In This Issue

• Mental Health Awareness Month 
• NEW Lived Experience Podcast
• Nursing Facility Guidance Update: Minimum Staffing Standards 
• Specialty Care After Transition to Long-term Care in Nursing Home: Journal Article
• Office Hours
  • Managing Substance Use Disorders in Nursing Facilities 
  • CARES® Serious Mental Illness™
• COE-NF Resources
  • Overcoming Stigma in Mental Health
  • The Power of Empathy: Bitesize Learning
  • Identifying and Supporting Residents with Major Depressive Disorders: Module
• Did You Know?
• Save the Date: Upcoming Trainings
• You Matter – Social Wellness

Mental Health Awareness Month was established in 1949 to increase awareness of the importance of mental health and wellness in the United States. The awareness month was established by Clifford W. Beers of Mental Health America. 
For over 20 years, the Substance Abuse and Mental Health Services Administration (SAMHSA) has recognized Mental Health Awareness Month every May to increase awareness about the role mental health plays in our health and well-being. 
SAMHSA’s Mental Health Awareness Month Toolkit is a one-stop shop of resources to help promote acceptance and support for anyone living with a mental illness. Access the toolkit for ideas on promoting mental wellness in your facility.

Tips To Improve Mental Health in Nursing Facility Residents

Balanced mental health includes emotional, psychological, and social well-being. This balance is essential to an enhanced quality of life.
Here are some ways to improve the mental health of residents:

Emotional support

• Incorporate meditation and stress relief activities into the daily schedule. 
• Incorporate animal-assisted therapy to improve emotional health.

Psychological

• Consider using group processes to allow residents to express concerns, fears and expectations.
• Encourage residents to participate in group therapy and counseling where applicable. 

Social

• Assist the resident in connecting with others through visitations, self-help or special interest groups.
• Incorporate pleasurable activities as an effective non-pharmaceutical approach to eliminating stress. Activities may include: 
  • Cultural sharing
  • Computer activities
  • Gardening
  • Music/Dancing
  • Storytelling
  • Learning a foreign language

Look for creative opportunities to support residents' emotional, psychological and social well-being. Each resident's interests and preferences will vary.

Looking for another way to increase your mental health awareness? Join the COE-NF training series Schizophrenia in Long Term Care to better support the mental wellness of residents diagnosed with schizophrenia.  

The Center of Excellence for Behavioral Health in Nursing Facilities is excited to announce the launch of our new podcast, Better Mental Wellbeing! Our team has been hard at work crafting insightful content, interviewing experts, and curating an experience we believe you will find both informative and engaging.

This compelling series of podcasts will delve into the profound and diverse stories of individuals navigating the intricate journey of recovery for mental health and substance use. In each episode, we invite you to explore first-hand testimonials from people across different walks of life, sharing their triumphs, challenges, and the transformative power of their lived experiences and recoveries.

This episode features Atlanta-based substance use counselor David McKay. He shares his motivations for seeking change in his life, pivotal moments he experienced during the process, and keys that have helped him sustain his recovery. It's an enlightening conversation that promises to be motivational, informational, and inspiring.

Let’s Get Started

• Complete or review your facility assessment to assess the residents' current acuity and individual care needs. 
• Use the COE-NF behavioral health needs assessment to identify strengths and gaps in the mental health and substance use services residents may need. Click Here to download the behavioral health needs assessment form.
• Submit a request for assistance, which includes a personalized consultation with the dedicated COE-NF behavioral specialist in your region. The behavioral specialist will help you identify the resources, training, and technical assistance needed to meet your facility’s needs. 

Source: Centers for Medicare and Medicaid Services (CMS): Minimum Staffing Standards for Long-Term Care Facilities and Medicaid Institutional Payment Transparency Reporting Final Rule (CMS 3442-F) https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid-0#:~:text=CMS%20is%20finalizing%20a%20total,of%20direct%20nurse%20aide%20care

New Research Articles: Keeping you up to date with the latest research, advancements, and best practices in managing and addressing behavioral health conditions in nursing facilities.

In 2022, The Journal of the American Geriatrics Society published Specialty Care After Transition to Long-Term Care in Nursing Home, which reviewed the specialty care required by nursing facility residents, including psychiatry and mental health care. As a follow-up in 2023, the journal published editorial comments on the article by Ulyte et al. in Falling Off a Cliff, Psychiatric Care of Nursing Home Residents. 

According to these journal articles, there are an estimated 150,000 individuals with serious mental illness residing in nursing facilities across the United States. This number is equivalent to the entire supply of inpatient psychiatric beds across the United States. The prevalence of nursing home residents with serious mental illness diagnoses has increased in recent years, with the number doubling in the past decade to an estimated 19% of nursing home residents in 2017.
 

The articles both recognized that nursing homes play a significant role for residents with psychiatric diagnoses and highlighted the mismatch between the specialty care that nursing facility residents need for behavioral health and what they may be receiving based on the capability and training of the facility. When analyzing the gaps, Ulyte et al. found that one-half of reviewed nursing facilities identified a lack of behavioral health education among staff as a contributing factor to unmet behavioral health needs at their facilities. The articles also discussed how telemedicine can provide mental health care for residents and help bridge the gap in care currently available to residents.

• Contact the COE-NF for assistance in designing a behavioral health training program for your nursing facility. Submit a request for assistance today.  
• Connect residents with telehealth to increase the availability of behavioral health services. Learn More

Sources: Read the entire articles
Ulyte, A., Mehrota, A., Huskamp, H. A., Grabowski, D. C., Barnett, M. L. (2022). Specialty care after transition to long-term care in nursing home. Journal of the American Geriatrics Society. 71(4) 1058-1067. https://doi.org/10.1111/jgs.18129
Gerlach, L. B., Maust, D. T. (2023). Falling off a cliff: Psychiatric care of nursing home residents. Journal of the American Geriatrics Society. 71(4) 1014-1016. https://doi.org/10.1111/jgs.18249

Have mental illness and substance use questions? We have the answers! Join us for office hours to talk with the experts. 

Interested in receiving expert answers to substance use challenges you are facing in your nursing facility? Join Dr. Jen Azen and Dr. Swati Gaur, Subject Matter Experts, as they answer questions related to your complex cases. No question is too small or too big!  

Join our monthly office hours on the third Friday of each month from 1-1:30 p.m. ET to get answers directly from the experts working in nursing facilities!

Managing Substance Use Disorder in Nursing Facilities Office Hours begins Friday, April 19, 2024! 

Audience: Appropriate for clinicians, nurses, administrators, and social workers.

The COE-NF is making the CARES® Serious Mental Illness™ Online Training Program available to CMS-certified nursing facilities at no cost. CARES SMI focuses on how to develop care strategies for individuals diagnosed with a serious mental illness and how it differs from dementia. 

Interested in learning more about CARES SMI before committing or have general questions about the program? Join our monthly office hours meeting on the fourth Wednesday of each month from 2:30-3 p.m. ET for an open discussion on implementation, benefits, case studies and successes.

Staff at all levels of care are encouraged to particpate. 

The COE-NF developed the following resource that nursing facilities can use to educate the team about behavioral health conditions.

Overcoming Stigma in Mental Health
Download this single-sided flyer to provide awareness and education regarding stigma and language. This flyer provides helpful tips for overcoming stigma for all nursing facility staff. Download Flyer

The Power of Empathy Bitesize Learning
This five-minute on-demand video will help nursing facility staff discover practical ways to build connections with residents by employing empathy. Learners will explore simple techniques for demonstrating empathy and ways empathy can help residents with mental health disorders. Watch Video

Identifying and Supporting Residents with Major Depressive Disorders Module
This 15-minute on-demand module provides effective tools for supporting residents with major depressive disorder. Learn to recognize common symptoms and warning signs and understand risk and protective factors. View Module

• Describe the biopsychosocial approach to the comprehensive treatment of schizophrenia.
• Discuss common adverse effects of antipsychotics used to treat schizophrenia.

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Learn the unique challenges posed by the co-occurrence of schizophrenia and substance use disorder and simple, practical strategies to address the challenges and successfully treat both conditions.

Learning objectives:

• Discuss signs and symptoms that help early identification of substance use disorder in individuals with schizophrenia.
• Identify at least two best practices in the management of substance use disorders in persons with schizophrenia.

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Join this final session of the schizophrenia in long-term care series to wrap-up and review the key points of the information shared throughout the series.

An important part of mental wellness is having a supportive social network to contact when you need help. Social wellness means having healthy relationships with friends, family, and the community. Consider one to two ways your facility can better support social wellness for staff and residents. 

Ideas for optimizing social wellness in your facility: 

• Ensure that schedules and routines allow space for quality time with friends and family or for meeting new people. 
  • Examples: When schedules permit, allow staff to have two days off in a row, with one of those days being a weekend day. Help residents keep track of who they need to catch up with and organize a weekly coffee and chat event in the lobby. 
• Research and promote local volunteer opportunities. 
  • Examples: Food bank, street cleanup, habitat restoration. 
• Create groups within your facility to support shared interests. 
  • Examples: Support groups, book clubs, exercise groups.

Source: Creating A Healthier Life: A Step-By-Step Guide To Wellness,SAMHSA Publications and Digital Products. (2016, April 1). 

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