heal. Winter 2015

healA publication of the Sheppard Pratt Health System • WINTER 2015

CONCUSSIONS:A SERIOUS CONCERN

NEW LEADERS AT THE RETREAT

FINDING SUPPORT FOR EATING DISORDERS

PLUS

Learning to Cope

For 12-year-old Bryce Greenberg

and his family, The Frost School

has been a ‘special’ gift.

Learningto Cope

For Bryce Greenberg and his

family, The Frost School has

been a ‘special’ gift.

3 Road to Recovery from Eating Disorders Is Shorter with Family Involvement

7 Calendar

8 In The News

10 3 Questions for Our Medical Director of the Trauma Disorders Program

11 Concussions: A Serious Concern

12 Philanthropy: You give. They heal.

14 Informing Ourselves About E-cigarettes

15 Meet Our Doctor: Edward Zuzarte, M.D.

4

heal. is published four times a year by the Marketing Department of the Sheppard Pratt Health System, a private, nonprofit health system with one of the nation’s leading mental health programs. Information provided is general in nature and should not be substituted for the medical advice of a physician. Please consult your health care provider for recommendations specific to your personal health, medical treatment, and medical conditions.

Editor/Director of Marketing Jessica Kapustin

Marketing Account Manager Chelsea Soobitsky

Design & Production Clipper City Custom Media

Jeni Mann and Cortney Geare

Contributing Photographers Brian Glock and David Stuck

On the cover.Bryce Greenberg, 12, is now thriving, thanks to the comfort of The Frost School and his constant companion, Griffin.

Photo by David Stuck

Connect with us.

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facebook.com/SheppardPratt @sheppardpratt youtube.com/user/SheppardPrattHealth

In this issue. WINTER 2015

13

4

12

EATING DISORDERS

How did this happen? Where did I go wrong?

Why won’t you just eat?

These questions, while quite common,

have no simple answers and can easily

distract from the ultimate goal of recovery.

When questions have no easy answers,

many family members fi nd themselves

bewildered by the illness and frustrated with the

affl icted individual. As an alternative, families are

often encouraged to ask a new set of questions:

How do eating disorders aff ect the body and the brain?

What can I do to support you in recovery?

Family involvement in the treatment of eating disorders

can play a critical role in an individual’s recovery and is considered

absolutely essential for children and adolescents. Family-based

treatment (FBT) is a type of family outpatient therapy in which parents are

coached to help their child to eat normally, end unhealthy behaviors, and regain

weight. FBT helps parents understand what an eating disorder is and how it

aff ects their child, both emotionally and physically. It views parents as the best

experts in the refeeding of their son or daughter. The focus is on behavioral

change, nutritional rehabilitation, and weight restoration. FBT is a “no blame”

approach. During weekly sessions, the therapist serves as a coach to the family,

and assists the family in supporting their child to eat what they need to in order

to meet the body’s nutritional requirements. While the therapist may be quite

active in treatment, most decisions are left to the parents. It is fi rmly believed

that most families CAN help their child recover.

A key principle in FBT is a therapeutic technique known as externalization of

the illness in which the child and the illness are viewed as two separate entities.

For example, when a child is struggling and resisting a meal, parents learn to

direct their frustration at the anorexia and not at the child. This allows parents

to remain aligned with their child, working together as a team against a common

enemy, the eating disorder, instead of battling each other.

Road to Recovery from Eating Disorders Is Shorterwith Family InvolvementWHEN A FAMILY MEMBER DEVELOPS AN EATING DISORDER,

THERE ARE MANY VARIED REACTIONS

Family-Based Treatment Promotes Success

The Center for Eating Disorders at Sheppard

Pratt (CED) recently participated in a multisite

NIH-funded study to assess the effi cacy of

family-based treatment (FBT). This fi ve-year,

international study found that parental

involvement promotes success in treatment

and recovery.

CED off ers FBT as a fi rst-line approach

for families of children and adolescents with

eating disorders. Because FBT is an outpatient

therapy, the individual needs to be medically

stable to utilize this approach. At times, an

individual may require hospitalization to

ensure safety during the beginning stages

of recovery. Family involvement remains

critically important at these higher levels of

care as well.

The benefi ts of family support for

recovery are not just for children. Changing

deeply ingrained eating disorder behaviors is

very diffi cult for individuals at any age. During

treatment, adult patients are encouraged

to identify people who are supportive and can

help them while they work toward recovery.

Support People Need Support, Too

The process of recovery is diffi cult for an

individual as well as for his or her support

network. To assist support people and

families, CED off ers free Collaborative Care

Workshops for families and friends of

individuals with an eating disorder. These

workshops are tailored to address the needs

of care providers, off ering education and

therapeutic communication techniques.

They provide a space for caregivers to seek

support while also learning self-care

strategies for themselves.

For more information on The Center for Eating

Disorders, visit eatingdisorder.org or call

410-938-5252.

sheppardpratt.org • heal 3

STEVEN CRAWFORD, M.D., co-director, The Center for Eating Disorders

Dr. Crawford has been in a leadership role at The Center for Eating

Disorders for more than 20 years. He also serves on the faculty of the

University of Maryland School of Medicine, where he teaches how to

identify eating disorders, and is also a lead investigator in federally

funded research grants.

4 heal • Sheppard Pratt Health System

Not so long ago, Tracy Greenberg

often looked like a battered wife.

She wasn’t one though.

She was a battered mother.

Her son Bryce, now 12, was often

uncontrollably violent. Diagnosed with

attention deficit hyperactivity disorder

(ADHD) at age 5, and later with bipolar

disorder and anxiety, Bryce’s rages, prior

to treatment, controlled family life.

“Everything was driven by what

Bryce’s moods were going to be,” Tracy

said. “Even going out to dinner or to a

friend’s house — I didn’t want to push him

because I didn’t know what his reaction

would be. We had to cancel a vacation

because he had to be hospitalized.”

Something as seemingly innocuous

as being asked to do his homework

could lead to an outburst. More often

than not, Tracy was the victim of Bryce’s

fury. “With children like Bryce, they tend

to take out their aggression on their

mother,” she said.

It hadn’t always been that way.

Bryce was “a fabulous baby,”

remembered Tracy, who with her

husband Terry adopted Bryce at

birth. “He hit all his milestones.”

The couple knew that the birth

parents struggled with drugs and mental

illness. “But when you want a baby, words

like bipolar and schizophrenia mean

nothing,” she said. She hoped nurture

would overcome nature.

But when Bryce was 18 months old,

Tracy and Terry “started to notice things

weren’t right. He had night terrors.

They were like nightmares on steroids,”

Tracy said.

In the following years, Bryce

developed new, violent behaviors.

When it was time for kindergarten,

the Greenbergs enrolled Bryce in

a public school. “For the next four

years, our life was awful,” Tracy said.

“In kindergarten and first grade he was

restrained more than 10 times. He had

FEATURE/SPECIAL EDUCATION

i Emotional disability (ED) is not so much an illness as it is

a diagnosis category that allows patients to access

benefits available through the Individuals with Disabilities

Education Act (IDEA). It governs how states and public

agencies provide early intervention, special education,

and related services to more than 6.5 million eligible

infants, toddlers, children, and youth with disabilities.

“Emotional disability defines what a child is entitled

to in services. It defines the parents’ rights in requesting

evaluations,” said Ayanna Cooke-Chen, medical director

of the Sheppard Pratt ED day school programs.

“It overlaps with the child’s medical definition such as

depression, anxiety, psychosis.”

The bottom line is that emotional disability

“impairs the child’s ability to get an education. It impairs

their ability to engage in satisfying interpersonal

relationships,” she said.

That was certainly true in Bryce Greenberg’s case.

There were long periods before he began attending The

Frost School when “he wasn’t learning at all,” his mother

Tracy said.

Taking Action

Learning to Cope BY DAVID HOLZEL

FOR THIS 12-YEAR-OLD AND HIS FAMILY, THE FROST SCHOOL HAS BEEN A ‘SPECIAL’ GIFT

Bryce Greenberg, with his pet dog Griffin.


fits. He was violent. He was aggressive

toward the staff and himself.” That’s when

Bryce was hospitalized for the first time.

The extent of Bryce’s illness isn’t

apparent on a recent fall afternoon at

the family’s home in the Maryland

suburbs of Washington, D.C. Bryce,

is eager to show off his bedroom,

where his pet gecko, Echo, has run of

the place. He rough houses with the

Greenbergs’ good-natured golden

retriever, Griffin.

“We found out Bryce is sensory

seeking,” Tracy said. “He wants to feel

everything all over him.”

The family learned this when he was

hospitalized at the Sheppard Pratt Health

System during fourth grade when, after

making some behavioral progress, Bryce

again had to be restrained at school.

“He was banging his head for an hour

on cement walls,” Tracy said.

The Greenbergs had an

Individualized Education Program (IEP)

for Bryce beginning in second grade;

however, it did not cover the level of

services Bryce needed to be successful

in school. Eventually, the Greenbergs

were able to get another IEP for Bryce,

where it was recommended that he

attend The Frost School, one of

14 special education schools in the

Sheppard Pratt Health System.

With small classes, individual

support, daily therapy where he learns

coping skills, and the freedom to take

a break when he needs one, Bryce “is

doing fine,” Tracy said.

At The Frost School, which Bryce

began attending in the middle of fourth

grade, he is reminded every day of the

coping skills he has learned. It has made

a difference. “He’s no longer violent.

That’s the hugest thing,” Tracy said. “I can

challenge him now. I can discipline him.

He knows how to use his coping skills,

and he comes out of [an episode]

quicker. He recognizes it.”

Rather than explode in anger,

Bryce is more likely to tell his mom,

“I have homework. I need a break first.”

“Frost has a way of holding the

students accountable, but it also allows

them to know that if they need support,

the support is there for them,” she said.

The process for requesting testing and evaluation

typically begins with a letter to the school principal.

“If you suspect a psychological issue or emotional

disturbance, go to your general practitioner and get

a referral to a psychiatrist and get it documented,”

she said. “Documentation gives you a basis for

talking to schools and what the next step is for getting

special education in the current school or finding

a place like The Frost School.”

Success for children like Bryce comes through

the heavy investment Sheppard Pratt makes in schools

such as Frost. Donor contributions make it possible.

Since mental illness touches almost everyone in some

way, “people are hopefully beginning to recognize that

we need to have these resources for young people,”

Cooke-Chen said.

For information regarding giving to the Sheppard Pratt

Health System, including our Special Education Fund,

contact Marguerite Kelley, director of philanthropy,

at [email protected] or 410.938.4018.

“He’s no longer violent. I can challenge him now.

I can discipline him. He knows how to use

his coping skills, and he comes out of

[an episode] quicker.”— Tracy Greenberg

Bryce Greenberg, shown here with father Terry, mother Tracy, and brother Cole, has made tremendous progress at The Frost School.

Continued on page 6.


Major Depressive Disorder Study (NCT02153502, NCT02158533)

a. Adults 18-plus with unresolved symptoms of depression.

b. This is a 10- to 14-week study.

c. We will evaluate an investigational medication designed to work with antidepressants to help address unresolved symptoms of depression.

Unipolar & Bipolar Depression Study (NCT01562184)

a. Adults 18-plus who are currently experiencing an episode of depression.

b. This study will last up to 12 weeks.

c. This study will evaluate the safety and effectiveness of transcranial direct current stimulation (tDCS) versus sham stimulation as an antidepressant treatment.

Tardive Dyskinesia Study (NCT02274558)

a. Adults 18 to 85 who suffer from schizophrenia, schizoaffective disorder, bipolar disorder, or mood disorder and are experiencing involuntary movements in their face or other parts of their body.

b. This study will last up to 46 weeks.

c. The purpose of this clinical research study is to evaluate the effectiveness, safety, and tolerability of an investigational oral medication for tardive dyskinesia.

Volunteers needed for research studies at Sheppard

Pratt Health System.

FOR MORE INFORMATION OR TO VOLUNTEER FOR ANY OF THESE STUDIES,

PLEASE CONTACT:Jennifer Sklar, study coordinator, at

410-938-3136 or [email protected]

Principal investigator, Scott T. Aaronson, M.D.

Bryce even tolerated the school’s

“dress code consequence” — putting on a

tie and dress slacks when he breaks the

rules. “For a kid with sensory issues, this is

not easy,” Tracy said. “But he did it.”

Bryce’s progress has allowed the

Greenbergs to live more like a family. But

Bryce still has a long way to go.

“His moods fluctuate constantly, and

he is sad, confused, and doesn’t really

live in the same world that we all live in all

of the time,” Tracy said. “He doesn’t sit still

and struggles in groups.”

Bryce made it through three swim

practices last summer. “Next year, we

hope for five.”

Tracy and Terry are discussing

whether they want Bryce to begin

preparing for his bar mitzvah, the

Jewish rite of passage celebrated at age

13 that draws family and friends to the

synagogue. Only two years ago, it

would have been out of the question.

So would have been the sight of

his younger brother Cole bringing

his friends over to play, now a

common occurrence.

As she watched Bryce and Griffin

playing tug of war with a chew toy, Tracy

said she “used to sit waiting for that phone

call every day” from school saying that

Bryce had had another violent episode.

Now Bryce is doing so well at The

Frost School that he made the honor roll.

After receiving the award, Bryce told

his therapist that he needed to talk to him

“because he had never won anything

before,” Tracy said. Bryce cried, telling the

therapist that they were “happy tears.”

“It’s important for people to know

how hard it was,” she said, “and how much

better it’s gotten.”

BRYCE GREENBERG is in a class of four kids. That’s the

kind of student-teacher ratio The Frost School in Rockville,

Md., employs to successfully educate its students.

Frost is one of the Sheppard Pratt Health System’s 14

special education residential and day schools located throughout Maryland.

Sheppard Pratt’s Special Education Program provides compassionate, nurturing

care and individualized attention to children with autism, as well as emotional and

behavioral disorders, to help them lead successful lives.

The Special Education Program is recognized as the largest provider of

nonpublic, special education programming in Maryland and serves nearly

700 students with special needs from the state and surrounding areas, more

than 50 percent of whom have been diagnosed with autism.

“Our purpose is to provide an educational environment that gives students the

opportunity to access tools to make education accessible for them,” said Ayanna

Cooke-Chen, medical director of the Sheppard Pratt ED day school programs.

For more information about Sheppard Pratt’s Special Education Program, visit

sheppardpratt.org/special-education-services or contact Jim Truscello, director

of day school programs, at 410.938.4747.

Making Education Accessible

FEATURE/SPECIAL EDUCATION

Mark Your Calendar!For a complete listing of events, continuing education classes, and lectures,

visit sheppardpratt.org/calendar-events.

PHILANTHROPY

Annual Care for Kids Benefi t

This year’s Care for Kids Benefi t will

be held on Saturday, March 21, at the

Four Seasons Hotel Baltimore. Presented

by Morgan-Keller Construction, it will

feature a ‘70s disco theme, with all

proceeds benefi ting Sheppard Pratt’s

pediatric patients and students.

Call 410-938-4020 for tickets

and information.

EDUCATION

Dick Prodey Lecture Series

Sponsored jointly by The Kolmac Clinic,

the Sheppard Pratt Health System, and

the National Council on Alcoholism

and Drug Dependence of Maryland

(NCADD-Maryland).

A FREE, eight-class series held Wednesday

evenings at The Conference Center at

Sheppard Pratt from 7 p.m. to 9 p.m.

Call 410.938.3900 for more information.

Continuing Education: Wednesday

Lectures at Sheppard Pratt

We off er a lecture series at The

Conference Center at Sheppard Pratt

most Wednesdays from noon to 1 p.m. to

support continuing education of medical

and mental health professionals. Visit

sheppardpratt.org/education-training

for more information.

Upcoming Wednesday Lectures:

The Pathetic Past But Hopeful Future of Schizophrenia

January 7

Fuller Torrey, M.D., executive

director, The Stanley Medical

Research Institute; professor of

psychiatry, Uniformed Services University

of the Health Sciences

Historical Trauma, Losses, and Separations: A Pilot Study to Evaluate the Psychological Problems of Exiles

January 21

Eugenio M. Rothe, M.D., professor of

psychiatry, Herbert Wertheim College

of Medicine, Florida International

University; professor, Robert Stempel

School of Public Health, Florida

International University; adjunct

professor, Cuban Research Institute,

Florida International University

The Changing Face of Autism

February 4

Fred R. Volkmar, M.D., director, Child

Study Center, Yale University School

of Medicine; chief of child psychiatry,

Yale New Haven Hospital; Irving B. Harris

professor of child psychiatry, psychiatry,

pediatrics, and psychology, Yale University

National Drug Abuse Treatment Clinical Trials Network: Research and Dissemination Accomplishments

February 18

Maxine L. Stitzer, Ph.D., professor of

behavioral biology, Department of

Psychiatry and Behavioral Sciences, Johns

Hopkins University School of Medicine

Culturally Competent Assessment and Treatment of Abused, Suicidal African-American Women

March 4

Nadine J. Kaslow, Ph.D., professor,

Emory University School of Medicine,

Department of Psychiatry and

Behavioral Sciences

Sleep Disturbances in PTSD: Rational Use of Prazosin and Other Treatment Modalities

March 25

Murray A. Raskind, M.D., professor,

vice chair, director, Mental Health

Services, VAPSHCS

COMMUNITY

National Eating Disorders

Awareness Week

February 23-March 1

Please stay tuned for events hosted by

The Center for Eating Disorders at

Sheppard Pratt, including a community

art exhibit featuring student artwork from

the annual Love Your Tree Campaign.

Learn more at loveyourtree.org.

CONFERENCE EXHIBITING

American Psychoanalytic Association 2015 National Meeting

January 14-18

New York City

Psychotherapy Networker

March 26-29

Washington, D.C.



Autism Research CollaborativeTHE SHEPPARD PRATT HEALTH SYSTEM’S Child and

Adolescent Neuropsychiatric Inpatient Unit is one of six

inpatient sites in the country to join the Autism &

Developmental Disorders Inpatient Research Collaborative

(ADDIRC) in an eff ort to characterize the severely aff ected

autism population. The goal of this collaborative is to develop

a comprehensive registry of clinical and biological data on

severely aff ected children and adolescents with autism.

Margo Lauterbach,

M.D., director of

The Concussion

Clinic, which treats

individuals who

have sustained

a concussion or multiple concussions

and have been impacted by the

neuropsychiatric consequences.

Dr. Lauterbach completed a residency

in psychiatry and fellowship training in

neuropsychiatry at the University of

Massachusetts Medical School.

Crystal Watkins,

M.D., Ph.D., director

of The Memory

Clinic, which treats

individuals who

have started

experiencing mild memory problems,

as well as those who have memory loss

and/or confusion related to medical

conditions, and those suff ering from

dementia. Dr. Watkins completed her

psychiatric training as well as a geriatric

fellowship at Johns Hopkins University.

Robert

Wisner-Carlson,

M.D., director of

The Developmental

Neuropsychiatry

Clinic, which

off ers specialty care for adults with

intellectual disabilities, autism spectrum

disorder, and genetic conditions who

are also experiencing behavioral

and/or neuropsychiatric problems.

Dr. Wisner-Carlson trained in psychiatry

at The Henry Phipps Psychiatric Clinic

at Johns Hopkins Hospital and at

Maudsley Hospital in London.

He is also service chief for the

Adult Inpatient Neuropsychiatry

Program at Sheppard Pratt.

IN THE NEWS

Neuropsychiatry Program Welcomes 3 New Clinic Heads

Trauma Disorders Unit Staff Nurse Receives Caul GrantJOIN US in congratulating Briana Snyder, MSN, RN-BC, CNE, a

registered nurse on the Trauma Disorders Unit, for being selected

for a David Caul Research Grant at the International Society of

Trauma and Dissociation’s 31st annual meeting for her ongoing

research study, “Views of Women with Dissociative Identity

Disorder on Intimate Partner Violence.”

HELP US WELCOME three new faces to the Neuropsychiatry Program at

Sheppard Pratt, an outpatient program that treats patients with developmental

disabilities, traumatic brain injury, age-associated cognitive impairments, and

related mental health problems.

For more information on the Neuropsychiatry Program at Sheppard Pratt, call 410.938.4981.

FAITH DICKERSON, PH.D., director of psychology and the program

director for the Stanley Research Program at Sheppard Pratt, has

been traveling the world presenting research updates. Among

other talks, she has presented “Infections, Infl ammatory Markers,

and Schizophrenia” at several conferences this year, including the

PsychoNeuroImmunology Research Society’s (PNIRS) 21st Annual

scientifi c meeting in Philadelphia, the 21st Multidisciplinary

International Neuroscience and Biological Psychiatry Stress and

Behavior Conference in Russia, the Fourth Biennial Schizophrenia

International Research Society Conference in Italy, and the 12th

Psychoimmunology Expert Meeting in Germany.

Dickerson: A Doctor on the Move


Thomas Franklin, M.D., was recently

appointed the new

medical director

of The Retreat at

Sheppard Pratt, a

premier residential

treatment program on Sheppard Pratt‘s

Towson campus. Dr. Franklin previously

served as medical director of Ruxton

House, The Retreat’s transitional living

program designed for residents who

need more time before transitioning

back into the community.

Dr. Franklin is also a clinical

assistant professor of psychiatry at

the University of Maryland School

of Medicine and an advanced

candidate at the Washington Center

for Psychoanalysis. He is board

certified in Addiction Medicine

and Psychiatry and has extensive

experience in psychotherapy,

psychopharmacology, addictions,

and co-occurring disorders.

We also

welcome Miles Quaytman, M.D., as the new

associate medical

director for

The Retreat and

the medical director of Ruxton House.

Dr. Quaytman has been an integral part

of The Retreat’s treatment team for

eight years.

Meet the New Leaders of The Retreat at Sheppard Pratt

About The RetreatWITH JUST 16 LUXURIOUS BEDROOM SUITES, The Retreat is a private-pay program

that is host to a select group of patients from all over the world. The treatment team

has extensive expertise in working with professionals at a crossroads, young adults

desiring increased independence and personal responsibility, and adults facing

retirement and loss, problems in marriage, and other interpersonal difficulties.

It treats the full spectrum of mental health disorders including depression and

treatment-resistant depression, addictive

disorders, anxiety disorders, and borderline

personality disorder.

For more information about The Retreat,

call our program director at 410.938.3891.

Visit our YouTube channel at youtube.com/user/SheppardPrattHealth

to watch our Q&A session with Dr. Thomas Franklin.

The Retreat at Sheppard Pratt, our

premier residential unit, offers patients

seeking a private-pay, intensive, and

highly personalized assessment and

treatment program, a chance to make

meaningful progress toward recovery.

We offer an intermediate length of

stay of three weeks to several months

in a therapeutic milieu and provide nationally renowned expert care for depression, anxiety, personality, and addictive disorders. Our 12-year

anniversary marks a new era for The

Retreat with a new medical director,

Thomas Franklin, M.D., a more intensive

co-occurring disorders treatment track, and a recently renovated facility

that provides unrivaled comfort.

• Experienced psychiatrists lead

treatment teams and are involved

in patient care.

• Our expertise is in working with

professionals at a crossroads,

young adults, and adults facing

life-changing events.

• Residential treatment takes place in

an open, unlocked setting.

Expert Psychiatric Care in a Residential Setting

6501 N. Charles Street

Baltimore, MD 21204

410.938.3891 • retreatatsp.org


What is a complex trauma disorder, and when is it

considered complex vs. non-complex?

“Complex” trauma is a term that means that an individual

has experienced multiple traumatic events, and/or types of

traumatic events over multiple developmental periods, usually

childhood maltreatment and/or exposure to domestic violence.

In general, these traumas also involve a betrayal at the hands of

someone who should be trustworthy and on whom the person

depends: parents, teachers, clergy, coaches, et al. However,

complex trauma may also describe multiple adult traumas

under conditions of captivity and imprisonment such as victims

of sexual traffi cking and political torture and prisoners of war,

as well as soldiers subjected to multiple combat experiences,

particularly if they involve committing or witnessing atrocities.

Complex trauma reactions cut across diagnostic

categories and describe individuals who have problems with

attachment and relationships or regulation of their mood and

emotions; have a damaged sense of self or identity; have a

sense of alienation from their bodies; or have a core set of

beliefs that see the world as dangerous and untrustworthy.

But also these individuals see themselves as blameworthy for

the traumas they have suff ered and frequently have problems

with reckless behavior, suicidal and/or self-harmful behavior,

anger and aggression, and substance and/or alcohol abuse.

What is unique about the Trauma Disorders

Program at Sheppard Pratt?

Our Trauma Disorders Program is unique in that it is

designed to treat individuals with the types of complex

trauma and complex trauma reactions described in Question 1.

Our program emphasizes highly intensive individual and group

psychotherapy. All of our psychiatrists, psychologists, social

workers, rehabilitation services, and nurses are specifi cally

trained to work with individuals with trauma symptoms.

We have success in treating patients who have failed

treatment in community settings or have not responded

to treatment at other trauma treatment programs.

What is the single most pressing need facing

mental health care today?

The single most pressing need is the shocking and

scandalous lack of resources and funding for treatment of

psychiatric disorders. Because of this, there are more than

10 times the number of mentally ill individuals in prison cells

than in state hospital beds. This was the condition of American

mental health “care” in the 1830s, when the movement for

humane mental health treatment began, exemplifi ed by our

founder, Moses Sheppard.

These imprisoned individuals receive virtually no

treatment. Many other severely mentally ill individuals spend

days in emergency departments because no psychiatric beds

are available for them. Additionally, large numbers of mentally

ill children are unable to fi nd services due to a lack of child

mental health providers, the lack of funding for adequate child

mental health at the state level, and insurance companies’

policies that prioritize profi ts over mental health treatment.

Similarly, most public and private insurance does not provide

reasonable reimbursement even for adult inpatient and

outpatient services.

For more information on the Trauma Disorders Program

at Sheppard Pratt, call 410.938.3584.

3 Questions for Our Medical Director of the Trauma Disorders Program

1.

2.

3.

RICHARD J. LOEWENSTEIN, M.D., medical director, Trauma Disorders Program

Dr. Loewenstein is a senior psychiatrist and founder of the Trauma Disorders

Program. He lectures frequently and has received numerous awards for his

contributions to clinical studies of trauma and dissociation. He is a clinical

professor of psychiatry at the University of Maryland School of Medicine.

TRAUMA DISORDERS

NEUROPSYCHIATRY


THANKS TO a settlement with the

National Football League, every football

player today knows about the dangers of

a concussion, an all-too-common brain

injury that can result any time the head

is subjected to a sudden acceleration of

forces. Untreated or repetitively infl icted,

concussions can even result in death as

in the high-profi le tragedies suff ered by

several high school football players in

the past couple of years.

All of the media attention is helpful,

but because reporters tend to focus on

the consequences, too few people can

recognize the signs and symptoms of a

condition that, according to Centers for

Disease Control statistics on sports and

recreation-related injury, aff ects millions

each year. The sooner a concussion or

head injury is diagnosed, the better the

person’s chanc es of recovery, so it’s

important to know what a concussion is

and what to look for should you suspect

that you or someone you know may be

suff ering from a concussion.

A concussion is a type of brain injury

broadly defi ned as a bump, blow, or jolt

to the head that can lead to a variety

of physical symptoms, including

headaches, dizziness,

and fatigue. You don’t need to be

playing sports to suff er one; car

accidents, assaults, falls, and being

struck by a hard object can also lead to

a concussion or traumatic brain injury.

Concussions have been linked to sleep

disturbances such as too much or too

little sleep or diffi culty falling asleep. But

when emotional symptoms or diffi culty

thinking or remembering things are also

present, recovering from a concussion

may be even more challenging.

Studies have shown that sadness

or depression, irritability, and mood

swings may follow a concussion and

that concussions may also be linked

to diffi culty concentrating, recalling, or

absorbing information, which can cause

serious issues for people in a school

or work environment.

Who can help someone recover

from a concussion after the immediate

trauma or emergency has passed?

While physicians of varying specialties

may be helpful, you may also want

to consider seeking treatment from

a neuropsychiatrist who specializes in

the assessment and treatment of

patients with emotional or cognitive

problems that result after brain

injury, illness, or disease.

The Concussion Clinic at

Sheppard Pratt embraces a team-based

approach to care for patients who have

sustained brain injuries and are suff ering

emotionally and/or physically. The clinic

is available to patients at all stages of

healing from a brain injury or concussion,

whether the concussion was a recent

occurrence or was incurred several

weeks, months, or even years prior to

seeking treatment. The clinic also

collaborates with other medical providers

in an eff ort to facilitate rehabilitation from

a concussion in a way that works best

for the patient.

Concussions: A Serious Concern

To make an appointment

at The Concussion Clinic,

contact the Neuropsychiatry

Program at 410.938.4762.

MARGO LAUTERBACH, M.D.,

neuropsychiatrist and

director of The Concussion

Clinic, part of the

Neuropsychiatry Program

Studies have shown that sadness or depression, irritability, and mood swings

may follow a concussionand that concussions may

also be linked to diffi culty concentrating, recalling, or absorbing

information.

XXXXXXXXXXXXX

THE SHEPPARD PRATT HEALTH SYSTEM recently received

a donation of $2 million from Mildred Kern of Baltimore,

the largest individual donation to the health system since its

doors opened in 1891. For more than a century, the largest

donation to mental health and the health system came from

benefactor Enoch Pratt, a well-known American businessman

and philanthropist from Baltimore who donated $1.6 million

in 1896.

Mildred, a Baltimore resident and New York native,

was six days shy of her 105th birthday when she died on

June 9, 2013. Her donation will support child and adolescent

programs at Sheppard Pratt, with the intent to improve

opportunities for education and care for children in need.

To honor and commemorate Mildred’s generosity,

a plaque was dedicated in the lobby of the Weinberg Building

on Sheppard Pratt’s Towson campus on September 17, 2014.

You give. They heal.You make great things happen when you give to the Sheppard Pratt Health System.

Thank You for Your GenerosityDR. STEVEN SHARFSTEIN, president and chief executive

officer of Sheppard Pratt Health System, hosted

Sheppard Pratt’s annual donor reception at the picturesque

Sagamore Farm House on October 15. More than 70 of

Sheppard Pratt’s most generous donors enjoyed networking, refreshments,

and a short program at the historic Vanderbilt family farmhouse now

owned by Kevin Plank, CEO and founder of Under Armour.

For more information on supporting Sheppard Pratt,

contact Marguerite Kelley, director of philanthropy,

at [email protected] or 410.938.4018.

Our Largest Individual Donation Ever to Benefit Child, Adolescent Programs

From left: Dr. Steven Sharfstein, president and CEO of the Sheppard Pratt Health System, joins Morris Roseman, Mildred Kern’s friend and representative, Marguerite Kelley, director of philanthropy, and Byron Forbush, chairman of the board of trustees, at the Weinberg Building to honor Mildred’s generous gift.

2


Dr. Steven Sharfstein (center) thanks honored donors, from left: Stan Goldman of the Weinberg Foundation; Hosanna Asfaw-Means of CareFirst BlueCross BlueShield; Donn Weinberg of the Weinberg Foundation; and Pedie Killebrew of the Women’s Hospital Foundation who is also a Sheppard Pratt trustee.


PHILANTHROPY

ON SEPTEMBER 27, the Sheppard Pratt

Health System held its fi rst Sheppard

Pratt Stride, a one-mile walk and family

fun day that raised awareness and

funds to support the many Sheppard

Pratt programs that help patients and

students, their families, and those

aff ected by serious mental illness. The

event surpassed all expectations, with

more than 350 participants, many of

whom were Sheppard Pratt employees

and friends. More than $40,000 was

raised. Additionally, as a result of the

Stride, Sheppard Pratt connected with

more than 500 new donors.

In addition to the one-mile walk

around Sheppard Pratt’s main campus

in Towson, there were many family-

friendly activities, including moon

bounces, face painting, balloon animals,

a pre-walk warm-up routine, and zumba

lessons. Musical entertainment for the

day was provided by four Sheppard

Pratt employees.

The Stride’s top fundraiser was Tracy

Greenberg, a member of the Sheppard

Pratt Health System’s Consumer Council

who raised more than $4,000. A former

Dallas attorney, she moved to Maryland,

so that her son, Bryce, could receive

better care. Bryce is a fi fth-grade student

at The Frost School, which is part of the

Sheppard Pratt Health System.

“The fi rst Sheppard Pratt Stride

united our employees, patients, and

Sheppard Pratt donors and reinforced

support for mental health in Baltimore,”

said Dr. Steven Sharfstein, president

and chief executive offi cer of the

Sheppard Pratt Health System. “It is

with great eagerness that we look

forward to hosting the Stride next year

on October 3.”

Special thanks to Sodexo,

the 1st Sheppard Pratt Stride

presenting sponsor.

Sheppard Pratt Stride Debuts as Family-friendly Fundraiser

Walkers of all ages helped raise more than $40,000 in the fi rst-ever Sheppard Pratt Stride.

Tracy Greenberg, the top fundraiser, and her family attended the Stride.

WHAT ARE THE BENEFITS? WHAT ARE THE RISKS?

CIGARETTES cause more than 480,000

deaths annually in the U.S. Seventy

percent of smokers say that they

would like to stop smoking, yet only

4 to 7 percent of people are able to

actually quit. E-cigarettes have now

emerged in the market, bringing with

them new promises and questions.

Time will tell, however, whether they

will actually be able to break the

stronghold of combustible tobacco

products and become a true

“breakthrough technology.”

E-cigarettes are designed to

emulate the experience of smoking

and usually deliver a certain amount

of nicotine but without exposing the

user to the highly carcinogenic tar and

harmful carbon monoxide gas that

cigarettes emit. Many of them look

very similar to cigarettes but are often

larger and sport different colors;

while others look very different from

traditional cigarettes.

The e-cigarette market has

expanded exponentially to the point

where it has become a $2 billion industry.

There are now close to 500 brands of

e-cigarettes and 8,000 unique flavors.

There are substantial differences among

these varieties, so one needs to be

cognizant before one chooses to use

them or advise others to use them.

They are highly variable in quality,

appeal, and efficiency.

They have also added some new

terms to our lexicon. “Vaping” denotes

the inhalation of the vaporized solution.

“E-liquid” or “juice” is the liquid solution

vaporized by e-cigarettes; it usually

contains water, propylene glycol or

glycerin, nicotine, or flavorings. “Atomizer”

refers to the part of the e-cigarette

that heats the e-liquid for vaporization.

E-cigarettes either use refillable

cartridges or a refillable tank. (Adding

more e-liquid is called “dripping.”)

Proponents of e-cigarettes feel

that they are a viable harm-reduction

strategy, which can reduce morbidity

and mortality. This reduction, if achieved,

could be vital, as our existing methods

have yielded limited success. They also

feel that the amount of toxicants found in

e-cigarettes is significantly lower than

in cigarettes. Opponents, however, are

not convinced of their safety. They

argue that smokers should use current

evidence-based strategies. They

also think that e-cigarettes will act as a

“gateway” and that youth can get hooked

on nicotine from their use. Poison centers

have received more than 200 calls a

month this year for nicotine-related

poisoning, and more than half of these

cases involve children in accidental

poisoning. Both proponents and

opponents, however, agree that there

is a need for better regulations.

Robert West, an epidemiologist,

writes, “We have to accept that it will

probably be more than 30 years before

we would have a chance of being able

to use epidemiology to quantify risks

from e-cigarette use.”

Informing Ourselves About E-cigarettes

SUNIL KHUSHALANI, M.D., service chief of the co-occurring disorders inpatient unit and the adult day hospital

Dr. Khushalani is a clinical assistant professor at the University of Maryland

School of Medicine and serves as a physician adviser to the Stanley

Research Program at Sheppard Pratt. He has co-moderated a monthly

“Addiction Forum” at Sheppard Pratt since 2010.

ADDICTIONS


Catching Up with Dr. Edward ZuzartePROVIDING COMPASSIONATE CARE IN A SAFE ENVIRONMENT

Q. What is a psychotic disorder?

A. A psychotic disorder is when a person

starts to lose touch with reality and loses

the ability to function. They may believe

things that aren’t true or have unusual

sensations such as hearing things or

seeing things that impact their behavior.

We don’t know why it happens, but it

is a medical problem in the brain.

These types of mental illnesses

usually manifest in a person in their late

teens and 20s. Because there is such a

strong hereditary component, people

should be particularly cognizant of any

changes in behavior among family

members in this age group who have a

history of mental illness in their family.

Frequently, early symptoms such as the

person starting to smile to themselves

or mumbling under their breath are

overlooked by family and friends — but

these symptoms should not be ignored.

Q. What should someone do if they are concerned about a loved one?

A. The earlier a person is diagnosed

and receives treatment, the better the

person’s prognosis. You don’t want to wait

until a person experiences a nervous

breakdown to seek help. If you suspect

that something might be wrong, the best

thing you can do is talk to a health care

professional, whether a primary care

doctor, pediatrician, or school counselor.

You can also reach out to a reputable

mental health organization, like NAMI

[the National Alliance on Mental Illness].

Q. What is unique about the Psychotic Disorders Unit?

A. For our patients, we’re not just a unit,

we’re a setting where they can receive

innovative treatment in a safe, eff ective

environment. The continuum of care

we are able to provide our patients is

unique to Maryland. On our unit, we

provide 24/7 intensive and acute care.

Once a patient is stabilized, they are

able to move directly into Sullivan

Day Hospital and can reside at night

in a halfway house run by Mosaic,

one of our affi liates, also on our

campus. Our nurses and doctors

are all extremely dedicated to the

work we do and have been

providing compassionate care to

our patients for a very long time.

Q. If you could spend a day with any infl uential person, who would it be?

A. That’s easy: Steve Jobs. My favorite

[Jobs] quote: “The only way to do great

work is to love what you do.” This is what

I always remember as life throws me

hurdles — I love what I do, my colleagues

love what they do, and we come here

each day to treat our patients and help

them get well.

Visit our YouTube channel to hear more

from our interview with Dr. Zuzarte:

youtube.com/user/SheppardPrattHealth

Dr. Edward Zuzarte, service chief of the Psychotic Disorders Unit, has worked at

Sheppard Pratt for more than 15 years, specializing in helping those with psychotic

disorders, such as schizophrenia and bipolar disorder, heal and recover. He also off ers

outpatient services through Mosaic Community Services, Inc., and is NAMI Metropolitan

Baltimore’s 2014 Frances J. Lentz Mental Health Professional of the Year.

MEET OUR DOCTOR

6501 N. Charles Street

Baltimore, MD 21204

410.938.3000

ALLEGANY

WASHINGTON

FREDERICK

MONTGOMERY

CARROLL

HOWARD

ANNEARUNDEL

PRINCEGEORGE’S

CA

LVE

RT

CHARLES

ST. MARY’S

BALTIMORE

BALTIMORECITY

HARFORD

CECIL

KENT

QUEENANNE’S

TALBOTCAROLINE

DORCHESTER

WICOMICO

GARRETT

WORCHESTER

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focused on helping you sheppardpratt.org

THESE FOUR SHORT, SIMPLE WORDS

succinctly and powerfully sum up exactly

what we try to do for each and every person

we touch and can be applied to all programs

and departments that comprise our vast

health system throughout Maryland.

SOMERSET

heal. Winter 2015

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Transcript of heal. Winter 2015