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Crestwood Behavioral Health


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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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Transformation – One person, one program, one community at a time.

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The day Crestwood Behavioral Health opened the Kingsburg Healing Center was one of those beautiful moments of transformation. We spend much of our lives working with people and ourselves on transformation, it could be changing a small behavior or a big one, and it may mean adding an exercise routine, revising a Recovery Service Plan, or helping a person find a job.  Transformation may also be seen in the developing of a new program, which was the central theme in the opening our Kingsburg Healing Center.

Transformation for Kingsburg Healing Center began with rehabilitating an old building that had been vacant and lifeless for decades, into a beautiful, warm, welcoming facility. It involved designing a new program that incorporates all of our recovery services such as Homelike Environments, Mind, Body, and Spirit Wellness, Wellness Recovery Action Plan (WRAP), Dialectical Behavior Therapy (DBT), and Trauma-Informed Approaches.  The development of the Kingsburg Healing Center also gave us a chance to get to know the neighbors and community leaders and to start becoming part of such a wonderful community.

Opening week for our Kingsburg Healing Center was very exciting and included an Open House on January 27, where community leaders and neighbors were welcomed in to tour the newly transformed facility and meet the staff. The event began by a warm blessing from Father Gregory, from the Holy Family Parish.  Kingsburg Mayor, Bruce Blayney, then provided opening words and other local community leaders such as Kingsburg District Hospital Board Members Glenn Snyder, Robert Johnson and Arlie Rogers, as well as Kingsburg City Manager, Alex Henderson also added their own words of welcome. Dawan Utecht, Director of Fresno County Behavioral Health, shared her kind words with the group.  Many other community leaders were also in attendance such as City Council Members Staci Smith and Michelle Roman; Chief of Police Neil Dadian; and Steve Safarjian, local broker/owner of RPS Real Estate.

The Open House was a great success with more than 200 community members attending.  One Kingsburg citizen, Mrs. Johnson, commented, “Thank you so much for letting us tour the facility.  Crestwood has done an amazing job transforming the old Hospital.  My husband and I are excited to leave here and tell all our friends what the facility looks like and what we learned from the tour.”  And another Kingsburg citizen, Mr. Lopez, said, “Your staff was so nice and gave us a lot of great information about the facility during our tour.   Thank you for giving the community a chance to see for ourselves all the hard work that has gone into the building and understanding what your company stands for.”

So one week later on February 1st, after two years of planning, challenges, hearings and a lot of hard work, the Kingsburg Healing Center was ready to open for clients!  On that opening day it was a gift to have five clients who were warmly received in our welcome room; who sat watching our fish tank; who walked in our yard; who found a space for a quiet time in our serenity room; who shared in delicious homemade lasagna; and who  slept on new beautiful, comfortable beds. These five people were now on a journey to start their own recovery transformation.

Kingsburg Healing Center is not only a transformation of an old building into a beautiful new program; it also is the beginning transformation in the lives of our clients and their families.  “I want you to know that I think the Kingsburg Healing Center is such a loving and warm place.  It is a wonderful place for my daughter.  She is doing so much better now that she is here,” said one client’s mother. No longer will clients in Fresno County have to travel hundreds of miles for mental health services and no longer will their families have to make long trips to visit them. “I wish this place had been here sooner, it would have been nice to have our son here sooner.  Now that he is back in Fresno County we can see him anytime we want and we know it will help him get better,” said one client’s parents.  The transformations at Kingsburg Healing Center are just beginning.

Contributed by:
Patty Blum, PhD
Crestwood Vice President

 


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Our Spiritual Path

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When a person has no hope, no sense of self, no meaning in life, and when they feel that their purpose on this earth feels nonexistent, their dreams have evaporated and thoughts of tomorrow are too heavy a burden to carry – that person can start to drown in emptiness.  It is at this time when they need that path to be opened – the path of connection, the path of light and a path that is uniquely theirs. It becomes the one place or thought that they can hold on to; this is their personal spiritual path. Spirituality is the connection to a greater power, others and self.  It is the way to find meaning, hope, comfort and inner peace in life.  Many people find spirituality through religion, music, art or a connection with nature, while others find it in their values and principles. At Crestwood Behavioral Health we hold spirituality as one of our core values for recovery.

The path can be dark at times. It can be difficult to find without a companion, a guide or simply someone who believes in you, who sees you and who can by a look, a touch or a word begin to open the door to your spiritual path.  The door may be a prayer, a moment of tears, or even a moment of silence. It is a connection with a higher power, with nature, with something or someone greater than ourselves.

The door to your spiritual path may be opened in the simplest and most humble of settings or it may be in a mosque, temple or church. It may be sitting near water or may be by spending time in the outdoors. At times it’s in silence or it can be brought on by a beautiful song.

Each person’s spiritual path can be healing, centering, a moment of peace that is filled with acceptance and love. It is often what brings back hope, a sense of self, purpose and a meaning to life. It is and shall always be a core value to what we offer in our services for our clients at Crestwood.

Contributed by: Patty Blum, PhD
Crestwood Vice President


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Collaboration Changes Lives

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It’s unusual to observe collaboration as it is happening. It is far more common to celebrate the success of collaboration after its culminated.  Crestwood’s collaboration with San Diego Health Care Hospital system and San Diego County Behavioral Health Services has provided an incredible opportunity to observe it in real time with measurable milestones and outcomes.

This collaboration story began in 1992 when a case manager from San Diego County was seeking a placement for a very challenging client and a Crestwood facility in northern California was willing to take a chance. Later that case manager’s program manager got a chance to visit this client at the Crestwood Facility in northern California. What she saw there that day left a very positive impression that she remembered for many years to come. This was the first collaboration between Crestwood and San Diego County and set the stage for future events. Fast forward to 2013 when that very astute and dedicated program manager, Anna La Rocca Palid, LCSW, who is now a leader as a Behavioral Health Program Coordinator in San Diego County Behavioral Health Services, contacted Crestwood about the need in San Diego County for secured behavioral healthcare services. The county had grown tremendously and there were more challenging people to serve and insufficient programs to serve them. They needed a provider to work with the community and them to serve at least 40 clients requiring intensive, secured, recovery-based services. The county also wanted a provider who thinks outside the box, has creative individualized employment programs, recovery services and focuses on integrated alternative tools for clients and they chose Crestwood to be that provider.

Crestwood and San Diego County Behavioral Health Services began devising a plan to address the county’s needs. Crestwood found a beautiful site for a 42-bed Mental Health Rehabilitation Center (MHRC) on a hospital campus in San Diego and created the first of two programs – Crestwood San Diego. Crestwood San Diego opened in June 2014 and quickly filled up with 42 clients. Before long, there was a flow of individuals successfully reintegrating into the community and new admissions moving into the program. The hospitals in the area felt a sense of relief and the new services served their purpose with helping many clients with their recovery.

Soon Crestwood San Diego was full and the San Diego County behavioral healthcare system again felt the pressure of impacted Emergency Departments, long waiting lists at the psychiatric hospitals and a bottleneck in the mental health system. So they looked among themselves to find a possible location for a 40-bed MHRC. Paradise Valley Hospital found a location that would work. Crestwood and Paradise Valley Hospital started discussions about creating a 40-bed MHRC on this site. Dimitrios Alexiou, FACHE, President and CEO of The Hospital Association of San Diego and Imperial Counties and San Diego County Behavioral Health Services worked very closely together to successfully garner support from the San Diego County Board of Supervisors and the community to commit to the 40-bed MHRC in Chula Vista. Crestwood and Paradise Valley Hospital invested significantly in an extensive refurbishing project to create a beautiful, homelike, welcoming recovery-based MHRC known as Crestwood Chula Vista. Crestwood Chula Vista opened in July 2015 and is Crestwood’s ninth MHRC in California.

Collaboration is working with others to do a task and to achieve shared goals. The wonderful collaboration of these groups created an environment that enabled San Diego County Behavioral Health Services to provide beds to some of the clients in greatest need for these services, helping them with their recovery and easing stress in the community and local hospital emergency rooms. It is clear to see that through collaboration we can make a difference.

Contributed by: Patty Blum, PhD
Crestwood Vice President


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Building Resiliency in the Treatment of Trauma

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Resiliency is the ability to recover readily from illness, depression, adversity, or the like, and is one of the cornerstones to health and recovery for individuals and communities. Trauma is an emotional and psychological result of extraordinarily stressful events that shatter a person’s sense of security, making them feel helpless and vulnerable in a dangerous world. The necessity to treat and heal trauma has never been more evident than in today’s environment and culture. In recovery services, treating, mitigating and preventing trauma is a primary expectation for us at Crestwood. It is the starting point for most people as they embark on their recovery paths. The ability to restore and build resiliency through a variety of trauma-informed techniques, including engagement, resourcing, spirituality and somatic work is the basis for this integrated trauma-approach to services.

The research in neuroscience provides a foundation for the understanding that neuroplasticity and neurogenesis enables the brain to reprogram and develop new pathways for survival and growth. This has led to an understanding that we can expand the resiliency skills, thus enabling people to be less vulnerable to re-trauma, prevent trauma and heal existing trauma.  The premise is that if you teach a person to identify and access their resilient innate abilities, aptitudes or inner wellness tools, the individual can practice using these tools as a means to heal and prevent trauma. These tools are skill-based and use a wide-range of evidence-based practices, promising practices and spiritual practices as the building blocks. The practices are integrated and enable the staff at Crestwood to walk with our clients, support and stand behind our clients and guide our clients when needed.  The skills and practices are based on the premise that you meet the client exactly where they currently are.  This methodology creates a client- centered and culturally-sensitive service model.

Recovery services now have shifted from patterns that created ongoing dependency for clients, to interventions that support resiliency, self-reliance, and prevention. This trauma-informed model of building resiliency enables our clients to become more empowered, more independent of the mental health system, and more intimately connected to their communities. As Crestwood programs seek to build resiliency in our clients, communities benefit from mitigating the trauma from occurring in the first place, reducing the likelihood of diagnosed conditions recurring, and build resiliency through the community.

Trauma-informed care approaches have been the basis of the resiliency skills building. At Crestwood we utilize these trauma-informed care approaches along with culturally-sensitive multidisciplinary approaches and integrating spiritual practices by utilizing evidence-based practices including Wellness Recovery Action Plan (WRAP), Dialectical Behavior Therapy (DBT), and Peer Providers to provide a rich source for mitigating and healing the impact of trauma for our clients.  In our Crestwood programs we will continue to work with and support our clients with developing resiliency skills to create a strong foundation from which they can build from and use in their recovery.

Contributed by: Patty Blum, PhD
Crestwood Vice President


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A Values-Driven Organization

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A values-driven organization identifies its values through a process of self-examination.  This involves identifying the organizational purpose, the needs of the customer, assessing all strengths, deficits, and opportunities, as well as threats to the organization’s mission. It also entails taking an extensive and comprehensive 360 degree look at the entire organization, in other words, a non-compromising organizational soul-searching.

At Crestwood Behavioral Health, Inc. this self-examination involves a view of our organization, our communities, and our purpose which stems from four different perspectives.

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The first view we examine is from the perspective of the organizational leadership which consists of our Board of Directors, Chief Executive Officer, Chief Financial Officer, executive leadership, program administrators and campus leadership.  Next we include our front line staff, mid-management staff and program supervisory staff.  This provides perspectives from all viewpoints in Crestwood.

The next vantage point that is vital to gaining the company’s full perspective is the client and family support system stakeholder group. This involves creating a safe space for our clients and their family voices to be heard.  The client and family are the primary voices to be listened to and it may take time, support and compassion to enable this perspective to be fully shared. At Crestwood we see this as the responsibility of the organizational leadership. One way we do this is to employ people with lived experience and have family members at the executive, management and front-line staff level job positions.

The next perspective that we include is from our county partners, customers, and the communities we provide services to. This perspective enables us to understand the needs of the community and provides the opportunity to develop and enhance meaningful relationships with our partners so we can better understand and anticipate the needs of the communities we work with.

Crestwood has developed its mission and values from gathering all of these different perspectives. Crestwood’s mission is to create a partnership with clients, employees, families, business associates and the community in caring for individuals of all ages affected by mental health issues. Together, we invest our energy to enhance the quality of life, social integration, community support and empowerment of mental health clients.  Crestwood promotes wellness and recovery by providing quality and cost-effective programs in a socially responsible manner, and works with families and communities to reduce the stigma associated with mental illness.

The values that were developed from this framework are simple and come from the heart. Crestwood’s values are family, compassion, enthusiasm, flexibility, character and commitment. It is through these values that Crestwood views all aspects of our operations. These values reflect the strength and vulnerability of Crestwood, with a focus on trauma-informed approaches with love and gratitude for the people and communities we serve and the staff and partners we work with.

Crestwood views all decisions, strategies, goals and objectives, and benchmarks for success based on these values.  Our organization is driven to achieve objectives and goals relying on the courage and strength to maintain the highest level of integrity, while honoring these shared values.

Having this values-driven perspective has allowed us to grow as partners in services with other community-based organizations such as Recovery Innovations, Turning Point and Dreamcatchers Empowerment Network. The understanding and recognition that our county and community partners provide the foundation for our services, enables Crestwood to develop community specific services, with the values of the community intertwined with Crestwood’s values.

The opening of our MHRC programs in San Diego and Chula Vista are an excellent example of involving all of these perspectives.  Crestwood worked very closely with the county and community leaders to identify the needs.  The community-based providers and hospitals helped Crestwood to find the right locations for the programs. The recruitment of employees was focused on hiring people with lived experience and allowing them to provide a strong client voice, as well having family members involved at all levels of service. We worked to include the voices of Crestwood San Diego’s and Crestwood Chula Vista’s leadership teams so that they could participate in all elements of program development, making it strong and reflecting all of Crestwood’s mission and values.

By being a values-driven organization and continuing to take a full 360 degree look at ourselves and our services, Crestwood will continue to grow and provide the best care possible for our clients and the communities we serve.

Contributed by: Patty Blum, PhD, Crestwood Vice President


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First Impressions

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In life we only get one chance for a few things – one of them is a first impression, so it’s vital we prepare ourselves to give an authentic and genuine one. In doing so, we share ourselves with others in the way we wish to be understood.  First impressions can be our calling card and they can be the one element or the one interaction that connects two people deeply.

At Crestwood Behavioral Health, we believe in the value of the first impression so we strive to make it the most authentic and positive one possible.  We create the opportunity to meet the person, whether it’s a client, a coworker, a family member or visitor, exactly where they are at. We have drawn from a course created in the hospitality industry called First Impressions to teach the skills needed to make this welcoming and warm first impression.  We included it in the curriculum lessons from Dialectical Behavior Therapy (DBT), the 12-Step Program, Core Gifts, Trauma-Informed Care and Wellness Recovery Action Plan (WRAP). The course framework focuses on the principles of commitment, leadership, attitude, service and support.

The principle of commitment in the First Impressions course emphasizes how to do our very best each day, to make a difference in someone else’s life and by doing so, we then make a difference in our own lives. We commit ourselves to the Crestwood values of family, to holding ourselves with integrity, to compassionately doing our work, to being flexible and forthright, and to have a sense of humor and positive attitude about the serious and challenging moments that frequently occur in our day.

The leadership principle in the course focuses on leading by example. No matter what position you hold in life or at Crestwood, we are certain that we all have an opportunity and responsibility to lead. In life we are all leaders and we must demonstrate our values each day so that we create a sense of positive peer pressure, creating a culture of caring behavior by “paying it forward.”

Attitude is addressed in the course as being reflected in our actions. We promote healthy productive behavior through building skills to increase the self-esteem and sense of value of our clients and staff. We create an environment where skills are taught and practiced to enhance the lives of our clients, families and ourselves, whether it’s DBT, Trauma-Informed Care approaches or WRAP. This culture of learning creates a positive sense of self which turns into positive performance at Crestwood.

The service principle in the First Impressions course focuses on the work we do and so much more. It is being committed to come to work on time and making each moment count. It is having a smile. It is consistently meeting the needs of those around us with healthy boundaries, dignity and compassion.

And finally the principle of support is addressed on how it holds the first impression and the ongoing relationship together. Support of others starts with self-care. In Trauma-Informed Care approaches we say “put your mask on first, before you can help someone else”, so if you are not healthy and supported, then you cannot provide care and support to others.  Support includes anticipating the needs of co-workers, as well as clients. It is creating a healthy environment where we feel cared for and appreciated. This leads to our sense of pride in the work we do and the people we are.

The First Impressions class at Crestwood teaches each of these values and allows our staff to spend time together sharing their thoughts and developing the rapport to truly emanate team work. The opportunity is always there for a positive first impression and at Crestwood we seize the moment to do so.

Contributed by: Patty Blum, PhD, Crestwood Vice President