WVUA: Health Matters – Anxiety (May 3, 2017)

May is Mental Health Awareness Month, and this week dean of the University of Alabama College of Community Health Sciences Dr. Rick Streiffer is highlighting anxiety.

According to the National Alliance on Mental Illness, one in five people in the U.S. will develop some kind of temporary or permanent mental health condition in their lifetime.

Social work and mental health specialist Bob McKinney said even though it feels harmful, not all anxiety is bad.

“Anxiety is a perfectly normal part of life,” McKinney said. “It’s the way our bodies react to stress and stressful situations. Anxiety can kind of hone your focus into the task at hand.”

Courtney’s Final Blog Post

As my time as a UA-Pickens County Fellow comes to a close, I wanted to reflect on my experiences in the county over the last year. In July, I will start medical school, which will fulfill a dream that I have had since I was 7 years old. Though I have always known that I want to be a doctor, I have never been able to definitively say what field of medicine I want to pursue. After this last year working with the county, I am definitely closer to figuring that out; however, I’ve also learned something even more important this year: there is nothing more fulfilling or important to me than serving the underserved. After working in Pickens County, I now believe that the future of healthcare is outside of the hospital and in the heart of the community. As such, I anticipate a future career serving alongside community leaders, aiming to improve healthcare delivery so that all residents have access to quality health care, regardless of their social or economic status.

In the last year, I have taught nutrition education to high school and elementary students across Pickens County. On my very first day, I remember Dean Streiffer saying something that I will keep in mind forever: the word “doctor” actually means “teacher.” Although that initial connection may be hard to make, I have learned that the best doctors are really just outstanding teachers that dedicate their lives to teaching health. One of the best doctors I’ve ever met was an orthopedic surgeon I met when I was in high school. What makes him stand out in my memory was his willingness to teach me on a level that I would be able to understand as a 15-year-old.  Whether it was drawing a diagram of the ligaments in my knee on the paper lining the exam table, or explaining biologically why my knee was swollen, I learned from him.

This last year has taught me that education drives change and that the importance of a quality health education cannot be overstated; in the future, I envision a career in academic medicine in which I will be able to combine my passion for research with caring for patients and teaching, which has been one of the most genuinely fulfilling experiences I have had in Pickens County.

As evidenced by the recent addition of sociology and psychology on the MCAT and the evolving requirements for admission into medical school, medicine is becoming a more holistic field. Physicians are learning to treat “health” in a much broader sense. Witnessing the social determinants of health firsthand this year in Pickens County will undoubtedly make me a better physician in the future. As someone who has a background in the natural sciences, it was initially challenging for me to understand how things that are not biological in nature can have such a profound impact on physiological processes within our bodies; after spending a year away from the microscope and interacting with the people of Pickens County, I can definitively say that is no longer the case and my understanding of this will guide my medical practice in the future.

I am thankful that I was in Pickens County to witness the development of this project, and I anxiously await a reunion in which I can meet the people from Gordo to Carrollton—and every mile of Highway 86 in between—that have been impacted by the work of this partnership.

Thank you, Pickens County, for the opportunity of a lifetime.

Rural Medical Scholars recognized at convocation

Ten students who want to become physicians and practice in rural communities were recognized April 23 at a convocation for the Rural Medical Scholars Program, which is operated by the College of Community Health Sciences.

The program is exclusively for rural Alabama students and includes a year of study, after students receive their undergraduate degree, that leads to a master’s degree in Rural Community Health and early admission to the University of Alabama School of Medicine. Rural medical Scholars spend the first two years of medical school at the School of Medicine’s main campus in Birmingham and then return to the College for their final two years of clinical education. The 10 graduates begin medical school this summer.

“Our mission is to produce physicians for rural Alabama who are leaders in their communities,” said Dr. John Wheat, founder and director of the Rural Medical Scholars Program.

State Sen. Gerald Dial of Lineville, Alabama, a former chair of the Senate Health Committee, provided the keynote address. He stressed to the student how important they will be to the communities where they will one day practice.

“In addition to providing medical services, a rural physician opens economic opportunities for communities. You can’t put a value on a rural physician, it means everything. You provide life to a community.”

Also during the convocation, the Rural Medical Scholars Program Distinguished Service Award was presented to Dr. Nathan Smith, who served as an assistant dean for Students and Admissions at the School of Medicine for many years and who is now a professor and vice chairman of the Department of Psychiatry there.

“Rural is close to my heart,” he said, noting that he was raised in Rockledge, Alabama. “Of all that I did as assistant dean of admissions, I am most proud of my involvement with the Rural Medical Scholars Program, and I am grateful for all that has been accomplished through these programs.”

Emily Sutton, a junior at UA majoring in Biology who has participated in other Rural Pipeline programs, received the Rural Alabama Health Alliance Student Award. “I love this program – its mission and purpose. I’m thankful for the program investing in me.”

Partners of the Rural Medical Scholars Program were also recognized: Dr. Charles Nash, vice chancellor for Academic and Student Affairs for the UA System; Dr. James Jackson, professor emeritus of Education in Medicine in the Department of Medical Education at the School of Medicine; and the Alabama Farmer’s Federation Women’s Leadership Division.

The convocation was held at the Hotel Capstone on the UA campus.

Graduating Rural Medical Scholars:

  • Veronica Coleman of Butler
  • Rebecca England of Demopolis
  • Andrew Seth Griffin of Centre
  • Jessica Luker of Camden
  • Dustin Marshall of Coaling
  • Colby James of Empire
  • Brionna McMeans of Fort Deposit
  • Johnny Pate, Jr. of Moundville
  • Madison Peoples of Hamilton
  • Madilyn Tomaso of Barnwell

College’s Transitional Care Clinic reducing re-hospitalizations

Dr. Tamer Elsayed, assistant professor of Family Medicine for the College of Community Health Sciences and assistant director of its Family Medicine Residency provided an overview of the College’s Transitional Care Clinic at University Medical Center during a lecture April 24 as part of the Mini Medical School lecture series hosted by then College and UA’s OLLI program.

The lecture was titled “Transitional Care Management Clinic: Discoveries made with Inter-Professional Collaboration.”

The clinic, located in University Medical Center, which is operated by the College, opened in November 2015 and is designed to assist patients with the transition from the inpatient hospital care setting to home or a community (assisted living) setting.

“The problem is that many patients have multiple chronic problems who require extra care and have been readmitted multiple times to the hospital,” said Elsayed. “We decided that we wanted to have the extra care to these patients as soon as possible, as soon as they get out of the hospital, and see what kind of services they need.”

At the clinic there is a large team of 8 different positions and a lot of resources available including nursing, pharmacology, social services, a dietician and family medicine. Each service does what they can to help the patient. For example, during the visit, a PharmD takes a look at the patient’s medications, notes changes and calls the pharmacy to make sure the patient has the correct medications.
“At the end of the visit, the patient receives a printed list of the medications they need for clarity,” said Elsayed.

Bringing attention to a mental health crisis in jails

In a mental health crisis, people are more likely to encounter police than get medical help, according to the National Alliance on Mental Health. As a result, more than 2 million people with mental illness are booked into jails each year, and the vast majority of these individuals are not violent criminals.

“They get arrested instead of getting into treatment,” said Dr. Marisa Giggie, associate professor of psychiatry and behavioral medicine at the College of Community Health Sciences and chief psychiatrist for the Tuscaloosa County Jail.

“The correctional system becomes the safety net.”

Once in jail, however, these individuals might not receive the treatment they need and might end up getting worse.

The College hosted a presentation and panel discussion April 25 to bring attention to the mental health crisis in jails. “Mental Health in Correctional Settings in Tuscaloosa” was held at DCH Regional Medical Center in Tuscaloosa. In addition to Giggie, presenters included Tuscaloosa County Sheriff Ron Abernathy and the Honorable M. Bradley Almond, presiding judge of Tuscaloosa’s Mental Health Court.

Giggie provided stark statistics about the mental health crisis in jails. She said there are 10 times more people with mental illness in jail than in state-funded mental health facilities. She said 30 percent of the 9 million inmates in Cook County Jail in Chicago have mental illnesses making the jail “the largest provider of mental health services in the country.”

Giggie said the mental illness inmates experience can include drug addiction, depression, Bipolar disorder, schizophrenia and post-traumatic stress disorder. She said confinement to jail cells can increase the symptoms of these inmates.

She sees approximately 30 percent of the total Tuscaloosa County Jail population, a daily average of 536 inmates, for a variety of mental health issues.

The issue of mental illness among offenders in the criminal justice system is not new, but now there is better information about the scope of the issue. The rise in inmates with mental disorders began decades ago when policies were enacted nationwide that moved mentally ill people out of state institutions in an attempt to allow them to return to their families and live independently.

To try to deal with the influx of mentally ill inmates, Tuscaloosa County, in 2012, implemented a mental health court that was established by Almond, Abernathy and Indian Rivers Mental Health Facility in Tuscaloosa. The Tuscaloosa County Mental Health Court is a jail diversion program for nonviolent mentally ill offenders.

Almond said to date, a total of 440 inmates have been assessed by the mental health court and of those, 140 have received mental health treatment and 81 have graduated, averting jail time.

“The last place a person with mental illness needs to be at is the county jail,” Abernathy said.

He and Almond estimate the mental health court keeps 30 to 40 inmates out of the system annually. “That’s saved us hundreds of thousands of dollars, but the most important issue is that these people don’t need to be there,” Abernathy said.

A jail diversion program for the mentally ill in Massachusetts has saved that state $1.3 million in health services costs, Giggie said. “A jail diversion program is less costly and more humane.”

In addition to Giggie, the Tuscaloosa County Jail also employs a full-time social worker and recently hired a health officer with the authority to seek mental health care for an individual rather than making an arrest.

Health fair provides information, free health screenings

The University of Alabama-Pickens County Partnership hosted a health fair earlier this month at the Pickens County Medical Center Healthplex in Carrollton, Alabama, to provide information about health care resources in the community.

There were also free health screenings available for blood pressure, weight and cholesterol, and people had the opportunity to review their results with a health coach, who also provided advice about how to better manage various health issues. The screenings were provided by the UA Capstone College of Nursing faculty and nursing students.

“This fair is a good example of the excellent resources available in a rural community,” said Dr. Richard Streiffer, dean of the College of Community Health Sciences, which leads the UA-Pickens County Partnership.

Streiffer said educating rural residents is vital to the existence of health care facilities like Pickens County Medical Center, which, like many rural hospitals, has faced tough economic times. “Without being able to serve people, hospitals like this and the facilities and services it has to offer are going to close and the access to health care for rural counties will be even worse.”

The UA-Pickens County Partnership works to place UA students in medicine, nursing, social work, nutrition, psychology and health education – and potentially other fields – in Pickens County for internships and experiences. Through the partnership, the rural, underserved county is provided with additional health resources, and UA students receive real world training in their respective areas of study.

“Having students in the county is beneficial for Pickens County,” said Wilamena Daily, partnership coordinator. “When you have those extra hands, it brings more resources.”

McKinney to advise student group

Dr. Robert McKinney, assistant professor of Social Work for the College, was tapped as the faculty advisor for the Carl A. Elliott Society, a student-led, community service based organization at UA that works to better society through social justice and community service.

The Elliott Society is named in honor of the late Carl Atwood Elliott, a former UA Student Government Association president who later became an Alabama congressman in the US House of Representatives. His political principles were based on assisting the needy, racial tolerance and educational opportunities. His efforts in Congress focused on education and he co-authored The Library Services Act of 1956 and the National Defense Education Act of 1958.

Avery honored by medical association

Dr. Dan Avery, director of Medical Student Recruitment and Scholarship for the College and a professor of Community Medicine and Population Health, received a Distinguished Service Award from the Medical Association of the State of Alabama earlier this month.

Avery received the honor for his work with MASA’s Council on Medical Education Committee. The council reviews, evaluates and approves hospitals and other health care institutions in Alabama to provide continuing medical education courses and credits.

At the College, Avery also serves as medical director and medical review officer for the Laboratory and X-ray Department at University Medical Center, which the College operates. He is professor and division chief of Pathology, and is medical director for the College’s Institute for Rural Health Research. He is a professor and former chair of the College’s Department of Obstetrics and Gynecology.

Weida completes fellowship, elected to Council on Medical Education

Dr. Jane Weida, associate professor of Family Medicine for the College and associate director of its Family Medicine Residency, completed a fellowship with the National Institute for Program Director Development in March. The fellowship is awarded by the Association of Family Medicine Residency Directors.

As part of the program, fellows engage with and learn from seasoned program directors and family medicine educators and leaders. The NIPDD fellowship model seeks to enhance knowledge and skills and to mentor fellows to become effective residency directors.

In addition, Weida was elected the District 7 representative to the Council on Medical Education. The council recommends educational policies to the American Medical Association House of Delegates, and recommends to the AMA Board of Trustees the appointment of representatives to medical education organization, accrediting bodies and certification boards.

The Council on Medical Education focuses on issues and initiatives related to undergraduate medical education, graduate medical education, continuing medical education and professional development.

Payne-Foster receives UA scholar award

Dr. Pamela Payne-Foster, associate professor of Community Medicine and Population Health for the College, received a 2017 Distinguished Community-Engaged Scholar Award from UA’s Council on Community-Based Partnerships.

Each spring semester, the council recognizes students, faculty, staff and their community partners for excellence in community-based research. The Distinguished Community-Engaged Scholar Award recognizes a faculty member, student and community partner for public service and engagement efforts that have improved the quality of life in Alabama over an extended period.

Payne-Foster, who is also deputy director of the College’s Institute for Rural Health Research, was the faculty recipient. The student recipient was Joon Yea Lee, a doctoral student in the College of Communication and Information Sciences, and Dr. Billy Kirkpatrick, executive director of West Alabama AIDS Outreach, was the community partner recipient.

Payne-Foster studies the spread of HIV in the South. Her current research focuses on developing an anti-stigma curriculum for African-American churches in rural Alabama. She hopes her work will educate congregations about HIV/AIDS and reduce the stigma around the disease.