By Dawn Brazell
Public Relations

It takes courage to hand a psychiatrist a brochure that describes how he can improve the care he provides for his patients with mental illness.

Yancey Wise, a retired psychotherapist, does just that, though, and with good success. David Beckert, M.D., Department of Psychiatry and Behavioral Sciences, Institute of Psychiatry (IOP) takes the "What Hurts, What Helps" brochure and praises her efforts.

Dr. David Beckert and Yancey Wise discuss how switching to patient and family-centered care can improve the quaity of health care.

Beckert said there are many in his field who can benefit from this type of material and the reminder to not forget or minimize the role that family can play in a patient's recovery. "It goes back to the mission of what we do."

For Wise, it gets to the heart of MUSC's latest push aimed at redefining the relationships in health care. Wise is a member of the new IOP Patient Family Partnership Council. It is one of two new patient-family partnership councils, one formed for IOP in April and another for the medical center last month.

Torri Jacobsen, coordinator of MUSC Patient and Family-Centered Care, said IOP has its own council separate from the medical center council because of its unique patient population that is underserved. "I have a passion for it. I've personally seen what it's like for someone to struggle with mental illness and addiction, and I've felt the impact. The most fulfilling part of my job is the work I get to do with this council. I love it."

Patient and family-centered care is not new. Other hospitals have adopted it with amazing results including increased patient satisfaction, decreased medical errors and improved communication, she said, adding that it's a way to take MUSC's excellence program to the next level.

"Patient and family-centered care focuses on what works for the individual. If patient and family members are actively involved with their care throughout the whole process, then there's better care and compliance when a patient gets discharged because it's a partnership, and everyone is on the same page. It's breaking down the hierarchy of 'I'm the doctor or nurse, and here are the answers.' It's understanding this should be a conversation with our patients and families, not a one-way discussion. We need to have an open dialogue and share information freely to achieve patient-centeredness."

Admitting it's an ambitious project to achieve such a cultural shift hospitalwide, Jacobsen said the research supports that this is the right thing to do. It's a win-win for staff and patients. "The council is called a partnership council because we want them to be true partners working side-by-side with our leadership, our clinicians, and our staff. They'll be working on strategic initiatives that will help support our cultural shift towards patient and family centered care."

Though the IOP council just started meeting in April, it already has made important contributions. "It's amazing what great ideas they have come up with in such a short amount of time. I feel very fortunate to serve as the council liaison to such an outstanding group."

Those ideas include: initiating plans for a weekly spiritual support group for interested patients; providing copies of "What Hurts, What Helps" by The National Alliance for Mental Illness (NAMI) to MUSC health providers and staff; setting up crisis intervention training for emergency department and medical center security staff about how mental health issues present and how best to help these patients; and planning question-and-answer panels on mental health issues that include the perspectives of patients, family members and professionals.

Providing the trainings and discussion sessions has the potential to dramatically affect care, she said. If staff members better understand how mental illness presents and that it is an actual illness and not just the patient being difficult, it changes the way patients and families are treated, and also provides much needed support to the hospital staff.

"The council thought if we can in any way help support hospital staff by helping to better manage their anxieties and fears, then we can help break down the walls and stigmas that surround mental illness."
Jacobsen, who still is recruiting members for both councils, said she's been incredibly lucky in who's volunteering for the job. The IOP council members are willing to use their own stories to put a human face on mental illness and to share what has and hasn't worked for them in hopes of easing the suffering of others with mental illness.

They are people such as Wise, who also leads a NAMI support group. The retired psychotherapist hit a wall in 1972 and found herself in the patient's chair with a diagnosis of major depression, and then in 1982 received a diagnosis of bipolar disorder. Wise said she struggled through a dark period where she felt she lost hope and her confidence was shattered. She had to quit working. Mental illness took over her life, her career and her dreams. She was hospitalized four times before she found a way to take back her life.

"The last 12 years, I've been in recovery. Now I have a chance to give to those with mental illness – to give people hope. For years I didn't have much hope," she said. "It is possible to lead a productive life."

Also on the IOP council is Marian Rzepkowski, a retired teacher, who uses her talents to lead a NAMI support group and co-teach the NAMI Family-to-Family Program, a free 12-week course for family caregivers of individuals with mental illness. An outspoken advocate, Rzepkowski knows the strains placed on caregivers, and teaches the class because she's seen it change people's lives. The council is another way to extend her advocacy work.

"It is my passion. I have a 38-year-old daughter who has suffered from mental illness since her teens. She has been married five times and lost custody of five children. I want everyone to understand mental illness. It's not because of some parental issue. In most cases, it's because of some brain issue that has happened. I want to do something to affect their care."

That's true of council members Lacey Lipe and her 19-year-old son, who has bipolar disorder and is on the autism spectrum. Lipe has learned the hard way what medical providers can do to better help those with mental illness, and the heavy toll that state budget cuts on mental health programs is having on families. She wants to get out the story of what a difference it can make to get patients with mental illness timely treatment and the right family support.

Marian Rzepkowski, left, Lacey Lipe, center, and Torri Jacobsen discuss council plans.

Her son, who at one point had to be admitted into an inpatient facility, has made great progress in getting to a point where he can be an advocate. "He's been through a lot, and even though I'm an aggressive go-getter mom, even I have had a hard time getting him the help he's needed," she said. "I think his voice is important as a young person who is willing to speak out about it. He's young, he's 19, and he will bring a unique perspective. He's living it right now. He's dealing with it. He's articulate and outspoken. He's a very big advocate for mental illness."

One of her hopes for the council is that it will bring hope to the parents and children who are getting lost in the system.

"I would like to be part of a change. To hear that MUSC is reaching out to the community and the families saying 'we want to be a different kind of hospital' makes me feel like we can be part of a change. Clearly, there needs to be a change in the way mental illness is viewed and treated."

To learn more about the Patient Family Partnership Councils, visit http://mcintranet.musc.edu/cceps/PFCC/index or email jacobsen@musc.edu.

For information on the Institute of Psychiatry, visit http://www.musc.edu/psychiatry.