Todays Date:
Inspiring Success on the Road to Recovery

Monday, December 3, 2018

Fighting Stigma

By Mercy Care Staff

It’s a warm mid-October day when Gabriel Maytorena takes his place in front of an imposing television camera that would intimidate most people. But, Gabriel just smiles calmly. The cameraman from Telemundo, one of the Valley’s Spanish-language television news stations, adjusts the camera to just the right angle. He tests the microphone to make sure it captures Gabriel’s every word. Then, as the camera starts rolling, he asks Gabriel about his experience living with mental health disorders.
Gabriel explains how he felt when he was first diagnosed with bipolar disorder, anxiety, depression and schizophrenia at the age of 12.

It was overwhelming. Confusing. Uncertainty about the future washed over him.

He talks to the cameraman about how he copes with his mental illnesses. And, he talks about why it’s important for others to also share their stories.

“I first realized how important it was to share my story when I was introduced to a community of my peers,” Gabriel said. “Instead of being cautious of me, they welcomed me whole-heartedly into the community.”

One of the young men in the community that Gabriel joined at that time had just died by suicide. He realized early on how stigma around mental illness can contribute to those types of outcomes.

To those people who may harbor shame about their mental illness, Gabriel encourages them to instead fight the stigma.
If they don’t fight stigma then “the battle is already lost,” he said.

“It’s going take as many individuals as the community can muster, at their full potential, to get close to getting rid of stigma,” Gabriel said. “Every action, every thought, every person matters.”
Being involved, fighting stigma is part of Gabriel’s mission.

He’s a member of various leadership and advisory groups, including Mercy Care’s Youth Leadership Council. He’s talked to lawmakers about the importance of continuing to fund behavioral health programs. And, he’s working on developing leadership training events for other youth experiencing mental health problems as a way to fight stigma.

Stigma: What is it and how can it hurt people?

The National Alliance on Mental Illness (NAMI), the grassroots mental health organization dedicated to improving the lives of the millions of Americans affected by mental illness, describes stigma this way:
“Stigma is when someone, or even you yourself, views a person in a negative way just because they have a mental health condition. Some people describe stigma as a feeling of shame or judgement from someone else. Stigma can even come from an internal place, confusing feeling bad with being bad.”

Navigating life with a mental health condition can be tough, and the isolation, blame and secrecy that is often encouraged by stigma can create huge challenges to reaching out, getting needed support and living well.”

NAMI’s website offers some insight into the damaging effect of stigma, and how we can learn to avoid and address stigma. Here are some of stigma’s effects:

People experiencing mental health conditions often face rejection, bullying and discrimination. This can make their journey to recovery longer and more difficult.

Mental health conditions are the leading cause of disability across the United States.

Even though most people can be successfully treated, less than half of the adults in the U.S. who need services and treatment get the help they need.

The average delay between the onset of symptoms and intervention is 8-10 years.

Suicide is the second leading cause of death of youth ages 15-24 and the tenth leading cause of death for all Americans.

Stigma and suicide

Mercy Care and its employees are committed to fighting stigma. We sponsor and participate in many community events to raise awareness about mental health and stigma, including the NAMI Valley Walk, Mental Health Night with the Phoenix Mercury and the Art of Recovery Expo. We participate in ongoing training, such as Mental Health First Aid and suicide awareness training called safeTalk.

And we support suicide prevention efforts through training and partnership with community organizations.

Heather L. Brown, Mercy Care’s Prevention Administrator, works to raise awareness about the intersection of suicide and stigma.

There is so much stigma out there about talking about mental health in general. But, then, consider suicide, which is especially hard to discuss, based on cultural, religious, and societal views.

“Part of the work we do in raising awareness about the public health issue of suicide is encouraging people to talk more openly and honestly about suicide, because it's the best way to ensure they will get help when they need it,” she said. 

She knows there are so many people that want to help, but may not know what to say or do.
“Stigma unfortunately prevents us from helping sometimes because we are worried about the consequences of talking about suicide. For the person who's thinking about it, they are not sure who they can trust to take them seriously, who will not judge them for what they are thinking about, and most importantly, who will help them,” she said. 

She noted that sometimes the people who want to help avoid asking about suicide because they think they're going to give someone the idea, or say the wrong thing, or that it's none of their business.

“Ultimately, we have to risk being helpfully nosey and asking the direct question in order to save lives,” she said. “Using the word "suicide" takes away its stigma, and lets persons with thoughts of suicide know that you are someone who cares and who takes things seriously. People who are thinking about suicide are often suffering in silence, and often don't get the help they need. It's time we all make a commitment to make suicide prevention our business.”

Stigma: How can we fight it?

All of us in the mental health community need to raise our voices against stigma. Every day, in every possible way, we need to stand up to stigma.
If you’re not sure how, here are nine ways NAMI’s Facebook community responded to the question: “How do you fight stigma?”

Talk Openly About Mental Health

“I fight stigma by talking about what it is like to have bipolar disorder and PTSD on Facebook. Even if this helps just one person, it is worth it for me.” – Angela Christie Roach Taylor

Educate Yourself and Others

“I take every opportunity to educate people and share my personal story and struggles with mental illness. It doesn’t matter where I am, if I over hear a conversation or a rude remark being made about mental illness, or anything regarding a similar subject, I always try to use that as a learning opportunity and gently intervene and kindly express how this makes me feel, and how we need to stop this because it only adds to the stigma.” – Sara Bean

Be Conscious of Language

“I fight stigma by reminding people that their language matters. It is so easy to refrain from using mental health conditions as adjectives and in my experience, most people are willing to replace their usage of it with something else if I explain why their language is problematic.” – Helmi Henkin

Encourage Equality Between Physical and Mental Illness

“I find that when people understand the true facts of what a mental illness is, being a disease, they think twice about making comments. I also remind them that they wouldn’t make fun of someone with diabetes, heart disease or cancer.” – Megan Dotson

Show Compassion for Those with Mental Illness

“I offer free hugs to people living outdoors, and sit right there and talk with them about their lives. I do this in public, and model compassion for others. Since so many of our homeless population are also struggling with mental illness, the simple act of showing affection can make their day but also remind passersby of something so easily forgotten: the humanity of those who are suffering.” – Rachel Wagner

Choose Empowerment over Shame

“I fight stigma by choosing to live an empowered life. To me, that means owning my life and my story and refusing to allow others to dictate how I view myself or how I feel about myself.” – Val Fletcher

Be Honest About Treatment

“I fight stigma by saying that I see a therapist and a psychiatrist. Why can people say they have an appointment with their primary care doctor without fear of being judged, but this lack of fear does not apply when it comes to mental health professionals?” – Ysabel Garcia

Let the Media Know When They’re Stigmatizing

“If I watch a program on TV that has any negative comments, story lines or characters with a mental illness, I write to the broadcasting company and to the program itself. If Facebook has any stories where people make ignorant comments about mental health, then I write back and fill them in on my son’s journey with schizoaffective disorder.” – Kathy Smith

Don’t Harbor Self-Stigma

“I fight stigma by not having stigma for myself—not hiding from this world in shame, but being a productive member of society. I volunteer at church, have friends, and I’m a peer mentor and a mom. I take my treatment seriously. I’m purpose driven and want to show others they can live a meaningful life even while battling [mental illness].” – Jamie Brown

Read the full blog at https://www.nami.org/Blogs/NAMI-Blog/October-2017/9-Ways-to-Fight-Mental-Health-Stigma


Mercy Care Complete Care Member Services representatives are available to help you Monday through Friday, 7 a.m. to 6 p.m. Just call 602-263-3000 or toll-free 1-800-624-3879 (TTY/TDD 711).

Mercy Care RBHA Member
Services at 602-586-1841, toll-free at 1-800-564-5465 or (TTY/TDD) 711. Representatives are available 24 hours a day, 7 days a week.

National Alliance on Mental Illness  |  www.nami.org
      Check out NAMI’s Cure Stigma Campaign at www.curestigma.org

Mental Health America   |  www.mentalhealthamerica.net

Suicide Prevention Lifeline  |  www.suicidepreventionlifeline.org

American Association of Suicidology  |  www.suicidology.org/

Behavioral Health Crisis Line  602-222-9444

Taming Your Inner Two-Year-Old: The Ego

By Carla Giglio, LMSW

We often hear a lot of talk about the ego. Once known as a foundational and integral piece of the human psyche, the ego has come to be known as an internal dragon that needs to be slayed at all costs. Death of the ego is often the ultimate goal for serious spiritual seekers looking to breakthrough to their divine, authentic self.

For every day folks who may not want to embark on a disciplined meditation practice or to ingest ayahuasca in the Amazon to (temporarily) slay their ego, we still have to contend with our ego at every step of our lives. How we decide to interact with our ego and how much power we give our it is the real objective.

Good or bad? 

Instead of looking at ego as a noun, and something that is, it may be helpful to look at the ego as a verb, and the function it performs in our life. Ego can serve as a protector, negotiator, mediator and an insulator. The way we need to look at ego is, “Is my ego helping or hurting me?” “Is my ego serving me or am I serving my ego?”

Learning to discern the ego is the first step. You can begin to identify when ego is in the driver’s seat by being aware of certain feelings that arise when it  is threatened or doesn’t get its way — just like a bratty little two-year-old that wants what he wants when he wants it.

When you feel like you are being made to be “wrong” in a situation, you will get angry, feel belittled or feel like you don’t deserve being treated a certain way, the ego’s hackles immediately go up and goes into fight mode. You will either want to retaliate with words, actions or getting “even.” Even if this is not a conscious dialogue in your head, your behavior will be taken over by a sense of inner justice for your “self” versus the other.

The ego always wants to see itself as “good” — having done, looked and acted good, yet that’s not always the case. The ego has a hard time admitting it has done something “bad” — especially in relation to hurting others.

Ego doesn’t like looking bad, it can justify its actions as a way to keep up our facade of looking and feeling good. When we truly learn to identify our ego and challenge its ways, we begin to live more of an authentic life. A life inspired by our authentic self.

In recovery we have to contend with all the wrong, shameful and hurtful things we did in the throes of addiction. Acknowledging and owning it all is not an easy task, but it is critical to the health of ego and the growth of “self.”

Shame and disappointment need to be allowed to seep into your ego, rather than your ego repelling shame because it is too painful to face. We learn from owning our shameful moments and move on.

You don’t need to stay in shame, but you will if you don’t contend with it properly. Just because we do “bad” doesn’t mean we are “bad.”

A transaction with an unhealthy ego may sound like this: “It’s no big deal that I stole his liquor, he wasn’t drinking it anyway. What does it matter?”

A healthy ego may sound like this, “Stealing is wrong, and I don’t condone it for any reason. I was in a bad place at the time and need to apologize to him.”

When your ego accompanies you during the recovery process, it is helpful to realize it may not always be rooting for YOUR best interest. It is important to learn to discern between your ego’s voice and your true, inner voice. How? By sharpening the skills of learning healthy introspection. By learning to distinguish between the ego and its need to be good and of the inner self, who possesses a clearer, truer, compass for your well-being.

When your ego gets “checked” you may feel belittled, angry, humiliated or threatened and ego’s reflex may be to attack back and lash out. Instead, when you feel like your ego is being checked, run the scenario through the lens of your inner self, and ask yourself:

  • Does what this person is saying have any validity? Why? Why not?
  • What about what they said is making me so -------?
  • What about this statement is triggering me to feel this way?
  • What can I learn from this?

Learning to keep ego in check means the ability to realize the lens in which you may be looking at a situation may be tainted by ego’s needs, and not what’s best for YOU, the person. An unhealthy ego does not like to take in new information because that means ego was lacking, and it does not like to feel inadequate.

Learning to discern the ego’s voice from your true, inner voice or authentic self is a skill. But learning to check your ego can make a very significant difference in your life. When led by your ego, new information can be easily shut out, and opportunity for real growth missed. When you soften your ego or push it aside, new perspectives can be seen, and new choices can be made. A healthy ego should be fluid and ever changing. Ego should be adjusted to be a framework, not a shield.
Ego work is a lifelong journey that requires mindfulness, being in the present and aware. By being conscious, you can empower yourself to turn the ego dragon into an ally and friend.

Carla Giglio, MSW, is a counselor turned Recovery Coach, NLP and Hypnotherapy trained, an advocate and pre-coach for entheogenic life healing and Associate Adjunct Professor at Grand Canyon University. 

Her practice is in Scottsdale and she can be reached at TheRecoveryCoachPhoenix@gmail.com and 718-710-9890.

Native Americans Don’t Need to Fight Drug and Alcohol Addiction in Silence

There’s a quiet struggle that remains across the Indian reservations across North America. Within these sacred boundaries of ancient and coveted traditions, lies a community whose cries are loud but only seem to echo a whisper amongst the mainstream. While the news headlines boast a sustained economic rebound as well as escalating job growth and GDP in the United States, it hardly scratches the surface in the tribal communities.

What is evident — an emotionally impoverished nation amongst indigenous peoples. Not in culture, in fact they bear some of the richest heritage. Then again, they are America’s first people. But their strength in rituals is silently overshadowed by the pain that exists from ongoing drug use prevalent in the community. Native Americans struggle each day to fight drug and alcohol addiction, but lack of resources is the overwhelming culprit to a less than desirable response.

Alcohol Addiction and Drug Dependency in Tribal Nation Well Above Other Populations
SAMHSA (Substance Abuse and Mental Health Services), the CDC (U.S. Centers for Disease Control) and other government agencies monitor and assess alcohol and drug use across the country each year. They weigh increases and decreases, trends, and segment use by age, gender and community.

For decades, evidence shows that Native Americans have a higher rate of substance abuse with correspondingly dangerous consequences to emotional, mental and physical health.

Root Causes for Addiction in Native Indian Population Include Neuroscience

Scientific and medical research case studies have long documented many underlying causes for drug and alcohol misuse and prolonged dependency. Some of the reasons include environmental circumstances (living in poverty or physical, emotional or sexual abuse, poor sustenance), sudden and traumatic life event (death of a loved one, divorce, or injury) as well as a genetic predisposition (familial, generational use). But there is another component to these layers of causation that increase the need or craving for use in Native Americans.

Physiology and Addiction to Sugar

The human is designed to function collectively with the body reacting to the messages sent by the brain. Within our mind is an area that responds to how we feel pain and perceive it. Through neurotransmitters, we are able to deal with pain by our natural ability to deflect it as much as possible, through our pleasure and pain center. It might sound strange but to some degree we are meant to withstand a certain level of pain. However, of course, we prefer the sensations related to pleasure.
The typical American diet includes the consumption of sugar. Even if you’re careful and choose not to eat processed sugar, many of our common foods include sugar such as breads, pasta, yogurt, milk, and more. Our bodies process complex carbohydrates in the same manner as they would a spoonful of sugar. When ingested, sugar ignites our pleasure center, much like alcohol and drug intake. Some people can process this more effectively than others.
For Native American peoples, by sheer genetics and physiology, there is a heightened risk for substance abuse. As with all chemical dependency, over time, the body and brain health are compromised, opening the door to a host of other issues adversely affecting physical and mental health.

Diabetes, Kidney Failure and Cancer Leading Chronic Diseases in Native Americans

According to the CDC, SAMHSA, IHS (Indian Health Services) and other healthcare agencies, the people who live on our reservations and those of indigenous descent have a greater risk in developing these medical conditions.

Living with purpose is an important element to experience a passion for life. But unfortunately, for generations, many Native Americans live in substandard environments and without the necessary financial resources or health services to effectively identify behavioral health issues.

Poor diet that lacks in proper nutrition will also diminish proper brain function, further igniting the cravings for sugar. The body also processes alcohol like sugar. Because there is an imbalance, causing an increase in stress and inflammation to the body, cravings for alcohol become more evident fueling more use.

When the body can no longer process sugar effectively, diabetes can occur. Alcoholism harms liver and kidney function. The Native American community has twice the rate of diabetes compared to Caucasians in the U.S., with diabetes also at the root cause of kidney failure in two out of every 3 Native Americans.

Diabetes, left untreated, can lead to blindness, loss of extremities, limbs and life. The suffering is often unbearable and limited resources in Maricopa County were the disconnect between those that needed help and viable solutions available. But change is not only on the horizon, it has arrived.

Outreach to Native American Communities Is Crucial to Change the Cycle

Chris Cohn, Founder of Scottsdale Recovery Center, announced the treatment center’s partnership with Arizona state’s Indian Health Services this month. Persons of tribal nations can seek relief from drug and alcohol addiction, as well as treatment for mental health conditions (common with addiction) at the Center, simply by acknowledging their culture, verifying their insurance coverage and starting the process online.

Time is of the essence. The youth of our reservations exude a hopelessness that’s seemingly contagious. While we’ve seen as escalation in the incidences of attempted and realized suicides from teenagers in this country, the numbers in Native American communities of adolescent and young adult suicides are alarming.

Beyond the Shame and Stigma, Addiction Recovery Touches Community
Drug and alcohol addiction has no boundaries and hurts households, neighborhoods and counties across North America. The destruction is swift, yet silent, and indigenous communities have known this long before the opioid epidemic ever began.

Find Out More about Addiction Treatment Services for Native Americans Here

Talk to Someone Who’s Been There. Talk to Someone Who Can Help. Scottsdale Recovery Center holds the highest accreditation (Joint Commission) and is Arizona’s premier rehab facility since 2007. Call 866-893-1276.

Content for Scottsdale Recovery Center and Arizona Addiction Recovery Centers created by Cohn Media, LLC. Passionate and creative writing and broadcasting, covering the following industries: addiction rehab, health care, entertainment, technology and advocate of clear communication, positivity and humanity at its best. www.cohn.media

The Real Presence

Br Dr. Dina Evan

Ho Ho Ho! Thought I’d start this column with a few of those because this era has brought so much stress and so very few ho, ho’s, we could use a few right now. It has also fine-tuned my antenna with reference to the importance of real in my life. Even with the people I love the most, I find superficial agonizing. I feel myself yelling inside, “Don’t you know we are running out of time, and this moment is precious. Stop the busyness and come connect with me.
Let me hold you and tell you how loved you are, what you have contributed to my life and my character.” Maybe it’s because I am old or ill, but it feels as if every moment should mean something, but the truth is I have always felt that way, because ultimately, we all get to this place where we look back to see what we have accomplished and what there is yet to do. We don’t need to wait until the end of our lives, we can do that each year, in fact, we can do that each day.
This feels like a perfect time to pause and reflect on this past year, to remember both the challenges we have overcome and the missteps from which we may still be learning. We can look at our promises made and broken, our intentions left unfulfilled and those we fully fulfilled. We can look at the times we were terrified, but still, took a deep breath and stepped into every challenge and great adventure. And equally as important, the times we stepped back in doubt, forgetting the Universe always has our back.

So how do we get to real? 

For me, it’s about telling the truth, even when it’s not comfortable or it reveals a flaw in us that we are working on. It’s about staying attentive and present to the things we may not want to know or hear — and understanding that by doing so we are pushing our souls forward into being who we really want to be. Real is about being flexible and open to possibilities and probabilities without compromising our integrity or truth.
Being present doesn’t have to mean we end up always somber or serious. It can also mean we are filled with outrageous joy and happiness and are willing to embrace it fully without holding back, releasing the fear that we will lose it if we don’t hold on tightly. I promise you that right behind that next challenge there is always another moment of unbridled joy if you are present and awake.           

Life unfolds, moment by moment, in the present. But so often, we are not in any of those moments. We are either dwelling in the past with regret or shame, or future-scaping with worry and fear. We lose time as we allow it to rush past unnoticed and lost. We are squandering the precious seconds of our lives as we worry about the future and ruminate about what's past. "We're living in a world that contributes in a major way to mental fragmentation, disintegration, distraction, decoherence," says Buddhist scholar B. Alan Wallace.
So my point is that maybe this, isn’t a time for presents, but rather a time for more presence. It’s a time to do more, to love more, to conquer more fear and be profoundly present to our purpose and path. It’s a time to express our appreciation to those who have chosen to dance with us in this incredible experiment. That way, at the end of every year we can look back and say, I did what I came here to do and I became who I came here to be.

Think about it! 

Nothing is more important and that is why we have put up the tools and the exercises you need that will help you in addition to our video series. Now most of the time when you read that line the next one is how much it costs. Well here is our present to you, IT COSTS NOTHING!
We ask only for your time and commitment and the promise that you will join us in helping to wake the world up by sharing the information with those whom you love. It’s our present and presence to you and we give it with great joy and love.

Just go to DrDinaEvan.com    Happy holidays to all.

Savor the Precious Moments

Savor the Precious Moments

The longer I am on this earth, the more I realize the importance of savoring the moments — they are passing by too quickly. This year was filled with many gifts, starting with a deeper commitment to my recovery, followed by new friendships; a stronger bond and connection with my sister and brother; a trip abroad, yet along with all the highlights, there was the loss of four friends, who I loved and cared about deeply. One moment here, the next not. The people who are new in my life and those I’ve lost — have all helped and guided me on my recovery road.

When I drank and used, the only people who mattered to me were the ones who could buy or supply the drink or drug that I craved. Friends and family who knew me in those days called me a loose cannon, a walking target for something really bad to happen, and somehow I was spared my life. I was given one more chance to get it right at exactly the right moment. Too scared to live or die, with “outside” help (perhaps my biggest precious moment) I leaped into sobriety head on.

I’ve said it before, the first commitment I ever made and kept has been to sobriety. Through all the good, bad, sadness, grief, laughter or love, I cannot stay sober without honoring that commitment every day, night and minute in between.

We’ve all heard when the student is ready the teacher arrives. To my teachers, I am grateful. I’ve learned from you the meaning of integrity, honesty, ethics, morals and truth. I’ve learned how to listen, forgive, and have compassion. I’ve learned gratitude is more than being thankful, it’s way bigger than that. Thank you for allowing me to fulfill my purpose on this amazing journey we are on together.

Happy Holidays.

This issue is dedicated to the memory of my friends
Ben Gallaway, Bob Maynard, 
Christopher Kennedy Lawford and Bill Forrest.  
Thank you guys for being in my life and for the precious moments.

Sunday, November 4, 2018

Living Our Purpose

The Path to Achieving Miracles and 
Providing Lasting Hope  

By Aaron Wilson, MD, Chief Medical Officer, Sierra Tucson

I distinctly remember the first time I drove through the gates of Sierra Tucson and experienced an overwhelming feeling of belonging. If the towering peaks of the Santa Catalina Mountains and the lush desert encompassing me weren’t captivating enough, certainly the sign that greeted me — Expect A Miracle — on the ascending driveway, was. At that moment, I knew that I was somewhere exceptional, a place complementary to my deepest professional ambitions.

It was in medical school where I came face-to-face with my professional destiny. As a student at Tulane University in New Orleans in 2005, I found myself in the middle of one of this country’s worst natural disasters — Hurricane Katrina.  Along with my fellow classmates, I was surrounded by the devastating wake of one of the most infamous weather catastrophes in recent U.S. history.

With an opportunity to provide support to those traumatized by the disastrous event and its aftermath, I felt a deep satisfaction as our teams were deployed to assist. There were untold numbers of individuals suffering from mental health challenges, and I found myself ardently driven to assist in any capacity. Five years later, and the explosion in the Gulf of Mexico of the British Petroleum drilling rig, Deep Water Horizon, affirmed my calling. I, again, had the opportunity to serve this same community stricken by overwhelming loss and trauma.

And now, all these years later, I have the distinct privilege of continuing my service and commitment to community as the Chief Medical Officer at one of the premier residential treatment facilities in the country. At Sierra Tucson, I am not only applying my many years of experience attending to the behavioral and mental health care of people in high-impact emergency zones in the service of our residents, but I’m also in a unique position to see, meet, and hire other similarly driven and passionate professionals, all with their own stories of why they chose one of the toughest, yet most rewarding, branches of the medical profession.

I am happy to announce that, since joining Sierra Tucson in March, over the last seven months we have added seven experts to our elite medical team here at Sierra Tucson, each nationally and internationally recognized specialists in their respective practice areas:

  • James Seymour, MD, Director of Trauma Recovery Program 
  • Jerome Lerner, MD, Director of Executive and Licensed Professional Program 
  • Jasleen Chhatwal, MD, Director of Mood Program 
  • Brandon Yates, MD, Attending Psychiatrist, Mood Program 
  • Janaka Sarathchandra, MD, Attending Psychiatrist, Desert Flower 
  • Donnie Sansom, MD, Medical Services, Attending Physician, Addiction/Co-Occurring Program 
  • Janet Tinkey, DNP, PMHNP-BC, Psychiatric Nurse Practitioner, Desert Flower  

Why I am so certain of their place at Sierra Tucson is because of their unwavering dedication to our signature integrative mental health approach and their heart for recovery. In addition, they all subscribe to our ‘less is more’ approach to medication management and will continue to champion Sierra Tucson’s Prescribing with Purpose movement.

For all of us, whether we are new to Sierra Tucson, or long-time veterans, this is truly a unique time in our 35-year history. We are experiencing unprecedented expansion to meet the growing demand for the care we provide. In April, we broke ground on a new 30,895-square-foot Behavioral Health Inpatient Lodge. The $16.5 million expansion will include 44 licensed beds, integrative therapy rooms, a new pharmacy center, expanded facilities for individualized treatment, and a dedicated admission center. 

Yet, even in the midst of the excitement that expansion can bring, we haven’t lost sight of the fact that whenever individuals make the very difficult decision to seek residential treatment, they are often at their lowest point in their lives. That is why we believe that individualized care and proper diagnosis, from the start, represent the core of our responsibility. Our patients and their families don’t care about how many books or peer-reviewed articles our doctors have written, or how many lectures she or he travels to present around the world. Instead, individuals come to Sierra Tucson expecting a miracle. And, they expect our brilliant doctors, nurses, and therapists to care as much about delivering their miracle as earnestly as they wish to receive one.

But miracles don’t just happen
Miracles are the result of dedication and hard work, and from the gritty resolve of a treatment team that believes in collaborating with each other, as well as collaboration with our trusted referents and after-care providers. Miracles at Sierra Tucson also include families. Our providers work directly with our patients each day and with their family members during Family Week. Families have an opportunity to sit down next to their loved ones and meet with our providers to discuss diagnoses and medications, as well as to ask every question they wish. At a time in their lives when things can look so frightening and hope can seem so elusive, it’s the individualized care that is a Sierra Tucson hallmark that our residents and their families relish.

We don’t use the word ‘miracle’ lightly at Sierra Tucson. While many treatment facilities struggle with provider shortages, I am grateful to say that we have been able to recruit the best and finest group of experts in the industry to polish off our distinguished team. We believe that every individual who steps foot inside our facility is looking for the kind of help that gives them enduring hope. Our treatment team’s goal is to provide that hope, not only when they are here, but long after they’ve left. This is why we can confidently post another sign that individuals can’t help but see as they exit our campus– You Are a Miracle – and it is our collective goal to help them truly believe it. Visit www. sierratucson.com.

CBD- What do you know?

What Parents Should Know About Kids Using CBD

THC (Tetrahydrocannabinol) is the most well-known component of marijuana, the one that “gets you high,” so to speak. But have you heard of CBD? Many parents haven’t, or if they have, they aren’t sure what to make of it or even understand if their son or daughter is using CBD. What’s certain is it’s becoming more and more widely available, and like vaping, is often marketed to young people. Below is an overview of CBD, the numerous forms it’s sold in, its efficacy in treating various problems and current knowledge about its relative safety.

What is CBD?

CBD, short for Cannabidiol, is the largest non-psychoactive component of marijuana, and interest in its effects is growing. High levels of CBD and low levels of THC are found in most medical marijuana products, but the CBD industry has started to expand and market their products as “life promoting” to healthy individuals.There are hundreds of online companies selling CBD, with the market estimated to grow to $2.1 billion by 2020. CBD tinctures, edibles, sprays, vaping liquid, capsules and items such as gels, hand lotions and shampoos are widely available, varying in price and CBD content.

Some of these products are illegal, while others can be purchased in supermarkets and health stores by anyone. The legality of CBD varies by state, often based upon whether it is hemp-derived or marijuana-derived. Hemp and marijuana both originate from the cannabis plant, but cannabis crops grown for their flowers have high THC levels, while when grown for their fibers and stalks are usually called hemp. Regardless of how CBD is derived, it’s best to check your state laws with respect to legality as it’s a rapidly changing landscape.

Why is CBD so Interesting to Young People?

The U.S. in general is becoming increasingly interested in CBD because of its ability to produce the medicinal benefits of cannabis without the high. It’s seen as a potential medicine without the side effects typically associated with marijuana — especially for cancer, serious chronic pain and epilepsy. For the first time, the FDA approved a new drug based upon CBD derived from marijuana called Epidiolex in June 2018. It provides patients with a concentrated dose of CBD to treat seizures in rare forms of epilepsy.

Teens and young adults are using CBD as a homeopathic remedy for pain relief, depression and anxiety symptoms, acne, insomnia and boosting productivity. However, there’s a crucial difference between CBD that’s studied in labs for medical conditions like epilepsy and CBD products that are sold to consumers for well-being.

The biggest problem is is a lack of well-controlled trials and little understanding of the long-term effects. For the most part, side effects from CBD alone are minor (dry mouth, dizziness, nausea), but they can be serious if the CBD products interact with other medications. CBD and other plant cannabinoids can interact with many pharmaceuticals by hindering the activity of cytochrome P450, a group of liver enzymes, so other drugs don’t metabolize as expected. Steroids, antihistamines, calcium channel blockers, immune modulators, benzodiazepines, antibiotics, anesthetics, antipsychotics, antidepressants, anti-epileptics and beta blockers could all potentially cause an adverse reaction when taken with CBD.

If you’re a concerned parent, the best thing to do is to talk with your child about CBD just like any other substance.

Suicide among Working Aged Men in the US: Understanding the Problem

Kurt Cobain, Hunter S Thompson, Ernest Hemingway, and Don Cornelius were all famous and influential men whose lives were cut short by suicide. These deaths were widely covered in the media and discussed publicly, with little understanding of how or why men with such success died with such great despair. Unfortunately, far too many men, particularly men of working age, are dying every year by suicide without public knowledge or outcry, which contributes to a lack of awareness of the significance of suicide in the US.

In 2009, 43 percent of the suicide deaths (15,904 of the 36,909 deaths) in the US were among men
ages 25 to 54, which by a large margin is the highest number of suicide deaths among any age/gender group.

For all ages, the suicide rate in 2009 was 12.02/100,000. For men ages 25 to 54, the rate was twice that at 24.83/100,000, illustrating the unique and significant burden men carry on the US suicide rate.
Men are four times more likely to die by suicide than women.
Suicide rates are highest among White non Hispanic Americans.
Suicide is the second leading cause of death for men 25 to 34.

Men’s unwillingness to acknowledge mental health problems or suicidal thoughts, coupled with the common behavior of not accessing available services contribute to the high suicide rate among men (Moller-Leimkuhler, 2002). While men die by suicide in much higher numbers than women, suggesting that men may be in greater need of mental health services, research finds that men appear far less interested in and likely to access services. While there is no evidence that women experience higher rates of depression, men account for only one in 10 diagnosed cases of depression
Mental Health America, 2007, and research suggests male depression goes 50 to 65 percent undiagnosed. Further, men are resistant to asking for help, communicating inner feelings and forming groups around emotional issues (Davies and Waldon, 2004).

While it is true that consistently over different ages, nationalities, ethnic and racial backgrounds, men seek help less frequently than women, the trend is due in part on men’s socialization and in part on health delivery systems and not entirely on “men behaving badly.”

Gender role socialization theories (Addis & Mahalik, 2003) offer a perspective that helps explain these statistics. Cultural codes of achievement, aggression, competitiveness, and emotional isolation are consistent with the masculine stereotype; depressive symptoms are not. Cultural ideals of rugged individualism lead to social fragmentation and fewer coping alternatives.
According to Mansfield, Addis and Mahalik (2003), when men consider seeking help, they often go through a series of internal questioning:

Is my problem normal?

The degree to which men believe other men experience the same problem affects their decision to seek help. A prime example of this psychological process is erectile dysfunction. Before Senator Bob Doles’ public disclosure, many men thought they were the only ones suffering from this highly common and highly treatable problem. After the public campaign, many more men sought help.

Is my problem central to who I am?

Mental health symptoms reflect an important quality about the person (for example the hypomania in bipolar disorder that impacts creativity or productivity), then the person will be less likely to seek help.

Will others approve of my help-seeking?

If others, especially other men, are supportive, then the person will be more likely to go. Help seeking is particularly likely if the group is important to the person and unanimous in their support.

What will I lose if I ask for help?

For many the biggest obstacle to asking for help is fear of losing control: losing work privileges or status, being “locked up,” or losing one’s friends or family.

Will I be able to reciprocate?

Usually, the mental health services offered do not allow opportunities for reciprocity.
Because of ethical standards, the mental health practitioner is often not allowed to share personal information or receive favors, thus maintaining a position of power over the client.

For some men, receiving help is acceptable only if they can return the favor later on; in the relationship with a mental health provider, this is often not possible.

One exception is Alcoholics Anonymous. According to their mission, “Alcoholics Anonymous is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.” According to the AA fact file, men make up 65 percent of membership in AA, indicating this model of reciprocity is appealing to men. By contrast, among persons with any recent mental health disorder, a higher percentage of women (16%-26%) made mental health visits than men (9%-15%).

These data suggest that historical, traditional approaches to reaching men with mental health and suicide prevention messages have been mostly unsuccessful, and new, innovative approaches need to be explored and developed.

We know many men experience suicidal thoughts, believe they are the only ones, and become hopeless as a result. We also know many types of interventions and mental health services that effectively prevent suicide exist. The problem is no one has successfully bridged the two and men continue to die without linking to a life-‐ saving treatment or other intervention.

THE GOAL OF MAN THERAPY is to show working age men that talking about their problems, getting help and fixing themselves is masculine.

National Suicide Prevention Lifeline or “the Pros” (a vetted list of professional mental health service providers).

Source: http://mantherapy.org

Thursday, November 1, 2018

Understanding and Coping with Grief and Loss

Grief and loss are unavoidable. They are a natural part of the human condition. No one can escape experiencing several forms of loss throughout their lives. However, in the American culture, many people attempt to avoid the feelings associated with grief and loss by denying the impact it can have on our present and future lives. Some people may quickly gloss over grief and loss, stating: “I’ve accepted, forgiven, and moved on” to put a matter to rest.

Others may delve into addictive behaviors or other dysfunctional ways to numb out or block the feelings associated with grief. Unfortunately, storing grief and loss in our heads is a missed opportunity for growth on an emotional and spiritual level. It’s also an overlooked chance for hope according to Dr. Elizabeth- Kübler-Ross, a Swiss-American psychiatrist who was a pioneer in near-death studies. When a person processes thoughts and feelings, including grief, in a supportive, therapeutic individual or group environment, hope is often a powerful outcome.

Dr. Kübler-Ross proposed that while each person will experience the stages of grief differently, the grieving process is a normal and healthy expression of emotions. Although emotions such as pain, anger, and fear may bring about much discomfort during the grieving process, these emotions also have worthwhile gifts.

According to Pia Mellody, Senior fellow at The Meadows, the gifts of feeling pain include healing, growth, and awareness. The gifts of anger encompass assertiveness, strength, and energy. The gifts of fear are preservation, wisdom, and protection. Dr. Kübler-Ross identifies the five stages of grief as denial, isolation, anger, bargaining, depression, and acceptance.

It is important to honor the feelings that arise during each of these stages. Dr. Kübler-Ross states that some people will skip stages, some may repeat stages, some may experience them non-sequentially, and some may not experience them all. In other words, there is no set formula for how each person will experience or move through the stages of grief. Additionally, it is clear that sometimes people benefit from getting a little outside help if they feel stuck in their grief.

When grief and loss are left unresolved, they may become like a stealth bomber showing up in covert ways such as sideways anger, guilt, depression, addiction, lethargy, and physical ailments. As a therapist I see various forms of grief show up while working with patients. I witness them grieving the loss of letting go of the old self, breaking the status quo in a family, or letting go of addictive behaviors after decades of familiarity. I see the loss and grief associated with an end to a long-term relationship through death, divorce, and retirement. Grief and loss come in so many forms, but what they all have in common is a change in circumstance and a change of course in one’s life. These massive changes can be hard to adjust to and even harder to internalize.

Whatever the loss, working through the grief takes time, energy and commitment. It is essential that people who are grieving honor themselves, especially when there is unfinished business. It is by working through the issues that hope is born and expressed while relationships and consciousness shift. Grief and loss can be beautiful and life-enhancing, as loss and love are the great unifiers in life.
The loss of innocence in childhood brings a love for independence and autonomy in teen and early adult years. The loss of love leads to challenges, new insights, and other relationships. Loss of career and jobs lead to different experiences and new opportunities. The loss of addictive behaviors leads to clarity of action and purpose. The loss of the old makes way for the beginning of anew, with hope evolving from resolved grief and the unknown future waiting to be discovered.

Are you are struggling with grief and loss and need help moving through the stages of grief? Do you feel stuck in your grief? Are you longing to find meaning and hope after experiencing loss? If you answered yes to any of these questions, you may want to consider seeking help. Rio Retreat Center at The Meadows offers a grief workshop called Healing Heartache.  Our next scheduled grief workshop is November 12-19, 2018.  If this resonates with you, please call our intake department at 1-866-582-9850 for more information or to register. 

Learn more about The Meadows by visiting www.themeadows.com


Sick as My Secrets

Patricia L. Brooks 

Sick as My Secrets is a powerful, compassionate, moving memoir told by a strong and honest woman who overcame a desperate need for alcohol to handle stress in her young life. Patricia L. Brooks, immensely proud of her 35 years of sobriety, openly and lovingly reveals her compelling story of powerlessness, her journey to recovery, and a spiritual transformation from the lowest point in her life to the apex of her trust in God. Her saga is a testament to resilience and hope for all of us. This is a must-read for anyone recovering from addiction, with questions about the recovery process, or curious about how a situation like this can happen to an ambitious young woman with a bright future.

Patricia’s newest memoir chronicles her topsy-turvy infidelities, her incarceration for a second drunk driving ticket, her rehab for alcoholism, and her years of therapy. She also tells her story of a struggle with love addiction and domestic violence on her road to gratitude, acceptance, forgiveness and purpose.

Both of her husbands from the 1970’s tolerated some of her behavior in their marriages. Neither marriage lasted very long, the first one beginning as a teenager. Her later drinking years were spent in Arizona, often alone, working in a demanding real estate career and going to night school at Arizona State while spiraling down the rabbit hole. She saw sadness and chaos in her marriages as she moved through four states, Michigan, Iowa, Illinois and Arizona, before she left her second husband in Arizona to try to make it on her own. 

She’s a brave survivor of alcohol, coming to the war of alcoholism as a married teenager who had no place being at the University of Dubuque’s Seminary in Iowa in 1969. It was there she found martinis and became a warrior, fighting for her life in many difficult situations that would have taken others down, such as grief, loss and deceit. 

This 300 plus page memoir reveals an insecure young woman, dependent on her second husband for everything while desperately trying to be independent. She drinks heavily to cope with her loneliness and anxiety yet has no idea what is wrong with her as she perseveres.

As the first woman to break into the sales team of a major homebuilder in Arizona in the early 1980’s, she earns many sales awards, and makes a name for herself. But despite her achievements, her perspective was that of an outsider pushing her way in where she wasn’t welcomed. This weighed heavily on her and contributed to her drinking alone after work, despite the number of homes she may have sold that weekend.

Best Friend? Alcohol

Widely talented, but extremely insecure, in a male-dominated career that was a pillar of sexism in those early years, Patricia found peace with her friend alcohol. While often finding herself in a haze of pot-headed boyfriends and late-night parties where cocaine was served for dessert, she chose to just drink. It was legal, she did not want to lose her real estate license. She drank a lot, kept to herself and left parties early to work weekends and avoid confrontation.

Patricia somehow survived the sex, drugs and rock and roll of the 1970’s and early 1980’s only to find herself in dead end love affairs, accompanied by drunk driving tickets. The new DUI laws of Arizona had just gone into place in 1983, and although she began to find her sisterhood with other women in the real estate business, she could not put down the drink. Patricia was eventually threatened with her job despite being Salesperson of the Year, before her last DUI. She conquered her desire to drink only after surrendering to God and recovery, going to jail in Phoenix for DUI and attending out-patient treatment to save her job. 

This author of Sick as My Secrets skillfully shows how alcohol slowly but surely invaded her life. The sad but very predictable progression of alcoholism is on full and well-explored display in her memoir. There’s a lot of typical Twelve Step Recovery in her words, yet her story is told in an intriguing manner. This memoir serves as a strong refresher course for anyone who’s been sober for a while and worried they may become complacent. Addiction to love and domestic violence issues are also covered as she moves through her early sobriety.

This memoir is also for those willing to buy into the spiritual aspects of Twelve Step Recovery. But if that’s not your bag, try this book anyway, you might find that what worked so well for Patricia could also be for you, a loved one or a family member of an alcoholic. Remember, one in four people in this country are impacted by alcoholism daily.

Author’s Comments

My life experiences are fodder for my books, and memoir and biography are always my first choice in reading. I have always loved to read, write and speak up. Sick as My Secrets is a very personal story of my adult life and what it was like as a drinker who drove drunk, what happened to change my drinking to sobriety, and what thirty-five years sober means to me. True stories intrigue me and speak to me. It is my hope Sick as My Secrets does that for you.

One of my passions is advocating for addiction awareness so I am out there today and no longer anonymous. This decision happened five years ago when I began to write my book and publicly talk about my recovery to a variety of audiences. My book Three Husbands and a Thousand Boyfriends focuses on domestic violence and love addiction. And I participate in the Addiction Awareness Day and the Domestic Violence Awareness Day at the Arizona Capital each Spring, speaking to my legislators in LD23.

There are many myths related to who is a woman alcoholic. One defining question is “How did I change?” I clearly show that in the last half of the book with stories of sponsorship and service. By redoing the Twelve Steps more than once, and staying close to recovery, thirty-five years sober became my reality.

The next important question is “What was the catalyst to my change?” That answer is renewing my faith in God while in jail. I write in detail how that experience impacted me, and how powerful and humbling it was to be there. Jail made me grateful for my life; the alternative was to drive drunk and eventually kill myself or someone else.

The purpose of the book is to share my experience strength and hope with those who may never find a meeting or talk to another person in recovery. It is for those who enjoy reading memoir or living vicariously through another’s experiences. My goal was to write a riveting book so that the reader shares my words of hope and inspiration. Since I worked through the shame of alcoholism and told my truth with a passion for healing myself and others, it is now in God’s hands. 
“It is like reading a friend’s diary.” I was told recently, “you are so brave.” That is how I wanted it to be, open and inviting, but attention-getting too. If you read memoir regularly, this book is for you. If you are new to memoir, check it out. It’s a window into my reflections of what I learned and am learning on the road of recovery, how I live after so much change, and how I work to be the person I was meant to be all along. 

Just like most of our reading in recovery, my words are meant to be suggestive only. I was brave and bold in my writing on the difficult topics of love addiction, alcoholism, domestic violence, post-traumatic stress and spirituality. They are everyday life to me. Real issues to me, for people like me. I faced this writing with integrity and hard work, and a lot of faith.

Not knowing how a reader will react to my work, I put it out there to the best of my ability with the noblest of intentions. I wrote for myself first and did not censor my audience. After conversations with myself and God, I wrote more and revised again. By acknowledging those who helped and supported me along the way, such as my author husband, Earl L. Goldmann, my critique group and my editor, the miracle happened. 

This book is dedicated to my dear friend Charmeon who was killed by a drunk driver over 40 years ago. She is a constant reminder to me of how grateful I am today for my incredible life as a sober woman.

Patricia L. Brooks, MAOM, is an award-winning author of three memoirs, a publishing consultant at her company Brooks Goldmann Publishing, LLC and president and Founder of the Scottsdale Society of Women Writers. She can be reached at patricia@plbrooks.com 480-250-5556 or www.brooksgoldmannpublishing.com 

Continuum Recovery Center now In-Network with Blue Cross Blue Shield

There are over 2,300,000 people living with addiction. 

Know that you are not alone. Continuum Recovery Center provides a comprehensive and holistic approach to overcoming chemical dependency, alcoholism and co-occurring mental health disorders in a safe, confidential and supportive environment.

Continuum Recovery Center provides outstanding options and individualized treatment services, because one size does not fit all. Services include Primary Extended Treatment, Intensive Outpatient, through Relapse Prevention and Aftercare.

We believe in identifying the “WHY”

Identifying the underlying issue of “why” the addict or alcoholic began using or drinking is the first step to treatment. If you’re able to process, learn coping skills, and even resolve the underlying issue, you will no longer need the drug or alcohol to live life.

“Addiction is a deadly disease immune to age, race, sex, and socio economic status. It does not care who you are or where you’re from. In my career as a professional athlete, I’ve seen it destroy the lives of several of my peers and the life of my brother who was as gifted an athlete as myself but is now serving a life sentence due to the grips of this fatal disease. I am passionate and committed to preventing this for you and your family.” Frank Johnson, Founder & Chief Executive Officer. 

For information visit www.continuumrecoverycenter.com or call 602-903-2999.

Finding Miracles Across the Table

By Dina Evan, PhD

This is the month for giving thanks and for many it may seem harder to feel thankful. The people having to rebuild lives and homes now still under water in many states, or many in Washington are feeling so separated from their own values they can hardly speak. I too am sad, even when my mind knows I have had an incredibly blessed life, not with material things, or wealth, but rather, like you, with doing what I came here to do and being who I came here to be.

Living on purpose, values, and an inner sense of connection with something bigger than ourselves — embracing the pain that shatters our souls into splinters out of which we build our cathedrals. We do it, chose it, to push our souls forward.

As an example, I have been so fortunate to find doctors who are present, compassionate and kind. I had to go back  for my monthly visit with my pain doctor. He’s a precious young family man who is awake, present and kind. As usual, we spent ten minutes talking about my prescriptions and then time talking about the world and what we are doing to try to make changes. He and his wife are bravely teaching young people in their church about relationships and I shared the videos we are putting up on my site that he had been watching, and invited him to use the material in his work. In that place of awareness — we were one.

When these kinds of connections take place, the energy in the room softens. It stills and vibrates differently in a deep sense of connection that arrives as if we had known each other forever. There are few, but deeply precious, people in my life with whom I share that magic. They stop whatever they are doing and show up, because they want to connect in that sacred space that says I care, we care.
They stop rushing to, or from, anything. They tell the truth. They express the kind of love that sustains us and is so unbelievable it can’t be contained with a description.

I left that office and sat in my car and wept for nearly fifteen minutes with the realization that nothing less that these connections have or could ever fill my soul or feed my spirit. The rest is mundane and unsatisfying. It leaves me longing for more.

That’s when it occurred to me, it is these conscious connections for which we get to give thanks.

Maybe when you get older like me, you realize your time here is limited, you know that only that which is real, matters. However, the millennials and young adults are getting these concepts so quickly and deeply it astounds me, like this precious doctor, my producer, and thousands around the world.

Looking for ways to fill up my time bores me, anything except knowledge bores me. None of which is to say I am spiritual, but rather, I simply feel the realization that walking for forty years on the path with these courageous people, who bare souls to heal the pain they carry so they can replace the pain with their purpose and calling. It’s a miraculous act of such courage that nothing less that their same level of bravery can or should be lived through my actions and service. They deserve that from me, because if I dare to ask it of them, they dare even greater to give it.

And so ....
This Thanksgiving, take a moment to thank the masters who sit across the table from you in your life. They came to share your journey, shoulder the responsibility and the joy and most of all to reflect back to you, your great courage and wisdom in choosing this path, at this very difficult time. Being real and conscious isn’t always easy, however, it’s it is vital to your evolution, as vital as your next breath. This my beloved readers, is what I mean when I say, “When you change inside, a world event takes place outside. Just breathe and know you are building cathedrals and fulfilling your purpose, and that’s what you came here to do. Give thanks for that and know I give thanks for you for giving me another place to fulfill my purpose.

Please go to DrDinaEvan.com and help me share the vital tools on the videos Your Path and Purpose. 

Tuesday, October 30, 2018

I do not want to write this piece, but I must.

I believe people who come into our lives; whether for a short time or a long while – arrive for a reason. And, there are those special ones we connect with on a soul level, in a deeper way, just like ‘family’.

Friendships, if truly authentic go through ups and downs, from spats to forgiveness, belly laughs and tears. The years go on and what develops is a bond between human beings. We help each other, we listen, call each other out when things go awry, challenge one another and accept one another. We focus on the lessons they bring us rather than the flaws. Each of us is perfect in God’s eyes, and that is what counts.

A month ago, on September 27th, my dearest and closest friend for over 20 years took his life. The Why’s will never be answered. The questions I’ve asked myself since, from “what did I miss, to why didn’t he let me know, I could have helped,” — spin in my mind, and it hurts.

It hurts because it is final. It hurts because he is gone. I’m angry, sad, and confused. I miss him and pray he will find peace.

To my best friend Bill, you were loved by many and you touched my life in ways I will cherish and remember all of my days till I see you again.

Peace my friend, may you find peace.

Let's be honest with our feelings 
without shame or fear of being judged,
We must ask for help when 
we don't want to,
If we feel hopeless or powerless 
or alone in this world, 
please, please reach out. 

1-800-273-TALK (8255)

Thursday, October 4, 2018

Looking Back, Looking Ahead:

Reflecting on the Progress of Mental Health Treatment and Recovery, Along with New Hope Anchored in Science, Education and Integrated Care

By Terros health staff

Addiction — to tobacco, alcohol or prescription or illegal drugs — is a disease that contributes to 632,000 deaths in the United States every year, according to the Centers for Disease Control and Prevention. 

Yet most physicians don’t have adequate training to treat addictions comprehensively, and too few medical schools offer addiction education. According to the National Center on Addiction and Substance Abuse at Columbia University, the medical profession has failed — “in medical school, residency training, continuing education and in practice” — to address addiction.

There is a need: Statistics about substance abuse addictions, mental illness and suicide
  • An estimated 16 percent of Americans ages 12 and older — about 40 million people — have a substance abuse problem, an addiction to alcohol, illegal or prescription drugs or nicotine.
  • Only 11 percent of people in need receive treatment.
  • One-third of all inpatient hospital costs are linked to addiction and risky substance use.
  • Serious mental illness costs in the United States amount to more than $193 billion in lost earnings per year.
  • Drug overdoses took an estimated 72,000 
  • lives in the United States in 2017.
  • Suicide is the 10th leading cause of death in the nation and the second leading cause of death among people between the ages of 15 to 34.
(Sources: Center on Addiction, National Institute on Drug Abuse, Centers for Disease Control and Prevention) 

In Arizona, however, a stellar example of a behaviorally-led integrated approach to wellness, mind and body, is building healthy communities through exceptional patient experiences, quality outcomes and controlled health care costs. 

Terros Health, founded nearly 50 years ago, last year helped more than 53,000 Arizonans on the path to better health and an improved quality of life. It started by treating physical and behavioral health conditions as one, rather than in silos. As part of its integrated model of care, Terros Health provides primary medical, mental health, substance abuse and wellness care under one roof.

“We look at the whole person,” said Dr. Saul Perea, Terros Health’s Integrated Care medical director. “And we are educating people one by one, helping people one at a time, bringing them in for treatment and ultimately changing lives.”
Terros Health is working hard to change the stigma of mental illness, reduce barriers to treatment and achieve more effective treatment protocols. It’s part of a movement that began in 1909 when former psychiatric patient, Clifford W. Beers, witnessed and experienced horrible abuse while being institutionalized. Today, Mental Health America (MHA) is a leading community-based nonprofit that has made an indelible mark on tens of thousands of people. 

MHA also led advocacy efforts that have resulted in landmark legislation, including the signing of the National Mental Health Act by President Harry Truman in 1946, the creation of the National Institute of Mental Health and allocation of government funds for research into the causes of and treatments for mental illness.

Fast-forward nearly two decades to 1963: Congress passed the Mental Retardation Facilities and Community Health Centers Construction Act, providing federal funding for the development of community-based mental health services. 

Then in 1977, President Jimmy Carter established the President’s Commission on Mental Health, among the first comprehensive surveys of mental health care. Formation of The National Alliance for the Mentally Ill followed in 1979 and the Americans with Disabilities Act was adopted in 1990 to protect mentally and physically challenged Americans from discrimination in a variety of settings.

Progress continued in 1996, when the Mental Health Parity Act, the first federal legislation to bring more equity to health insurance coverage of mental health care, was adopted. The same year, President Bill Clinton moved to end discrimination in such coverage for 9 million federal workers by enacting mental health insurance parity for them. 

Mental health parity is important because it ensures equal treatment of mental health conditions and substance use disorders in insurance plans. Although Congress passed this legislation in 1996, the advent of the Affordable Care Act in 2010 delivered on this promise. 

As a result of the ACA, patients with physical and mental health conditions cannot be denied health care coverage. What’s more, behavioral health services are an “essential benefit” required by law.

Education brings awareness, science gives answers 
Public policies have come a long way in helping the one in four Americans challenged by mental illness and addiction, yet more must be done. Society’s false beliefs about mental illnesses — that only weak people, poor people, damaged people have them — once were widespread. 
Fortunately, advancements in neuroscience, the advent of the Information Age, and focused public awareness campaigns are reversing that trend, said Dr. Randy Brazie, Terros Health’s chief medical officer. As Brazie explains, addiction isn’t selective. “It affects people of all socioeconomic levels, races, genders, ages and occupations,” he said. “A mental illness is no different, in terms of being ‘real,’ than a physical illness, such as cancer or heart disease.”
This realization is bringing mental illness out of the shadows, showing patients they aren’t alone, acknowledging they can’t just “snap out of it,” and expanding empathy and understanding, he said. 

Addictions have long been thought to be related to any number of things: psychological factors, stress and personality traits such as high impulsivity, environmental influences, including exposure to physical, sexual or emotional abuse or trauma, and using alcohol, nicotine or other drugs at an early age.

But just as the field of genetics is pinpointing the causes of cancer and Alzheimer’s disease so, too, is science revealing more about addiction and its associated risk factors. These include genetic predispositions and certain brain characteristics that may make a patient more vulnerable to addictive substances. 

Neuroscience also is producing a rapid evolution in our understanding of how pathways in the brain may be triggered by substance abuse. 
“Addictions are very much driven by how the brain responds to things,” Brazie said. “And when a pathway in the brain gets triggered, it can be very difficult to extinguish.”

“Dramatic revelations about the role of biology and genetics in mental illness make the hope for better diagnoses and treatments exciting,” Perea said. The Center on Addiction reports that genetics account for 50 to 75 percent of the risk for addiction. 

“Genetics are so impressive in other areas of medicine, in terms of prediction and treatment,” he said. “For example, in a cancer patient, what type of treatment will he or she respond to best, based on his genetic makeup? The same thing is happening in mental health, where we are identifying the gene that causes schizophrenia. The promise is huge.”

A new model of care

So is the promise of integrated care. 

Terros Health’s model of care hinges on many years of research at the AIMS Center – Advancing Integrated Mental Health Solutions, at the University of Washington. 
The Center’s evidence-based model, known as Collaborative Care, was used in a large randomized treatment trial for depressed adults who visited primary care clinics across the United States and abroad. Collaborative Care was shown to double the effectiveness of depression treatment while lowering long-term health care costs, according to study findings reported in the Journal of the American Medical Association. 

For example, at one year, about half of the patients receiving Collaborative Care reported at least a 50 percent reduction in depressive symptoms, compared with only 19 percent of those in primary care. They also experienced more than 100 additional depression-free days over a two-year period than those in primary care.

When a new patient with anxiety, depression or another mental health condition comes to Terros Health, he/she is seen by a primary care physician for a health screening, then meets with a behavioral therapist where medications, medical history and symptoms are chronicled. Throughout the process, Terros Health physicians, nurse practitioners and clinicians access the patient’s electronic health record and communicate about the course of treatment and progress. 

Such was the case with Shannon Ballejos. 

An unexpected job loss, a car accident, oxycodone for back pain, followed by heroin use, tore Ballejos’ family apart. Thanks to integrated care, she has been off drugs for nine months and is putting her family back together.

Ballejos was devastated when, after moving with her three younger children to a new city for her company, her new job fell through. She returned to Phoenix, was recovering from the disappointment and was planning to start over until the accident. 

“When I was no longer able to get the prescription for oxycodone, a friend introduced me to heroin. I was 39, and this was the first time I had used drugs. I changed so much. I was neglecting my children to the point that DCS (Arizona Department of Child Safety) had to step in and take them from me. They were 5, 7 and 11 at the time. It broke my heart, but contrary to every value I thought I had, I still wanted heroin.”

DCS referred Ballejos to Terros Health for treatment
“My case manager believed in me when I didn’t. I kept relapsing, but she stuck with me and recommended that I enter residential treatment for 30 days at Maverick House. 
“Going there was the best decision I ever made. I not only learned the painful lessons of my addiction, but I also discovered what made me happy, little things like crocheting, reading and hiking.”
Ballejos’ recovery has been supported with Suboxone prescribed by Perea, whom she sees monthly. Another Terros Health physician manages her asthma and other general medical issues. 
Ballejos doesn't take her new life of recovery lightly. After Maverick House, she completed two sessions of outpatient treatment, has a recovery sponsor she speaks with every morning and participates weekly in Narcotics Anonymous and Heroin Anonymous.

Family life is becoming normal for Ballejos, who also has three adult children and has been reunited with her three younger children. 

Treatment works

The importance of treatment cannot be overstated, Brazie said. ”The reason is simple: treatment works.”

Christopher Gabriel Jojola had been using Percocet and heroin for six years, and when he tried to stop, he experienced excruciating withdrawal symptoms. “I felt sick and everything hurt. I didn’t crave the drug. In fact, I hated the drug. I needed help with my withdrawal.”
Jojola, 34, researched health care organizations and chose a Terros Health clinic about a year ago. 

“I had not used for 16 hours, which was a requirement before I could get treatment. I walked into the clinic fairly sick. They put me in a quiet room and made me comfortable. The doctor gave me Suboxone (an FDA-approved medication for testing opiate dependence) and monitored me to adjust the dosage. I felt better and came back the next two days for additional medication adjustment, and then they gave me a two-week prescription to continue helping me with the withdrawal.” 

When asked to begin intensive outpatient treatment, Jojola questioned whether he could get to the clinic three days a week for the three-hour group sessions. “Cathy, a primary care support specialist, asked me if I had been able to make it to my drug dealer every single day. Of course, I had. I realized I could make it to the counseling sessions.”

Jojola credits his successful recovery to his physicians and medication, plus seven months of intensive outpatient treatment, and individual counseling sessions when he needed it. He wondered if anyone at the clinic truly cared about him. “It turns out the staff does care. It is not just a job for them.”

Jojola is now working full-time as a commercial plumber and has joint custody of his two children, ages 7 and 9. “My future is looking bright.”
Prince Zombo is feeling equally hopeful about what lies ahead. 
Zombo is a permanent resident of the United States who was born in Liberia, Africa. When a civil war in his homeland broke out, Zombo and his family moved to New York City.

Soccer is Zombo’s passion. He played it in Africa and New York, where he graduated from high school, then coached soccer there. Since moving to Arizona in 2011, he has continued to coach, and enjoys involving children in healthy sports.

In August 2014, life became difficult for Zombo, 41, and his two sons, Prince Jr. and Promys, whom he was raising alone. Because of a medical emergency, Zombo was taken to the hospital, leaving his children with a neighbor. 

When DCS became involved in the matter, Zombo appeared in family court. He tested positive for marijuana, his two boys were placed in foster care and he was ordered to receive treatment.

“I didn’t think my marijuana use was at the level that needed treatment, but I wanted my boys back. I was willing to do anything for us to be a family again.” 

Zombo participated in two years of counseling and treatment services at Terros Health, and worked as a behavioral health technician in a group home.

He quit marijuana use and was reunited with his sons in June 2016. The most important lesson he learned in counseling was living a sober life.
Today, he says his life is great, “I have a roof over my head, a job as a manager of a group home and a beautiful family.” He has set a personal goal to become a peer recovery coach.

Knocking down insurance barriers

For some, it’s hard to imagine the thought of having mental health issues, particularly when there is no history of mental illness in the family. It’s how one confronts these challenges that is key to their recovery, Brazie said. “Shannon, Prince and Christopher are shining examples of what can happen when you are set on a path of recovery.”

Despite the roadblocks, mental health care in America and Arizona are evolving in a positive way, Brazie added. This includes stepped-up assistance by health insurance companies, which historically have been slow to reimburse providers for mental health services. A new program in Arizona, effective Oct. 1, will change that, when 1.5 million AHCCCS members will move to Complete Care integrated health care plan. It will provide both physical and behavioral health services. 

“This is good news for all Arizonans,” Perea said. “People should never suffer in silence. As a mental health community, we are here to help them get the services and treatment they expect and deserve.”

There is help: Mental health resources
Terros Health, terroshealth.org, 602-685-6000
National Institute of Mental Health, nimh.nih.gov, 866-615-6464
Substance Abuse and Mental Health Services Administration, samhsa.gov, 877-SAMSHA-7
National Alliance on Mental Illness, nami.org, 800-950-NAMI
Mental Health America of Arizona, mhaarizona.org, 480-982-5305
Veterans Crisis Line, veteranscrisisline.net, 800-273-8255

14th Annual NAMI Valley 5K Walk

Recovery is something that you have to work on every single day and it’s something that doesn’t get a day off.

14th Annual NAMI Valley 5K Walk on Saturday, October 20

Walk to increase awareness in Arizona about mental illness and its devastating effects. Help us bring Arizona’s mental illness community together, and raise dollars for NAMI’s outstanding and vital support and education programs!

Visit http://www.namiarizona.org to join and/or donate to the NAMI Valley of the Sun Stigma Stompers Walk Team. Help us exceed our goal of $5,000.

The community is coming together at the Arizona State Capitol grounds, 1700 W. Washington St. in downtown Phoenix.Registration starts at 8:30 a.m. The walk starts at 9:15 a.m. Sign up for either the 1.2K or 5K walk.

NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI shapes national public policy for people with mental illness and their families and provides volunteer leaders with the tools, resources and skills necessary to save mental health in all states.

Suport and Events

Professional Events
OCT. 16—PCS Networking Luncheon,12:15 -1:30 pm. 3302 N. Miller
Road, Scottsdale. Jacquee Nickerson, 480-947-5739, E:pcs@pcsearle.com

Nov.4 —Arizona Psychodrama Institute Full Day of Basics — ($99 per session). API offers “Basics of Psychodrama” every two months and each one is uniquely different.

Nov. 30,— Sierra Tucson 11th Annual— “Gratitude for Giving” Celebration Sierra Tucson will recognize professionals in the Phoenix area for their years of giving to others. Join us in honoring your selected peers who have made a significant contribution to our community. 9:00 a.m.-Registration. 9:30 a.m. - 11:00 a.m. Breakfast, Presentation of Awards, Arizona Biltmore, 2400 E. Missouri Ave.

Support Groups & Events

LGBTQ - IOP Program. Dedicated specialty program designed to meet the mental health and substance abuse, treatment needs of the LGBTQ+ population. Mon., Tues., Thurs. 6:00-9:00 pm. Transportation available. Call 602-952-3939/602-952-3907.Valley Hospital, 3550 E.Pinchot Ave. Phoenix. www.valleyhospital-phoenix.com

SIERRA TUCSON— Alumni Groups. Scottsdale, Tues., 6:00- 7:00 p.m.Valley
Presbyterian Church. 6947 E. Mc-Donald Drive, Paradise Valley. 480-991-4267. Counseling Center(Parlor Room). Rob L. 602-339-4244or stscottsdalealumni@gmail.com.

SIERRA TUCSON— Continuing Care
Groups—Phoenix. Thurs. – Resident Alumni. Psychological Counseling
Services, 3302 N. Miller, Scottsdale. 5:30 –7:00 p.m. Group facilitated by staff of PCS. No charge for Resident Alumni. Courtney 520-624-4000, Ext. 600205 or email: Courtney.Martinez@SierraTucson. com.

SIA (Survivors of Incest Anonymous) 12-step, self-help recovery program for men and women, 18 and older, who were sexually abused as children. The only requirement for membership is you were sexually abused as a child and want recovery.  Scottsdale, Saturday, 2:00pm - 3:00pm, Bethany Lutheran Church, 4300 N 82nd St. 480-370-3854. www.siawso.org

FAMILY RECOVERY GROUP—Facilitator, Brough Stewart, LPC. 5:30-7:30 p.m. Designed to help begin/continue family recovery. Meadows Outpatient Center, 19120 N. Pima Rd., Ste. 125, Scottsdale. Jim Corrington LCSW, 602-740-8403

HEALTHY INTIMACY GROUP— Tucson—Weekly women’s group.  Explore intimacy issues and help heal relationship and intimacy wounds. Desert Star Addiction Recovery Center. 520-638-6000.

Celebrate Recovery — Compass Christian Church. Fridays 7 p.m. Room B-200. For men and women dealing with chemical or sexual addictions, co-dependency and other hurts, Hang-ups and Habits. 1825 S. Alma School Rd. Chandler. 480-963-3997.

Valley Hospital—IOP Group for Chemical Dependency/Co-Occuring. Mon.,Tues., Thurs. 6:00-9:00 p.m. 602-952-3939. 3550 E. Pinchot Avenue, Phoenix. valleyhospital-phoenix.com

Open Hearts Counseling Services — Women’s Therapeutic Group for Partners of Sex Addicts. Comfort, strength and hope while exploring intimacy issues. Cynthia A. Criss, LPC, CSAT 602-677-3557.

Families Anonymous—12 step program for family members of addicts. Scottsdale Sun. 4:00 p.m., 10427 N. Scottsdale Rd., N. Scottsdale Fellowship 480-225-1555 /602-647-5800

NICOTINE ANONYMOUS (NicA) Fellowship for those with a desire to stop using nicotine. Phoenix Sat., 5-6:00 p.m. Our Saviour’s Lutheran Church, 1212 E. Glendale Ave., Glendale, Sun., 9:15-10:15 a.m. Fellowship Hall, 8910 N. 43rd Ave. 480-990-3860 or www.nicotine-anonymous.org

Chronic Pain Sufferers “Harvesting Support for Chronic Pain,” 3rd Saturday of month, 12-1:00 p.m. Harvest of Tempe, 710 W. Elliot Rd., Suite 103, Tempe. 480-246-7029.

Jewish Alcoholics, Addicts, Families and Friends. 1st / 3rd Wed., 7:30 p.m. Ina Levine Jewish Community Campus, 2nd floor. 12701 N. Scottsdale Rd. 602-971-1234 ext. 280.

COSA (12-step recovery program for thosewhose lives have been affected by another person’s compulsive sexual behavior) Thurs. 11:00 a.m. 2210 W. Southern Ave. Mesa. 602-793-4120.

LIVING GRACE SUPPORT GROUP– A Christ centered approach for individuals and families affected by mental illness. Oasis Community church, 15014 N. 56th St. Scottsdale. 602-494-9557. 2nd & 4th Tuesday 6-8 p.m.

Women for Sobriety —womenforsobriety.org. Sat. 10-11:30 a.m. All Saints of the Desert Episcopal Church-9502 W. Hutton Drive. Sun City. Christy 602-316-5136.

Co-Anon Family Support— Message of hope and personal recovery to family and friends of someone who is addicted to cocaine or other substances. “Off the Roller Coaster” Thurs., 6:30-7:45 p.m., 2121 S. Rural Rd., Tempe. Our Lady of Mount Carmel Church. Donna 602-697-9550 /Maggie 480-567-8002.

ACOA Thurs., 7:00 p.m., North Scottsdale United Methodist Church, 11735 N. Scottsdale Rd., Scottsdale.www.aca.arizona.org

ACA. Tucson. Wed. 5:30-7:00 p.m Streams In the Desert Church 5360 E. Pima Street. West of Craycroft, Tucson. Room A. Michael 520-419-6723.

OA—12 Step program for addictions to food, food behaviors. 520-733-0880 or www.oasouthernaz.org.

Pills Anonymous—Glendale, Tues. 7-8:00 pm. HealthSouth Rehab 13460 N. 67th Ave. Rosalie 602-540-2540. Mesa Tues. 7-8:00 pm, St. Matthew United Methodist Church. 2540 W. Baseline. B-14. Jim, 480-813-3406. Meggan 480-603-8892. Scottsdale, Wed. 5:30-6:30 pm, N. Scottsdale Fellowship, 10427 N. Scottsdale Rd., Rm 3. Tom N. 602-290-0998. Phoenix, Thurs. 7-8:00 pm. First Mennonite Church 1612 W. Northern. Marc 623-217-9495, Pam 602-944-0834, Janice 602-909-8937.

GA—Christ the Redeemer Lutheran Church, 8801 N. 43rd Ave. Sunday, Spanish 7:00-9:00 p.m. Good Shepherd Lutheran Church, 3040 N 7th Ave. Sunday, English 6:00-8:00 p.m. 5010 E. Shea Blvd., Ste. D-202, Contact Sue F. 602-349-0372

SAA — www.saa-phoenix.org 602-735-1681 or 520-745-0775.

Valley Hope Alumni Support. Thursdays 6-7:00 p.m., 2115 E. Southern Ave. Phoenix. Tues. 8-9:00 p.m., 3233 W. Peoria Ave. Ste. 203, Open.

Special Needs —AA Meetings. Cynthia SN/AC Coordinator 480-946-1384, E: Mike at mphaes@mac.com

SLAA—Sex and Love Addict Anonymous 602-337-7117. slaa-arizona.org

GAM-ANON: Sun. 7:30 p.m. Desert Cross Lutheran Church, 8600 S. McClintock, Tempe. Mon. 7:30 p.m., Cross in the Desert Church, 12835 N. 32nd St., Phoenix, Tues. 7:00 p.m., First Christian Church, 6750 N. 7th Ave., Phoenix, Tues. 7:15 p.m. Desert Cross Lutheran Church, Education Building, 8600 S. McClintock, Tempe, Thurs. 7:30 p.m.

Debtors Anonymous—Mon., 7-8:00 p.m., St. Phillip’s Church, 4440 N. Campbell Ave., Palo Verde Room. Thurs. 6-7:00 p.m., University Medical Center, 1501 N. Campbell. 520-570-7990, www.arizonada.org.

Eating Disorder Support Groups— PHX— Monday  7:00 p.m. 2927 E. Campbell Dr. Ste. 104, (Mt. View Christian Church). Jen (602) 316-7799 or edaphoenix@gmail.com. Wed. 7:00 p.m.  Liberation Center, 650 N. 6th Ave, Phoenix. (cross street McKinley).  Jennifer (602) 316-7799. Tempe—Thursday6:30 p.m. Big Book/Step Study.  Rosewood Centers for Eating Disorders, 950 W. Elliot Rd, Ste. #201, Tempe. E: info@eatingdisordersanonymous.com. Tucson— Tues.  5:30 - 6:30 p.m. Steps to the Solution.Mountain View Retirement Village, 7900 N. La Canada Drive, Tucson.  leeverholly@gmail.com. Thurs. 5:30 - 6:30 p.m. EDA Big Book Step Study. Mountain View Retirement Village, 7900 N. La Canada Drive, Tucson.  (203) 592-7742 / leeverholly@gmail.com.  Wickenburg—Wed. 7:15 p.m. and Sunday 7:45 p.m. (N,D/SP,O,) Capri PHP program. (928) 684-9594 or (800) 845-2211.Yuma —Wed. @ 5:00 - 6:00 p.m. 3970 W. 24th St. Ste. 206 Yuma. Alyssa (928) 920-0008 or email 2014yumae.d.a@gmail.com.

GODDESSESS & KACHINAS Philosophical, spiritual, religious 12 step, 12 Tradtition/12 Promises support group. Details 480-203-6518.

Crystal Meth Anonymous www.cmaaz.org or 602-235-0955. Tues. and Thurs.Stepping Stone Place, 1311 N 14th St. Phoenix.