When I was a child visiting my grandparent’s Iowa farm, I would often hear stories of how my mom and her eight brothers and sisters lived during the war efforts of the 1940’s. My grandma described a common purpose—that sense of pride that the family rationed and repurposed. Their singular focus was that the good of the individual was less important than the whole of the country, even the world.

Watching the coronavirus make its way across the world and rapidly grow in the United States, I can’t help but think of those stories. As the shelves of Costco and Sam’s Club stores emptied this weekend, and school closures were announced community by community, it made me realize that our time to step up is now. Our singular, collective focus needs to be mitigation and in order to be successful, mitigation efforts need to be embraced and enacted on by us as individuals.

What is Mitigation?

Mitigation is a strategy to reduce the seriousness or impact of a natural disaster, such as a pandemic. The goals of mitigation include minimizing morbidity and associated mortality, avoiding an epidemic peak that overwhelms healthcare services, keeping the effects on the economy within manageable levels, flattening the epidemic curve to wait for vaccine development and manufacturing to reach populations, and actively pursuing the development of antiviral drug therapies. Practically, mitigation relies on social distancing—measures that are taken to restrict when and where people can gather to stop or slow the spread of infectious diseases such as the coronavirus.  Social distancing measures include limiting large group gatherings, closing buildings and canceling events. However, for mitigation to be successful, individuals, even those who are asymptomatic, must be willing to self-isolate.

Self-Isolation Challenges

In a society as mobile as ours, and where high degrees of social contact is the norm, self-isolation is challenging. For instance, if one has become accustomed to eating meals outside the home, the transition to grocery buying and cooking may seem formidable. If one is used to getting together with friends to play cards, go running, have a beer after work, the loss of those types of activities will create holes in one’s social network.

We are fortunate to have an infrastructure in which many people can work from home and education can be delivered virtually. Workers who cannot isolate because the nature of their work cannot be done virtually, must take precautions. While in the workplace, distancing at least six feet, maintaining high levels of handwashing and the use of hand sanitizers is a must.   When returning home, it is best to avoid being in the presence of those most vulnerable to coronavirus—elders and persons with underlying comorbidities. It is also important to acknowledge that one may feel anxious and may not have all the answers that our members or clients are seeking. Maintain lines of communication with co-workers and supervisors. For those who are new to work at home, talk to coworkers for whom this has been the norm to get some advice on structuring the workplace and the day. And don’t forget that you can use technology to connect with friends. Facetime, Skype and other video conference capabilities are a great way foster your relationships during social isolation.

Mitigation is a critically important strategy to quell the spread of the virus. It has been beneficial in China as new cases are now falling. In areas where community spread is mild, targeted isolation of high-risk people, or those who may have come in contact with the virus, can be implemented. Even inside households, those with symptoms should keep distance from the healthy. And, even if you are asymptomatic, but have been in a high-risk area or where there is growing or wide community spread, it is important to maintain social distancing and self-isolation.

Social distancing and isolation are not easy—but I am trying to look at them as the Victory Gardens of my mother’s childhood. I hope that 50 years from now, my grandchildren will hear stories of how the United States and the world beat back the coronavirus, and I hope that my children who are on this journey with me now will reflect and recognize the importance of a global community, productively working together for the common good.

The novel coronavirus (COVID-19) outbreak in the United States continues to evolve, with more cases and quarantines popping up on news feeds everywhere. The closer it gets to their homes, the more people are worrying. In our last post, “Addressing anxiety about the coronavirus,” we talked about the things people can do to help feel less anxious and more in control. But what about the people on the front lines? Nurses, doctors, healthcare workers and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public. What can they do to take care of themselves, physically and emotionally?

As Kushal, Gupta and Mehta stated in Study of Stress among Health Care Professionals: A Systemic Review, “Work related stress is a potential cause of concern in healthcare workers and is associated with decreased job satisfaction, days off work, anxiety, depression, sleeplessness , medical errors and near misses.” Long shifts and working with sick people—some of whom are gravely ill—can lead to burnout and anxiety from their normal jobs. These already-struggling healthcare workers are now faced with COVID-19 unknowns and demands, including taking care of people with confirmed cases of the virus.

While some people may feel they are at the whims of the virus, there are things healthcare workers can do to take some control over their work environment and manage their fear or anxiety.

• Know what your organization’s plans are. Read the business continuity plan and know your role. Talk to your team members about cross-training and covering for each other if one of you gets sick. In addition, ensure you are following proper protocols for cleaning and preventing spread. Visit cdc.gov for helpful information. This is particularly important for behavioral health providers who may not always think about universal precautions.
• Surround yourself with green. If your facility permits, bring in a few plants to liven up your surroundings. Being around plants has a calming effect on people. Employees who work in offices with plants tend to feel better about their jobs, worry less and take fewer sick days.¹ If you can’t have plants in your space, take time to look out the window and find some green. You may find that is enough for a quick mental break and perspective.
• Use small tools to create a calming environment. A small water feature, a sand garden or hourglass, stress balls and other items can provide a quick way to refresh your mind. Or just step back, take deep breaths, stretch and/or meditate.
• Find someone to talk to. Some hospitals have on-site or on-call chaplains; take advantage of them. Don’t be afraid to talk to your coworkers about how you are feeling. Chances are, they are feeling the same way and would welcome a discussion. Many medical settings offer a form of rounds that addresses the emotional impact of caring for a particular patient or theme. Similar semi-structured discussion groups with peers can be very helpful in handling stress and preventing the development of PTSD.²
• Get professional help. Be open to contacting your organization’s EAP, if you have one, or reach out to a therapist if you find yourself developing “compassion fatigue,” where your desire to help others erodes.
• Limit exposure to media. Media outlets have a tendency to sensationalize stories, so it’s important to consume news thoughtfully and with a critical eye.

In addition, do all the normal things to take care of yourself: try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs. Doing these things can have a positive impact on your mental health and help you manage anxiety.

For more information and tips, visit MagellanHealthcare.com/COVID-19. We wholeheartedly thank you for all you are doing to combat this outbreak.

1: https://www.webmd.com/a-to-z-guides/ss/slideshow-health-benefits-houseplants.

2: See Schwartz rounds.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.

As the coronavirus disease (COVID-19) continues to evolve with ongoing media coverage, many people are experiencing anxiety due to the uncertainty about how this will impact them. They are worried about the impact to their communities, how they can protect themselves and their families, and how to be prepared if the situation disrupts the normal course of daily life.

It is normal to feel anxious, unsettled, distracted, scared and/or overwhelmed by COVID-19 and the uncertainty surrounding its impact to communities. Some people may be more vulnerable due to pre-existing physical and mental health conditions, including generalized anxiety disorder.

Feeling stressed can affect the immune system and increase the risk of getting ill in general. That is why it is important to take steps to manage anxiety and reactions to this evolving situation. The following suggestions can help people manage anxiety and stress for themselves and their families:

1. Seek health information from trusted resources like the U.S. Centers for Disease Control & Prevention (CDC), The World Health Organization and state health department websites.
2. Plan ahead to feel more in control. Make contingency plans for work, childcare or travel if it becomes necessary.
3. Wash hands often, get plenty of rest, exercise, eat well, don’t smoke and limit alcohol consumption.
4. Put things into perspective:
   1. Of the 80,000 confirmed coronavirus cases reported in China, “more than 70% have recovered and been discharged,” according to the World Health Organization (WHO) in a news conference on Monday.¹
   2. Per the CDC, only certain groups, such as older adults and people with serious chronic medical conditions, are at higher risk of getting very sick from COVID-19.²
   3. Public health officials are working to mitigate the virus’ spread.
5. Limit exposure to media. Media outlets have a tendency to sensationalize stories, so it’s important to consume news thoughtfully and with a critical eye.

Magellan Healthcare has resources to help people during crises and difficult times. Our Crisis Communications website provides topical information and connects people with U.S. resources, and our Mind Your Mental Health site addresses many topics related to emotional well-being.

1: https://www.cnn.com/asia/live-news/coronavirus-outbreak-03-09-20-intl-hnk/index.html, “More than 70% of coronavirus cases in China have recovered, WHO says,” posted 3/9/20, 7:25 p.m. EDT, Jacqueline Howard, accessed from site 3/10/20, 12:57 p.m. EDT.

2: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html#who-is-higher-risk, accessed 3/10/20, 12:34 p.m. EDT.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.

It’s officially the holiday season—bring on the parties, travel, end-of-year work activities, and squeezing in quality time with loved ones! This year, remember to make time to take care of yourself and start 2020 off with your healthiest, most vibrant YOU. Here are our top three holiday health hacks:

Be mindful of your alcohol intake.

Avoiding triggers can be challenging this time of year. Dr. Caroline Carney, chief medical officer of Magellan Rx, was quoted in a helpful Huffington Post article that offers 14 useful tips for navigating the holidays when you’re not drinking.

Be mindful of your plate.

The celebration over food and eating during the holidays can be tough…but it doesn’t have to be! With a little planning and preparation, you can make healthy choices. Check out these 10 easy tips to for managing your diet this holiday season.

Be mindful.

Close your eyes, take a deep breath through your nose, and exhale slowly through your mouth. It will do wonders when you’re sitting in all that holiday traffic.

Wishing you and yours a happy and healthy holiday!

The following is an excerpt from the 2018 Magellan Community Impact Report.

It is estimated that 130 Americans die every day from an opioid overdose. The opioid epidemic has become a national crisis and is continuing to grow rapidly, affecting families in every city across our nation.

No one is exempt from experiencing the effects of the opioid crisis. Magellan’s own Janet Edwards, RN, senior clinical director of Magellan’s Chronic Pain Management program, describes how close to home the opioid epidemic hit her:
It is estimated that 130 Americans die every day from an opioid overdose. The opioid epidemic has become a national crisis and is continuing to grow rapidly, affecting families in every city across our nation.

“My daughter, Nikki, was 26 when she  died of a Fentanyl overdose. As the mother of a six-year-old and a critical care nurse working in a respected healthcare organization, Nikki was the picture of success. But to handle the pressures of nursing school, a full-time job, and life as a single mother, Nikki sought prescriptions for Adderall and Xanax from multiple physicians. Over time, her addiction to these substances gave way to a new addiction: Fentanyl, which she began to confiscate from the critical care unit where she worked.
Like many others, Nikki didn’t show any signs of addiction. But five years after her son was born, Nikki sat at my kitchen table and admitted that she was addicted to heroin. She was afraid to get help, because she did not want to lose her job or the respect of her peers. She insisted she could recover on her own. Even though I, as a nurse, knew the odds were not good that Nikki could manage her recovery alone, I respected my daughter’s wishes. It’s a decision I will forever regret. Eleven months later, Nikki died of an accidental overdose in front of her son and a friend.”

Following the loss of her daughter, Janet has openly shared Nikki’s story, becoming an advocate for helping prevent opioid addiction. Further, Janet has taken on clinical leadership of Magellan’s Chronic Pain program, which offers alternatives to opioid use.

Meeting opioid users where they are

No matter where or how someone encounters opioids or where they may be in the cycle of use, dependence or addiction, Magellan offers many other ways to address the opioid problem. Our behavioral health products forged from decades of serving the public, our specialty healthcare solutions supported by clinical excellence, and our customized pharmacy programs are ready to answer the call as organizations and individuals look for answers.
Hosting a forum for sharing successes  and discussing solutions

In September 2018, Magellan brought together  national and local leaders in Pennsylvania to  exchange ideas, share successes and  discuss solutions to the opioid  epidemic in our communities.  The free, second-annual  conference featured  keynote addresses and  workshops and highlighted  the proactive efforts of local  organizations. Participants included  national and state officials, county human  services and drug and alcohol leaders, legislative  staff, providers and community stakeholders.

Not staying silent on the silent epidemic

Magellan is actively helping individuals and families on their path to recovery. Further, to educate the public, doctors and other healthcare providers, we offer resources on our Magellan Health OPIOID INSIGHTS microsite. The site includes links to blog posts, videos, resources and published articles.

Hosting a forum for sharing successes and discussing solutions

InSeptember2018, Magellan brought together national and local leaders in Pennsylvania to exchange ideas, share successes and discuss solutions around the challenge we face together in addressing the opioid epidemic in our communities. The second-annual conference featured keynote addresses and workshops and highlighted the proactive efforts of local organizations. Participants at the free one-and-a-half-day conference included national and state officials, county human services and drug and alcohol leaders, legislative staff, providers and community stakeholders.

The following is an excerpt from the 2018 Magellan Community Impact Report.

Learning and evolving aren’t just how we approach doing business. Magellan is committed to helping people reach their fullest human potential. But reaching your fullest potential could get derailed at any minute by a disaster.

Serving state employees during their toughest moments

The Camp Fire, which began November 8, 2018, was the deadliest and most destructive wildfire in California history to date. It destroyed much of the town of Paradise, took 85 lives, and destroyed 13,972 homes, 528 businesses and 4,293 other buildings. The fire was followed by severe flooding. As the Employee Assistance Program (EAP) provider to the State of California, Magellan was immediately there to help. Through centralized specialty critical incident stress debriefings (CISDs), Magellan provides structured on-site support to employees who have been impacted by a traumatic event.

Delivering an employee wellness strategy best practice

CISDs give employees access to immediate, expert and compassionate support to help them understand and process their feelings about the traumatic event. Magellan can also recommend additional resources available through EAP, such as legal and financial assistance, and provide referrals to community resources. And, where appropriate, we provide one-on-one follow-up support. Magellan’s dedicated call center is available 24/7 and is staffed with trained clinical professionals to take calls and work with employers to develop appropriate support.

Providing support in critically stressful times

Magellan provided more than 40 CISDs for over 300 California state agency employees in response to 2018 wildfire and flooding natural disasters. Magellan CISD provider Shammy Pius, MFT, describes her experience leading debriefings for the Camp Fire event:

“I conducted numerous sessions with state agency employees, many of whom had to cope with their own personal losses while serving and supporting others. The support Magellan gave state employees was beneficial to them but also had a positive ripple effect in their communities. The group sessions helped employees feel like they weren’t alone. The feelings they were experiencing were normalized when they heard that their colleagues were also experiencing anger, sadness and stress. Importantly, it was essential that each employee not minimize their own experience.    Everyone felt disruption to some degree. Educating them about resiliency and coping techniques during the event and soon after encouraged employees to accept the support that was offered to them. We help set the expectation that recovery will take a while, but there is hope and things do get better over time. It’s incredible how people come together in times of adversity – it’s truly heartwarming. I’m essentially a stranger going into these workplaces, and I get to be a part of people’s journeys during some of their most difficult times. It’s an honor to me to do this work  for Magellan.”

Evolving through our experiences

Magellan’s team responds to more than  5,000 critical incidents annually. Our CISD program offers access to a network of 8,100+ masters-level clinicians with crisis intervention training. We intervene carefully and thoughtfully, listen, reassure and teach resiliency. We wish these services were never needed, but since they unfortunately are, we embrace them as times to learn, evolve and help others live healthy vibrant lives.

Satisfied customers

•   99% of clients said the CISD plan was easy  to arrange and done in a timely manner
•   98% of clients said the EAP counselor was professional, courteous and understood their needs In response to tragedies and detrimental weather events, Magellan sets up a 24-hour toll-free hotline for individuals to access, regardless of whether or not they are Magellan members.

The 24-hour crisis lines are staffed by behavioral health professionals who provide free, confidential consultation services and other resources, such as referrals to local non-profit organizations, shelters and additional community based support.

The following is an excerpt from the 2018 Magellan Community Impact Report.

Care is core to every service we deliver and everything we do. For Magellan, success is about so much more than profit or prestige. It’s about doing well by doing good. We’re always caring, listening, learning and using our collective insight to make a difference. When we care together, we turn hope into reality.

Caring and sharing our lived experiences

Wyoming’s High Fidelity Wraparound program is just one of many examples where Magellan team members, who have lived through similar experiences, are returning the care and concern they personally received.

High Fidelity Wraparound is a voluntary planning and care coordination process for children and youth (ages 4-20) with complex behavioral health conditions. High Fidelity Wraparound’s community based solutions and planning process bring people together from different areas of a family’s life to form a team. The team creates steps to help youth stay in their homes, schools and communities.

Through our partnership with the Wyoming Department of Health, Division of Healthcare Financing (Medicaid), Magellan serves as the Care Management Entity for the High Fidelity Wraparound program, setting the rules and providing training for everyone involved in the process.

The  Wiederspahn  family

When Magellan Care Worker Chassity Wiederspahn’s son began  to struggle behaviorally, mentally  and emotionally in first grade, she knew she needed assistance but was at a loss.  Through High Fidelity Wraparound, she was  able to build a team around her family to guide  them in their search for help. The High Fidelity  Wraparound program allowed them to build a strong  support system and learn the resources available in their  community. It gave them confidence that they could handle  the challenges that might lie ahead. As a graduate of High Fidelity Wraparound, Chassity shares her story with the families and providers  she speaks to on a daily basis.

Many of our Magellan team members have lived these  experiences. which enables them to bring a valuable  set of life skills to their daily jobs each and every day.  As employees, the job is more than just the tasks at hand, we  truly care and offer ourselves as role models of hope and success.

The Campbell family

Magellan’s Kathryn (Kat) Campbell, family support specialist, is the proud mother of four beautiful children, two of whom are adopted from Wyoming’s foster care system. Blending a family was an overwhelming process despite the research and preparation of a therapist team. The crash course in secondary trauma left Kat and her partner reeling.

The family was referred by the local crisis center to High Fidelity Wraparound. The process created a safe space for Kat’s entire family to focus on caring for themselves, and they started to feel the support of those around them who were waiting to help. High Fidelity Wraparound’s empowerment and team building strategy gave the family the skills to run their own team for the high needs their children had, long after the family graduated from the process. Kat now trains and mentors providers who work directly  with families like her own.

Wyoming’s High Fidelity Wraparound program continues to show successful outcomes for enrolled youth with complex behavioral health challenges.  Operated by Magellan Healthcare, Inc. through a collaboration with the Wyoming Department of Health, Division of Healthcare Financing (Medicaid), Wyoming’s High Fidelity Wraparound demonstrates that young people are getting more needs met in their own homes and communities.

High Fidelity Wraparound, an evidenced-based non-clinical intensive care coordination program, is a national model designed to bridge gaps for youth where challenges in behavior and mental health exist. The program uses peers and lived experience in a strengths-based way, focusing on what people do well and provides alternative options in addition to therapy and other traditional methods that fit individual preferences and cultures. This team approach provides a network of support for families, allowing them to be the experts of their lives and learn to drive the process.

“When youth behavior is extreme, there is higher probability of needing to leave home or school to address their needs in a clinical, therapeutic or detention setting. We meet people where they are, use assessments like the Child and Adolescent Needs and Strengths (CANS) to identify needs and strengths, which inform the team of behaviors that should be addressed,” said Tammy Cooley, senior director of operations, Magellan Healthcare. “Youth are supported in meeting challenges like staying in school, having more positive relationships, and doing more of the things children should be doing at their age, which ultimately builds confidence and lasting positive change.”

In Wyoming’s High Fidelity Wraparound programs, CANS are administered at the beginning of a youth’s enrollment into the program and every three months until the youth successfully completes the voluntary program and transitions out.

Barbara Dunn, Director of Program Innovation and Outcomes for Magellan of Healthcare in Wyoming, said, “From July 2018 to June 2019, over 75 percent of youth enrolled in Wyoming’s High Fidelity Wraparound program experienced reduced severity of needs. The typical youth enrolls with nine treatment needs and resolves almost four while increasing strengths to maintain their gains.”

 Decreased Needs and Increased Strengths

July 2018-June 2019

Cooley said, “The evidence is powerful and shows reductions in high prevalence needs between a youth’s enrollment and discharge. Our program works when youth and families are engaged. Wyoming’s Department of Health, Division of Healthcare Financing (Medicaid) has given us a chance to deliver a quality home and community-based program through a care management entity model that gives high risk youth more access to care right where they need it most. From the results of this year’s CANS report, we show Wyoming’s High Fidelity Program is making a positive impact in the lives of our youth participants. We want all youth who qualify for this Medicaid program to see the benefits.”

 Wyoming CANS Initial Scores vs. CANS Discharge Scores in Key Intervention Areas

June 2019-July 2019

For more information about Wyoming’s High Fidelity Wraparound program, please visit www.MagellanOfWyoming.com.

About Magellan Health: Magellan Health, Inc., a Fortune 500 company, is a leader in managing the fastest growing, most complex areas of health, including special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining focused on the critical personal relationships that are necessary to achieve a healthy, vibrant life. Magellan’s customers include health plans and other managed care organizations, employers, labor unions, various military and governmental agencies and third-party administrators. For more information, visit MagellanHealth.com.