lynn, what do you think are some of the barriers?

00:14:58:06 - 00:15:01:16
I think most of those I see is what you just discussed.

00:15:01:16 - 00:15:03:05
The patients

00:15:03:05 - 00:15:06:01
know I'll make the referral for them and give them that information to call.

00:15:06:01 - 00:15:09:02
And sometimes I even just recently had one call back and say that,

00:15:09:08 - 00:15:11:20
you know, they can't see them until 2024.

00:15:11:20 - 00:15:15:04
Um, but as far as my job goes, I think that's, that helps

00:15:15:04 - 00:15:16:28
that they have a person
they can contact and say,

00:15:16:28 - 00:15:19:25
well, let's just try to do another role if we can get you on somewhere else.

00:15:19:25 - 00:15:21:25
But I think that's one of the biggest barriers

00:15:21:25 - 00:15:24:26
is just trying to get those appointments for those patients in a timely manner.

00:15:25:10 - 00:15:29:11
Ms. Campbell, I guess this is a question directed towards you and

00:15:30:22 - 00:15:32:28
we can't

00:15:32:28 - 00:15:38:16
thank our therapists enough and we we think it's an invaluable resource.

00:15:38:16 - 00:15:38:25
Right.

00:15:38:25 - 00:15:41:15
And, you know, we're we're trained in this aspect that,

00:15:41:15 - 00:15:42:21
hey, behavioral therapy

00:15:42:21 - 00:15:45:28
and conjugation with medical therapy is better than by themselves.

00:15:45:28 - 00:15:48:24
And we're always trying to get our patients into behavioral therapy.

00:15:48:24 - 00:15:51:25
But do you can you give us is there a resource that you know,

00:15:51:26 - 00:15:55:16
Ms. Lynn or my brother and I as primary care physicians where we can

00:15:55:24 - 00:15:58:25
there's like a catalog of therapists that,

00:15:59:22 - 00:16:02:02
you know, a resource that we can give our patients

00:16:02:02 - 00:16:04:20
so they can get in contact or make an appointment,

00:16:04:20 - 00:16:06:21
because right now we're depending on Ms. 

00:16:06:21 - 00:16:10:10
Lynn put a lot on our plate, though, right, 
she's getting drowned in all the referrals. 

00:16:10:25 - 00:16:14:00
And if there's something we can help our patients ourselves do and take some

00:16:14:00 - 00:16:17:15
work off of her and get them established, that'd be great.

00:16:17:15 - 00:16:18:01
Right?

00:16:18:01 - 00:16:19:20
And the unfortunate piece is you

00:16:19:20 - 00:16:21:24
you kind of have to get, you know, if they're health choice,

00:16:21:24 - 00:16:23:07
then you've got to look at the health choice list.

00:16:23:07 - 00:16:24:13
If they're Blue Cross, you can.

00:16:24:13 - 00:16:26:10
So you kind of have to do that for the patient.

00:16:26:10 - 00:16:28:13
I mean, if they want to pay out of pocket $200

00:16:28:13 - 00:16:31:13
an hour for cutting edge therapy, go for it and we can find you somebody.

00:16:31:13 - 00:16:34:04
But if, you know, you kind of have to again,

00:16:34:04 - 00:16:37:05
look at the individuals and what their needs are,

00:16:37:05 - 00:16:40:02
what type of therapies they need and who is available.

00:16:40:02 - 00:16:41:17
Right. So does that answer?

00:16:41:17 - 00:16:43:16
Yeah, that makes sense.

00:16:43:16 - 00:16:46:17
And so it's pretty much tied to their insurance company?

00:16:46:17 - 00:16:48:23
Unfortunately I mean right?

00:16:48:23 - 00:16:50:03
Isn't? Yup.

00:16:50:03 - 00:16:51:22
But there's a soapbox. I don't want to hop on.

00:16:55:03 - 00:16:57:19
That that was that was great.

00:16:57:19 - 00:17:00:20
Um, something that we are trying to do on this podcast is

00:17:01:09 - 00:17:02:19
we try to like bridge

00:17:02:19 - 00:17:06:14
the gap between patient and provider, or provider or practitioner.

00:17:06:14 - 00:17:10:11
And so we've been asking our guests to talk about a success story,

00:17:10:15 - 00:17:14:18
you know, where you felt like really made a difference and a change.

00:17:14:18 - 00:17:18:03
And so for each each of you, if you don't mind, you can think of one.

00:17:19:00 - 00:17:21:26
Dr. Jawed, if you would 
like to go first, sir.

00:17:21:26 - 00:17:24:27
Well, um,

00:17:25:26 - 00:17:31:26
so obviously in our line of practice, we cannot discuss the details.

00:17:31:26 - 00:17:32:20
Right? Of course.

00:17:32:20 - 00:17:34:25
Of how the stories are.

00:17:34:25 - 00:17:37:26
But I will tell you that on an everyday basis

00:17:38:11 - 00:17:42:20
we have several patients who benefit from our services.

00:17:43:05 - 00:17:45:11
The biggest challenge that we get to have

00:17:45:11 - 00:17:48:15
is that when they come to an inpatient unit, um,

00:17:48:24 - 00:17:52:00
they're at a very, very difficult and dark moment in their lives.

00:17:52:16 - 00:17:55:17
They get admitted because they want to end their life.

00:17:55:20 - 00:17:59:07
And for those who are fortunately able to make it

00:18:00:04 - 00:18:00:25
to the E.R.

00:18:00:25 - 00:18:04:23
and get appropriate help and get admitted to a facility, they have a chance.

00:18:05:25 - 00:18:06:21
So what we

00:18:06:21 - 00:18:10:02
do is we do our best to provide them with the best care we can.

00:18:10:16 - 00:18:14:27
When somebody gets admitted to us as physicians, we see them daily.

00:18:14:27 - 00:18:16:25
They are seen by the counselors regularly.

00:18:16:25 - 00:18:19:26
They go through a battery of counseling sessions

00:18:20:06 - 00:18:24:02
and we make sure that we provide them with all the tools that they need

00:18:24:02 - 00:18:27:13
to be successful outside of our facility when they're discharged,

00:18:27:27 - 00:18:31:09
whenever, after a week or so or more, they are medically

00:18:31:09 - 00:18:34:10
stabilized, psychiatrically stabilized, they are discharged.

00:18:34:11 - 00:18:37:08
We set them up with psychiatrist, psychologist,

00:18:37:08 - 00:18:40:09
primary care physicians, give them a month's supply of medicines

00:18:40:12 - 00:18:43:17
so we not only take care of them acutely and provide them

00:18:43:17 - 00:18:44:17
with the tools that they need.

00:18:44:17 - 00:18:47:28
We make sure that on the outside they are secure as well

00:18:47:28 - 00:18:51:14
and they have a follow up where they can get appropriate help.

00:18:52:06 - 00:18:53:00
So that is our

00:18:54:01 - 00:18:54:13
general

00:18:54:13 - 00:18:57:14
way of how we treat and help everyone.

00:18:57:15 - 00:19:01:13
But if you talk about particular a successful stories,

00:19:01:22 - 00:19:03:18
there are several in which people came in

00:19:03:18 - 00:19:05:24
and after their treatment when they were leaving,

00:19:05:24 - 00:19:10:10
they would almost want to hug us and and thank us and shake our hands

00:19:10:16 - 00:19:13:28
and say that if I had not come here, I would not be here.

00:19:15:02 - 00:19:16:03
That's powerful.

00:19:16:03 - 00:19:21:04
So and that's a huge responsibility on our shoulders

00:19:21:04 - 00:19:24:20
to make sure you can imagine how many patients we see a day.

00:19:24:26 - 00:19:27:27
And we are responsible to make sure they are safe to go home.

00:19:28:00 - 00:19:31:17
So that's a big responsibility, but that's why we do this.

00:19:31:17 - 00:19:34:18
There are very few of us who like to do this kind of job,

00:19:35:04 - 00:19:38:14
but it makes us happy and we are glad we are making a difference.

00:19:38:23 - 00:19:39:02
Yeah,

00:19:41:12 - 00:19:42:23
I want echo everything he said.

00:19:42:23 - 00:19:46:18
But also, I mean, every day I see miracles

00:19:46:18 - 00:19:49:26
every hour I see miracles in my patients.

00:19:49:26 - 00:19:52:17
And that's what keeps me afloat

00:19:52:17 - 00:19:55:15
because it's that little light inside of them that makes them still

00:19:55:15 - 00:19:59:13
want to be there that we have to find and we have to fan that flame with them.

00:19:59:13 - 00:20:02:14
And that is every time a success story.

00:20:04:02 - 00:20:05:13
Too many countless stories.

00:20:05:13 - 00:20:07:28
I mean, I'd have to tell you the success story of yesterday

00:20:07:28 - 00:20:09:10
because there's so many.

00:20:09:10 - 00:20:13:27
But there is one in particular who was able to overcome

00:20:14:10 - 00:20:17:11
a domestic violence situation.

00:20:18:12 - 00:20:20:12
And of course, I'm not going to give any further details,

00:20:20:12 - 00:20:25:02
but I've never seen anyone work as hard as they did to overcome that.

00:20:25:02 - 00:20:28:22
And our whole to everyone on our unit, all of the staff, 

00:20:28:27 - 00:20:31:03
if they were here now, they'd say every single one of us

00:20:31:03 - 00:20:33:16
contributed to that because we're a family there.

00:20:33:16 - 00:20:34:23
And so.

00:20:34:23 - 00:20:37:24
You know, we always try to help them understand

00:20:38:03 - 00:20:40:25
that at your deepest, darkest moment,

00:20:40:25 - 00:20:43:20
it is it is fine to have that thought,

00:20:43:20 - 00:20:46:21
that life would be better, would be better off if I'm not here.

00:20:47:01 - 00:20:48:11
But you have to understand that

00:20:48:11 - 00:20:51:13
there's a lot in life that you are not looking at.

00:20:51:25 - 00:20:55:15
And once you start to see that, you realize there is so much

00:20:55:15 - 00:20:58:16
out there for you that you are missing and you can achieve.

00:20:58:23 - 00:20:59:24
So we help them

00:20:59:24 - 00:21:02:27
get to the point where they see the other aspect of life as well,

00:21:03:23 - 00:21:04:23
which keeps them going.

00:21:06:23 - 00:21:08:13
Ms. Ms. Lynn. I think

00:21:08:13 - 00:21:12:18
my biggest role and just the success I've seen so far with this new

00:21:13:24 - 00:21:17:12
process that we're doing with behavioral health is just the patient knowing

00:21:17:12 - 00:21:20:26
that that we're there to call and say, Have you gotten your appointment?

00:21:20:26 - 00:21:24:04
And, you know, I've had several call back and say, you know, thank you

00:21:24:04 - 00:21:27:05
for for being there, for knowing that I have your contact number,

00:21:27:22 - 00:21:29:11
you know, if I need anything and I've been able

00:21:29:11 - 00:21:32:15
to get this appointment and go get, you know, talk to someone.

00:21:32:15 - 00:21:37:03
And so there's so many of them as you both well know in our office, that we've

00:21:37:06 - 00:21:40:07
that I've done referrals on, it's just not to know that I've been a bit,

00:21:40:07 - 00:21:43:20
been able to be a part of helping somebody be able to get, you know,

00:21:44:06 - 00:21:45:14
the help that they need.

00:21:45:14 - 00:21:48:25
Yeah, I think this is going to be one of your questions as well and 
I would like to answer it.

00:21:48:26 - 00:21:51:20
So yeah, yeah, answer I'm saying ahead of time, 

00:21:51:20 - 00:21:52:26
Yeah. A prophylaxis. 

00:21:52:26 - 00:21:56:26
That, yeah, I think we have to normalize the conversation.

00:21:56:26 - 00:21:57:26
Yeah. Yeah.

00:21:57:26 - 00:22:01:07
I there was a time when there was this concept that, oh,

00:22:01:07 - 00:22:03:20
you don't talk about suicide or you don't talk about it

00:22:03:20 - 00:22:05:15
because then it's going to become a problem.

00:22:05:15 - 00:22:07:07
Or people were hesitant.

00:22:07:07 - 00:22:08:15
It is very simple.

00:22:08:15 - 00:22:10:12
I cannot tell you how easy it is.

00:22:10:12 - 00:22:15:23
That patient is actually waiting for you to ask. When they're in distress,

00:22:16:02 - 00:22:19:00
they don't know how to initiate a conversation.

00:22:19:00 - 00:22:21:12
We can see people, we can read body language.

00:22:21:12 - 00:22:24:15
You all are so trained that you can tell that this patient

00:22:24:15 - 00:22:27:21
is not the way this patient was the last time they came in.

00:22:28:01 - 00:22:30:20
So I tell people, talk to them.

00:22:30:20 - 00:22:32:19
I tell family members to talk to them.

00:22:32:19 - 00:22:34:22
It's this whole new concept of

00:22:36:15 - 00:22:39:16
independence and confidentiality.

00:22:39:25 - 00:22:42:07
And, you know, your life is separate from mine

00:22:42:07 - 00:22:47:27
and your personal life is your personal and not mine, at times does not work.

00:22:48:21 - 00:22:51:08
You need to talk to your family and friends

00:22:51:08 - 00:22:54:03
and anyone who looks different than where they are.

00:22:54:03 - 00:22:55:19
I mean, we all have a sixth sense.

00:22:55:19 - 00:22:58:10
We can look at them and tell that they're not feeling right.

00:22:58:10 - 00:23:02:18
So I recommend everyone to make the conversation simple and open.

00:23:02:24 - 00:23:07:01
And all primary care physicians because you guys are the gatekeepers.

00:23:07:09 - 00:23:07:27
Yeah.

00:23:07:27 - 00:23:10:22
When they come to you, you just have to ask a similar, 

00:23:10:22 - 00:23:13:19
a simple conversation about how are you feeling today?

00:23:13:19 - 00:23:15:07
And you don't look the way you are.

00:23:15:07 - 00:23:17:06
Are you struggling with depression, anxiety?

00:23:17:06 - 00:23:18:26
Are you feeling safe?

00:23:18:26 - 00:23:22:03
These are simple questions, and I cannot tell you how quickly

00:23:22:03 - 00:23:24:27
they will open up and they'll start talking about

00:23:24:27 - 00:23:26:25
their stress and what issues they are having.

00:23:26:25 - 00:23:28:20
And that's your word.

00:23:28:20 - 00:23:30:11
That's your cue to get in.

00:23:30:11 - 00:23:31:16
And that's one thing that we do

00:23:31:16 - 00:23:33:09
with every every patient that comes to our clinic.

00:23:33:09 - 00:23:34:25
We are, we have them do,
fill out the PHQ-9

00:23:34:25 - 00:23:38:03
questionnaire and we and we make sure that we address it

00:23:38:07 - 00:23:39:11
before the end of the visit.

00:23:39:11 - 00:23:42:26
But you brought up an interesting point, which is we are the gatekeepers.

00:23:43:10 - 00:23:44:14
But then one of the things

00:23:44:14 - 00:23:47:15
that I've always been kind of unsure of is, is the boundary.

00:23:47:15 - 00:23:52:12
At which point is it that we need to hand them over to you?

00:23:52:23 - 00:23:54:08
That is a very good question.

00:23:54:08 - 00:23:57:23
So oftentimes patients are sometimes hesitant

00:23:57:23 - 00:23:59:11
about not talking about these issues

00:23:59:11 - 00:24:01:11
because they think that as soon as they tell someone

00:24:01:11 - 00:24:03:18
that they are having thoughts about harming themselves,

00:24:03:18 - 00:24:05:16
that they'll be committed to the hospital.

00:24:05:16 - 00:24:08:19
So they have to be reassured that that is not the case.

00:24:09:05 - 00:24:11:26
First, you have to assess the patient in a way,

00:24:13:14 - 00:24:15:04
in a way that they feel comfortable

00:24:15:04 - 00:24:17:20
that they can talk to you about their concerns.

00:24:17:20 - 00:24:21:07
And depending upon the severity and nature of the situation,

00:24:21:07 - 00:24:23:14
then you as a clinician has to decide

00:24:23:14 - 00:24:26:15
if this is a situation where they need to be admitted or not,

00:24:26:18 - 00:24:29:07
because sometimes pretty simple somebody is in distress,

00:24:29:07 - 00:24:31:12
they are struggling with depression, they're having thoughts,

00:24:31:12 - 00:24:33:09
but they are not going to harm themselves.

00:24:33:09 - 00:24:36:10
So involving the patient, their families,

00:24:36:11 - 00:24:39:12
providing them with the resources, getting them

00:24:40:03 - 00:24:44:17
resources for all the acute care help and then outpatient follow ups.

00:24:44:22 - 00:24:47:23
If it's acute situation, yes, you have the training

00:24:48:00 - 00:24:50:23
or idea to determine if they're going to be safe or not.

00:24:50:23 - 00:24:52:10
And then you encourage the patient.

00:24:52:10 - 00:24:55:21
I will tell you, there are many patients who are at that point.

00:24:55:21 - 00:24:58:06
And when you tell them, you know what, there's help available

00:24:58:06 - 00:25:01:25
we'll get you admitted to a place where you can get the help, they will be open to it.

00:25:02:12 - 00:25:04:24
That is what I have always seen.

00:25:04:24 - 00:25:06:23
But you have to ask the question.

00:25:06:23 - 00:25:09:21
You have to initiate that conversation.

00:25:09:21 - 00:25:14:00
And even if you feel that this patient is not open at this point of time,

00:25:14:05 - 00:25:16:18
you can just tell them that if you're not feeling safe,

00:25:16:18 - 00:25:17:25
you can call us anytime.

00:25:17:25 - 00:25:20:03
You can call 911, you can call nine, eight,

00:25:20:03 - 00:25:21:18
eight, the national mental health line.

00:25:21:18 - 00:25:24:25
You can go to the nearest E.R., you can give us a call anytime.

00:25:25:12 - 00:25:28:13
But anytime something happens, I am here for you.

00:25:28:19 - 00:25:33:06
I cannot tell you how effective that is and how powerful that is.

00:25:33:13 - 00:25:36:05
I will tell you, sometimes we have patients on our inpatient unit

00:25:36:05 - 00:25:39:23
that I don't feel they are ready to go home, but they're not suicidal anymore.

00:25:39:23 - 00:25:40:20
They want to go home.

00:25:40:20 - 00:25:43:21
And what I tell them is if you go home

00:25:43:22 - 00:25:48:03
and things are not working right and you are not feeling safe, come back.

00:25:48:21 - 00:25:50:24
We will take care of you. And guess what?

00:25:50:24 - 00:25:53:28
Three days ago I told a patient and I didn't want that patient to leave.

00:25:53:28 - 00:25:55:08
That patient decided to leave.

00:25:55:08 - 00:25:57:06
Last night, that patient was in the E.R.

00:25:57:06 - 00:25:59:25
and what she said was Dr. Jawed
asked me to come back.

00:26:01:05 - 00:26:01:21
Wow that's.

00:26:01:21 - 00:26:03:04
uh.

00:26:03:04 - 00:26:05:02
That's pretty powerful there.

00:26:05:02 - 00:26:08:16
I mean, that trust that you build with the patient, goes so far.

00:26:08:28 - 00:26:12:16
Building that trust and letting them know that they have a safe

00:26:12:16 - 00:26:16:05
and secure place where they can come to is the most important thing.

00:26:16:19 - 00:26:19:24
It's just like telling a child that you are going out

00:26:20:05 - 00:26:23:04
to your school or somewhere and then you will come back home

00:26:23:04 - 00:26:25:08
and this is a secure place for you.

00:26:25:08 - 00:26:26:17
You have to build that trust

00:26:26:17 - 00:26:29:18
and let them know that there is a secure place for them.

00:26:30:27 - 00:26:33:28
That's a great question Krishna.

00:26:34:19 - 00:26:36:03
Um, any other like,

00:26:36:03 - 00:26:39:12
from any of you guys as primary care providers, like what other advice

00:26:39:12 - 00:26:43:20
would you give to us to better take care of our patients

00:26:43:21 - 00:26:47:16
in terms of mental health or opportunities for us to learn more?

00:26:48:13 - 00:26:48:21
You know.

00:26:50:00 - 00:26:51:27
So my recommendation would be

00:26:51:27 - 00:26:55:07
when the patients come to you, you do your usual physical exams,

00:26:55:07 - 00:26:58:04
their basic health screenings within those screenings,

00:26:58:04 - 00:27:01:05
like you mentioned, that you have incorporated PHQ-9.

00:27:01:05 - 00:27:03:28
There are other different scales that if you feel

00:27:03:28 - 00:27:07:12
the patient is struggling with anxiety or other issues, theres scales

00:27:07:12 - 00:27:11:04
for anxiety, for PTSD, dissociation and Ms..

00:27:11:04 - 00:27:14:02
Collyn can speak more to that.

00:27:14:02 - 00:27:14:26
And those are simple.

00:27:14:26 - 00:27:18:08
Some of them are physician administered, some of them are patient reports

00:27:18:18 - 00:27:19:24
and those can be done.

00:27:19:24 - 00:27:23:14
And actually, if they have done that and next time they come in

00:27:23:14 - 00:27:27:03
and they do that, you can show them the kind of improvement that they have had.

00:27:27:14 - 00:27:29:22
They may not be feeling that they have made improvement,

00:27:29:22 - 00:27:32:22
but you can show them that, hey, you wanted this level and look how

00:27:32:22 - 00:27:34:07
how much improvement you have made.

00:27:34:07 - 00:27:36:20
So this medicine that we gave you is actually working

00:27:36:20 - 00:27:38:04
and your counseling is working.

00:27:38:04 - 00:27:40:26
So sometimes empowering them and reassuring them

00:27:40:26 - 00:27:43:01
and showing them the pathway actually helped a lot.

00:27:44:05 - 00:27:44:15
And I think.

00:27:44:15 - 00:27:46:20
That's like a big point in our clinic now was where

00:27:46:20 - 00:27:48:26
we're incorporating GAD-7 pretty frequently for anxiety.

00:27:48:26 - 00:27:52:18
Started doing Mood Disorder questionnaire and screen for like

00:27:53:15 - 00:27:56:27
bipolar disorder and sutff. Do you 
have any other screening tools that you use.

00:27:57:05 - 00:27:59:01
I can't think of any off the top of my head,

00:27:59:01 - 00:28:01:02
but to be honest, to change the direction of what

00:28:01:02 - 00:28:03:03
we're saying, like getting out of the medical model

00:28:03:03 - 00:28:07:03
and measuring model, to me it goes to counseling 101, rapport.

00:28:07:13 - 00:28:07:25
Like Dr.

00:28:07:25 - 00:28:11:22
Jawed said, rapport is number one and installation of hope,

00:28:12:00 - 00:28:13:17
like Doctor Jawed was talking about.

00:28:13:17 - 00:28:16:25
If you can connect with your patients and let them know, I mean,

00:28:17:02 - 00:28:20:03
from your heart, people know when you're connecting from your heart

00:28:20:04 - 00:28:23:28
and that, that's the way that's the way to help them.

00:28:24:07 - 00:28:26:05
That's thank you for that.

00:28:26:05 - 00:28:28:13
Ms. Lynn, What can we do better for you?

00:28:31:07 - 00:28:31:23
I think

00:28:31:23 - 00:28:35:19
this whole process when we first started was, you know, a new process.

00:28:35:19 - 00:28:38:00
But I think it's over time.

00:28:38:00 - 00:28:42:11
We as providers and myself have learned to kind of work together.

00:28:42:11 - 00:28:45:23
And it seems, you know, every week seems to go a little bit better.

00:28:45:23 - 00:28:47:09
And the rountine's going better.

00:28:47:09 - 00:28:50:13
Patients I'm seeing are getting appointments and and I think

00:28:50:13 - 00:28:53:14
they're coming in after appointments and are doing better,

00:28:53:15 - 00:28:55:25
you know, and I think it's just been a process.

00:28:55:25 - 00:28:57:03
But I think we're all doing well.

00:28:57:03 - 00:29:00:04
We, you know, talk together. We

00:29:00:11 - 00:29:03:12
you know, we're all here for one reason and that's for our patients. So.

00:29:04:11 - 00:29:04:20
You know,

00:29:04:20 - 00:29:05:05
I will

00:29:05:05 - 00:29:08:06
while we're having this conversation, lots of thoughts are coming to my mind.

00:29:08:19 - 00:29:10:13
Of course, sir. Please, please.

00:29:10:13 - 00:29:13:11
Yes. I will, as the conversation is heating up,

00:29:14:24 - 00:29:17:03
I had a patient

00:29:17:03 - 00:29:20:04
because, you know, some of our patients get admitted repeatedly.

00:29:21:18 - 00:29:24:00
Sometimes it's not the medicines,

00:29:24:00 - 00:29:28:11
sometimes it's the trauma in their life that does not help build

00:29:28:11 - 00:29:31:12
their personality strong enough that they can care for themselves

00:29:31:26 - 00:29:35:28
and they falter and they fail from time to time and they do get admitted.

00:29:36:18 - 00:29:40:27
So I have this had this one patient and this patient had been admitted

00:29:40:27 - 00:29:44:02
to different psychiatric facilities at different times.

00:29:44:13 - 00:29:47:25
And then this patient started to get admitted to our facility.

00:29:48:05 - 00:29:52:13
And every time we, this patient would come to the facility,

00:29:52:13 - 00:29:55:13
we will have some conversations about treatment

00:29:55:13 - 00:29:59:05
and what this person was supposed to do, but they would not follow through.

00:29:59:05 - 00:30:02:06
And we talk about the personality issue and all those things.

00:30:02:12 - 00:30:05:22
Sometimes we'll have some like disagreements

00:30:06:02 - 00:30:08:27
or some messy arguments.

00:30:08:27 - 00:30:13:06
And after three or four admissions, I asked that patient one day, you know

00:30:13:06 - 00:30:15:18
what, You have been doing this for a while

00:30:15:18 - 00:30:19:27
and you come here and we do this, and then you come back and we do this again.

00:30:20:15 - 00:30:24:00
So. And why do you think you keep on doing this?

00:30:24:15 - 00:30:27:24
And her answer was that I have been getting

00:30:27:24 - 00:30:31:03
admitted to the psychiatric facilities for the last 20 years.

00:30:31:26 - 00:30:35:20
But when I come here and we have these conversations

00:30:35:20 - 00:30:39:03
and you have these so-called arguments with each other,

00:30:39:16 - 00:30:41:22
it makes me realize that you actually care.

00:30:41:22 - 00:30:43:22
Oh my gosh, that's great.

00:30:43:22 - 00:30:46:16
And probably that's what I'm looking for and that's why I come back.

00:30:46:16 - 00:30:47:15
I mean.

00:30:47:15 - 00:30:48:26
You're fighting for them.

00:30:48:26 - 00:30:50:05
Yeah, that's what they want.

00:30:50:05 - 00:30:52:11
You fight for them and he does.

00:30:52:11 - 00:30:53:11
He's the best doctor.

00:30:54:13 - 00:30:56:18
He really is.

00:30:56:18 - 00:30:57:21
Couldn't do it without him.

00:30:57:21 - 00:31:02:10
So we're just lucky to have a great group of counselors.

00:31:03:07 - 00:31:05:24
Like Collyn, and we have Ms. Joanna

00:31:05:24 - 00:31:07:21
and Ms. Amanda and our staff.

00:31:07:21 - 00:31:10:00
We are very fortunate and lucky, I'll tell you that

00:31:10:00 - 00:31:13:01
We have the longest tenured staff in Norman Regional history,

00:31:13:16 - 00:31:16:18
and one of our nurses has been working there for 36 years

00:31:16:18 - 00:31:19:13
and our recreational therapist has been working there for 40 years.

00:31:19:13 - 00:31:21:28
50, 50, 50 years.

00:31:21:28 - 00:31:23:08
Wow. That is what you call committment. 

00:31:23:08 - 00:31:26:03
Randy Wallace, I'm calling him out. Yes. Yeah.

00:31:26:03 - 00:31:27:24
We need all the shout outs.

00:31:27:24 - 00:31:30:04
So these are the people who have been there.

00:31:30:04 - 00:31:32:03
And actually there was me and Collyn.

00:31:32:03 - 00:31:35:04
We are the youngest ones.

00:31:35:13 - 00:31:35:19
I call us

00:31:35:19 - 00:31:38:20
The youngest ones because we've been there for 
only twelve, thirteen years.

00:31:38:27 - 00:31:42:19
But these guys who have been the backbones of that unit

00:31:42:28 - 00:31:45:21
and they have always provided the best care.

00:31:45:21 - 00:31:49:25
So we are just following that model and that legacy of people who came

00:31:49:25 - 00:31:53:24
before us because like I said, it is a very, very difficult job at times.

00:31:53:25 - 00:31:56:18
Yeah, but I guess that's who we are.

00:31:56:18 - 00:31:57:19
So we just do it

00:31:57:19 - 00:32:00:20
and we are very fortunate that with this new facility

00:32:00:23 - 00:32:02:20
we'll be able to help more people.

00:32:02:20 - 00:32:07:21
And we are changing and modernizing, 
modernizing as the world is.

00:32:08:08 - 00:32:13:00
So we are very happy to say that Norman Regional will be providing the most

00:32:14:03 - 00:32:17:04
cutting edge care and

00:32:17:25 - 00:32:20:20
to all of our community members in future.

00:32:20:20 - 00:32:21:12
Yeah.

00:32:21:12 - 00:32:22:18
Wow that's great.

00:32:22:18 - 00:32:23:09
50 years.

00:32:23:09 - 00:32:25:14
50 years, that's a lot. 50 years is a lot.

00:32:25:14 - 00:32:29:00
Um, and it's funny that you guys have been working for over a decade

00:32:29:00 - 00:32:31:24
and you're still considered to be the youngest there.

00:32:31:24 - 00:32:36:19
Um, one of the things that I've noticed is that, uh, whenever I need to refer

00:32:36:19 - 00:32:40:25
somebody and specifically for a mental health specialist is the waiting times.

00:32:40:25 - 00:32:44:13
And I've always figured that was because of, of a lack of sufficient

00:32:44:21 - 00:32:47:14
either behavioral therapists or psychiatrists.

00:32:47:14 - 00:32:52:15
But I was wondering why is it, is that is that because we have not invested

00:32:52:15 - 00:32:56:12
in um, training programs for either a psychiatrist, psychologist,

00:32:56:12 - 00:32:59:13
and behavioral therapist, or is that because people

00:33:00:07 - 00:33:03:08
do not want to be involved in something like that?

00:33:03:19 - 00:33:04:05
You know,

00:33:04:05 - 00:33:08:23
I don't think that the physicians don't want to be in this profession.

00:33:08:26 - 00:33:09:08
Mm hmm.

00:33:09:08 - 00:33:13:13
I just feel that we have not made this profession as appealing

00:33:14:08 - 00:33:17:02
to many people. For a very long time.

00:33:17:02 - 00:33:22:10
There was always a stigma attached to it, and that goes with the patients.

00:33:22:10 - 00:33:26:00
And to be very honest, in the medical facility as well, fraternity as well.

00:33:27:02 - 00:33:29:14
So I think all of that is changing now.

00:33:29:14 - 00:33:32:19
We have had this shortage of psychiatric providers,

00:33:32:19 - 00:33:35:20
whether they are psychiatrists or counselors

00:33:35:23 - 00:33:40:17
or um, other providers, and the time is changing.

00:33:40:25 - 00:33:44:15
Um, there is more awareness now, um, and more people,

00:33:44:15 - 00:33:47:18
more and more people are getting trained to do this kind of work.

00:33:48:02 - 00:33:48:27
But like again,

00:33:48:27 - 00:33:52:17
we don't have enough training places also to train these people.

00:33:52:28 - 00:33:55:06
So it's going to take a time.

00:33:55:06 - 00:33:58:09
I think it's going to take quite some time before we catch up to the need

00:33:58:20 - 00:34:00:02
that we are running behind.

00:34:00:02 - 00:34:03:03
So we need to disseminate this information

00:34:03:03 - 00:34:06:09
and and make it more and more, provide

00:34:06:09 - 00:34:09:10
more and more possibilities for people to get training.

00:34:10:14 - 00:34:12:07
Ms. Campbell?

00:34:12:07 - 00:34:14:07
I can you repeat the question?

00:34:14:07 - 00:34:16:25
I'm sorry, I got lost in the discussion, 
I'm so sorry. 

00:34:16:25 - 00:34:21:03
So basically the thing is, is, um, you know, what can work?

00:34:21:03 - 00:34:24:14
What do you think it is that we may have a shortage of behavioral therapists?

00:34:24:15 - 00:34:25:24
Oh, yeah, definitely.

00:34:25:24 - 00:34:28:14
I mean, a shortage of behavioral therapists.

00:34:28:14 - 00:34:33:25
You have to, you have to have a lot of training and a lot of school.

00:34:34:06 - 00:34:35:13
You have to have a master's and a

00:34:35:13 - 00:34:38:14
Two years license in order to be a psychotherapist.

00:34:38:17 - 00:34:39:22
I'm not arguing with that.

00:34:39:22 - 00:34:41:15
I think that that's important.

00:34:41:15 - 00:34:45:03
But it's it's hard to to commit to something like that.

00:34:45:03 - 00:34:46:25
I think, for a lot of folks.

00:34:46:25 - 00:34:49:05
And so there's that piece. And then

00:34:50:17 - 00:34:52:21
I don't really know how else to answer that. 

00:34:52:21 - 00:34:55:22
So time and commitment. Time and commitment.

00:34:56:02 - 00:34:59:25
And I will tell you that a lot of us burn get burned out.

00:35:00:09 - 00:35:01:04
Yeah.

00:35:01:04 - 00:35:04:05
Because this is a very difficult and demanding job.

00:35:04:07 - 00:35:08:12
It is very hard to separate yourself from this kind of work.

00:35:09:12 - 00:35:10:26
And that's another thing.

00:35:10:26 - 00:35:13:27
We are talking more and more about physician burnout these days,

00:35:13:27 - 00:35:17:24
and especially COVID has really caused us a lot of stress.

00:35:18:12 - 00:35:21:09
But in the psychiatric world, you are dealing

00:35:21:09 - 00:35:25:09
and trying to help patients with all of their stress and.

00:35:26:01 - 00:35:29:22
Sometimes you take that stress because you are human as well.

00:35:30:03 - 00:35:32:17
Yeah. So that's that's a hard job.

00:35:32:17 - 00:35:35:18
And sometimes not many

00:35:36:07 - 00:35:38:28
people feel that that's what they want to get into.

00:35:38:28 - 00:35:43:07
Yeah, and I think a lot of folks to do go into it for wrong reasons.

00:35:43:07 - 00:35:47:22
They go into it to heal their own past and and that can absolutely

00:35:47:22 - 00:35:52:18
skew your entire efficacy as a therapist.

00:35:52:18 - 00:35:54:11
So I think that happens a lot.

00:35:54:11 - 00:35:56:08
We just have to we have to take care of ourselves.

00:35:56:08 - 00:35:58:01
I love that you've pointed out burnout,

00:35:58:01 - 00:36:00:18
because if we don't take care of ourselves,

00:36:00:18 - 00:36:03:12
we have nothing else to give and we have to give a lot.

00:36:03:12 - 00:36:05:23
And that's okay because that's our calling.

00:36:05:23 - 00:36:09:10
But we have to be very wise about it and take care of ourselves.

00:36:10:06 - 00:36:13:07
Yeah, well, usually in our

00:36:13:12 - 00:36:16:18
in this podcast we do a little segment called Question of the Day,

00:36:16:27 - 00:36:18:07
and it's usually questions

00:36:18:07 - 00:36:22:07
that are provided to us from patients that that submit them.

00:36:22:14 - 00:36:25:12
And we have one interesting one that we wanted to ask all of you guys

00:36:25:12 - 00:36:28:13
from patients perspective, and it's how can I ask my provider about

00:36:28:13 - 00:36:32:25
any potential risks or complications associated with mental health?

00:36:32:25 - 00:36:34:27
So pretty much saying, how do we bring it up?

00:36:37:25 - 00:36:39:20
Can you say that again?
How can I ask my provider or

00:36:39:20 - 00:36:42:12
bring up the topic of mental health with my providers?

00:36:42:12 - 00:36:45:10
I know we talk about physicians being proactive,

00:36:45:10 - 00:36:48:11
but what's the way that the patient can bring it up?

00:36:48:15 - 00:36:49:12
Oh, yes. Well.

00:36:49:12 - 00:36:52:09
Well, I am very happy to hear that question

00:36:52:09 - 00:36:55:18
because, you know, I always tell people that you need to talk about it.

00:36:55:18 - 00:36:56:04
Yeah.

00:36:56:04 - 00:37:01:02
So I would encourage everyone, if you need a way to communicate

00:37:01:02 - 00:37:02:28
with your physician about your mental health,

00:37:02:28 - 00:37:06:00
the only way is just to open up your mouth and speak.

00:37:06:19 - 00:37:08:22
Okay. Simple.

00:37:08:22 - 00:37:09:01
Yeah.

00:37:09:01 - 00:37:13:24
Whenever you go to a provider these days, there is enough awareness

00:37:14:10 - 00:37:17:07
that whether it's a primary care physician or a specialist,

00:37:17:07 - 00:37:20:22
if you are struggling, they can see it and you can be very open

00:37:20:28 - 00:37:23:01
and you talk to them because all the clinics

00:37:23:01 - 00:37:26:17
now have their nursing staff, they have their clinical care coordinators,

00:37:27:04 - 00:37:30:22
they have somebody like Ms. Lynn who can take care of patients

00:37:30:22 - 00:37:32:02
that have them with referrals.

00:37:32:02 - 00:37:35:03
So all you have to do is, just talk to your providers.

00:37:35:13 - 00:37:38:18
And even if you feel you're at a place where you don't have a provider,

00:37:38:18 - 00:37:40:12
I'll tell you guys another thing.

00:37:40:12 - 00:37:44:00
Most of our communities and counties have community mental clinics.

00:37:44:12 - 00:37:46:12
You can pick up the phone, give them a call.

00:37:46:12 - 00:37:49:13
If you cannot do that, you pick up the phone, call nine, eight, eight.

00:37:49:13 - 00:37:53:01
If you feel you're not able to do that, pick up the phone, call 911.

00:37:53:10 - 00:37:56:16
So but the only thing is

00:37:56:16 - 00:38:00:06
you just make a simple effort of speaking out.

00:38:00:23 - 00:38:01:07
That's it.

00:38:03:05 - 00:38:04:08
You guys have anything to add?

00:38:04:08 - 00:38:07:09
There's a, absolutely to everything he said.

00:38:07:17 - 00:38:10:14
There's a lot of stigma attached.

00:38:10:14 - 00:38:12:07
And so folks are really afraid.

00:38:12:07 - 00:38:14:23
They they've heard horror stories of, well, you know, I was suicidal

00:38:14:23 - 00:38:16:14
and then I got handcuffs put on me and I had to

00:38:16:14 - 00:38:19:19
you know, that that's humiliating and shameful for them.

00:38:19:19 - 00:38:22:16
But it's it's standard protocol and it's for a reason.

00:38:22:16 - 00:38:26:27
So they they hear horror stories or they think that a psych,

00:38:26:27 - 00:38:30:05
Norman Regional psych ward is like [the] American Horror Story shows that, you know, it's

00:38:30:27 - 00:38:32:08
not, not even close,

00:38:32:08 - 00:38:35:17
you know, so so I think the stigma is a part of the reason people don't ask.

00:38:35:17 - 00:38:38:17
Then you just have your upbringing of, you know, the machismo.

00:38:38:17 - 00:38:42:03
I cannot be I cannot show weakness and all the things, you know.

00:38:42:13 - 00:38:45:07
So if I think it's important

00:38:45:07 - 00:38:48:26
to as providers to always, I love how Dr.

00:38:48:26 - 00:38:52:07
Jawed said the Sixth Sense, because nonverbal communication, just eye

00:38:52:07 - 00:38:55:08
contact, just a facial twitch, you're going to know.

00:38:55:08 - 00:38:58:23
You know your people, you know your patients and just just go with it

00:38:59:19 - 00:39:01:00
and it can get them to open up.

00:39:01:00 - 00:39:02:08
You know, it's very simple.

00:39:02:08 - 00:39:05:09
If you look around, I tell people, you look around your families,

00:39:05:22 - 00:39:08:27
you will have this one uncle who was always angry

00:39:09:03 - 00:39:11:11
and yelling and screaming at people.

00:39:11:11 - 00:39:14:18
You would have this one aunt who was always fearful

00:39:14:23 - 00:39:16:20
and she'll always be crying.

00:39:16:20 - 00:39:18:18
Then you had a sister

00:39:18:18 - 00:39:21:26
who would always be having problems with the rest of the sisters.

00:39:22:12 - 00:39:26:03
Then you would have one brother who was always getting into trouble

00:39:26:03 - 00:39:27:19
and legal problems.

00:39:27:19 - 00:39:30:14
And we all think of growing up, that that's normal.

00:39:30:14 - 00:39:32:10
Yeah, that's who Uncle Joe is.

00:39:33:09 - 00:39:35:12
Or that's how Aunt Nancy is.

00:39:35:12 - 00:39:38:13
No, that is not what they are.

00:39:38:19 - 00:39:40:21
There is something going on there.

00:39:40:21 - 00:39:43:13
There is a mental health component attached to it,

00:39:43:13 - 00:39:46:00
so the family needs to address it

00:39:46:00 - 00:39:48:26
and you have to be open to talk about it.

00:39:48:26 - 00:39:53:09
And I want the viewers, sorry the listeners, to know

00:39:53:21 - 00:39:57:25
that you can talk to your primary care physicians or any physician,

00:39:57:25 - 00:39:59:14
or provider about these things.

00:39:59:14 - 00:40:02:11
And people now are so open that

00:40:02:11 - 00:40:05:12
they will listen to you and guide you and help you.

00:40:05:17 - 00:40:08:18
So please be open about it and talk about these things.

00:40:09:03 - 00:40:10:08
And for the listeners,

00:40:10:08 - 00:40:12:25
if you notice that a friend or family member is that way

00:40:12:25 - 00:40:14:20
and they're not going to reach out, do it.

00:40:14:20 - 00:40:15:23
You'd rather them be alive

00:40:15:23 - 00:40:18:13
and mad at you the rest of their life than not alive anymore.

00:40:18:13 - 00:40:21:14
So always, always protect your loved ones.

00:40:21:22 - 00:40:22:12
Mm hmm.

00:40:23:12 - 00:40:25:17
Well, I think we have now that we have the clinic here,

00:40:25:17 - 00:40:28:18
coordinators in all the offices, you know, maybe they're not comfortable,

00:40:29:11 - 00:40:32:11
you know, with the providers or we've made contact with them

00:40:32:11 - 00:40:33:22
or a different referral

00:40:33:22 - 00:40:37:13
to know that clinic care coordinators are there to help the patients as well,

00:40:37:14 - 00:40:41:23
you know, and if they need anything or to reach out to us as well,

00:40:42:03 - 00:40:45:04
Yeah.

00:40:45:12 - 00:40:46:00
Anything else

00:40:46:00 - 00:40:49:01
you want to add and tell our listeners.

00:40:49:12 - 00:40:52:05
Please take care of yourself.

00:40:52:05 - 00:40:56:20
Thank you, sir. And never, ever underestimate the power of mindfulness.

00:40:56:20 - 00:40:59:21
I think that is the key for all of us.

00:41:00:08 - 00:41:06:02
So I think just take care of each other and ourselves, you know,

00:41:07:11 - 00:41:10:12
always be there for ourselves and each other.

00:41:10:25 - 00:41:13:19
Well, we just want to say thank you so much for your time

00:41:13:19 - 00:41:17:09
and for coming and talking to to us and to our listeners.

00:41:17:09 - 00:41:20:04
We really appreciate, uh, you guys coming here today.

00:41:20:04 - 00:41:21:25
So, yeah, thank you. Yeah.

00:41:21:25 - 00:41:24:10
I just want to reiterate to our listeners is

00:41:24:10 - 00:41:27:11
We're so lucky to have such wonderful people working in our system

00:41:27:16 - 00:41:31:23
and giving their insight and their experience and expertise

00:41:31:23 - 00:41:35:15
to this podcast and just to summarize, guys, mental health

00:41:35:15 - 00:41:36:28
is real,

00:41:36:28 - 00:41:39:09
It's part of your overall health.

00:41:39:09 - 00:41:41:02
We need to normalize the conversation.

00:41:42:06 - 00:41:45:07
Don't be afraid to bring it

00:41:45:07 - 00:41:49:01
up to anybody to take care of yourself and take care of the people around you.

00:41:49:09 - 00:41:53:10
And for our primary care doctors out there, our residents and students

00:41:54:06 - 00:41:57:08
remember that visual communication is just as important

00:41:57:19 - 00:42:00:20
as as verbal and

00:42:00:27 - 00:42:05:03
look out for resources that that can help yourself and your patients as well.

00:42:05:05 - 00:42:05:16
Yeah.

00:42:05:16 - 00:42:09:18
And with that being said, I going to do something, something different.

00:42:09:18 - 00:42:10:21
I've been reading about

00:42:10:21 - 00:42:13:20
Bruce Lee's philosophies, so I'm going to end with 

00:42:13:20 - 00:42:15:20
Be water, my friends.

00:42:15:20 - 00:42:16:27
And stay out of trouble.