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Presentation Q&A
Presentation Q&A
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Video Transcription
So, Lisa, let me talk to you about some of the questions we've received. So, one person wrote in and let me know that the CDC has changed the age for colon screening to an earlier age, so people may want to check in on that, both for themselves and for their patients. Another thing that people are writing in about is that there's a nice string throughout your presentation around peer support. And people want to know if there's any limit to what area you wouldn't use a peer support in terms of health promotion. You know, it's a really interesting question. And the important thing I think to remember is that, you know, peer support oftentimes is the ability of an individual to connect with another individual about something they have in common, you know, and so traditionally peer support has been about people with lived experience of mental illness working alongside others to work with individuals with living the experience of mental illness to provide that support and a mutual understanding of things. For me personally, there are, professionally from our research, we have not found a lot of areas where peer support is not valuable. The caveat that I would say to that is people need to have a certain amount of knowledge. And so while living with diabetes, for example, gives an individual insights into management of that illness, feelings related to it, consequences and progression, that doesn't necessarily mean that that experience alone translates into them being a good technical discussion. And so what we've tried to do is to provide supportive materials, fact sheets, things like that to our peer support workforce and help them understand, you know, what principles of better health management are that everybody should engage in. So I don't feel that. We've used peer support in all of the interventions. We've had peer supporters work with us at the health fair where they were trained to talk about all of the stations, whether it was BMI to cholesterol. We actually used nurses in recovery to do some of our cholesterol and A1C testing because nurses were just better at it than pretty much everybody. We've used peer supporters for medication adherence, for HIV testing, over on the infectious disease side. And so I feel that that's an enormously influential area. You know, you're always going to find one area where it maybe encounters different kinds of obstacles, but I would say that would be the exception. Wonderful. Another person has written in and asked, how could they find out when the next WAM training is? The best thing to do for the next WAM training would be to contact National Council. If you would like to go through the WAM section of their website, we'd probably have that listed. The other thing that I would encourage people to do is they could visit the UIC website in full disclosure and listen to the podcast, go through the facilitator guide, and maybe look at those materials. They are very parallel to the training that National Council does. Again, we did a research project, and as we all know, sometimes those can look slightly different. But they're very translatable to the National Council training. And so you could really get a sense of whether it would be a good fit for your program and what it would be to put some facilitators out as a workforce for WAM. Terrific. Another individual wrote in, a little bit long, so let me read this to you. Unemployment is rather bad for your health, as we know. Has there been any focus on how to help people achieve employment or employment at a higher level among healthcare staff to increase a person's overall mental health and physical health? Are there things we can do to improve this? So I think this person's asking about the relationship between thinking about employment as part of the overall plan to improve both mental and physical health. I would say, well, I don't know if absolutely is the right answer to the question. I would say unquestionably there's a relationship between employment and health in bi-directional relationship. Work can create stress and other factors that can have a negative impact on your health. If you're in a stressful job, you might have higher blood pressure some days. You might be dumping those cortisol hormones that create that nagging belly fat for a lot of people. And so stress, as it relates to work, can be a real problem. We also know in some adherence projects, employment could create an obstacle if a person has a demanding medication where it makes them drowsy or it has some other physical symptom or that they want to be more private about a medical condition that they have. We've done research about people with HIV who said, quite frankly, that the reason they wouldn't go into the workforce was because they didn't want to disclose their HIV status or be found out or have to use medications on the job. And we've worked with people, again, to try and frame that as an opportunity for recovery and discussion about managing something like HIV in the workforce. The other thing I think about it is work promotes a little structure. It gives you more access to resources, more social support. And so having people reenter the workforce can be enormously, positively influential on their health. Many people also report that if they're using substances, they can't go to work high or drunk. And so sometimes the structure and the responsibility of being in the workplace is something that will positively affect their substance use. I would say among people with serious mental illness, unquestionably the ability to be in the workforce or if you're participating in a supported employment like an individual placement or support or IPS type of program, there should be a focus on health. And in previous research we did at the center and many others that was funded by SAMHSA, the Employment Intervention Demonstration Program, it's an older study now, but I think the outcomes are lasting. We found that people with medical conditions in addition to their mental health condition were less likely to be in the workforce. And maybe the attribution isn't that their mental illness is the barrier. It might be their physical illness that's really the barrier there. And so I think employment programs have an enormous opportunity. We are starting to examine our data from our longitudinal health study, not just by putting people into traditional demographics like the women or people of color versus not. We're starting to look at people based on their program type, whether they're in a sort of community treatment program, whether they are in the IPS program to see if there's something that we can inform those service programs about health where they can make some progress with clients. Great. We have time for one more question. What resources do you recommend to motivate youth who have comorbid conditions? It's a real struggle for youth 15 years old with mental illness and obesity, diabetes, other health conditions. Any evidence or places where this person can find resources? So for youth, like transitional age youth. Yes. For transitional age youth, there's a number of places that you can reach out to and just know that this is something we at our center at Threshold, the place I usually recommend people starting is the SAMHSA and NIDILRR-funded Rehabilitation Research and Training Center on Young Adults and Transition Age Youth, which is at the UMass Medical Center. That's led by Marianne Davis and Marsha Ellison and a number of other researchers who work specifically with this population. They do a lot of employment, but they also do a lot of health. There's a woman you can Google. Her name is Michelle Mullen. She has some materials. Some of those are focused on employment, but they have health components. You could reach out to me and I could connect you with individuals at Thresholds for our youth and young adult programs like MindStrong and Emerge that are trying to address these issues. There's been some pilot research done in the use of nicotine and electronic decision-making about nicotine use and smoking. That was conducted by a woman named Mary Brunette, who is a psychiatrist at Dartmouth in concert with Thresholds. Then you could look at some state initiatives that have gone on. We have a program, for example, here called First Illinois, which is all about people who are at higher risk for first episode or psychosis, early psychosis. They're incorporating a more wraparound type of service programming around people. Then I think just medically, we all have to look at one another, whether we're psychiatrists, psychologists, nurses, whoever we are. As people come into treatment for first episode or early onset or the first stages of their experience with the mental health system, we should be talking to them about their health now. This is where, I guess, the health literacy component of our research we're hoping has some influence. What do we tell young people about if you choose to take a medication? What's your informed choice? What are long-term things that could happen? Here are models that we could offer you to try to prevent those things. I would say, if anything, our prevention presence needs to be much more aggressive, much more tailored to the lifestyle of the population, and not just, here's an example tool of how you can do healthy eating, and to really work with people in how to implement these health-promoting behaviors in addition to their symptom management for mental illness, and in addition to some of the health risks that treatment of mental illness can introduce if that's something they're using. Thank you so much, Lisa. That has been a wealth of information. I can see from the question box that this has been a really hot topic. We appreciate your talk today.
Video Summary
In the video, Lisa discusses some questions and topics raised by viewers. One person mentioned that the CDC has changed the age for colon screening and Lisa suggests checking in on that. Another question was about the use of peer support in health promotion and Lisa explains that peer support can be valuable in many areas as long as the peer supporters have the necessary knowledge. Lisa also mentions that peer support has been used in interventions such as health fairs, medication adherence, and HIV testing. There is a question about finding out when the next WAM training is, and Lisa suggests contacting the National Council or visiting their website. The relationship between employment and overall mental and physical health is discussed, including the impact of work-related stress on health and the benefits of structure and social support in the workplace. Lisa also mentions that focusing on health is important in employment programs, especially for people with serious mental illness and comorbid physical health conditions. Finally, Lisa provides resources for helping youth with comorbid conditions, including the SAMHSA and NIDILRR-funded Rehabilitation Research and Training Center on Young Adults and Transition Age Youth, as well as various programs and initiatives focused on youth mental health and wellness.
Keywords
CDC
colon screening
peer support
WAM training
employment and health
Funding for SMI Adviser was made possible by Grant No. SM080818 from SAMHSA of the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, SAMHSA/HHS or the U.S. Government.
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