This article is co-written by Elizabeth Duprey, LMHC.

Domestic violence, also known as intimate partner violence, is not about violence; it is about control. It is a pattern of behavior a person uses in a relationship to gain and maintain power and control over an intimate partner. Domestic violence is not just physical. It can be sexual, emotional, economic, psychological, and technological. These behaviors intimidate, silence, isolate, and manipulate another person. The common denominator is that all these areas can be used to dominate over another.¹

Domestic violence is a pervasive problem worldwide, including in the United States, and affects approximately 10 million people in the US every year. One in four women and one in nine men are victims of domestic violence. Since 2015, over 100,000 domestic violence cases have been reported in the military. However, most instances are not reported. ²

In addition, domestic violence cases can go unnoticed. Abusers and victims can go to great lengths to keep the abuse a secret for various reasons. Abusers will often engage in tactics such as coercion, threatening, manipulation, physical violence, and more to keep victims from exposing the abuse. On the other hand, victims of domestic violence may feel guilty, ashamed, scared, helpless, and/or hopeless, which can create barriers to exposing the ongoings of the abuse. Recognizing warning signs of domestic violence, understanding barriers to reporting, and dispelling common myths are important steps in helping a victim of domestic violence.

Warning Signs of Domestic Violence Victims

Domestic violence warning signs in the military can often be overlooked due to several factors, such as Permanent Change of Stations (PCSs), limited knowledge of support services, little understanding of healthy relationship counseling/education, financial dynamics within a military family, and limited reporting.

Signs of physical abuse

• Bruises, black eyes, busted lips, marks, sprained wrists
• Excusing aggressive behaviors
• Reports of aggressive behaviors: Yelling, physical violence, having personal property damaged
• Wearing clothes that cover the face, neck, and arms when the weather, cultural, or personal norms cannot better explain it
• Reactivity to loud noises
• Significant absences or tardies to daily activities

Abusers often work to isolate victims, such as by controlling what they do and who they talk to. They may use jealousy or concern as a rationale. Abusers may also prevent victims from getting or keeping a job and/or limit their access to money.

Signs of isolation and mental abuse

• Little access to social network
• Withdraws and isolates self from family and friends
• Cancels appointments or meetings at the last minute
• Drops out of activities they would usually enjoy
• Absenteeism at work
• Limited access to resources: communication devices, money, vehicles
• Checks in often with the abuser; the abuser calls the victim several times to find out about whereabouts

The following warning signs should be considered in context. They indicate something is wrong, and with some more context or in conjunction with the signs listed above, may be a sign of domestic violence.

Other warning signs

• Tired, lethargic, poor sleeping
• Trouble concentrating
• Agitation, anxiety, or constant apprehension
• Depression/sadness
• Feelings of hopelessness
• Low self-worth
• High levels of stress reported related to home life
• Excessive privacy concerning personal life or intimate partner

Barriers to Reporting

Many victims of domestic abuse in the military have reported various barriers to reporting abuse, most notably a lack of confidence that the situation will be dealt with adequately and financial barriers. Other barriers include but are not limited to fear of retaliation, limited access to resources, fear of outcome, lack of counseling services, limited insight into community support services, fear of not being believed, and limited access to legal counsel.

There are some notable differences between the military and civilians regarding reporting domestic violence in the military. With its rule-based system, the military adheres to its chain of command, influencing how domestic violence is reported. Reporting domestic violence in the military has traditionally allowed commanding officers the responsibility to address domestic violence reports with judicial administrative or other types of punishments for both domestic abuse and violence. Although corrective action is directed at the abuser, it can often negatively impact the victim, creating more difficulties for the victim than the intended support. One of the most significant reported barriers is the victim’s concerns over the financial impact due to most military families being single-income families. ³

Domestic Violence Myths

Dispelling myths about domestic violence can help remove some of the obstacles to helping.

1. MYTH: There is a typical profile for a domestic violence victim.  

FACT: Anyone can be a victim, regardless of age, background, community, education, military rank, culture, ethnicity, sex, ability, etc. That said, women are more likely to be victims. In the military, victims are more likely to be women and civilian spouses of active-duty personnel.⁴

2. MYTH: Victims lack self-confidence and are too weak to stand up for themselves or escape the situation.

FACT: Power and control behaviors can be hard to notice at the beginning of a relationship and may not be apparent at all. Over time, the abuser seeks increasing control, and due to the reasoning and rationale offered for the abuser’s actions (manipulation and gaslighting), victims may not recognize it, may dismiss it, or may believe it is themselves that needs to change. In this way, even the strongest and most confident people can become victims.

3. MYTH: Victims behave in a way that leads to violence against them. 

FACT: Remember that domestic abuse is not about violence but about power and control. Due to the dynamic of power and control, violence in relationships is never equal. One person is always the primary source of power, control, and abuse. Victims who fight back or even instigate violence do so as a result of this unequal dynamic or may be trying to diffuse a situation. However, the abuser may use instances of this behavior to blame the victim and defend abusive retaliation.

4. MYTH: If the abuse were bad, the victim would report it or leave.

FACT: The most violent outbursts and anger often occur when victims seek freedom, such as defending themselves, asking for more access to resources, countering manipulative reasoning, or trying to escape.  Leaving an abusive relationship can be dangerous; 75% of domestic violence-related homicides occur at that time.⁵

As long as the victim is passively agreeing with the parameters and perceptions of the abuser, the relationship will be smooth.  But when abusers perceive they are losing control of the intimate partner, they may escalate violent behavior in an attempt to regain power.  When there are children involved, the question of leaving becomes more complicated.  Some abusers threaten to hurt the children.

5. MYTH: Reporting abuse or leaving may be dangerous, but the victim may also not accurately perceive the abuse as bad as it is. 

FACT: Because of the slow and manipulative nature of emotional and psychological abuse, victims may believe they are the problem or excuse the abuser’s behavior. After particularly violent behaviors, when both parties know a line has been crossed, the abuser often shows remorse, promises change, and attempts to cater to the victim for a while. The victim may believe the relationship is improving, be reminded of why they fell in love with the other to begin with, and often negate thoughts of reporting or leaving during those times.

How to Help a Victim of Domestic Violence

Military OneSource

The military recognizes the negative impact of domestic violence and has been working to address the issue in various ways. The military notes that more must be done to support victims. In 2021, the Department of Airforce (DAF) noted an objective to create more “confidence in leadership and enhance survivor support capabilities.” They have taken a sharp stance, stating, “There is no place in our Air and Space Forces for domestic violence or interpersonal violence in any form.” DAF notes that they will explore the implementation of various support services to promote the trust and needs of victims. DAF reports wanting to “make improvements to the application process for transitional compensation for abused dependents, which in certain circumstances provides economic support, medical, and on-base, privileges to eligible survivors of domestic violence.”

The U.S. Army has identified the importance of comprehensive assistance for victims of domestic abuse, crisis intervention, risk assessment, safety planning, medical treatment support, counsel on legal rights and Judicial proceedings, and resources and referrals to local community support centers. Other military branches have also taken on the responsibility to make changes that will allow ease of reporting, confidence that action will be taken, and supporting victims.

Magellan Federal Solutions and Support

Magellan Federal’s assists the Department of Defense in delivering the Military Family Life Counseling Program (MFLC). Magellan Federal counselors are embedded at various installations and schools nationwide and overseas to offer non-medical psychoeducation, consultation, and referrals to service members and their families. In the schools, they teach about healthy relationships to youth so that they can recognize signs of abuse before entering a committed relationship. With service members and spouses, the MFLC program supports resiliency and healthy relationships; MFLCs teach emotion regulation, communication, conflict management, and decision-making strategies that have been shown to impact relationships and reduce domestic abuse positively (RAND Study, 2021). Moreover, Magellan Federal is proud to offer pilot programs in partnership with the MFLC program that directly supports couples and family resiliency.

A large-scale study by RAND Corporation suggested that the Armed Services can benefit in reducing and preventing domestic violence by focusing on awareness, support, education, diversification of services, and more emphasis on identifying risk factors. They also noted “the importance of having other organizations outside of FAP help in supporting Domestic violence victims.” The MFLC program is one of those other organizations. Magellan Federal MFLCs can provide psychoeducation to prevent military dependents and single service members from entering abusive relationships, and they are well-trained on risk factors and identification of domestic abuse, making them an excellent resource for intervention.

Tips for Helping a Victim of Domestic Violence

Historically, the general public’s view of domestic violence is that conflicts between a couple are personal, and it is not appropriate to intervene. As we learn more about the power dynamics and how difficult it is to get out of this situation by oneself, it becomes clear that we must dispel this notion and learn how to help.

1. Increase your situational awareness by learning the warning signs and dispelling myths.

• If you see something, don’t be afraid to communicate concern respectfully: “I am concerned about your safety….”, “I am noticing…”

2. Support the victim with respect.

• Be supportive, letting them know they are valuable and deserve to be treated with respect and dignity.
• Listen without judgment. Be patient, kind, and respectful. Understand that the victim may have ambivalent feelings due to the illusion that it is getting better during periods of peace. Alternatively, the reality of the abuse, especially if it is verbal or emotional, may not be readily evident to the victim. There may also be fear of retaliation or change. On average, a victim of domestic violence will leave the abuser and return approximately seven times before completely breaking away from that relationship.
• Offer supportive words such as “This is not your fault…” “I believe you.”

3. Be familiar with local and federal resources.

• Help a victim connect to local domestic violence support and learn about the local domestic violence centers near you. Some domestic violence centers will offer free Mental Health counseling services for victims of domestic violence.
• Connecting the victim to local resources. Providing resources such as case management can be an integral part of ending domestic violence. Victims often don’t have access to finances, personal documentation, clothing, housing, or other important resources.
• Safety planning with an advocate, domestic violence therapist, or case manager.

There is still work to be done to break down the perceived barriers to reporting in the military. Since domestic violence is about one person seeking power over another, help from community sources is imperative for the safety and wellbeing of the victim. The military has made great strides in addressing the problem of domestic violence through implementing more resources and engaging in victim support, including Military OneSource and the Military Family Advocacy Program. Magellan Federal is proud to help those impacted by domestic violence by delivering our expertise through our victim advocacy and family support services. Together with the government, our programs add an extra layer of protection, intervention, and prevention from domestic violence for our service members so that they may be empowered to take action to improve their overall wellbeing.

References:

1. https://www.justice.gov/ovw/domestic-violence
2. https://www.ncbi.nlm.nih.gov/books/NBK499891/
3. https://www.military.com/
4. National Coalition Against Domestic Violence. https://ncadv.org/
5. https://stoprelationshipabuse.org/educated/barriers-to-leaving-an-abusive-relationship/
6. Kendall, Frank. (January 23, 25, 2023). [Letter from Secretary of Defense Frank Kendall to Department of the Air Force (DAF), 2023]. Retrieved from https://www.af.mil/Portals/1/documents/2023SAF/PolicyUpdates/Domestic_Violence_Message_to_the_Force.pdf
7. Miller, Laura L., Dmitry Khodyakov, Joachim O. Hero, Lisa Wagner, Coreen Farris, Katie Feistel, Emily Dao, Julia Rollison, Rosemary Li, Jamie Ryan, Stephanie Brooks Holliday, Laurie T. Martin, and Amy L. Shearer, Domestic Abuse in the Armed Forces: Improving Prevention and Outreach,RAND Corporation, RR-A1550-1, 2023. As of October 4, 2023: https://www.rand.org/pubs/research_reports/RRA1550-1.html

Elizabeth Duprey, LMHC, is a MacDill regional supervisor and has been with Magellan Federal since 2020, when she started as a school MFLC. Born in Fayetteville, NC, Elizabeth was a “military BRAT” who traveled with her family and even lived overseas. Elizabeth is passionate about providing MFLC services to our service member and their families, as she understands the pressures of military life. Elizabeth received a bachelor’s degree in psychology from Florida Atlantic University and a Master’s in Counselor Education from Florida Atlantic University before becoming a Licensed Mental Health Counselor. With a great passion for helping people, Elizabeth has worked in the field of domestic violence, substance abuse, and juvenile rehabilitation. She now has the honor of working to provide support for military service members and their families.

In her free time, Elizabeth enjoys traveling and photography. She notes both traveling and photography allow her to see the world from a different perspective and to gain a greater appreciation for the differences that make people and places special.

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.

As October comes to a close, so does the monthly observance known as National Disability Employment Awareness Month. This year’s theme selected by the Office of Disability Employment Policy was “Advancing Access and Equity.” According to the Autism Society, adults with Autism are represented in every field of employment.

In this Q&A article featuring Dr. Amy Latta, a psychologist advisor for Magellan Healthcare, we explore the question – is Autism a disability?  Dr. Latta shares her thoughts on this question below.

Q: Is autism considered a disability (from social, legal, and medical viewpoints)?

Dr. Latta: The medical and legal perspectives both view Autism as a disability. The disability is created when the individual’s impairments (social communication and social interaction, as well as restricted interests, behaviors, or activities) interfere with daily functioning.

In contrast, a social perspective views the individual with Autism as “neurodivergent”  or having a brain style that is simply different from the average or “neurotypical” person in society.  From this perspective, Autism is not a disability. The disability is created by society’s lack of acceptance of an individual with a different or “neurodivergent” brain style. Within this framework, as society becomes more inclusive of persons with Autism and adapts better to their needs, the disability fades.

Q: How do you discuss neurodivergence with a child with autism?

Dr. Latta: If you ask a group of children to draw a person enjoying something fun, do you think all the pictures will look the same? Would anyone’s drawing be the “right” drawing or the “wrong” drawing? That is neurodivergence. It means everyone’s brain functions differently. There is no right or wrong way.

Q: Please briefly outline state government disability benefits people with autism can take advantage of.

Dr. Latta: Social Security Administration’s (SSA) administers the Social Security Income (SSI) program, which provides financial assistance to children and adults with Autism. In order to meet eligibility for SSI, there are income limits and medical requirements (e.g., symptoms of Autism need to be severe enough).

Q: How does getting disability benefits differ for children and adults (especially for parents with teens about to turn 18 – do they need to go through the process of conservatorship before the 18th birthday or will their child need to show financial responsibility, such as a job or paying rent, to get the full amount of disability)?

Dr. Latta: A child (under age 18) with Autism may qualify for Social Security Income (SSI) if the symptoms of Autism are severe enough and the parents’ income does not exceed the income limit. The income limit increases with each additional child under age 18 in the family.

Once a child with Autism turns 18, the parents’ income is no longer counted (even if the child is living at home) in the calculation for SSI benefits.

If a child is going to turn 18 and needs help making life decisions as an adult, the family may want to consider providing support to the child after age 18 through guardianship, conservatorship, or power of attorney. Guardianship and conservatorship are more involved legal processes so the family will want to start this process six months before the child turns 18.

Guardianship: A trusted adult is court-ordered by a judge to make decisions on behalf of the individual. There are full and partial guardians. A full guardian can make decisions about all areas of an individual’s life. A partial guardian can make decisions about select areas of an individual’s life.

Conservatorship: A trusted adult is court-ordered by a judge to make decisions about financial affairs only.

Power of Attorney: Is a legal document that authorizes a trusted adult to make decisions about the individual’s property, finances, or medical care. Under a POA, the individual still retains the right to make decisions on his or her behalf.

National Healthcare Quality Week, observed on October 15 to 21, celebrates the many healthcare quality professionals who tirelessly work toward ensuring that quality service is delivered. This week is also a time to spread awareness of the importance of quality healthcare services and create policies that facilitate the safety of both patients and healthcare professionals.

In honor of National Healthcare Quality Week, we’re spotlighting Magellan Health’s Allie Kelley, quality specialist. Some of Kelley’s responsibilities to ensure quality healthcare include managing certain member notifications, generating internal reports for customer requirements, and assisting with EAP record requests within our Employee Assistance Program (EAP) provider network. Continue reading to learn more about Kelley’s work in healthcare quality:

What sort of projects are you currently working on?

I am brand new to the responsibility of running a Quality Improvement Activity (QIA) so I’m learning responsibilities such as barrier analysis, which examines limitations or obstacles to the efficiency of a process or desired outcome, investigating root causes, developing, and discussing interventions, and ongoing monitoring are my biggest tasks right now.  I am very excited about how this process can improve the level of service we provide to our members. It is awesome to have different department leaders come together to talk about barriers and interventions to improve identified metrics and then be able to measure the success of these interventions.

Why is Magellan Health the best place to do this project?

Magellan’s values include integrity, accountability, knowledge, collaboration, caring, creativity, and results. Every one of those values is critical to the success of any QIA. Leadership also shows great support of the overall QI department, and ultimately Magellan as a whole.

What are your thoughts on the culture here at Magellan?

I have been a part of Magellan Health for 25 years and have had the opportunity to work in many different roles. I have seen this company grow in the healthcare industry, and I have never once doubted how much Magellan cares for and believes in their employees. Magellan has been an industry leader when it comes to diversity, equity, and inclusion, and offering comprehensive employee benefits.

Beyond that, the member lives we cover, especially the most vulnerable populations, have always been the most important thing to me in every position I’ve held here. Magellan’s philosophy and mission have always aligned with this. Positively influencing the health and wellbeing of our members has always been a top priority throughout this organization.

How did you get involved with the Healthcare Quality field?

My heart and my passion have always been with our members and working to make sure they are receiving the best care possible. I am a social worker at heart, so when I read the job description for my current role, it was very clear to me that the role in a strong Quality Department is not at all separate from what my mission in the clinical department had always been! I became excited about the possibility of stepping out of my comfort zone while keeping in mind what I came here to do, which is to help people.

What are some of the most challenging and rewarding aspects of working in Healthcare Quality?

Some of the more challenging aspects have been learning the more technical side of things, while the most rewarding part of being in this department has been being a part of a team so committed to integrity, accountability, and data driven results. This is demonstrated in the preparation of the annual Trilogy documents, where everyone on the team comes together to work toward a common objective. Trilogy is our annual evaluation of the QI Program that evaluates outcomes, reviews effectiveness, assesses goal achievements, evaluates the deployment of resources, documents, and trends input from advisory groups. Seeing that final document come together was amazing. I was so proud to have contributed to that and we are getting ready to do it all over!

What does Healthcare Quality Week mean to you? Is there anything else you’d like to highlight about Healthcare Quality?

Healthcare Quality Week to me is a time to raise awareness of the positive impact healthcare quality professionals have in our organizations and communities. At Magellan Health, healthcare quality is organized around the positive influence of the health and wellbeing of individuals by identifying gaps in care and service, improving clinical outcomes, assuring patient safety, and adding value through efficiency. In healthcare quality we’re also focused on enhancing services and the individual’s experience of care. We also work to assure that all core business processes are innovative and meet or exceed contract, regulatory, and accreditation guidance while leading to system and cost efficiencies.

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.

This year’s theme for National Case Management Week is keeping the person at the heart of collaborative care. Celebrated the week of October 8-14, we’re recognizing the crucial role of case managers on healthcare teams. These individuals have the important responsibility navigating the complex healthcare system to facilitate care coordination and connecting members to the resources they need.

We’re spotlighting Valerie Lees, senior care manager for Magellan Behavioral Health of Pennsylvania. Lees is responsible for reviewing and approving mental health and substance use disorder services for members across five Pennsylvania counties and assisting providers with patient discharge, planning, and care coordination to provide the member with direct assistance.

Continue reading to learn more about what Lees does as a case manager and what National Case Management Week means to her:

What exciting projects are you currently working on as a case manager?

I’m excited to be part of a few very active and ongoing projects. One of them focuses on increasing care coordination, especially for those members in any kind of 24-hour level of care. Care coordination involves meeting with our 24-hour level of care treatment providers and in these meetings, we brainstorm, discuss, and collaborate on ways to assist the member to increase their community tenure. We look at many different factors, from the members’ clinical needs to their social needs.

I’m also working with a co-worker on presenting a trauma training that will be presented to all Magellan staff. This is an area of interest of mine and it’s great to be part of educating and learning about topics like trauma informed care and best practices for members who have experienced trauma.

Lastly, myself and other members of the 24-hour level of care team at Magellan will take part in a volunteer project at a local shelter in Lehigh Valley where we will be preparing and serving lunch for the shelter’s residents. It’s a wonderful opportunity to connect with the community.

Why is Magellan Behavioral Health of Pennsylvania the best place to do these projects?

Magellan has a large skilled and diverse staff, working with so many talented people does create the best environment to work on projects. Many of our members have complex needs that go beyond the clinical realm and it’s nice to have so many talented people come together to find new ways to help improve the quality of care our members receive and ultimately the quality of their lives.

What are your thoughts on the culture here at Magellan Behavioral Health of Pennsylvania? How has that culture had an impact on your projects?

I think the culture is truly one of connection and collaboration. I have always had the sense that everybody that works here, no matter what they do in what department, has a shared goal to improve the care and quality of our members lives. The Magellan managers are always encouraging my colleagues and I to think outside the box. I feel very supported in that way. It’s really a culture where projects can thrive because of this out-of-the-box thinking where people’s voices are heard.

October 8-14 is National Case Management Week. How did you first get involved with case management and what are some of the challenges and rewards of working in this field?

I started in case management when I worked in inpatient psychiatric hospitals. I met with case managers there who were discharge planning for patients and started meeting with case managers from different insurance companies as well. I started collaborating with them quite a bit, that’s when I really got a taste of case management. Ultimately, the goal is always to collaborate and figure out different ways to help people. I think that case management goes beyond just supporting people with their mental health or substance use disorder challenges, it’s all encompassing. A case manager looks at the whole person. So not only are we looking at what we can do treatment wise for any mental health challenges or substance use disorder challenges that a member may have, but we’re also looking at their social determinants of health issues as well.

What does it mean to be a case manager? Is there anything you’d like to highlight about this field for National Case Management Week?

To me it means that I get to collaborate and help people, which is what I’ve always wanted to be able to do. Being able to collaborate with people in other departments at Magellan allows me to learn new ways to assist our members. I also really enjoy collaborating with other case managers, social workers, nurses, etc. outside of Magellan. The entire process is very rewarding and fulfilling for me.

The theme for National Case Management Week this year has to do with keeping the client in the center of what we do and that’s something that I completely agree with. I see that happening every day here at Magellan and it’s an honor to be a part of it.

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/

The first full week in October, organizations are taking the time to recognize and celebrate their employees in customer service. Customer Service Week is an international celebration that highlights the importance of customer service and those individuals who serve and support customers daily. We’re spotlighting four Magellan Health employees who share why they chose to work in customer service, and some of their most rewarding and challenging aspects of working in this field:

• America Phinsee, care worker
• Kimberly White, outreach and engagement specialist
• Edward Daduya, supervisor, customer care
• Chelsey Aguilar, customer experience associate

Continue reading to learn more from America, Kimberly, Edward, and Chelsey on their experiences working in customer service:

Why did you want to pursue customer service and what is the most rewarding aspect of working in this field?

America: I pursued a career in customer service because I have a genuine desire to help others in a way that directly impacts their personal or professional life in a positive way. The most rewarding aspect of working in this field is going above and beyond for our members and being able to hear the joy in their voice when you deliver good news to them.

Kimberly: Customer service chose me. I have always been in a role of wanting to help people find resolutions, that is the most rewarding outcome. Being that person who gets someone the help they need and hearing the satisfaction on the other end is very rewarding.

Edward: I decided to embark on a career in customer service because of my passion for assisting individuals and resolving their concerns. The most gratifying aspect of this profession is being given the chance to make a positive change in our customers’ lives. It’s truly fulfilling to recognize that I have the capacity to aid customers in addressing their challenges and leave them with a favorable perception of our company.

Chelsey: I personally pursued customer service because I genuinely enjoy problem solving and providing service that can initially resolve issues or concerns for people seeking answers. It is crucial to understand the importance of customer service because delivery of customer service can have a major impact in someone’s life.

What are some challenges you face in this profession and how do you overcome them?

America: My biggest challenge in customer service is not knowing the answer to a question, sometimes agents are caught off guard and simply can’t answer a complex question. However, the best way to overcome this challenge is to put yourself in the member’s shoes. Ask yourself what information you would need if you were the member; then you will be able to anticipate the questions, you will find the answers, and be ready when the questions arise.

Kimberly: As much as I would like to say that every call is a success, it’s not. Sometimes it’s hard to connect with people. Some people just want to vent and are not going to be happy with me, my company, their health plan, or even themselves. In those situations, it’s my responsibility to not take it personally, to listen more than I speak, be empathetic, ask questions, and try to do everything I can to get some sort of resolution on the call. At the very minimum set up a tone so when we do talk to them again, it might be a better experience for them.

Edward: The realm of customer service often presents challenges stemming from diverse factors, including managing clients, addressing intricate problems, and striving to meet elevated service standards. To surmount these obstacles, I place an emphasis on active listening, empathy, and proficient communication. Furthermore, I maintain an ongoing commitment to training and supporting my team, ensuring they possess the requisite skills to adeptly navigate these complexities.

Chelsey: The biggest challenge that I face in this profession would be incoming calls that relate to customer grievances. It’s important to listen to the caller, learn from the mistakes, and if possible, resolve the caller’s concerns. Callers need to be reassured that they are valued, and their time is important. We can build trusting relationships with our callers by initiating a safe space for callers to voice their concern and then proactively taking the steps to get a resolution for the caller.

Is there anything you’d like to highlight about working in customer service?

America: I believe that what we do is very important. We assist our members, and their loved ones to find adequate mental health. Some calls with members are better than others, but we must always show empathy and compassion. It helps to remember that our members are looking to us for assistance and when we deliver the help, our members can get their life back on track.

Kimberly: It’s not always the easiest but there is always satisfaction in helping others. I always try to remember the phrase about how important listening is, “How can we help people if we do not listen to the problem first?”

Edward: Customer service extends beyond addressing customer issues; it involves cultivating enduring relationships. It offers a platform to embody our company’s principles and showcase our unwavering dedication to customer contentment. This dynamic domain presents a diverse array of experiences, where each day brings new challenges and continuous opportunities for learning.

Chelsey: Essentially working in this field can help you become a more mindful person because customer service can help shape individuals to be more aware of their approach and delivery to others’ concerns.

What does Customer Service Week mean to you?

America: Customer Service Week means this is the time in which we recognize, appreciate, and celebrate those on the front line, for without them, there would be no human connection over the phone.

Kimberly: It means a time for me to be happy and reflect on the impact I make within my organization and be recognized for it.

Edward: Customer Service Week holds a special significance for me as it serves as a dedicated occasion to honor and commemorate the steadfast commitment and diligent efforts of our customer care team. It acts as a powerful reminder, emphasizing the importance of the customer experience in our organization and aligning seamlessly with our foundational company values. This week is a time of reflection, celebration, and renewed commitment. It serves as a testament to our dedication to customer satisfaction, embodying our company’s values at every step of the way.

Chelsey: Customer Service Week is a time to appreciate all of those who provide services to others. Whether it’s a phone call to your insurance rep, the grocery store clerk, or the person behind the check-in desk, take the time to thank those who help you!