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6 Connecting Prevention Along the Continuum of Care
Pages 71-80

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From page 71...
... (Wocasek) • Intensive case management is sometimes essential for people with mental health disorders that have caused them to become disconnected from families and support groups.
From page 72...
... MULTIPLE INTERVENTIONS IN A DEPARTMENT OF VETERANS AFFAIRS SYSTEM Nikole Jones, a suicide prevention coordinator with the Department of Veterans Affairs (VA) Maryland Health Care System, was working in a mental health care unit of the VA system in 2006 when a family tragedy changed the focus of her career.
From page 73...
... in Baltimore. It is an integrated program, which means "we meet the clients exactly where they are needed." The program provides substance abuse, mental health, psychiatric rehabilitation, and many other kinds of services.
From page 74...
... He oversees the behavioral urgent response team, which is a 24/7 consultant-based team that provides three kinds of services. They address psychiatric emergencies and do risk assessments, for example, of patients who chose not to have a procedure for a life-threatening condition.
From page 75...
... , they can pick any one, it's their choice, they're empowered to do that, and no one is controlling them." For some people, intensive case management is essential. Many people with mental health disorders have burned bridges with their families and support groups, so intensive case management is a way to keep an eye on them and not have them go to a hospital to seek help.
From page 76...
... But this situation exemplified for Wood the challenges of doing prevention with a population that has been seen largely as passive recipients of care. "The way we manage them may have a lot to do with the outcomes that we've been seeing." GAPS IN AVAILABLE RESEARCH The moderator of the panel, Andrey Ostrovsky, chief executive officer of CCG, asked the panelists whether enough research has been done on the populations they serve, or whether existing research can be adapted to those populations.
From page 77...
... conducts research on the work done by the Southcentral Foundation, that research needs to be approved by the institutional review board, and in some cases the board has not approved research involving Alaska Natives because of past abuses involving research. BILLING FOR SERVICES Ostrovsky also asked whether any of the panelists had experience with payment mechanisms aligned with the care that needs to be delivered rather than deriving from simple reimbursement codes.
From page 78...
... One thing she often hears from veterans is that whenever they mention suicide, the automatic response of the health care system is to escort them to the emergency department. If health care providers could respond instead by saying that having the thoughts is one thing and thinking about suicidal behaviors is another, that these thoughts come and go but you can control them, discussions about suicide could be much more open.
From page 79...
... Every day I say let me see how I can be transparent to them so they can trust me and that way if they trust me I'm able to help them and they're able to receive my help." Finally, Wood said he would shift the emphasis within suicide prevention from pathology to adaptive functioning.


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