Graduation may have been over a decade ago, but I finally got around to publishing my Thesis, ANALYSIS OF ATTITUDES SURROUNDING THE POLICY CHANGE FOR GAY,
LESBIAN, AND BISEXUAL SERVICE MEMBERS IN THE UNITED STATES ARMED
FORCES SINCE THE REPEAL OF DON’T ASK, DON’T TELL.
It can be found on ProQuest at no cost for the pdf.
This month is Mental Health Awareness Month. Small Steps. Big Impact.
Read more: May!!!Some days may be more difficult than others. All you can do is make the next best choice. Whatever that is for you. I think we all do the best that we can with the information we have at the time. Sometimes that means only being able to do the bare minimum on activities of daily living and that is okay. In fact, it is okay to not be okay sometimes! I know, shocking right, in a society where one may be expected to work 40+ hours, be present with family, engage in social events, fitness, and keeping the body nourished all without slowing down. Breathe.
Overwhelm can be described as trying to spin too many plates on sticks at once. This month, if overwhelm creeps up, or any emotion gets too intense, I highly recommend feeling it. What does that mean? Experience the sensations in the body that go along with the feeling. For example, when some folks get anxious the stomach can feel like one has butterflies or the chest can seem tight. Noticing these sensations and noticing them shift is processing. To feel it is to heal it I think someone once said. This is different than stewing. Sitting in unnecessary anger is only going to increase one’s internal distress. For anger, it is okay to avoid the person/place/thing that elicited that emotion for at least 30 minutes to reduce the intensity of the emotion before proceeding mindfully. Try not to go more than 24 hours when using avoidance skillfully as that can be a slippery slope into sweeping things under the rug (not advised).
One tip I’ve learned over the years it to picture a light, like you know how a copy machine has the light that scans the document? You can imagine a light scanning your body and you can go head to toe or toe to head, whichever you prefer. This is called a body scan. Notice the sensations and notice they will pass. Emotions are temporary. They will pass. Well, if you choose to feel it. Choose to shove it down, and it may persist for days, weeks, months or even years.
Mental health matters. You matter. Whether you believe it or not. Try taking the next small step that will make a big impact for you, whatever that it.
See below for a pdf that has a day to day by TherapyAppointment of what you can do this month to take small steps that have a big impact.
Check out my Podcast on YouTube, Spotify, or where ever you listen. New content weekly.
Sometimes saying ‘no’ can be the most difficult thing a person does…and sometimes ‘no’ is a complete sentence. I think of boundaries like a colander except with a bunch of flexible holes. Those holes can expand and let people in, or contract and close people out. Healthy boundaries are not rigid or inflexible. When we put up walls and call it a strong boundary…sometimes we set ourselves up for a self-fulfilling prophecy, whatever that prophecy may be. So how do you know if you have problems setting or keeping boundaries? There’s a few different things to look at and today I’ll go over a few.
A sign that it may be helpful to set a boundary is If you find yourself experiencing a great deal of annoyance, disrespect, and/or resentment. That’s the emotional side. On the cognitive side, maybe you find yourself “shoulding” on others. Such as, “they shouldn’t be asking” or “they should know how much I’ve already done”.
A warning sign of a poor boundary is an overdeveloped sense of responsibility for others. Of course we do have responsibilities in life and parents especially. What I mean is where the way other people think and feel is up to you. You might feel guilty and anxious pretty regularly and just not at peace because someone’s always got a fire to extinguish. Perhaps there is even the thought, “If I don’t, no one will,” which depending on the context may or may not be true. Just because something could be true…doesn’t mean it is going to come to fruition.
Feeling exhausted all the time may be familiar to many, but I don’t mean parent-tired or work-stressed. I mean when you put all of your needs on the back burner to where all of your energy goes into others. I have noticed some common needs that get neglected are sleep, nutrition and fitness. These are basic needs for living a long and healthy life. If you’re not getting enough time to eat, adequate nutrition, enough sleep, or a chance to breathe…consider drawing a boundary that might be helpful. Remember, you reserve the right to change your mind.
Difficulties in making decisions for oneself is a big sign to consider setting a boundary. I like to identify what I need to alleviate any inaccurate guilt that may arise from setting a boundary. For example, when I need privacy because I’m with a client, I close my office door. That’s a physical boundary. Emotional boundaries can be trickier but equally as helpful. Making decisions can feel emotionally draining or exhausting, it can also make you question your own likes and dislikes. If we make decisions based on what other people might think….we may have difficulty making decisions based on our own needs, wants, and preferences.
Maybe you absolutely despise or hate letting other people down. This may mean you often go along with other people’s plans even if you are not interested in participating. Maybe you’re on a board you’d rather not attend meetings for, agree to go eat at restaurants that don’t accommodate your dietary needs, or pick up every shift you’re asked to cover because being unavailable does not appear as an option.
If any of this resonates with you, do some research on setting and maintaining healthy boundaries. Here are some resources I’ve worked with in the past; comment with any you’ve taken insight from!
Boundaries: When to Say Yes, How to Say No to Take Control of Your Life: Cloud,
Henry, Townsend
Beattie, M. (1987). Codependent no more: how to stop controlling others and start caring for yourself (1st Harper & Row ed.). Harper/Hazelden.
Boundaries : where you end and I begin ; Author: Anne Katherine ; Edition: View all formats and editions ; Publisher: MJF Books, New York, ©1991.
I regret to inform you that the Oklahoma Health Care Authority board meeting did not go in our favor. The board voted yes. What does this mean? It means The Health Information Exchange in the state of Oklahoma is going into effect July 1st, 2023.
It does appear there may be some exemptions granted for small private practices such as mine. I’ll believe that when I see it in writing. So far I cannot find this language. This is how their website currently reads:
“The proposed rules allow temporary exemptions based on size, technological capability or financial hardship. OHCA is actively engaging with providers to discuss exemption criteria for specific provider types regarding transmission of data restrictions, with a particular focus on behavioral health, and are expecting to revise the proposed rules to apply exemptions based on provider type.”
What’s the next step? Well, the legislature still has the power to stop this and permanently exempt mental health records completely from the Health Information Exchange.
During the board meeting it was stated, “No patient data of any kind should be submitted to the HIE if the patient does not approve.” This appears to contradict the concept of ALL providers being forced into participating.
The Oklahoma Health Care Authority did create a feedback section on their website. Send them this simple message: “Permanently exempt all Mental Health records from the Health Information Exchange mandate”: oklahoma.gov/ohca/okshine
If you are so inclined, you can also call your legislature and ask them to permanently exempt all Mental Health records from the Health Information Exchange mandate.
If you don’t know your representative, you can search for them at: http://www.oklegislature.gov/findmylegislature.aspx
This small setback is not the end. In the event that the legislature approves without exempting mental health records, I will attempt to obtain an exemption and keep my doors open. Whatever the future holds, I intend to continue to serve Oklahomans to the best of my ability.
Dear fellow Oklahomans –
In May of 2021 Oklahoma SB 574 created OKSHINE – and in May of 2022, the State of Oklahoma passed SB 1369 which required ALL health care providers across the state of Oklahoma to report data by utilizing a State Designated Entity (SDE) for Health Information Exchange (HIE) beginning July 1, 2023.
The proposed policy changes are currently in effect as Emergency Rules and must be promulgated as Permanent Rules. The proposed changes are scheduled to be presented as Permanent Rules to the OHCA Board of Directors on March 22, 2023.
Very few providers across the state were aware of this bill until last week.
We would like to take this opportunity to tell you what we know, what we want you to know and how you can get active to fight this bill and protect mental health records.
From the OKSHINE website:
“OKSHINE connects providers throughout the state through our secure, online network to share patients’ virtual health records. Members include hospitals, ambulatory practices, ancillary services, behavioral health, specialty care providers, emergency medical services, social services organizations, and payers.”
The OKSHINE website goes on to share that the HIE will be accessible to Dept of Corrections, Dept of Human Services and even the Dept of Defense. These are NOT medical entities.
For those who are seeking mental health services, it is your RIGHT to the privacy of these services and your right to be free from bias based on the services you are seeking.
State law specifically states that mental health records have greater protections than regular medical records. (Oklahoma Statutes §43A-1-109 (2021) – Confidential and privileged information)
As an attendee of mental health services, you have a right to privacy and confidentiality. As providers, we have many concerns that this could create undue bias for clients with other providers and with the various social service organizations that the HIE has indicated they will give access to.
This law does not grant any additional safety or privacy that each client is not already promised under State and Federal law, Licensure rules and ethics and Professional Organizations Code of Ethics. This law does pose an INCREASED risk of client safety by compromising the privacy of their records.
OHCA and the HIE has stated that a client has the right to “opt-out” of this HIE; however, the opt-out form still must be submitted to OHCA/MyHealth; therefore still further violating the right to privacy and identifying the relationship between the client and the provider(s). The rules surrounding this law do not indicate the extent of information that will be shared or required to be shared.
This law requires ALL licensed providers to participate. Many solo/small practices like ours cannot afford the high fee to join the system and the monthly fees to continue to participate. For those who opt out of insurance and choose private pay services for added privacy, you are not protected by this law and your information must be shared. If mental health providers are not excluded from participating I will likely make some big decisions about my practice as I can neither afford financially or ethically to support this violation of privacy.
As constituents and members of the communities we serve, you deserve to be heard by your representatives as quickly as possible regarding this bill. You are welcome to contact them to let them know that you are not ok with your protected information being shared freely; and that you do not support a law that would force providers to choose between protecting your rights and protecting our license.
The media has portrayed the Health Information Exchange in a way that makes it sound like only other medical professionals would have access to your information. This is inaccurate as the Oklahoma Health Care Authority clearly lists the additional agencies that will be able to access your protected health information.
If you would like to advocate to have mental health excluded from this new law, write letters of concern to all of the OHCA board members and also to express your concerns directly to the Governor’s office, as he has the power to refuse to allow the policy to go into effect if the OHCA board does vote to approve it.
OHCA Contact Information
OHCA Board Members:
Marc Nuttle – Chairman
Alex Yaffe – Vice Chairman
Tanya Case
John Christ
Jeffrey Cruzan, M.D.
Corey Finch, M.D.
Phillip Kennedy
————————————————
Steve Miller – OHCA HIE Coordinator
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Additionally, you can reach out to your legislators directly with the message: “Remove Mental Health from the HIE mandate” . If you don’t know your representative, you can search for them at:
http://www.oklegislature.gov/findmylegislature.aspx
As mentioned, there is the OHCA board meeting Wednesday March 22nd where the final vote will be held. I’ll post again with the results of that meeting.
Thank you for your patience and understanding and we move forward and adapt to these changes.
The following is the current criteria listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders for Intermittent Explosive Disorder. Most folks have not heard of impulse control disorders unless you know someone that has one of the five types or work in the medical field. Please do not read this and diagnose yourself or your loved ones. If you or someone you know needs treatment for mental health, please seek help in your area instead of trying to power through or be strong. It is okay and usually necessary to ask for help in a myriad of different areas.
Continue readingInconsiderate is defined, according to the Oxford dictionary on Google, as “thoughtlessly causing hurt or inconvenience to others.” Many folks just refer to inconsiderate folks as “idiots” or some other words with a derogatory connotation. I also hear people ‘should’ on others to “do the right thing”. My intention with this post is to provide a few alternatives, not necessarily conflict resolution but more along the lines of regulating one’s own intense emotions when finding oneself face to face with an a** who thinks it’s okay to hit someone’s ankle repeatedly with their shopping cart or other inconsiderate acts. I also see all kinds of videos with altercations over the mask situation. Here we go:
Continue readingThe following is a brief autobiographical narrative by a guest blogger, Paula Venegas, a mother that was misdiagnosed and put through the severely dysfunctional medical system with all sorts of people trying to “help” while simultaneously harming. It brings some comfort to me to know she now has the correct diagnosis and hopefully a helpful treatment team who doesn’t just have clinical knowledge but the empathy and vulnerability needed to help this family thrive. This is Paula’s story:
Continue readingAn anonymous family has graciously shared some of their innermost communications with one another. Please take what you like and leave the rest.
Communication is an incredibly difficult thing. I hear at least about 70% of communication between humans is nonverbal. IDK about you but my in person interactions in the past year have been through the virtual mediums that I have never been so grateful for. That means those social skills that get exercise when getting together with others have been neglected quite a bit. Then there is this written word. Eww. It is so friggin hard for me to read tone! Please tell me I am not alone in this. Someone smarter than I said that asking the following question can be extremely helpful: What is the story I’m telling myself?
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Marsha Linehan is well known for her successes in developing effective treatment protocols for people struggling with Borderline Personality Disorder. However, a few of her skills may benefit the general public so I will summarize a few specific ways to increase awareness of the present moment. First take a moment to look away from the screen and spell the word EARTH backwards. Okay, now you may have noticed an inability to focus on anything except picturing the word in your mind or even trying to spell it out forwards so you could see it backwards. This is a minor example of a mindful moment and shows just how brief a mindfulness activity can be.
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