Answers to Two Common Questions

I thought I would do some writing today to answer a couple of questions (in print) I am often asked; one is a question I often field from other professionals in the field of behavioral health......therapists, clinicians, referring physicians, and the other, families of persons who have witnessed a "cerebral incident".

I have a twenty year background in helping treat addiction and mental health, of being a part of a nationwide network of (mostly) quality providers (with some bad players interspersed) who, for the most part, try to do the right thing.

It's a bit like being a telephone operator, in some ways, for the world's tapestry of human tragedies: each one a unique story, each one a puzzle of unmet needs.

Every placement I've made- or treatment plan I've created, I've held to the same acid test: If this were my nephew, sister, or father, would I send them to this program, or put this plan in place? That is as much love and compassion as I can bring to this work, and the best service I can provide. For me, it defines integrity.

Oh, but back to the question. I am called these days, on a weekly if not a daily basis with this question: "I am looking for a residential treatment center or psychiatric hospital who is the best at treating brain injuries? Who do you think is the best at treating that?"

Answer: technically, nobody.

There are a few, whose websites promote having a brain healing center: these are program with what I like to call "bells and whistles" features, but whose ability to significantly treat still fall wildly short of the mark. Not to say brain mapping and biofeedback aren't good; they're great. Many programs offer them. They are also only one piece of the puzzle.

The programs- the really sharp programs- are the ones that are sharp enough to realize that they are dealing with a co-morbidity whose presentation is outside the scope of what they can screen for, assess and treat, and are quick to make a referral and begin to work with someone collaboratively like myself. Of these, there are many. Programs that would consult with a brain injury informed professional and create accommodations to have, as example, a driver take them daily, as example, to hyperbaric medicine as an ancillary- and equally important- part of their treatment plan.

And sadly, in the current day and age, this is about as good a help as you'd find, specifically in regards to behavioral health as a whole. In an upcoming blog I will highlight some of the challenges health care has to move forward with meaningful treatment, but for now, I'll just stick to these questions.

The second question I get asked, comes from families. The scenery, stagehands, and back story changes from call to call, but is usually plays out like this:

"My nineteen year old son was on an electric scooter last week, lost control of the scooter and hit a curb. He flew about eight feet and when he landed, his head hit a fire hydrant. Do you think he has a TBI?"

Answer: I don't "think" your son has a TBI, he does have a TBI.

If you've injured your head, you've injured your brain with it.

So the question becomes: will his newly acquired traumatic brain injury affect the rest of his life? That is the real question.

And also, a question that can't be answered on a simple phone call. That is, at minimum, a TBI ID screening assessment hopefully coupled with a PET, QEEG, fMRI or other comprehensive scan and an ongoing evaluation to see what symptoms arise, their severity, and which will accommodate and yield to treatment, and which will not.

I suppose it the old days parents were quick to label it as "he got his bell rung" and then were mystified at watching a life spiral out of control days, weeks, months later. I should know- that is my story, too.