Tag: DBH

Income Insecurity Impacts Access to, Affordability of, and Outcomes for Men’s Wholistic Health

Men’s access to, use and affordability of physical and behavioral health care is at issue. They have the highest rates of avoidable deaths worldwide and are the most likely to skip care due to costs.

This blog has focused on varied population health and access to care challenges for racial and ethnic minorities, among other vulnerable and marginalized communities. Recent blogs addressed the dismal state of Maternal mortality and mental health, escalating women’s reproductive health crisis, and disappearing birthing centers across rural regions. The impact of systemic racism and other realities, such as trauma, on quality of care has also been of note. Considerable research identifies their influence on exacerbation and emergence of chronic physical and mental illness; every age group, gender, and individual across the cultural landscape is at risk. 

The 2020 International Health Policy Survey from the Commonwealth Fund and Organisation for Economic Co-operation and Development (OECD) highlights a plight worthy of notice: health care habits of American Men faced with financial insecurity. The report compares the access to, use, and affordability of care for males in the U.S. compared to 11 high-income countries. 

Startling Outcomes

The report summary focused on overall demographics by gender versus among racial and ethnic groups. The wholistic health triad of physical, behavioral, and psychosocial health gets primary attention yet again with troubling outcomes:

  • At least, 16 M men in the US lack health insurance:
    • Affordability of health plans remains the primary reason 
  • 45% of men have problems paying medical bills:
    • 67% of these men are frequently stressed about employment and/or financial security

Men in the U.S with income insecurity:

  • Are least likely to have a regular physician
    • They have the highest rates of Emergency Department use, especially for conditions that could have been treated in the Doctor’s office (e.g., asthma, diabetes, hypertension) 
  • Skip necessary care due to costs
  • Incur medical bills at the highest rates
  • Are least likely to access preventative care
  • Have the highest rates of avoidable deaths: 337/100,000
  • Are more likely to have integrated health issues, especially chronic conditions
    • Almost 30% have two or more chronic illnesses
    • Have significantly higher rates of smoking and alcohol use, and increased likelihood of having multiple chronic conditions:
      • 4X greater likelihood of being in fair or poor health
  • Have among the highest rates of mental health care needs: 35% of men

The Bottom Line and Mandate

At this point in time, the data affirms that rates of avoidable deaths, chronic conditions, and mental health needs for U.S. men remain the highest in the world; wholistic health equity quality is at a crossroads. Decreased access to routine preventative primary physical and behavioral health care is compromised by financial insecurity, as readily as traditional behavioral or cultural norms; this includes male resistance to appear vulnerable, weak, or infirmed. The cycle of reactive, emergent, and costly care has an identifiable cause that can be mitigated through a proactive means, encompassing:

  • Expanded access to affordable, comprehensive health coverage. 
  • Targeted person-centric and concordant care, including but not limited to:
    • increased access to racially, culturally, and ethnically-diverse providers and practitioners, as well as those trained in and sensitive to LGBTQIA wholistic health
    • Increased emphasis on integrated care frameworks that leverage patient engagement through comprehensive visits, concordant treatment approaches, and clinical expertise
      • Funding and reimbursement are also enhanced
    • Implicit bias training to debunk stigma and systemic racism, and also builds patient-provider trust
  • Collective efforts of providers, health plans, systems and organizations, and communities to promote preventive care and healthy behaviors, through targeted population-based engagement, psycho-education, and outreach

For my fellow wholistic health equity quality warriors, we’ve got miles to go before we sleep. Feel free to add further strategic recommendations and resources below.  

The Madness Behind My Market Validation and Professional Brand

Employers value investing in staff development, but that coveted benefit often falls to the bottom of the priority list from competing fiscal foci or insufficient funds. This is paradoxical amid the value-based healthcare climate where quality drives patient-satisfaction and ultimately, volume. That’s where my marketing validation madness enters the scene.

I frequently get queries about my entrepreneurial scope, especially after being a successful business owner for 18 years. I’ll fess up: this is not my traditional blog article, but serves dual duty as a Doctoral class assignment and my usual bi-weekly post. For those growing their professional identity and brand, it responds to queries I’ve received regarding my company’s fiscal focus, market validation, and ongoing trajectory.

Quality Professionals Render Quality Care, But

Healthcare organizations juggle costly operational priorities from delivery and quality of care, to population target scope, complexity, and case mix, as well as reimbursement and revenue capture. That Quadruple, if not Quintile Aim reigns supreme to render the right patient-centric care, at the right time, cost, by professionals who embrace the work, and informed by wholistic health equity. Yet, any healthcare organization’s quality of care also relies on hiring and retaining knowledge-rich, appropriately credentialed employees. Employers value investing in staff development, but that coveted benefit often falls to the bottom of the priority list from competing fiscal foci or insufficient funds. This is paradoxical amid the value-based healthcare climate where quality drives patient-satisfaction and ultimately, volume. That’s where my marketing validation madness enters the scene. 

Value via Alleviating Operational Burden

My blog followers may already know my mission; every contract I accept empowers the interprofessional workforce through knowledge acquisition. My services span CEU-products (webinars, presentations, trainings), professional speaking, authoring books and other publications, licensure supervision (Virginia only) and professional mentoring among other areas. My subject matter expertise is shared with associations, organizations and higher education; I teach at the baccalaureate and masters’ levels of academia. 

Organizations contract with me to ease their professional development burdens. I do the heavy lifting via per diem and bundled contracts encompassing their individualized needs. Some request CEU pre-approved content required for licensure or certification renewal of social workers, nurses, physical therapists, occupational therapists, and credentialed case managers (ACMs, CCMs). The high demand for mental health intervention mandates workforce expansion, and quickly; everyone wants to expand their behavioral health workforce but this takes a concerted effort. Social workers in Virginia seeking clinical licensure (LCSW) must receive Board-approved supervision process with an approved supervisor for 100 hours, a minimum of 1 hour of individual (or maximum of 50 hours of group) supervision weekly per 35-40-hr work week; this occurs in no less than 24 months and no more than 4 years from approval. Most healthcare organizations are unable to provide this labor-intensive process due to other staff priorities. It is worth an organization’s effort and time for a contracted provider as myself, to manage the regulatory rigor of application filing, regulatory monitoring of documentation, and service provision. Employers pay me a defined hourly rate for individual and group supervision. When an organization will not cover the (full) rate, individuals pay the same hourly rate. This actions yields a considerable return on investment for organizations: the more benefits provided for employees the better workforce retention, and patient satisfaction.

An Intentional Fiscal Focus 

Many presume my company provides therapy; this is unsurprising as a Virginia-licensed clinical social worker, certified clinical trauma professional with EMDR-basic certification, and holding credentialing as a board-certified case manager. Besides, there are a plethora of behavioral health billing codes I could leverage, especially with my integrated care scope. The current Magellan fee scale for Virginia Department of Medicaid Services is a fascinating read, though highlights an important disparity in payment; LCSWs earn 20-35% less than their fellow behavioral health colleagues (e.g., psychologists), per psychotherapy visit ($92 vs. $69 per 45 min, $120 vs. $90 per 60 min). That difference, plus time for billing and revenue capture, makes psychotherapy a tough road for sole proprietary, small business owners to travel, especially when it isn’t where the heart lies. It is also further incentive for me to continue empowering the workforce through my innovative business perspective, which is far more fiscally and professionally rewarding. 

Where Will My DBH-Road Lead?

I’ve carved out a unique, yet expansive space, locally, nationally, and globally; my assorted books and articles have a large global following. My gaze is always on market analysis to leverage expansion opportunities. Non-profit agencies or others who worry about affording my rates are never told no. Instead they are asked, “what can you afford?”. If an entity is interested in my unique presentation content, then we partner on pricing to make it accessible to them, as possible.

Expanding my brand happens organically at this point, as my energy drives ongoing inspiration and new dimensions for pursuit. As a Doctor in Behavioral Health Candidate (DBH-C), my lens spans the integrated care, population health, and health equity realms. I am an interprofessional subject matter expert working to mitigate physical, mental, and psychosocial health disparities. I also believe in the power of Trauma-informed care and leadership as vehicles to address workforce retention and manage turnover. These paths will provide further ways to spread those Doctoral wings. The author in me is excited to contribute my brain trust to industry white papers. I plan to advance my EMDR-training path and potentially offer intervention to our worn, interprofessional workforce. The incidence of collective occupational trauma from recent years is massive with EMDR a successful intervention to foster recovery from this unique trauma. Perhaps one day this blog will be monetized. Each of these services stays true to my current billing structure and company mission and vision. Where will my DBH-road go? The short answer is, wherever I want it to! Let this unique entrepreneurial journey continue!

12 Ways to Bust Brain Fog

Brain fog has become a common occurrence across age groups. Clear strategies can ease the stress and bust those brain fog symptoms.

As colleagues and peers know, I’m in a Doctorate of Behavioral Health program. My quest for learning is insatiable, especially in a curriculum focused on integrated care, medical literacy, leadership, healthcare quality, and entrepreneurship. Amid my zest to gain knowledge, my brain and I can be at odds. This precious organ periodically reminds me it will only absorb so much information. My critical-thinking is challenged by episodes of brain fog: a collection of symptoms impacting the ability to think, such as distraction, memory lapses, word-finding, and utter frustration.

Activities that would previously take me 30 minutes, took hours. Anxiety kicked in, then rapidly escalated. I worried my brain fog was caused by a medical condition. At times, I thought it was due to being a post-menopausal women on a rigorous academic journey. Instead, I learned there was another explanation. I was among a new generation of persons dealing with the condition. Brain fog has become a common occurrence across age groups, impacting hundreds of millions of persons around the globe.

Brain Fog More Norm Than Exception

A variety of medical conditions are associated with brain fog (e.g., anemia, autoimmune disorders, COVID, diabetes, migraines, pregnancy), as well as stress. In fact, brain fog and stress are in a synergistic dance. We become easily overwhelmed by daily tasks. We struggle to remember the name of the last movie we watched, our beloved actor, favorite restaurant, or just the last thing we ate. Studies have addressed the traumatic impact of the recent waves of chronic, pandemic-related stress on populations: fear of virus transmission and personal/family safety, grief and loss, job and economic security, increased isolation, profound fatigue. Simultaneously occurring societal tensions have meant an added psychological hit for the population. 

Stress and the Brain

Prolonged stress and associated allostatic overload amplify cortisol production. This can lead to behavioral health manifestations, such as anxiety, depression, and insomnia. It can also exacerbate co-occurring chronic illnesses (e.g., asthma, cardiac issues, diabetes, lupus, multiple sclerosis). Our pre-frontal cortex is in peril, as continuous stress impacts the ability to engage in mental calisthenics necessary for normal cognition. Carry-over of new learning, concentration, focus, and memory are all at risk. We become stressed about being stressed, which sends us spiraling further. Neural plasticity falters as the brain loses its ability to rewire itself. Fear reigns as we worry brain cells are leaking out faster than they can ever regenerate! 

Take Control to Bust the Block

Managing our stress is key to busting brain fog! Here are 12 ways to bust those brain blocks:

  1. Breathe: 4,7,8 breathing is a must: breath in for 4 seconds, hold the breath for 7 seconds, then exhale for 8 seconds. It can be done anywhere, anytime, and any frequency. 4 cycles work, 3 times a day works wonders.
  2. Take a break: We can become too committed to finishing tasks at any expense, even if our brains don’t wish to cooperate. This floods our system with stress and cortisol. Even a brief break will enhance your efforts to regroup and refocus.
  3. Exercise: Physical activity increases blood flow, brain activity, and motivation.
  4. Get rest: Good sleep hygiene, promotes restful sleep, which is a priority. The Sleep Foundation has a lengthy list of easy ways to achieve this goal. 
  5. Monitor your diet: Hydrate, nourish, rinse, repeat. Also, watch caffeine and spicy-food intake, particularly late at night or close to bedtime.
  6. Engage in at least one peer interaction daily: Don’t let too much time go by without a quick text or meet-up with friends. They enhance your spirit!
  7. Monitor internet and social media use: ‘Doom-scrolling’ is an energy-drainer, so set limits on social media use!
  8. Engage in one positive activity daily: What one thing do you engage in daily that is energy replenishing versus depleting?  Cooking, gardening, meditation, journaling, taking a drive with the music blaring, or solo dance parties are all considerations.
  9. Set limits and SAY NO: Toss those tasks that stress you out. Ask for extensions of deliverables. These actions ease those pressures on you!
  10. Give yourself grace: Accept that you may not get a task done when you want: Ease the stress by taking 10, whether seconds, minutes, or hours. Give your brain permission to stop. This allows you time to regenerate, restore brain activity, and ready yourself for other cognitive conquests to come. 
  11. Be the master of one versus none: We all multi-task and simultaneously juggle activities, yet there are limits. Even the highest functioning brains hit a wall! Instead, take charge by approaching activities one by one. This relieves those internal and external pressures, while reducing your cortisol levels.
  12. Seek support: It is easy to isolate, but don’t give in! Reach out to friends and family, but also behavioral health professionals, as needed. Use employee assistance programs (EAP), organizational and community therapy resources, whether in-person or virtual. 

***This blog post is not meant to replace a medical evaluation. Scheduling an evaluation with a trusted primary care provider may be your first step!

RELAX, REPLENISH, RECHARGE, RENEW, then REFOCUS to RESTORE YOUR RESILIENCE! 

Get going! What are you waiting for?

I’ll look forward to seeing what other suggestions you have to bust brain fog; add them in the comments space below!

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