Mental Health is Part of Overall Health

By Katie Bui, clinical pharmacist at CHOC Children’s

Mental health is an important part of our overall health. It affects our energy level, our ability to connect with family and friends, our confidence, and our performance at school and work. Sometimes, it means taking medicine to help maintain our mental health. These medicines are safe and effective when taken appropriately under a doctor’s supervision.

Take medicine exactly as it’s prescribed

It’s important for patients taking medicines to take them exactly as prescribed. If you closely follow the medication schedule and directions, it will help your doctor know if the medication is working or not. It will also help minimize unwanted side effects from stopping it abruptly. When you take a medicine inconsistently, it is hard to figure out if the medicine is working or not, if the dose needs to be changed, or if your physician should have you try a new medication. If you have trouble sticking to a medication schedule, or if you have trouble helping your children follow their medication schedule, set a daily medicine reminder, plus a refill reminder so you don’t run out of medicine. Using a pill box can help you stay on top of a medication schedule and be mindful of when you’re due for a refill.

Possible side effects of antidepressants

Since these medicines affect the chemicals in the brain, they may take time to work, sometimes up to a month. Sometimes you might experience side effects before seeing positive changes results in mood. Most of these side effects are relatively minor and may include nausea, vomiting or sleepiness. If you experience major side effects like confusion, fever, rapid heart rate, high blood pressure, increasing depression or suicidal thoughts, no matter how long you have been on antidepressants, seek immediate medical help. These side effects are rare but it is important to know the signs and symptoms that require emergency treatment.

How mood medications interact with other medications

Sometimes, the medicine you take to treat a mental health condition can interact with other medicines you might be taking. This is another reason to follow the directions as prescribed by a doctor, and to ask your pharmacist any questions you have when you pick up a prescription. For example, mood medications such as fluoxetine (Prozac) or citalopram (Celexa) can interact with certain antibiotics like linezolid (Zyvox) and cause high fevers and confusion. Others can cause more sleepiness with sedating medicines like diphenhydramine (Benadryl) and clonazepam (Klonopin). As mentioned earlier, most of these interactions and side effects are rare and patients should talk to their doctors and pharmacists regularly when taking new medicines.

How lifestyle choices may positively impact mental health

Some lifestyle choices can also have a positive impact on your mental health. These can include simple daily activities such as going for a walk and being physically active, eating lunch outside to get fresh air and sunlight, listening to calming music, meditating, yoga and getting enough sleep each night. These activities help with relieving stress, which can directly help with mental health. It’s important to have an ongoing, open and honest conversation with your primary care physician and mental health professional about your mental health, what resources you need, and what lifestyle changes you can make.

-Reviewed by Dr. Hoang (Wayne) Nguyen, medical director of child and adolescent psychiatry at CHOC Children’s

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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Mental Health Staff Give Back Through CHOC Walk

Inspired by the care provided to patients and families at CHOC Children’s and the desire to further eliminate the stigma of living with a mental health condition, clinical staff members of the newly opened Mental Health Inpatient Center have formed a team for CHOC Walk in the Park, one of the largest and most anticipated fundraising events of the year. The team will join a crowd of more than 15,000 CHOC supporters for the Walk on Sunday, August 26.

choc-walk-mental-health-team
Select clinical members of the Mental Health Inpatient Center’s CHOC Walk in the Park team.

The team, Stomp Out Stigma, has already organized two fundraisers, with a third in the works, to support their fundraising goal for the Walk. The first two fundraisers were held at local restaurants, with a portion of proceeds going to their team. An upcoming fundraiser, at a local thrift shop, allows community members to drop off and donate household goods such as clothing, books and home supplies in exchange for denominations to the team.

The staff wanted to come together and form a team for the Walk, one of the largest and most visible fundraisers of the year, to further decrease the stigma associated with mental health.

“Mental health has a stigma attached to it, so we wanted to create a team to inspire others to decrease that stigma that can be associated with mental health,” says Kelsey, a clinical nurse in the Center and team captain of Stomp Out Stigma. “We want to promote that mental health is just as important as physical health, and by participating in this Walk as a team, we are helping to bring mental health into a new light.

The team also hopes their participation in CHOC Walk will provide further education about the new Center.

“We want the community to know that Center is a healing, nurturing environment that provides resources to families in need as well as a safe place for children to learn how to cope with their Mental Illness,” Kelsey says. “Mental health is important because it includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.”

The chance to be part of a patient and family’s healing process is what inspired Kelsey to pursue a nursing career.

“I believe that nursing is simply to give tender loving care while applying it to the everyday concept of medical care,” she says. “I have been a pediatric psychiatric registered nurse for five years. When I learned that CHOC was building a Mental Health Inpatient Center, I wanted to be a part of it since it is my goal to be able to give back to my local community.”

Since joining CHOC’s staff, Kelsey has been inspired by CHOC’s commitment to innovation.

“I’m thoroughly excited to be a part of an ever-changing, excellent organization where our strive is to provide innovative health care to patients and their families. Being the first Mental Health Inpatient Center for children under the age of 12 in Orange County, we are inspired to change the way mental health is viewed through the community as well as the way care is given to our population.”

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Rising Rates of Children’s Hospital Visits for Suicide Thoughts, Attempts

The percentage of patients seen at U.S. children’s hospitals each year for suicidal thoughts or attempts has increased steadily, according to a recent study published in Pediatrics, the official journal of the American Academy of Pediatrics.

Suicide is the second leading cause of death in children and young adults ages 10-24.

Rising rates for suicide thoughts, attempts infographic

Learn the warning signs of suicide in children and adolescents

Mental Health Inpatient Center

Our Mental Health Inpatient Center, which opened in April 2018, is the only center in Orange County that can accommodate children younger than 12. The 18-bed Center is designed for patients ages 3 to 17.

ASPIRE® Intensive Outpatient Program at CHOC Children’s

This intervention (four afternoons/evenings per week for eight weeks) is intended to prevent psychiatric hospitalization and re-admission in high school teens ages 13-18. CHOC opened the IOP in early 2018.

Mental health screenings in primary care settings and the Julia and George Argyros Emergency Department at CHOC Children’s Hospital

One-third of all visits to pediatricians are solely for psychological reasons. To support immediate assessment and intervention in primary care, CHOC is providing depression screenings in its own clinics and promoting embedded mental health care in pediatric practices. We also provide depression screenings in the CHOC emergency department.

Mental health triage at the Julia and George Argyros Emergency Department at CHOC Children’s Hospital

Implemented in fall 2016 with public and private funds, the innovative family-based crisis intervention model helps families address mental health crises and is already reducing psychiatric hospitalizations (25 percent reduction) and time spent in the emergency department (17 percent reduction).

CHOC Children’s is taking a leadership role in tackling the pediatric mental health crisis in Orange County. Half of children with symptoms of mental health disorders have conditions that cause significant impairment in daily life. In Orange County, 20 percent of youth reported needing help for mental health problems, while less than a third actually received that help.

Learn more about CHOC’s commitment to mental health

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Mental Health Nurse Manager Shares How Nursing is the Art of Caring for People

CHOC Children’s wants its patients and families to get to know its staff. Today, meet Lisa Schneider, nurse manager in CHOC’s new Mental Health Inpatient Center. Lisa has a degree in nursing from The Ohio State University, and is in the last semester of completing her master’s degree with a focus on Nursing Administration. She is also a board-certified psychiatric-mental health registered nurse.

mental health inpatient center nurse manager
Lisa Schneider, nurse manager in CHOC’s new Mental Health Inpatient Center

Q: What are your special clinical interests?
A: I am very passionate about pediatric mental health. I have a strong interest in trauma-related diagnoses and crisis prevention, as well as serving as an advocate to destigmatize mental health.

Q: How long have you been on staff at CHOC?
A: I am new to the organization and so excited to be here! I have been with CHOC since January 2018.

Q: What diagnoses are most common among the patients you care for?
A: As the community is beginning to recognize mental health disorders sooner, children and adolescents can present with a wide range of diagnoses such as depression, anxiety, eating disorders, psychosis, autism, PTSD, and ADHD, among others.

Q: What myths about mental health would you like to dispel?

A: Many people believe that talking to kids about suicide can put the idea into their heads. However extensive research has shown that this is not the case. Suicide is currently the second leading cause of death in children and young adults ages 10-24. Start the conversation now and talk to your kids about suicide – it could save their life.

Q: What excites you most about the Mental Health Inpatient Center?

A:  The opening of the Mental Health Inpatient Center is so exciting because we will be providing innovative care and services to children and their families. The unit will consist of private rooms, group activity rooms, an expansive outdoor play area, along with daily programming such as music therapy, art therapy, pet therapy, and classroom education. The Center is designed around aspects of nature to promote a holistic and healing environment. In addition, every child will receive a comprehensive treatment plan which will include individual and family therapy sessions while inpatient, and care continuation at discharge. I am so excited for the positive impact this Center will have on the kids in our community, especially since we will be the first to offer inpatient mental health services to children under the age of 12 in Orange County.

Q:  What inspires you most about the care being delivered here at CHOC?
A: I am inspired by the tremendous amount of dedication that CHOC Children’s has shown in our mission to provide quality healthcare to children. Specifically, we are taking a leadership role and setting a high standard through our commitment to de-stigmatizing mental health and expanding services. It is important to remember health does not solely rely on physical health, but strongly depends on mental health as well. In order to achieve overall health and well-being, mental health must be cared for with the same emphasis that is placed on physical health.

Q: Why did you decide to become a nurse?
A:  I chose to become a nurse based on the philosophy of nursing. Nursing is known not only as a science, but also as an art in caring for people. I have a passion for creating strong nurse-patient relationships, which can promote the healing process. I chose pediatrics because I’m inspired by the resiliency I see in children, and mental health specifically because I strongly believe in the concepts of prevention and early intervention.

Q: If you weren’t a nurse, what would you be and why?
A: If I wasn’t a nurse, I think I would probably be a police officer. I enjoy serving others and building strong relationships within the community.

Q: What are your hobbies/interests outside of work?
A: Outside of work, I love spending time with my husband and 4-year-old son. We are new to California so we have been spending a lot of time exploring this beautiful state!

Learn more about CHOC’s commitment to mental health

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CHOC Children’s Celebrates Completion of Mental Health Inpatient Center

CHOC Children’s leaders joined with mental health supporters today to celebrate the completion of our pediatric health care system’s Mental Health Inpatient Center, which will provide the first psychiatric inpatient beds in Orange County for children younger than 12 years old.

Set to open in April 2018, the 12,000-square foot, 18-bed facility will serve children ages 3 to 17. It is the only facility in California to offer all private rooms, as well as an option for parents to stay overnight with their children, as appropriate.

CHOC Mental Health Inpatient Center_hallway artwork
Hallway artwork in the CHOC Mental Health Inpatient Center.

One in five children experience a diagnosable mental health condition during childhood — about 150,000 children in Orange County alone. Previously, the absence of designated space to treat young patients and a shortage of beds for adolescents in Orange County meant that often children with serious mental health episodes remained in emergency departments for days at a time waiting for a bed in an outside county.

“For the first time, Orange County children younger than 12 experiencing a mental health crisis will have a place for care close to home,” CHOC President and CEO Kimberly Chavalas Cripe said. “The Center’s completion is evidence of CHOC’s commitment to ensuring that every Orange County youth receives the mental health care services they need in a safe and healing environment.”

The Center’s other unique features include two sensory rooms – one sensory-rich and the other low-stimulation to help children learn to manage strong emotions and calm themselves. In addition, the facility includes a 3,600-square-foot outdoor play area with sensory activities and a basketball court.

Mental Health Inpatient Center
The outdoor play area of the CHOC Mental Health Inpatient Center.

The Center’s innovative floor plan was designed with guidance from national experts and incorporates elements of several exemplary programs observed by CHOC staff. It was built with two primary goals in mind: patient safety and creating an optimal healing environment. The facility incorporates safety features such as shatterproof glass, special high-density materials, doors that open one at a time, and many other measures. The design includes elements of nature, curved features and a soothing color palette to promote healing and relaxation.

With pediatric psychiatrist Dr. Hoang “Wayne” D. Nguyen as its medical director, the Center will offer specialty programming to children 12 and younger. Patients will participate in therapeutic programming seven days per week, which is unique among inpatient facilities. During their stay, typically five to seven days, patients will also have access to medical specialists if assessments suggest a relationship between the mental health condition and an underlying health issue.

CHOC Mental Health Inpatient Center_activity room
One of several activity rooms in the CHOC Mental Health Inpatient Center.

CHOC broke ground on the Center in September 2016. The Center was announced in May 2015 as the centerpiece of a pediatric system of mental health care that would be scalable and replicable by other health systems nationwide.

“CHOC is committed to the truth that mental health is as important as physical health,” Cripe said. “Put simply, health is health. We want to create a system that others can replicate and help empower health systems across the country to support children’s mental health.”

CHOC’s broad and robust pediatric system of mental health care has been built to facilitate early diagnosis, intervention and treatment of pediatric mental health problems.

The system’s components include the ASPIRE® (After School Program Interventions and Resiliency Education) Intensive Outpatient Program at CHOC Children’s, designed to prevent psychiatric hospitalization and re-admission; mental health screenings in primary and specialty care settings; pediatric mental health training for community health care providers, school personnel and therapists; and a co-occurring clinic for patients with mental health challenges complicated by physical illnesses.

Other aspects include mental health triage at the Julia and George Argyros Emergency Department at CHOC Children’s Hospital; an early childhood mental health initiative set to begin in spring 2018 that is aimed at reducing behavior-related suspensions from child care and preschool settings; and faith community partnerships.

“While the Mental Health Inpatient Center at CHOC Children’s will support children and families while in crisis, we cannot meet all the needs for pediatric mental health care alone,” Cripe said. “By joining with our community partners, we are working together to ensure that children get the help they need when they need it and where they need it.”

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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