“What would my son or daughter do in that situation?” The news of school shootings and other violence is hard to escape these days. Along with it comes the cruel reality that the same thing could happen to anyone’s child. It’s a scary thought.

This reality hit me hard after the Sandy Hook Elementary School shooting in 2012. At the time, my son was a five-year-old kindergartener. I watched the coverage in disbelief and kept thinking this could have been his classroom. Would he have known what to do? Would his teacher? Would anyone? That was the point when I decided that it was my job to teach my four children how to be safe in the event of a violent intruder.

But how could I, a mom from small-town Wyoming, even know where to start?

I quickly turned my attention to Google. I poured my energy into finding what I thought was the best way to protect my kids. I wasn’t solely focused on the type of violent event they could encounter. Kids can get hurt by someone with a gun or knife, by a stranger driving a windowless van – or in any other scary scenario we can only imagine. What was important was learning how to respond. That’s when I found A.L.I.C.E.

A.L.I.C.E. is a training curriculum that was developed shortly after the Columbine massacre in 1999 by a police officer and his wife, who was a school principal at the time. Their goal was to develop strategies children could use in the event of an active shooter. But what they found was that those strategies could be useful for victims of any age, during any type of violent event.

According to the ALICE Training Institute, A.L.I.C.E. is an easy-to-remember acronym that teaches different strategies people can use in the event of a violent intruder:

• A – Alert
  • Be alert to your surroundings.
  • Trust your gut. If something doesn’t seem right, don’t ignore it.
  • If you hear a strange sound or see something that seems off, investigate it.
• L – Lockdown
  • If you cannot escape a violent intruder, lock down and barricade your area.
  • Barricading is crucial. Don’t just sit against a wall or under a desk waiting for a violent intruder to enter the room.
  • Make it harder for the violent intruder to get to you.
  • Don’t wait to be attacked. Be proactive.
• I – Inform
  • Tell people what is going on.
  • Call law enforcement, post on social media, make an announcement on a PA system.
  • Communicate with everyone.
  • Spread the word any way you can.
• C – Counter
  • If left with no choice, defend yourself.
  • Defending yourself could mean throwing things at a violent intruder, creating a distraction, moving around or even engaging in physical contact.
  • Do whatever it takes to survive.
  • Fight for your life – because it might be your last chance.
• E – Evacuate
  • Get out!
  • The best response is always to remove yourself from the threat.
  • If you can’t evacuate, try the lockdown and counter strategies.

These strategies can be employed in any order, and at any time. Data show that taking a proactive response to these incidents – when people realize they have options and can help themselves – can increase survival rates substantially.

As for me? I just wanted to make my children a little safer. It’s not necessarily anyone else’s job to teach them what to do in these situations. In fact, there are many places that still tell victims to crawl under desks or tables and wait to be rescued. Yet, the data show that violent intruder events are commonly over before law enforcement arrives at the scene. So I wanted to empower my kids, let them know they can take action to increase their chances of survival.

I strongly believe in giving people options in these situations. So I became a certified A.L.I.C.E. trainer in 2015. I have trained hundreds of people throughout Wyoming who work in government agencies and businesses, as well as kids. And every time there is a violent intruder event on the news, I reinforce the A.L.I.C.E. strategies with my own kids at home and practice drills with them.

I recently hosted an A.L.I.C.E. training event for Magellan Healthcare of Wyoming’s MY LIFE (Magellan Youth Leaders Inspiring Future Empowerment) program, attracting more than 60 students, parents and others from across the state. At the beginning of the discussion, I asked the group, by raise of hands, how many thought they would survive a violent intruder event. Roughly five people raised their hands. At the end of the class, I asked the group the same question, and every single person raised their hand.

A.L.I.C.E. training has evolved into offering its curriculum to nearly 12,000 law enforcement agencies, K-12 schools, healthcare facilities, higher learning institutions, businesses, governments, houses of worship and numerous other entities across the country. A.L.I.C.E. is about saving lives. My goal is to share these strategies with as many people as I can. Just like I wanted to prepare my kids, I believe that all of us can do a lot to save ourselves and each other. To learn more, visit https://www.alicetraining.com.

The following is an excerpt from an article appearing in Advances in Addiction & Recovery

Deaths from prescription opioid abuse have more than quadrupled since 1999, prompting President Donald Trump to declare the opioid epidemic a national public health emergency.[1] But while discussions around opioid abuse prevention have intensified, numerous barriers to recovery continue to exist.

For example, one of the most effective ways to combat opioid addiction is through medication-assisted treatment (MAT), an evidence-based approach that combines medication with psychosocial intervention. MAT empowers those suffering from opioid use disorder (OUD) to recover from their addiction while rebuilding their lives.

However, the stigma often related to MAT—on the part of both the medical community and addiction support professionals as well as family members of patients—continues to limit its use across the industry. Further, the need to educate communities and legislators about the complex issues surrounding addiction treatment cannot be overstated. Addiction should be considered a chronic condition, and such treatments need to be viewed the same way.

You can read the rest of the article on pages 24-25 in Advances in Addiction & Recovery.

[1] https://www.cdc.gov/drugoverdose/epidemic/index.html

1. Myth: Mental health problems don’t affect me.

Fact: Mental health problems are actually very common.

Annually, about:

• One in five American adults experienced a mental health issue
• One in 10 young people experienced a period of major depression
• One in 25 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression
• Suicide is the 10th leading cause of death in the United States. It accounts for the loss of more than 41,000 American lives each year, more than double the number of lives lost to homicide.

2. Myth: Children don’t experience mental health problems.

Fact: Even very young children may show early warning signs of mental health concerns.

These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before age 24.

Unfortunately, less than 20% of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

3. Myth: People with mental health problems are violent and unpredictable.

Fact: The vast majority of people with mental health problems are no more likely to be violent than anyone else.

Most people with mental illness are not violent, and only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population. You probably know someone with a mental health problem and don’t even realize it, because many people with mental health problems are highly active and productive members of our communities.

4. Myth: People with mental health needs, even those who are managing their mental illness, cannot tolerate the stress of holding down a job.

Fact: People with mental health problems are just as productive as other employees.

Employers who hire people with mental health problems report good attendance and punctuality as well as motivation, good work, and job tenure on par with or greater than other employees.

When employees with mental health problems receive effective treatment, it can result in:

• Lower total medical costs
• Increased productivity
• Lower absenteeism
• Decreased disability costs

5. Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.

Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better.

Many factors contribute to mental health problems, including:

• Biological factors, such as genes, physical illness, injury, or brain chemistry
• Life experiences, such as trauma or a history of abuse
• Family history of mental health problems

6. Myth: There is no hope for people with mental health problems. Once a friend or family member develops mental health problems, he or she will never recover.

Fact: Studies show that people with mental health problems get better and many recover completely.

Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. There are more treatments, services, and community support systems than ever before, and they work.

7. Myth: I can’t do anything for a person with a mental health problem.

Fact: Friends and loved ones can make a big difference and be important influences to help someone get the treatment and services they need by:

• Reaching out and letting them know you are available to help
• Helping them access mental health services
• Learning and sharing the facts about mental health, especially if you hear something that isn’t true
• Treating them with respect, just as you would anyone else
• Refusing to define them by their diagnosis or using labels such as “crazy”

Help is available.

For additional information, visit MagellanHealth.com/MYMH

What is the difference between mental health and mental illness? The former refers to our emotional and psychological state, our social well–being and how we feel about ourselves and interact with others. Mental health is not the same as mental illness, although poor mental health can lead to mental and physical illnesses.

When we have good mental health, we are resilient, can handle life’s challenges and stresses, have meaningful relationships and make sound decisions. Being mentally healthy, like being physically healthy, is important at every stage of life, from childhood and adolescence through adulthood and old age.

Being mentally healthy is influenced by life experiences, relationships with others, physical health and one’s environment. Just as people may experience physical problems over the course of their lives, they may also experience emotional or mental health problems that affect their thinking, mood and behaviors. This does not necessarily mean that a person who is going through a difficult time and is experiencing poor mental health has a mental illness. Feeling miserable and socially isolated are red flags that one’s mental health needs attention.

The benefits of improving one’s mental health are well worth the effort. Being mentally healthy helps you feel confident in your worth and abilities, accept your strengths and weaknesses, set realistic goals and create a sense of meaning and purpose in your life. Emotional health and mental health are closely intertwined, and both can positively or negatively impact physical health as well.

What is Mental Illness?
Mental illness refers to a wide range of disorders that affect mood, thinking and behavior. Mental illness can affect anyone regardless of age, gender, social standing, religion or race/ethnicity. People with mental illness often experience distress and problems functioning at work, home and in social situations. Mental illness is not something the person can “overcome with willpower,” and can be caused by biological factors such as genes or brain chemistry, trauma and abuse, and family history of mental illness.

The major types of mental illness include:
• Depression
• Anxiety
• Mood disorders, including bipolar
• Personality disorders
• Schizophrenia
• Trauma disorders
• Eating disorders
• Addictive behaviors

Mental illnesses are common in America, and approximately one in five adults lives with a mental illness (43.8 million in 2015.)1 While depression and anxiety are two of the most common disorders, mental illness includes many different conditions that range from mild to moderate to severe. People who don’t have a mental illness might still be impacted by the mental illness of a friend or family member.

Signs and symptoms of mental illness vary, but may include changes in sleep, appetite, and energy level, severe mood swings, persistent thoughts or compulsions, hearing voices, social withdrawal, feeling sad, hopeless, or agitated, having trouble performing everyday tasks, or wanting to hurt oneself or others.

With the right treatment, people can and do recover from mental illness. Friends and family members can be important influences to help someone get the treatment and services they need. Primary care physicians can refer individuals to psychiatrists and other professionals who specialize in mental health treatment. Treating a physical illness might require medications and physical therapy, and treating a mental illness might also require medications and different therapies. For many people, the first step is to recognize there is a problem and be willing to accept help.

For more information on treatment resources, contact:
National Institute of Mental Health
https://www.nimh.nih.gov/health/find-help/index.shtml

NAMI (National Alliance on Mental Illness)
http://www.nami.org/

Substance Abuse and Mental Health Services Administration (SAMHSA) https://findtreatment.samhsa.gov/https://www.mentalhealth.gov/

Mental Health.gov
https://www.mentalhealth.gov/
Help is available. For additional information, visit MagellanHealth.com/MYMH

1. https://www.nami.org/learn-more/mental-health-by-the-numbersd to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned

Read more more about this topic from Magellan Health Insights

Exponential Organizations (ExOs) deliver outcomes (or impact) that are disproportionally (10x) greater than their traditional competitors through the use of innovative business models, organizational techniques and digital technologies. Over the past two years, we at Magellan have developed, implemented and are continuously improving a new approach for managing IT in ExOs. Magellan Exponential IT (ExO IT) is a digital and cloud-first healthcare strategy that is enabled by agile operational processes and implemented by a highly engaged learning organization. These three basic components of ExO IT – Digital Strategy, Agile Operations and Learning Organization, work together in a cadence to deliver iterative technology enabled capabilities that build on each another to deliver business agility, 10x results and be adaptive to meet the evolving needs of today’s healthcare industry.

Earlier this year, we started to automate Magellan’s ExO IT model through a highly scalable, secure and always-on system called DREAMS (Digital Real-time Management System). DREAMS has six modules that are built on ServiceNow (Kingston) platform using a customer focused low-code, no-code approach. With DREAMS, we aim to deliver minimum efficient scale through the use of today’s cloud-based technologies, ubiquitous access, real time insights and lean processes. It is highly influenced by Design Thinking, Lean Thinking (The Toyota Production System), Agile Methods, and the Amazon Way (Customer first, develop press releases, two-pizza team etc.). The broad scope of DREAMS includes:

1. Lead IT – This module operationalizes and automates our ExO IT strategy through focused and highly visible initiatives and expected outcomes. It does this through several Lean Thinking work products such as the X-Matrix, Leader Standard Work, Visual Management Systems, Initiative Press Releases, Project A3s and OKRs. At the center of Lead IT is a Digital 5S System. 5S (Sort, Standardize, Set-in-order, Shine and Sustain) is a Lean Thinking technique that makes the most frequently used and current and properly configured tools available to the right people, at the right time and at the right place. The Digital 5S is used to enable a highly engaged, productive and collaborative IT leadership team.
2. Manage IT – This module aims to maximize the throughput of IT by continuously aligning demand with the supply of IT at the most optimal cost. Manage IT standardizes and automates IT Service Delivery capabilities such as demand, resource, capacity, portfolio and financial management. This module is built around the Magellan Asset Portfolio (MAP) and it provides an easy to use and easy to search repository of infrastructure and application assets used within Magellan. MAP is enabled and operationalized through Service Owners and Solution Owners within our ExO IT organizational model.
3. Ask IT – This module aims to improve employee productivity by helping them request and receive IT solutions and services through simple, secure, easy-to-use, reliable and context-aware experiences. Ask IT implements a Services Portal and Services Catalog that can be used by employees to order, track and receive solutions and services in a way that is similar to leading online services such as Amazon.
4. View IT – This module focuses on driving continuous improvement within ExO IT by providing access to real-time dashboards, interfaces, benchmarks, metrics and outcomes used to measure the effectiveness of IT and its operations.
5. Secure IT – This module automates Security Operations, GRC, adherence to standards, audit controls and other mission critical functions related to protecting the security and privacy of healthcare information and
6. Operate IT – This module focuses on delivering predictable, secure, always-on operations using standardized and automated IT Service Management capabilities in the areas of Incident, Problem, Change, Event, Release and Capacity Management.

We are currently in flight with rolling DREAMS V1.0 out to the leadership ranks within Magellan IT. This release provides limited scope across all six modules and represents a significant step forward. We have 4 more releases planned for 2018. These releases will add more functionality and roll these capabilities out to a broader audience within Magellan.

Our own Seth Feuerstein spoke recently at the APA annual meeting about how Digital Mental Health Care is increasing access and delivering positive outcomes.

“Here’s what’s interesting…subjectively, patients described [the digital program] as by far the most positive experience they have when they go to that center,” said Feuerstein. “Their engagement with it was kind of off the charts.”

You can read about Seth’s comments and more at the American Journal of Manage Care by clicking here

April is Autism Awareness Month and another opportunity to promote inclusion and self-determination for those on the autism spectrum. Like many impacted by this challenging disorder, my family has our own story and my hope is that by sharing it, we can help others.

Our now nine year old son, Vaughn, was diagnosed with autism at 18 months. A mere 13 months younger than his typically-developing sister, my husband and I could tell that something was not quite right with our son. Vaughn wasn’t walking or talking and was overly-obsessed with anything that spun. He wouldn’t make eye contact with people and wasn’t motivated to engage with our family. It was both scary and heartbreaking and we knew we needed to do something. Little did we know how much our next steps would change, and continue to shape, our lives.

Artwork by Vaughn

The day we were given the diagnosis was one of the hardest days of my life. I worried about my son’s future and whether he would ever learn to communicate his needs, make friends or even live independently. As a mother, you want those things for your children and you worry when the future path isn’t clear. Thankfully my husband and I parked our tears and bonded together to do everything we could to change the trajectory of Vaughn’s life. We quickly immersed ourselves in learning all we could about this complex and wide spectrum disorder, discovering just how important it was to intervene early and often for the biggest impact. And we did just that; fully determined, we dove in and never looked back.

While most children were enjoying the freedoms of exploration and play, Vaughn was working as many as 35 hours a week for years on things that would seem so simple to some—things like learning how to speak and shape sounds, how to play appropriately with toys and even how to properly engage other children and people. My husband and I often marveled at how hard Vaughn worked and how little he complained. However, as parents, we often struggled to strike the balance between being therapists consistently executing interventions and being just a regular mom and a dad to both of our children.

Fortunately, and with the help of many wonderful people and organizations, we were able to effectively navigate the system and provide Vaughn with comprehensive services and support, some of which he still receives today. Vaughn is in a typical classroom, participating in typical activities and has many friends. He is a talented artist with a creativity and sense of design well beyond his years. And, most importantly, he has a loving and supportive big sister that celebrates his success, despite the years of being in her brother’s autism shadow. We are fortunate.

In an effort to honor those that have helped us and to give back to our community, I have joined the board of directors at Arizona Autism United as they have played, and continue to play, a key role in Vaughn’s treatment and success. It is my goal to do whatever I can to support this organization that has done so much for my family and share what we have learned to help other families struggling with autism in our community.

I’ve said it a million times, and will say it again. If I could go back in time to the day Vaughn was diagnosed and change things, I wouldn’t. He is such a special and creative person that has positively shaped how our family sees the world. Our journey has made us who we are and we are grateful for the lessons we’ve learned and the people we’ve met along the way. This Autism Awareness Month, take the time to learn more about autism and what you might be able to do to help those in your own community.

In honor of World Hemophilia Day, Magellan Rx Management has released results from the first six months of its hemophilia management program launched in collaboration with Health New England, a non-profit health plan serving the commercial, Medicaid and Medicare markets.

Hemophilia is a rare genetic bleeding disorder, for which treatment is expensive and difficult to manage. The average annual cost per member with severe hemophilia can exceed $250,000, and may be upward of $1 million for members who have developed inhibitors. Personalized care programs for patients with hemophilia aim to reduce unnecessary costs while improving the overall quality of care.

“As April 17 is World Hemophilia Day, we’re excited to bring hemophilia care into the spotlight and highlight the early results achieved with Health New England through our hemophilia management program,” said Haita Makanji, vice president, clinical specialty solutions at Magellan Rx Management. “Through personalized interventions, we’re able to better determine the individual member needs and coordinate across key stakeholders to deliver a truly personalized care program that ensures members with hemophilia receive best-in-class care and achieve optimal outcomes.”

Since launching the hemophilia management program in August 2017, Magellan Rx Management and Health New England have standardized care across various stakeholders without compromising patient outcomes, resulting in:

• Optimized doses through assay management or pharmacokinetic (PK) testing in 50 percent of members
• Reduced average assay dispensed in prophylaxis patients from 5 percent to 1 percent, reducing the potential for waste
• No breakthrough bleeding reported from members who had a dose reduction

“In the past eight months of collaboration with Magellan, we’ve achieved our goals of ensuring high quality of care for members with hemophilia while minimizing potential waste created through excess dispensing and inappropriate dosing,” said Andrew J. Colby, R.Ph, MBA, Health New England’s pharmacy director. “By announcing our hemophilia management program results on World Hemophilia Day, we hope to raise the profile of this condition and look to continue to make strides in standardizing best treatment practices to benefit members across the country.”

The hemophilia management program aims to enhance overall quality and personalization of hemophilia care by coordinating with prescribers, members and pharmacies while reducing unnecessary costs. Key elements include:

• Helping payers analyze information related to member bleed history and hemophilia treatment patterns.
• Standardizing dispensing and optimal dose protocols to promote best practices and improve transparency in hemophilia care.
• Updating policies to encourage individualized treatment regimens based on member-specific metabolic factors.