October 2023 Newsletter
The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) provides mental health and substance use evidence-based training, customized technical assistance, and resources to certified Medicare and Medicaid nursing facilities who care for residents with a variety of behavioral health conditions at absolutely no cost. To submit a request for assistance, complete the online request form by clicking HERE.
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In This Issue
- National Depression and Mental Health Screening Month
- World Mental Health Day - Tuesday, October 10, 2023
- Major Depressive Disorder (MDD): An In-Depth Look
- Listen to the American Association of Post-Acute Care Nursing (AAPACN) Podcast
- COE-NF Resources for Nursing Facilities
- Nursing Facility Guidance Updates
- Did You Know?
- Earn Accreditation Council for Continuing Medical Education (ACCME) Credits
- Register for Upcoming COE-NF Training Events
- You Matter - STOP - SMILE - GO
- We Want Your Feedback
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October is National Depression and Mental Health Screening Month. This observance is aimed at encouraging depression awareness and mental health screenings. Not everyone experiences depression in the same way, but it can affect anyone at any time.
There are many different treatment options available to those struggling with depression. A qualified medical professional can help determine the best course of treatment for any resident experiencing symptoms of depression.
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World Mental Health Day is recognized on Tuesday, October 10, 2023. This year’s theme is Mental health is a universal human right. World Mental Health Day is about raising awareness of mental health and driving positive change for everyone's mental health. CLICK HERE to learn more.
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Major Depressive Disorder: An In-Depth Look
Major Depressive Disorder (MDD), also known as clinical depression, is a common but serious brain disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating or working. MDD is much more than feeling sad or having a bad day. It is a serious mental illness that requires understanding, compassion and medical care.
Causes
There are various causes of MDD involving genetic, environmental, psychological and biochemical factors. A person has an increased risk of depression if there is a family history or if they have experienced trauma, major life changes, stress or certain physical illnesses (such as diabetes, cancer, or Parkinson’s).
Signs and Symptoms
To be diagnosed with MDD, some of the following signs and symptoms must be present nearly everyday for at least two weeks:
Reference:Substance Abuse and Mental Health Services Administration, Depression
Causes
There are various causes of MDD involving genetic, environmental, psychological and biochemical factors. A person has an increased risk of depression if there is a family history or if they have experienced trauma, major life changes, stress or certain physical illnesses (such as diabetes, cancer, or Parkinson’s).
Signs and Symptoms
To be diagnosed with MDD, some of the following signs and symptoms must be present nearly everyday for at least two weeks:
- Continued feelings of sadness, hopelessness, pessimism and emptiness
- Fatigue, lack of energy
- Insomnia or other sleep issues, such as waking up very early or sleeping too much
- Anxiety, irritability and restlessness
- Feeling worthless or guilty
- Lack of interest or joy in hobbies and activities
- Changes in appetite, leading to weight loss or weight gain
- Moving, talking or thinking more slowly or feeling extra fidgety
- Forgetfulness
- Trouble concentrating, thinking clearly or making decisions
- Thoughts of not wanting to live, suicide thoughts or self-harm behaviors
Reference:Substance Abuse and Mental Health Services Administration, Depression
Contributing Factors to Depressive Symptoms in Nursing Facility Residents
Several factors can contribute to depressive symptoms among residents:
To promote mental wellness and manage depressive symptoms among residents, staff should:
Treatment
Among mental disorders, MDD is the most common and most treatable. Medication, psychotherapy, self-help, and coping skills are all treatment options. Treatment should be tailored to the unique circumstances of each resident. Therefore, it is crucial to involve health care professionals who can assess the resident’s needs, abilities, preferences and any existing medical conditions. Treatment strategies should be reflected in the resident’s care plan and communicated to the entire team.
Several factors can contribute to depressive symptoms among residents:
- Admission to a nursing facility
- Chronic illness or injury
- Chronic or acute pain that is not well-controlled
- Changes in lifestyle
- Loss of independence and personal autonomy
- Inactivity
- Social isolation and loneliness
- Separation from family and friends
- Decline in functional competence
- Grief and loss
- Processing or accepting the end-of-life
To promote mental wellness and manage depressive symptoms among residents, staff should:
- Foster a supportive and engaging environment
- Encourage social interactions
- Organize meaningful activities
- Provide opportunities for residents to pursue their interests and hobbies
- Train the entire team to recognize and respond to signs of depression
- Collaborate with mental health professionals for treatment
Treatment
Among mental disorders, MDD is the most common and most treatable. Medication, psychotherapy, self-help, and coping skills are all treatment options. Treatment should be tailored to the unique circumstances of each resident. Therefore, it is crucial to involve health care professionals who can assess the resident’s needs, abilities, preferences and any existing medical conditions. Treatment strategies should be reflected in the resident’s care plan and communicated to the entire team.
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Listen to the American Association of Post-Acute Care Nursing (AAPACN) Podcast featuring COE-NF and Behavioral Health in SNFs
In this podcast, Amy Stewart, MSN, RN, DNS-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jacob Berelowitz, LNHA, LMSW, CPHQ, CCM, program manager for the Center of Excellence for Behavioral Health In Nursing Facilities (COE-NF), discuss how the COE-NF can assist nursing facilities with mental health and substance use training and resources.CLICK HERE to listen to the podcast.
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COE-NF Resources for Nursing Facilities
The COE-NF developed the following resources related to MDD and co-occurring disorders. Nursing facilities can use these resources to educate the team about these mental illnesses.
Understanding Major Depressive Disorder in a Nursing Facility
This resource provides information that can be used to support residents with a diagnosis of major depressive disorder.
This resource provides information that can be used to support residents with a diagnosis of major depressive disorder.
Treatment Strategies for Co-Occurring Disorders
This introductory fact sheet explains co-occurring disorders and provides treatment strategies and practical tips for treating residents diagnosed with a co-occurring disorder.
This introductory fact sheet explains co-occurring disorders and provides treatment strategies and practical tips for treating residents diagnosed with a co-occurring disorder.
Substance Abuse and Mental Health Services Administration (SAMHSA) Resource: Good Mental Health is Ageless
This brochure aims to help older adults understand the importance of good mental health. It identifies signs of depression and emotional issues and offers steps to overcome them.
This brochure aims to help older adults understand the importance of good mental health. It identifies signs of depression and emotional issues and offers steps to overcome them.
Interested in accessing additional COE-NF resources for your facility?
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Nursing Facility Guidance Updates: Minimum Data Set (MDS) Section D Changes (Depression Screening)
Effective October 1, 2023, MDS Section D, “Resident Mood Interview,” which captures depression screening, will change from the full PHQ-9 (nine questions) to the PHQ-2 (two initial questions). A resident’s response to the PHQ-2 questions may trigger the need for the full PHQ-9 questionnaire to be completed.
What To Do:
- Ensure facility staff who normally complete the PHQ-9 screening are educated about the change and know how to complete a PHQ-2-9 properly.
- Remember - A proper approach to the PHQ-2 is important, as the responses to the two initial questions will determine whether the full nine-question PHQ-9 is necessary.
- View and share this webinar created by CMS that discusses the changes and provides instructions on completing MDS Section D:SNF Section D: Resident Mood Interview and Total Severity Score Training Webinar.
- View and share this step-by-step guide to completing MDS Section D and the PHQ2-9, available in theLong-Term Care Facility Resident Assessment Instrument 3.0 User Manual Version 1.18.11(Pages 197-213).
The COE-NF is available to support your facility in any of these guidance areas. Contact the COE-NF today:
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Major depressive disorder is one of the most common mental disorders in the United States.
Visit the National Institute of Mental Health Website to learn more.
Visit the National Institute of Mental Health Website to learn more.
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Earn Accreditation Council for Continuing Medical Education (ACCME) Credits by Attending COE-NF Trainings
The COE-NF is now offering Accreditation Council for Continuing Medical Education (ACCME) credits to those that attend COE-NF webinars. The webinars and ACCME credits are provided at no cost.
The offering of ACCME credits mark the high standard of educational content presented during COE-NF webinars.
ACCME credits are a valuable addition to your professional profile by demonstrating your commitment to continuous learning and growth.
To earn ACCME credits, register for our upcoming webinars below.
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The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) is offering training opportunities in October.
These sessions are being held at no cost to you.
Click the REGISTER HERE buttons below each training to sign up.
See you there!
Wednesday, October 11, 2023
2-3 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
Duration: 60 minutes
Substance use disorders and mental illness overlap at the rate of 50-70%. Compared to individuals with a single diagnosis, those with co-occurring disorders experience more instances of hospitalizations, suicide attempts, actual suicides and relapse. Topics covered in this presentation include the definition of a co-occurring disorder; how substance use disorders and mental illness interact; person-centered recovery; integrated co-occurring disorders treatment; stage-based interventions; and how to support residents with co-occurring disorders.
Learning Objectives:
- Define co-occurring disorders.
- Articulate seven (7) ways substance use disorders and mental illness interact with each other for residents with co-occurring disorders.
- Explain the differences between three (3) types of co-occurring disorders treatment.
- Be able to provide services and make referrals based upon a resident’s level of readiness to change
- Provide support for residents with co-occurring disorders.
Thursday, October 17, 2023
2 - 2:30 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
Duration: 30 minutes
This half-hour training is a basic introduction to understanding bipolar disorder, its onset, symptoms and treatments. Participants will also learn approaches to support residents experiencing symptoms of bipolar disorder.
Learning Objectives:
This half-hour training is a basic introduction to understanding bipolar disorder, its onset, symptoms and treatments. Participants will also learn approaches to support residents experiencing symptoms of bipolar disorder.
Learning Objectives:
- Gain an understanding of bipolar disorder.
- Recognize and understand signs and symptoms of mania and depression.
- Learn appropriate responses of engagement with residents.
- SESSION FULL -
Wednesday, October 18, 2023
2-3:30 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
PART 2:
Thursday, October 19, 2023
2-2:30 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
Duration: 30 minutes
This 2-part training series is designed to provide information, strategies, and engagement tools that can be used to create calm for the distressed resident, while ensuring the delivery of effective care. Participants will improve their self-awareness regarding their own reactions to distress, in addition to discussing risk, safety factors and concrete tools for creating calm.
Learning Objectives:
- Develop greater empathy and understanding related to distress.
- Gain insight into personal reactions to distressed residents.
- Review tools for responding to distress that will improve staff and resident engagement.
- Identify risk and safety boundaries.
- SESSION FULL -
Friday, October 20, 2023
11 am. - 4:30 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
Friday, October 20, 2023
11 am. - 4:30 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
Tuesday, October 24, 2023
2 - 3:00 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
2 - 3:00 p.m. EST
***ACCME CREDITS WILL BE OFFERED***
Duration: 60 minutes
This interactive virtual training will take a deep dive into the importance of person-centered care through a case scenario. It will also offer practical tools to identify and mitigate the impact of implicit bias around mental health and substance use disorders and inform how cultural humility improves the staff and resident connection.
Learning Objectives:
- Describe person-centered care as it relates to nursing facilities and staff practice.
- Identify how bias induces assumptions that impact communications and rapport building.
- Identify the benefits of an ‘individualized’ approach to resident engagement.
- Learn how person-centered strategies can help residents achieve care plan goals.
You Matter - STOP - SMILE - GO
Be gentle with yourself. Use the STOP-SMILE-GO technique to promote a sense of calm and balance that will benefit your emotional well-being and your overall health.
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Contact us:
For more information, please call 1-844-314-1433 or email coeinfo@allianthealth.org.
To submit a request to inquire about substance use and/or mental health training options for your facility, complete the inquiry form.
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Alliant Health Solutions (AHS) was awarded a three-year cooperative agreement from the Substance Abuse and Mental Health Services Administration (SAMHSA), in collaboration with the Centers for Medicare & Medicaid Services (CMS), to create a COE-NF. AHS has over 50 years of experience working with nursing homes and behavioral health in nursing homes.
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This newsletter was made possible by grant number 1H79SM087155 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Substance Abuse and Mental Health Services Administration.
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