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Liz Unruh (Host): Hello, listeners. And thank you for tuning in to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Liz Unruh. And joining me today is April Balzhiser, the Director of Inpatient Behavioral Health here at Riverside. Thanks for joining us today, April.

April Balzhiser: Thank you.

Host: Before we jump into our topic, which is talking about the exciting changes that are coming to our inpatient behavioral health units, can you tell us a little bit about yourself and your role here?

April Balzhiser: Sure. I have been the Director of Behavioral Health, the inpatient side of things, for just about two years. I came to Riverside with almost 20 years of social services and behavioral health experience, and I was really excited to come continue that journey here, and it's been exciting to say the least.

Host: Yeah. So, when people hear inpatient behavioral health, they often have like a certain image in mind. What are some of the biggest misconceptions that you hear, and what does inpatient behavioral health actually look like?

April Balzhiser: I think the biggest misconceptions that I still hear today come from old movies that were made to make psychiatric facilities and patients seem scary. For Hollywood ticket sales, they often show dark, locked asylums, everyone being restrained or in padded rooms. Modern inpatient behavioral health is generally a safe, voluntary, and collaborative short-term stay, using evidence-based therapies, group counseling, and medical stabilization. So really, nothing like the movies or a lot of those misconceptions that are out there.

Host: Yeah. I know, before I worked here and before I had been even on our current units, that was kind of the vision that I had just based off of, you know, Hollywood—

April Balzhiser: Yes.

Host: The movies, just like what it looked like. But behavioral health treatment has really changed over the past several decades. And like you said, there's a team that works together collaboratively for care. What has changed with the philosophy of inpatient care? And, obviously, it's gone from just keeping them safe in those padded rooms or a restraint to like actually helping them heal. How has that shifted?

April Balzhiser: Sure. Keeping patients safe is still, first and foremost, the most important thing still today. Once someone is safe though, we then do want to promote true healing from the inside out. Behavioral healthcare is healthcare. So if we are mentally unwell, we're also not taking care of our physical health. So, whole healing and overall wellbeing is always the best route.

Host: Yeah, for sure. So, who would be a good candidate for an inpatient, behavioral health treatment? And what would be some signs that someone that you're close to or a loved one might need that level of care?

April Balzhiser: Safety is, like I just shared, still the biggest factor in determining if someone may need a higher level of inpatient care. If you have concerns about someone keeping themselves safe or keeping others around them safe, inpatient care is likely the needed option. Someone who's unable to care for themselves due to their current mental state can also be a candidate for inpatient; if they're not completing their ADLs, meaning they're not bathing, not eating, doing the everyday things that we need to do to make sure we stay well.

Medication changes can also warrant a shorter safe inpatient stay as well. That ensures your loved one stays safe while their physician might be making maybe some more drastic medication titrations or starting over sometimes if a patient feels like their current regimen is not working for them or producing the results that they want to feel their best self.

Host: That's really great to understand that because, you know, an environment itself can really have a major impact on someone's healing process. So, I mean, that goes into my next question here. Why is the physical space so important in behavioral health, and how will that influence a patient's recovery?

April Balzhiser: Sure. Well, the same goes for our homes and our personal spaces technically, right? So you'll often hear friends or family say they can't handle when they have lots of clutter in their homes or everything feels messy or out of place. Lighting matters as well. We often see someone struggling with mental health kind of isolate themselves into their room, draw the curtains, just creating a very dark space. Our surroundings matter to mental health and our overall wellbeing. What we surround ourselves with, who we surround ourselves with all makes a difference.

Host: Yeah, I can definitely see. Just personally, I know, when I'm feeling down, I try and get out and, you know, be in the sun and bring that warmth back to try and—not to say get out of the funk, but, like, try and bring my mood back up.

April Balzhiser: Right.

Host: Yeah. We're going to take a quick break to talk about primary care at Riverside. At Riverside, our primary care are right here in our community, offering personalized care for you and your family, close to home and connected to the specialists and services you may need.

Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing everyday concerns, because remarkable care should never be out of reach. Remarkable care right where you live.

To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

And we're back. So, the next section kind of talks about the exciting changes and investments that Riverside is making to improve our inpatient behavioral health units. Can you talk about what kind of inspired this project, and what does it say about Riverside's commitment to behavioral healthcare?

April Balzhiser: Sure. So, behavioral healthcare has come a really long way over the past few decades, and just as it's important to update medical spaces and equipment in order to offer current state-of-the-art treatment options, it's the same for behavioral healthcare. Riverside is continuously committed to providing advanced and innovative care across the healthcare spectrum, and that includes behavioral healthcare, of course.

Host: Yeah. I know that there are a lot of people in a lot of organizations in the country that are limiting behavioral healthcare, and it's a great thing that Riverside's doing by investing in updating our spaces and making sure that we're able to provide the best care for our patients. I know there are some specific features in the new units that are designed specifically for improved inpatient experience and to support recovery, creating that more therapeutic environment. Can you talk about a few of those?

April Balzhiser: Yes. So, we're so excited to share some of those details that are included in the new units. Probably my absolute favorite are the circadian lights that will be lining the new hallways of the units. Circadian lights mimic the natural lighting patterns outside. So when it's daytime, the lighting looks like you're standing outside in a courtyard. And then, they gradually decrease until the sun goes all the way down, and that is helping sleep-wake cycles, cognitive function, promoting the natural feeling of sunlight while being indoors.

Another exciting design feature is using the pillars that we have to promote the feeling of being surrounded by trees and by nature, the trees, like the cloud of leaves as well as clouds above are sound absorbent materials that help control overstimulation from background noise, conversations, or any other noise, creating a calming, peaceful environment, kind of similar to what you get with noise-canceling headphones.

Host: That's really cool. I know we saw the clouds during the renovation process go up. They just naturally blend into the ceiling. If you hadn't told me those were sound absorbing, I would have never known. So, it's great little just pieces. Like I mentioned, across the country, many hospitals have reduced or eliminated inpatient behavioral health services, and we're expanding and modernizing both our inpatient and outpatient services. Why is it so important for us to have this investment in our community?

April Balzhiser: So, healthcare is expensive in any capacity, and behavioral healthcare is not a sector that is generally very profitable. So naturally, a lot of hospitals and facilities across the nation are reducing or getting rid of behavioral healthcare altogether. That is actually a terrible shame, because I think our world saw a shift in how we look at mental health and how important it is, especially after the pandemic.

As I said earlier, behavioral healthcare is healthcare. So, it's just as important to invest in behavioral health as it is in any other kind of healthcare. If I'm not feeling well mentally, I'm certainly not following up with my primary care doctor to make sure I get my annual labs and make sure everything checks out. If I'm not feeling well mentally, I'm not making plans to dine out or frequent community establishments or businesses. And if I'm feeling not well mentally, I'm also not able to actively engage with my neighbors and my community. So by continuing to support the mental health of the Riverside community, we will have a much healthier and stronger community because of it.

Host: It's a great investment, and just great for the wellbeing of our community for sure. If there's someone who is listening today that's struggling with their mental health or they're concerned about a friend or family member, what would you want them to know about seeking help and what message of hope would you leave them with?

April Balzhiser: The first thing that I'd want everyone to know is that we all fall on the mental health spectrum. I think of it as a line that we move back and forth on throughout our lifespan depending on what's happening in our lives at any particular time, hour, day, any time at all. Most of us are really just one job loss, one relationship loss, one death away from needing mental health care or support. There's nothing wrong with reaching out for help, for ourselves or to make sure a loved one is getting the support that they need. Anyone listening that needs assistance of any kind when it comes to mental health is encouraged to call our central intake department at 844-442-2551. We're here to help 24 hours a day, seven days a week.

Host: Yeah. That's a really great message, and I love your analogy of the line where we're constantly shifting, because that's a really good powerful thing to remember that we all are on that spectrum somewhere. Well, thank you, April, for joining us today and sharing about our, improvements that are coming to inpatient behavioral health here at Riverside.

April Balzhiser: Thank you for having me.

Host: And thank you for tuning in to the Well Within Reach podcast with April Balzhiser, Director of Inpatient Behavioral Health at Riverside and your host, Liz Unruh. To learn more about the services provided by Riverside's behavioral health, visit our website at riversidehealthcare.org or call our Central Intake Department at 844-442-2551.