This type of positive outlook which can be learned tells your genes to switch from inflammatory to anti-inflammatory actions and boosts your antiviral immunity. The opposite is also true: when we feel miserable or have a negative outlook, inflammation goes up, and antiviral immunity goes down.

Amit Sood: I would tell them to continue to keep looking at mental and behavioral health holistically, focusing on prevention, treatment, and rehabilitation. Instead of focusing on productivity, focus on purpose, cultivate compassion, and give employees the agency to make decisions.

Helping employees find their purpose and meaning can drive productivity. And people who are compassionate and caring tend to learn skills better and become more competent. Also, the more autonomy employees feel, the more likely they will blossom in what they do, and the more engaged they will be.

It’s important to keep in mind what makes employees tick. What really keeps them going is a sense of control and a sense of purpose. And if you give them both, it can help combat the cognitive overload that we may all be feeling.

Amit Sood: One approach is based on having perspective. We have a practice called “kind attention,” where you assume that everybody is struggling in some form or another. With that awareness in mind, it can help bypass judgment of others and, in its place, produce a sense of empathy—a silent good wish—even before you get to know the person. Doing that preemptively creates a stronger connection and bond with another person.

There is also a lot of support for transformation through gratitude. I believe that when gratitude and kindness become part of our breadth, then the physical distancing and the mandates matter less because the potential to feel connected to the person you’re talking to remotely can be just as strong as it would be talking in person. If you’re dealing with a difficult transactional or potentially adversarial meeting at work, you can preemptively try asking yourself, “Why am I grateful to the person I’m going to meet?”

Amit Sood:  The uptick in psychological resilience seems promising as we become more comfortable with things being less controllable. And with lesser stigma related to mental-health issues, I hope we can preserve our growth as we emerge fully from the pandemic by validating each other with gratitude and kindness.

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Lots of millivolts zipping and zapping from one neuron to the next neuron.

So can we, the medical doctors and medical researchers, figure out how to use electricity to tune up the brain?

That’s the BIG QUESTION.  

But the brain is the most complex structure in the universe aside from the universe itself.

But the work of using electricity to tune up the brain of those with mental health challenges is well underway.

Depression , for example, involves multiple neural circuits. This is different in different patients. So what is needed is a personalized approach to using electricity to treat depression.

The personalization is based on brain mapping of brain activity. EEG does that trick.

And then electrodes are programmed to target areas of the brain involved in creating depression.

This is like a pacemaker for the brain.  Deep brain stimulation with leads deep in the brain has been used for decades but it is very invasive and very expensive.

So transcranial brain stimulation using MRI targeting is a much less invasive and more accessible approach to treating depression and other conditions such as OCD.

Personalized brain stimulation requires accurate targeting of the right area of the brain but also the right rhythm. The neural code or the brain code is frequency dependent.  Like a song. Get the frequency wrong and Taylor Swift’s song is gaarbbage.

So the brain is and has been proven to be plastic. It can be rewired and using electricity in targeted and personalized methodologies will help humanity with the biggest illness of all – mental illness.

Raymond Rupert  health system disruptor and patient advocate.

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To fix the wiring in your house, you need an electrician. To fix the pipes, you need a plumber.

To address mental health problems in a multi-generational family, you need to engage with persons with specific roles and functions and specialities.

Let’s look at 3 roles: the therapist, the coach and the mental health advisor.

The therapist ( a social worker, psychotherapist or psychiatrist) enters into a therapeutic alliance ( relationship) with the patient.

This role is carefully defined by the provider’s approach to mental health. The provider’s regulator ( College) has much to do with how the relationship unfolds. It is essential that the provider use motivational interviewing strategies to engage the patient with the objective of getting healthier. The therapist can’t push too hard or the therapeutic alliance will be damaged and the process will stop.  The process is typically incremental. Small steps over time.  The goal is to keep the patient involved over time.  And there are over 300 therapeutic models that can be employed to assist the patient. Maybe more than 300 models. So this choice of therapeutic model is complex.

The coach takes a different approach. Coaching is goal oriented. There is a goal and an outcome. The coach is there to reinforce this process of trying to reach those goals. Consequences or alternative strategies might result if the patient fails to attain the goals.  The relationship with the coach is about negotiating the goals and then reinforcing the process of attempting to attain them. There can be friction in this relationshp but that is factored into the approach. Coaching might be shorter term than therapy because it about clearly defined goals over a certain time horizon.

The advisor is different. The mental health advisor for the family is the architect of the entire solution. This relates to both the family system and the person of concern. The mental health advisor defines the problem or problems involving both the family system and the person of concern. Then the mental health advisor orchestrates the solution with an integrated team of providers. These can be therapists or coaches using many different modalities from family system coaching to music therapy to wilderness therapy. The mental health advisor must have a complete understanding of all the options available to address the problems. The approach has to be comprehensive. It is sometimes costly and the mental health advisor will help with the budget for these services.

Case Study:

Andy was 9 years of age. He had a bad temper and would act out periodically. His older brother would taunt him. His father had big expectations about his sports performance.

One day, he ran screaming into the kitchen, grabbed a sharp knife and threatened to self harm.

That is a crisis for this family. Our job at RCM Health Consultancy was to take the role of mental health advisor for the family.

It took a village to address this set of problems because it involved all the members of the family.

Our job was to mobilize an integrated team of providers to assist and to address the root cause of Andy’s acting out.

Our process worked to assist Andy and the family.

This is often a work in progress requiring tweaking over time as the children grow and mature and the family system seeks to adapt.

Raymond Rupert

CEO

RCM Health Consultancy Inc.

647 350 5500

info@rcmhealthconsultancy.com

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Unfortunately, if the child sustains adverse childhood experiences (ACEs) including trauma, separation and abuse, then there are likely to be resulting mental health concerns and challenges.

So planning for mental health for the family starts on day 1 of the infant’s journey in attachment and brain development.

If mental health challenges do arise, then the quality of socially and emotionally authentic relationships within the family are the key to helping the person with the mental health challenge.

The analogy often used in mental health involves the use of the oxygen mask on the airplane. The first thing to do on the airplane is for the parent to put on the oxygen mask and then the parent can help the child.

The parents have to take care of their mental health first in order to help the child.  The parents must be emotionally healthy in order to help the child.

The family system is an important part of our work at RCM Health Consultancy.   In family systems work, we look at the existing narrative within the family system.

The narrative is what the parent’s think. It is their assumptions about the child. If the problem has become entrenched and the parents have suffered with the problem for a decade or more, they might assume that nothing can be done. And then nothing will be done.

We recently spoke with the parents of a 30 year old child assumed to have “failure to launch”. The parent’s narrative and assumptions were that the child was not capable of becoming a productive and purposeful individual. When we offered to help with the narrative and assumptions, the parents said no thanks.  Nothing will change because of their assumptions which stopped any possible progress from being made.

If the narrative and assumptions can be unpacked and changed and a new more positive and optimistic outlook is adopted , then the ensuing changes in the conversation and actions might in fact work to help the child.  At least, an effort will be directed at changing in a positive and healthful way.

Challenges exist at this stage of implementing change, as well. Having the parents look at their own enabling behaviours is very difficult. It is hard work to change what is unexplored. Even if the parents had the best intentions in raising the child, things can go wrong.

Once the parents have examined their enabling behaviours,  and then changed the conversation and their actions including introducing consequences , then things might get worse before things get better. That is to be expected. So put on your seat belts for the bumpy ride and be patient.

This describes the family systems work that we do at RCM Health Consultancy when families commit to work with our teams in helping a family member with a mental health problem.

Raymond Rupert

CEO

RCM Health Consultancy Inc.

647 350 5500

info@rcmhealthconsultancy.com

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That is a certainty and all you have to do is look at the stats to see that it is a reality for many families.

It is time to start putting a plan in place for these mental health crises. Or the vague reference by a family member to ending it all might, in fact, happen.

In planning for a mental health crisis, it is important to realize that the family doctor is not likely going to provide the solution. And the healthcare system won’t likely provide a solution. A patient might be admitted to hospital for a crisis but that is just the beginning and not a solution. Solutions have to be crafted one patient at a time with a team with deep expertise in this field.

A family needs a mental health advisor to take the role of mental health coach. The mental health coach’s job is to build deep and trusting relationships with the family members. He/she has to understand how to use langugage to build trust.  And how to engage the family members either individually or as a group.

The mental health coach should have training in the assesment of mental health conditions. RCM Health Consultancy team members can take this role and RCM is able to provide an audit of the mental health status of the family members. Or at least an audit for those where there is some concern.

The family member will get feedback on their metrics and understand that if the family member wants help that the mental health advisor/coach can help to guide them on a treatment pathway. Crafting the treatment pathway requires a multi-disciplinary team with various skillsets.

This is a complex role. If there are 4 generations in the family, and an individual can have any of 30 conditions and if there are at least 40 different options for that person, then there are 4800 different scenarios to possibly consider.

This is a complex decision that a family needs to consider and hopefully with a team of professionals supporting their decision. That is what we do at RCM Health Consultancy.

A  family can call RCM Health Consultancy Inc. to learn more about how RCM can assist the family to prevent mental health crises.  We are always pleased to assist.

Raymond Rupert CEO  RCM Health Consultancy Inc.

647 350 5500 ext 118 /   info@rcmhealthconsultancy.com

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The sum of an person’s observable characteristics is their phenotype. A key difference between phenotype and genotype is that, whilst genotype is inherited from one’s parents, the phenotype is not. Whilst a phenotype is influenced the genotype, genotype does not equal phenotype

Any digital phenotyping systems used to track a person’s mental health status will be inaccurate. There is no such thing as a 100 per cent accurate medical test, and it’s important to consider the potential misuse of any mental health data.

But to dismiss digital phenotyping because of these limitations is to miss its potential utility. At the very least, a person’s smartphone information could help to inform their clinician’s decision-making and the mental health care that they provide.

Even if a test can’t be used to home in on an exact diagnosis, it could narrow down the range of possibilities and ultimately help inform human judgment and treatment-path selection in a field that needs better diagnostic tools.

Traditional mental health care relies on a person self-reporting their symptoms, which can be unreliable. Furthermore, once a therapy session is over, there’s no established way to monitor a patient’s thoughts, feelings or behaviour in their real life.

Thus, being able to assess mental health objectively and continuously by analysing a person’s daily digital footprint offers a transformative alternative to traditional methods. Digital phenotyping will be an important tool for use in mental health care.

To learn more call RCM Health Consultancy  647 350 5500 or email us at info@rcmhealthconsultancy.com

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source: McKinsey Dec 15 2020

The healthcare sector may consider shifting its focus from short-term mental health “fixes” in the aftermath of acute events and toward the development of an integrated framework to address clinician mental health and the long-term effects of trauma.

While the precise formulation of individual programs will vary, there are a set of principles that should inform any new mental health framework.

Providers can consider embedding mental health training through education, deploying regular risk assessments for all students and staff, establishing new structures within the organizational hierarchy to prioritize mental health and well-being, and procuring resources dedicated to supporting clinicians who require safety net services.

These are essential services that warrant immediate implementation. Healthcare providers during COVID are experiencing continuous and cumulative trauma. The destructive impact of trauma must be countered by developing resilience building capabilities for these providers.

Source: McKinsey Dec 15 2020

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The findings show that worsening psychological health, an increase in employment dissatisfaction, and extended mental strain continue to impact the mental wellbeing of Canadians.

The score of -11.1 is a slight improvement from October (-11.4). The score measures the improvement or decline in mental health from the pre-2020 benchmark of 75. “We’re at a pivotal point in navigating the pandemic.

On one hand, the recent news about potentially life-saving vaccines being administered in the first half of next year should bring Canadians some encouragement.

On the other hand, we are also approaching some of the most difficult months of the year for many Canadians as we approach the holidays and winter months,” says Stephen Liptrap, president and chief executive officer. “Information overload will continue to be an issue in the coming months.

Employers cannot assume that all employees are feeling positive about the new pandemic-related developments and must continue to check in on their wellbeing to maintain a productive workforce.”

This increase in the incidence of mental health amongst employees is of concern. There is a gap in the supply of psychiatric services for these patients. The EAP providers fill an important need for mental health services. However, many of these cases are complex and there is a gap in the suppliers of mental health services for complex mental health patients.

That is a role that RCM Health Consultancy fulfills in the Canadian healthcare ecosystem for mental health services.

Raymond Rupert patient advocate and healthcare consultant

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The problem is that each prescription is a chemistry experiment. No one can predict how a patient with depression, anxiety or a bipolar mood disorder will respond to the medications. Each patient is different. Each patient reacts differently to their medications.

It is time to end the chemistry experiment.

Now a simple genetic test using some cells from inside your mouth can be used to determine how a patient will respond to mental health medications.

The results of the genetic analysis, called pharmacogenomics, provides great intelligence about how to treat the patient.

The results of the tests such as inagene or one ome will tell the prescribing doctor what to avoid and what to use. It is simple.

And the test results will tell the prescribing doctor who is likely to become addicted to opioids and which type of cannabis to use for therapeutic reasons.

So we can stop the chemistry experiments and personalize the use of mental health medications with the use of a simple and modestly priced genetic test.

Tell your doctor about this test and that you don’t want to be involved in a chemistry experiment. Tell your doctor that you want personalized medicine. Or call RCM Health Consultancy and we will arrange for the genetic testing. 647 350 5500.

Raymond Rupert patient advocate and healthcare consultant.

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People who receive telephone-delivered therapy are happy to have treatment that way. One interview study looking at depression and anxiety, for example, found that most people were broadly content with it, particularly saying how convenient it was. The trial of CBT for OCD in adults, discussed above, also found comparable and high levels of satisfaction with treatment delivery in either manner.

Post pandemic, it will be essential for health systems to continue to fund phone therapy or zoom therapy as an effective form of therapy for those with psycho-social challenges.

source: AEON magazine Oct 14 2020

Dean McMillanis professor of clinical psychology at Hull York Medical School and the Department of Health Sciences, University of York.

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