The History of Mental Health Treatment

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The history of mental health treatment is a long story. The first private hospitals, known as almshouses, for those with severe symptoms of mental illnesses and the infirmed elderly, were created in the early 18th century. In the early 19th century, a new idea about care for the mentally ill called “moral treatment” emerged, which focused on the belief that kindness and quietness in treatment would help with recovery.

In the 1840’s, Thomas Kirkbride developed the “Kirkbride Plan” for moral treatment that included sunshine, fresh air, privacy and comfort. Throughout the 1850s and ’60s Dorothea Dix traveled throughout the country promoting this approach. By the 1870s virtually all states had such asylums. By the 1890s, private almhouses were sending people to the asylums. This influx overwhelmed both space and resources of the asylums and threatened their attempts at humane treatment. 

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An Occupational Therapist’s Top 5 Outdoor Work Tips

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Planning on getting some work done outdoors? Keep these tips from Occupational Therapist Sam Penkala, O.T.R.L. in mind.

  1. Examine your body mechanics of the shoulder when your arms are elevated.
  • Above the shoulder internal rotation can cause irritation in the shoulder called shoulder impingement
  • Try to avoid internal rotation of the shoulder, essentially making a thumbs down motion
  • Keep your arm activity below the shoulder, if possible
  • Take breaks, especially if above the shoulder activity is necessary, to give your muscles a chance to rebound, and analyze the effect your task is having on your body

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What’s Wrong with My Vision?

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Having trouble seeing things clearly? Is it difficult to watch TV, scroll on your phone, look at your computer, read a book or complete close-up tasks such as cross-stitching? Does it make you dizzy when you try to do any of these things? Have you been told you have a lazy eye? Does it seem like your glasses aren’t working well? Has your eye doctor told you there’s nothing wrong with your current glasses prescription?

If you’ve answered yes to any of these questions, you may have a problem with your visual or vestibular system, such as a condition of convergence insufficiency or unilateral or bilateral vestibular hypofunction.

The visual sensory system consists of the receptors in our eyes that detect light and the colors of objects, and the ability to have fine discrimination and visual acuity through the pupil. In other words, it helps us see things clearly.

The oculomotor system is a motor component of the eye function. It helps bring targets onto the fovea, found in the pupil, and keeps the targets on the fovea. This system uses six muscles that we have in each eye to move the eye in all positions. The eye movements perform two functions. First, it holds the image on the retina, and second, it allows the gaze or focus to be shifted.

One of the two functions of the eye movements is that it holds the images in the retina. There are three ways that oculomotor control works with eye movements to hold images onto the retina.

  • Visual Fixation: Where the retina holds the image of a stationary object on the fovea while your head is stationary, for example, reading a posted sign while standing to look at it.
  • Vestibular Ocular Reflex: Where images of the seen world are held steady on the retina during brief head rotations, for example, following a flying insect or animal.
  • Optokinetic Reflex: Where images of what we see in the world are held steady on the retina during sustained low frequency head rotation, such as driving and looking out the window at passing objects or reading.

The second function of the eye movement allows your gaze to be shifted. There are three types of gaze shifting.

  • Smooth pursuit: Holds the image of a moving target on our eyes
  • Saccades: Where there is rapid movements of the eyes, for example, when we’re watching a tennis match
  • Vergence: Moving the eyes in opposite directions to provide depth perception such as when reading a book or looking at your computer or phone.

Vestibular hypofunction occurs when the vestibular nerve is not responding to movement at an accurate rate. The person experiencing this can feel “off,” dizzy, unbalanced and may have trouble focusing. Vestibular therapy and exercises can help with these conditions.

Occupational Therapist Dawn Wylie, O.T.R.L., is a vestibular and balance specialist and part of MidMichigan Health’s Rehabilitation Services team. She sees patients in Alma.


5 Reasons Why Wounds Don’t Heal

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There are four key phases for a wound to heal successfully:

Infographic showing five common reasons why wounds don't heal: poor circulation, diabetes, infection, nutrition deficits and repeat trauma to the wound site.

[click image to enlarge] Specialized Wound Treatment Centers have better outcomes because they bring together many disciplines to not only treat wounds, but also to address the underlying barriers to healing.

  1. Hemostasis – clotting to control bleeding.
  2. Inflammation – swelling occurs as helpful materials are transported to the wound site and invasive microbes are pushed out.
  3. Proliferation – a protective layer of tissue is formed.
  4. Remodeling – rebuilding of tissue and revascularization and reorganization of the new tissue to function like the surrounding tissue.

Any factors that interfere with one or more of these phases can prevent wounds from healing. Some of the most common factors include:

  1. Poor Circulation – Oxygen and materials needed for healing can’t get to the wound site. Dead cells and harmful materials can’t be carried away.
  2. Diabetes – Diabetes interferes with healing in many ways, including lower oxygen levels, weaker immunity and decreased ability to form new skin cells and blood vessels. Diabetic nerve damage can also make it harder to sense a wound and seek treatment.
  3. Infection – Harmful bacteria can prolong inflammation and prevent new
  4. Nutrition Deficits – Wounds need energy, protein and other vital nutrients to heal.
  5. Repeat Trauma – Wounds on feet, moving joints and any body parts that may easily get bumped, rubbed or pressured are more susceptible to reopening.

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Reducing the Stigma of Mental Illness

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May is Mental Health Awareness Month. Many people in modern society seem to have a perception that the world is divided into two categories when it comes to mental health conditions; those who have them and those who don’t. This mentality leads to all sorts of problems, including stigma.

 According to the American Psychiatric Association a stigma is a pervasive negative perception of people with mental health conditions. They identify three types of stigma:

  • Public stigma – the negative attitudes others have concerning mental health disorders
  • Self-stigma – the negative attitude one has about their own mental health, which can show up as internalized shame
  • Institutional stigma – includes government or organizational policies that limit opportunities for those with mental health conditions, either intentionally or unintentionally

Humans have a tendency to divide the world into ‘us’ and ‘them,’ no matter what the topic is. People will put down ‘them’ in some way, to perceive ‘them’ as not as good as ‘us.’ This is true for mental health conditions as well as many other characteristics. Mental health issues have additional complexities involved with the perception.

Often people are uncomfortable with mental illness because they don’t understand it. Mental health conditions can result in behaviors that look bizarre or seem strange to some people. This is especially true for psychotic disorders. But people are often uncomfortable even with symptoms related to depression or anxiety, which are very common disorders. This may be because when people put all mental health conditions into one category and that category is associated with bizarre behavior they are likely to want to avoid it.

When people divide the world into two categories and perceive the ‘other,’ those with a mental illness, as somehow strange, they are not only perpetuating stigma and setting themselves up to treat others poorly, but they are also putting themselves at risk to feel shame when they, themselves, may struggle with a mental health condition, which they are likely to experience at some point; according to the World Health Organization, 46 percent of people will experience a mental health condition at some point in their life.

When people feel ashamed of their mental health status or repeatedly hear messages that they should feel shame, it’s less likely they’ll seek the care they need. According to the Centers for Disease Control and Prevention, embarrassment is one of the many barriers that stop people from seeking treatment. In fact, only about 20 percent of adults with a mental health condition actually seek treatment. 

There are many things people can do to reduce stigma. It begins with each person looking at how they think about mental health conditions. Instead of compartmentalizing the world, it is useful to recognize that every person is human and all humans have struggles at times. Sometimes these struggles interfere with functioning. When this disruption of functioning is great enough it may be diagnosed and may benefit from treatment.

People can also talk about it. Being open and honest about your own mental health can help others feel comfortable opening up about what they might be going through. People need to be careful with words. Using real mental health conditions as negative adjectives sends a message that those diagnoses aren’t taken seriously and aren’t worthy of seeking treatment for.

People should educate themselves. Learning more about mental health conditions and available treatments can help people to be better prepared to help friends and family by recognizing symptoms of mental health conditions, and recognizing and accepting in themselves.

There is no shame in seeking help for a mental health issue. In fact, seeking treatment is a commitment to yourself and for everyone you love. Recognizing that there is no shame in mental health struggles will result in reduced stigma and increased compassion for yourself and others.

All humans have struggles; it’s part of the human condition. Recognizing this can help people to be honest and accept others, and themselves, without shame.    

For those who are struggling, MidMichigan Health provides a Psychiatric Partial Hospitalization Program at MidMichigan Medical Center – Gratiot. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit


Group Therapy at Senior Life Solutions

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With May being Mental Health Awareness month, I would like to take this opportunity to introduce myself and the services we offer at Senior Life Solutions. We provide group and individual therapy for an older adult population. We provide these services in person or by using a telehealth platform.

Due to COVID-19, mental health challenges have been on the rise in the senior population. This can be due to many factors, but isolation and loneliness appear to be two of the largest contributing factors. If you know or are an older adult struggling through this pandemic, there is help available. Many people feel ashamed, anxious or embarrassed about entering group therapy. This is normal. But for most people, even after one session they feel that they have been heard by their peers and understood by people that are going through very similar situations. 

Things that you might have noticed about yourself or a loved one like changes in appetite, sleep patterns, not enjoying the things in life that you used to enjoy or giving up on hobbies, can all indicate emotional distress. These are all symptoms of depression that many people mistake for “normal aging.” 

Grief is another issue that affects seniors. If you have recently lost a spouse, family member or loved one, your life might be feeling out of control, hopeless or meaningless.  It may feel like you are going through all of this alone or that no one could possibly understand. I have had many people say similar statements to me when they first start this program. 

But the truth is, there are many people who have gone through and are going through what you are experiencing right now. That is where the power of group therapy comes in. Recognizing your story in another person can give the feeling of hope and that recovery is a possibility. 

For some people, “the golden years” are not as golden as they should be. With the COVID-19 pandemic, it can seem that there is no way to get out to attend a program like this. This is where telehealth plays a huge role. We are able to offer these services and you are able to attend group from your home. Telehealth has been a real game changer during this pandemic as it has allowed people who otherwise would not be able to attend group and individual sessions get the help that they deserve. 

If you or someone you know could be helped by our services, call our office at (989) 246-6339 and we’ll guide you from there. On a personal note, I have been the program therapist since the beginning, and I’ve had the opportunity to work with many people and see the improvements that people make as they progress through the program. I feel blessed that I have the opportunity to play a part in people’s lives changing for the better.

David Bailey, L.M.S.W., is the program therapist for Senior Life Solutions.


Don’t Let a Wound Limit Your Summer Fun

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One of the best parts of summer is spending time outdoors with family and friends. Whether you enjoy backyard cookouts, picnics at the park or swimming at the pool, lake or beach, you should take extra care to help identify and prevent common summer skin wounds.

Check for Wounds on Your Feet and Legs Every Day

This is especially important for people living with diabetes, vascular disease or other coexisting health conditions that may affect the body’s ability to heal. A small blister can quickly develop into a non-healing wound. Puncture wounds have a high rate of infection. Seek medical care if you have a wound that is not healing or shows signs of infection such as redness, fever or chills.

Prevent Bug Bites and be Aware of Allergies

Most insect bites are harmless and can be avoided with bug repellent and protective clothing. If you have a bug bite, use a topical anti-itch cream to avoid scratching your skin. Watch for signs of an allergic reaction. Seek emergency care if you are experiencing chest pain, difficulty swallowing or breathing, nausea, cramps, vomiting or severe swelling.

Protect Against Sunburn and Skin Cancer

Skin cancer is more common than all other types of cancer combined. You can help prevent cancer and sunburn with the right sunscreen, clothing and shade. Mild sunburns can be treated with over-the-counter remedies. Seek medical attention if you experience chills, dizziness, rapid breathing, nausea, extreme thirst, faintness or a rash.

Avoid Summer Shoes Like Sandals or Flip-Flops

Choose supportive shoes with closed toes and flat heels. Sandals, flip-flops and other open-toed styles do not provide good support and often cause blisters. Always wear socks. Ask your physician or podiatrist to check if your shoes are a good fit.

Seek Specialized Wound Care

A non-healing wound can limit your ability to enjoy your summer. If you are living with a health condition, such as diabetes, vascular disease, obesity or advanced age, you may be at greater risk for chronic wounds. The longer a chronic wound goes without proper care, the greater the risk of infection, hospitalization and amputation.

This article was originally published by Healogics, Inc. Through a partnership with Healogics, MidMichigan Health is able to offer expanded specialized wound care and hyperbaric oxygen therapy. Healogics is the nation’s leading wound care management company, providing high-quality wound care and consulting services to more than 500 hospitals across the United States. Member hospitals have access to advanced healing technologies including hyperbaric oxygen therapy (HBOT) management.


Understanding Neuroscience of Trauma for Effective Healing

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It is common knowledge that past traumas change people. It is well known that trauma increases the chance of anxiety and depression, and disrupts functioning in a number of ways. But it may not be so common to think about how this change happens. It is through changes in our brain that trauma disrupts our thought patterns, emotions and behaviors. Recent research has dug deep to understand the details of these changes and what needs to be done to heal the brain so that we can experience less disruptive symptoms. According to researcher Jennifer Sweeton PsyD, M.S., M.A., ( the goal of therapy is to change the brain.

There are several areas of the brain that become overactive or underactive because of traumatic experiences. These are then manifested in disruptive symptoms. The primary area that becomes overactive is the amygdala. It is the ‘smoke alarm’ of the brain. It asks, ‘Is this dangerous?’ Working with the memory center, it determines if something is dangerous and begins the stress response, which can be experienced as anxiety, or any of many physical symptoms. It also suppresses the higher thinking. When someone has repeated dangerous events the amygdala can become overactive and hypersensitive, resulting in an overreaction to even small events that would not normally be considered dangerous. When the amygdala completely hijacks the rational thinking it can cause a blackout or amnesia.

To heal from trauma the amygdala needs to be calmed and relearn what is truly dangerous, and what is not. This can be done within a safe therapeutic setting where the person learns to turn off the danger signals and can think through triggers that had set them off, to relearn that they are not really a threat.  

There are several areas of the brain that become underactive due to repeated trauma. The hippocampus is one of these areas. It is the storage area for autobiographical memory. It is the memory center that the amygdala works with to decide what is dangerous. With repeated trauma there can be atrophy in the hippocampus, which can cause memory problems. People can help the hippocampus to stop sending danger signals by working with memories that used to feel dangerous, learning that they are not dangerous. Bringing the memory up in a safe environment, and doing something with it, like telling the story, can reduce the sense of danger, because every time we remember something we remember the last time we remembered it, not the original, so we are reconsolidating each time. The hippocampus can also be strengthened with physical exercise, Omega 3 and meditation.

Another area of the brain that is underactive after repeated trauma is the insula. The insula is the part of the brain involved in awareness of the body and internal states including emotions. During trauma people learn to turn this awareness down or off as a way to protect themselves from the pain, either physical, sexual or emotional.  Turning it down can become a habit resulting in the feeling of numbness or, when turned off completely, can cause dissociation. Spikes in insula functioning can create flashbacks. This area of the brain needs to be on for healing to happen. Low insula functioning is the main reason attempts at therapeutic change fails, according to Dr. Sweeton. Use of sensory awareness exercises like movement, stimulation and mindfulness exercises can improve insula functioning.

Two more areas that are underactive after repeated trauma are the cingulate cortex and the prefrontal cortex. The cingulate cortex is involved in emotional regulation and decision making. The prefrontal cortex is the center for rational thoughts, goal-making and decision-making. When the amygdala senses danger it deactivates both of these areas. When the amygdala is over sensitized and habitually turned on, then both of these decision making areas are chronically turned off. They need to be activated to make good decisions. They can be strengthened with cognitive work, like talk therapy, once the insula has been activated and the amygdala has been calmed in a safe environment.  

It is more clear than ever that trauma in a person’s past has real changes in their functioning based on the direct effect of the trauma on the brain. It is also clear that there are many positive and effective treatments that can improve a person’s life and functioning. These therapeutic interventions are generally done within the support of individual therapy. Some people have found self-help tools that address many of these symptoms. For those who need more support than either of these approaches MidMichigan Health provides a Partial Hospitalization Program at MidMichigan Medical Center – Gratiot. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit


Adjustment Disorders

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All humans face stressful life events. Sometimes these stressful events are navigated with little difficulty. At other times they cause troubling symptoms. Adjustment Disorder may be diagnosed when a stressful event triggers symptoms. An Adjustment Disorder is a psychological response to stressors that results in clinically significant emotional or behavioral symptoms.

This may include a decrease in performance at school or work, substance use, changes in relationships and somatic complaints. Somatic complaints are complaints about the body including pain, nausea, headaches and body aches, which often have no medical explanation. This reaction to the stressful event is marked by distress that is in excess of what would be expected given the nature of the stressor, or causes a significant impairment in social or occupational functioning.

When these emotional or behavioral symptoms develop within three months from the onset of the stressor it may be an Adjustment Disorder. Symptoms may be present for several weeks and may last up to several months. The Adjustment Disorder may be considered acute when symptoms last less than six months, or chronic when longer than six months. They may occur at any age.

Adjustment Disorders are relatively common and require an identifiable stressful event that can be of any severity. This is different than Post-Traumatic Stress Disorder, which is a more familiar, but less common diagnosis that requires the presence of an extreme stressor.

Examples of the variety of triggering stressors that may lead to Adjustment Disorder include:

• Single events, like a termination of a relationship

• Multiple stressors, like business difficulties or marital problems

• Recurrent stressors, including seasonal problems at work

• Continuous stressors, like living in an area where there is frequent crime

• Developmental events, like getting married, becoming a parent, or going away to school

Adjustment Disorder may include emotional symptoms, like a depressed mood or anxiety, or both. It can also include disturbances of conduct, like angry outbursts or lying. Or, it can include both disturbances of emotions and conduct.

Adjustment Disorder is considered a short-term illness. With time and proper treatment it is likely to resolve and allow the person to return to their normal functioning. The treatment of Adjustment Disorder may include both medication and therapy. Often therapy alone can be effective in helping the person to improve their ability to cope with the stressor. These improved coping skills often include learning to use support systems more effectively, changing negative thinking and changing unhealthy behaviors.

The setting for such therapy may include outpatient therapy with a counselor or psychologist. Or, for more severe cases, it may include an Intensive Outpatient Program (IOP) or a Partial Hospitalization Program (PHP). IOP treatment is generally three hours of therapy three times a week. PHP treatment is six hours of daily therapy five times a week. It is rare that Adjustment Disorder requires inpatient psychiatric treatment. The needed level of care is determined by the severity of the symptoms and the amount of disruption to the person’s functioning. No matter what level of care a person needs there is no reason to feel ashamed for seeking treatment. Part of being human is leaning on other when there are struggles. And all humans struggle at times.

MidMichigan Medical Center – Gratiot has a Psychiatric Partial Hospitalization Program (PHP) for those who need this level of treatment. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit


The Power of Our Creativity for Our Mental Health

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Over the past century it seems that every type of creative activity has grown into a type of therapy. The first four decades of the 20th century were particularly productive. While music therapy was first noted as early as 1789, its first professional organizations were founded between 1903 and 1926. Art therapy and dance/movement therapy were first promoted in the 1940s with professional organizations following 20 years later.

There are strong reasons why these creative endeavors became recognized as therapeutic. But one does not need to be, or see, a professional to gain from some therapeutic effects of the creative process. Integrating some creative activity into daily life can give many of the same benefits.

The creative process is often thought to be related to artistic activities, but in reality creativity can occur in any area. This idea has been presented by psychologist Howard Gardner who introduced the theory of multiple intelligences during the last quarter of the 20th century. He stated that every area of intellectual development is an opportunity for creativity. This includes linguistic, logical/mathematical, spatial, bodily-kinesthetic, musical, interpersonal, intrapersonal and naturalist.

The essence of creativity is not the modality within which one works, but the process of using the imagination to produce original ideas. It is this process of making new connection that appears to have the therapeutic effect, whether it is in music, words, movement or mathematics. Participating in creative activity stimulates the brain by making new neurological connections, which improves the mood and increases mental flexibility, improving problems solving skills.   

Some of the benefits that have been noted in research are seen in all the areas, others are area specific. Some benefits are physical. Research suggests that music can improve respiration, lower blood pressure, improve cardiac output, reduce heart rate and relax muscle tension. Dance and movement can reduce the body’s stress response, enhance disease prevention and improve coordination and mobility. Creative activities can give a boost to the immune system.

Some effects are social, emotional or psychological. Research indicates that participating in visual art production can improve communication, improve concentration and help reduce feelings of isolation, as well as increase self-esteem, confidence and self-awareness. Therapeutic effect of dance and movement include improved mood management. Participating in the creative process in any form can help people focus, discover a sense of happiness and reduce burnout. The creative process nurtures emotional and social growth.

Trying a creativity activity may seem a bit intimidating to some people. This is likely because our society has created an artificial division between “artist” and “non-artist,” with the latter somehow being less gifted. Therefore, people don’t see themselves as creative and end up denying their own creativity. While it is true that there are people who decide to become professional artists, and there is a wide variety of talent, everyone has the capability of using their imagination in creative ways. And everyone can benefit from it with improved mental and physical health.

Those who need additional help to overcome mood disorders are encouraged to seek help. The Psychiatric Partial Hospitalization Program (PHP) mental health day program at MidMichigan Medical Center – Gratiot is available for those who need additional support. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit