Dr. Tom Vendetti New Maui Mental Health Center Chief
Transcription
Dr. Tom Vendetti New Maui Mental Health Center Chief
News September, 2002 volume 2 issue 9 Dr. Tom Vendetti New Maui Mental Health Center Chief T he Adult Mental Health Division is pleased to announce Dr. Tom Vendetti as the new Maui Mental Health Clinic Chief (MMHC). Dr. Vendetti comes to us with a record of exemplary service in both the private and public mental health sectors. The beginnings of Dr. Vendetti’s record of service in mental health may be traced to his initial position as a psychiatric aid at Shepard Pratt Hospital in Towson, Maryland, some 32 years ago. Dr. Vendetti was awarded a MSW degree in Clinical Social Work in 1978, and subsequently relocated to Flagstaff, Arizona, where he assumed a position at The Guidance Center, Inc. In his new position, Dr. Vendetti played an instrumental role in developing the first community based treatment facility for Seriously Mentally Ill (SMI) consumers in Northern Arizona. In 1989, Dr. Vendetti was awarded a Ph.D. in Psychology, and promoted to Clinical Director of The Guidance Center, Inc. As Clinical Director, Dr. Vendetti oversaw the building and development of a state of the art acute care unit as part of the continuum of care for treating the SMI population. That acute care unit became a model for Northern Arizona and resulted in four other units being built throughout Coconino County. In 1994, Dr. Vendetti moved to Maui, where he was initially hired by Maui Kokua Services as Residential Program Director and later became the Executive Director. In his capacity as Executive Director, Dr. Vendetti recognized that there was a scarcity of community housing for SMI consumers. To rectify this situation, he supported an initiative to merge Maui Kokua Services with Mental Help Hawai‘i, which is one of Tom Vendetti, PhD. several non-profit organization in the state that provided housing services for adults with SMI. Dr. Vendetti’s efforts were a success, as the merger was completed on January 1, 2001. When asked for his thoughts regarding the current status of mental health services on Maui, including needs and wants, Dr. Vendetti shared the following: Maui County was noted for lacking community resources for the Seriously Mentally Ill consumers. This year, however, it appears that a significant change is going to occur. Mental Health Kokua is planning to open several housing projects, a psychosocial rehabilitation day program, increase staffing for the crisis mobile outreach program and will continue to provide host family and intensive case management services. Aloha House has started a residential and day treatment program for the dually diagnosed clients in our community. These services were terribly needed and will help fill the gap in the continuum of care for the consumers. This will result in fewer psychiatric hospitalizations and a higher standard of care being provided for the consumers. The most apparent need at the Maui Community Mental Health Center is to fill the large number of vacant or unfilled positions. The most obvious example is the Clubhouse. The Clubhouse property is a perfect facility to provide either a Clubhouse model or Day Program model (PSR) and give the consumers a place to meet and become the “House of Success” (as it is named). Currently, approximately twenty or more consumers “drop in” and occupy the facility daily. The program needs to be adequately staffed. Maui County also needs a jail diversion program. Too many SMI consumers are jailed primarily as a result of exhibiting dysfunctional behavior related to their illness or disability and need treatment, not jail time. It is my hope to work closely with AMHD, the police, and the judiciary to create an effective program on Maui. Maui Mental Health Clinic is actively providing services to Hana that are greatly needed and appreciated. Hana is a difficult area to service because it is not like L āna‘i where ninety-nine percent of the people live in close proximity. The population in Hana is spread out and often inaccessible. Even with this barrier it appears that the center is having a positive impact on the community. AMHD News September, 2002 Page 2 of 8 When asked about his goals and plans, as well as the improvements he would like to see as the new Chief of Maui CMHC, Dr. Vendetti answered: My first goal is to get orientated to the job and assess the current situation. I have worked over the years with the majority of the employees at the center and respect their work and roles as professionals. I think there may be some misconceptions in the community regarding the center’s function. A major goal is to educate the community about the types of services provided and consumers served by the system. I would like to make a video addressing these issues and air it on Public Access Television. I believe that this program would have a positive impact on the center and our community. Making a video is very feasible, because I am a filmmaker. I made a film recently that was presented at the Consumers Conference on Maui and at the National NAMI Conference in Washington DC. The film was titled “Haleakala Miracle Trek.” It is an educational program dispelling the myths of mental illness, featuring ten (10) consumers trekking from the top of the volcano to sea level. I also made the award-winning documentary “Journey Inside Tibet” that was aired nationally on PBS. I also see my role as working closely with the non-profit sector, the Mental Health Association and Maui Service Area Board on Mental Health and Substance Abuse with the goal of promoting quality care and programs for our consumers. Jean McDaniel, Sandi Alvestad, Deborah Shoup, Debra Kae Sutton, Tom Vendetti Social & Independent Living Skills (SILS) Training at Hawai‘i State Hospital (HSH) O ver sixty Hawai‘i State Hospital employees and community mental health providers attended a one-day training on Social & Independent Living Skills (SILS) at HSH on July 9th. The training was presented by HSH SILS coordinator Daniel Gutkind, Ph.D., state hospital clinicians, and SILS consultants from the University of California, Los Angeles and the Seattle, Washington VA Medical Center. The Social & Independent Living Skills (SILS) program is designed to teach seriously mentally ill individuals illness-management and core living skills that are needed to function successfully in the community. “Health care professionals go to school for many years to learn how to effectively treat mental illness,” says Dr. Gutkind. “But mental health care consumers don’t just automatically know how to lead an effective life with mental illness. The SILS program helps consumers learn how to actively manage their own illness, how to communicate more successfully, and how to handle both everyday hassles as well as problems that may be specific to mental illness.” Social skills training is listed in the American Psychiatric Association Clinical Practice Guidelines as an indicated evidence-based treatment for SPMI individuals. The therapy is highly interactive and uses structured treatment manuals to guide participants through “learning activities” which include group discussions, videotaped educational material, peer support, and learning and practicing of skills through role-playing and rehearsal. Group participants share personal examples from their own lives to illustrate the success of using these skills or the need to improve skills. Members are encouraged to assist each other and provide helpful feedback. SILS groups are “modulized,” whereby similar methods are used to teach information and skills in a variety of topics. Consumers may participate in one or more groups, depending on their needs. Several hospital patients have reported being able to negotiate with their doctors and other hospital staff more successfully after participating in SILS groups, and feel more confident that they “know what to do” should their symptoms worsen. “It was really gratifying to see such an interest in this training, especially from the community providers,” said Dr. Gutkind. “Any kind of skill someone learns works best if there are consistent opportunities to practice and get feedback from many different people in a variety of settings. The more we can get consumers, the hospital, community providers, care home operators, family members, self-help groups and peers all speaking the same language, the better the quality of life consumers will have.” The Psychosocial Rehabilitation Therapists Ten SILS Group Topics: 1. 2. 3. 4. 5. Assertiveness Conflict Management Basic Conversation Skills Medication Management Community Re-Entry Preparedness 6. Recreation Benefits 7. Interpersonal Problem Solving 8. Friendship & Intimacy 9. Employment Preparedness 10. Conflict Management AMHD News September, 2002 Page 3 of 8 The AMHD Quality Management Team Is Growing T wo new QM Specialists have been hired to to help in the implementation of quality control for the provision of services to consumers. the provision of services to consumers. The Team will work in accordance with the State Plan for Mental Health, Fiscal Years 2002 – 2003. The two new members of the Team are Sue Goodman, RN, LSW, and Kelly Snavely, RN. Both hold the positions of QM Specialist and will be joining Christie Gibson, LSW, who has been with the Adult Mental Health Division for several years, and started as the QM Coordinator in November 2000. Ms. Goodman was born in Connecticut, raised in both Connecticut and California, and completed her education at the University of Southern California in Los Angeles, Metropolitan State College in Denver, and the University of Hawai‘i at Manoa. Ms. Goodman has been a social worker for over 12 years, and a nurse for over 30 years. She has also served as a U.S. Peace Corps volunteer (family planning and public health) in the rural Philippines, a health/medical cross-cultural educator for newly arriving volunteers, and as a consultant for the United Nations maternal/child health project in the Philippines. Ms. Snavely was born in Key West, Florida, and spent much of her childhood moving up the southern east coast, ultimately settling in Chicago. She received a Bachelor of Arts degree in Psychology from Wheaton College in Wheaton, Illinois, and a Bachelor of Science in Nursing from the University of Cincinnati in Cincinnati, Ohio. Ms. Snavely has worked on the Child, Adolescent and Adult inpatient Psychiatric units at Children’s Hospital Medical Center in Cincinnati, Ohio, and at Rush-Presbyterian-St. Luke’s Medical Center in Chicago, Illinois. Moreover, following the move to Hawai‘i, Ms. Snavely worked for Hawai‘i Biodyne as a Mental Health Benefits Manager for HMSA, where she was involved in case and utilization management for HMSA’s commercial and Quest health insurance plans. Some personal interests of Ms. Snavely include running marathons (which she has done in each of the last 3 years), reading novels, shopping, and scuba diving. The responsibilities of the newly formed QM team are diverse, but nevertheless guided by the unified goal of working to ensure that the AMHD provides quality treatment for consumers. Some of the activities of the Team include on-site monitoring of AMHD providers and programs, review of provider organization’s practices and consumer records, risk management activities, and certification of AMHD providers, programs, and services. Moreover, the Team is committed to the promotion of evidence-based best practices, and the rapid dissemination and implementation of needed practices and procedures through the process of ongoing quality improvement initiatives. Kudos To… A nnette Crisanti, PhD, who has been accepted to give a presentation at the American Public Health Association Meeting in Philadelphia in November. Dr Crisanti is an epidemiologist for Adult Mental Health Division located on the Big Island and Oahu . The title of her presentation is “Perceptions of safety regarding current living arrangements among persons treated at Hawai‘i Community Mental Health Centers.” E lizabeth Lam, research assistant with the Services Research and Evaluation Unit of the AMHD who was selected to present a paper titled, “Housing Needs of Mental Health Consumers in Hawai‘i” at the Annual meeting of the American Public Health Association Conference. The meeting will be held in Philadelphia, PA in November, 2002. Liz is a graduate student in clinical psychology at the University of Hawai‘i. Her interests include cross-cultural psychology, the empowerment of disenfranchised individuals, psychosocial rehabilitation, and working with adults diagnosed with severe mental illness. Christie Gibson, LSW, Sue Goodman, RN,LSW Kelly Snavely, RN More Kudos To… Waianae Coast Community Mental Health Center’s Hale Na‘au Pono (House of Inner Balance) who was one of three programs featured and given recognition in the N a t i o n a l Te c h n i c a l Assistance Center’s (NTAC) report as having an exemplary program for services to Asians and Pacific Islanders. The clinical programs of Hale Na‘au Pono are uniquely influenced by cultural practices that emphasize the relationships of the individual, the family, the community, and the natural environment in the context of a broader spiritual realm. In Native Hawaiian culture, the focus is on this system of relationships rather than on the individual. AMHD News September, 2002 Page 4 of 8 Spotlight on Nancy Wright Slain Ms. Nancy Slain is currently the First Vice President of the State Council, and has held this position for three years. Nancy has been a member of the State Council for the past six years. During her tenure, one of Nancy’s continuing priorities is exploring ways in which the Council can work together with CAMHD and AMHD. She is pleased with the inroads that have been made in the last few years in the creation of a more trusting and productive partnership. When speaking about the nature and treatment of mental health, Nancy shared the following insights: Mental health is something we often take for granted. Within my immediate family I have lived with bipolar disorder, alcoholism, depression, suicide, ADHD, Tourette’s Syndrome, and all the accompanying disorders and occasional victories associated with these. To me substance abuse and mental health and joblessness and homelessness and on and on form an inseparable chain that will shackle a person unless the chain is broken. Receiving appropriate services early is the hope we can offer. Nancy Wright Slain In addition, Nancy related her thoughts regarding continuity of treatment: Mental health is ageless—it is a carefully woven thread that can unravel at any point in a person’s life. When we pigeonhole services that only apply to a very narrow and specific population, we run the risk of leaving many outside the safety net. Although I fully realize the population that Adult Mental Health is charged to serve, the transition from Child and Adolescent Mental Health services to Adult Mental Health is a dramatic and dangerous narrowing of that net. Nancy has a background in teaching and education, first having taught at Iolani School some 30 years ago. In 1989, her interests and training in teaching and education led her to teach personal growth courses in Melbourne, Australia, and later in Houston, Texas. While in Houston, Nancy worked with a women’s shelter. Since returning to Hawai‘i in 1996, Nancy has been a small business owner, corporate trainer, and prior to her current post, Executive Director of the Kailua Chamber of Commerce. Her current hobbies include swimming, biking, cooking, reading, sailing, writing, and video production. Nancy is married and has a 20 year-old son in the Army at Fort Lee, Virginia. AMHD Sponsors Five Participants to Attend Alternatives Conference, 2002 E llen Awai, Randy Hack, Charlene Ryerson, Kaanoi Kaapana and Rita Gorospe were chosen by a panel of judges to attend the Alternatives 2002 Conference in Atlanta, Georgia. The Adult Mental Health Division is sponsoring the five participants (left to right) Rita Gorospe, Ellen Awai, Randy Hack, to attend the conference on September 18-22, Charlene Ryerson, Kaanoi Kaapana 2002. There were 29 excellent applicants. The selection criteria was based on previous participation in mental health, presentation skills and what the participants intended to share with other consumers on their return. A luncheon was held at the Kau Kau Cafe on August 8, 2002 for all applicants. The judges selection was announced at that time. Everyone received a prize and a had good time. Thank you all for your participation. Provider Fair in October at Hawai‘i State Hospital AMHD will be working with HSH to sponsor a Provider Fair on October 10, 2002 as part of Mental Health Awareness Week 2002. Community providers will showcase their services to HSH staff, consumers and each other. It will also be open to consumers residing in the community, case managers, and any other interested parties. There will be a brief Quarterly Provider Meeting following the fair. For more details contact: Eva Kishimoto at 539-3944 (RSVP required) AMHD News Page 5 of 8 September, 2002 Nationally Acclaimed Forensic Psychiatrist Spearheads UH Forensic Psychiatry Residency Program D r. Daryl Mathews, Director of the Forensic Psychiatry Residency Program at the University of Hawai‘i, is credited for spearheading the first forensic training for psychiatrists in Hawai‘i. Dr. Matthews is a nationally recognized forensic psychiatrist who is also a long-time resident of Hawai‘i. In discussing the status of forensic psychiatry training in Hawai‘i, Dr. Mathews related that the State is “behind the times in this area.” As a response to this lag in training, the Forensic Residency Program will enable the training of board-certified forensic psychiatrists to provide court-ordered forensic evaluations for individuals with severe mental illnesses who are also involved in the criminal justice system, including individuals at OCCC, HSH, and those residing in the community. The curriculum of the Forensic Psychiatry Program was created by integrating the best features of other programs throughout the U.S., and is a DOH-UH Collaboration Project, operated by the Department of Psychiatry, John A. Burns School of Medicine, with funding provided by the AMHD. A significant goal of the Program is to train psychiatrists to become experts in conducting psychiatric evaluations for the legal system. The Program sponsors special seminars and case conferences directed to the training needs of forensic residents, along with other ongoing and developing forensic training experiences which are of more general interest. The one year Program, which started July 1, 2002, is currently training two psychiatry residents. Each of the participating residents is a fully trained board-eligible psychiatrist who, over the course of the year, will study and work at the interface of psychiatry and the legal system. At the conclusion of the Program, graduates will be eligible to sit for the certification examination in forensic psychiatry given by the American Board of Psychiatry and Neurology. The program is expected to receive provisional accreditation this year by the Accreditation Council on Graduate Medical Education. Darryl Mathews, M.D. (back row) Jonathan Briskin, M.D., Daryl Mathews, M.D. Sharon Tisza, M.D., Lena Osher, M.D. Age and Gender of Consumers Served by the AMHD January 1, 2001 – December 31, 2001 T Number of Consumers Served 800 he figure on the right shows the number of male and female Males consumers served by the AMHD at HSH and at State operated 700 CMHCs during calendar year 2001 broken down into different age Females groups. The figure illustrates a higher prevalence of males in the 600 younger population and a higher prevalence of females in the older 500 population. This pattern is consistent with typical epidemiological data on age and gender of individuals with severe and persistent 400 mental illness. It is not clear why this pattern emerges in this population and a number of theories have been suggested. Among them 300 are (a) males come to the attention of mental health systems sooner 200 because of aggressive acts; (b) females are nurtured by family members longer and come into contact with the mental health system 100 only later in life; (c) hormonal factors in women are protective for a period of time; and, (d) the pattern represents two distinct illnesses 0 18-24 25-34 35-44 45-54 55-64 65+ in men and women. It is also apparent from the figure that the majority of the population served by the AMHD are adults in middle Age Range adulthood (ages 35-54) which account for 62% of the population served. Very few individuals receiving services from the AMHD fall into the 18-24 or 65 and over age groups (i.e., 13.9% of the population served). AMHD News September, 2002 Page 6 of 8 Consumers Gain Literacy Skills in Pilot Program I n what was once a barbershop, located in a quiet area on the periphery of a courtyard, a man sits across from a woman who is speaking slowly and articulately. He does not understand what she is saying but he listens and watches with a deep yearning for more. Without taking her eyes off him, she says a word and points to a picture. He is excited as he responds to her encouragement. He repeats the word she has just said and points to the same picture. He cannot remember a time when anyone looked into his eyes and believed that he could learn anything. He does not speak or understand English and he does not read or write. He is fifty-three years of age, has a mental illness, and is being taught to read and write English for the first time in his life. The above description is a scenario in the life of a non-English speaking student receiving oneon-one instruction In the Adult Literacy Program at Hawaii State Hospital. The Adult Literacy Program is an important part of accomplishing a mission to improve the quality of life and recovery for persons who have a severe and persistent mental illness. Those who lack the ability to read and write fluently are encouraged to take advantage of the literacy skills offered in the program in order to become as independent as possible. In the fall of 2000 Dr. Kim Meyer suggested the Morningside Model of Generative Instruction be considered when the Adult Literacy Program was initiated. In January of 2001 Roshani Samarasinghe, whose expertise is in the field of Special Education, developed the Adult Literacy Program. This curriculum has a history of success in helping minority and underprivileged students improve their reading, writing and math skills. With the collaborative efforts of Dr. Meyer and other staff members, the program is run with a zest and passion that is infectious to be around. Enthusiasm, fun and laughter permeate the classroom with an atmosphere where morale is high and hope is born. Students are referred to the program by treatment teams at the Hawaii State Hospital. After an assessment is performed to understand the individual’s needs and goals, an individualized curriculum is designed for each student. When students begin the program, they are encouraged to set attainable goals for themselves at the beginning of each class. At the end of the session their improvement is shown to them on a graph. This feedback is instrumental to instill confidence and motivation so the students can see they are capable of learning new skills. Under the best of circumstances it is hard for people to admit that they cannot read. This may be even more difficult for individuals with a mental illness. One of the remarkable parts of the Literacy Program is the confidence it instills in its participants. Ms. Samarasinghe sees the feedback the students receive as a vitally important tool and points out that the consumers are much more likely to ask for more classes than to ask for less instruction time. Students report liking the class very much. This is supported by observations that suggest students are on-task about 80% of the time (most teachers in schools would be thrilled with these percentages!). The Adult Literacy Program provides services for students at all levels, ranging from nonreaders to students wishing to complete their GEDs. Of the 30 consumers who have participated in the program, about fifty percent of them have demonstrated gains after six months using standardized educational tests. So far, students have made more consistent gains in the math curriculum compared to the reading curriculum. Although the program is still investigating why this occurs, it may be because of the number of students who have language impairments resulting from English being their second language. Some students have made very impressive gains. For example, one math student went from a fifth grade level to an eighth grade level. The most outstanding gains made by an individual to date was a person who started the program reading at sixth grade level and reached GED level before being discharged from the hospital. Another student who was once a delivery person admitted he could not read the forms needed for his job. After three months of being in the program, he was able to read by himself. Pat Spencer, Kim Meyer, Roshani Samarasinghe Pat Spencer working with student Chart of Instructors AMHD News September, 2002 In addition to standardized tests, timing charts are used to show short-term gains within and across daily sessions. For example one student improved from reading twenty-three words per minute to fifty words per minute within one week. It is also quite common to see students show 30-50% increases in the numbers of problems completed correctly per minute when working on basic math problems. One of the surprising things about the curriculum is that students are often timed while doing their work. This is because the curriculum requires that students be accurate and fast. Speed is essential because it shows that the student has mastered a particular skill. The Adult Literacy Program also has three book clubs run by Ms. Samarasinghe, Amanda Stewart (another teacher who joined the staff in January of 2002) and Winter Hamada (a graduate student in the Department of Psychology at the University of Hawai‘i who has been with the program since its inception). The book clubs emphasize student participation through reading, prediction of stories and retelling of information. Hawaiian culture is now also included in the program with the assistance of outside speakers and hospital consumers whose knowledge of Hawaiian history has provided meaning and a feeling of connectedness during the learning process. Stories of Hawaiian mythology enrich the curriculum with the depth and knowledge of ancient Hawaiian history and culture. Ms. Samarasinghe’s plans are to continue developing different themes to enrich the curriculum and to meet student preferences. Hopefully, the success of this hospital program will soon be seen in other settings throughout the state. The AMHD has been soliciting input on a draft Vocational Psychosocial Rehabilitation Plan. One related element in this plan is the further development of literacy training and supported education programs. Page 7 of 8 Supplies and Goal Charts Map developed with students Progress and Goal Charts IAPSRS Officers Elected For New Hawai‘i Charter Chapter I t’s official! Hawai‘i now has its own IAPSRS chapter. Congratulations to the new officers of Hawai‘i IAPSRS Charter Chapter. The chapter officers are: Eva Kishimoto (President), Dr. Dan Gutkind (President Elect), Ellen Awai (Consumer Representative), Eve Okumura (Chair Newsletter Committee), Dr. Philippe Gross (Chair Conference Committee), Randy Hack (Chair Social Committee). Come join us at the next meeting on October 23, 2002 at 5:30 pm. The meeting will be held at the Queen’s Hospital new outpatient mental health clinic on the corner of Vineyard and Nuuanu. Eva Kishimoto, President and Dan Gutkind, President-Elect September, 2002 AMHD News Page 8 of 8 RFP Update… T he following (RFPs) that were issued June, 2002 are presently being reviewed. AMHD plans to send out notices of awards September, 2002: • Supported Housing • Specialized Residential (24 hour rehabilitaiton and 24 hour dual diagnosis • Semi-Independent • • • • • • • • Respite Care Employment Rehabilitation Supported Employment Clubhouse Day Treatment for Persons with Dual Diagnosis Consumer Support and Warm Lines Outpatient Treatment/Targeted Case Management Homeless Services • Supported Case Management/Case Coordination If you are not on the RFP notification list and wish to be placed on the list, please call Vivian or Enid at 586-4688. Department of Health o Healtho 1250 Punchbowl Street Room 256 Honolulu, Hawai‘i 96813 Phone: (808) 586-4686 Fax: (808) 586-4745 E-Mail for Newsletter: mgmcdono@hsh.health.state.hi.us Employment Update… Clubhouse Programs • Waipahu Aloha Clubhouse reports 125 active members. 17 members were employed (14%). Of those, all 17 were employed part-time in positions that were less than 20 hours per week. • Ko‘olau Clubhouse reports 92 active members 21 members were employed (23%). Of those, all 21 were employed part-time in positions that were less than 20 hours per week. • Honolulu Clubhouse reports 169 active members. 23 members were employed (14%). Of those 23, one worked full time (i.e., 40 hours per week); one worked 28 hours per week; the remaining 21 members worked part-time in positions that were less than 20 hours per week. • Friendship House reports 68 active members and 29 members were employed (43%). Of those 29, six worked full time. (i.e., 40 hours per week). Eight additional members worked 20 or more hours per week. The remaining 15 members worked part-time in positions that were less than 20 hours per week. • Hui Hana Pono Waianae reports 74 active members. 14 members were employed (19%) Of those 14, one worked full time (i.e., 40 hours per week). 13 members worked in part- time positions that were less than 20 hours per week. Supported Employment Program • Good news! We now have 171 consumer job placements, compared to 162 last month, with a 53% retention rate. Consumer Survey • As of August 1st, at State Operated Community Mental Health Centers, 2,178 consumers completed a quality of life interview within the previous 7 months. Of these, 366 (17%) reported being employed (140 full-time and 226 part-time employment) We’re on the Web! See us at: http://amh.health.state.hi.us