Getting the Help We Need

Getting the Help We Need

We’ve been sharing ways to cope well during stressful and uncertain times. For the next few weeks, our Wellness Wednesday tributes go out to partner organizations who provide vital services to those struggling to cope. It’s important to reach out and get help even if a person doesn’t think they are “that bad off,” as we so often hear. Just like with other prevention measures, it is better to seek and get help early. This week’s shout out goes to Tillamook County Community Health Centers (TCCHC) and their behavioral health providers who responded to our interview.

What are the more common issues for which people are seeking help right now?

We are noticing an increase in Depression, Anxiety, Mood disorders, PTSD, and Substance Use Disorders. There is also an increase in difficulty managing chronic conditions such as health conditions like hypertension and diabetes as well as insomnia and other sleep issues, fatigue, chronic pain, stress, migraines and headaches. People are also struggling with weight concerns and behavioral challenges for children which can include ADHD.

What are some common warning signs for these conditions and how common are they? 

Warning signs can include insomnia and other sleep issues, emotional dysregulation, difficulty concentrating, increased disassociation, difficulty with organization, no or low motivation, lack of interest in pleasurable activities, irritability, increased risky behaviors, increased use of alcohol, drugs, gambling, food, etc.

Statistics cited by the National Institute for Mental Health for these conditions include:

Anxiety: 19.1% of the US adult population (23.4% are female, and 14.3% are male).  31.9% of the US adolescent population ages 13-18 (38.0% female, and 26.1% male)

Depression: 7.1% of the US adult population (8.7% female, 5.3% male). 13.3% of the US adolescent population ages 12-17 (20.0% female, 6.8% male).

Suicide: 10th leading cause of death overall in the US in 2018.  2nd leading cause of death among individuals ages 10-34, and 4th among individuals ages 35-54.

Post-Traumatic Stress Disorder (PTSD): 3.6% of the US adult population (5.2% female, 1.8% male), 5.3% in ages 45-59.  5.0% of the US adolescent population (8.0% female, 2.3% male), 7.0% for ages 17-18.

Substance use: (2018) 60.2% of the US population ages 12 and older (this includes alcohol, drugs, and tobacco). Highest use is 39% among ages 18-25.

(https://www.nimh.nih.gov/health/statistics/index.shtml)

During a study in June 2020, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation. (CDC, https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm)

Nearly half of Americans report the coronavirus crisis is harming their mental health, according to a Kaiser Family Foundation poll. A federal emergency hotline for people in emotional distress registered a more than 1,000 percent increase in April compared with the same time last year. Last month, roughly 20,000 people texted that hotline, run by the Substance Abuse and Mental Health Services Administration. (Washington Post, https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/)

Online therapy company Talkspace reported a 65 percent jump in clients since mid-February. Text messages and transcribed therapy sessions collected anonymously by the company show coronavirus-related anxiety dominating patients’ concerns. (Washington Post, https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/)

What are some of the specific services your organization provides that help individuals with these concerns?             

As behavioral health clinicians who are integrated into primary care our focus is to work with patients around improving health outcomes.  Patients are referred to behavioral health via their primary care provider, and our sessions are generally 30 minutes in length with periodic follow ups as needed or recommended.  We do refer patients to other services as needed; this can include linking with Tillamook Family Counseling Center or a private therapist. Behavioral health is intended to be a short-term consultative service, it is not intended to be long-term intensive psychotherapy.

We engage patients using motivational interviewing, cognitive behavioral therapy, focused acceptance and commitment therapy, behavior activation, and many other tools.

We have a medication assisted treatment (MAT) program for individuals with opioid use disorder; this means we have providers who can prescribe suboxone to treat opioid use disorder.  Individuals must be a patient of the clinic or be willing to establish care, they must have an assessment by the behavioral health provider before they are determined eligible for the program.  MAT participants are then seen by the prescribing provider and behavioral health clinician on a pre-determined schedule to monitor effectiveness, and address any challenges the individual may be experiencing, along with working on their individual goals.

Psychiatry services are available in our clinic; your primary care provider can consult with the psychiatrist, and if needed, the psychiatrist can provide direct services for patients (such as evaluation, follow up, medication starts or changes, and then facilitate return to your primary care provider for ongoing management). Currently this service is only available for patients of the Health Center.

What are common outcomes for people who receive these services?   

We have seen improvements in diabetes management (reduction in a1c’s), improvement in blood pressure control, medication adherence, improved nutrition, improve sleep, and improvements in depression, anxiety, weight management, and stress.

In our MAT program we have seen a reduction in use of opioids and other substances, increased education about overdose and the use of Narcan, and we have seen patients meet their goals, such as getting stable housing, stable employment, improved relationships, etc.

Are these services covered by insurance and/or do you offer a sliding scale for payment?     

TCCHC accepts all forms of insurance, including Oregon Health Plan (OHP), private insurance, and self-payments. We have a sliding fee scale and will not refuse services based on the inability to pay.

What else should people know about your services?

We are a team-based clinic that will assist you in accessing needed resources and services.  We can collaborate with other treatment facilities, and community agencies to help coordinate the care you need.

Individuals may contact us at 503-842-3900 or 800-528-2938.  TTY at 800-735-2900.

 

Caring for Our Veterans

Caring for Our Veterans

The COVID-19 pandemic has been difficult for almost everyone to navigate. Certain populations, such as veterans, may face even greater challenges under stressful circumstances. According to the National Center for PTSD, “the COVID-19 pandemic creates stressors like fear about getting sick, concern for loved ones, isolation, job loss and new childcare and family demands.” They note that many of the ways people normally cope, like eating out or going to the movies, are not an option. Without the usual coping mechanisms, it is critical that our veterans know about local care options and resources available to them.

We asked our veterans’ services advocates to share how local veterans are coping with the anxiety, uncertainty and stress of the pandemic, as well as other local and national events that are impacting people’s sense of safety and well-being.

Are you seeing any trends with veterans needing or seeking additional services during the pandemic?

The VA shut down community-based out-patient clinics for several months, only accepting urgent/emergency care, so a lot of routine healthcare was put off. This is causing delays in getting routine exams and health screenings, many of which also require transportation to Portland.  During the pandemic, there have been more interactions with veterans seeking mental health support. Stress, uncertainty and civil unrest can impact individuals with PTSD, increasing paranoia, anxiety and depression. Treatment for these conditions are often being provided through telehealth.

For many years, veterans were required to receive their healthcare at a VA clinic or hospital, which we do not have in Tillamook County. Now, under the Mission Act (formerly called the Choice Act), veterans can access local care with prior approval. Going through that approval process is a service provided by our Tillamook County Veterans Services office, located at the County Courthouse in Tillamook.

Are there common triggers or events that contribute to increased need for mental health services?

Current civil unrest is putting veterans on edge. There has also been a rise in homelessness and substance use. Like many people, veterans have been impacted by unemployment during the pandemic.  According to an article published in the Military Times, 54% of female vets have sought mental health support, compared to 31% of male veterans. It is thought that female vets are likely balancing more family responsibilities due to pandemic-related distance learning.

Job loss is a concern for veterans, whose unemployment rate was 3.5% prior to the pandemic. That rate is now at 6.4%, which is still lower than for non-military peers at 7.2%. Military training and experience may contribute to increased adaptability and a more resilient perspective during the pandemic.

What services, resources or connections does our county veterans services office provide?

The top priority for veterans services is mental health support and eliminating suicide. All Tillamook County Veteran’s Services office staff attended a recent suicide prevention training called “QPR.” Most of the time when a veteran is in a mental health crisis, they are immediately taken to Portland for specialty care.

What are some common outcomes for people who receive these services?

While outcomes differ from vet to vet, many of them are able to completely avert such a crisis. Often, they may get their medications adjusted and they are always provided follow up care to help them manage and avoid future occurrences.

How are these services covered?

Many people assume the VA is a type of insurance, but it is actually a healthcare provider. The VA contracts with other entities (Tri West in Tillamook County) to provide insurance benefits for eligible vets, under a tiered, income-based system. For example, if a veteran has a service-connected disability, they are fully eligible, while someone who is working may have coverage under their job and may be able to use their veterans benefit as a secondary insurance. Retirees on Medicare are also able to use their VA-sponsored “Tri Care for Life” benefits as secondary insurance.

The key is for veterans to get enrolled, which they can do through our local veteran’s services office.

Is there anything else we should share about veterans’ healthcare services?

When veterans go to the Emergency Department, they visit will only be covered through the VA if they are notified within 72 hours of the admission. A medical staff personnel, family member or the veteran themselves must contact the VA Notification Hotline at (844) 724-7842.

The local office also refers veterans to other services such as, CARE, Inc., Helping Hands and Habitat for Humanity’s Ramps and Rails program. They also coordinate with the PUD Light Brigade for utility vouchers and holiday baskets.

To learn more, call or visit Tillamook County Veterans Services Office, 201 Laurel Ave (Basement, Room 12), Tillamook, OR 97141, (503) 842-4358 during regular office hours. A Veterans Services Facebook page is coming soon!

To celebrate and honor our veterans, join the Veteran’s Day outreach event, Wednesday, November 11th, 10-4 pm at the Air Museum. Free admission to veterans.

AUTHOR: Michelle Jenck, Director of Community Well-Being, Adventist Health

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Finding Hope Through Service

Finding Hope Through Service

For many Oregonians, the week following Labor Day 2020 will be remembered for quite some time. The wildfires that swept across our state left devastation for families, businesses, and entire communities – many of which are still working to recover and rebuild today.

Like so many others, Tillamook County’s Director of Community Development Sarah Absher knows it is no secret that Tillamook is a generous community. A handful of locals quickly organized a dessert auction through Facebook to raise money for fire relief on Sunday, and Sarah was stationed at the Tillamook Nazarene Church on Saturday to welcome and receive desserts. As someone who is ready to dive into any project that may need help, Sarah ended up joining the Open Table event that was occurring at the same time at the Nazarene Church. As she helped serve meals to community members in need, she was acutely aware of the increasing number of community residents impacted by hunger, but she also felt gratitude and hope in the volunteers who work so passionately to fill that void.  Although this was not her initial plan for where the weekend was headed, she was touched by the experience and gave her email to the volunteer coordinator with plans to return.

On Sunday, Sarah woke up bright and early to bake a few goodies for the PNW Fire Relief Auction, an event quickly organized by Jesse Boroughs, Nichole Crossley and Kourtnie Zwald. The event was set to last 2-3 hours but ended up going for over 6 hours on Facebook with auction items being sold every 3 minutes – by the end, the community had raised over $22,000. This event demonstrated the amazing power that a community has when it comes together to support a cause. As Sarah pointed out, “It is easy to think that our actions as one individual are not enough to change the world, but each and every one of us has a unique set of skills that we can bring to the table.” She continued with the wildfires specifically, “I have no experience fighting fires, but I do have experience running an auction and I’m a halfway decent baker.” Although many of us may have felt helpless as we watched the smoke settle over the horizon, no act of service is too small to be left unappreciated. We may find that serving others not only lifts up those around us, but it also just might be the medicine our souls need to find the goodness in the world that still exists.

For Sarah, this weekend of service lifted a burden from her chest and restored a feeling of hope. “I am speechless and humbled, and thankful that my path crossed with so many wonderful humans over the course of the weekend. What it also reminded me is that we are all special, gifted people in our own ways, and that it takes all of us working together to overcome the challenges we face.”

AUTHOR: Ariel Slifka, TCW AmeriCorps VISTA

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

Help is Here, Now.

Help is Here, Now.

We’ve been sharing ways to cope well during stressful and uncertain times. For the next few weeks, our Wellness Wednesday tributes go out to partner organizations who provide vital services to those struggling to cope. It’s important to reach out and get help even if a person doesn’t think they are “that bad off,” as we so often hear. Just like with other prevention measures, it is better to seek and get help early. This week’s shout out goes to Tillamook Family Counseling Center.

What are some of the more common issues for which people are seeking help right now?

Anxiety, depression, substance use, trauma history, and becoming overwhelmed by family demands.

What are some common warning signs for this condition? 

Warning signs vary. Common warning signs include: struggles with decision making, limited problem solving skills, trouble managing relationships with others, substance use, challenges managing stress, and difficulty managing employment.

Are there statistics that show how common these challenges are?

There are many statistics that illustrate how common these challenges are. According the National Institute of Health 7.1% of adults have at least 1 depressive disorder in the United States. And, according to the National Institute of Health there is an estimated 19.1 percent of the United States population that have had an anxiety disorder in the past year.

What are some of the specific services Tillamook Family Counseling Center provides that help individuals with these concerns?             

  • Individual, family, and group counseling                                                                            
  • Medication management      
  • Peer support services                                                                                                                                                                                                                                  
  • Substance use disorder treatment                                                                                                   
  • Crisis services and support
  • Developmental disabilities services and supports
  • Parenting services and supports

For more details visit our website: https://tfcc.org/

What are some common outcomes for people who receive these services?   

People gain the ability to manage anxiety in ways that are not harmful, improvement of depressed mood, improved quality of relationships, improved communication skills, and the improved ability to manage stress.

Are these services covered by insurance and/or do you offer a sliding scale for payment?     

Yes, our organization is recognized by most insurance providers and we are part of the Columbia Pacific Coordinated Care Organization (CPCCO). Columbia Pacific Coordinated Care Organization is the entity that manages health benefits for the Oregon Health Plan. Our organization also has a sliding scale fee system available for individuals without health insurance.

How has COVID-19 impacted services?

The Tillamook Family Counseling Center is continuing to offer services during the pandemic. Most of the visits are being done remotely through telehealth or by phone. In-office services are very limited at this time and primarily targeting individuals with very challenging behavioral health issues. Crisis services are available 24/7 and can be accessed by phone and mobile response.

We’ve been sharing ways to cope well during stressful and uncertain times. For the next few weeks, our Wellness Wednesday tributes go out to partner organizations who provide vital services to those struggling to cope. It’s important to reach out and get help even if a person doesn’t think they are “that bad off,” as we so often hear. Just like with other prevention measures, it is better to seek and get help early. This week’s shout out goes to Tillamook Family Counseling Center. Click on the link below to learn more. (Italics will only appear in the social post teaser)

What are some of the more common issues for which people are seeking help right now?

Anxiety, depression, substance use, trauma history, and becoming overwhelmed by family demands.

What are some common warning signs for this condition? 

Warning signs vary. Common warning signs include: struggles with decision making, limited problem solving skills, trouble managing relationships with others, substance use, challenges managing stress, and difficulty managing employment.

Are there statistics that show how common these challenges are?

There are many statistics that illustrate how common these challenges are. According the National Institute of Health 7.1% of adults have at least 1 depressive disorder in the United States. And, according to the National Institute of Health there is an estimated 19.1 percent of the United States population that have had an anxiety disorder in the past year.

What are some of the specific services Tillamook Family Counseling Center provides that help individuals with these concerns?             

  • Individual, family, and group counseling                                                                            
  • Medication management      
  • Peer support services                                                                                                                                                                                                                                  
  • Substance use disorder treatment                                                                                                   
  • Crisis services and support
  • Developmental disabilities services and supports
  • Parenting services and supports

For more details visit our website: https://tfcc.org/

What are some common outcomes for people who receive these services?   

People gain the ability to manage anxiety in ways that are not harmful, improvement of depressed mood, improved quality of relationships, improved communication skills, and the improved ability to manage stress.

Are these services covered by insurance and/or do you offer a sliding scale for payment?     

Yes, our organization is recognized by most insurance providers and we are part of the Columbia Pacific Coordinated Care Organization (CPCCO). Columbia Pacific Coordinated Care Organization is the entity that manages health benefits for the Oregon Health Plan. Our organization also has a sliding scale fee system available for individuals without health insurance.

How has COVID-19 impacted services?

The Tillamook Family Counseling Center is continuing to offer services during the pandemic. Most of the visits are being done remotely through telehealth or by phone. In-office services are very limited at this time and primarily targeting individuals with very challenging behavioral health issues. Crisis services are available 24/7 and can be accessed by phone and mobile response.

If you are interested in services provided by Tillamook Family Counseling Center call (503)842-8201 or (800)962-2851.

Connections Are What Count

Connections Are What Count

Between COVID-19 and the wildfires, Tillamook County has seen its fair share of challenges this year. Yet Jody Bell, who was born and raised in Tillamook, is proud of how the community has stepped up to support those in need. She points out that within the first 24 hours of the stay-at-home order this spring, three separate Facebook groups had formed: one for making masks, one for those who needed extra support, and one for organizing the volunteers who could help. This immediate response to community needs was also seen more recently with the wildfires when the local fire command center and evacuation shelter received more donations than they could even use. As Jody reflected, “That is Tillamook in a nutshell. We take care of each other.”

As we all try to adapt to the continuation of COVID-19, it is important to remember that for many of us, the impacts of COVID-19 still weigh heavily. For Jody, who uses a powerchair to move around downtown, the closure of local businesses and handicap restrooms, along with the risk of COVID-19, has limited her ability to leave her home. Some of us may have noticed that many places have closed their bathrooms to the public due to the pandemic, but this has also severely impacted the already few handicap restrooms that are available. The addition of the wildfires also added another difficulty for those who have limited mobility – how do you quickly gather necessary items and organize transportation for an evacuation while using a powerchair?

Jody has faced these challenges head on and continues to look for opportunities to engage with others even when following physical distancing guidelines. Although her favorite coffee shop has closed their indoor seating, she has more recently been able to spend time at Tangled Yarns, a local craft store where community members can share crocheting projects and tips on Friday afternoons. Jody has found crocheting to be a stress-relieving hobby that also provides the opportunity to give back to the community – she has so far donated 17 hats to victims of the fires in southern Oregon.

Despite this coping strategy, the most difficult aspect of COVID-19 for Jody has been the isolation and the loneliness that comes with living on her own during a pandemic. Although her cat Tilly responds to emotions, she is unable to provide the human interaction and conversation that we all need in order to thrive. Jody emphasized the importance of utilizing video chat functions or even just making a quick phone call instead of sending a text message. With months of physical distancing, checking in on each other through a vocal conversation can make a world of a difference in providing genuine care or support. She also highlighted the reality of many of us feeling lonely or depressed and the difficulty of reaching out for help, which is why someone else making the first move can be critical. Therefore, Jody urges people to reach out to their neighbors: “Any disability can be very isolating which is where I encourage community members – if you have a neighbor with a disability and you haven’t seen them in a while, check on them and commit to stopping by every once in awhile just to say hi. These connections are what count.” The community members of Tillamook County have shown their ability to step up for each other during a crisis, and as COVID-19 continues, let us all reflect on the power we each have in building these essential connections. 

AUTHOR: Ariel Slifka, Tillamook County Wellness AmeriCorps VISTA

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.

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How to Build Resiliency During a Crisis

How to Build Resiliency During a Crisis

How’s your heart? No, I don’t mean that organ working so hard to pump life throughout your body. I mean that space inside your chest, that vast space that holds your tenderness, grief and sorrow. These are overwhelming times. Dr. Cornel West recently said, “we would be numb if we weren’t wrestling with despair.”

As this year has unfolded, I have found my own heart wrestling with much despair. The pandemic exposed so many issues around racism and health equity. Black, Indigenous, Latinx and other People of Color have been disproportionately impacted by COVID-19. According to the COVID Racial Data Tracker (a partnership between The COVID Tracking Project and the Center for Antiracist Research), Black people are dying due to COVID-19 at 2.3 times the rate of white people. In Oregon, Black people are 2% of the population, but 4% of the cases; Native Hawaiian and Pacific Islander people are less than 1% of the population, but 2% of cases; American Indian or Alaskan Native people are 1% of the population, but 3% of cases; and Hispanic or Latinx people are 13% of the population, but 43% of cases. To give a comparison for context, white people make up 84% of Oregon’s population, but 49% of cases. These numbers reveal the racial inequities within healthcare, as well as the many other interwoven systems of our society, both historical and current, including—housing, employment, education and the legal system.

My anguish multiplied as this year continued the legacy of state-sanctioned violence towards Black people in so many cities across our nation. The brutal murder of George Floyd brought feelings of hopelessness and despair, and I know I am not alone.

I knew I needed to find a way to stay resilient during these times. My first step was recognizing that my feelings of despair and overwhelm are there because I care. My heart breaks because I have let myself be open to the suffering of others. I know that numbness is not my way out of this; continuing to feel more, not less, is the path to staying resilient.

I also have to allow myself to self-protect. I sometimes need to take a break from the news. I know I cannot respond wisely from a place of agitation. I have to respond from a place of calm and care.

I do my best to stay engaged and remember hope–the hope that is rooted in the mystery and uncertainty of it all. I know that both optimism and despair can give us the illusion that we already know the outcome (It’s all going to be fine! or It will continue to get worse!) and that can lead to apathy. Instead, I work to stay in that place of “wise hope” or “active hope” that is rooted in I don’t know and urges me to continue working to end racial inequities and racism. Because it feels the pain of others, my own heart is uplifted, and that helps me stay engaged.

The poem “Clearing” by Martha Postlethwaite brings me a sense of clarity as I find my way on this journey. Perhaps it will also help guide you if you are wondering or feeling stuck on your own path towards making the world a better place.  

Do not try to save
the whole world
or do anything grandiose.
Instead, create
a clearing
in the dense forest
of your life
and wait there
patiently,
until the song
that is your life
falls into your own cupped hands
and you recognize and greet it.
Only then will you know
how to give yourself
to this world
so worth of rescue.

AUTHOR: Sara Todd, Licensed Social Worker at Rinehart Clinic

For more local health and wellness information, follow Tillamook County Wellness on Facebook, Instagram and Twitter.