We made it through Thanksgiving – hopefully emotionally unscathed. But for many, managing mental health during the holidays is not easy. Whether you deal with anxiety for months leading up to the holiday, your family is plagued with arguments or more subtle discomfort during get-togethers, and/or you are mourning the loss of a loved one and have an empty seat at the table – the holidays can be tough. In fact, in a 2021 survey, 44% of Americans said that preparing for the holidays is stressful and 39% said that family gatherings during the holidays are stressful.[1]

Holiday anxiety

Anxiety is defined by the National Institutes of Health as “a feeling of fear, dread, and uneasiness.”[2] And why might we feel anxious leading up to what one might consider a wonderous and magical occasion, such as Thanksgiving or a December holiday, with our family? The reasons are endless. It could be a difficult family member we are not looking forward to seeing. It could be that we are not feeling particularly good about ourselves and want to face others. Maybe we are hosting a holiday gathering and worried about getting everything done in time, how much everything will cost and whether everyone will have a good time.

We are barraged with media images of what the perfect holiday looks like, and we may sometimes feel pressure to be happy and festive and live up to expectations.

When we dread an upcoming holiday, it puts a damper on more than merely just that day or specific gathering, but the days, weeks, or even months leading up to it. It is almost like the reverse of excitement or anticipation. But whether we are excited or anxious about something, the actual event often does not live up to our expectations. In the case of holiday anxiety, if we can remember that it may actually end up being better than we think and simply try not to care as much, our anxiety time may be reduced. We can let go of others’ expectations of us and do what truly makes us happy.

Family arguments during the holidays

Yes, most families argue – even during the shiny holidays and behind the scenes of the happy pictures we post on social media. And just when our typical bickering was not enough, our country has become increasingly divided, and it has seeped into our very own families. There are things we can do to prevent the arguments and deal with them in a healthier way when they occur.

You have probably heard the phrase “communication is key.” A lot has changed over the past couple of years and continues to change at a rapid pace. We may think we know how a loved one would like to celebrate the holidays, for example. But their preferences, and our own, may have changed just like so much else has changed.

It’s a good idea to initiate respectful conversations – early in the holiday planning process – with our family and friends to understand where they are coming from on certain issues. It can be a way to identify the topics that should be off-limits during the upcoming holiday gathering and prevent arguments.

During these early conversations and when we’re all together for the holidays, our family members may inevitably do or say something that rubs us the wrong way. At that moment, our reaction will set the course for what comes next. As our feelings come together to form that reaction, why not assume goodwill and the best intentions of the offending person. It may be that their actions and comments reflect the way they feel about themselves and not the way they feel about you.

With so much to disagree about these days, there is also a lot we can agree on. Try to focus on the latter, agree to disagree when possible, and assume that others are coming from a place that is genuinely meaningful to them.

Grief and missing a loved one during the holidays

The pandemic has taken so much from us, including the lives of precious loved ones. The holidays have always been a difficult time to bear when we cannot share them with a lost family member or friend. During this holiday season, you can uphold and honor memories of those you have lost in many ways: Look through photographs of the person and reminisce about holidays of the past; do things you used to do with a lost loved one during the holidays, like cooking or baking a certain recipe, a craft, or decorating; and journaling or talking with others about your feelings.

It can be hard to move on without a person we love, but they would want you to be happy. We will always have their memories during the holidays and beyond, as we carry on with old and new traditions.

We can all agree that it has been another tough year. But we have endured, and it is time to let go of expectations and focus on our mental health during the holidays and how the holidays can be a time to do what makes us happy, spend quality time with those who are important to us and cherish the memories of those we have lost.

Visit MagellanHealthcare.com/Holidays for additional information and resources on holiday emotional wellbeing and how to find peace and moments of joy with family and friends this holiday season.

[1] Collage Group Holidays and Occasions Survey, May 2021

[2] https://medlineplus.gov/anxiety.html

Candice Tate, MD, MBA, serves as a medical director at Magellan Healthcare. Dr. Tate’s treatment philosophy includes a strong physician-patient therapeutic alliance and safe, responsible medication management. Dr. Tate joined Magellan in 2017. She has years of experience in psychotropic medication management for a variety of psychiatric conditions in inpatient and outpatient settings. During her graduate medical training, Dr. Tate was extensively trained in psychodynamic psychotherapy and was supervised by experienced psychoanalysts. She is also familiar with cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and dialectical behavior therapy (DBT). Dr. Tate graduated from the University of Tennessee Medical School in Memphis and completed her graduate medical education in General Psychiatry at Northwestern University’s Feinberg School of Medicine in Chicago, IL. Dr. Tate is a board-certified psychiatrist by the American Board of Psychiatry and Neurology.

The holidays can be a joyous time—a time to spend with family and friends, reflect, and be thankful. Yet, for many people, the holiday season can bring on the blues, including feelings of anxiety, stress, worry, and sadness. These feelings may even be worse for those who have experienced divorce, lost a loved one, or are living far away from family and friends.

The holiday blues

A 2014 survey conducted by the National Alliance on Mental Illness (NAMI) found that the holidays contribute to feelings of sadness or dissatisfaction. Of those surveyed:

• 63% reported there was too much pressure
• 57% stated they had unrealistic expectations
• 66% reported experiencing loneliness
• 50% were unable to be with loved ones
• 55% found themselves remembering happier times in the past contrasting with the present
• 68% reported feeling financially strained

While the holiday blues are different from mental illness, it can lead to clinical anxiety and depression. It is important that we do not ignore these feelings, especially as we all continue to deal with changes wrought by the COVID-19 pandemic but deal with them in a proactive and healthy manner.

Tips for beating the holiday blues

1. Throw guilt out the window. Try not to put unreasonable pressure on yourself to be happy or enjoy the holidays and avoid overanalyzing your interactions with others. Give yourself an emotional and mental break this holiday season.
2. Be realistic and try not to expect the “ideal” holiday. Keep expectations for the holiday season manageable by not trying to make the holiday “the best.” Be truthful to yourself and others about what you can and cannot do. And remember, nobody has a perfect holiday or perfect family.
3. Give to others. Volunteering somewhere, like a soup kitchen, food bank, children’s group home or facility for the elderly can fill you with feelings of love and pride. You will spend time with others and immerse yourself in the true spirit of the holiday season.
4. Stay connected. Schedule phone calls or virtual gatherings with your favorite folks where you can open gifts together, sing songs and reminisce. Spending time with those who love and value you can be very comforting and help ground everyone involved.
5. Acknowledge the past yet look toward the future. Change is a constant part of life. If your holidays are not like they used to be, it is OK. Cherish the memories and remember everything does not have to be like past holidays for you to enjoy the season.
6. Make a budget. Budgeting at the start of the season for holiday shopping and expenses is one of the most effective ways to alleviate stress. It helps prevent accidental overspending and allows you to manage expectations.

Want more tips for beating the holiday blues?

Visit the Magellan Healthcare holiday emotional wellbeing website for resources to help you find peace and moments of joy this holiday season here.

The United States (US) Food and Drug Administration (FDA) recently authorized the Pfizer-BioNTech COVID-19 vaccine for children ages 5 to 11 years old. The Centers for Disease Control and Prevention (CDC) also recommended the vaccine in this age group. There are 28 million children in the US ages 5 to 11 years old. This age group makes up 39% of COVID-19 cases in those under the age of 18 years. While children are less likely to develop severe COVID-19 than adults, severe illness, hospitalization, and death have occurred in younger ages. Now that there is a COVID-19 vaccine option for ages 5 to 11 years, here are answers to vaccine questions that are top of mind for many parents.

1. How effective is Pfizer’s vaccine in children ages 5 to 11 years?

• According to results from the ongoing study in ages 5 to 11 years, the vaccine has been 90.7% effective in preventing COVID-19 measured 7 days after the second dose. The study has been going on with delta as the prevalent strain.
• Immune responses in this age group were comparable to 16 to 25-year-olds.

2. What are the common side effects?

• The most common side effect was injection site pain (sore arm). Some of the other common side effects include fatigue, headache, redness and swelling, fever, chills, and muscle pain.
• Side effects were generally more common after the second dose. Side effects were mostly mild to moderate, started within 2 days of the second dose, and resolved within 1 or 2 days.
• There have been no cases of myocarditis (heart inflammation) reported in this age group.
• The study is ongoing, and the FDA and CDC will continue to monitor for vaccine safety and look for rare or serious side effects.
• The vaccine should not be given to anyone who has a history of anaphylaxis (severe allergic reaction) to any part of Pfizer’s vaccine.

3. How is Pfizer’s vaccine dosed in ages 5 to 11 years? What type of vaccine is it?

• The dose for 5 to 11-year-olds is a two-dose regimen of 10 mcg given 21 days apart.
• It is a messenger RNA (mRNA) vaccine, but the dose is one-third of the adolescent and adult doses (30 mcg).

4. Can the flu and COVID-19 shots be given at the same visit?

• COVID-19 vaccine can be given at the same visit as routine childhood immunizations, including flu.

5. Where is Pfizer’s vaccine available?

• Pfizer’s vaccine for ages 5 to 11 years is available in pediatrician offices, pharmacies, health departments, hospitals, and other sites.  Vaccines.gov lists vaccine availability at different locations.

Disclaimer: The content in this blog article is NOT a substitute for professional medical advice. For questions regarding COVID-19 vaccines, any medical condition, or if you are in need of medical advice, please contact your healthcare provider. Given the fluid nature of the pandemic, information in this article is subject to change and may not be current.

Sources

• VRBPAC FDA Briefing Document. October 26, 2021. https://www.fda.gov/media/153447/download
• Pfizer EUA Press Release. October 29, 2021. https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-receive-first-us-fda-emergency-use-0.
• FDA Press Release. October 29, 2021. https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age
• CDC Interim Clinical Considerations. November 3, 2021. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#children
• Pfizer EUA Fact Sheet. Revised October 29, 2021. https://www.fda.gov/media/153714/download
• AAP Policy Statement. November 2, 2021. https://www.aap.org/en/pages/covid-19-vaccines-in-children-and-adolescents-policy/
• Vaccines.gov.

The COVID-19 pandemic has had a profound affect on everyone, particularly children with emotional health concerns. Many support structures in place prior to the pandemic to help children thrive have disappeared or been changed significantly, resulting in increased pressure on caretakers and overwhelming stress for children. New and innovative solutions are needed to meet these challenges. Magellan Healthcare’s Emotional Health for Kids by Mightier is a clinically proven video game solution that helps children build emotion regulation skills through play and caregivers build emotionally healthy homes.

Developed at Boston Children’s Hospital and Harvard Medical School, Mightier helps children ages 6 to 14 who are struggling with emotional health concerns, such as irritability, aggression, and anger, as well as children diagnosed with oppositional defiant disorder, attention deficit-hyperactivity disorder, autism spectrum disorder (ASD) and general anxiety disorder.

Mightier’s impact on children’s emotional health

In a pilot program, Magellan provided members access to the Mightier program for a period of twelve weeks during the COVID-19 pandemic. Families were recruited and randomized into a group that received Mightier in addition to applied behavior analysis (ABA), or a group that received only ABA as a control.

• Children engaged with Mightier at a high rate. On average, Mightier families played for 30.4 minutes above the 30 minutes per week recommended to see clinical change.
• Clinical symptoms improved. Eighty percent of children with ASD who used Mightier showed an improvement on primary symptoms, compared to only 50% in the control group.
• Children showed twice as much decrease in aggressive behaviors. Adding Mightier to ABA resulted in a reduction in aggressive behavior in children with autism by twice as much compared to ABA alone.
• Families reported a less stressful and more supportive environment. Families using Mightier showed 50% improvement in family stress, 114% improvement in parent confidence, and 114% improvement in access to resources relative to control.

Visit  Magellanhealthcare.com/kids-emotions-mightier/ to learn more about the pilot and how Mightier helps children build self-regulation skills and supports caregivers in building emotionally healthy homes.

Among those who experience a mental health illness, more than half do not receive treatment.[1] The 2019 National Survey on Drug Use and Health reveals no treatment was received by:

• 90% of the 20.4 million individuals aged 12+ who have a substance use disorder (SUD)
• 55% of the 51.5 million individuals aged 18+ who have any mental illness (AMI)
• 35% of the 13.1 million individuals aged 18+ who have a serious mental illness
• 90% of the 9.5 million individuals aged 18+ who have a co-occurring SUD and AMI
• 57% of the 3.8 million individuals aged 12-17 who have had a major depressive episode

In fact, what we’ve seen in our data is that 60% of patients who are admitted to inpatient care were first seen in a primary care setting within 6-12 months of the admission and the mental health condition was either missed or not addressed.

Through effective screening for mental health conditions on your own or through a physician or mental health professional, it is possible to identify problem areas and get help, so you can live a happier and healthier life.

Mental health self-screening tools

Magellan Healthcare provides links to reputable, free self-assessments of behavioral/mental health, substance use and more.* Once you complete an assessment, be sure to review your results and any recommendations with your doctor.

• Addiction(CAGE-AID)
• Alcohol consumption (AUDIT-10)
• Anxiety (GAD-7)
• Bipolar disorder
• Child depression (CES-DC)
• Child trauma (CTS)
• Depression (PHQ-8)
• Drug abuse (DAST-10)
• Eating disorder (SWED)
• Insomnia (ISI-7)
• Obsessive compulsive disorder (OCD) (Y-BOCS)
• Pain (PEG-3)
• Parent mental health
• Postpartum depression
• Post traumatic stress disorder (PTSD) (PC-PTSD)
• Psychosis (PQ-B)
• Youth mental health

*Note these are links to outside websites that are not monitored by or affiliated with Magellan Healthcare. If your screening results indicate you are at high risk, call 911 or go to the emergency room immediately.

We encourage you to watch a recording of our webinar, “Depression is more than just a rough patch,” and find additional resources addressing depression at MagellanHealthcare.com/Mental-Health.

[1] https://www.samhsa.gov/data/sites/default/files/reports/rpt29392/Assistant-Secretary-nsduh2019_presentation/Assistant-Secretary-nsduh2019_presentation.pdf

October is Breast Cancer Awareness Month, which focuses on increasing awareness and highlighting the importance of early detection. Although there has been a significant increase in awareness over the years, there is still a great deal of information about the disease that can cause some confusion.

Here is a look at three common myths about breast cancer and the truth behind them.

Myth: Finding a lump in your breast means you have breast cancer.
The Truth:  Only a small percentage of breast lumps turn out to be cancer. If you find a lump in your breast or notice changes in tissue, it is very important that you see a physician for a clinical breast exam or imaging.

Take charge of your health. Perform routine breast self-exams, establish ongoing communication with your doctor, get an annual clinical breast exam, and schedule your regular screening mammograms.

Myth: Men do not get breast cancer; it affects women only.
The Truth:  Quite the contrary. Annually, approximately 2,190 men¹ will be diagnosed with breast cancer, and 410 will die each year. While this percentage is small, men should also periodically do a breast self-exam while in the shower and report changes to their physicians.

Breast cancer in men is usually found as a hard lump underneath the nipple and areola. Men carry a higher mortality than women do, primarily because awareness among men is less. Men are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.

Myth: You are not likely to develop breast cancer if you do not have a family history of breast cancer.
The Truth:  Women who have a family history of breast cancer are in a higher risk group. However, most women who have breast cancer have no family history. Statistically, only about 10% of individuals¹ diagnosed with breast cancer have a family history of this disease.

• A first-degree relative with breast cancer: If you have a mother, daughter, or sister who developed breast cancer below the age of 50, you should consider regular diagnostic breast imaging starting ten years before the age of your relative’s diagnosis.
• A second-degree relative with breast cancer: If you have had a grandmother or aunt who was diagnosed with breast cancer, your risk increases slightly. It is not at the same risk as those with a first-degree relative with breast cancer.
• Multiple generations diagnosed with breast cancer: If there are several family members diagnosed under age 50, the probability increases that there is a breast cancer gene contributing to the cause of this familial history.

When breast cancer is detected early, in the localized stage, the 5-year survival rate is 98%.³

Knowledge is power, it is vital to learn the facts about the disease. The more you learn about this disease, the better equipped you will be to make decisions about annual exams, screenings, risk reduction, and treatment options. Work with your provider to better understand your risk, and the steps you can take to be in charge of your breast health.

1. https://seer.cancer.gov/statfacts/html/breast.html
2. https://www.cancer.gov/about-cancer/causes-prevention/risk/myths/antiperspirants-fact-sheet
3. https://www.nationalbreastcancer.org/breast-cancer-stage-0-and-stage-1

By Dr. Beall-Wilkins and Dr. Jamie Hanna

Magellan Health hosted a free webinar for September Suicide Prevention Awareness Month. If your question wasn’t answered during the webinar, or if you would just like to learn more about suicide prevention, read on for information shared by our webinar presenters, Dr. Rakel Beall-Wilkins, MD, MPH, and Dr. Jamie Hanna, MD. For more information and resources addressing suicide prevention, and to watch the recording of this webinar, visit MagellanHealthcare.com/Suicide-Prevention.

Question: Please say more about the interplay between chronic pain and suicide risk.

Dr. Beall-Wilkins: It is estimated that the prevalence of suicidal ideation is roughly three times greater in people living with chronic pain compared to those who do not have chronic pain, and chronic pain is linked to higher rates of not only suicidal ideation but also suicide attempts and completed suicides.[1] When coupled with impaired functionality and disability, chronic pain can result in socioeconomic hardships and limitations in access to care that further exacerbate both physical and mental health symptoms. Chronic pain and depression often go hand-in-hand, and clinical studies have shown that upwards of 85% of people with chronic pain have experienced severe depression.[2] It is essential that patients with chronic pain be routinely screened for psychiatric symptoms and acute safety concerns, and that they be referred to treatment if issues arise.

Question: Is a person really considered suicidal if they have considered it a lot but have never acted on their thoughts? What measures can we put in place for individuals with a baseline of passive suicidal ideation who are in outpatient therapy?

Dr. Hanna: Understanding the risk factors that can lead to suicidal behavior provides an opportunity to identify and support people at risk for suicide. Risk factors include a previous suicide attempt, diagnosis of mental illness/substance use, isolation, social/legal problems, trauma in childhood, a family history of suicide, recent stressors and access to lethal means. Learn more about suicide risk and protective factors from the American Foundation for Suicide Prevention and the Centers for Disease Control and Prevention. Suicidal ideation – or thoughts about suicide – is also an important risk factor and can be a warning sign of imminent suicidal behavior. There is greater risk when suicidal thoughts occur more often, over greater time periods or are more challenging to control; there are fewer barriers to acting on the thoughts; and the reason for the suicidal thoughts is to stop the pain. Identifying suicidal ideation and implementing treatment strategies are critical in preventing suicide.

It is always the goal to treat suicidality in the least restrictive setting and subsequently, treatment of suicidal ideation often occurs in the outpatient setting. There are a variety of measures that can be put in place to assess and treat suicidal thoughts in the outpatient setting. Some of these include screening, crisis intervention, and evidence-based and research-informed interventions.

One example of a screening tool is the Columbia-Suicide Severity Rating Scale (C-SSRS). This scale focuses on evidence-based metrics to assess the severity of suicidal ideation and behavior. Items on the scale also serve to differentiate between suicidal and non-suicidal self-injurious behavior.

Crisis intervention assistance is typically provided by connecting a person in crisis to trained staff for support and referral to additional services. The goal is to impact key risk factors for suicide, including depression and hopelessness, increase future mental healthcare access, and put space and time in between suicidal thoughts and action. Examples of crisis intervention services include the National Suicide Prevention Lifeline (1-800-273-8255) and Crisis Text Line (text HOME to 741741).

There are only a small number of evidence-based treatment interventions directly targeting suicide risk. These include cognitive behavioral therapy for suicide prevention (CBT-SP), dialectical behavior therapy (DBT) and Collaborative Assessment and Management of Suicidality (CAMS). Additional research-informed interventions include collaborative safety planning and reducing access to lethal means. These interventions are emphasized in both the CDC suicide prevention strategy and the Zero Suicide approach to suicide prevention.

Question: What do you say to someone who says they want to die and that life is torture, and asks why they were born? What types of things can you tell the person going through this, and how do you do it without sounding judgmental?

Dr. Beall-Wilkins: Feelings of despair, hopelessness, worthlessness and helplessness are commonly experienced by people who are in the midst of a mental health crisis. During episodes of emotional distress, it can be very difficult for some people to think positively or constructively, and this can manifest itself in the form of self-deprecating statements and thoughts of self-harm. When someone is feeling this way, it can be helpful to reassure them that things can get better, and that comprehensive treatment can improve how they feel. It’s also very important to assess their safety, inquire about any thoughts they may be having of hurting themselves or someone else, and encourage them to seek immediate professional help if they’re feeling unsafe.

Question: I had a family member take her life on 9/7. She went about her day as normal, and then chose to take her life that evening after placing her kids down for the night. As a family member, we are still trying to figure out why. Is this a normal feeling? Similarly, for people attempting to support those with suicidal thoughts, or who have tried to support someone who died by suicide, what suggestions do you have to help them find the balance between supporting the suicidal individual and feeling overly responsible for the suicidal individual’s choices, behaviors, etc.?

Dr. Hanna: When a loved one dies by suicide, intense emotions – such as disbelief, anger, guilt, isolation and despair – can become overwhelming, and there is no right or wrong way to feel. Many people will feel confused as they try to understand why their loved one chose suicide. And it is likely there will always be unanswered questions. The events which lead to suicide are often complex and most commonly there are many factors that contribute to a person ending their life.

The feeling of guilt can lead suicide survivors to blame themselves for the death of their loved one. It is critical that survivors do not blame themselves, and that they seek support and engage in self-care. Support and self-care can include reaching out to community members, such as friends, family, co-workers and mental health providers. Both in-person and online support groups are available specifically for suicide survivors. The American Foundation for Suicide Prevention provides resources to find a support group. It can also be beneficial to seek professional help with a licensed therapist or psychiatrist, especially for symptoms of depression and thoughts of suicide.

Question: The hardest part about helping someone who is suicidal is the concern that the police will be called, and the person will end up in handcuffs. How can we change this?

Dr. Beall-Wilkins: It is often the case that family and friends of those who are experiencing acute mental health crises face the prospect of summoning law enforcement to assist in maintaining safety and facilitating transportation to care. This can be a very daunting prospect and a growing movement of advocates, policymakers and mental health providers are now pushing for reforms that would reduce the likelihood of adverse outcomes in these circumstances.[3] One such reform involves greater collaboration between police departments and mental health clinicians, including training, education and joint response to crisis calls. Preliminary data indicate this approach can be a very effective means of reducing adverse outcomes, increasing public safety and strengthening trust within communities.[4]

Question: Is being suicidal hereditary? Are the mental/emotional issues that caused a previous suicide in a family hereditary?

Dr. Hanna: There is clear evidence that suicide can run in families, and family history of suicide has been identified as a significant risk factor for suicide. Studies show that individuals who have a parent or sibling die by suicide are two and a half times more likely to die by suicide than those without a family history of suicide. Research has identified a number of genes that appear to be associated with suicide risk. Psychiatric illness has also been shown to run in families and is a risk factor for suicide. Depression plays a role in over half of all suicide attempts. Children of parents with depression are three times as likely to develop major depression, anxiety disorders and substance use – all of which increase the risk of suicide.

While family history of suicide and psychiatric illness are important risk factors of suicide, other risk factors include previous suicide attempts, depression, substance use, stressful life events, physical illness and access to lethal means, among others. Suicide occurs as a result of many interacting genetic and environmental factors. Family members share genes, and they often share experiences – they eat together, live together and face economic stressors and loss together. These shared experiences may combine with genetics to increase an individual’s vulnerability to suicide. This does not mean that everyone with a family history and increased risk of suicide will have suicidal behavior, but that they could be more vulnerable and should take steps to reduce their risk. These may include early evaluation and treatment of mental illness and building protective factors to buffer against suicidal behavior.

Question: Could you speak to the legalities of those who need help but are past the age of responsibility, and family members and friends are told there is nothing they can do if the person refuses the help or that we can’t keep them somewhere against their will?

Dr. Beall-Wilkins: In most jurisdictions, the ability to commit an individual to treatment against their will is typically conferred by the courts based upon three guiding principles: harm to self, harm to others and evidence of significant mental deterioration that renders an individual unable to practice self-care in their own best interest. If an adult person is explicitly stating an intention to hurt themselves or others, or exhibiting grave mental disability, they can be involuntarily committed for observation, evaluation and acute stabilization.

Rakel Beall-Wilkins, MD, MPH, served as a medical director for Magellan Healthcare. Prior to joining Magellan in 2018, Dr. Beall-Wilkins assisted in the launch of an addiction psychiatry clinic embedded within Harris Health System’s Healthcare for the Homeless Program, to combat local impacts of the nationwide opioid and synthetic cannabinoid (“K2”) epidemics. Dr. Beall-Wilkins also served as a member of the Baylor College of Medicine faculty with clinical duties at both the Ben Taub General Hospital Psychiatric Emergency Center and the Thomas Street Health Center. There she helped to expand behavioral health services by launching a neurocognitive clinic collaborative to better screen, diagnose and treat individuals with HIV/AIDS-associated neurocognitive disorder and psychiatric comorbidities. She is a graduate of the University of Texas at Austin and the Johns Hopkins School of Public Health, where she obtained a Master of Public Health degree. She obtained her medical degree from Baylor College of Medicine. 

Jamie Hanna, MD, serves as the medical director for the Magellan of Louisiana Coordinated System of Care (CSoC) program. She is board certified in Psychiatry and Child and Adolescent Psychiatry. Prior to joining Magellan in 2020, Dr. Hanna served as an assistant professor and assistant training director with Louisiana State University School of Medicine, working with the acute behavioral health unit, and leading the psychiatric consultation liaison service and emergency psychiatric services at Children’s Hospital of New Orleans. Dr. Hanna completed medical school at the University of Alabama School of Medicine and a subsequent internship in Pediatrics, residency in General Psychiatry, fellowship in Child and Adolescent psychiatry, and fellowship in Infant Mental Health with Louisiana State University in New Orleans.

For more information and resources addressing suicide prevention, and to watch the recording of this webinar, visit MagellanHealthcare.com/Suicide-Prevention.

[1] Pergolizzi JV (2018) The risk of suicide in chronic pain patients. Nurs Palliat Care 3: doi: 10.15761/NPC.1000189.

[2] Sheng, J., Liu, S., Wang, Y., Cui, R., & Zhang, X. (2017). The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural plasticity, 2017, 9724371. https://doi.org/10.1155/2017/9724371

[3] https://www.npr.org/2020/09/18/913229469/mental-health-and-police-violence-how-crisis-intervention-teams-are-failing

[4] https://www.apa.org/monitor/2021/07/emergency-responses

October is American Pharmacists Month and an excellent opportunity for us to celebrate all of our Magellan Rx pharmacy heroes that help our members live healthy, vibrant lives! To kick off American Pharmacists Month, we wanted to shine a spotlight on our two pharmacy residents. We will be taking you behind the scenes to find out what got them interested in pharmacy and what they love most about their residency program.

Magellan Rx: Why did you decide you wanted to become a pharmacist?

Shyra Bias, PharmD: I decided at a young age that I wanted to be the drug expert in my family after witnessing a family member suffer from the complications of extremely uncontrolled latent autoimmune diabetes in adults (LADA). My desire to help my family led to a passion to improve many patients’ lives by ensuring that they can receive the medications they need at a cost they can afford.

Alaka’i Montalbo, PharmD: Growing up, I played a lot of sports and was always in the gym. As an athlete, you learn about sports supplements and how they can help you. In high school, I loved diving into the science of supplements. I later learned in life that the “science” of supplements was not backed by clinical data. After having my dreams crushed, I was working in the hospital and one of the nurses asked me if I had ever considered being a pharmacist? She knew I enjoyed talking about supplements and learning how different medications worked in the body. After researching what pharmacists do, I realized this was exactly what I wanted to do, and I have not looked back since.

Magellan Rx: What advice would you give to someone who wants to become a pharmacist?

Shyra Bias, PharmD: Keep your eye on the prize! The road to PharmD is not an easy one, but if you are truly passionate about the profession, you will get through it. Also, pharmacy is a very small world, so be intentional about making connections because you never know who may be able to change the trajectory of your career.

Alaka’i Montalbo, PharmD: Find joy in your journey. While pharmacy school is a long journey, it will fly by in the grand scheme of life. Don’t give up and never stop believing that you can do it. Don’t fall into the trap of saying to yourself I’m not ready yet. Right now, start making connections with pharmacists and current pharmacy students.

Magellan Rx: What different career paths can you do as a PharmD?

Shyra Bias, PharmD: There are many options for Pharmacists; many do not come to mind immediately when someone thinks of the traditional roles of a pharmacist. Some of the first paths that come to my mind include industry pharmacy, nuclear pharmacy, managed care pharmacy, and clinical pharmacy (hospital setting) to name a few.

Alaka’i Montalbo, PharmD: During pharmacy school, I had the opportunity to go to local high schools and talk about the profession of pharmacy. There are so many different careers Pharmacists can choose and every route is unique. There are traditional roles like retail, hospital pharmacy, and then some non-traditional roles are academia, nuclear (chemotherapy) pharmacy, FDA pharmacists, and Indian health services.

Magellan Rx: What made you choose managed care pharmacy?

Shyra Bias, PharmD: I chose managed care because I really enjoy the population health aspect of the industry. It gives me a true feeling of gratitude to change millions of lives with “the click of a button.”

Alaka’i Montalbo, PharmD: Managed care is the perfect balance between using clinical data and real-world efficacy to help patients manage their disease states. One of my favorite quotes about pharmacy is from Everett Koop, “Drugs don’t work in patients who don’t take them.” I would add to this quote, also with patients who can’t afford them. Managed care is that perfect bridge between both worlds of pharmacy, and I feel like I am making a huge difference every day, not just for one patient but for entire populations.

Magellan Rx: How do you like your residency at Magellan Rx?

Shyra Bias, PharmD: I am grateful beyond words to have been matched with Magellan Rx. The company culture makes me feel extremely welcomed, and the variety of experiences that we are exposed to through our rotations will allow us to succeed no matter where I end up in the managed care industry.

Alaka’i Montalbo, PharmD: Being Native Hawaiian, Ohana (family) means everything to me, and family means no one gets left behind or forgotten. Magellan Rx is one big Ohana and every day, I get to stand on the shoulders of giants. I feel so blessed to be a part of this company and everyone in this residency program is always willing to stop what they are doing, take time out of their busy schedules to help me grow! I cannot express my gratitude enough and I look forward to paying it forward in my career.

Don’t forget to follow us on LinkedIn and Twitter where we will be featuring different pharmacists and pharmacy techs throughout October. #MRxAmericanPharmacistMonth