Shanna M 00:11
It's time to be well with your health! Welcome to the "Adventist HealthCare & You" podcast. I'm Shanna.

Nimeet K 00:15
And i'm Nimeet.

Shanna M 00:16
We're back. And we have a wonderful topic today, continuing our series on mental health. And we have a guest that i've known for many years now Nyree Price, who is the director of therapeutic services with Shady Grove Medical Center, and our behavioral health services. She's also a clinical social worker, welcome, Nyree.

Nyree Price 00:38
Thank you. Excited to be here.

Shanna M 00:39
Thank you. So one of the things we want to talk about today is we talk all the time about the physical symptoms that may send us to the ER. Chest pain, stroke symptoms, broken leg, severe cuts, all of the you know, we know, essentially, what would send us to the ER for something physical. What we don't talk about is what may send us to the ER, or what to look for, in a emergency situation regarding our mental health, because that is just as important as our physical health. And there are services for that. There's a lot of people that may not know that, and how that works. And so you're here to talk about that.

Nyree Price 01:25
Yeah, I'm excited to!

Shanna M 01:26
Thank you. So what is it that you do here at Adventist HealthCare, let's start with that, tell our listeners, how you help our community and patients.

Nyree Price 01:35
Great. So I oversee our social workers and our professional counselors that work on our units. We have seven units at our behavioral health site on Shady Grove campus. And so my therapists do the group therapy, they do initial intakes, they do a lot of coordination with family members and the community and making sure that the patients once they leave our facility, are you know, we do a warm handoff to community providers. But ultimately, we're here to serve, we want to make sure that our patients get the treatment that they need when they're in that acute state. I also oversee codependency program. And we also have an adult partial hospitalization program. So I have clinicians there. And in both of those spaces, it's group therapy modality and so patients come from the outside and come into our space and receive that group therapy for a full day.

Shanna M 02:29
Okay, thank you. So we're here to talk specifically in an emergency situation. So what may happen in a mental health emergency? What are some symptoms? And what should we be looking for?

Nyree Price 02:42
Sure. So you know, if you're having persistent, overwhelming feelings of wanting to hurt yourself, and even if it's more of a thought, but maybe you don't have a plan, but it's persistent, overwhelming, and it's something that you can't shake, I would recommend coming to the ED. It could be related to chemical dependency, maybe you feel overwhelmed with, you know, you have a desire to be sober and you are struggling, we have many people that come in just for services for that. And what happens when you do come into the hospital for those type of services is that, we have a licensed clinician that will assess you and determine, you know, are you safe to go back into the community with resources? Or do we feel like you reach a level of care that you need additional support, meaning that we don't feel like you're safe enough, or you don't feel safe enough being out on your own, where you feel like you need additional oversight, medication management. And so we would recommend that you come in and be admitted. And there's different ways to be admitted. Obviously, we would love you to come in voluntarily and be in agreement with us that you want and need this help. But there are times where unfortunately, we have to, someone may not honestly feel like it rises to that level. But as our you know, licensed clinicians do their assessment, they identify that there are some concerns and we like you can't keep yourself safe. You know, we look for protective factors, things like that. If you can't identify or share with us those things, then we might say, you know, we really want you to come in and if you don't agree, then we might have to basically certify you and you would have to come involuntarily.

Shanna M 04:31
Okay

Nimeet K 04:32
So sounds there's a lot of services offered once they're into the, coming into the facility and depending on what their needs are, they can go to the right stakeholders or right departments and even,

Nyree Price 04:41
Correct

Nimeet K 04:42
So if I'm having some sort of mental health crisis, and I'm debating about going to the ED, what are some of the things that I should know before I go to the emergency department? What are some of the aspects that I should consider before coming to the hospital?

Nyree Price 04:56
Sure. Let's say yeah, you're in that space where you don't know, I would recommend starting off by calling 988. That is our mental health support, similar to like 911, right, you call there, you're having a state of emergency, and then they sort of route, you know, either EMTs to you or the police. So in this case, you call 988, you explain your situation, they're licensed clinicians that respond, they either kind of talk you through whatever that is, sometimes that's all you need. Sometimes it does rise to where they need to send out personnel. And usually it's a police and a social worker that goes out, just because again, we understand the sensitivity of mental illness. And a lot of times, it can be triggering, if it's just the police. So the social worker goes out with the police to sort of give that extra care and try to understand better, like, from a mental health perspective, what's going on, and what do you need, and sometimes they may recommend going to the hospital.

Shanna M 05:56
Just like, if you call 911, the police may come but so do EMS who are trained to handle you know, an emergency health situation, this is the same.

Nyree Price 06:05
Yeah. You know, with mental health? It's, you don't see it, right?

Nyree Price 06:05
Exactly

Shanna M 06:05
So, I was thinking about that when you were saying to you know, you may come into the ED, and you may need to be admitted because you need some extra, that's just like if you were to have a heart attack or stroke, you have to stay to ensure that you get the the right care that you need to set you up to go home safely. It's the same when it comes to your your mental health, too. And I sometimes I think we don't think about it like that, you know?

Shanna M 06:27
Yes

Nyree Price 06:29
If I have a broken arm, you see my arm is broken. Right.

Nimeet K 06:34
And you clearly right.

Shanna M 06:35
And you feel the pain,

Nyree Price 06:37
Right? But many times with mental health, people suffer in silence.

Shanna M 06:41
Yes.

Nyree Price 06:42
Which is challenging, you know, they feel like they can manage it. And, you know, they just don't feel comfortable seeking supports. And so you're right, you tend to, because we don't see it, sort of like, is it real? And so I think people and you know, there's a stigma with mental health as well, you know, and so I think for those reasons, people may be apprehensive of coming in, when truly there are services that you can really tap into if you just trusted, just the process.

Nimeet K 07:12
But I do like the fact that you could call 988, whenever there's an emergency crisis going on for them. So they can help navigate what they should do, whether it be you know, help deescalate what they're feeling or directing them to the emergency department or their nearest local hospital. So they can get the right help.

Shanna M 07:12
Yeah

Shanna M 07:30
Because we don't talk about it that much., people don't know what to do in a situation, they know what to do when they're not feeling good. But it's not necessarily thought about in the same sense, you know, so that's a great resource. And that's newer.

Nyree Price 07:44
Yeah, that's within the last year or two.

Shanna M 07:47
Is it? Okay

Nyree Price 07:48
Yeah. So it is fairly new, and a lot of monies and resources have been poured into it. It's a great resource to have. And certainly, if I were having a mental health crisis, I would prefer a licensed professional than a police, not to say the police don't understand. But I would, given that it's a mental health issue, I would want the experts in that field to come and provide that support to me in that moment of like, dire need.

Nimeet K 08:13
Yeah, I think it's a team approach. It's like the hospital, you go, you know, doctors, nurses, therapists.

Nyree Price 08:17
Yes.

Nimeet K 08:18
So that's a team based approach, similar to the in the community where there you may need a licensed provider and police officer at the same time, depending on what the needs are.

Shanna M 08:26
I was gonna ask, you know, you talked about some of the services that we have throughout our behavioral health program, what is unique? I mean, the fact that we even have all of these is great and maybe not a lot of people know about that. But what is special or unique about the programs available under Shady Grove Medical Center and behavioral health?

Nyree Price 08:45
The hospital itself, the unit, I say that very loosely, because it's 133 bed capacity.

Shanna M 08:52
I didn't even, I didn't know how many beds we had their either.

Nyree Price 08:57
And so we're the largest in Montgomery County and the second largest in the state of Maryland.

Shanna M 09:03
Okay.

Nyree Price 09:03
It's pretty significant the amount of the community we can serve. And we do service, like I mentioned, voluntary and involuntary patients. So we have two adolescent units, and then we have five adult units. And they just range by a different presentation. So we sort of match your presentation to

Shanna M 09:24
where you need to be.

Nyree Price 09:25
a unit. Yes.

Shanna M 09:26
How does someone access that? Do they have to come through the ER to access that? So it truly is, you know, if you need emergency, you know, emergency services?

Nyree Price 09:37
Correct.

Shanna M 09:37
And then you'll then go into the program?

Nyree Price 09:40
Correct. So yes,

Shanna M 09:41
or I don't know if you'd call it program, but then you're admitted.Taking care of just like you were admitted to the hospital.

Nyree Price 09:49
Correct! So yes, to access those services, you would have to come in through the emergency room, like I said, you would get, you would be assessed by a licensed clinician, who would then determine whether your symptoms rose to the level of needing inpatient, obviously, we want to choose the least restrictive level of care, right? You know, if we can, if your symptoms are your presentation can be serviced out in the community, then we will give you community resources. And sometimes those community resources are within our Adventist HealthCare system. So for example, if you needed a therapist and maybe medication management with a psychiatrist, we have our outpatient Wellness Center, but that's a space for individuals who just need more maintenance.

Shanna M 10:36
Yep.

Nyree Price 10:37
And then from there, we have our adult partial hospitalization program, now that you can come in from the community, you don't have to come in through the emergency room, your community provider can make a referral for that program. You can contact the program, they can sort of do an assessment to determine if that's the level of care you need. And that program runs from 8:30 to 3:30, Monday through Friday, so you're there all day. And it's, groups and the groups are given. We have expressive therapists doing groups, we have our licensed clinicians doing groups, we even have a nutritionist that comes into those groups, we have a certified peer recovery specialist, who also provides groups. So it's a well rounded, holistic approach.

Nimeet K 11:23
It's a very holistic approach.

Shanna M 11:26
and integrated too right, if this part of our services don't match your needs, then we have another level, or another level, you know, and so there's options.

Nyree Price 11:37
Right

Shanna M 11:38
Which I think is important for people to know is that it's not an all or nothing sort of thing, right? There's options, and you have options. And you're not alone in that.

Nyree Price 11:46
Right, right. And it's great that on site, we can provide that level of referral. So it's truly a warm handoff, you know, my clinicians in the ED can reach out to our PHP program, or Partial Hospitalization Program and make that sort of warm handoff and connection and get that patient right into those services. I also want to add that we have our chemical dependency program, which is a chemical dependency intensive outpatient program. So they service individuals who have co occurring diagnosis, which means that they have mental illness as primary, and then they have substance abuse as a secondary diagnosis. So it's exciting that, you know, we really, truly can provide care for the full gamut of mental health needs of our community.

Nimeet K 12:30
And what I like is that just because I came through the ER doesn't mean that i'm automatically admitted to the hospital. As you said that, they could be placed into different programs or be admitted to the hospital. But also, some of them may not need to be admitted or be part of the program. They may just need some crisis resolution, they could be discharged with some community resources and follow ups. Is that what I'm hearing?

Nyree Price 12:52
Yes, yes, yes. So yes, just because you come into the ED, I would hate for people to feel like, immediately, you're gonna go impatient. I'm excited that we do have just these different levels of care, and options. Because we do, it's individualized, right? Like, it's not a one stop, you come in, and you have to go into an you know, an inpatient unit, again, we really want to treat you in the least restrictive space. And so yeah, so we, you know, the clinicians are really good about determining, like, what that level of care should be for you.

Nimeet K 13:24
That's right.

Shanna M 13:25
I know, this wasn't one of the questions that we, that we were, that we have for you, but I wonder if you know, as you, we sort of like, you know, just because you go doesn't mean, you're gonna end up in a certain place or, or anything like that. Is there a myth or a, or just something that you want to share, or that you see a lot that you want to dispel here that you want people to know about when it comes to their mental health. And in an emergency situation, or just in general?

Nyree Price 13:54
I would say there are licensed individuals that really, truly have passion for this work, and really, truly want to see individuals who have mental illness flourish, and feel, and know that they can. And so, you know, my team, and I'm not just blowing them up, but they truly have a passion for the work that they do. And, you know, they think about ethical things like it's, it's not again, we're not just trying to bring everybody impatient, we truly want to meet the patients where they are. And I'm excited that I get to work alongside team members that have this passion for this particular like vulnerable population.

Shanna M 14:36
Yes.

Nyree Price 14:37
So I don't know if that answered your question, but

Shanna M 14:41
I think it does, because I think there's notions of you know, it's like in the movies or you know, on TV shows where they, it's, you know, the people don't care about you or as you say, they're just putting people away or something like that. That's truly not what it is.

Nyree Price 14:55
No and even when they get to the hospital again, like in movies, you know, people are drugged up and sitting in chairs, that is not, the units are super interactive, you are encouraged, if not expected to attend groups. And you know, the groups that we provide, I mean, they run the gamut of psycho education. We do music therapy, we do art therapy, we have drama therapy, we have Tai Chi, we have yoga. So we really are trying to provide like these additional coping skills and like teach these, sometimes patients come in, and they don't have any coping skills. And so the first time they're ever presented or exposed, is when they come to our units, and they're like, oh, Tai Chi can calm me down. And so we expose our patients to the different modalities of treatment, and hopes that they will engage in these, when they leave, just have these things in their toolbox. So that, you know, as they're going through life's, you know, life and things happen. And, you know, they can pull from these things, you know, if they connect it with the music therapy modality, right, so then they know, okay, when we did music, it calmed me down. So let me try that now. So I'm excited that my clinicians, and that we have have a gamut of clinicians who have these different skills to provide to our patients. And so again, the patients aren't just sitting in chairs and staring out the window.

Shanna M 16:01
No they're actively participate.

Nyree Price 16:22
Yes. And that's the expectation. And, you know, you're seen by psychiatrists on the unit daily, you're you have a nursing team that they're daily with you might the clinicians are there have even care navigators or discharge planners, so it's a full treatment team, and everyone is engaged in that patient's journey, and they want a positive outcome for them. And so everyone is really, like, engaged to making sure. And so we want to make sure like, we pride ourselves on our programming, just to make sure that, again, the patients just aren't sitting and doing nothing.

Shanna M 16:56
Yeah. I love that. Thank you.

Nimeet K 16:57
You can hear the passion in your voice.

Nyree Price 16:59
I'm excited about it.

Nimeet K 17:00
Part of me just wants to come learn for myself and like learn a lot of the skills, because I think just from a mental health aspect of it, just like trying to strengthen your build their resilience, I think having those, some of those therapies is hugely beneficial.

Shanna M 17:13
We take care of our physical health, we like to take care of our mental health too. You know, it's good that we take that into account for everyone, right?

Nyree Price 17:20
Yes.

Shanna M 17:21
In a emergency. Just to go back to that. You mentioned some of the symptoms that someone might be feeling that would make them go to the emergency department. What about if you were a friend or a family member or a loved one? What type of things should you be on the lookout for to be able to get your loved one friend to the right place?

Nyree Price 17:42
Sure. So like, if you notice, your friend or family member isn't enjoying the things that they used to do, you know, they're isolating more, sometimes they may speak, probably with ambiguity. But you know, I don't want to be here anymore. You know, I don't want to do life, you know, just it's not a clear,

Nyree Price 18:04
But those things should pique you to maybe start asking more questions. You know, what do you mean by that? You know, do you feel safe? How long have you been feeling this way? And then directly asking, do you feel like you would hurt yourself? And sometimes, it can be uncomfortable. But if you think about it in the sense that you could be saving their life, right? Because you could be the only person that has asked them that just so plainly, right? We get busy with life and people, you know, how are you and you say, dine, and you keep moving, right? But we notice, we know when something's off with our friends and our loved ones. And so really tapping into that, and just taking a moment to say, talk to me more, you sound a little off? What's going on, you know, how can I support you, really can go a long way. And you could be the one person that really sort of took a pause to really sort of check into their mental health, where no one else has, and that could be the opportunity or just the thing that they needed to prompt them to get services. Or it could be like, let me go with you to the emergency room to get assessed.

Shanna M 18:04
Right

Shanna M 19:10
Hold their hands, you know, offer them the support that they're not alone.

Nyree Price 19:13
Right. Right.

Shanna M 19:14
That's wonderful. You mentioned 988 as a resource, are there any other resources in the community that people can be aware of?

Nyree Price 19:24
So I'll go back to Adventist HealthCare, because we do have quite a bit of different groups that we provide. I want to give a shout out, we do a parent support group right at our hospital, where we provide support for just parents that have children that are just sometimes you don't even know what it is right? You just know something's not right. And it could be anything from like, maybe they're they're indulging in, you know, substances, some, maybe they're isolating, you know, it could be school triggers. And so we offer a parent support group that meets on Wednesdays at 6:30. And that's for the community to come in and just have an expert just be able to talk to them and share like resources. We also have speakers come to that, we invite NAMI to come. Again, that's a resource for individuals having challenges with mental illness. They have a slew of different groups and just resources to connect you to the right behavior health supports, whatever that looks like for you.

Shanna M 20:28
And for our listeners. What is NAMI?

Nyree Price 20:30
Oh, yeah, it's the National Alliance for Mental Illness.

Shanna M 20:33
Okay, so that's a great resource for people too.

Nyree Price 20:35
Correct, yes.

Shanna M 20:36
All right. Thank you.

Nyree Price 20:37
Yeah, I just want to give a shout out, we actually partner with NAMI. And so they actually come to our lobby, once a month on Wednesdays. So they come, and they, it's a support to the family members and the visitors that are coming to visit their, their family. So it's great. And again, it's just connecting them to resources. We also have mindful eating, which is a five week series. And we're hoping to add coping with chronic conditions support groups soon as well. And those are all provided, again, by Adventist HealthCare.

Shanna M 21:08
To give some plugs on the chronic health conditions and the mental health aspect of it. There's a podcast, so check out, for our listeners, there's a podcast on that one that you can check out. And then also, you mentioned chemical dependency, we will do a deeper dive into that, too. So for our listeners, you can check out that one as well.

Nimeet K 21:28
You mentioned some of the resources. You know, we do have another resource with the Serenity Spot at rio at Gaithersburg. Can you explain to our listeners what the certainly spot is?

Nyree Price 21:38
We actually partner with the rio, when I say we my expressive therapy team.

Shanna M 21:43
Well, that's an important thing to say, right? This is guided by their expertise to ensure that it meets the needs or presents to the community in a well thought out and very special way.

Shanna M 21:56
Mindfulness and peacefulness. And, you know, you think about the rio here, it's a bustling activity, you know, it's we're all participating in our lives. And it's a spot where we can just stop and take a breath, download some resources to help us throughout any part of our day.

Nyree Price 21:56
Right, and it's a beautiful tranquil spot, where you go and it promotes like meditation, it promotes like a sense of calmness. It's located, as I mentioned, right at the rio, there is a QR code there, where you, once you download or scan that QR code, it goes to a playlist. And that playlist was curated by our recreational therapist. And again, that consists of music and art therapy. So it is a very intentional, around like those tranquil thoughts and promoting, you know, that level of healing and just,

Nimeet K 22:55
Yeah, and the whole area is so calming to with the lake and playground.

Shanna M 23:00
I mean, the kids are yelling.

Nyree Price 23:04
Right.

Nimeet K 23:06
As a new parent, I enjoy the playground as well as my son.

Shanna M 23:09
Yeah, but it does, I mean, it's a bustling place. But right in there is a spot where you can just stop and take a breath. So that's, that's a great thing that we do. Nyree, we like to ask a lot of our guests, what is one tip that you have, and maybe it's more than one, and that's okay, for our listeners to have a happy, healthy life.

Nyree Price 23:34
I would say, really, being purposeful about self care. And it's an area that I myself struggle in, because again, you just get busy with life. And you know, when you have kids and other family members, they become priority. But I would say, if your cup isn't full, you can't serve anyone else. And so and I think that just serves for your overall mental health is taking that moment out whatever that looks like for you. If it's a walk on a Sunday, if it's you know, reading a book, if it's going to get your nails done by yourself, or massage, like just really being purposeful, of just taking some time away, even if it's just an hour of just focused time on yourself, doing something that you enjoy doing, and that you choose to do. But being purposeful and making sure that you get it in and getting it in, not accidentally, but truly even like scheduling it in. So every Wednesday from six to seven and I tell my family and my friends, like don't reach out to me, because that is my time. And I don't have to necessarily tell you what I'm doing, but it's just my time to

Shanna M 24:43
to take care of yourself

Nyree Price 24:44
to take care of myself. And so I would say that goes a long way in just promoting your own mental health.

Nimeet K 24:51
Yeah, I think many people know what self care is and what they should do. But just being purposeful and intentional about doing those things, even though if it's a small thing like mowing your lawn, I find really great

Shanna M 25:03
serenity while you're mowing the lawn

Nimeet K 25:05
Yes I do.

Shanna M 25:08
Yeah, I do I identify with that I have a large yard and

Nimeet K 25:12
yeah.

Shanna M 25:12
Just putting some headphones on

Nimeet K 25:14
exactly

Shanna M 25:14
and just it's going in that line and back and forth. It's very you know,

Nyree Price 25:18
calming, yeah

Nimeet K 25:19
But I agree being purposeful and intentional on self care is very

Shanna M 25:24
I like that word purposeful about it. Yeah. And not by accident,

Nyree Price 25:27
Not by accident

Shanna M 25:28
Not by accident.

Nyree Price 25:29
It won't happen.

Shanna M 25:31
All right, well thank you for being here today. We hope you'll come back again. And to learn more about our mental health services, please visit AdventistHealthcare.com/mental health. And don't forget to subscribe to our podcast so you can get all of our new episodes. We will put a lot of the resources Nyree talked about today in the show notes, so please check those out. And be kind to yourself, be well!