A New Year — A New You?

January is Mental Wellness Month, which is an excellent place to start.

The World Health Organization defines mental wellness as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” The clean slate that the new year offers makes it the perfect time to evaluate how we are holding up mentally and emotionally–and what we need to do in order to feel even better. 

 In the field of psychiatric treatment, research points to the effectiveness of mind-body practices to foster psychiatric recovery. Research-based evidence also indicates the value of a more integrated and comprehensive approach to psychosocial rehabilitation.

 At Ellenhorn, our wellness clinicians are an integral part of each client’s PACT team and work hard to create a personalized program that integrates all the factors that influence health and wellness, whether mind, body, spirit or community.

 Some clients are ready, able and willing to dive into integrative wellness practices–and some are not. Since each client’s lifestyle, nutrition and resiliency affects their ability to partner with their team in clarifying and working toward their psychosocial goals, we meet each client where they are, assess their ability, find their best starting points and build from there. 

  Below are some tips from Ellenhorn’s wellness team on ways to boost your mental wellness this January—and far beyond. 

Mindfulness: Noticing the five senses can be powerful, so get out those aromatherapy oils, some incense or maybe a candle–and take a nice deep breath. Buy yourself some flowers. Take time to eat mindfully by focusing on what tastes you are experiencing and how it actually feels to nourish your body. Get cozy under a soft blanket–or head outside to take a walk and feel the sun on your skin, even on the cold days. Put on some music, or simply be still–what sounds do you notice most?  

Hydration: Drink that water! Yes, it can be hard to drink when it’s so cold out, but in the dry winter it is just as important to stay hydrated as it is in summer. For a warm alternative, add some lemon and honey to some warm water or consider a cup of herbal tea.  

Movement: When you’re feeling down, lounging around and doing nothing might feel like the preferable option, but inactivity can actually increase negative emotions. Physical activity, on the other hand, engages both your brain and body, and can increase the feel-good chemicals in your brain. The idea of physical activity might seem daunting, but it doesn’t have to be. You don’t always need to push yourself to get in a long run or head to the gym to lift weights. It can be as simple as doing some light stretching, going for a walk around the block or even cleaning your home.

Spirituality: Remember to look for opportunities to develop your spiritual well-being in every-day life. Taking time in the morning (or even before bed) to breathe deeply (in and out, in and out) for even a few minutes will help you build a sense of balance in both body and spirit–and allow time for self-reflection. Consider which rituals ground you, what you do to make yourself laugh, what your dreams are like lately or the ways you enjoy moving your body–

thinking of spirituality can mean many things! 

Meditation: Meditation does not necessarily have to be a sedentary activity. Mix it up by taking a quiet walk (no talking) and try to use all five senses to engage with the world around you. Meditate without a guide, and try some music playlists that you’ve never tried before. (Consider, perhaps, tunes by Alucidnation, Benn Jordan or Shpongle.) Set the stage with an invocation of your choice, i.e., clear the energy by lighting sage or incense or consider using an eye mask, pillow and/or blanket. Stretch or shake out any tension before meditation begins in order to encourage fluidity in your mind. Set an intention or pick a mantra to use as an anchor.

If you find yourself feeling more stressed than relieved by your chosen self-care activities, don’t beat yourself up. Mental wellness is a long, nonlinear journey. Be patient with yourself, and don’t let a “failed” self-care attempt dissuade you from continuing to prioritize your mental wellness–even if that means trying multiple self-care activities in order to find what works best for you. 

Remember: If you are struggling with a substance-use disorder, addiction or mental-health disorder, simply improving your overall mental wellness is not always enough, and it may be a good idea to seek treatment.

 Ellenhorn’s multifaceted assessment approach to treatment provides a stable, thoughtful and holistic picture of where each client is as they begin. It reflects a person so thoroughly that it provides a base from which they can seek and receive the right kinds of interventions throughout their lives. Our assessments are living documents focused on creating both a diagnostic picture and a highly personalized plan for recovery. Once an assessment is complete, the client and their PACT team meet to develop a comprehensive, multidisciplinary treatment plan. 

Our treatment plans are made for each individual and include traditional therapies as well as mindfulness, yoga, nutrition and music therapy. We believe in integrating mind, body and spirit in our approach to recovery. 

Photo by Alysha Rosly on Unsplash

Using the PACT Model to Navigate the Pandemic

Since March 2020, we have been navigating an unpredictable, delicate, and always changing landscape due to the ongoing COVID-19 pandemic. While this has presented its own set of challenges to our work, the model we at Ellenhorn use – Program for Assertive Community Treatment, or PACT, is designed to be improvisational — always changing and adapting in real time to respond to our clients’ day-to-day lives and their shifting needs. This fluid framework allows us to respond to crises in an efficient and individualized manner while also adhering to current safety guidelines. As we face the ongoing surge of the Delta variant, its impact on hospital systems, and the rising threat of the Omicron variant, the PACT model continues to be the best professional model of care for people experiencing complex psychiatric events during the pandemic – especially those individuals who are reluctant to engage in treatment. Here’s why: 

PACT is the most researched evidence-based model for the care of people who have been diagnosed with severe and persistent mental illness and is especially effective for individuals who are reluctant to engage in treatment. PACT, however, is not a type of treatment as much as it is a novel approach to organizing how treatment is offered. This highly agile and adaptable model of care is readily able to respond to the ever-evolving and changing nature of living beings – which is more important than ever in today’s climate. We call our organic approach a “living systems” alternative to hospital and residential care. It’s an “organic,” model as opposed to a more “industrial” one that approaches treatment as one-size-fits-all, as if care can be provided effectively in an assembly-line fashion. As Dr. Ellenhorn has explained in detail in the Psychiatric Annals, “when we participate in the living world with an appreciation for its ever-changing, relational and communicative nature, we have a greater chance to support its natural tendency toward growth and survival.” 

Nearly 70 percent of our PACT teams’ contacts with clients happens outside the office and in the community and homes where clients already live and experience some level of security. Meanwhile, our PACT team providers meet daily and communicate consistently throughout each day on ways to shift the care of their clients as needed.

Since the start of the pandemic, organizational agility has been the key to staying afloat during this crisis. One significant challenge for all health care organizations continues to be providing organizational agility in the face of new and changing recommendations, new variants, and mandates for keeping individuals safe. Our adherence to PACT prepares us for that challenge, since our model balances significant long-term plans for clients with the understanding that teams must be ready to respond to the inevitability of crises with ad hoc immediate innovations. 

As a result, we are able to shift our care immediately to adapt to the course of the pandemic, providing in-person interactions when we can, then immediately turning to more virtual care when that’s necessary due to a reemergence of the virus or new scientific information. We don’t need to create blanket policies about providing care virtually or not; rather, we can adapt to changes on a dime. What’s more, we can do this while remaining focused on accommodating the unique needs of each client.

Because we are able to be flexible and adaptable in this way, it allows us to provide truly individualized care to our clients. With particular regard to mental health care, being able to meet your clients where they are and form a meaningful and collaborative therapeutic relationship is imperative to successful treatment. Research on therapeutic change increasingly shows that this kind of relationship between clinician(s) and client is the central source of recovery. In fact, even applying best practice procedures has little effect if they are deployed without first building a collaboration. A collaborative relationship results from interactions based on seeing the client fully: understanding their dreams, their talents, and their purpose in life.

During the pandemic, our clients need collaborative relationships more than ever–ones in which they feel that someone is by their side ready to help them navigate the challenges ahead. As much as possible, we strive to continue providing this one-on-one and highly collaborative form of care in person.

Coronavirus is transmitted through the air. That means that congregating with groups of people indoors, especially in situations in which a lot of conversation occurs, places individuals at the greatest risk. Without extreme precautions, in-person group therapy fits within this category. While we’ve always offered a few groups at Ellenhorn, our main focus has been to provide clinical care on a one-on-one basis. We are thus able to easily suspend group treatment or move group treatment to virtual mediums without a significantly detrimental effect on clinical care or disruption to the overall process. In fact, we are convinced that we can remain as effective a program without group treatment.

When we meet with clients in person, we conduct our clinical meetings in the safest manner possible: We wear the safest masks (KN95 or N95), meet one-on-one/outdoors as often as possible, and remember to stay six feet apart. Moreover, our fully-vaccinated staff is tested twice a week – adding an additional level of precaution and care. Such an approach places both the client and clinician at minimum risk. It goes without saying that that level of safety simply can’t be duplicated as easily in other treatment settings. 

Looking back at the past year, we really shouldn’t have been surprised that a model based on being as organic as possible would be (and still is) the best model for responding to a community-level crisis such as this. The Ellenhorn PACT approach allows us to continue to be present, productive, and creative in the work that we do with clients even in the face of a public health crisis.

Photo by Chris Montgomery on Unsplash