When immigrant families bring their children to the Yale Children’s Hispanic Clinic, it’s just not about check-ups and vaccinations. Clinicians help them deal with everything from teething to nutrition to finding a place to live. But these days when front-line clinicians encourage families to use the many services offered through federal public programs, parents have questions—and misgivings. “They are hesitant because they are afraid,” said Patricia Nogelo, a clinical social worker at the Yale Children’s Hispanic Clinic. A proposed change in immigration law is making immigrants in Connecticut and nationally wary of utilizing federal programs that cover health, food and housing assistance.
Among women, those who are low-income or minority are less likely to get treatment for depression, according to multiple studies. A report by the Connecticut Behavioral Health Partnership found that women were underrepresented in Medicaid-funded behavioral health services in the state even though research shows that women suffer from the most commonly diagnosed mental health disorders more frequently than men. Racial and ethnic disparities, while still considerable, are decreasing in some physical illnesses. “But in mental health care, in the last 10 years, we see those disparities widening,” said Megan Smith, associate professor in the Departments of Psychiatry and in the Child Study Center in the Yale School of Medicine, who runs the Mental health Outreach for MotherS (MOMS) Partnership®, a program that offers mental health services to “overburdened and under-resourced mothers.”
In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses the hurdles to mental health care and the programs breaking barriers to care with Yale’s Megan Smith and UConn Health’s Dr. Sarah Nguyen. Lack of insurance coverage, the cost of treatment, a shortage of qualified clinicians, stigma and even fear of losing custody of their children can keep women from seeking help, Smith said.
Depression is the leading cause of disability worldwide, according to the World Health Organization, and affects women at about twice the rate that it does men. In Connecticut, 21.4 percent of women report experiencing depression, compared with 13.4 percent of men, according to 2015 Department of Public Health data. Millennial women in the state experience depression four more days in an average month than their male counterparts, the Status of Women data project reported this year. Women are more likely to use mental health services than men, but studies consistently show that the majority of Americans with depression go untreated. In this podcast, sponsored by ConnectiCare, Colleen Shaddox discusses depression and pathways to better mental health with Yale’s Carolyn Mazure, and NYTimes best-selling author Luanne Rice.
Iasiah Brown, 25, of New Haven, said he does not see a need for a primary care doctor for himself and his daughter, opting to visit clinics in the area instead of waiting up to two weeks for an appointment at a doctor’s office. Brown is among the 83 people who said they didn’t have a primary care doctor in response to a health-care usage survey by the Conn. Health I-Team and Southern Connecticut State University. The team surveyed 500 people and interviewed dozens statewide between January and March. About 83 percent of respondents said they had a primary care doctor, but the rate was lower for African American (78 percent) and Hispanic respondents (75 percent).
Joanne Goldblum of New Haven is on a mission to get health care clinicians to recognize that poverty may be the underlying cause of their patients’ illnesses and that the best treatment might be as simple as a brown bag of food or a tube of toothpaste. Goldblum is CEO of the New Haven-based National Diaper Bank Network (NDBN), an organization dedicated to getting basic needs to people. She co-authored the Basic Needs-Informed Care Curriculum—with support from Yale School of Medicine faculty—designed to help clinicians, social workers and educators recognize the myriad ways a lack of resources can present itself. For example, a baby comes to a well child visit in dirty clothes. Clinicians might typically ask: Is the mother too depressed to care for the infant?
When doctors and patients communicate well, research shows that patients are more likely to follow treatments, recover more quickly and are less likely to be the victims of medical errors. But with an average office visit of just 18 minutes and an increasingly complex variety of diagnostic and therapeutic options, good communication may be modern medicine’s final frontier. In this podcast, sponsored by ConnectiCare, Dr. Juan Estrada, medical director of Sanitas Medical Centers and Lisa Freeman, director of the Conn. Center for Patient Safety, provide tips on how to communicate with your doctor. A recent patient survey by ConnectiCare found that patients generally rated communication with their doctors highly, but there were concerning gaps.
Combining medication with other forms of therapy can help people with opioid addition avoid relapse by calming cravings and managing the symptoms of withdrawal. Less than half of the privately drug addiction programs nationally offer medication-assisted treatment (MAT); and even in those programs, only one-third of patients receive MAT, according to the National Institute of Drug Abuse. In Connecticut, there are about 40 Medicaid providers that prescribe medication for treatment. In our podcast, sponsored by Wheeler Clinic, Dr. Robert Grillo discusses medication-assisted treatment for opioid addiction. Increasing access to MAT is important given the extreme danger associated with relapse, says Dr. Robert Grillo, medical director for psychiatry at Wheeler Clinic.
Adult children should talk with parents about health and end-of-life preferences long before these matters become urgent, experts in the field say. “If you can think early on about options, identify preferences, talk to people about what they would like done, you really tend to have more control over the process,” according to gerontologist Donna Fedus, founder of the Connecticut-based consulting company, Borrow My Glasses. More than a third of U.S. adults provide care for an older relative, according to the Pew Charitable Trusts. As life expectancy increases and health care becomes increasingly complex, Fedus said, that role becomes more difficult.
Our podcast, sponsored by ConnectiCare, Donna Fedus, founder of Borrow My Glasses and Anne Elwell of Qualidigm, provide tips on ways to discuss care with an elder parent years before it is needed. Talking with parents about their health status, their medications and their doctors while health is relatively good can give children important information and make the transition to the adult child actively managing care less jarring, she said.
Stephanie Almada’s journey to opioid addiction began with a prescription to relieve her premenstrual symptoms and accelerated after she had a cesarean section. “The pain pills came, you know, very quickly and I had bottles at home anyway,” she said. “And then it became energy for me. It became the way I coped with life.” Today Almada, 44, is a peer recovery specialist at Wheeler Clinic in Plainville, where she helps women get off opioids. Americans are using opioids at record rates.
Is marijuana a harmless way to relax or a dangerous gateway drug? The science says “No” and “We don’t know,” respectively. Arguments for and against legalization often misrepresent the medical effects of cannabis, some experts say. Several bills proposed in the 2017 session of the General Assembly would make recreational use of marijuana legal in Connecticut. Medical marijuana use for conditions ranging from post-traumatic stress disorder to cancer has been legal in the state since 2012, though dispensaries did not open until 2014.