February 1^st is known around the world as Time to Talk Day. This is a national day that encourages individuals to have an open dialogue about their mental health and to be supportive of others.

In this DocTalk article, Magellan Healthcare’s Medical Director Dr. Chris Squillaro shares why the act of talking about mental health is so important, the common misconceptions about mental health, and advice on how to approach the conversation for all age groups.

Q: In your opinion, why is it important to talk openly about mental health?

Dr. Chris Squillaro: Open conversation is important to communicate our feelings and emotions.  Without the ability to share the things that we are feeling inside, they can become confusing, which can feel out-of-control and lead to worsening emotions and possibly behavior.  Conversing about mental health also normalizes the subject matter.  The more frequently mental health is openly discussed the more accustomed we become to discuss it within our relationships and as a society.  Lastly, talking about it helps us to realize that we are not alone.  Since mental health and substance use is so prevalent in our culture, every one of us likely has a connection to someone struggling with one or the other.

Conversely, not openly discussing mental health has no benefit.  History has already shown that this only leads to stigma and worsens the potential problems associated with unaddressed mental health conditions.  If we’re not openly discussing it, we’re also not openly seeking solutions when needed.

Q: In 2024, what do you think is the biggest misconception about mental health?

Dr. Squillaro: That mental health issues are resolving as fast as our concerns about COVID.  Even though we are moving away from the day-to-day threat of COVID to us and our loved ones, mental health and the mental health system are far from recovered.  We are seeing consequences both in terms of children and adolescents who lost social connection at critical junctures in their development and are struggling to catch up from the delay.  This not only impacts them but also their family unit and their community.  The increase in alcohol and drug use that occurred during the height of the pandemic was not resolved.  Many of the people who developed addictions are just now starting to seek help and there are many who have not realized that there is a problem.

At the same time there is a greater need as the delivery of mental health services shifted.  Services moved from primarily face-to-face to virtual.  With this came a shift in the workforce.  Many mental health workers sought virtual positions and left critical services that required face-to-face interaction.  This left vacancies that have not been filled.  Every service in every level of care is experiencing staffing shortages.  The misconception is that as society normalizes, the mental health system has normalized and can accommodate the demand.  However, we are not seeing that same level of normalization at a time when it is needed.

Q: How do you think we can create a more supportive and understanding community when it comes to mental health?

Dr. Squillaro: It starts in the home.  Each generation has gotten better at this.  The best way to influence change is to teach our young.  More knowledgeable and understanding parents teach their children acceptance.  These children then begin to make a difference as they interact in the community and in school.  As the members of the generation mature, they create a more compassionate and embracing community.  When children grow up with these concepts that are taught and modeled in the home, their thinking and behavior is more solidified and less likely to be influenced by many of the external influences that continue to be intolerant.  I doubt anyone feels that society will eliminate extreme points of view that preach intolerance.  But the hope is that these extremes get smaller with the majority being a community that is accepting and supportive.

Q: What role can friends, family, or colleagues play in supporting mental well-being, and how can they contribute positively to someone who may have mental health struggles?

Dr. Squillaro: In terms of having tougher conversations and feeling safe to communicate about mental health and mental health struggles, family and friends are critical. They contribute to each other’s lives by caring and having the best of intentions, even when saying things that aren’t always easy to hear or when someone isn’t necessarily ready for help.  Many times, family and friends will be the first to identify when something is wrong and should be the first to speak up.  The most positive thing you can do for someone is to let them know what you’re seeing and that you are a person they can come to for help.  They may not be ready in that moment and they may need additional encouragement, but being there is the hardest and best thing to do.

On the other end, as things begin to improve, they will also likely see it first.  They can encourage and provide that perspective to continue instilling hope.  They can walk the recovery journey with their loved ones and make the connection even stronger.

Q: What advice would you give to someone hesitant to talk about their mental health issues?

Dr. Squillaro: An analogy I use to make this point is that emotions are like water.  Eventually, there is nothing that can hold it back and when it breaks through, it is one of the most transformative and potentially destructive forces on the planet.  Hesitating to talk about mental health doesn’t mean it’s not there.  We’re only able to hold it back for so long before the pressure becomes so great that we no longer control how it comes out and what it destroys.  Talking about mental health is like choosing to release the pressure and having a more constructive say as to how those emotions come out.

Q: Can you share 3-4 ways to begin an open dialogue with someone about your need for support?

• Identify the issue – you don’t need to know exactly what is wrong, only that your emotions are affecting your functioning.
• Identify someone who has historically made you feel safe.
• Take a risk – anxiety is about feeling conflicted. Choosing to move forward despite that feeling is how you begin to change take control of it.
• Gather information – after you’ve taken one risk, a second, third or more becomes easier. In that process, collect what people tell you and find your own path forward.

Q: Are there unique ways to approach a discussion about mental health with an adult versus a child (under 18) or a young adult?

Dr. Squillaro: Pay attention to the language you use.  Whether it’s a child, adolescent, or an adult, they must be able to understand what you’re saying.  Logically, children will need more simple language and concepts.  It’s okay with adolescents to take a more informal approach to how you communicate.  You’re trying to connect with someone who is at a stage where they may not want to rely on authority figures or feel that they know better.  Adults can have a wide range of capabilities.  Trying to match the language they use will put it in terms they can understand.

Be aware of their developmental stage.  Each age group is at a different stage of brain development.  Children will need to be told the answer and will need help developing the solutions.  They are much more open to direction from authority figures.  Adolescents are more impulsive and tend to believe they can easily overcome the issues.  They may also be more comfortable receiving recommendations from peers, so look to engage people within their age group to help reach them.  Adults have more lived experience, and their decision-making is more progressed.  Predicting the consequences in areas of importance to them helps to prepare them engage in help.  No matter what age group, sometimes people need time to process information.

As a person trying to support someone with a mental health issue, patience and consistent messaging are key.  Very few people react immediately.  Continue to support them through their process and reinforce a message of help and hope that will eventually be heard when they are ready.

Q: What tools or resources would you recommend on this topic?

Dr. Squillaro: This may sound simplistic, but doing an online search can bring you to both national organizations and local resources that may be of benefit.  It offers choices about which sites, information, or resources speak to you.  Specifically, the Substance Abuse and Mental Health Services Administration (SAMHSA) has a resource on this: How to Talk About Mental Health | SAMHSA.  Another great organization to seek support is the National Alliance on Mental Illness (NAMI) Resources | NAMI: National Alliance on Mental Illness.  NAMI also has local chapters and can provide support to families as well.

Your insurance provider will also have resources available on their website and may be able to aid in facilitating referrals or tools to help you understand what you’re feeling or start a conversation with someone who needs help.  Along the same lines, the county you live in has mental health resources and is well-versed in the network of providers who can provide the services needed.

Resources

How to Talk About Mental Health from the Substance Abuse and Mental Health Services Administration

Resources from the National Alliance on Mental Illness

Walk into any store after Halloween and you more than likely will see the twinkle of holiday lights, trees, and decorations that quickly remind us that the Christmas season is upon us. For some, these reminders are a welcomed sight, and, for others, these reminders may trigger feelings of stress.

One way to help ease stress levels can be by setting healthy boundaries. Magellan Healthcare’s medical director Candice Tate, MD, MBA, shares advice on the importance of setting healthy boundaries during the holiday season.

Q: What are some factors that you feel are adding to stress this holiday season?

Dr. Tate: I think people are still trying to get that pre-pandemic holiday spirit back. People feel overworked and underpaid. Many stressors do not seem to have a deadline or an endpoint. This is also the time when people tend to mourn the loss of loved ones or feel emotional because they are unable to attend family gatherings.

Q: What are the steps to setting healthy boundaries during the holiday season?

Dr. Tate:

1. What are your needs and/or what are your stressors? This first step is important because it is difficult for others to know what you need and what stresses you. This can be effective by focusing on your top five.
2. You should expect resistance from others because your needs may conflict with their needs. This can be a challenging step in establishing boundaries for that reason. This is also challenging because you are imposing a change from past behavior.
3. You must communicate the boundaries and any subsequent changes. This may result in uncomfortable discussions and possibly conflict, but this is a necessary step in establishing boundaries. This is important for the people who will be directly impacted by the changes.
4. You must be consistent with the boundaries and hold yourself accountable. Others may intentionally or unintentionally challenge your new rules and habits. It is important to stand firm and remind others of what has been discussed. For this step, practice makes perfect. The longer you are consistent in reinforcing your boundaries, the more beneficial the boundaries will become.
5. Be prepared to distance yourself if necessary. On occasion someone may wholly reject your boundaries and object to any change. That is okay for them to do, and it is okay for you to distance yourself from the person or the situation. The boundary has been created to provide you with peace of mind and protection.

Q: What are examples of healthy boundaries? Is this important for both adults and children? How so?

Dr. Tate: An example of a healthy boundary during the holidays is setting a budget. Many people are faced with financial challenges due to rising costs of food and gifts. Many people feel that their disposable income has decreased over the past few years. Setting a budget for holiday spending to include gifts, decor, travel, and entertainment is a form of a boundary. Overspending causes anxiety, depression, and relationship problems. A budget can be beneficial for an individual and/or a family. It can be shared electronically or on paper, and it can be discussed with significant others and children. This allows for spending a certain amount, managing expectations, sparking creativity, and establishing new standards for the holidays.

The holiday season is an optimal time to take a social media break as another example. Recent reports in the news highlight how social media harms teenagers and children. Not only is this information not new, but we also know that social media negatively affects adults too. This is an opportunity to disconnect from what others are doing (or pretending to do) and allows you the space to focus on your values and the needs of your family.

There is so much pressure for us to experience a certain type of holiday season that usually includes overspending, indulgence, and being happy about it. Establishing boundaries is an opportunity to show yourself and your children that you can create positive and meaningful memories by doing things that suit your family based on your means and your values.

The Military & Family Counseling (MFLC) Child/Youth Behavioral (CYB) Program was created to expand supportive services to military families by providing non-medical counseling opportunities to their children. Magellan offers CYB counseling positions only to independently licensed clinicians who possess education and experience in counseling children in age groups and environments similar to those of their MFLC counseling assignment. CYB MFLC services are utilized frequently. During a one-year period (October 2022 – 2023), Magellan CYB MFLC counselors provided approximately 1,071,000 counseling or consultation sessions focused on child issues.

Military life is complex, challenging, and dynamic. The government and Magellan continue to conduct research and identify new issues impacting military children and families. Best practices continue to emerge or be augmented to address difficulties that may negatively impact military children’s functioning levels and wellbeing. To maintain our commitment to providing the highest level of care for our military children, Magellan has developed a voluntary certificate program for CYB MFLC counselors to:

• Build on foundational knowledge of child development theories and emotional, behavioral, and psychological challenges that may occur in each stage,
• Provide information on challenges unique to military children and how they are manifested in day-to-day living, and
• Enhance knowledge and application of evidence-based protocols to address specific internal and environmental factors that may negatively impact healthy childhood development.

The CYB Professional Certificate program is comprised of two tracks and was designed, sponsored, and administered by Magellan to meet the evolving needs of today’s military youth. MFLC counselors may complete one or both tracks depending on professional development interests and learning needs. Completion certificates are available for each track. All training modules within the program are approved for continuing education units (CEU) for maintaining counselor professional certifications.

The goals of this youth-focused counseling training program are to:

1. Develop healthy military children,
2. Reduce the probability of problem escalation to clinically significant levels and
3. Assure service and family members’ readiness and resilience.

The success of the program is dependent on MFLCs’ abilities to provide developmentally appropriate evidence-based interventions that engage and support military children, their families, and others involved in children’s lives. The CYB Certificate Program enhances the level of expertise among CYB MFLCs and the likelihood of positive outcomes among military children/families, thereby meeting or exceeding program goals and ensuring a resilient, ready military workforce.

Each year, many Americans suffer from different mental health conditions, like Major Depressive Disorder and Anxiety Disorders. Some seek help, while others deal with the negative symptoms alone. Stigma, mistrust, misinformation, fear, or socioeconomic status can prevent us from seeking help.

Addressing these negative symptoms is very important. They can affect several aspects of our lives, including work, social interactions, and personal relations.

Here are some important facts about mental health:

• In 2020, 21% of U.S. adults (52.9 million) experienced a mental health condition. ¹
• Due to COVID-19, the number of anxiety and depressive disorders grew worldwide. Depressive symptoms grew from about 193 million people to 246 million worldwide. This represents an increase of 28% in cases. Anxiety disorders grew from 298 million to 374 million, close to a 25% increase. ¹
• In the U.S., young adults ages 18 to 25 have the highest rate of experiencing mental health conditions (30.6%). They are followed by those ages 26 to 49 (25.3%) and adults ages 50 and over (14.5%).¹

Every year, Mental Illness Awareness Week occurs in the United States during the first week of October. During this week, various organizations come together to promote activities about mental health. This campaign aims to raise public awareness about mental health issues in support of individuals and families. While the week has passed, the importance of bringing awareness to this topic remains year-round.

Activities take place to increase understanding and support for those living with mental illness. The education and resources provided during this week can reduce stigma and other factors preventing us from seeking help.

These activities can include:

• Educational Events: Workshops, seminars, conferences, and informational sessions. They provide information about mental health conditions, treatment options, and strategies for managing mental health challenges. ² (NAMI | National Institute of Mental Health)
• Public Awareness Campaigns: Mental health organizations often launch public awareness campaigns using various mediums to share stories, statistics, and information related to mental health. These include social media, posters, and online content. ² (S. Department of Health and Human Services)
• Community Outreach: Local events, support groups, and community discussions are often organized to foster understanding and support among individuals, families, and communities affected by mental illness. ² (988 Suicide & Crisis Lifeline)
• Advocacy Efforts: During this week, advocacy groups champion improved mental health services, insurance coverage, and policies that support individuals with mental health conditions. ² (NAMI | National Alliance on Mental Health)
• Media Coverage: Media outlets may cover stories related to mental health, including personal stories of recovery, interviews with mental health professionals, and discussions about the importance of mental health awareness. ² (SAMHSA | Mental Illness Awareness Week)
• Sharing Personal Stories: Individuals who have lived experiences with mental illness may share their stories to help and inspire others to seek help. ² (S. Department of Veterans Affairs | Mental Health)

We can all participate in these activities every month to learn more about mental health topics, help raise awareness, lower judgment, and be mindful of others experiencing mental health challenges.

Look out for what Magellan Federal has to offer on this topic!

¹ Mental Health Statistics. (2023, March 9). Forbes. https://www.forbes.com/health/mind/mental-health-statistics/#:~:text=Worldwide%3A%20Due%20to%20the%20COVID.

² Mental Illness Awareness Week | NAMI: National Alliance on Mental Illness. (n.d.). Nami.org. https://nami.org/Get-Involved/Awareness-Events/Mental-Illness-Awareness-Week.

For more than 80 years, organizations have turned to employee assistance professionals to support their employees and people leaders dealing with issues that threaten personal wellbeing or hinder workplace productivity. Today’s most trusted expert is the Certified Employee Assistance Professional (CEAP), who is multifaceted and has a sharp focus on the Employee Assistance Program (EAP) core technology to guide their work. Here’s how and why Magellan believes obtaining a CEAP certification can benefit your professional development and help organizations receive top-tier EAP services.

What Makes Employee Assistance Professionals Unique

Fostering employee engagement and wellbeing is associated with a positive workplace culture, helps retain and attract talented employees, and contributes to higher productivity. Employer organizations have long relied on the unique blend of expertise possessed by experienced Employee Assistance (EA) professionals to support and advance their programs. Skilled EA professionals are knowledgeable in organizational culture, mental health, workplace policy, program promotion, and crisis management. They possess the ability to interact with and support all levels of the organization.

On any given day, EA professionals intervene with individual employees and family members in managing life’s challenges; furnishing opportunities for people leader development; conducting program promotion activities; and addressing organizational impacts such as preventing and coping with workplace violence, critical incident support, and crisis management. Unlike other helping professionals who often play a client–advocate role, EA professionals recognize and are bound by the principle of their dual-client relationship and maintain neutrality as well as confidentiality. EA professionals’ distinct expertise and adherence to the dual-client philosophy sets them apart from other types of helping professionals.

The Value of CEAP Certification

The Certified Employee Assistance Professional (CEAP) certification is the only EA professional credential that demonstrates mastery of the concepts and skills required by competent EA professionals. CEAP certification is a recognizable commitment to excellence and demonstrates the EA professional’s unique body of knowledge and alignment with the EAP core technology.

Voluntary certification establishes professional credibility by demonstrating the following:

• Observance of quality and industry standards
• Well-trained in your area of expertise
• Commitment to continuous professional development
• Personal drive and motivation to excel in the Employee Assistance profession

The CEAP certification process provides an evaluation of existing knowledge and skills while concurrently providing professional development. The required knowledge modules cover essential EAP components, updated industry information, exposure to international EAP, policy issues along with relevant legal issues, EAP clinical assessments, marketing, training, supervision, and program management for EAPs.

The CEAP is the gold standard in the field of employee assistance. It is the only credential that confirms proficiency in the concepts and skills required by competent EA professionals, and it is why Magellan Federal seeks to hire professionals with this designation and offer free certification for our staff. We believe that the CEAP empowers our professionals to provide exceptional EAP services to the government, our ultimate goal.

How to Become a CEAP

There are multiple pathways to becoming a CEAP, depending on your education and work experience. Many CEAPs are masters-level counselors, but there are other roles in the EA profession that do not require a counseling degree. For example, account executives, program managers, human resource professionals, and union stewards benefit from CEAP certification in their roles.  All candidates seeking initial certification should visit the Employee Assistance Professional Association (EAPA) website for more information.

The opioid epidemic is a significant public health problem in the United States. In 2021, over 75% of drug overdose deaths involved an opioid.[1] Between 2010 to 2019, drug overdose mortality rates have increased by 53% among U.S. military veterans.4 Opioids include prescription opioids, heroin, and synthetic opioids. About 150 individuals die each day from synthetic opioids. 2

Fentanyl is a synthetic opioid that has been associated with a significant number of overdoses in the U.S. It is considered to be “up to 50 times stronger than heroin and 100 times stronger than morphine”; thus, even small amounts of fentanyl can be deadly. 2 Pharmaceutical fentanyl has been prescribed for severe pain after surgery and with medical conditions such as cancer pain. Pharmaceutical fentanyl can be given as a patch, shot, or lozenge. Illegally manufactured fentanyl is found in liquid or powder form and is commonly mixed with other illicit substances or hidden to look like over-the-counter medications. Fentanyl is linked to a high number of overdoses and deaths. Between 2017 and 2021, fentanyl was involved in 52% of overdose cases in the military.5

Combating the Epidemic: Prevention and Treatment

The risk of overdose increases significantly when drugs are contaminated by or combined with fentanyl. Since it is difficult to taste, smell, or see fentanyl in other drugs, an individual may not know that fentanyl is present. Fentanyl test strips, used to detect whether fentanyl has been mixed with another drug, are available and can help prevent overdose. However, caution should be taken since these strips may not detect all forms of fentanyl, including carfentanil.2

Fentanyl is addictive and binds to the body’s opioid receptors in the brain, which control emotions and pain. Like natural opioids, fentanyl’s effects include drowsiness, confusion, difficulty breathing, unconsciousness, overdose, and death.3

How to Respond to an Overdose and Stay Informed

Individuals who use opioids as prescribed, those who abuse them, and persons in the general public should be aware of the signs of overdose as life-saving measures, such as halo one, are available. Signs and symptoms of an opioid overdose include small, constricted pinpoint pupils, loss of consciousness, slow or weakened breathing, cold or clammy skin, and discoloration of skin. When encountering someone who has overdosed, contact 911 immediately and administer naloxone when available.2

We recommend that persons using any form of opioids, and those who are likely to have contact with individuals using opioids, carry naloxone, which is now available over the counter and can be obtained at a pharmacy, through mail order, or through community risk reduction programs. Training for administering naloxone and learning about the opioid overdose epidemic is available, and additional information can be found through the VA’s Opioid Overdose Education and Naloxone Distribution Program (OEND), state or county health departments, GetNaloxoneNow, the CDC, and the American Red Cross.

The Military Health System and Defense Health Agency provide resources for opioid overdose education and naloxone distribution, including information for patients and caregivers. Additional toolkits and naloxone distribution videos are also provided by the U.S. Department of Veterans Affairs.

Resources

1. Centers for Disease Control and Prevention (CDC). “Understanding the Opioid Overdoes Epidemic”. Last modified June 17, 2021, https://www.cdc.gov/opioids/basics/epidemic.html
2. Centers for Disease Control and Prevention (CDC). “Fentanyl Facts”. Last modified September 6, 2023, https://www.cdc.gov/stopoverdose/fentanyl/index.html
3. National Institute on Drug Abuse (NIH). “Fentanyl DrugFacts”. Last modified June 2021. https://nida.nih.gov/publications/drugfacts/fentanyl#:~:text=Naloxone%20is%20a%20medicine%20that,require%20multiple%20doses%20of%20naloxone
4. Bennett, Alex S et al. “U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts.” Annals of medicine 54,1 (2022): 1826-1838. doi:10.1080/07853890.2022.2092896. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262363/
5. Myers, Meghann. Military Times. “Fentanyl deaths among troops more than doubled from 2017 to 2021”. Last modified February 15, 2023, https://www.militarytimes.com/news/your-military/2023/02/15/fentanyl-deaths-among-troops-more-than-doubled-from-2017-to-2021/

While sleep may appear to be a reward or special treat for some, it is a vital biological process that is necessary for optimal functioning.Without proper sleep, the body cannot adequately process new information, create memories, rid itself of toxic waste, restore energy, balance hormone secretion, and repair cells.  Inadequate length and/or quality of sleep can lead to both mental and physical challenges. (Nunez & Lamoreux, 2023)

Our Built In Sleep Cycle

Our master biological clock regulates physical, mental, and behavioral changes that follow a 24-hour cycle.  This process is referred to as a circadian rhythm.  Sleeping at night and wakefulness during the day is an example of the circadian rhythm.  Day light alerts the body to send messages to the brain to release hormones that promote attention, awareness, and energy.  Conversely, in the evening, hormones that produce relaxation and sleep are released.  Because the circadian rhythm is deeply rooted in our biological systems, it is difficult to sleep during the day and stay awake at night.  Even when the length of sleep is adequate, frequent awakenings and the absence of deep sleep may occur when one attempts to sleep during the day (Suni & Dimitriu, 2023).

When Life Gets in the Way of Our Built in Sleep Cycle

Individuals who work nights, early mornings, rotating shifts, or irregular hours lose one to four hours of sleep per day, as they experience problems falling asleep and staying asleep (insomnia) during non-work hours (Pacheco & Rehman, 2023). A stressful job such as a police officer (Ma et al., 2015), healthcare worker(Stimpfel, 2020) or active-duty military (Troxel et al.), coupled with non-traditional work hours, compound the problem.  One of the most often reported complaints of military members returning from deployment is a sleep disturbance.

Sleep deprivation and sleep disruption may result in consequences that negatively impact health and day-to-day functioning. Furthermore, there is a bi-directional association between sleep problems and illness, meaning that sleep problems may cause or increase symptoms of illness and illness may cause or increase sleep problems. (Medic, Willie, & Hemeis, 2017).

Short Term consequences of sleep problems consist of but are not limited to:

• Emotional distress
• Mood changes
• Problems with decision making and memory
• Problems in work performance
• Increased negative reactions to stressful situations
• Physical complaints (e.g., low level pain, cold symptoms).
• Weight gain

Potential long term consequences may include:

• Depression and anxiety
• High blood pressure
• High cholesterol
• Digestive problems
• Heart conditions
• Diabetes

Tips for Promoting Better Sleep

Many individuals do not have the luxury of changing jobs or life circumstances to resolve sleep problems.  But there some simple things you can do to increase the probability of better sleep even if your daily waking/sleeping routines are not synchronized with your natural circadian rhythm (Shriane, Rigney Ferguson, 2022).

Try making simple modifications to your daily schedule.  Some of the ideas listed below may fit better into your lifestyle than others, and some may be more effective for you than others (Suni & Dimitriu, 2023; Lammers-van der Holst et al., 2020; health.mil., 2023).

• Before sleeping, set your thermostat to a cool temperature (no higher than 68 degrees).
• Wear sunglasses on your way home from working a night shift if you plan to sleep when you arrive home. Sunlight tells your body it is time to wake up.
• Block out as much light as possible using dark shades on windows, eye masks, and turning off computers that may be emitting light.
• Block out as much noise as possible. Turn off TVs and other mobile devices, close doors, and use ear plugs.
• Spend a few minutes winding down and clearing your mind before trying to sleep.
• Avoid caffeine (coffee and energy drinks), and nicotine (cigarettes) at least 6 hours before trying to sleep.
• Avoid alcohol intake. Even though alcohol has a calming effect, it negatively impacts the quality of sleep.
• If possible, take prescribed medications at times when side effects, such as stimulating effects) won’t interfere with sleep.
• Be careful with over the counter supplements. Melatonin, a popular supplement may actually worsen sleep problems if taken at the wrong time or wrong dose.  Seek out a sleep professional for advice before using it.
• Do not eat a large meal immediately prior to sleep. The work involved in digestion may reduce sleep quality.
• Moderate exercise relieves muscle tension and promotes relaxation. Several hours before attempting to sleep, move around and stretch.

If you experience challenges falling or staying asleep for a prolonged period, and your sleep problems are causing distress and problems with daily functioning, contact your health care provider.  Sleep problems may signify other health issues.  Your health care provider can explore and address the root causes with you, suggest options that may reduce sleeping challenges, and help you get back on track.

References

Health.mil. (n.d.). Sleep Tips for Sift Workers.  https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/Real-Warriors-Campaign/Articles/Sleep-Tips-for-Shift-Workers

Lammers-van der Holst, H. M., Murphy, A. S., Wise, J., & Duffy, J. F. (2020). Sleep tips for shift workers in the time of pandemic. Southwest J Pulm Crit Care., 20(4), 128–130. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189699/

Ma, C.C., Andrew, M.E., Fekedulegn, D., Gu, J.K., Hartley, T.A., Charles, L.E., Violanti, J.M., & Burchfiel, C.M. (2015) Shift work and occupational stress in police officers.  Safety and Health at Work, 6(1) 25-29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372186/

Medic, G., Wille, M, Hemels, ME.  (2017) Short- and long-term health consequences of sleep disruption.  Nature and Science of Sleep.  9, 151-161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/

Nunez, K & Lamoreuz, K.  (2023) What is the purpose of sleep? https://www.healthline.com/health/why-do-we-sleep

Pacheco, D. & Rehman, A.  (2023) Shift work disorder. What it is, what causes it, and its potential complications.   https://www.sleepfoundation.org/shift-work-disorder

Sleep Health Foundation. (2023). Healthy sleep practices for shift workers. https://www.sleephealthfoundation.org.au/?view=article&id=1141:healthy-sleep-practices-for-shift-workers&catid=98

Stimpfel, A.W. (2020) Shift work and sleep disruption: Implications for nurses’ health.  American Nurse.  https://www.myamericannurse.com/shift-work-and-sleep-disruption-implications-for-nurses-health/

Suni, E. & Dimitriu, A.  (2023). Circadian rhythm.  What it is, what shapes it, and why it’s fundamental to getting quality sleep.   https://www.sleepfoundation.org/circadian-rhythm

Troxel, W.M., Shih, R.A., Pedersen, E.R., Geyer, L., Fisher, M.P. Fisher, Griffin, B.A., Haas, A.C., Kurz, J., Steinberg, P.S. (2015). Sleep in the military: Promoting healthy sleep among U.S. servicemembers. Rand Health Quarterly, 5(2), 19. https://www.rand.org/pubs/research_reports/RR739.html

Although 21% of U.S. adults have a mental illness, access to behavioral healthcare remains out of reach for most. From 2008 to 2019, the number of adults with any mental illness increased nearly 30%. The pandemic further exacerbated mental health problems for adults and sparked an expanding youth mental health crisis. As the demand for behavioral healthcare continues to grow, Magellan Healthcare recognizes the need to increase access.

Increasing Access to Evidence-based Care

Magellan has collaborated with NeuroFlow, an award-winning behavioral health technology company, to increase access to our evidence-based digital cognitive behavioral therapy (DCBT) programs and enhance engagement. With a history of over 20 years of research and development and an endorsement from the Substance Abuse and Mental Health Services Administration (SAMHSA), Magellan’s DCBT programs are integral components of our Digital Emotional Wellbeing program, including FearFighter® for anxiety, panic and phobia and MoodCalmer for depression. Both programs, as well as RESTORE® for insomnia and other difficulties sleeping, are available online in Spanish, further increasing access to evidence-based programs.

Understanding Digital Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a short-term intervention that behavioral health clinicians use to help individuals overcome negative thoughts and behaviors. CBT is effective for depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. CBT has been demonstrated to be as effective in certain conditions as other forms of therapy or psychiatric medications. Digital CBT (DCBT) is the implementation of CBT on a digital platform with the same core principles, language and exercises used in live practice that include:

• Learning to recognize thought distortions
• Evaluating distortions against reality
• Gaining a better understanding of others’ behavior and motivations
• Using problem-solving skills
• Developing a greater confidence in one’s own abilities
• Changing behavioral patterns
• Developing coping skills

True evidence-based DCBT follows the exact CBT process, differing from evidence-informed digital programs that use some CBT practices but are not built with fidelity to the intervention model. Learn more about evidence-based vs. evidence-informed behavioral health interventions here.

Impact of FearFighter and MoodCalmer on Mental Health

Our collaboration with NeuroFlow has yielded remarkable outcomes that underscore the power of innovative partnerships. In a recent study, members participating in the Digital Emotional Wellbeing program who completed 75% or more of FearFighter and MoodCalmer reported significant reductions in anxiety and depression symptoms within 90 days.

• FearFighter users experienced a 41% average reduction in Generalized Anxiety Disorder Assessment (GAD-7) scores, compared to other DCBT users who averaged an 11% reduction in GAD-7 scores.
• MoodCalmer users experienced a 24% average reduction in Patient Health Questionnaire (PHQ-9) scores, compared to an average 13% reduction among those who completed less of the program.

Beyond these impressive results, Magellan has seen a 124% increase in registrations after launching Digital Emotional Wellbeing over previous programs. Members also report high levels of satisfaction with the Digital Emotional Wellbeing program with 85% indicating they would recommend the program to someone else.

Visit Magellanhealthcare.com/digital-bh/ to learn more about the results and how our Digital Emotional Wellbeing program, including our award-winning DCBT programs improve anxiety, depression and more.

Sources:

• Exploring Barriers to Mental Health Care in the U.S. | AAMC
• What is Cognitive Behavioral Therapy? (apa.org)
• Satiani A, Niedermier J, Satiani B, Svendsen DP. Projected Workforce of Psychiatrists in the United States: A Population Analysis. Psychiatr Serv. 2018 Jun 1;69(6):710-713. doi: 10.1176/appi.ps.201700344. Epub 2018 Mar 15. PMID: 29540118.

FearFighter® and MoodCalmer are owned by CCBT Limited Corporation, United Kingdom. CCBT has granted Magellan exclusive rights to FearFighter® and MoodCalmer in the U.S.