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BH Video Series

2021 Behavioral Health Video Series

Each month during 2021 we will feature an aspect of Behavioral Health in our Provider Update newsletter, along with a brief video from Dr. Alvin Pelt, BH Medical Director. These articles and videos are intended to support you to help you help your patients. 

January 2021: Substance Use Disoder

Buckeye Addresses Ohio’s Opioid Epidemic

Difference Between Controlled and Illegal Substances

To reduce drug abuse and dependence, there are tight controls on the production, sale and distribution of many drugs.  Illegal substances include “street drugs” such as cocaine, heroin, marijuana, methamphetamine, and Ecstasy/Molly. Controlled substances, are sold legally and include Ritalin and Adderall, pain relievers such as OxyContin and Vicodin, and sedatives such as Valium and Xanax. Controlled substances have been added to Federal Class 1 drug lists due to widespread abuse. When controlled drugs are taken without a proper prescription, it is considered illegal.  These drugs can be easily accessed and illegally purchased online, however.

Differences Between Opiates and Opioids

The poppy plant creates opiates. Opiates are labeled “natural”, because nature creates the active ingredient molecules. Common opiates include opium, morphine and codeine.  Both made directly from poppy plants.

An opioid is a substance (molecule) that is synthetic or partly synthetic. This means the active ingredients are created chemically. Opioids act just like opiates in the human body, because of the similar molecules. Common opioids are OxyContin, hydrocodone, fentanyl and others.

Buckeye Battles Opiate Epidemic

Ohio has seen a steady increase in opiate addiction over the past ten years, making it one of hardest hit states in the country. Higher demand for heroin has driven the costs down.  In addition, suppliers have put purer, more potent heroin on the street.

Buckeye has specifically targeted the opiate epidemic with several initiatives:

  • Care Management Outreach & Engage: the team quickly identifies members with an opiate addiction through weekly claims reviews and uses evidence-based practice techniques to outreach and engage in care management.

  • Special ‘New Leaf’ program: identifies members who are struggling with addition during pregnancy and links the member with treatment. Pregnant members who have engaged in our care management prior to birth have better health outcomes including:
    • lower rates of neonatal abstinence syndrome
    • lower NICU admission rates and
    • shorter NICU lengths of stay
  • Specialized substance use disorder supervision workgroup: which includes 14 team members actively obtaining specialized training and licensure in chemical dependency. Weekly meetings include:
    • clinical case reviews and presentations
    • psychopharmacology and MAT presentations
    • preferred drug list updates
    • latest trends in use
    • regional resource sharing

For more information on how Buckeye can help you assist your patients, see our Behavioral Health video given by Dr. Alvin Pelt, Buckeye Health Plan Behavioral Health Medical Director located at the top of the page.

National Eating Disorder Awareness Week for 2021 is February 22-28.

National Eating Disorder Awareness Week for 2021 is February 22-28. The National Eating Disorders Association (NEDA) estimates ~30 million people will experience an eating disorder at some point in their lifetime. Eating disorders tend to have a high prevalence rate of co-occurring diagnosis such as anxiety, depression and substance use disorders.

There are a range of onset factors involved with these disorders:

1.   Biological

  • Family history
  • Genetic predisposition

2.   Psychological

  • Low self-esteem
  • Feelings of inadequacy

3.   Cultural norms

  • Body dissatisfaction
  • Norms that overvalue appearance

Eating disorders can impact people of all:

  • Genders
  • Ages
  • Race
  • Ethnicities
  • Body shapes

Below are a few of the specific types of disorders.

  • Anorexia nervosa- restricting intake with intense fear of weight gain.
  • Bulimia nervosa- characterized by binge eating and purging behaviors.
  • Binge eating disorder- recurrent binge eating episode without the use of compensatory behaviors.
  • Avoidant-restrictive food intake disorder- lack of interest in food and fears around food intake.
  • Other specific feeding or eating disorders that cause significant stress for the individual.

The impact on an individual’s physical health is significant. Eating disorders have the second highest rate of mortality, only surpassed by opiate use disorders. Of greatest concern include:

  • Cardiovascular
  • Gastrointestinal
  • Neurological
  • Endocrine

Early intervention can help support individuals through their journey to recovery. Various levels of treatment are available to support individuals from outpatient care through inpatient levels of care. For more information on eating disorders, please reach out for education and engagement supports at NEDA

Learn what bullying is, how you can recognize it and steps you can take.

What is bullying?

Bullying is serious and includes unwanted aggressive behaviors, observed or perceived power imbalance and repeated behaviors over time.

What is the impact?

Research shows bullying not only affects those who are bullied, but also those who bully and those who witness it. Roughly 20% of students between the ages of 12-18 have experienced bullying within the past 12 months on school property and less than half the children tell an adult at school. It can impact:

  • Mental and physical health and educational performance.
    • According to www.nobullying.com, nearly 160,000 bullied students miss school each year which leads to 1 out of 10 students dropping out of school.
    • Studies show that kids who experience bullying are more likely to have poorer academic performance and decreased class participation.
  • Bullied children often report physical and mental health concerns including headaches, stomach aches, depression, anxiety, difficulties sleeping and even thoughts of suicide.
  • The impact of bullying often continues into adulthood.

What to look for?

You can play a critical role in preventing and responding to bullying. Recognizing the following warning signs is key:

  • Unexplainable injuries
  • Lost or destroyed clothing, books, electronics, or jewelry
  • Frequent headaches or stomach aches, feeling sick or faking illness
  • Changes in eating habits:
    • Suddenly skipping meals or binge eating.
    • Coming home from school hungry because they did not eat lunch.
  • Difficulty sleeping or frequent nightmares
  • Sudden loss of friends or avoidance of social situations
  • Feelings of helplessness or decreased self esteem
  • Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide

What can you do?

  • Maintain open lines of communication by asking questions about school and their friends and help children understand what bullying is through education.
  • Let children know that bullying is unacceptable and help them identify trusted adults they can talk to with any concerns.
  • Share the SYSC video (explained below) with at-risk students.
  • Review Ohio’s anti-bullying laws in addition to federal laws that provide protections from harassment based on race, color, national origin, sec and disabilities.

What is Buckeye doing to help?

No One Eats Alone

Buckeye and our parent company Centene partner with Beyond Differences to bring No One Eats Alone Day to schools throughout Ohio as part of a national effort to end social isolation and promote inclusion for children who feel left out or that they don’t belong. 

Social isolation is a pre-cursor to bullying and can happen anywhere. It occurs anytime students feel misunderstood, left out, or alone. It especially affects those who are seen as “different” because of their appearance, race, disability, ethnicity, sexual orientation, gender identity, religious beliefs or any other reason that makes them seem “different.” 

Through in-school activities led by students, No One Eats Alone Day promotes acceptance and inclusion by encouraging students to make friends with classmates who are eating alone.  Schools that have a culture of inclusion have far fewer instances of bullying, self-harm, and community violence.

Strong Youth Strong Community

Buckeye Health Plan, along with Centene, our parent company, also partners with Strong Youth Strong Communities (SYSC℠).  As we shared in our February issue, SYSC is an excellent opportunity for young people ages 13-19 to find support and learn development skills.

During our Ohio virtual Summit last year, Iman McFarland, who is one of our SYSC ambassadors and a former athelete, spoke about her experience being bullied as a child/teen. She shares her tips on how to be FLY

Autism is a pervasive developmental disorder that affects children in all areas of the world, and presents significant challenges to children and their families. Considering the knowledge that autism affects children around the world, on December 18, 2007, the United Nations General Assembly passed a resolution to establish a World Autism Day.

April 2, 2021, marked the 14th annual World Autism Awareness Day that kicks off Autism Awareness Month. During this month activities and education events are shared with the public to raise awareness of the realities of autism. In addition to increasing awareness, the activities provide opportunities for people to learn how to create events that are inclusive of individuals with autism spectrum disorder diagnoses.

What is Autism Spectrum Disorder (ASD)?

  • A pervasive (widely spread) childhood developmental disorder
  • Characterized as a developmental disorder because the symptoms usually appear in the first two years of a person’s life.
  • The word “spectrum” is included because the type and severity of symptoms people experience can vary widely on a spectrum from very high-functioning to in need of assistance with multiple challenges.

What are common symptoms of Autism?

  • People with ASD think, behave, learn, communicate, and interact differently than those without the disorder.  Depending on the presentation and placement on the spectrum symptoms can vary. The core symptoms of autism are social communication challenges and restricted, repetitive behaviors.
    • Social communication challenges include:
      • Spoken language (around a third of people with autism are nonverbal)
      • Feeling overwhelmed in social situations
      • Gauging personal space (appropriate distance between people)
    • Restricted and repetitive behaviors include:
      • Repetitive body movements (e.g. rocking, flapping, spinning, running back and forth)
      • Repetitive motions with objects (e.g. spinning wheels, shaking sticks, flipping levers)
      • Need for unvarying routine/resistance to change (e.g. same daily schedule, meal menu, clothes, route to school)

The pervasiveness of Autism has increased efforts to find treatment, therapies and interventions that teaches skills to help them succeed in the community and educational system. Depending on the presentation and placement on the spectrum, treatment of ASD can vary.

Mental Health Awareness Month raises awareness and educates others about mental health conditions and services. Even before COVID-19, the prevalence of mental health conditions in the U.S. was on the rise. In 2019, nearly 52 million adults experienced some form of mental illness.

Since the onset of COVID-19, one in four adults reported experiencing symptoms of an anxiety or depressive order in February 2021 according to the CDC. This is a significant increase from previous years. According to NAMI.org, 1 in every 20 adults is living with a mental health condition such as schizophrenia, bipolar disorder or long-term reoccurring major depression.

People living with mental health conditions should be treated with compassion, respect and understanding. Too often they feel they have nowhere to turn. Reports indicate that suicide is the tenth leading cause of death in the United States and the second leading cause of death for our nation’s youth. It’s also reported that suicide rates are disproportionately high among Black youth, and LGBTQI+ persons. Those in need of help can call the National Suicide Prevention Lifeline at 1-800-273-TALK or call 1-800-662-HELP. 

Buckeye Health Plan is devoted to working with behavioral health physicians, counselors, social workers, and case managers to assist with mental health conditions. Individuals can achieve wellness when they are empowered with education about their diagnosis, effective treatment, and the support of peers and family.  

Buckeye continues to work on key Behavioral Health Initiatives:

  • Behavioral Health cell phone program – We provide cell phones to members with high ER or IP utilization
  • Community Rounds – Buckeye Medical staff members participate in BH rounds for children in Cuyahoga County
  • Everlywell – Buckeye partners to provide in-home lab testing to meet BH HEDIS measures
  • Buckeye Spectrum – This new program focuses on members who have a diagnosis of schizophrenia.
  • Depression Disease Management – Buckeye’s program provides care management and support services to engage members who have major depression
  • Pathlight – This program partners with VPA.   Nurse Practitioners provide care management for members who have multiple co-morbidities and work with an established behavioral health provider.
  • New Leaf Program – Pregnant members who have a SUD diagnosis receive help with resources and medication assisted treatment during and after pregnancy.

Be sure to watch our short, but inspiring, three-minute video about Buckeye member Vivian and her return to wellness and independent living after learning how to manage her depression with help from Buckeye Health Plan.