Over the past year, COVID-19 has brought forth higher acuity, complex comorbidity and greater demand for mental health services. As a comprehensive mental health center, Lindner Center of HOPE (LCOH) offers many different levels of evaluation and assessment, emphasizing the need for an accurate diagnosis to set patients on the best track for success.
LCOH offers a number of ways to take the first step in seeking treatment. LCOH offers outpatient psychological & learning assessments; stabilizing evaluation, which includes ongoing consideration of stability and next steps; comprehensive diagnostic assessment; and outpatient child/adolescent comprehensive diagnostic assessment. At every level, the team at LCOH works to set patients forth with a solid foundation for ongoing treatment success.
At LCOH, clinical staff direct patients to the best level of care after an initial phone assessment with their Access and Referral Center to determine if the patient’s need is urgent or if they would benefit from acute in-patient care, day treatment or outpatient services. They also have the Rapid Access Service because a lot of people struggle with getting an outpatient appointment given the shortage of providers and a high demand for mental health needs. The Rapid Access Service enables someone to meet with a psychiatrist and social worker and do a 2.5-hour comprehensive assessment for next-step treatment.
If someone really needs to be in a hospital, we’ll admit them and stabilize them,” says Dr. Jennifer Farley, clinical psychologist. “Whether they’re detoxing from alcohol or drugs, that’s part of the evaluation, too. It’s nice that they can come in, detox and get more stable before undergoing testing.”
When patients arrive, sometimes their diagnosis is fairly clear but not always.
“There may be a disorder that’s taking center stage or there may be other things that are contributing to the depression that aren’t so obvious. That’s where assessments, specifically residential assessments, come in,” says Dr. Thomas Schweinberg, noting that the assessments they do are two-fold. They conduct a neurocognitive battery of tests because they know that if someone is having depression, anxiety, bipolar disorder or schizophrenia, they tend to find a pattern of cognitive weaknesses.
“We can let people know why maybe they’ve been experiencing daily forgetfulness or difficulty attending to things,” says Dr. Schweinberg. “It could be associated with their mental health disorder.”
The other component in the assessment that helps with diagnostic clarification is the personality measures they administer.
“That’s where we uncover things that maybe weren’t so obvious that need to be a focus of treatment,” says Dr. Schweinberg. “From there we create a blueprint of treatment going forward.”
According to Dr. Farley, when people are committed to residential treatment, they’ve usually been experiencing symptoms, have been in & out of the hospital, or have participated in an outpatient or partial program. When they enter residential, they are looking at a comprehensive diagnostic assessment in order to sort out complex comorbidity. The benefit of residential treatment is that observation plays a key role in determining next steps. Doctors can watch how patients interact with staff and other patients in the units as well as pay attention to how their medications impact them.
“Residential offers that comprehensive look that you don’t get to see if it’s done exclusively as an outpatient appointment,” says Dr. Schweinberg.
Historically, mental health disorders have not been seen as being on par with medical disorders. If a person is experiencing physical pain, they will immediately seek treatment. The same is not true of emotional anguish.
Adds Dr. Farley, “It’s challenging for people to understand because they can do a stress test to see how their heart is functioning, but with mental health it’s different and much more complex.”
For adults, LCOH offers comprehensive diagnostic assessment in a residential setting. For young people, ages 6-17, comprehensive diagnostic assessment can be conducted on an outpatient basis. Doctors work in treatment teams that include a neuropsychologist, psychiatrist, and social worker to provide a comprehensive, multidisciplinary perspective when it comes to assessment and evaluation. Being able to come at it from multiple sides means that they look beyond the diagnosis to identify a patient’s strengths & weaknesses as well as the patient’s family and living circumstances to help make recommendations regarding academics, medicinal protocol and more.
“We are often the first-line providers for these people who have never been in mental health treatment before,” says Dr. Farley. In some cases, diagnosis may be rather straightforward perhaps just a simple ADHD evaluation, for example. However, sometimes even those diagnoses that appeared clear-cut at the onset turn out to be much more complex. For instance, someone with ADHD may also suffer from secondary anxiety or depression. That’s why usually with an outpatient testing case, doctors still incorporate a lot of the cognitive as well as the behavioral and personality and emotional questionnaires in order to reveal the full picture.
They have a specialized program for children and adolescents in which the team does a deep dive with the family into what’s going on with the child or adolescent. Just like with residential, the treatment team outlines all the levels of assessment that are available at the LCOH.
Dr. Farley recently did an assessment for a teen who has dyscalculia (a math disorder), along with a history of ADHD. It was revealed that this adolescent has significant anxiety as well and that the patient’s issues revolved more around anxiety with ADHD than the math disorder.
“That revelation was really helpful to the family whose parents were hesitant about medication before, but now with this information, they felt comfortable going forward with medication treatment,” says Dr. Farley. “Sometimes the data from outpatient evaluations really helps with the commitment level as far as what to do about treatment.”
Many people especially during this surreal, emotionally exhausting year have run up against ample barriers when they have tried to access mental health resources. At LCOH, they eliminate one of those barriers by not requiring a referral.
“I’ve never in my life been as busy on an outpatient basis as I am right now and while that’s disheartening on one level, at the same time with the increased demand and increased calls for evaluation, I’d like to think it has dispelled a lot of myths about mental health,” says Dr. Farley. “I’m hoping all of this will help the stigma associated with mental health that has been around for so long.”
Lindner Center of HOPE is located at 4075 Old Wester Row Road, Mason, OH 45040. For more information, call 513.536.4673 or visit lindnercenterofhope.org