NORTH CONWAY, NH - When someone has a heart attack or stroke, or is diagnosed with a chronic illness such as diabetes, it's natural to first think about what health care services are needed to address their physical well-being. Unfortunately, mental health issues often accompany these health crises and can be overlooked by patients and their families. Many suffer from some degree of depression that medical research says can result in fatigue, hopelessness, general apathy and an increased risk of death.

However, when health care providers are able to recognize and treat all the consequences of illness, including depression, a person's ability to manage their disease is greatly improved. One of the best places to evaluate the mental health of someone dealing with a life-altering diagnosis is in the primary care setting. Recognized as a best practice of medicine, this approach helps people adjust to a chronic disease, adapt to necessary lifestyle changes, and engage in ongoing prevention.

Based on such outcomes, the inclusion of behavioral health services is a major component of becoming certified as a "Patient-Centered Medical Home". Primary Care at Memorial Hospital is on track for achieving their certification by 2017. The practice must demonstrate effective collaboration that supports their patients in preventive care and self-management of chronic disease.

With these concepts in mind, a proposal was submitted last year to the Memorial Hospital Foundation seeking funding for behavioral health services to be offered in Memorial's primary care practice. The board approved the proposal and program development began. Since then, a psychiatric nurse practitioner and a licensed clinical social worker have begun seeing primary care patients.

Lorinda MacDonald, APRN came on board in October to set up the integration of behavioral health services into the primary care setting. She is an experienced Family Psychiatric Nurse Practitioner with significant background in mental health program development, psychiatric evaluations and medication management.

MacDonald said she's very pleased to be at Memorial and to be part of the Maine Health system. "The program we've developed is in keeping with the concept of the patient-centered medical home," she said. "It allows us to destigmatize mental health care by offering it in the same office where a patient sees their primary care provider. If we are truly treating the whole person, mental health services shouldn't be separate from other health care services."

MacDonald has already added a brief assessment tool to help providers identify patients who may be depressed or suffering with generalized anxiety. For people coping with a new diagnosis or ongoing chronic conditions, MacDonald can manage their behavioral health medication needs while their primary care provider oversees ongoing medical care.

"The overall goal is to improve the quality of our patients' lives by making mental health care more accessible and available," MacDonald said. "If someone has had a cardiac event or a diagnosis of cancer or diabetes, it's likely that they are dealing with some level of depression as well. Research shows that when these patients are treated with counseling and anti-depressants, they have a better response to their overall treatment plan."

MacDonald earned her Master of Science in Nursing in 2012 at the University of Southern Maine and is a certified psychiatric-mental health nurse practitioner. Prior to coming to the Mt. Washington Valley, she was the first psychiatric nurse practitioner in Lewiston, Maine. Working for Sweetser, she was charged with developing a full service community mental health center in the town.

Within two years, the center had a staff of three nurse practitioners and offered a full array of behavioral health services for children and adults. In 2014, she began providing services in three family centered residential treatment programs for children ages 8 to 18 located in Rockport, Belfast and Winterport, Maine.

MacDonald also loves teaching and has served as preceptor to nurse practitioners and physician assistants during her career. "I see it as passing on my passion for nursing," she said. "I want to light a fire in the next generation."

Last month, Lynn Meehan, a Licensed Clinical Social Worker, joined MacDonald in Primary Care. Meehan provides counseling and other support as part of the overall wrap-around behavioral health services for patients of the practice.

Shauna Cameron, RN, director of Primary Care, said the introduction of behavioral health services is a huge step. "As we move towards our certification as a Patient Centered Medical Home, this addition is a critical component of that designation," she explained. "It demonstrates a significant level of coordination between our primary care teams with everyone right here, on site."

The behavioral health services are available to patients of Memorial Hospital's primary care practice. To learn more or make an appointment to see one of the primary care providers, call 356-4949 or visit www.MemorialHospitalNH.org.

Memorial Hospital is a not-for-profit 25-bed Critical Access Hospital located in North Conway, NH, and is a member of the MaineHealth family. Its hospital services include a 24-hour emergency department, surgery center, clinical laboratory, heart health & wellness programs, family birthing center, sleep center, wound care and hyperbaric medicine center, and the Miranda Center for Diabetes. Physician practices include primary care and family medicine, women's health, orthopedics and sports medicine. The Merriman House, a 45-bed nursing home specializing in Alzheimer's and other memory disorders, is also located on the hospital campus. Together, our staff and providers are committed to meeting the health needs of the Mt. Washington Valley and surrounding communities by collaborating with community partners in the delivery of accessible, comprehensive, compassionate, and quality health care.


Posted 2/3/16