heal. summer 2015

UNDERSTANDINGADDICTION

HELPING ADULTSWITH AUTISM

A WORKSHOP IN AFRICA

PLUS

healA publication of the Sheppard Pratt Health System • SUMMER 2015

Breaking New Ground

After a $4 million renovation,

the Steven S. Sharfstein, M.D. Integrated

Health Care Center is completed.

Breaking New Ground

After a $4 million renovation,

the Steven S. Sharfstein, M.D.

Integrated Health Care

Center is completed.

3 Helping Adults with Autism Spectrum Disorder

6 Understanding Addiction

7 Progress Report: Medication Management in the Dementia Population

8 In the News/Calendar

10 Out of Africa

12 Philanthropy: You give. They heal.

13 Raising Autism™: A Family Aff air

15 Meet Our Team: Behavior Specialists Remy Chappell and Thomas Flis

4

heal. is published four times a year by the Marketing Department of the Sheppard Pratt Health System, one of the nation’s top mental health programs, providing compassionate solutions to help those suff ering from mental illness and addiction recover and get back to their lives. 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 specifi c to your personal health, medical treatment, and medical conditions.

Editor/Director of Marketing & PR Jessica Kapustin

Outreach & Project Manager Chelsea Soobitsky

Design, Production & Editorial Mid-Atlantic Custom Media

Cortney Geare, Jeni Mann,

Geoff rey Melada, and

Suzanne Pollak

Contributing Photographers Brian Glock, Patti Prugh,

and David Stuck

On the cover.Steven S. Sharfstein, M.D., and Jeff Richardson cut the ribbon at the dedication of the new Steven S. Sharfstein, M.D. Integrated Health Care Center.

Photo by David Stuck

Connect with us.

CMYK / .epsCMYK / .eps

CMYK / .eps

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

In this issue. SUMMER 2015

4

10 12

If you wish to have your name removed from the list of those receiving communications from Sheppard Pratt Health System, please email the Marketing Department at [email protected] or call 410.938.3133.

This issue of heal. is dedicated to the late Czarina (Rina) Santos-Borja, M.D., director of geriatric services

at Sheppard Pratt Health System who died in April of a sudden cranial aneurysm. She was a distinguished

member of our medical staff and a long-standing part of the Sheppard Pratt family. We will never forget

her determination, brilliant smile, and kind heart.

sheppardpratt.org • heal. 3

ADULT PSYCHIATRY

SHEPPARD PRATT marked Autism

Awareness Month this past April by

reopening our seven-bed Adult

Neuropsychiatric Unit, which provides

inpatient treatment for adults with

developmental and/or intellectual

disabilities, including those diagnosed

with Autism Spectrum Disorder

(ASD) who are having an acute

psychiatric emergency.

This new unit, which I am privileged

to lead, is the only inpatient unit of its

kind in Maryland and one of only a

handful in the country to specialize in

treating patients with severe psychiatric

and behavioral problems. It was fi lled to

capacity in its fi rst weekend of operation.

Because some of the patients are

nonverbal, diagnosing and treating mood

disorders or other mental illnesses in

this population can be diffi cult. Finding

psychologists and nurses specially

trained to treat this patient population’s

needs is, admittedly, a challenge. But

meeting a need is the core of what we

do at Sheppard Pratt.

To give you a better sense of that

need, one in every 68 children is

diagnosed with ASD today, a number that

has increased from 1 in 88 just two years

ago, according to the U.S. Centers for

Disease Control and Prevention.

As a result, programming and resources

must keep pace, or an enormous

burden falls on the caretakers. This

need is particularly acute with the adult

population, as they age out of the

programs and services that were once

available to them when they were part

of the educational system.

Despite these challenges, it was

critically important for us to move

forward with this venture. And yet the

opening of this new unit is just the

beginning. In terms of securing

state funding and program

development to serve this

adult population, there

remains much work to

be done.

Helping Adults with Autism Spectrum Disorder RECOGNIZING AN URGENT NEED, SHEPPARD PRATT OPENS ADULT NEUROPSYCHIATRIC UNIT

ROBERT WISNER-CARLSON, M.D.

Robert Wisner-Carlson, M.D.,

is service chief of the Adult

Neuropsychiatric Unit and

medical director of The

Developmental Neuropsychiatry

Clinic, part of the Neuropsychiatry Program at

Sheppard Pratt. A graduate of University of

Michigan Medical School, he trained in psychiatry

at The Henry Phipps Psychiatric Clinic at Johns

Hopkins Hospital and at Maudsley Hospital in

London. He holds specialty certifi cation in

Behavioral Neurology and Neuropsychiatry from

the United Council for Neurologic Subspecialties.

4 heal. • Sheppard Pratt Health System

FEATURE/SHEPPARD PRATT

W hen Kelly Damon finished

a year-long, state-run

rehabilitation program, she walked

away with a certificate, a 30-day supply

of medicine, and nowhere to go.

Six months later, Damon overheard

someone talking about Mosaic

Community Services. She went there

that very day, beginning what became

an eight-year relationship that she

believes saved her life.

The 51-year-old Baltimore native

started using drugs when she was 19 and

soon became addicted to heroin. She

had attempted suicide six times. But

through Mosaic’s classes and therapies,

she said she has learned to control her

anger, better deal with her family, and

even lose 70 pounds.

“Mosaic’s integrated care combines

a range of services — including

psychiatry, addiction, primary care, and

pain management — in one facility,

making it easier for its clients to get the

help they need,” said executive director

Jeff Richardson. That approach has

paved the way for Mosaic, part of the

Sheppard Pratt Health System since

1995, to become Maryland’s largest

community-based behavioral health

services provider.

Today, that growth continues,

with the reopening of The Harry and

Jeannette Weinberg Building in May,

including a new $4 million integrated

health care center on North Charles

Street in Baltimore. The Steven S.

Sharfstein, M.D. Integrated Health

Care Center is named for the

president and CEO of Sheppard Pratt

Health System.

Sharfstein, who will step down from

his leadership position in July of 2016 but

continue to be involved in clinical work,

has presided over a period of exponential

Breaking New Ground BY SUZANNE POLLAK

AFTER A $4 MILLION RENOVATION, THE STEVEN S. SHARFSTEIN, M.D. INTEGRATED HEALTH CARE CENTER IS COMPLETED

Steven S. Sharfstein, M.D., and Jeff Richardson cut

the ribbon to officially open the new center.

The writing’s on the wall: Community members gathered in May to dedicate the newly launched Steven S. Sharfstein, M.D. Integrated Health Care Center.


growth for Sheppard Pratt — from the

single hospital he joined in 1986 to

a health system today spawning

38 locations throughout Maryland.

When he started, Sheppard Pratt

had 850 employees and a $40 million

annual budget. It now has 2,700

employees and a $350 million annual

budget. The health system, which

had 1,000 admissions in his first year

and extremely long lengths of stay,

now provides services for 10,000

admitted patients and another

70,000 outpatients annually.

About 27,000 people received

assistance from Mosaic last year.

Although numerous therapies

and medications designed to treat

mental illness have been developed

since Sharfstein began his psychiatry

career in Boston more than 40 years

ago, there is still much to learn in the

field, he said.

For one, scientists are only

beginning to understand the workings

of the brain, he said. Removing

the societal stigma attached to

mental illness remains a critical

priority. Increasing funding

is another.

“We still struggle with

these illnesses,” Sharfstein said.

“They are poorly understood.

We do a good job, but we can

do better.”

The building opened in 1959

and was renovated to include the

brand new center that bears his

name in an effort to redesign its

space to accommodate the needs of the

clients by offering a variety of services

under one roof. Mosaic offers patients a

team-based approach, coordinating care

for its clients among professionals in

different fields.

Statistics show that, on average,

people with mental health problems

die 25 years earlier than the general

population largely due to treatable

medical conditions. Mosaic is battling

this early mortality rate

by embedding primary

care into a behavioral

health setting so that

people coming in with

mental health and

addiction issues, for

instance, can access

services to help stop

smoking, lose weight,

and make other

behavioral changes.

Mosaic treats

a wide range of

people, from those

who need immediate

hospitalization to

others who can

best be helped

with short-term interventions. It provides

medical and psychiatric services, as

well as residential, vocational, and

crisis services. “We will go to a bridge.

We will go to a hospital. We go to

where the people are, where they live,

wherever and whenever they need us,”

Richardson said.

The goal is to do more than treat

a discrete illness by guiding individuals

back into society.

Damon said she has been clean

and sober for more than eight years

now. She believes Mosaic is successful,

because “they actually take time out

to find out what’s wrong with you.

They talk to you, not at you.” She tried

other programs and failed. Mosaic

was different.

“They don’t talk down to you,

and I never had a program that did that.”

Damon lives with her husband in

Mosaic housing and has a part-time job

helping a child with special needs learn

in an integrated classroom setting. She is

taking care of herself, too. Her weight

loss has enabled her to control her blood

pressure. She is no longer suicidal.

If not for Mosaic, she said, putting

it bluntly: “I don’t think that I’d be here

right now.”

Jeff Richardson, Mosaic’s executive director and Steven S. Sharfstein, M.D., Sheppard Pratt’s president and CEO.

Kelly Damon uses Mosaic’s classes and therapies to help take charge of her life.

Mosaic treats a wide range of people, from those

who need immediate hospitalization to others who

can be best helped with short-term interventions.


THE RETREAT

DENISE CONNELLY, LCSW-C, CAC-AD

Denise Connelly is a licensed clinical social worker and certifi ed addictions

counselor at The Retreat at Sheppard Pratt. She holds bachelor’s and

master’s degrees in social work from the University of Maryland.

WHAT sort of person do you picture

when you think of a drug addict or an

alcoholic? Film and television give us

caricatures — a homeless man, collapsed

in an alley, clutching a bottle wrapped

in a brown paper bag.

The truth is that most people who

suff er with drug addiction or alcoholism

cannot easily be spotted in a crowd.

In fact, chances are good you know

someone who has a substance use

disorder. Addiction aff ects every ethnic

group, gender, and tax bracket.

Most people are introduced to

alcohol or drugs by someone close to

them, an infl uencer — a parent, sibling,

or friend. Some unwittingly become

addicted after taking prescription

medications lawfully prescribed by

their doctors.

The reasons people abuse drugs

and alcohol also vary. Some fi nd

temporary relief from emotional and

physical pain or from boredom and

loneliness. For others, they simply like

the way substances make them feel, at

least until addiction takes hold.

Addiction, which includes

alcoholism, is a brain disease. It is not a

moral defi ciency. The American Society

of Addiction Medicine defi nes addiction

as a chronic disease of the brain

characterized by impairment in behavior

control and an inability to consistently

abstain from cravings. Along with these

symptoms, addicts experience signifi cant

problems with interpersonal relationships

and dysfunctional emotional responses.

Addiction does not happen

overnight. It is a progressive

disease. How quickly one becomes

an addict depends on a number

of factors, both genetic and

environmental. No one signs up to

be an addict or alcoholic. And once

the brain is altered from addiction,

recovery is not simply a matter

of “Just Say No!” As a disease,

addiction requires intervention

like any other.

There is good news:

Recovery from addiction

is possible.

Like addiction itself, though,

recovery is a process — not a single

event. Inpatient, intensive outpatient,

and outpatient substance abuse

programs are fi rst steps on that path.

In early recovery, medications are

available to help patients combat

powerful, physical urges to return to

substance abuse, while self-help

groups such as Alcoholics Anonymous,

Narcotics Anonymous, and SMART

Recovery provide emotional support.

When used in tandem, these treatment

approaches work.

Because addiction is a process,

some people will experience setbacks or

even relapses along the way. People who

have never experienced addiction or

seen it up close sometimes struggle to

understand this. “Why can’t you just

stop?!” they ask.

If only the solution were that simple.

Because the reality is more complicated,

it is important for family and friends

to educate themselves about addiction

and recovery. Al-Anon, Alateen, and

Nar-Anon are self-help programs for

people coping with someone else’s

addiction or alcoholism.

If you, or someone you know is

using substances, ask for help — doing

so is not a sign of weakness. It takes

courage to pick up the phone, or to walk

into that fi rst meeting. But you can do it.

And when you do, know this: You will fi nd

an entire community of professionals and

recovering individuals there who

understand you, support you, and are

ready and willing to help you.

Understanding Addiction

GERIATRIC SERVICES launched an

initiative in 2013 to more safely and

eff ectively manage agitation on the

Geriatric Neuropsychiatry Unit at

Sheppard Pratt. There is good

progress to report.

During the course of an 11-month

period, a 90 percent reduction in the

frequency of agitation was shown in

the rate of antipsychotic use for the

management of behavioral and

psychological symptoms of dementia.

How did we get there? Studies have

shown an increased risk of side eff ects

with uncertain benefi ts for some elderly

patients with symptoms of dementia

being treated with antipsychotic

medication. In the face of that evidence,

Centers for Medicare & Medicaid

Services launched a broad eff ort to

reduce the use of these medications

among this patient population.

As part of our LEAN methodology

program that focuses on continuously

improving and eliminating waste, the

geriatric services team at Sheppard Pratt

fi rst implemented a new process in the

pharmacy order system calling

for physicians and team members to

re-evaluate the way they document

behavioral symptoms and communicate

with each other. For example, instead

of recording a patient’s symptoms

generally as “agitation,” the team began

listing more specifi c symptoms such as

exit-seeking, kicking, or insomnia. This

greatly improved communication among

staff deciphering records and created

process effi ciencies. An increased focus

on documenting nonpharmacological

interventions — such as art, music, and

exercise therapies — also helped convey

the benefi ts of these activities, so they

were used more often.

The process improvements resulting

from this project continue to be in eff ect

at Sheppard Pratt.

Ultimately, our hope is to advance

fi ndings and share them with the greater

health care community to encourage

increased safety and eff ectiveness in

managing medication among loved ones

in this elderly dementia population.

Sheppard Pratt’s geriatric services

serve older adults experiencing clinical

depression, anxiety, severe forgetfulness,

and other mental health problems. These

services include two inpatient units,

outpatient care, and off -site medical

daycare services.

The staff members who were

part of this project included myself,

Emily Draper, Rochel Friedman, Sheila

Harvey, Dr. Robert Roca, the late Dr. Rina

Santos-Borja, Sheila Underwood, and

Susan Wolski-Vincenzes. This team was

awarded a 2015 Minogue Award for

Patient Safety by the Maryland Patient

Safety Center.

Progress Report: Medication Management in the Dementia Population

During the course of an 11-month period, a 90 percent

reduction in the rate of agitation was shown in

the rate of antipsychotic use for the management

of behavioral and psychological symptoms

of dementia.

DR. JOSHANA GOGA

Joshana Goga is a pharmacist and clinical specialist with Sheppard Pratt

Health System. She is also an assistant professor at the University of

Maryland School of Pharmacy.

GERIATRIC PSYCHIATRY


Some of the staff from the Geriatric Neuropsychiatry Unit who participated in the project.

IN THE NEWS

PHILANTHROPIC EVENTS

2nd Annual Sheppard Pratt Stride

Saturday, October 10, 2015

Save the date for this family-fun

event complete with music,

games, and more.

EDUCATIONAL CLASSES

Dick Prodey Lecture Series

Sponsored jointly by The Kolmac Clinic,

Sheppard Pratt Health System, and the

National Council on Alcoholism and

Drug Dependence of 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 information.

Continuing Education:

Wednesdays @ Sheppard Pratt

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.

Two Doctors, Two Generations: Medical Ethics Then and Now

July 8, 2015

Barron H. Lerner, M.D., Ph.D.,

professor, Department of Medicine

and Population Health,

Lagone Medical Center

Please Join Us in Congratulating• DR. STEVEN SHARFSTEIN, president and CEO of Sheppard Pratt Health System,

for receiving a 2015 NAMI Exemplary Psychiatrist Award.

• DR. HARRY BRANDT, co-director of The Center for Eating Disorders at Sheppard

Pratt, for being selected by the readers of Chesapeake Family as one of their

Family Favorite Doctors.

• BONNIE LINK, program coordinator and teacher at Hannah More School, and

VERA ROTH, career and technology education director at The Forbush School at

Glyndon, for being recognized as recipients of this year’s Unsung Hero Award

by the Reisterstown/Owings Mills/Glyndon Chamber of Commerce.

Student Shows Poster at Annual Child and Adolescent ConferenceCONGRATULATIONS to Jenna Michelle

Jackson, a student at The Jefferson

School at Finan Center, whose artwork

was selected as the Maryland Coalition

of Families for Children’s Mental Health

Awareness Week poster for this year.

The poster was unveiled at a reception

on March 24 during the annual statewide

Child and Adolescent Conference.

Exemplary Physicians HonoredTHE SECOND RECIPIENTS

of the Michael Edelstein, M.D.,

Physician Humanitarian Award

were announced at Sheppard

Pratt’s annual Doctor’s Day

Luncheon on Thursday,

April 2, 2015. More than

80 nominations were received for

the award, which recognizes physicians who dedicate their time to fulfilling the

needs of patients in a selfless and extraordinary way. Congratulations to Dr. Khizar

Khan and Dr. Edward Zuzarte for being recognized as this year’s winners.

Mark Your Calendar!For a complete listing of events, continuing

education classes, and lectures,

visit sheppardpratt.org/calendar-events.

stride

Dr. Khizar Khan Dr. Edward Zuzarte


Acceptance and Commitment Therapy July 22, 2015

Jesse M. Crosby, Ph.D., administrative

director, Office of Clinical Assessment

and Research, OCD Institute,

McLean Hospital

Value in Mental Health Care: What Is It and Who Decides?

August 5, 2015

Robert P. Roca, M.D., M.B.A., M.P.H.,

vice president and medical director,

Sheppard Pratt Health System

How Can Biological Measures Help Guide Diagnostic Classification in Psychiatry? A Focus on Psychotic Illnesses September 9, 2015

Godfrey D. Pearlson, M.D., professor

of psychiatry and neurobiology, Yale

University School of Medicine

The Bad Mother in American Psychiatry: Where She Came From, Why Her Story Still Matters

September 30, 2015

Anne Harrington, Ph.D., director of

undergraduate studies, Department

of the History of Science,

Harvard University

CONFERENCE EXHIBITING

Throughout the year, Sheppard Pratt

Health System and its programs exhibit

at a number of conferences and

community events. Make sure to stop

by our booth if you plan to be at any

of these.

NASW MD 10th Annual Clinical Conference

September 24-25, 2015

Linthicum Heights, Maryland

Diamonds in the Rough 2015Conference for families, educators, and professionals working with students with special learning needs

September 26, 2015

Rockville, Maryland

5th Biennial Trauma Conference Kennedy Krieger Institute

October 1-2, 2015

Timonium, Maryland

ISTSS 31st Annual Meeting

November 5-7, 2015

New Orleans, Louisiana


The Mann Residential Treatment Center (RTC) Residents Lend Hands, Help the HungryAS PART OF an initiative created by occupational therapy interns at Mann RTC,

residents within this program have been spending time in the community helping

others. The girls units provided care packages

to families at the Baltimore Ronald McDonald

House, and the boys unit visited Moveable

Feast, a local food pantry, and made more

than 600 sandwiches for those in need. We are

proud of the work this program is doing to give

back and support our local community.

Sheppard Pratt Sponsors Art Exhibit to Promote Mental Health AwarenessTHIS MAY, Sheppard Pratt was a proud sponsor of the Maryland Coalition for Mental

Health Awareness’s Third Annual Art Exhibit, which took place on May 7th at the American

Visionary Art Museum. In addition to helping sponsor the event, which showcases artwork

created by behavioral health consumers to eradicate stigma surrounding mental health,

Sheppard Pratt also sponsored artwork created by a patient of The Neuropsychiatry

Program at Sheppard Pratt.

Recognized ExcellenceSHEPPARD PRATT received

awards for both our logo

design and Heal magazine in the

2015 Aster Awards competition,

which recognizes the nation’s

most talented healthcare marketing

professionals for outstanding

excellence in advertising.

IN THE NEWS

Interns at Mann RTC.


SHEPPARD PRATT

What was the purpose of the trip

to South Africa?

Desmond Kaplan: This trip was a further

step in the work we’ve done with the

Capetown community. We wanted to

focus on what we felt were the real

needs of the community. This wasn’t a

fancy academic conference; it was a free

conference that was sold out every day

for five days.

Telemedicine has allowed us to

expand our reach on a local, national,

and international level. For the purposes

of this project, we used our telemedicine

equipment to video conference with

those in South Africa, which helped

us open the lines of communication

and understand the needs of their

community before we even arrived.

What inspired each of you to get

involved with this project?

Mark Rapaport: Look at it from the lens

of what we do here. We forget how much

expertise we have in our own little world

at Sheppard Pratt. This was a chance to

bring that knowledge someplace where

they were willing to hear what we have to

say, and, in the end, it was very beneficial

for us and the participants. And it was

a chance to get the Sheppard Pratt name

out there, on a truly international level

and show people what we stand for.

Eunice Dube: Having come from the

region, and having worked there as a

nurse, I have an idea of what health care

services are like, so to be invited to

participate in this really big, educational

component of our health services,

was inspiring.

Desmond Kaplan: The issues in inner

city Baltimore are not that different from

what goes on in the shanty towns with

drugs, alcoholism, and poverty.

How is the mental health landscape

different in South Africa from in the

United States?

Eunice Dube: There is a lack of enough

qualified psychiatrists, and too many

patients to care for.

Desmond Kaplan: Just to give you some

perspective, in South Africa there are

70 million people and approximately

20 child psychiatrists. In the United

States, we have 350 million people and

8,600 child psychiatrists. In South Africa

they are producing just two child

Out of Africa

From left: David Pruitt, Tamara Maresky, Desmond Kaplan, Rene Nassen, Patti Prugh, and Eunice Dube.

Spray-painted mural by Juma Mkwela, Khayelitsha Township, South Africa.

IN ORDER TO ADDRESS the mental health needs of those living in the underserved

communities of the Western Cape of South Africa, a joint South African/U.S.

child and adolescent mental health alliance was recently established among

the University of Cape Town, Stellenbosch University, Columbia University, the

University of Maryland, and Sheppard Pratt Health System.

The inaugural project was a five-day child and adolescent mental health

workshop that took place this past March, in which three Sheppard Pratt

employees and two University of Maryland employees participated and led many

of the lectures, workshops, and clinics. The workshop was free and open to all

mental health and allied professionals.

In their first debriefing with Sheppard Pratt since returning from the workshop,

the participants reflect on their experiences in South Africa, the inspiration for this

collaboration, and where they see it headed.


psychiatrists a year, and, in the United

States, we are producing 800 a year.

Mark Rapaport: On the trip, I went to

several schools for children with autism

and related disabilities. There were 27

children in a classroom with one teacher

and then a couple of people who were

not trained. In contrast, in our schools, we

put a lot of time into training, even for the

noncertified and non-disciplined staff.

On the units, the modality and delivery

of services was lacking.

David Pruitt: Their public health thinking

was actually more sophisticated than

ours here in the United States, because

they have to look at the whole and find

the issues they want to intervene on. But

there is a large gap between the private,

public, and academic centers; they’re

much more siloed there because of the

lack of resources.

Patti Prugh: When I was really on

the ground, I found that the frontline

workers who do not have formal training,

the work that they would do was so

sophisticated and really

targeted at what we felt

were the important topics

for this community.

And while that disconnect

is there within their

system, there’s been

a back door for addressing

the issues through the

para-professionals.

I wouldn’t have known that

without having spent time

going to the presentations

for domestic violence that were going on

directly in these little community

organizations, in the shacks.

What happens next?

Desmond Kaplan: One of the nurses

from South Africa is coming in June to

Sheppard Pratt to visit, and I’m going

to South Africa in August to work on

a project in Johannesburg, and one of

the focuses will be telepsychiatry.

Patti Prugh: People are asking us

for help with grants writing, how to

formulate their concept into something

they can convey to a funder. Teaching

this skill isn’t something that has to

happen in South Africa; it can be done

long distance using telemedicine.

David Pruitt: I would hope that, whatever

we do, we layer on to the good work

that’s already been created. Telemedicine

is a remarkable technology, and it can

help us, but I still think the group coming

together and creating the experience

we had was key.

What is your biggest take away

from the trip?

Patti Prugh: I did not know that I had so

much that I could give that would be

meaningful for others.

Laurel Kiser: I walked away with an

appreciation of the universality of the

issues that we’re dealing with. The recent

protests in Baltimore have made these

parallels all the more real. The magnitude

of the issues and the problems and how

we can intervene to help people is just so

critical at this point. One of the things I

heard in South Africa was that it’s not very

often that someone from the United

States comes over and talks about

poverty here and draws those parallels.

David Pruitt: I took away the

relationships, both internally and once

we were in Cape Town. I really did feel

I learned more than I taught which

is remarkable. Because of those

relationships, I think it’s sustainable.

Mark Rapaport: The relationships.

As much as I think we gave, we were

able to receive. It was not a one-way

process. The need to go back and do

more is another take-away.

Desmond Kaplan: This get-together

has made me dream big. I’d love to

create an institute of international child

mental health through Sheppard Pratt

and the University of Maryland. There’s

an enormous amount of work to be

done, and the world is getting smaller

through technology.

From Sheppard Pratt: Desmond Kaplan, M.D., service chief of the Child and Adolescent Neuropsychiatry unit and medical director of the Telepsychiatry

Program; Patti Prugh, senior art therapist and rehabilitation services coordinator; Mark Rapaport, M. Ed., principal/education director at The Forbush School at

Prince George’s County and special education teacher on the Child and Adolescent Neuropsychiatry unit. From the University of Maryland School of Medicine:

Laurel Kiser, Ph. D., M.B.A., psychologist and associate professor in the Department of Psychiatry, University of Maryland School of Medicine; David Pruitt, M.D.,

child and adolescent psychiatrist, director of the Division of Child and Adolescent Psychiatry, and director of Telepsychiatry, University of Maryland, Baltimore.

From the VA Baltimore: Eunice Dube, R.N. Also participating in the collaboration: From Columbia University: Christina Hoven, Ph.D.; From Hershey Medical

Center: Fauzia Mahr, M.D.; From the Psychiatric Institute of Washington: Michael Bogrov, M.D; From Tel Aviv University: Alan Apter, M.D.

Monica “Momma” Duda conducting a frontline domestic violence workshop in Khayelitsha Township, South Africa.


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

SHEPPARD PRATT HEALTH SYSTEM PHILANTHROPY

Join us for a family-fun day to raise awareness and funds to support Sheppard Pratt

programs that help patients and students, their families, and those affected by

serious mental illness.

SAVE THE DATE for the 2nd Annual Sheppard Pratt StrideSaturday, October 10, 2015Sheppard Pratt Health System’s Towson Campus

stride

SHEPPARD PRATT HEALTH SYSTEM hosted its

23rd Annual Care for Kids Benefit on March 21 at the

Four Seasons Hotel Baltimore. More than 400 donors and

community members gathered at the disco-themed gala,

which raised money to provide essential supplies and

therapeutically beneficial activities to our 20,000 pediatric

patients and students. It was the most successful event

to date and raised over $300,000!

RECORD-BREAKING BENEFIT

To see more photos from the Care for Kids

Benefit, please visit facebook.com/

SheppardPratt. You do not need an

account to view the pictures. Save the

date for next year’s event on April 2!

QUESTIONS regarding the Sheppard Pratt

Stride or the Care for Kids Benefit can be

directed to the Office of Philanthropy at

[email protected] or 410.938.4020.

SPECIAL EDUCATION

THE CHERRY FAMILY knows autism.

In 1996, Cathy and Michael Cherry

traveled to Russia to meet Matthew for

the first time. They quickly found

themselves interacting with a 3-year-old

whose actions could only be described

as chaotic. Once in the states and old

enough for a diagnosis around age 3,

Matthew was shown to have autism

spectrum disorder (ASD), bipolar disorder,

attention deficit hyperactivity disorder

(ADHD), obsessive compulsive disorder

(OCD), and fetal alcohol syndrome.

Later, with two other children in the

household, Jason, the middle child, and

Samantha, the youngest, the Cherry

family began a lifelong journey to

understand autism and to raise a family

with compassion, patience, and, most

importantly, humor.

We recently sat down with Cathy,

principal of Purposeful Architecture and

Purple Cherry Architects, and her middle

son, Jason, now 18 and the exclusive

professional race car driver of the Autism

Society of America (ASA), to find out a bit

more about their journey and to share

their advice on navigating family life

with a child with special needs.

Disability is a household eventAccording to Cathy, one of the greatest

challenges to life with a child on the

autism spectrum or any other special

need, is realizing that it impacts

everyone in the house. Says Cathy,

“You don’t just raise a child with autism;

you raise a family through autism.”

By the time Matthew was in second and

third grade, home life was tumultuous.

It was a highly structured environment in

school, but not at home, and things only

got worse as Matthew hit puberty.

In sixth grade, Matthew began attending

The Hannah More School in Reisterstown,

Md., part of the Sheppard Pratt Health

System, where he progressed and did

well in the school setting for about

five years.

Through this process, the family has

learned that you must look at home and

school settings together. Children with

special needs require more time to

transition to adulthood. Ensuring that

they have both life and social skills is key

to establishing their independence.

The Cherrys have also learned

not to feel guilty about actively finding

respite for the entire family, however

they have to go about accomplishing

this. Often, the family would break

apart mealtime, sometimes feeding

Matthew at a different time to avoid

conflict. According to Jason, the family

“has not been afraid to take breaks

and to operate atypically as a family.

We’ve looked past the commotion and

frustration inherent to Raising Autism™

to find the humor in life.”

Parents have no frame of reference when their first born is a child with special needsWhen Matthew was about 13 years

old, he became more physically

aggressive and had very poor judgment,

especially as it came to safety. Cathy

understood that Matthew never wanted

to intentionally harm other children, but

he had such poor judgment that she had

concerns for the safety of the whole

family. Then conflict started happening

among the siblings.

“As a parent, when your first-born

child has special needs, you have no

frame of reference for what behaviors

and social skills may be typically

developing,” says Cathy. “Without any

prior parenting experience, I could not

determine what was autism, what was

adolescence, and what was just being

a boy.” Not until her second son,

Jason, was 8 did she finally gain a better

understanding of what was neurotypical

development. During these early years,

as Cathy was learning how to manage

Matthew’s challenges, her younger two

children experienced events that were

scary to them. When Matthew pulled a

knife on his aide, it created a year-long

fear in Jason, then about 7, which

manifested as anger and defense.

Raising Autism:™A Family Affair

Matthew and Jason Cherry.


SPECIAL EDUCATION

Samantha, who was much younger,

would deflect her feelings in response

to the fear. Jason went to private

counseling to learn how to cope with his

anger. And Cathy learned that she

needed to take Matthew’s audience

away when he was becoming aggressive.

“Sometimes I turned off the lights in the

house and other times, I honestly had to

place him outside on the lawn to remove

him from a space where he could harm

himself and others,” explains Cathy.

Humor is the best remedyIt took years for the younger siblings to

get past their anger and resentment. But

once they did, and once Matthew started

maturing, the family was left with humor

to help piece the relationships back

together. Matthew is usually the one

generating the humor, sometimes on

purpose and other times by accident.

Cathy and Jason remember one time

when Matthew was stung by a bee

because he picked it up. When they

asked him why he would ever do

something like that, his response:

“Because I wanted to see if I was

worthy of holding a bee.” Says Cathy,

“Developing such a great sense of humor

has empowered all of us with a level

of patience that we would not have

developed otherwise.”

Full disclosure is vitalOne of the biggest mistakes parents

make, in Cathy’s opinion, is to hide the

realities of how difficult the situation is

and to make it seem that everything is

wonderful. For the Cherry family, it’s been

very important to fully disclose

everything that they’re going through, the

good and the bad, so that they can

receive the maximum support they need.

When Matthew was 17, the family

knew it was time to seek residential

treatment for him. He would throw huge

fits, running across the room and

slamming his entire body into the

window. He’d throw himself into shower

doors. Cathy says, “We fixed the wall 10

times. He was hospitalized three times.

When it happens too much, you’re

overwhelmed.” And every member of

their support team needed to know what

was happening at home.

Now that Matthew is in a residential

environment, he composes himself

better and is more comfortable. He can

be home for two or three days at a time,

and the family is able to enjoy that time

together. According to Cathy, “When he

got into residential treatment, it allowed

the whole family time to begin healing.”

Be proactiveWith the siblings now 15, 18, and 23, the

family, especially Cathy and Jason, has

used the knowledge and patience

they’ve learned from raising and growing

up with Matthew, to help others with

special needs. As principal of Purple

Cherry Architects, Cathy started receiving

calls to work on special needs projects.

She began creating living, learning, and

vocational environments locally, but

knew she could do more. This led to the

development of Purposeful Architecture,

a nonprofit arm of her firm dedicated to

creating spaces where children and

adults with special needs can thrive.

Purposeful Architecture allows Cathy

to marry her expertise in architecture

with her experience working with

individuals with special needs. She can

truly understand goals and provide

compassionate solutions to impact these

environments. “It’s what’s important to

me now,” she says.

Jason chose to use his career

as a race car driver as a springboard to

support ASA. Says Jason, “When I was

growing up with Matt as my brother, I was

embarrassed to have friends come over

the house, and so I would ride my dirt

bike a lot.” I then got into auto racing and

began pro road racing. With 50,000 to

150,000 people in attendance at each

race, and millions of viewers watching

at home, Jason wondered, “What can

I do with all of this attention? I saw an

opportunity to speak as a sibling of

autism, so I partnered with the Autism

Society.” As the exclusive professional

race car driver of ASA, Jason works with

its local affiliates to host families with

special needs at each of his races. He is

working to form an ASA sibling board for

the next generation of leaders who will

eventually represent their autistic siblings.

Today, the relationship among

all three siblings is healed. A video on

Jason’s YouTube channel shows true

love and friendship between the

brothers. Jason’s best advice to other

siblings is to “be patient, give it time,

things will come full circle. In the

moment, you don’t think anything will go

right — I thought that for years. Looking

back on it, I can attribute a lot of my

success to my brother and to dealing

with the challenges and adversity.”

Jason Cherry can be reached through his

website, jasoncherryracing.com, or through his

Facebook page. To learn more about Cathy

Cherry’s Purposeful Architecture firm, visit

purposefularchitecture.com.

“ Without any prior parenting experience, I could not

determine what was autism, what was adolescence,

and what was just being a boy.” — Cathy Cherry


Get to Know Our Behavior SpecialistsCREATING POSITIVE BEHAVIORAL CHANGES IN OUR PATIENTS

MEET OUR TEAM

Q. What is a behavior specialist?

A. Chappell: Behavior specialists look

at behavior to determine why a person

is doing what they are doing. There is

a reason behind every behavior, and

we try to fi gure that out by looking at

environmental infl uences to determine

the cause of the negative behaviors and

to break the cycle and replace with and

reinforce new, positive behaviors.

Flis: For example, an individual who is

unable to communicate verbally may be

hitting his head against the wall because

he has learned that every time he wants

or needs something, hitting himself in the

head has gotten the attention he wanted.

Our goal is to try to manage problem

behavior and to teach adaptive behaviors.

Q. What types of patients do you

work with?

A. Chappell: On 1H, we work with

children with neurodevelopmental issues,

including autism spectrum disorder (ASD),

Down’s syndrome, traumatic brain

injury (TBI), and intellectual disabilities,

among others. In addition to working with

children, we also work with their families,

bringing them to team meetings, showing

them what has worked and what hasn’t;

it’s the key to reinforcing the positive

behaviors once a child leaves the unit.

Flis: Remy and I are the only two behavior

specialists at Sheppard Pratt. On A7,

I work with adults with developmental

disabilities, including ASD, genetic

disorders, TBI, and intellectual disabilities.

The adult population is diff erent than the

child population, because sometimes

these adults have had problem behaviors

for a long time, so it is much harder to

break those behaviors.

Q. How do you work with patients once they leave to ensure they continue practicing the positive behaviors you have taught them?

A. Chappell: Our biggest challenge

is our time limitations, as patients are

only on our units for about two weeks,

and we’re aiming to accomplish a lot

in a short time.

Flis: Modifying behavior is a long-

term process for people on and off

our units. We perform numerous

assessments, work to create intensive

behavior plans, and determine

what works and what doesn’t

work for our patients.

It takes continuous

reinforcement to make

a behavior stick.

Chappell: We also work

to connect caretakers

with outside resources for

in-home support, like an in-home

therapist.

Q. What do you love most about your job?

A. Flis: Many of our patients want to be

able to express themselves, but because

of their illness, they’re not able to. It’s

amazingly rewarding when we’re able to

manage a problem behavior and then

teach a new, adaptive behavior that

allows them to be more independent

and express their feelings.

Chappell: For me, it’s working with

families who are really invested and want

our help and accept our feedback. Those

are the kids that get better and stay better

and stay out of the hospital. That makes

it all worth it.

Remy Chappell has worked since 2008 as a senior behavior specialist on 1H, the Child and Adolescent

Neuropsychiatric Inpatient Unit. Her colleague, Thomas Flis, a 12-year veteran of Sheppard Pratt, serves as a senior

behavior specialist on A7, the new Adult Neuropsychiatric Unit, having previously held the same position on 1H.

The following are highlights from a conversation with these two professionals dedicated to achieving

positive behavioral changes in our patients.

To learn more from our behavior specialists, visit our

YouTube channel: youtube.com/user/SheppardPrattHealth

CMYK / .eps

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

★ ★

★

★ ★

★★

★★

★

★★★

★

★ ★

★★★

★★

★

★

★★

★

★★

★★★★

★

★

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

NON-PROFIT ORGU.S. Postage

PAIDMechanicsburg, PA

Permit No. 63

Share Your Story With UsShare with us your memorable story from your time with Sheppard Pratt, and help us fi ght stigma.Please contact us at 410.938.4466 or [email protected].

heal. summer 2015

Documents