Teams help improve outcomes

You would think that health care providers by now would have learned to work together as teams.  While there has been some improvement in team work there remains much yet to be improved.  Over and over I hear from young people with lived experience (and their parents) how their care has “fallen between the cracks”, even within teams who are supposed to be working together to help them.

It has also been my observation that health care teams are often highly constricted to those providers who work in the same location.  While this is almost understandable, it is not to my mind the meaning of a team.  A health care team needs to be based on the needs of the person who is receiving care, not the location in which some or most of the care givers are situated.

And, the data shows that when we widen the team members, and when the team members work together in the interests of the patient, good things happen for the patient!  Great!  This is what our goal should be.

A recent study (it was in the journal called Schizophrenia Bulletin 37: 727-736; 2011) examined the role that pharmacists play in helping people who have chronic and severe mental disorders better understand the medications that they were taking.  These pharmacists also provided counseling about medications and what to do if the patient experienced any problems.  Guess what?  Patients who received this support were much more likely to take the medications that they needed to stay well.  Seems almost obvious to me.

Actually, when I think about it, I have been very lucky to have worked with two outstanding Pharmacists (both have their PhD in Pharmacy – it’s called the PharmD) for many years now, Dr. David Gardner and Dr. Andrea Murphy.  I have learned a ton from each of them.  They can show us the way for how all health providers can work together to help improve the lives of young people and their families.  And they worked with me to create an amazing resource called Med Ed which helps young people and their families get the best medications care.  Click here to learn more about MED ED.

-Stan

Suicide prevention in the water we drink?

Now, who would think that the kind of water we drink could possibly be implicated in the prevention of suicide.  If that was the case, what impact would that have on our community based, very expensive and not at all clearly impactful suicide prevention programs?  I mean, if prevention is in the water, what could that mean?

Now some very interesting epidemiological research (published in this month’s edition of the British Journal of Psychiatry) suggests that there actually be a link between the type of water we drink and rates of suicide.  Ok – be careful.  This is a co-relation so it does not prove causality, but the relationship has some solid other evidence to suggest it may be a strong finding.

The culprit (if you want to call it that), turns out to be small amounts of lithium!  Lithium is known to have therapeutic effects on mood control when given in specific doses that lead to specific blood levels.  Lithium is also known to have an anti-suicide effect for people who have a mood disorder.  That is, lithium treatment is linked to low suicide rates while discontinuing lithium treatment is linked to high suicide rates.   Lithium has also been successfully used to treat impulsive anger outbursts, and impulsive self-directed anger may be associated with suicide.  And, apparently the Roman’s used to send people who were suffering from mood disorders (depression and bipolar) to therapeutic spas whose waters were rich in natural lithium salts!

The study, which was conducted in Austria, showed that in regions where the water was lithium rich the suicide rate was about one-third less than in regions in which the water was lithium poor.  Now these were very small amounts of lithium; much less than are used therapeutically.

We do not know what impacts small amounts of lithium could have on brain function.  Perhaps there is a mood or impulsivity mediating effect – both of these factors are known to increase suicide risk.   In any case, this is an observation worth researching further, both at the level of epidemiology and at the level of understanding what small amounts of lithium can do to affect our emotions and behaviors.  Who knows what the outcome will be?

- Stan

Concussions are brain injuries...it's time to get BRAIN SMART

Martin was 16 years old, an excellent athlete, good student, fun to be with and very popular at his school.  Elise was 15 years old, relatively shy, hard working and dedicated to becoming a doctor.  Josh was a creative artist, avid environmentalist and raconteur.  Amanda was 14, loved to party – more than her parents were comfortable with but she was getting by at school.  Steven was 15 and struggling with overuse of alcohol that was getting in the way of his successfully completing his school year, and he had just agreed to get help.

Very different young people.  From all over.  One sad thing in common.

Before they could reach the next phase of their lives, their hopes and dreams and plans were derailed by a brain injury – a concussion.  Martin took a head shot while playing hockey.  Elise fell when climbing up a ladder to the roof of her house.  Josh collided with another bicyclist when riding to school.  Amanda got into a car driven by a friend – and was not wearing her seatbelt when the accident happened.  

Steven got drunk and got into a fight – he was knocked out.

Many of these unfortunate outcomes may have been prevented.  Many of these young people could have had a better recovery if they knew what a concussion was and what to do about it.  Martin for example, continued to play because he did not want to let his team down and took another hit to the head – ending up in hospital for a few days.

The life success of young people depends in great part on how their brains function.  After all, that is where civilization lives.  Our brains chart our lives for us, they do all our thinking, they house our emotions, they control our bodies, they signal us when something is wrong and they direct and guide our behaviors.  So, clearly, they are very important to all of us.

It is really important to have a SMART BRAIN and to help us do this we need to live BRAIN SMART.  Part of living brain smart is learning how to protect our brains against injury and what to do if we are unlucky to get injured (this can happen even if we are doing our very best to prevent it).  The first step is educating ourselves about brain injuries: how we can best try to prevent them, how to recognize them if they happen and what we should to help us recover and avoid further injury.

That is why we developed two Brain Injury Guides.  One version is for young people and one for parents, coaches, educators and all those that work with youth.  Find out more about living Brain Smart by clicking here. Share these links with your friends, family and adults who you hang out with.  Do your best to live BRAIN SMART. The brain you protect is yours!

-Stan