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1 day ago · Mental Health Care Needed More Than Ever During COVID-19 Pandemic -- Telehealth Can Help Make it Happen

We live in a time when health care is being transformed by
technology and mobile applications. Few mental health services, however, have
been delivered via technology, despite offering an easy and convenient way to
reach patients.

Live video telehealth services are a critical component of the COVID-19 response. Offered by physicians, other clinicians and health-care organizations, telehealth provides a useful method for starting and continuing essential mental health treatment without risk of spreading infection.

This is especially important given the anxiety many are feeling
due to the uncertainty of COVID-19 and the sense of loneliness that can result
from stay-at-home and shelter-in-place orders that public health experts have encouraged
to save lives. 

Most people with serious mental illnesses own and use a mobile
phone, according to a study that included researchers
from UCLA. This is a good time for clinicians to start using mobile technology
to provide interventions to our patients.

A major barrier to video telehealth has been the refusal by payors, including Medicare, to pay for most of these sessions.  While some private insurers started to pay for these visits, others have continued to refuse coverage, or have created administrative barriers that limit coverage. 

Recently, Medicare announced that beneficiaries can receive covered telehealth services even
if they do not live in a rural community where providers are scarce. Clinicians
can bill for dates of service, starting March 6. The extent to which
private insurers will follow suit remains to be seen.

To ensure access to telehealth,
some state governments have taken action with insurance companies that are
subject to their regulations. The federal government has not yet taken similar
action, and some insurance companies continue to restrict coverage for
telehealth, despite the national emergency.

Furthermore, the federal Department of Health and Human Services’ Office
for Civil Rights announced it will waive potential penalties for HIPAA
violations against health-care providers that serve patients through widely
available non-public communication applications like FaceTime and Skype.

Live video telehealth works with almost all patients with mental
health issues. It is well accepted and effective. At UCLA, we have rapidly
moved to delivering mental health services by telehealth. Telehealth can play a
critical role in ensuring continuity of care for people with mental illness
during the COVID-19 pandemic.  

Alexander Young, MD, is the interim chair of the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA, the interim director of the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, and interim physician-in-chief of the Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA.

4 days ago · Staying Safe and Healthy During the COVID-19 Pandemic

With the uncertainty and evolving impact of COVID-19, it is natural to experience anxiety. Like any emotion, anxiety can spread from person to person. Following current recommendations for social distancing will help to limit the community spread of the virus, but it also can present its own challenges of isolation and loneliness. Dr. Gary Small, professor of psychiatry and biobehavioral sciences and director of the UCLA Longevity Center and UCLA’s Division of Geriatric Psychiatry, offers some tips to help navigate through these difficult times.

  • Be cautious about unreliable sources of information in the media. Rumors and distortions increase stress and anxiety levels. Turn to trusted sources of information so you can remain up-to-date on emerging situations.
  • Anyone overwhelmed with emotions should contact a mental health professional for assistance.
  • Repeatedly hearing about the pandemic can be unnecessarily upsetting for many people so take breaks from watching, reading or listening to news stories, especially on social media.
  • To overcome isolation while sheltering in place, stay in touch with friends and family by phone, or use social media and videoconferencing platforms such as Skype, Zoom or FaceTime.
  • Keep to your daily routine as much as possible. If you are working from home, be sure to take your usual lunch break and maintain your daily habits.
  • Try to remain positive. Just as anxiety can spread from person to person, so can optimism and a positive outlook. Rather than focus on worse-case-scenarios, be mindful of what you are grateful for during these trying times.
  • If you are feeling anxious, take deep breaths, stretch, do some yoga or meditate.
  • Try to eat well-balanced meals, exercise regularly, get plenty of sleep and avoid excessive alcohol use.
  • Try to stay physically active. Search online to find available videos for simple ways to stay active, such as chair exercises.
  • Talk about your concerns with people you trust. Sharing the facts about COVID-19 and understanding the true risk to yourself and people you care about will reduce your anxiety.
  • Relaxation practices can help reduce levels of stress. The UCLA Mindful Awareness Research Center provides a variety of options for people interested in learning methods to pay attention to present moment experiences with openness. Click here and search under “Free Programming and Resources.”

5 days ago · Shanna F.

Shanna was wonderful. She was there for me from pre-op to recovery and sending me home. She is professional, efficient and compassionate. She made my surgery and recovery go smoothly and easy. Thanks. Steve.

By: Stephen O.

5 days ago · Erica O.

I have been extremely satisfied with my care from Dr. Oberman.  She is extremely knowledgeable about fibroids and always takes my concerns about how my symptoms affect not only my health but my quality of life seriously.  For example, she takes the time to discuss what’s important to me when planning the course of action for my care, whether it’s mitigating my symptoms, preserving my fertility, or planning my surgeries around my work or vacation schedules.

I was terrified before my sonohysterography but Dr. Oberman and Dr. Valentina Rodriguez were extremely kind and patient and made the procedure very tolerable.

I remember that after my first surgery with her on a Friday in 2018 she called me that weekend and when I didn’t pick up, she called again because she wanted to make sure to hear my voice because she knew that I was recovering alone all weekend.  

Before my most recent surgery in February 2020, I appreciated her balance of tempering my expectations as well providing hopefulness and optimism.  After my surgery I messaged her with some questions and she called the same day and when I missed the call, she immediately followed up with an email.   

Surgery is never fun, but it can definitely be less scary when you know that you’re in such competent hands.

By: Shirley Y.

5 days ago · Erin C.

Thank you Erin for debriefing with me after a Rapid Response/code situation we were in together. Your kind and understanding approach in explaining to me allowed me to grow, learn, and become a empowered practitioner from this experience. I particularly appreciated that there were no pointing fingers/blame, but an understanding on both ends what we could do differently next time. You are very intelligent and calm under pressure. I always feel supported when you are in an emergent situation like that with me. I admire and appreciate you!

By: Sherry T.

5 days ago · Dani D.

Unfortunately my daughter had to have surgery during this pandemic. I was so impressed with the nursing staff and the doctors. We were handled safely, with compassion, and efficiently. Dr Aria Fallah is an amazing surgeon. Even when I had a question, he emailed me directly to put me at ease. The ICU nurses Dani and Cori, the 5East nurses Vanessa and Whitney, and the PACU nurse Jing were amazing. Caring, responsive, informative, helpful, and smart! I couldn’t have asked for more for my daughter. Thank you UCLA. Best in the west!

By: Angelique C.

Mon, Mar 23 4:02pm · As Stay-at-Home Orders Increase, so do Feelings of Loneliness and Depression

To stop the spread of the COVID-19 coronavirus, the governing bodies of cities and states across the country are ordering people to stay home. But studies have shown that the loneliness and depression that may result from social isolation impacts not only mental health but physical health as well.

Jena Lee, MD, a board-certified child and adult psychiatrist and clinical instructor at the David Geffen School of Medicine at UCLA, discussed how stay-at-home and shelter-in-place orders may affect emotional and physical wellbeing, and how to counteract those effects.

What are some of the immediate effects of social distancing and isolation on emotional wellbeing, especially for people who live alone?

Isolation may cause loneliness, fear or anxiety. But, if you look a little deeper, these seemingly immediate effects stem from our thoughts around isolation and are not particular to the act of isolation or social distancing, per se. These thoughts can be so fast and implicit that we may not even realize we are having them. As a result, we often misunderstand the emotional effect of our thoughts and equate them to be the direct effect of external circumstances, such as a stay-at-home order. Ultimately, we end up feeling more helpless.

Some common thoughts for those who already are alone might be, “Now I’m going to be even more alone,” or “I’ll be alone forever.” My suggestion would be to try to make changes in your thoughts, such as “I am helping to fight this virus by being temporarily isolated” or “There are many ways I can stay socially connected despite being physically distanced.” When you’re better able to recognize what you are thinking, you can better control your emotional wellbeing.

What are some of the things people can do to keep their minds and bodies active while practicing social distancing?

We must be creative while we’re practicing social distancing to stay active in a healthy way. Physically, try new home exercises, including yoga or strength training, and try to minimize use of substances like alcohol. It takes just as much effort to immerse ourselves with messages of hope, compassion, and calm, as it does to minimize our attention on thoughts of fear and anxiety. Often fear, depression and anxiety are associated with a mind that is focused on the past or future and not on the present. Practice bringing your attention back into the present, back into gratitude, using exercises such as meditation, prayer or even conversations focused on these topics. It takes practice, but, like physical exercise, it becomes increasingly beneficial and easier with regular practice.

Are some people more susceptible to feeling anxious, lonely and depressed during times of required distancing?

Yes. People who might be more vulnerable to anxiety and depression include those who have a pre-existing mental disorder, those who struggle with loneliness or low self-esteem, those who may not already be socially connected to friends or family and those who live alone and depend on others for assistance. The more challenging limitations someone has, including physical illness and financial difficulty, the greater the risk for stress and subsequent symptoms of anxiety and depression. The older population is also more vulnerable to risks associated with social isolation.

What can people who are both out of work and feeling socially isolated do to improve their emotional well-being?

Make a schedule and allot time to try out new healthy behaviors, even if you haven’t tried them before. For example, schedule video conferencing time with relatives and old friends, take an online course or update your resume. Include time for productive activities like cooking, exercise, meditation and journaling, but also for relaxing time to watch a movie, take a bath or play games. Also, consider a goal for sleep and wake time. Being able to stick to a schedule itself can feel very productive and really help balance out your activities so you don’t get stuck watching television all day.

What advice would you give to parents on how to keep children entertained and maintain a regular routine while schools are closed?

Keeping to a routine schedule for children is especially important because structure often translates into more emotional regulation in children. Despite school being closed, block out time for education and try to get access to online lessons that you can go through with your child. Reading, physical activity and art can be included in the educational part of the day. Then, the evening can be more relaxed. This structure will also help children eventually adjust back to school. Stay engaged in the activities of your child, ask them how they are feeling and thinking and do activities together as a family. For example, instead of telling children to read for 30 minutes, read in parallel and then ask them about what they read. Regular wake and sleep times are very important to the physical, emotional and cognitive development of children.

Are there long-term consequences of social distancing and isolation on emotional wellbeing?

There is a lot of evidence that does link chronic isolation and loneliness not only to emotional problems like depression but also to physical problems such as cardiovascular health and even mortality. Research also shows that increased symptoms of depression, anxiety, trauma, confusion and anger can result from quarantine. The good news is that we know about these negative consequences, and by trying to adjust them, we can try to prevent some of these effects. These factors include: inadequate information or supplies, longer duration of quarantine, extent of boredom, financial loss, fear of infection and stigma. So, by actively engaging each other in activities and encouragement, for example, we can mitigate boredom and stigma, which can have significant impact on our emotional wellbeing in this time.

When should people seek help if they are feeling depressed, anxious or increased stress?

You should always consider checking in with a primary care provider when you are struggling, but some of the signals to look for that would warrant help sooner include: depressed or anxious feelings that dominate most of the day; having difficulty enjoying or wanting to do activities you typically like; withdrawing socially from others, even from phone contact; changes in sleep and/or appetite; difficulty getting out of bed or taking care of yourself; and thoughts of suicide.

Fri, Mar 20 8:04am · Shu K.

On the most recent patient survey, a patient mentioned Shu by name and commended her great work, stating, ” my Nurse: *Shu was excellent in my treatment and she always explained the procedures. “!!!

By: Michelle R.