Prakash Chandran (Host): May is a Mental Health Month in the United States. And each year, First Health joins the national movement to raise awareness and provide patients with the support they need. We're going to talk today with Dr. Jason Jerry, a psychiatrist with board certifications in Psychiatry and Addiction Medicine and Medical Director of Behavioral Services at First Health of the Carolinas.

Host: Welcome to the First Health and Wellness Podcast by First Health of the Carolinas. I'm your host, Prakash Chandran. So Dr. Jerry, thank you so much for joining us today. I really appreciate your time. I wanted to get started by asking why exactly is mental health awareness so important? And how has the perception of it changed over the years?

Dr. Jason Jerry: So, I think it's especially important now with the increased rise in mental health issues across the country. I think we're all much more aware of the increase in depression and anxiety that we've seen, especially since the onset of COVID and its aftermath. I think the other main thing that makes this important is that we also have a shortage of psychiatric beds, of psychiatrists, of all psychiatric services across the country. And so, that makes it much more important for people to pay attention to their loved ones and friends and be able to notice perhaps what psychiatric issues are arising and to be able to advise them on what to do. I think there are a lot of people out there that just don't know what they're supposed to do when they're not feeling well from a mental health standpoint.

Host: So, I want to elaborate on that just a little bit. Can you talk at a high level around how someone can identify in a loved one or a friend when something might be a little off and what they should do about it?

Dr. Jason Jerry: If you see somebody who you see an abrupt change in their mood or a relatively abrupt change in their mood and they're looking more depressed than normal or just not acting themselves, I think engaging them in conversation. Are they having trouble sleeping? Are they not doing things that they previously enjoyed doing or having a difficult time getting up and getting out to do the things they would normally do? Are they having trouble concentrating? Are they not eating as much or perhaps overeating? Have they voiced any plan of harming themselves? Those things are often signs that something may be going wrong.

If something is going wrong or somebody's concerned about it, oftentimes the best place to start is with your primary care physician. Primary care doctors prescribe more antidepressants than we as psychiatrists do. And sometimes they are able to handle things just fine. And if they can't and they feel like they're in over their head, then they can refer them to a psychiatrist. That's the best place to start for most people.

Host: Yeah. And I think that what you said there at the beginning is important, because I think generally people are just more aware that mental health issues are real, especially in the wake of everything we experienced during COVID. So, generally at least the conversations that I've had with my loved ones, everyone is more susceptible to it. But the big problem really is, as you were saying, there's just like a shortage of people to help, right?

Dr. Jason Jerry: Right. Yes, unfortunately, that's what we're dealing with right now.

Host: I wanted to ask what are some of the services that are available at First Health?

Dr. Jason Jerry: So, we have an inpatient psychiatric unit, it's 23 beds. And we serve not only general psychiatric needs, but we also do medical detox on that unit as well, detox from alcohol, from sedatives like Xanax and Ativan, and also from opiates like fentanyl, heroin, oxycodone, that kind of thing.

We do have an outpatient clinic as well where we have both therapists and psychiatrists who see people on a regular basis in the outpatient clinic

.

Dr. Jason Jerry: We are also looking into actually developing right now what's called a collaborative care model, where we will have psychiatric services, for lack of a better term, embedded in the primary care clinics throughout our system. And we'll have care coordinator, psychiatric care coordinator, working closely with a psychiatrist here in the clinic to help guide the primary care docs in their prescribing and management of these patients.

Host: So, you started to touch on some of the detox services that you offer. But more broadly, I'm curious if First Health offers substance use disorder treatment as well?

Dr. Jason Jerry: So, we do. So on the inpatient unit, in addition to that, we get patients lined up with an aftercare plan and oftentimes that is referring them to a residential treatment program somewhere in the state or outside the state, you know, your typical 30-day residential treatment program for addictions. Lot of time, patients request to just go back home and maybe attend 12-step meetings and that kind of thing. And for them, we may send them home on medication, medication that helps with cravings and that sort of thing. We also have volunteers from the community, from the AA community that come in and do 12-step meetings every night on the inpatient unit at the hospital. So, those who are dealing with those issues will often attend that and find it helpful and find it sort of an introduction to the local AA community and they found that extremely helpful.

Now, in the outpatient clinic, I treat quite a few people with addiction-related issues. Some of them I manage on suboxone, which is an opioid that's used ironically to treat those with opioid use disorder. And again, if we rekindle our intensive outpatient program and partial hospitalization program, we'll also have addiction services within that as well.

Host: So, I think one thing that might be on people's mind as they listen to this is the overall experience that they have when they first come to the hospital. Is that something that you can speak to?

Dr. Jason Jerry: Okay. So, typically, they either come to the emergency room on their own because they're not feeling well and they're having thoughts of harming themself, that kind of thing. They come into our emergency room and they're seen by one of the emergency room doctors who then consults one of us, one of the psychiatrists. We evaluate, and if we feel that they're a danger to themself or others, then we admit to our inpatient unit, provided we have a bed.

At that point, when they come up to the inpatient unit, they'll interface with the nursing staff first and be evaluated and then assigned to either me or Dr. Eugene Kim, who's another psychiatrist on the inpatient unit, and we'll take it from there. We'll, do a thorough evaluation of them, make recommendations for their medication and that they will participate in groups that happen on the unit every day. And they'll work closely with a case manager or social worker to talk about what comes next, where are they going to stay in terms of their living situation. They will interface with the family and get collateral information from them and line them up with treatment after discharge.

Host: Yeah, totally makes sense. And I think an important piece about what you're saying there, just around the fact that they'll interface with you and potentially another group is that they are not alone in this, like this is something that you've probably seen quite often. A lot of people struggle with mental health issues and I think sometimes getting over the hurdle to bring themselves in or having a family member have a conversation with them to do so can be intimidating and anxiety-inducing and going into the unknown, but just understanding that obviously you're there to help and that this is something you see all the time. Is that correct?

Dr. Jason Jerry: It is. Yes, it is. And some of them are brought in, in fact, a good chunk of them are brought in, by police in that after a loved one called the police, or taken out an involuntary commitment at the court to get them the help that they need because they're resistant to that. So for some, it is a bit more dramatic and much more anxiety-provoking. But again, we try to normalize it as much as we can and take away their anxiety and worry about the process.

Host: As people go through the process, especially if they're brought to the process in a more forceful way, what's one thing that you've noticed as they've gone through the program and experienced those services that First Health has to offer?

Dr. Jason Jerry: Well, by the time that they leave our facility, they're doing better than when they came in, and I think they're in a better place to understand the whole process and why all of that transpired. I think initially they may feel like they're being persecuted by being brought in that way. But at the end, when they're back to themselves and back to their baseline, I think they understand that, "Hey, that was a necessary thing to do, because I probably would've done something that I would've regretted."

Host: Yeah, totally. Just as we start to close here, I always like to ask, what is one thing that you know to be true, you know, given all of the experience that you've had, that you want to leave with our audience today?

Dr. Jason Jerry: That there is a solution to these problems. And that even if untreated, people don't stay depressed forever. They get out of that depression and go back to baseline for a time. They may have another episode down the road, but things always come back to baseline eventually. And so, unfortunately, I think people act on these feelings and do things like commit suicide and if they would've just dug in their heels, the depression would've passed and it would've passed even more quickly had they been able to reach out and seek help.

Host: Well, Dr. Jerry, this has been a great conversation. Just before we close, is there anything else you'd like to share with the audience?

Dr. Jason Jerry: I think you've covered quite a bit of ground there, so I'm glad we're having this conversation. Again, I think more people need to realize that this is a big issue in this country. The depression and anxiety rates are going up significantly. And these conversations need to be had more often around the country.

Host: Yeah. Well, Dr. Jerry, thank you so much for your time. I really appreciate it.

Dr. Jason Jerry: Great. Thank you.

Host: That was Dr. Jason Jerry, a psychiatrist with board certifications in Psychiatry and Addiction Medicine and Medical Director of Behavioral Services at First Health of the Carolinas.

For more information, you can go to firsthealth.org/behavioral. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks for checking out this episode of the First Health and Wellness Podcast by First Health of the Carolinas. I'm Prakash Chandran. And until next time, be well.