Friday, December 23, 2016

When Something Isn't Right

Heather Wilson, Early Childhood Support Team Leader at NCSS, notes that many expectant mothers feel thrilled about the upcoming birth of their child; they expect motherhood will be fulfilling and sublime, but when the baby is born, they might not feel that way at all. Mothers may experience depression, anxiety, Obsessive Compulsive Disorder or Post Traumatic Stress Disorder following a traumatic birthing experience. Feelings of depression, compulsion, or anxiety do not mean someone is a bad mother and they do not mean she doesn’t love her baby. Every mother has her own story, says Heather. “We want [expectant and postpartum mothers] to know we’re here to help. We want to be a source of light during a time of darkness and provide comfort to unsettling distress.”   

Anna Gabaree knew throughout her pregnancy that she was at risk for postpartum depression and anxiety, and she knew what signs to look for. As soon as her baby was born, she felt a change instantly, like something wasn’t right. For Anna, the symptoms didn’t manifest in depression—as most people might associate with struggling new mothers—rather, she feared for her baby’s safety to a degree that was harmful. She would sit awake and stare at her daughter through the night fearing that something would go wrong and her baby would die. After feeding, Anna wouldn’t allow herself to leave her baby’s side for even a moment, worrying that something terrible would occur in her absence. As her daughter grew a bit older, she felt intense anxiety that she was doing everything wrong: she hadn’t read to her daughter enough; she hadn’t cleaned up enough; she hadn’t completed enough puzzles with her child. Like many mothers, Anna held it together at work and with her friends—people who saw her every day didn’t even know anything was wrong—but on the inside, she was bubbling over with anxiety. On the day she found herself screaming into a pillow to release, she knew she needed to seek help.

As supervisor of the Northwestern Medical Center Birthing Center, Anna was in a knowledgeable position; she knew she was at risk and she also had an understanding of symptoms and the kinds of resources that could help. For expectant or postpartum mothers who are not as familiar, there are screening tools to help identify troubling feelings, like the Edinburgh Postnatal Depression Scale (EPDS) that is used at Northwestern Medical Center (NMC). The EPDS is a 10-question screening tool that asks mothers to consider their feelings over the week leading up to the test. It is intended to be administered with the mother privately; this way the mother has the best opportunity to feel comfortable being honest. The EPDS can reveal results that are then reviewed with the mother’s provider, and referrals can be made from there.
While referrals can come from anywhere, a majority of the referrals to the NCSS Perinatal Mental Health Counseling program come from NMC do to their thorough screening process. The EPDS is conducted after delivery; in the two-three days that a mother stays in the NMC Birthing Center; two weeks after delivery; and again six weeks postpartum.

Sometimes a mother in the birthing unit might feel like something is wrong, but she can’t identify it. These upsetting thoughts or emotions can start during pregnancy. “It can be easy to brush off,” Anna says. “But it’s okay to say that. It’s okay to say ‘something isn’t right. I’m not okay.’” When a woman does say this, Anna and the other nurses in the Birthing center might follow up with questions like, “Can you tell me more about that?” “What are you afraid of?” “What does it look like?” Expectant or postpartum mothers can speak with any of the nurses in the Birthing Center; the nurses can help attach vocabulary and understanding to feelings and also connect mothers with programming at NCSS that can offer further supports. It’s important to have quick access to programs and support, says Anna. A mother experiencing these unsettling and forbidding feelings does not want to wait days to hear from a provider. Within hours, a mother can be referred to the Perinatal Mental Health Counseling program and feel like support is on the way.

The Perinatal Mental Health Counseling program is a unique one at NCSS. Expectant mothers or new mothers who may be experiencing troubling symptoms can receive counseling in their homes from a traveling counselor:  Jessica Dewes, Early Childhood Specialist. Packing up the car and driving to NCSS might not feel feasible for new mothers just adopting a routine at home. Jessica will sit amidst a pile of laundry, or push aside diapers and rattles to engage in a conversation. “Messes don’t matter,” she says, laughing, as though she is recalling messes in her own home that might invite judgement. Jessica can work with families and mothers to reduce symptoms so motherhood can feel enjoyable and fulfilling. Jessica is also able to make referrals to other programs for the family while she works with the mother; as can be expected, the entire family can be affected when one is struggling with a mental health issue. Jessica loves the work she does with mothers, and she is moved by how many community members and mothers are open to the program. It can be difficult to seek treatment; some mothers are experiencing these feelings for the first time, and unfortunately, like many mental health issues, there is stigma attached to postpartum depression and anxiety.

Part of that stigma might come from the media’s portrayal of mothers experiencing depression or anxiety. Often, in movies, TV, and even the news, stories are sensationalized and depict mothers as dangerous to their babies. Within NCSS’s program, counselors and other staff try to break the cycles of stigma. Every mother has her own story and her own journey, and for each of those mothers NCSS can help them to develop some strategies for success. Prior to a diagnosis of symptoms, everything can feel strange, misunderstood, and weird. Jessica says she can tell a mother’s situation is improving when the mother begins to be honest with herself about her feelings. Surrendering can lead to important understanding and reduction of symptoms.

Finding a solid support system that encourages open, honest communication can make all the difference for expectant and postpartum mothers.  For Anna, that meant talking to her family and her doctor. For other mothers, maybe that support person is a sister or a spouse, a partner or a neighbor; maybe it’s the person who delivers the paper in the morning.

The Perinatal Mental Health Counseling program at NCSS is intended for expectant or postpartum mothers in Franklin and Grand Isle counties. If you know of someone who is experiencing any of these troubling symptoms, please reach out. There is no wrong door at NCSS; if you are looking to make a referral to the Perinatal Mental Health Counseling program, please call our main number, 802-524-6554 and someone will be happy to assist you.
Please click on the link to watch the NCSS Here for You episode on Perinatal Mental Health Counseling. In this episode, you can hear Heather Wilson, Jessica Dewes, and Anna Gabaree talk about this unique program.

we’re here for you.

Written by Meredith Vaughn


Monday, November 14, 2016

The Paths That Lead Us

When you think about why you do your job, what comes to mind? Maybe you always dreamed of your career from when you were a little kid, or perhaps you developed a passion for a trade and worked at it, made it your life’s work.  Or possibly you’re still searching for the thing that will fulfill you. Sometimes, like in Kathy Brown’s case, our work finds us.
Kathy Brown
Brown, Director of Developmental Services at NCSS, eagerly entered the mental health field in 1979 after graduating from college.  For two years, she worked at the state hospital, and things were different back then for those with disabilities. It wasn’t until 1990 that the Americans with Disabilities Act was passed, a civil rights law that prohibits discrimination against individuals with disabilities, and it wasn’t until 1995 that the Vermont Developmental Disabilities Act was passed. To say the least, Brown has been witness to some pretty big changes on the Vermont hill. Brown notes that when she first entered the field, the population she served was institutionalized; now they are living in the community with their families, and have access to education and a fulfilling life just like everyone else.
Brown smiles as she reflects on the start of the career. Apparently, she surprised herself by getting married—something she swore she’d never do—and then again by having two sons—something else she said she’d never do! Everything changed for Brown when her oldest son Kyle got into an accident and endured a severe traumatic brain injury. He spent a year and a half in rehab, regaining skills he had learned once as a very small child. There is intensity in Brown when she talks, especially when she recalls reentering the field of developmental services in 1996. Brown left mental health in 1981 and worked as a program manager at what is now Mylan for 23 years. But her son’s journey lit a fire in her, she says, and that’s when she applied at NCSS. Over the last ten years, she’s worn a number of hats at the agency: she started working on the employment team, then oversaw the behavioral team; she then became interim director, got her master’s in rehabilitative counseling, and in 2014, Brown found herself in the director’s chair where she currently sits. This is quite a seat to settle into, as there are over 250 clients receiving services, 157 staff working in the division, and 110 contracts with shared living providers. Brown certainly doesn’t do it alone; she has help from many people, like her leadership team: Amy Bronson, Assistant Director; Emily Norris, Assistant Director; and Amber Schaeffler.

Schaeffler, a licensed clinical social worker in the DS division, was on the NCSS Here for You television show and also presented at the last Grand Rounds seminar along with Brown. She coordinates the Clinical Oversight Committee and the Internal Behavior Support Review. Schaeffler is also getting certified in biofeedback and neurofeedback, both alternative forms of therapy that are quite effective with those with developmental disabilities. Biofeedback refers to the clinical applications where physiological signals from the body are used for auditory or visual feedback. When given this feedback during a therapy or training session, an individual can learn how to alter their breathing or behavior. Biofeedback provides a visual representation of a client’s stress, thereby giving them the tools to learn about their body and shift behavior—even slightly—to work toward a goal. A client’s ideal BPM (breaths per minute) will provide the most restorative functions for the body; this information can be gathered from biofeedback. With biofeedback, an individual’s tension is visually displayed on a screen, providing a powerful tool for recognizing stress within the body. The visual graphs allow individuals to see the control they have over their own Autonomic Nervous System and that can be very powerful in healing. This form of therapy is especially beneficial for those who may not find success with traditional talk therapy.
 This is just one of the many programs available within the DS division.* Maybe you’re wondering what makes someone eligible for DS services. There are several criteria: an individual must have an IQ of 70 or less and have significant adaptive behavior challenges in at least two areas of daily living—in other words, everyday social and practical skills.  The Intellectual Disability must have originated before the age of 18. This last criterion can prove tricky for staff in the DS division, especially if an individual who has never sought services before attempts to access DS services as an adult. Before services can be provided, staff must sift through years of documentation to find evidence of the disability prior to the age of 18; this might mean contacting previous school placements or family members conducting intensive interviews to establish functioning as a child. It can be challenging for our Intake Coordinator Samantha Burnell to locate, engage, and scour through information to uncover this proof; staff wants to deliver services in the most meaningful way and when they are needed.
Amber Schaeffler
Schaeffler, like Brown, followed an interesting path before coming to NCSS, and hers was punctuated by several advance degrees. Given her position now, you might not know that she has a bachelor’s degree in sociology and criminology and a master’s in criminal justice. That’s not all! She has a master’s in social work too! Schaeffler isn’t just wealthy in degrees; she’s also rich in life experience: before she moved to Vermont, where she met her husband, Schaeffler worked with the Deaf, Hard of Hearing, Late-Deafened and Deaf-Blind who had experienced domestic violence and/or sexual violence. It’s special that she found herself working at NCSS—given her background—since NCSS is home to the only developmental deaf services team in the state.

Talking to Brown and Schaeffler, it’s easy to see how they landed where they are. Schaeffler is approachable, unassuming, and gentle; she sits with her hands folded in her lap and smiles as she answers questions. Brown is soft spoken but pointed in her speech, and it’s evident that she’s passionate about her work. She knows what she’s fighting for every day. The most common misperception of those with intellectual disabilities, Brown says, is that they are not intelligent or capable of living a life like everyone else in their communities. “They are extremely capable of that,” Brown says. “They should have the same rights as all of us.” Brown says that the laws have heightened awareness and given advocates some teeth, but there is still a lot of stigma. Anyone doing this work day in and day out is doing it because they care about crushing the stigma that follows individuals with disabilities. They care about every individual being able to fulfill their goals.
Some of that stigma is in the way we talk. Putting the disability before the individual can perpetuate stigma, and you might be surprised by how commonplace this language is. How often have you heard the following phrases? “She’s autistic.” “He’s learning disabled.” “They’re in special education.” This kind of language defines the individual as their disability, rather than a person who has a disability. “She has autism.” “He has a learning disability.” “They receive special education services.” Think about it: Would any of us want to be defined by just one thing?
*There are many services and programs available within the DS division of NCSS. You can read more about these services on our website by clicking on the “Developmental Services” tab at the top of page or by clicking on this link:
Written by Meredith Vaughn

Wednesday, September 28, 2016

Welcome to Minds & Matters, the new NCSS blog!

Hello and welcome!

Our blog is also about to head down a new path, and we’re very excited to be launching it at the same time that our responsive website has its debut. We know how busy life can be. Every day can feel like a marathon and you’re perpetually stuck at mile 23!

You might be thinking to yourself, “I don’t have time to read a blog!” While some days you might be right, we hope you can find the time (at least some of the time) to join us on our new path.

Did you know that 1 in 5 adults in America experience a mental illness in a given year? And 1 in 25 adults in America lives with a serious mental illness? Even with these numbers, the average delay between onset of symptoms and intervention is 8 to 10 years, according to the National Alliance on Mental Illness (NAMI). While there may be a number of reasons for this statistic, we at NCSS recognize that there is a social stigma associated with mental illness; this stigma can feel debilitating and it prevents the majority of people with mental illness from seeking help. NCSS prefers to view STIGMA as an acronym for Striving To Increase Good Mental Health Awareness.

Minds & Matters is for everybody—clients, staff, families, community members—and we invite you to join us. A blog post may focus on one of our programs here at NCSS, offer a discussion about a mental health article or issue, cast a glow on an inspiring story from our community, or provide tips and pointers for general health and well-being. It is NCSS’ mission to build a stronger community; engaging in meaningful conversations can move us just a bit closer to our goal.

We hope you’ll visit Minds & Matters again.

we’re here for you