Category:Behavioral Health - Revision history

JenniferH: /* YKHC Psychiatric Resources */

2023-02-01T02:43:57Z

YKHC Psychiatric Resources

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	==Behavioral Health Outpatient Resources==		==Behavioral Health Outpatient Resources==
	=== YKHC Psychiatric Resources===		=== YKHC Psychiatric Resources===
	David Ondich, MD is our adult psychiatrist who prescribes most of the psychiatric medication needed in the Delta. He sees patients via VTC in the Behavioral Health Department in Bethel. He is available ~~by phone at 612-824-9812 or~~ by email at David_Ondich~~@ykhc.org.~~		David Ondich, MD is our adult psychiatrist who prescribes most of the psychiatric medication needed in the Delta. He sees patients via VTC in the Behavioral Health Department in Bethel. He is available by email at David_Ondich@ykhc.org.

	Nick White, a Psychiatric Nurse Practitioner, mostly sees patients via VTC. He is in Bethel three times per year and has in person appointments. Nick can be contacted via Tiger Connect or at Nicholas_White@ykhc.org.

	=== YKHC Psychological Resources===		=== YKHC Psychological Resources===

JenniferH: /* Non-YKHC Behavioral Health in Bethel */

2020-10-28T11:29:19Z

Non-YKHC Behavioral Health in Bethel

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	===Non-YKHC Behavioral Health in Bethel===		===Non-YKHC Behavioral Health in Bethel===
	~~Some psychiatric~~ services ~~available locally are not covered by~~ YKHC ~~Native benefits. These~~ would ~~have to~~ be ~~private pay or insurance payment~~.		Patients may choose behavioral health services outside of YKHC, which would be the financial responsibility of the patient. The Bethel Family Clinic has behavioral health services, including narcotic addiction. Bethel Family Clinic is the local Health Resources and Services Administration (HRSA) clinic and uses a sliding scale fee.
	Bethel Family Clinic has ~~some~~ behavioral health ~~counselors~~, including ~~ones who work with~~ narcotic addiction. ~~They are~~ the local HRSA clinic and ~~run off~~ a sliding scale.

	==SRC Outpatient Behavioral Health Resources==		==SRC Outpatient Behavioral Health Resources==

JenniferH: /* YKHC Behavioral Health Department */

2020-10-28T11:29:00Z

YKHC Behavioral Health Department

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	===YKHC Behavioral Health Department===		===YKHC Behavioral Health Department===
	The YKHC Behavioral Health Department ~~lives across~~ the ~~street from~~ the hospital. There ~~they have~~ several family and child counselors. They also supervise the Behavioral Health Clinicians and the Behavioral Health Aides that work in the SRC facilities.		The YKHC Behavioral Health Department is on the second floor of the hospital. There are several family and child counselors. They also supervise the Behavioral Health Clinicians and the Behavioral Health Aides that work in the SRC facilities.

	===Non-YKHC Behavioral Health in Bethel===		===Non-YKHC Behavioral Health in Bethel===

JenniferH: /* YKHC Outpatient ACT Program */

2020-10-28T11:28:29Z

YKHC Outpatient ACT Program

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	===YKHC Outpatient ACT Program===		===YKHC Outpatient ACT Program===
	At the Ambulatory Outpatient Clinics in Bethel, there are Outpatient Behavioral Health Clinicians, who work with the ~~Access to~~ '''Collaborative Treatment or ACT ~~(formerly IMPACT)~~ program'''. All patients over 12 are offered a PHQ 9 ~~which is a~~ depression screening questionnaire. Please review it briefly when seeing the patient. If they score =>15, or they check the questionnaire saying they think about dying, or they need a real time intervention, call ext. 6553 and one of the ACT clinicians will respond. They are available during the day to counsel patients about depression, anxiety, relaxation exercises, grief, etc. If the ACT clinician feels they need a few more sessions, the ACT clinician can set up appointments with the patient. If he/she feels the patient needs more extensive counseling, he/she can facilitate an appointment with a counselor from the main Behavioral Health Department ~~across the street~~.		At the Ambulatory Outpatient Clinics in Bethel, there are Outpatient Behavioral Health Clinicians, who work with the '''Access to Collaborative Treatment or ACT program'''. All patients over the age of 16 are offered the PHQ-9 depression screening questionnaire. Please review it briefly when seeing the patient. If they score =>15, or they check the questionnaire saying they think about dying, or they need a real time intervention, call ext. 6553 and one of the ACT clinicians will respond. A referral to ACT can also be made via PowerChart/FirstNet. They are available during the day to counsel patients about depression, anxiety, relaxation exercises, grief, etc. If the ACT clinician feels they need a few more sessions, the ACT clinician can set up appointments with the patient. If he/she feels the patient needs more extensive counseling, he/she can facilitate an appointment with a counselor from the main Behavioral Health Department.

	===YKHC Behavioral Health Department===		===YKHC Behavioral Health Department===
	The YKHC Behavioral Health Department lives across the street from the hospital. There they have several family and child counselors. They also supervise the Behavioral Health Clinicians and the Behavioral Health Aides that work in the SRC facilities.		The YKHC Behavioral Health Department lives across the street from the hospital. There they have several family and child counselors. They also supervise the Behavioral Health Clinicians and the Behavioral Health Aides that work in the SRC facilities.

JenniferH: /* Emergency Services */

2020-10-28T11:27:45Z

Emergency Services

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	Village Services directly administers the Emergency Services component. Emergency On-Call Responders-Emergency Services Clinicians and Complex Care Managers are available twenty-four hours per day to respond to behavioral health crisis for all individuals in the Yukon-Kuskokwim service area. The responders provide immediate mental status examinations and work with the primary care providers in the village or hospital to plan care for management of the crisis and follow-up of the individual. On-Call Attendants are available to stay with an individual admitted to the hospital for evaluation when ordered by an admitting physician to provide safety and security for a client. During the evaluation period comprehensive mental health and substance abuse assessments are completed by the Emergency Services Clinician to assess and manage the client within the behavioral health system of care. '''The Emergency On-Call Response Team is available twenty-four hours per day at 543-6100 or 1-800-478-2642'''		Village Services directly administers the Emergency Services component. Emergency On-Call Responders-Emergency Services Clinicians and Complex Care Managers are available twenty-four hours per day to respond to behavioral health crisis for all individuals in the Yukon-Kuskokwim service area. The responders provide immediate mental status examinations and work with the primary care providers in the village or hospital to plan care for management of the crisis and follow-up of the individual. On-Call Attendants are available to stay with an individual admitted to the hospital for evaluation when ordered by an admitting physician to provide safety and security for a client. During the evaluation period comprehensive mental health and substance abuse assessments are completed by the Emergency Services Clinician to assess and manage the client within the behavioral health system of care. '''The Emergency On-Call Response Team is available twenty-four hours per day at 543-6100 or 1-800-478-2642'''

	If you have an actively suicidal patient in a village, the VPOs or state troopers will need to be involved and ~~will escort~~ the patient to the ~~Emergency Department in Bethel~~ on a Title 47. There is always an on-call Behavioral Health Clinician in Bethel who is available by Tiger Connect. He/she can help make the arrangements for the Title 47 with the VPOs and make sure that the patient goes straight to the ED when they arrive in Bethel.		If you have an actively suicidal patient in a village, the VPOs or state troopers will need to be involved and the patient will have to be escorted from the village on a Title 47 with a police escort. There is always an on-call Behavioral Health Clinician in Bethel who is available by Tiger Connect. He/she can help make the arrangements for the Title 47 with the VPOs and make sure that the patient goes straight to the ER when they arrive in Bethel.

	===Inpatient Psychiatric Services===		===Inpatient Psychiatric Services===

JenniferH: /* Inpatient Psychiatric Services */

2020-10-28T11:26:07Z

Inpatient Psychiatric Services

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	===Inpatient Psychiatric Services===		===Inpatient Psychiatric Services===
	~~On North Wing, we~~ have ~~two~~ observation rooms where ~~we may admit Title 47~~ patients. ~~Drug overdose patients~~ may also be ~~admitted to those rooms so they can be observed while we monitor their blood levels (e.g.~~, ~~acetaminophen levels)~~.		We have four observation rooms where psychiatric patients (suicidal/homicidal ideations, overdoses, acute psychosis) can be admitted.
	~~If they need more care, the patients will~~ be transported to ~~Anchorage to API (~~Alaska Psychiatric Institute) or ~~to Charter~~ North ~~for adolescents~~.
			There is a psychiatric service for ED and inpatient which is staffed by Psychiatrists, Psychiatric NPs, and Psychiatric PAs. They can be reached via Tiger Connect to ‘Psych On-Call’. They may also be involved in following-up, typically via VTC or Telehealth with recently discharged patients.

			Patients may also be transported to the Alaska Psychiatric Institute (API) or North Star Behavioral Health in Anchorage.

	=== Crisis Incident Stress Debriefing ===		=== Crisis Incident Stress Debriefing ===
	Coordinate Critical Incident Stress Debriefings (CISD) response teams with other providers throughout the YK –Delta and debrief with trauma first responders. Develops Crisis intervention teams with community partners throughout the YK-Delta. Coordinates the training and certification of the crisis team members. Coordinates all logistics of crisis village-based responses by contacting and deploying team members and ensuring adequate coverage and follow-up.		Coordinate Critical Incident Stress Debriefings (CISD) response teams with other providers throughout the YK –Delta and debrief with trauma first responders. Develops Crisis intervention teams with community partners throughout the YK-Delta. Coordinates the training and certification of the crisis team members. Coordinates all logistics of crisis village-based responses by contacting and deploying team members and ensuring adequate coverage and follow-up.

JenniferH: /* YKHC Psychiatric Resources */

2020-10-28T11:25:23Z

YKHC Psychiatric Resources

← Older revision		Revision as of 11:25, 28 October 2020
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	==Behavioral Health Outpatient Resources==		==Behavioral Health Outpatient Resources==
	=== YKHC Psychiatric Resources===		=== YKHC Psychiatric Resources===
	~~YK has 2 rotating psychiatrists.~~		David Ondich, MD is our adult psychiatrist who prescribes most of the psychiatric medication needed in the Delta. He sees patients via VTC in the Behavioral Health Department in Bethel. He is available by phone at 612-824-9812 or by email at David_Ondich@ykhc.org.
	~~'''~~David Ondich, MD~~'''~~ is our adult psychiatrist ~~that~~ prescribes most of the psychiatric medication needed in the Delta. He ~~works in from~~ VTC in Behavioral Health in Bethel. He is ~~always~~ available by phone ~~if needed~~ at 612-824-9812 or by email- David_Ondich@ykhc.org.

	'''Karen Jackman, MD''' is the child psychiatrists and works directly out of Specialty Clinic in the hospital and does VTC and face to face visits only in Bethel. She works 50% for YKHC. She also supervises the children at the McCann Treatment Center who are under her care for drug/inhalants/alcohol use and other psychological diagnoses. Her contact information is Karen_Jackman@ykhc.org.		Nick White, a Psychiatric Nurse Practitioner, mostly sees patients via VTC. He is in Bethel three times per year and has in person appointments. Nick can be contacted via Tiger Connect or at Nicholas_White@ykhc.org.

	Nick White, ~~our~~ Psychiatric Nurse Practitioner ~~is also working out of Specialty Clinic doing Video Teleconferencing from Montana~~. He is ~~a full time provider~~ and ~~is excellent with prescribing medications~~. ~~He consults with all of us as well as Drs~~. ~~Ondich and Jackman when necessary~~.

	=== YKHC Psychological Resources===		=== YKHC Psychological Resources===

JenniferH: /* SRC Outpatient Behavioral Health Resources */

2020-10-28T11:23:57Z

SRC Outpatient Behavioral Health Resources

← Older revision		Revision as of 11:23, 28 October 2020
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	==SRC Outpatient Behavioral Health Resources==		==SRC Outpatient Behavioral Health Resources==
	At each SRC there should be at least one Wellness ~~Counselor—a~~ Behavioral Health Aide who can counsel and listen to patients who have anxiety, depression~~, etc~~.		At each SRC there should be at least one Wellness Counselor, a Behavioral Health Aide, who can counsel and listen to patients who have anxiety or depression.

	== Prevention Services ==		== Prevention Services ==
	Prevention services, established in January 2012, has established traditional healing and elder consultation as the forums with which to implement community and family support systems in the region’s villages.		Prevention services, established in January 2012, has established traditional healing and elder consultation as the forums with which to implement community and family support systems in the region’s villages.

JenniferH: /* OVERVIEW */

2020-10-28T11:23:20Z

OVERVIEW

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	==OVERVIEW==		==OVERVIEW==
	We have an at-risk population ~~in the Yukon-Kuskokwim Delta~~ for ~~depression,~~ suicide and substance abuse. ~~The~~ suicide rate ~~has consistently been higher than the national average~~. ~~In order to capture patients who need help, we~~ screen for depression at every visit ~~in the outpatient clinics~~, ~~village clinics~~ and ~~SRCs~~.		We have a very at risk population for suicide and substance abuse. We have a very high suicide rate. We screen for depression on every visit, and contact the ACT clinician for a positive screen. If the depression screen is positive during the screening for an outpatient visit in the SRCs, the Wellness Counselor or Behavioral Health clinician in the SRC should be called to see the patient. Below is a list of the different resources available in the different parts of the hospital for our patients.

	If the depression screen is positive during the screening for an outpatient visit in the SRCs, the ~~wellness counselor~~ or BH clinician in the SRC should be called to see the patient. ~~Here~~ is a list of the different resources available in the different parts of the hospital for our patients.

	The Behavioral Health Services division for YKHC is located across the street from the hospital. They have several family and child counselors. They also supervise the behavioral health clinicians and the behavioral Health Aides that work in the SRC facilities. There is a position for a Psychiatric Nurse Practitioner.

	The service delivery system at YKHC is comprised of various service components, including Crisis Services, Outpatient and Village Services, Residential Services, Developmental Disabilities, and Support Services.		The service delivery system at YKHC is comprised of various service components, including Crisis Services, Outpatient and Village Services, Residential Services, Developmental Disabilities, and Support Services.

JenniferH: /* Alcohol/Drug Use In The Delta */

2020-10-28T09:11:58Z

Alcohol/Drug Use In The Delta

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	===Alcohol/Drug Use In The Delta===		===Alcohol/Drug Use In The Delta===
	Alcohol is the ~~drug~~ of ~~choice for~~ the Delta ~~with marijuana running~~ a ~~close second~~.		Alcohol and drug use, like the rest of the country, is problematic in the YK Delta. At this time, Bethel is a “damp” community, which means alcohol is not sold here, but it can be brought in.

	Marijuana use is very common and ~~per~~ Alaska state law every person is allowed to grow 4 plants and have product for personal use. They are not allowed to transport, smoke in public, or sell it to others. People can get marijuana cards from providers in Anchorage, but YKHC is not allowed to give medical marijuana cards or prescribe marijuana as we are a federal facility. The exception is for Marinol.		Marijuana use is very common, and recreational use is legal in Alaska. Per Alaska state law, every person is allowed to grow 4 plants and have product for personal use. They are not allowed to transport, smoke in public, or sell it to others. There are two marijuana retail shops in Bethel. People can get marijuana cards from providers in Anchorage, '''''but YKHC is not allowed to give medical marijuana cards or prescribe marijuana as we are a federal facility. The exception is for Marinol.'''''

	We also are having an influx of heroin in the Bethel area ~~that is spreading out to~~ the villages~~. We have had several~~ deaths due to ~~heroin~~ overdose ~~in the past few years~~. Use seems to be mainly smoking, but there is also some injection use.		We also are having an influx of heroin in the Bethel area and the villages, which has resulted in deaths due to overdose. Use seems to be mainly smoking, but there is also some injection use. Naloxone is available in the Village Clinics and can be prescribed for patients on chronic narcotic therapy.

	Prescription medication abuse is also present~~, which~~ YKHC works hard to combat with our Pain Management Program and Pain Committee. For opioid dependence ~~seeking treatment~~, contact the ~~'''~~Opioid Treatment Case Manager~~'''~~.		Prescription medication abuse is also present and YKHC works hard to combat this with our '''Pain Management Program and Pain Committee'''. For patients seeking treatment for opioid dependence, contact the Opioid Treatment Case Manager.

			Options for patients interested in getting treatment for substance abuse include a Bethel alcohol treatment facility (i.e., The Healing Center) and multiple treatment facilities in Anchorage, Juneau, and Sitka. The best way to get our patients into treatment is to either refer them to YKHC Behavioral Health through PowerChart/FirstNet or call 543-6161 to help get them set up for an assessment. For patients with private insurance, you can call Bethel Family Clinic to help facilitate setting up treatment plans.

	Options for patients interested in getting treatment for substance abuse include a Bethel alcohol treatment facility (i.e., The Healing Center) and multiple treatment facilities in Anchorage, Juneau, and Sitka. The best way to get our patients into treatment is to either refer them to YKHC Behavioral Health through PowerChart/FirstNet, or call 543-6161 to help get them set up for an assessment. For patients with private insurance, you can call Bethel Family Clinic to help facilitate setting up treatment plans.

	Several AA/NA groups and Al anon meet in town weekly at the Catholic Church, The Healing Center, Tundra Women’s Coalition, and the Hospital Main Conference Room.		Several AA/NA groups and Al anon meet in town weekly at the Catholic Church, The Healing Center, Tundra Women’s Coalition, and the Hospital Main Conference Room.