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Trauma among top mental health issues in New Orleans Area

by Anitra D. Brown

It takes a great deal of self-awareness to recognize and accept that one is suffering from mental illness or an addiction. Even more courage is required to actually reach out for help. For individuals most in need of mental health treatment, those moments can be few and fleeting–offering only a small “window of opportunity” to assist people in getting the services they need to improve their lives.

And when a person who needs mental health services or addiction treatment has to make a phone call to make an appointment and then wait for the appointment date, they may never get the treatment they need, says Dr. Rochelle Dunham.

“Over 50 percent of the people we schedule for appointments don’t come in,” she says. “The people we see, they’re not using schedules.”

That’s one reason Dr. Dunham, executive director of the Metropolitan Human Services District, has been busy converting the MHSD clinics that serve residents of Orleans, Plaquemines and St. Bernard parishes to a walk-in model.

When and if a resident of any of these local parishes recognizes his or her need and reaches out to MHSD for assistance, Dr. Dunham doesn’t want waiting lists, phone calls and appointments scheduled for the future to get in the way of helping people.

“We’re gradually rolling it out; but anybody walking through the door, they have to get a service,” she says. “The phone system is still important, but you can come to this clinic right now. It doesn’t matter what the question is, they leave with an answer.”

Dr. Dunham has served as the executive director of MHSD since February 2016. Before that she was the state’s assistant secretary and medical director for the Department of Health and Hospitals/Office of Behavioral Health and the state of Louisiana mental health commissioner.

MHSD is one of 10 local human service districts/authorities operated by the state of Louisiana Department of Health and Hospitals throughout Louisiana to provide treatment for mental illness, behavioral and addiction disorders.

The district treats children and adults with mental health, addiction or disability needs in its service area. Among the services offered for adults are assessments and referrals, crisis intervention, case management, medication management, individual and group therapy, substance use treatment, as well as HIV and TB testing. Children and youth services include psychiatric evaluations/assessments, mental illness and substance abuse evaluations, medication management, diagnostic and psychological testing, psychological interventions and school-based prevention services.

MHSD also offers an array of intellectual and disability services including respite care for caregivers, nursing home assessments, crisis assistance and behavioral services.

In order to facilitate the new walk-in model that MHSD clinics are transitioning to, Dunham says front desk workers are being trained to manage walk-in clients and a psychiatrist is always on duty to see patients.

“I don’t want anyone sitting in here with their arms folded while there are people out there dying,” says Dr. Dunham. “It takes everybody owning and accepting and doing their part.”

And speaking of windows of opportunity, Dr. Dunham is seizing May—Mental Health Awareness Month—to ramp up her agency’s efforts to get the word out about the walk-in option as well as the array of services and assistance that MHSD offers to both children and adults in the three-parish area it covers.

According to the National Alliance on Mental Illness, at least one in five adult Americans experience some mental health condition in their lifetime.

In 2015-2016, MHSD served more than 26,000 adults and children suffering from mental illness or addictive disorder, according to the agency.

In addition to Algiers Behavioral Health Center at 3100 General DeGaulle Ave., MHSD operates the Central City Behavioral Health & Access Center, 2221 Phillip St.; the Chartres-Pontchartrain Behavioral Health Center, 719 Elysian Fields Ave.; the New Orleans East Behavioral Health Center, 5630 Read Blvd.; the St. Bernard Behavioral Health Center, 6624 St. Claude Ave. in Arabi; and the Plaquemines Community C.A.R.E. Center, which serves as a MHSD contractor, at 115 Keating Dr. in Belle Chasse.

Together, the clinics typically serve between 2200 to 3000 individuals a month, Dunham says.

As for the types of mental health issues most observed, trauma tops the list, she says, adding that many times individuals, especially children, are diagnosed with other disorders when they are actually suffering from trauma and that trauma often exacerbates other mental illnesses.

“Trauma is huge in Orleans Parish,” Dr. Dunham says. “In St. Bernard, Plaquemines and Orleans Parish, I would say everybody has suffered some kind of trauma with Hurricane Katrina.

She continues, “A lot of what is being diagnosed as ADHD is really trauma—post-traumatic stress disorder. Hyperactivity is a way that children address stress. Or there is the person who deals with the stress of a traumatic event by drinking and drugging. Anxiety, depression, confusion—trauma can look like all of that. There must be increased awareness that trauma is hugely problematic and contributes to a lot of behaviors.”

In March 2017 alone, Dr. Dunham says MHSD fielded more than 5,100 calls. All MHSD services are outpatient. With about 170 people on staff and many of them hired as administrative workers, partnering with other agencies such as the Vera Institute of Justice, LSU and University Hospital to leverage resources and provide the best treatment options and services to those in need is vital, she says.

MHSD also works to connect its clients with other services they might need such as food, clothing, housing and shelter, tutoring services, and even utility bill assistance, for example. The idea is that easing concerns or challenges in other areas of the client’s life makes seeking and receiving treatment for mental illness, behavioral or addiction disorders a little easier.

And leveraging resources by partnering with others become especially important in a community like New Orleans with pervasive criminal justice issues.

“Untreated mental illness and substance abuse disorders become criminal justice issues,” says Dr. Dunham. “About 70 percent to 80 percent of all incarcerated individuals—depending on whose data you look at—have a substance abuse or mental illness diagnosis or both. It’s a treatment issue . . . and a huge problem across the nation.”

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