A theme for September’s Recovery Month is “Recovery is for Everyone.” It sounds nice, but is it really true? We’re all impacted by mental health and substance use conditions in some way, whether we live with them or know someone who does. But with 74 million adults and 5 million adolescents in America living with a mental health or substance use condition,[1] is recovery really for everyone?

Where do you stand?

Do you think recovery is possible for a person given a diagnosis of schizophrenia? Is recovery possible for someone in active heroin addiction?

If you think recovery is possible for them, do you expect recovery for them?

Think about it for a minute.

Recovery for me

I am a person in recovery. At the beginning of my journey, I was a teenager with a bright future ahead of me who had been given a mental health diagnosis. It was easy for others to hold hope for me because my accomplishments were a recent memory. Recovery was possible and expected for me.

Today, I have a successful career, an advanced education, a home, and a deep connection to my community. It’s easy for people to expect recovery for me because I’ve proven it’s possible.

But in the middle of my story is endless years of pain and despair. My teenage accomplishments quickly became overshadowed by more diagnoses, hospitalizations, failed medication trials, and a disability determination. The longer my struggles continued the harder it was for me and the people around me to believe my recovery was possible. An expectation of recovery was replaced with low expectations of my abilities, personal responsibility, and chances for a meaningful life.

The irony is that these low expectations quickly became more distressing for me than any symptom I was experiencing. It was the lack of expectation for recovery in my life that brought the soul-crushing despair that nearly ended my life.

Measuring down

My experience is not isolated. It is common to determine someone’s ability to recover based on internal and external factors and then act accordingly. These factors may include a person’s income, education history, employment, housing, support system, family culture, ethnicity, and geography; the number of times they have been in rehab or failed medication trials; and the number of diagnoses, type of diagnoses, drugs used and number of physical health comorbidities. The list could be endless.

Now let’s go back to the scenarios above and add a few more details:

Do you expect recovery for the man you pass at the bus stop who is experiencing homelessness, who hears voices and who has no education?

What about the woman you see at the park who uses street drugs, whose kids are in foster care and who is unemployed. Do you expect recovery for her?

Recovery for everyone in action

Expecting recovery for everyone requires an unwavering commitment to the belief that recovery is possible for every person, no matter their diagnosis, treatment history, or current and past circumstances. The next step after believing recovery is possible is taking action on that belief through communicating with hopeful, empowering language, encouraging risk-taking in the pursuit of recovery, and focusing on strengths versus perceived deficits.

At the systems level, expecting recovery for everyone means:

• Providing equitable recovery opportunities through services and supports, including beyond traditional treatment delivery systems
• Outreaching to engage Black, Brown, LGBTQ+ and other marginalized communities
• Transforming practices and environments to reflect recovery-oriented principles

If we all believed that recovery was for everyone, it would radically change our communities and service delivery systems for the better. It would send a message of hope and save lives during a time when suicide rates in the U.S. have increased 30% from 2000 to 2020.[2]

Imagine what would change if we believed recovery was for everyone.

Join the conversation

We are pleased to host a free webinar, “What I would tell my younger self: Conversations about hope, recovery and the “S” word,” on Wednesday, September 14, 2022, at 3:00 p.m. ET. Register today to hear our presenters share the advice they would give to their younger selves to better navigate mental health and substance use challenges, and engage in the conversation!

Visit MagellanHealthcare.com/Recovery for resources to use and share this Recovery Month and beyond.

[1] Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health

[2] National Institute of Mental Health, “Suicide” information

Magellan Healthcare is a proud supporter of Mental Health Month in May. We are committed to increasing awareness about mental health, wellbeing, and the importance of recognizing and addressing concerns through our community outreach and innovative behavioral health services for members and providers.

Here are five things you can do every day to improve your mental health and wellbeing:

1. Connect
Build and strengthen relationships with the people around you. Meet up with friends, have lunch with a coworker or join a group in your community. Feeling close to and valued by others, including at work, is critical to boosting wellbeing. When we devote time to these relationships, we feel happier and more secure, giving us a better sense of purpose.

2. Be active
Look for ways to be active every day. Find something you enjoy that suits your fitness and mobility, like running, walking, gardening, dancing, and working on projects around the house. Being active every day causes changes in our brain which can positively affect our mood and decrease stress, depression, and anxiety.

3. Give
Carrying out acts of kindness for other people, whether small or large, can increase happiness, life satisfaction, and a general sense of wellbeing. Make someone a meal, help with a project, or volunteer at an organization. You could just ask a friend or someone you work with how they are and really listen to the answer. Giving back to others can create positive feelings and help us feel more satisfied with life.

4. Take notice
Be present in the here and now. Pay attention to the world around you, nature, people, and your thoughts and feelings. Becoming more aware of the present moment boosts our wellbeing by helping us enjoy the world we have around us and understanding ourselves better.

5. Keep learning
Practice new skills and seek information about topics that interest you. Try a new recipe, listen to a podcast or fix something in your home. Generally being curious and seeking out new experiences at work and in life can boost your confidence and self-esteem, help you build a sense of purpose, and connect with others.

Each of these five practices has been shown to make a positive difference in how we feel and live our life.

Visit our 2022 Mental Health Month web page to discover more tools to address and spread awareness about mental health, wellbeing, and specific conditions as we recover from the pandemic and deal with civil, economic, and global unrest.

Source: New Economics Foundation

“Our obligation to act is not just medical—it’s moral.”
Vivek H. Murthy, M.D., M.B.A. Vice Admiral, U.S. Public Health Service, Surgeon General of the United States

 
To support the Surgeon General’s recent advisory related to protecting youth mental health issues exposed by the COVID-19 pandemic, Magellan Federal offers best practices for professionals specializing in behavioral issues to foster the wellbeing of our military families.

Magellan Federal directly supports the mental health and resiliency of military youth and families, serving over 4.5 million service members and families a year. Read more about risk factors and recommendations in our whitepaper here.

It was hard enough for kids without social media. Many of our older readers will remember… We compared ourselves to others, but it happened mostly in-person at school or events, or when we consumed one-way media like TV or magazines. While it could be hurtful, we still got a break at home, while riding in a car, or for much of the rest of the day, as we didn’t have smartphones. We became the subject of gossip, but we had the benefit of an imperfect “grapevine” that took longer to spread information, and likely, we didn’t even always hear about it. And we played the popularity contest, but we could never be sure just who were the winners and losers.

We’ll dive into these issues in this post and you can learn more by watching a recording of our webinar, “Addressing the impacts of social media on kids,” here.

Kids’ self-image and social media

Social media makes it easy—and even entertaining—to endlessly scroll through the latest and greatest images of our friends, celebrities, and perfect strangers. We get to see the best of everyone all the time. If any one of our friends isn’t posting their best on any given day, we’re seeing someone else who is posting their best. This can put undue pressure on our kids to attain perfection, as they are developing their self-image and self-esteem.

For kids, and us all, there is tremendous value in limiting the time we spend on social media and understanding that what we see there isn’t usually the full picture. Social media can provide a great sense of connection with others, along with many other positive impacts, but life outside of it can be refreshing and cleansing when we focus on all that we have and want to do.

Social media and cyberbullying

It’s a lot easier to be mean to someone when you’re not doing it to their face. With social media, not only is it easy for a bully to target another child from behind the protection of their screen, but they can do so publicly for classmates and the world to see and weigh in with opinions, or even just a “like,” on the matter. This ruthlessness can be humiliating and overwhelming for the victim, and lead to serious mental health concerns.

As our kids’ gossip and squabbles naturally pervade and have the potential to be broadcasted instantaneously on social media for all to see, let’s talk to them about leaving the negativity off of social media and focusing on positive messages that will ultimately reflect better on us all. If your child is a victim of cyberbullying, find resources at https://www.stopbullying.gov/cyberbullying/prevention and learn more in our webinar on May 11.

Our kids’ popularity, quantified

Our kids’ popularity is now quantified and displayed on social media. They have a number of followers, and every time they post, it’s assigned a number of likes and comments. Is this environment creating additional pressure for our kids to be liked and drive up their social stats at the risk of harming their mental health in the process?

While we can’t make a direct correlation with kids’ use of social media, we know the prevalence of depression among adolescents aged 12–17 has steadily increased–and more than doubled–from 8% in 2010 to 17% in 2020, and that certain demographic groups have been disproportionately affected, including girls, of which the prevalence of depression has increased from 11.9% in 2010 (4.4% among boys) to 25.2% in 2020 (9.2% among boys).[1]

We know our kids are much more than the number of likes they receive on a social media post. It’s important that we talk to our kids about what is really important and build up their self-worth through meaningful activities that stimulate their learning and interests, and help others.

On May 11 Magellan Healthcare hosted a webinar, “Addressing the effects of social media on kids,” for Mental Health Month with former Magellan child psychiatrists, Dr. Keith Brown and Dr. LaShondra Washington, and Senior Director Children’s Healthcare Barbara Dunn, and Creator of Magellan Youth Leaders Inspiring Future Empowerment Greg Dicharry. Watch a recording of the webinar at https://www.magellanhealthcare.com/event/addressing-the-effects-of-social-media-on-kids/.

[1] SAMHSA 2020 National Survey of Drug Use and Health, Youth Mental Health Trend Tables

Total wellbeing means that you feel fulfilled in all aspects of your life. Your mental health is a big part of your wellbeing. It is important to be aware of the signs or symptoms of mental stress so you can seek help or recognize when someone you care about may need help.

5 reasons why it is important to pay attention to your mental health and wellbeing

1. Mental illness is more common than you think. Mental illness does not discriminate, it affects people of all ages, genders, and ethnicities. One in five U.S. adults experience mental illness, 1 in 20 U.S. adults experience serious mental illness, and 17% of youth aged 6 – 17 experience a mental health condition. Unfortunately, too many don’t seek help.
2. Mental illness affects your physical health. Your brain is part of your body. Mental and physical health are connected. In fact, mental illness can be the root of many physical symptoms. For example, if you are suffering from insomnia, heart palpitations, or fatigue, your doctor may want to rule out depression, anxiety, or other mental health conditions as a potential cause.
3. Diseases or injuries can increase your risk. Just as mental illness can cause physical symptoms in your body, physical diseases, like cancer, multiple sclerosis, diabetes, and trauma such as head injuries, can raise your risk of mental illness. It is important that you are honest about your experiences when speaking with your doctor.
4. It runs in families. Mental illnesses tend to run in families due to both genetic factors and family cultural issues. Remember to include things like depression, bipolar disorder, and attention deficit hyperactivity disorder in your family health history along with information about heart disease, cancer, and other conditions.
5. Early detection makes a difference. Like medical conditions, getting diagnosed early generally leads to better outcomes. Getting the help you need can prevent symptoms of mental illness from getting worse and causing negative effects on your life, including strained relationships and difficulty managing work and finances.

Visit our 2022 Mental Health Month web page to discover more tools to address and spread awareness about mental health, wellbeing, and specific conditions as we recover from the pandemic and deal with civil, economic, and global unrest.

Sources: health.clevelandclinic.org, nami.org, nih.org

Obstructive sleep apnea (OSA) has been linked to an increased risk of physical health problems, including high blood pressure, heart disease, stroke, and diabetes. But how does OSA affect your ability to think clearly, learn and remember, and your emotional psychological, and social wellbeing?

If you have ever worked a 24-hour shift or experienced back-to-back days of poor sleep, it probably comes as no surprise to hear that OSA has been linked to cognitive and mental health issues. OSA causes frequent breathing interruptions, or apneas, while you sleep—as many as 30 per hour. OSA is associated with:

1. Trouble concentrating—OSA can lead to significant changes in two important brain chemicals, gamma-aminobutyric acid (known as GABA) and glutamate. Together, these two chemicals help maintain balance. People with OSA may have decreased levels of GABA and elevated levels of glutamate. GABA is a chemical messenger that acts as an inhibitor in the brain. It slows things down and helps you remain calm. Glutamate, on the other hand, speeds things up. When your glutamate levels are high, your brain is working in a state of stress and does not function as effectively.[1] Glutamate in high amounts has also been shown to contribute to brain damage.
2. Memory problems—Throughout the night your body fluctuates through different sleep stages, allowing your brain to process and sort out all the information it has gathered throughout the day. OSA stops the flow of oxygen to your brain or completely cuts it off multiple times during the night, robbing your ability to reach deep and restorative sleep These frequent disruptions can contribute to memory loss and have a negative impact on overall brain performance.[2]
3. Poor decision-making—Sleep is essential in maintaining brain health and contributes to your ability to learn and recall information. A lack of sleep caused by OSA can cause frequent problems with attention and concentration. If you suffer from OSA, you may have trouble focusing at work or school, being creative, solving problems, and making decisions.[3]
4. Depression and stress—OSA can cause hundreds of interruptions in your breathing during the night, which can set off a constant fight-or-flight response. You may wake up suddenly with your heart racing, sweating, and a feeling of doom. This can carry over into the daytime, causing you to feel run-down and sleepy and your body to be without the energy it needs to protect you against depression and stress.[4]

The good news about obstructive sleep apnea’s impacts on cognitive and mental health

While OSA can negatively impact your day-to-day life, there is hope. The harmful cognitive and mental health effects of OSA can be reversed with treatment. For some, this may mean lifestyle changes. For others, it may mean continuous positive airway pressure, or CPAP—a machine that helps you sleep easier.

Want to learn more about obstructive sleep apnea?

Find the recording of our webinar, “Obstructive sleep apnea: Impacts, diagnosis and treatment,” to hear board-certified somnologist and neurologist, Dr. Karen Jablonski, physician clinical reviewer, Magellan Healthcare, and I discuss the mental and physical health impacts of OSA, and OSA diagnosis and treatment here.

[1] https://newsroom.ucla.edu/releases/sleep-apnea-takes-a-toll-on-brain-function#:~:text=They%20found%20that%20people%20with,calm%20%E2%80%94%20like%20a%20brake%20pedal.

[2] https://goodsomnia.com/blog/snoring-sleep-apnea/can-sleep-apnea-cause-memory-problems/

[3] https://www.sleephealthsolutionsohio.com/blog/sleep-apnea-and-brain-health/

[4] https://www.everydayhealth.com/sleep/sleep-apnea-link-depression-anxiety/

In the midst of a national children’s mental health crisis, families are doing the best they can to assess how well their children are coping with increased stressors from the pandemic and figure out what to do if it seems they are having difficulty. Psychotropic medication is among the options to consider when indicated. However, over the years, children and adolescents with behavioral health challenges have generally been prescribed an alarming number of medications. This high prescription rate, paired with questions about the appropriateness of the diagnoses used to justify the drugs’ use, has raised many concerns among families, practitioners, and youth advocates alike. Prescribing medication to treat children’s mental health conditions can be appropriate, but parents, caregivers, and practitioners need to fully understand the risks and monitor their use.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Appropriate Use of Psychotropic Drugs in Children and Adolescents, which highlights evidence-based research on the use of psychotherapeutic agents in children and principles for optimal children’s psychopharmacotherapy practice.

Considerations for treatment with medication for children’s mental health

When families consider medication as an option to treat a child’s mental health condition, Magellan’s monograph offers the following to contemplate:

The practice of evidence-based medicine for children and adolescents requires health professionals and child welfare advocates to engage in a careful assessment of the risks and benefits of using psychopharmacological treatments while addressing serious concerns of over-diagnosis and overtreatment in this vulnerable population. As attention to these issues has grown, a strong undercurrent of anxiety and confusion exists about whether the use of psychotropic agents to remove undesirable impulses and behaviors of children may affect their neurological development, personality, character, and temperament. Suspicions exist that over-diagnosis and overtreatment are driven by a supply-induced demand created by pharmaceutical companies and medical providers.

Addressing the shortage of children’s mental health professionals

Another consideration for parents and families is the shortage of professionals providing specialized mental healthcare services for children. Mental healthcare for children is often initiated at the pediatrician’s office, Magellan’s monograph provides the following insights:

Given the significant national shortage of child psychiatrists, there remains a realistic need to rely on primary care clinicians to perform screenings of children for mental health disorders and treat uncomplicated ADHD, anxiety, or depression. However, the problem of follow-up care and ongoing monitoring of mental health problems in pediatric primary care is a matter that must be addressed.

Principles for optimal use of medication to treat children’s mental health

The American Academy of Child and Adolescent Psychiatry published the Practice Parameter on the Use of Psychotropic Medication in Children and Adolescents to promote the appropriate and safe use of medication to treat children’s mental health by emphasizing the best practice principles that underlie medication prescribing. These principles, as highlighted in the monograph, are as follows:

Principle 1: Before initiating pharmacotherapy, a psychiatric evaluation is completed.

Principle 2: Before initiating pharmacotherapy, a medical history is obtained, and a medical evaluation is considered when appropriate.

Principle 3: The prescriber is advised to communicate with other professionals involved with the child to obtain collateral history and set the stage for monitoring outcomes and side effects during the medication trial.

Principle 4: The prescriber develops a psychosocial and psychopharmacological treatment plan based on the best available evidence.

Principle 5: The prescriber develops a plan to monitor the patient, short and long-term. Clinicians should use standardized, objective measures to measure the efficacy of pharmacologic interventions.

Principle 6: Prescribers should be cautious when implementing a treatment plan that cannot be appropriately monitored.

Principle 7: The prescriber provides feedback about the diagnosis and educates the patient and family regarding the child’s disorder and the treatment and monitoring plan.

Principle 8: The child’s assent and parent’s consent are completed and documented before initiating, and at important points during, medication treatment

Principle 9: The assent and consent discussion is focused on the risks and benefits of the proposed and alternative treatments.

Principle 10: Medication trials are implemented using an adequate dose and for an adequate duration of treatment.

Principle 11: The prescriber reassesses the patient if the child does not respond to the initial medication trial as expected.

Principle 12: The prescriber needs a clear rationale for using medication combinations.

Principle 13: Discontinuing medication in children requires a specific plan.

We encourage you to learn more about medication to treat children’s mental health in the full clinical monograph and Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents, here. Both provide valuable insights and information to support the critical behavioral health needs of our nation’s children.

The war in Ukraine is continually changing with updates to the minute within the news cycle and social media. Constantly, there are reports and images flooding our electronic devices with images that are incomprehensible to see. Military families have intense stress as they look at the uncertainties of deployments and the impact on military families. To add to the stress and concern, this global crisis comes on the heels of being exhausted and socially isolated by a two-year pandemic. The following are some tips to take care of your mental health during the Ukraine situation.

Limit your exposure – disconnect from electronics and social media. Although it is important to understand what is happening in the world, it is important not to immerse oneself in the event every moment. Set time limits for yourself regarding how much News or social media you watch or follow.

Recognize that people will have different reactions. People respond and react to tragedy and stress in multiple ways. Personal circumstances, such as deployment, may have different responses than those that are not experiencing deployment.

Talk about it. Do not keep your reactions inside alone. Process your feelings by talking to family, friends, and colleagues about your experience. If the feelings are overwhelming, consider talking to Mental Health Professional that can offer personalized strategies for managing your anxiety about current events.

Engage in activities that provide meaning. Participate in activities that are healthy and you enjoy. Some ideas include exercising, cooking, taking a hike, or playing with a pet.

Engage in meditation and mindfulness. Relaxation, or breathing exercises can improve your state of mind and reduce stress. Taking a few moments just to be present can shift your body’s reaction from a stress response. Try a simple breathing exercise of breathing in for a count of 6 hold for a count of 2 and breathe out for a count of 6.

COVID fatigue. Acknowledge that after a two-year pandemic and many people are tired. The Ukraine situation is especially hard to absorb. It is normal to feel overwhelmed

Avoid catastrophizing. Avoid thinking about future scenarios and what the outcome might be. Focus on one day at a time for now.