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Crestwood Behavioral Health


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Lacing up their shoes for Health and Wellness

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“A journey of a thousand miles begins with a single step.”- Confucius

At Crestwood Chula Vista, they offer several types of fitness and movement activities for their clients, from Yoga to Zumba, to strength training, to dodgeball and kickball. Unfortunately, they found that only a small percentage of their clients were participating in these activities and at the same time were also still struggling with their desire to be healthy and to maintain their weight. “I’m too overweight to exercise” and “I don’t have the energy to work out” were common explanations as to why they were not participating in activities. This presented the staff with a challenge. They asked themselves what activity can just about anyone do, what activity will they want to do and what would be something that would also benefit both their physical and emotional health? The answer was right in front of them. Every client was doing it every day – walking!

It was right about this time that the City of San Diego advertised the Parks Fit San Diego 2016 Challenge, which is to walk 30 miles in 60 days. Clients and staff were excited to become involved in the 30-mile challenge and it was a way for them to celebrate every step they would take. But as their clients thought about it, they decided that 30 miles in sixty days was not enough and they would instead do 30 miles in 30 days. So the staff purchased pedometers for everyone participating and off they went.

The challenge began on June 18th with a 1-Mile Fun Run.  After that, they went on walks in the community, took nature hikes, and joined 5k events. Each and every day, clients could be seen walking the halls and the patio at the facility with pedometers in hand. They pounded the pavement in their neighborhood, trampled the grass at Balboa Park, explored the trails of the Living Coast Discovery Center, and even kicked up some sand at Imperial Beach. The results of the challenge were tremendous! One of their clients walked 215 miles! She reported her miles to the staff proudly every morning. One day she joked, “I didn’t do so well yesterday, I only went 20 miles.” Other clients were motivated to keep up and the race was on!  Four clients logged more than four hundred miles and together, as a group, they walked more than 500 miles!

“Beyond the miles they racked up, we were seeing firsthand what we have all read in the research studies, that walking and exercise promotes good health, reduces anxiety, increases self-esteem, and boosts mood,” said Shanel Stec, Recreation Assistant.  Clients also made healthier food choices. One client lost 20 pounds and another client lost three pounds.  They set goals for themselves and tracked their progress faithfully. They worked together as a team, challenging each other to keep up and they joined other groups. They were out in the community, they were out in nature, and best of all, they were having fun.

The challenge ended on August 13th with the Parks Fit San Diego 5k finale. However, this finale is not the end for them walking, even more clients and staff have signed up for a new challenge that begins soon.  Shanel said, “We are excited to lace up our shoes and walk together, not as clients and staff, but as companions on our journey toward health and wellness.”

Contributed by:
Shanel Stec
Recreation Assistant
Crestwood Chula Vista


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Health Crisis

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How many times do we have to see our clients, friends and coworkers receive a diagnosis of breast cancer, chronic obstructive pulmonary disease (COPD) or coronary disease at an early age? How many times do we see these same people pass away from “natural causes” in their 30s, 40s and 50s, while we see the average life span of people grow from 51 years in 1910 to 78 years in 2010?

The sad fact is that for those among us living with a mental health diagnosis, the average life expectancy is conservatively 10 years less than those who don’t have that challenge and it also accounts for 8 million deaths worldwide annually.  NAMI and other research suggest that the life expectancy gap is actually 14 to 31 years shorter for those with a mental health issue.  The mortality rate for people with schizophrenia is four times higher than those without this diagnosis and those with a bipolar disorder have a 13 year decreased life expectancy. This is a reflection of our broken system and communities in need of healing and compassion.

Much of this early mortality is attributed to “natural causes” such as heart disease, pulmonary diseases, cancer, cerebrovascular, respiratory, and lung diseases. Elizabeth Walker, a researcher at the Emory University Rollins School of Public Health in Atlanta, writes, “People with mental health disorders have a high prevalence of chronic medical conditions, with fewer resources to manage these conditions. People with mental health challenges are dying prematurely and at a rate far exceeding their peers without this diagnosis.”

How many people that we love and care for have to die before their time and how many times do we have to plan services and mourn their passing? This disturbing health crisis is often overlooked. According to the National Institutes of Health (NIH), life expectancy has increased dramatically, unfortunately, “reductions in mortality are not shared equally in this country across racial, ethnic, and socio-economic groups or health-related conditions.”

So what can be done to start to change this shocking reality?

The first change that is needed is how we deliver services as a society. We need to be honest about the disparities in our culture. Services may be accessible with wheelchair ramps and Braille signage, however, there is no tolerance for people who are disheveled, responding to voices, have ticks, look different or have unpredictable behavior.  This intolerance creates barriers so preventive healthcare, such as routine checkups, mammograms, and teeth cleaning, is out of reach.  These disparities have led to women with mental health issues dying from cancer at twice the rate as the general population, and these women are also three times more likely to die from breast cancer.   Researchers, Colton and Manderscheid, found that the secondary consequences of mental illness are poverty, unemployment, poor housing, stigma, and low self-esteem leading to challenges accessing healthcare, including health professionals’ misdiagnosis, less focus on physical health, low compliance with health screening and treatment, and poor communication.  This has to stop! We have to create pathways to accessibility, prevention and care.  We need to train more primary healthcare providers to work with people with mental health challenges, which is something Crestwood Behavioral Health has been providing to our county stakeholders.  We need to design clinics, waiting rooms and services that are more accepting and inclusive of all marginalized populations. We need to develop more welcoming and validating preventive health screenings and utilization of services.

The second thing we need to do in our communities is the creation of Federally Qualified Health Clinic Clubhouses that welcome those with mental health challenges, the homeless, the disenfranchised and their families.  A Clubhouse is first and foremost a local community center that offers people who have mental health challenges the hope and opportunities to achieve their full potential.  During the course of their participation in a Clubhouse, members gain access to opportunities to rejoin the world of friendships, family, employment and education, and to the services and support they may individually need to continue their recovery. A Clubhouse also provides important routine health screenings that are completed in a client-friendly space, rather than in a hospital or sterile clinic setting. Crestwood is currently looking to explore creating a Clubhouse program in San Diego.  Also, a mobile whole health services unit, a companion to the Clubhouse, is needed to bring health screenings and health services to the homeless where they are, whether it is under a bridge, in a shelter or at a wellness center.

The next action that needs to be taken is to launch a statewide Wellness and Resiliency Initiative similar to the one Crestwood has adopted in all of our programs that includes serving heart-healthy diets and creating client-oriented cookbooks with heart-heathy recipes and shopping guides. It includes planting organic gardens and using the farm to table approach in our meals. It is bringing Zumba and Yoga to every campus and community.  It is having exercise tracks in yards that used to be used for smoke breaks. At Crestwood we support smoking cessation, sobriety and meaningful roles to help replace addiction and isolation. Crestwood also teaches meditation and mindfulness to our clients which lowers heart rate, reduces risk of heart disease and increases pulmonary capacity.

Another action we can take is to live healthier lives as healthcare providers. At Crestwood we use Wellness Recovery Action Plan (WRAP) to support our workforce, with staff being paid for time off the floor to attend WRAP groups. We provide mental health days, as well as sick days and expect our staff to do routine health screenings – modeling wellness. We employ meditation and mindfulness practices at all staff meetings and events to encourage our staff to practice mindfulness as a health and wellness practice.

At Crestwood we will continue to do our part by looking for and incorporating innovative health and wellness measures into our programs.  We can truly practice self-care each day, creating a compassionate community of people caring for themselves and others. This may not move the needle on the mortality rate very quickly; however, it is a promising start that we hope will begin to create healthier, longer lives for our clients, friends and coworkers.

Contributed by:
Patty Blum, PhD
Crestwood Vice President


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Garden to Table Bounty

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The staff at Idylwood Care Center is always looking for new ways to support the well-being of their residents.  Recently, Dietary and Occupational Therapy staff and interns came together to design and launch the Garden to Table program.  This program guides residents in the gardening of seasonal vegetables and herbs, provides education on plants, promotes physical activity, encourages healthful nutrition and supports emotional and mental well-being.

The daily schedule for the program begins with staff sharing with residents a variety of information on nutrition, food basics and overall health and well-being strategies.  Next they demonstrate how-to gardening fundamentals such as weeding, watering, pruning and harvesting. In addition to working in the garden, residents are also encouraged to walk through the garden and get moderate sun exposure during sitting breaks. This give them an opportunity to enjoy the garden, while increasing their Vitamin D levels through sun exposure, which helps with calcium absorption to improve bone density and maintain muscle and nerve function.

Residents are also involved from the beginning in the preparation of the garden by helping to choose what types of vegetables to plant such as peppers, basil and tomatoes.  When it is time to harvest the vegetables and herbs, residents are able to help choose a favorite recipe to use them in, so they can enjoy first-hand the delicious benefit of what they have grown.

The Garden to Table program has been successful in helping residents to increase their group participation and peer interaction; improve their overall well-being and fitness by increasing strength and dexterity; increase their moderate sun exposure time and Vitamin D levels; and improve their weight management and lab levels.

The facility plans to expand their Garden to Table program by having Dietary and Occupational Therapy interns and staff collaborate with residents to create new recipes for what they have grown and also donate a part of their garden produce to local community outreach programs. By sharing their garden bounty with the community, the hopes are that the residents will feel a sense of accomplishment and empowerment that they are making a difference in other people’s lives. With all of these amazing benefits, the Garden to Table program is having an overall positive effect on the mind, body and spirit of the residents at Idylwood Care Center.

Contributed by: Sandy Narasimhan MS,RD,CSG
and Rashmi Rajadhyax PD,OTR/L


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Zumba’s Spark is Energizing Crestwood

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One of the biggest challenges for both our clients and staff is finding the time and motivation to get adequate exercise. Greg Parnell, the Director of Education and Assistant Program Director at Crestwood Behavioral Health Center Eureka’s campus, has been a licensed Zumba instructor for five years now, and to say he is passionate about Zumba, would be an enormous understatement. He teaches Zumba classes not only for the clients in the Eureka facility, but also in the community at recreation centers and schools.

Zumba was started in the 1990s blending aerobic exercise with infectious Latin dance music. It is now a worldwide phenomenon being done in 180 countries, with more than 15 million students taking classes. What Greg and many others that participate in Zumba have found is that it is an activity that sparks something deep inside your spirit. That spark energizes you, changes your mood, and changes your outlook on life. Not only does Zumba bring about physical changes in you, it brings about mental and spiritual changes as well. Zumba can be a spark that starts with a simple routine of fun exercise, which then progresses into wanting to eat better, feel better, present one’s self better, and be more active in the world.

Crestwood has added Zumba to our Mind, Body, and Spirit Initiative. To get Zumba started in our facilities, Greg, along with Margaret McDonald, Administrator at Crestwood Center at Napa Valley and Crestwood’s Director of Nutritional and Wellness Services, wrote a proposal for a Crestwood Zumba Program that has several components and was geared toward both clients and staff. Their first goal was to get one or two staff members at each facility to be trained as Zumba instructors. These staff members can then teach 3 to 5 classes a week for clients and staff at their facilities. The second component was the purchase of Zumba DVDs that could be used to do additional Zumba classes or while trained staff is away. And the third part was to reach out to local Zumba instructors and develop a mutually beneficial relationship with them, in which they would volunteer their time to do Zumba at our facilities, in exchange for directing staff toward their classes in the community. Greg, as Crestwood’s in-house Zumba resource, will also travel to the facilities quarterly to reinvigorate the programs and troubleshoot any problems.

At the 2015 annual Zumba Convention that was held in Orlando, Florida, Greg shared Crestwood’s proposal for a Zumba program with Alberto Pearlman, the CEO of Zumba, who then shared it with conference Keynote speaker, actress and singer Ashley Judd, who lives her own recovery story of depression and wellness through Zumba. Ms. Judd and Mr. Pearlman were so fascinated by what Crestwood is doing with Zumba that they both decided they wanted to be involved. Mr. Pearlman graciously offered to train Crestwood staff to become licensed Zumba instructors. In November 2015, 11 Crestwood facilities, (Angwin, American River, Sacramento, Pleasant Hill, San Jose, Fresno, Bakersfield, Vallejo, Solano, San Diego, and Chula Vista) sent nineteen staff members to Cheryl Louie’s Studio Z in Newark, California, where they were trained by Joy Smith, a Zumba Education Specialist, to become licensed Zumba instructors.

Since then, Greg and Margaret have been traveling to our facilities helping our licensed Zumba instructors plan their classes, help with choreography, and incorporate classes into program schedules. “The enthusiasm from staff and clients has been overwhelming, and the support from Administrators has been amazing. It is inspiring to see how many of our clients really get into the classes, the music, the movement, and just losing themselves into the rhythms,” said Greg. “There are also stories of amazing transformations of our very quiet and soft-spoken clients who suddenly come alive when the Zumba class starts. They see and feel the energy around them and then want to join in.” And then there are also staff members, who after just one of Greg’s Zumba visits, are then inspired to want to do more, learn more, and become Zumba instructors themselves.

Greg and Margaret hope to measure the success of the program and the influence of Zumba on our clients and staff in several ways. They have developed a pre-survey to be used before Zumba is offered in the facility and a post-survey after Zumba has been added to the program schedule. These surveys will assess the number of days clients exercise, reported enjoyment of exercise, and reported barriers to exercise, such as feeling self-conscious or not enjoying exercise.

When the Zumba program is fully up and running in our Mental Health Rehabilitation Centers, Psychiatric Health Facilities, Adult Residential Facilities, and Social Rehabilitation facilities, they intend to bring Zumba Gold to our Skilled Nursing Facilities. Zumba Gold is a specialized form of Zumba for older adults. “We believe all of our clients and staff, no matter what age or ability level, will benefit physically, emotionally, and spiritually from participating in such an accessible and inspiring form of exercise,” said Margaret. “We also would love to eventually have clients be trained to become Zumba instructors, giving them meaningful roles in the facilities and the potential for employment once they are back in their communities.”

Zumba truly provides that amazing spark to energize the mind, body and spirit of those who experience and embrace it in their lives.

Contributed by:
Margaret M. McDonald, M.S.
Director of Nutrition and Wellness Services
and
Robert Pitts, Campus Administrator
Crestwood Behavioral Health Center Eureka