DOCSLIB.ORG

A Family Guide to Concurrent Disorders

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Family Guide to Concurrent Disorders Caroline P. O’Grady W. J. Wayne Skinner aving concurrent substance use and mental health problems obviously affects the person Hexperiencing the problems directly, but they also have powerful effects on family members and friends. Families need help to deal with the impact of concurrent disorders, but families are also a key to finding effective solutions. A Family A Family Guide to Concurrent Disorders is based on the collection of materials that was developed for a family support and education group at the Centre for Addiction and Mental Health. Part I is an overview of concurrent disorders, an introduction to treatment options and Guide to information about substance use problems, mental health problems and how they interact. Part II focuses on the impact of concurrent disorders on family life. It includes information on self-care strategies for family members and understanding and coping with the effects of stigma. Part III explores treatment and support for people affected by concurrent disorders. It includes Concurrent strategies for navigating the mental health and substance use treatment systems, information about psychosocial and medication treatment options, recognizing and planning for relapses, and anticipating and coping with crisis situations. Part IV talks about the journey to recovery. Disorders A Family Guide to Concurrent Disorders Guide to Concurrent A Family Also available from CAMH: Addiction: An Information Guide Anxiety Disorders: An Information Guide Bipolar Disorder: An Information Guide Concurrent Substance Use and Mental Health Disorders: An Information Guide Couple Therapy: An Information Guide Depressive Illness: An Information Guide The Forensic Mental Health System in Ontario: An Information Guide Caroline P. O’Grady Obsessive-Compulsive Disorder: An Information Guide Schizophrenia: An Information Guide Women, Abuse and Trauma Therapy: An Information Guide W. J. Wayne Skinner Women and Psychosis: An Information Guide For information on other CAMH publications or to place an order, please contact: Sales and Distribution Tel: 1 800 661-1111 or ISBN 978-0-88868-628-2 416 595-6059 in Toronto Email: [email protected] A Pan American Health Organization / World Health Organization Collaborating Centre Website: www.camh.net 3222/09-07 A Family Guide to Concurrent Disorders Caroline P. O’Grady, RN, MN, PhD W. J. Wayne Skinner, MSW, RSW A Pan American Health Organization / World Health Organization Collaborating Centre Library and Archives Canada Cataloguing in Publication O’Grady, Caroline P., 1961- A family guide to concurrent disorders [electronic resource] / Caroline P. O’Grady, W. J. Wayne Skinner. Includes bibliographical references. 1. Dual diagnosis. 2. Dual diagnosis--Patients--Family relationships. I. Skinner W. J. Wayne, 1949- II. Centre for Addiction and Mental Health. III. Title. RC564.68.O37 2007a 616.86 C2007-904957-5 ISBN: 978-0-88868-628-2 (PRINT) ISBN: 978-0-88868-629-9 (PDF) ISBN: 978-0-88868-6305 (HTML) Product code PM077 Printed in Canada Copyright © 2007 Centre for Addiction and Mental Health Any or all parts of this publication may be reproduced or copied with acknowledgment, without permission of the publisher. However, this publication may not be reproduced and distributed for a fee without the specific, written authorization of the publisher. Suggested citation: O’Grady, C. P., Skinner, W. J.W. (2007). A Family Guide to Concurrent Disorders. Toronto: Centre for Addiction and Mental Health. A reproducible copy of this publication is available on the Internet at: www.camh.net/About_Addiction_Mental_Health/Concurrent_Disorders/CD_priority_projects.html For information on other CAMH publications or to place an order, please contact: Sales and Distribution Toll-free: 1 800 661-1111 Toronto: (416) 595-6059 E-mail: [email protected] Website: www.camh.net Disponible en francais sous le titre Guide a l’intention des familles sur les troubles concomitants. This book was produced by: Development: Caroline Hebblethwaite Editorial: Martha Ayim, Jacquelyn Waller-Vintar Design: Eva Katz Cover photography: W. J. Wayne Skinner Typesetting: Tracy Choy, BTT Communications Production: Christine Harris 3222/09-07 ACKNOWLEDGMENTS This project has been an amazing journey. To start with, we owe so much to the family members who participated. They were our teachers in many ways, and their generosity and commitment to this project has inspired our belief in the importance of partnering with families. Elaine Mason of Elmgrove Outpatient Services co-ordinated the family project at our study site in Brockville and continues to actively collaborate in our workshops and com- munity forums throughout the province. We are fortunate to work in an organization that has an explicit priority commitment to concurrent disorders and to families. We have also benefited from the opportunity to work with talented and passionate colleagues who helped to sustain and expand the scope of our project. Christine Bois has been a true champion of concurrent disorder capacity building in Ontario. Monique Bouvier is co-ordinating an ambitious provincial dissemination effort, supported by a great team in CAMH’s provincial services. A special thanks goes to editors Martha Ayim and Jacquelyn Waller-Vintar and designer Eva Katz. And finally we want to thank Caroline Hebblethwaite who managed the development and execution of the manual from the first family group meeting through to the final production. She has been an extraordinarily inspiring guide—resourceful, generous, tireless, skilled and wise. Contents Preface ix Dealing with the impact of concurrent disorders ix History of the project ix Using this resource x PART I: WHAT ARE CONCURRENT DISORDERS? 1 Introduction to concurrent disorders 3 How common are concurrent disorders? 4 The relationship between substance use and mental health problems 6 The impact of concurrent disorders 7 An introduction to treatment 8 References 11 2 Substance use problems 13 Substance-related disorders 14 What is the risk of addiction? 15 Why do people develop addictions? 16 Types of substances 18 References 29 3 Mental health problems 31 Why do people develop mental health problems? 32 Mental health disorders 33 Personality disorders 45 References 49 PART II: THE IMPACT ON FAMILIES 4 How concurrent disorders affect family life 53 Behaviour changes 54 Relationship changes 55 Increased responsibility 57 Impact on caregivers 58 References 66 5 Self-care 67 Resilience 68 Short-term self-care strategies 73 Long-term self-care strategies 77 Building a self-care plan 83 References 86 6 Stigma 87 Understanding stigma 88 Experiencing stigma 91 Surviving stigma 95 Combating stigma 98 References 104 PART III: TREATMENT 7 Navigating the treatment system 107 Is there a system? 108 What should happen: Integrated treatment 108 What may happen: Sequential or parallel treatment 109 Access points 110 Screening, assessment and diagnosis 113 Treatment planning 114 Treatment 119 Treatment approaches 129 Co-ordinating treatment 133 Continuing care 134 References 135 8 Medication 137 Drug therapy for mental health problems 138 Drug therapy for substance use problems 140 Medication management 142 Medication abuse or dependence 148 Drug interactions 149 Ongoing treatment 151 Stopping medication 151 References 152 9 Relapse prevention 153 What is relapse? 154 Relapse prevention for substance use problems 154 Relapse prevention for mental health problems 156 10 Crisis and emergency 161 Understanding crises and emergencies 162 Whose crisis is it? 162 Limit-setting 163 Dealing with inappropriate behaviour 163 Example of an escalating crisis 164 When a crisis becomes an emergency 168 Creating an emergency plan 174 Creating a crisis plan 174 References 177 PART IV: RECOVERY 11 Recovery 181 What is recovery? 182 Key factors in recovery 183 References 199 12 Resources 201 Websites 203 Online publications 207 Books and booklets 208 Preface DEALING WITH THE IMPACT OF CONCURRENT DISORDERS Over the past few years, we have received numerous calls from family members of people who have co-occurring substance use and mental health problems. The family members were often overwhelmed as they tried to cope with difficult issues. We know that the mental health and substance use systems could be better at helping families become more resilient, at recognizing the work that family members do every day to find solutions and resources for problems related to concurrent disorders. Families need help to deal with the impact of concurrent disorders, but families are also a key to finding effective solutions. To help their relatives on the journey to recovery, families need: • information about substance use and mental health problems—and above all, to know that families do not cause the problems • a common language with treatment providers—to make it easier to collaborate • strategies to cope with issues associated with concurrent disorders • strategies to look after themselves and reduce the impact of their relatives’ problems on their own lives. HISTORY OF THE PROJECT In 2004–05, we offered a support and education group to help family members: • learn about concurrent disorders • develop skills that would help them deal with the impact of concurrent disorders on their family life • collaborate with their relatives with concurrent disorders as well as treatment providers to find ways to manage substance use and mental health problems. The feedback we have received—both directly from family members and indirectly from the research measures
Load more

Recommended publications
  • A Short Antipsychiatry Bibliography – Selected and Annotated Sources Compiled by Don Weitz
    A Short Antipsychiatry Bibliography – Selected and Annotated Sources compiled by Don Weitz Peter Breggin (1991). Toxic Psychiatry. NY: St. Martin’s Press. This dissident psychiatrist launches a serious attack on biological psychiatry, cxposes the fraud of psychiatric diagnostic labels, particlarly ”schizophrenia”, and many abuses in medication and electroshock. Peter Breggin (1997, Second Edition 2008). Brain-Disabling Treatments in Psychiatry. NY: Springer Publishing Co. A powerful critique of psychiatric treatment and brilliant discussion of the brain-disabling hypothesis to explain how the drugs and electroshock ‘work’. Bonnie Burstow & Don Weitz, Eds. (1988). Shrink Resistant: The Struggle Against Psychiatry in Canada. Vancouver, B.C.: New Star Books. A powerful collection of survivor accounts of psychiatric abuses and resistance in Canada by over 30 psychiatric survivors. A damning critique of psychiatry by the editors, a feminist academic and psychiatric survivor-activist--the first antipsychiatry anthology work published in Canada. Bonnie Burstow (1992). Radical Feminist Therapy: Working in the Context of Violence. Newbury,CA, London,UK, New Delhi,India: Sage Publications Inc. A critical analysis of women’s psychological issues and counselling from feminist and anti-oppression perspectives; includes a chapter on psychiatry as “fundamentally problematic.” Bonnie Burstow (2006a) “Electroshock as a Form of Violence Against Women.” Violence Against Women, vol.12, no.4. A feminist and political analysis of electroshock as violence – a brilliant deconstruction of this psychiatric “treatment” that mainly targets women. Bonnie Burstow. (2006b). ”Understanding and Ending ECT: A Feminist Imperative”. Canadian Woman Studies, vol.25, numbers 1,2. A comprehensive critique of electroshock (‘ECT’) informed by a feminist analysis. Dr.
    [Show full text]
  • Suicide Postvention : How Can We Improve Existing Models?
    Smith ScholarWorks Theses, Dissertations, and Projects 2007 Suicide postvention : how can we improve existing models? Seana Carmean Smith College Follow this and additional works at: https://scholarworks.smith.edu/theses Part of the Social and Behavioral Sciences Commons Recommended Citation Carmean, Seana, "Suicide postvention : how can we improve existing models?" (2007). Masters Thesis, Smith College, Northampton, MA. https://scholarworks.smith.edu/theses/1327 This Masters Thesis has been accepted for inclusion in Theses, Dissertations, and Projects by an authorized administrator of Smith ScholarWorks. For more information, please contact [email protected]. Seana Carmean Suicide Postvention: How Can We Improve Existing Models? ABSTRACT This study was undertaken to assess the effectiveness of suicide postvention approaches used with suicide survivors, who are defined as the families, partners and friends who have lost a loved one to suicide. The goal was to determine the experience of postvention support for survivors through their own voice, and then to use the findings to develop a proposal for a National Suicide Postvention Plan to better meet the stated needs of this disenfranchised population. Twelve male and female survivors from around Massachusetts were interviewed using an open-ended question format to encourage the description of their own postvention experience. The participants were all over eighteen years old at the time of the suicide and had endured the loss at least one full year ago. The questions also elicited the participant’s perspective on what an ideal postvention plan would look like. The findings of the research showed that more than half of the participants had no postvention support available to them after the death.
    [Show full text]
  • Eating Disorders Other Resources List of Psychiatrists and Psychologists
    List of Psychiatrists and Psychologists Child-Adolescent Psychiatrists Eating Disorders • Michelle Banducci, MD – San Ramon (925) 362-3861 • Sara Buckelew, MD – Pleasanton (415) 353-2002 • Alex Anastasiou, DO – Pleasanton (925) 425-0191 • Vandana Aspen, PhD – Pleasanton (925) 238-3622 • Lisa Hardy, MD – San Ramon (925) 362-3862 • Jeanine Pontes-Boeiter – Pleasanton (925) 399-8015 • Daniel Kostalnick, MD – Pleasanton (925) 784-4000 • Stanford Children’s Health – (650) 498-4468 - www.CNSMedical.com Therapists (Licensed Marriage & Family Therapists) • Khurram Durrani, MD – Tracy (209) 835-8583 • Julie McCloskey, LMFT – Livermore (925) 605-6283 • Mohsin Khalique, MD – Pleasanton (925) 463-5674 - Also specializes in chemical dependence • Vivian Sun, MD – San Ramon (925) 277-0730 • Debbie Curtis, LMFT – Livermore (925) 332-6851 • Ana Yeganeh – San Ramon (925) 400-9604 • Mina Skoutelakis, LMFT – Pleasanton (925) 216-6561 • Children’s Hospital, Psychiatry – Oakland (510) 428-3579 • Laurel Edgecomb, LMFT – Walnut Creek (925) 914-0444 • UCSF Langley Porter Psychiatry – (415) 476-7500 • Randy Bloch, MD – Walnut Creek (925) 943-1561 Other Resources • Kirk Hartman, MD – Danville (925) 552-5140 • Rogers Behavioral Health (for children 8+yrs) • Ray Hearey, MD – Oakland (510) 655-3284 420 N. Wiget Lane, Building 2 Walnut Creek, CA 94598 • Michael Schwab, MD – Walnut Creek (925) 930-7744 Phone: 844-650-4411 or 925-266-8800 • John Muir Behavioral Health Center – Concord (925) 674-4265 - For intensive evaluations • John Muir Outpatient Behavioral Health
    [Show full text]
  • Surveymonkey Analyze
    2014 Maryland Psychiatric Society Annual Survey Thank you to members who completed the annual MPS survey online or returned the survey enclosed with the FY14 dues mailing. As of September 29th, we received 224 responses! Three respondents were chosen at random to receive a $100 credit toward MPS dues or events. The lucky recipients are: David Cowie, M.D., Carmen Lopez, M.D. & Brian Siegel, M.D. Member input through the survey is essential, and is shared with MPS leadership and committees so it can inform decision-making during the year. Q1 Please describe your practice: Answered: 216 Skipped: 8 Academic 36 Public 28 Private 103 Private/Public 26 Retired 9 Other 14 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 Answer Choices Responses Academic 16.67% 36 Public 12.96% 28 Private 47.69% 103 Private/Public 12.04% 26 Retired 4.17% 9 Other 6.48% 14 Total 216 1 / 33 2014 Maryland Psychiatric Society Annual Survey Q2 If you are in private practice, please select one: Answered: 147 Skipped: 77 Solo 90 Group 26 Institution 31 0 10 20 30 40 50 60 70 80 90 100 Answer Choices Responses Solo 61.22% 90 Group 17.69% 26 Institution 21.09% 31 Total 147 2 / 33 2014 Maryland Psychiatric Society Annual Survey Q3 How long have you been in practice? Answered: 219 Skipped: 5 In Training 16 1-5 20 6-10 14 11-20 34 Over 20 135 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190200 Answer Choices Responses In Training 7.31% 16 1-5 9.13% 20 6-10 6.39% 14 11-20 15.53% 34 Over 20 61.64% 135 Total 219 3 / 33 2014 Maryland
    [Show full text]
  • A Korean Survey on Qualities and Definition of a Good Psychiatrist
    ORIGINAL ARTICLE Psychiatry & Psychology http://dx.doi.org/10.3346/jkms.2015.30.5.632 • J Korean Med Sci 2015; 30: 632-638 A Korean Survey on Qualities and Definition of a Good Psychiatrist Ji Hyun Kim,1 Phern-Chern Tor,2 The definition of a “good” psychiatrist has varied over the past decades due to changing Joel King,3 and Jeong Seok Seo1 roles of psychiatrists. Studies on the qualities of “good” psychiatrists have been completed in many countries. However, no such study has been undertaken in Korea. In Korea, recent 1Department of Psychiatry, School of Medicine, Konkuk Unversity, Chungju, Korea; 2Department of growing interest in psychiatry demands the identification of qualities for a good Psychological Medicine, National University psychiatrist. The purpose of this study was to define the qualities of a good psychiatrist in Hospital, Singapore; 3Department of Psychiatry, Korea, subsequently facilitating the improvement of psychiatric training programs. The University of Melbourne, Melbourne, Australia questionnaire was based on a Singaporean survey with the permission from the original Received: 11 September 2014 authors. Respondents were divided into patient group and psychiatrist group. The 40-item Accepted: 3 December 2014 questionnaire contained items grouped into four themes: Professional, Personal Values, Academic Executive and Relationship. Of the four themes, both patient and psychiatrist Address for Correspondence: groups considered Professional as the most important, whereas Academic Executive as the Jeong Seok Seo, MD Department of Psychiatry, School of Medicine, Konkuk least important. The mean scores for all items of each theme in the patient group were University, 82 Gugwon-daero, Chungju 380-704, Korea higher than those in the psychiatrist group, reflecting higher expectations for good Tel: +82.43-840-8470, Fax: +82.43-845-8470 E-mail: [email protected] psychiatrist in the patient group.
    [Show full text]
  • Mental Health Resources -May 2015
    PASTORAL SELF-CARE AND RESOURCES FOR CONGREGATIONAL PASTORAL CARE Mental Health Resources and Professionals Section I: Groups and Organizations Rochester Mental Health Association Guide The Rochester Mental Health Association publishes an on-line guide called Finding Your Way: A Guide to Mental Health Services in Monroe and Livingston Counties. You may search the guide or download it from www.mharochester.org. G.R.A.P.E. The Greater Rochester Area Partnership for the Elderly (G.R.A.P.E.) is a not-for-profit organization. Its membership consists of professionals, volunteers, students, and other interested persons who serve the older adult population in the Greater Rochester area and aspire to improve the quality of services for the elderly. G.R.A.P.E. accomplishes this by sharing expertise, knowledge and skills, and by acting as advocates for the elderly in ways deemed appropriate by the membership. G.R.A.P.E. seeks to foster a sense of camaraderie among professionals; provide high-quality education and training; influence social and public policies, and facilitate debate about emerging issues. They have an extensive Guide to Senior Services in Monroe County. The Guide covers adult day care, elder abuse, emergency services, community health services, legal services, respite care and many other subjects. For information, go to www.grapelder.org. NY Connects NY Connects Livingston County offers free and confidential information and referral on long-term care, hospice facilities, elder abuse, and other health care needs. Visit www.NYConnectsLivingstonCounty.org to search for local services and resources. Click on the services you are interested in.
    [Show full text]
  • The Evolution of Psychiatry and Neurology Two Disciplines Divided by a Common Goal?
    2 The Evolution of Psychiatry and Neurology Two Disciplines Divided by a Common Goal? François Boller and Gianfranco Dalla Barba INTRODUCTION This chapter traces the evolution of psychiatry and neurology with special emphasis placed on the European scene. For a long time, there was hardly any distinction between these two disciplines that are now considered quite separate. They started together and they may well be in the process of reunit- ing, particularly in certain domains. We may see, and as the Germans say, Zukunft in der Vergangenheit (translation: the past is probably holding the key to the future.) It is nearly impossible to state when neurology and psychiatry were “born,” but most historians hypothesize that scientific interest in the brain and mind—which had always existed—developed and reached a critical mass in Europe in the late 18th and early 19th centuries. As pointed out elsewhere (1), for much of the 19th and even parts of the 20th century, many persons practiced not only neurol- ogy and psychiatry including, in some cases, psychoanalysis—but also neuropathology. One could go even farther and extend the “boundaries” of the disciplines. For instance, the founders of neuro- surgery in France, Thierry de Martel and Clovis Vincent—who was first trained as a neurologist and gained a special fame of sort for having operated on Ravel (2)—first developed their neurosurgical practice within the context of the Neurology service of the Salpêtrière, then directed by Joseph Babinski (3). As for neuroradiology, some of its pioneers like Arthur Schueller in Vienna and Egas Moniz in Lisbon were neuropsychiatrists (4).
    [Show full text]
  • Health Care System, Provider and Patient Predictors of Prescribing Quality and Efficiency
    HEALTH CARE SYSTEM, PROVIDER AND PATIENT PREDICTORS OF PRESCRIBING QUALITY AND EFFICIENCY by Yan Tang BA in Business Management, China Pharmaceutical University, China, 2005 MS in Management, China Pharmaceutical University, China, 2008 Submitted to the Graduate Faculty of Graduate School of Public Health in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Pittsburgh 2015 UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH This dissertation was presented by Yan Tang It was defended on January 20, 2015 and approved by Dissertation Advisor: Julie M. Donohue, PhD Associate Professor Department of Health Policy and Management Graduate School of Public Health University of Pittsburgh Judith R. Lave, PhD Professor Department of Health Policy and Management Graduate School of Public Health, University of Pittsburgh (Joyce) Chung-Chou H. Chang, PhD Professor Department of Biostatistics Graduate School of Public Health University of Pittsburgh Walid F. Gellad, MD, MPH Assistant Professor VA Pittsburgh Health Care System, RAND, and University of Pittsburgh ii Copyright © by Yan Tang 2015 iii HEALTH CARE SYSTEM, PROVIDER AND PATIENT PREDICTORS OF PRESCRIBING QUALITY AND EFFICIENCY Yan Tang, PhD University of Pittsburgh, 2015 ABSTRACT Understanding factors influencing medication utilization and provider prescribing behavior has important implications for the quality improvement and cost containment in health care. This dissertation seeks to shed light on the quality and efficiency of medication prescribing. Chapter one examines the association between Medicare Part D plan features and choice of generic antidepressants, antidiabetics, and statins using Medicare claims data. Low cost- sharing for generics, large differentials in cost-sharing for generic vs.
    [Show full text]
  • Psychological Terms for Mood
    Psychological Terms For Mood Heartsome Dino efface sidelong. Skulking and thermostatic Boris window-shopped his quantities chevies tores senatorially. Sullied and ecchymotic Wes jubilated her marmoset boulevardiers waxes and introverts therapeutically. What is the mood in English grammar? Depression is your low impact that lasts for a significant study of reflect The severity of depression can chart a mild depression might not stop blood from under your. Depression Psychology Tools. Mood Words Pdf. Mood-related Disorders Mood disorders include major depression dysthymia and bipolar disorder in mood disorders share further common symptoms. Affect had to be distinguished from date which refers to provide pervasive and sustained. Mood among the feeling created by the poet for the reader Tone is on feeling displayed by the author toward the subject enter the poem. Sometimes put on mood you for psychological terms for mood may for psychological terms in. In applying Langer's definitions of signs and symbols to art music sign project be its image. A psychologist's science-based tips for emotional resilience during the coronavirus crisis Image search a caption Sergiy MaidukovFor The. An expansion of emotional descriptive terms could also maintain useful in helping. Color psychology and perform impact will a child's learning abilities and bustle is a. Different states of consciousness psychology quizlet. Supplied vocabulary and formulates those expectations in familiar terms. The Seven Universal Emotions We comply On display Face weight of. Want more videos about psychology every Monday and Thursday Check each our sister channel SciShow Psych at. Odds and Rates of 45-Day Case Fatality by Recent Psychiatric Diagnosis.
    [Show full text]
  • Fall 2001, Vol
    BULLETIN NEW YORK STATE PSYCHIATRIC ASSOCIATION Fall 2001, Vol. 44, #3 • Bringing New York State Psychiatrists Together President’s Message: Responding Coping With Bioterrorism Anxiety to Disaster and Aftermath The following is a press release from the APA central office. It is intended for the lay press and is reproduced here for your use with your patients and to help answer questions from the by Jim Nininger, M.D., President, New York State Psychiatric Association public. Feel free to distribute as needed. –Ed. s I write this referral. Members should ear and anxiety are normal dren, especially when it is viewed message, thou- contact their district human reactions to a perceived repetitively. A sands of psychia- branches directly. Hospi- Fthreat or danger. But such Find ways to distract yourself from trists in New York City, tals, clinics and social uncertainty is manageable if people thinking about the potential for harm. New York State and service agencies also are keep the threat in perspective, the Get involved in an activity that you across the country are offering counseling and American Psychiatric Association said can control: work in the garden, clean responding to the attack referral. Help is out there. today. the basement, do volunteer work, take on the World Trade Psychiatrists are espe- “The reports and images of the up an old hobby, take a “time out” Center and the Pentagon. cially prepared by their September 11 atrocity and recent and go to the movies or a play. There are thousands of training and expertise to bioterrorism are frightening to all of casualties, tens of Jim Nininger, M.D.
    [Show full text]
  • Proposed Rulemaking Prohibiting Electronic Liquid-Vaporizing Devices at Proposed Rulemaking Underground Bituminous Coal Mines
    Volume 51 Number 11 Saturday, March 13, 2021 • Harrisburg, PA Pages 1299—1488 See Part II page 1449 Part I for the Governor’s Office Agencies in this issue Regulatory Agenda Notice The General Assembly The Courts Board of Coal Mine Safety Department of Agriculture Department of Banking and Securities Department of Community and Economic Development Department of Environmental Protection Department of Health Department of Labor and Industry Department of Transportation Environmental Hearing Board Game Commission Governor’s Office Independent Regulatory Review Commission Insurance Department Milk Marketing Board Pennsylvania Public Utility Commission Public School Employees’ Retirement Board State Board of Funeral Directors Unemployment Compensation Board of Review Detailed list of contents appears inside. Latest Pennsylvania Code Reporter (Master Transmittal Sheet): Pennsylvania Bulletin Pennsylvania No. 556, March 2021 TYPE OR PRINT LEGIBLY Attn: 800 Church Rd. W. 17055-3198 PA Mechanicsburg, FRY COMMUNICATIONS, INC. COMMUNICATIONS, FRY CUT ON DOTTED LINES AND ENCLOSE IN AN ENVELOPE CHANGE NOTICE/NEW SUBSCRIPTION If information on mailing label is incorrect, please email changes to [email protected] or mail to: mail or [email protected] to changes email please incorrect, is label mailing on information If (City) (State) (Zip Code) label) mailing on name above number digit (6 NUMBER CUSTOMER NAME INDIVIDUAL OF NAME—TITLE OFFICE ADDRESS (Number and Street) (City) (State) (Zip The Pennsylvania Bulletin is published weekly by Fry PENNSYLVANIA BULLETIN Communications, Inc. for the Commonwealth of Pennsylva- nia, Legislative Reference Bureau, 641 Main Capitol Build- (ISSN 0162-2137) ing, Harrisburg, Pennsylvania 17120, under the policy supervision and direction of the Joint Committee on Docu- ments under 45 Pa.C.S.
    [Show full text]
  • Postpartum Depression
    Postpartum Resource List Please talk to your doctor before making an appointment with a specialist. We can direct you to the right practice for you and send records to facilitate care. Healthcare Providers A list of psychiatrists, therapists, and other healthcare providers in Georgia with specialized training, experience, and/or interest in perinatal mood and anxiety disorders: Psychiatrists and Therapists: Holistic Wellness Practice Robyn Watts, M.A., Psy.D., LCP Courtney Daniels, LCSW, PMH-C Focus Forward 400 Prospect Place 5975 Parkway North Boulevard Alpharetta, GA 30005 Suite 300 D (P) 470.231.5355 Cumming, GA 30040 www.holisticwellnesspractice.com Psych Atlanta Northside Behavioral Health Specialty Services 11755 Point Place, Suite A-1 6105 Peachtree Dunwoody Road Roswell, GA 30076 Building F. Suite 155 (P) 770.667.1264 (F) 770.667.2238 Atlanta, GA 30328 (P) 404.851.8960 (F) 678.320.0383 www.northside.com/behavioralhealth Disclaimer: We have compiled these lists as a resource for our patients. We are happy to facilitate the referrals. Johns Creek Pediatrics is not responsible for the care you receive from anyone on our referral lists. Other Organizations: A list of support groups, fitness facilities, and other organizations in Georgia that promote self-care and support among pregnant and/or postpartum women. Peer support (in-person, telephone, online, etc.) • Atlanta Postpartum Support Group: Meet with other moms who have recovered from or are currently experiencing a challenging pregnancy or postpartum period. Experience the benefits of peer support. Learn about postpartum depression and related disorders and discuss resources such as therapists, doctors, opportunities to meet other moms/children, and ways to improve your health and mood.
    [Show full text]