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June 27, 2011

Mental health clinic opens to execs

Photo/Jason P. Smith Meadow Wood, a new mental health facility in Bangor, caters to high-level executives and others searching for discreet ways to get treatment, says Allen Schaffer, chief medical officer of The Acadia Hospital
By Jackie Farwell

The stigma associated with seeking mental health services deters many people from seeking help, but for high-level executives and professionals, the potential career repercussions add yet another layer of anxiety.

A new service in Bangor called Meadow Wood is serving those professionals, drawing business and community leaders with its “ultra discreet” approach and individualized treatment. In an indication of the value its clients place on anonymity and confidentiality, the majority of Meadow Wood’s patients travel more than an hour one-way to their appointments, seeking help with substance abuse, stress, cognitive decline, family trouble or other mental health issues, and most pay out of pocket.

Launched 10 months ago, the service is located just a mile down Stillwater Avenue from The Acadia Hospital, Bangor’s primary mental health facility. Both operate under Acadia Health Care Inc., but while several of the hospital’s physicians make up Meadow Wood’s psychiatric staff, the service is purposefully distinct from the hospital. Its financial and medical records systems are separate, as well as its phone system. For the business people, attorneys, physicians, clergy and others Acadia initially surveyed about the service, not being tied to Acadia Hospital proved paramount. “They don’t want to go to a place that’s a psychiatric campus,” says Allen Schaffer, Acadia’s chief medical officer.

Meadow Wood grew out of tragic death in the area’s medical community. A prominent physician committed suicide, later prompting his family to request that a confidential facility be created outside of the public mental health system, Schaffer says. Outlying hospitals also spoke of residents with mental health and behavioral issues who refused to come to Acadia, further evidence that such a facility was needed, he says.

Seeking anonymity

Located in a nondescript building on Gilman Road near the Bangor Mall, Meadow Wood serves dozens of patients, Schaffer says. With a few other office and retail buildings in the same plaza, patients can travel the road without worrying that someone will see them and deduce where they’re headed.

Patients, a mix of men and women generally over 40, enter of one three suites, each with its own separate entrance and waiting room, for sessions that are staggered to avoid awkward encounters with other patients. Most are referred to Meadow Wood through networking and word of mouth, though the service has been marketed directly to hospitals, law firms, the state chamber of commerce and professional associations. “The reaction I get is, ‘Wow, Maine doesn’t have anything like this,” says Rick Redmond, director of business development for Acadia Hospital.

As an outpatient-level service, Meadow Wood doesn’t treat more serious mental health conditions, though it does offer neurological evaluations. “In this type of setting, we can’t see people in really acute crisis,” or at the height of drug withdrawal, Schaffer says. Meadow Wood’s two-part psychiatric evaluation, lasting a combined two-and-a-half hours, represents most patients’ first experience with mental health services, he says. “In most cases, it’s not just a single evaluation,” Schaffer says. Patients return for weekly, monthly and quarterly visits, or sometimes less frequently, often during the evening hours. “People in this professional group have tight schedules,” Schaffer says. “We try to work with that.” Plus, “we can see a patient within a week.”

Still, many patients carve time out of their hectic schedules to drive from all corners of the state for their appointments; the furthest lives six hours away. And it’s not only the sessions that require the utmost privacy. “A surprising question was, ‘Can you tell me of a confidential pharmacy where I can get my prescription filled?’” Schaffer says.

The premium placed on confidentiality also means Meadow Wood forgoes insurance billing, a process many patients fear leaves them vulnerable to discovery by HR departments or through national databases. Patients can file for reimbursement with their insurance companies, however. “Only one or two have asked for documents to file on their insurance,” Schaffer says. “Many people pay by cash.” Additionally, Meadow Wood’s medical records system is inaccessible to other records systems, he says.

Patients are also concerned about another potential opportunity for discovery: licensing boards. Professionals in the medical, pharmacy and law fields are often required to disclose if they seek mental health treatment, raising fears of a blow to their professional and social standings. “If someone sees all of that at stake, they are likely to defer getting help,” Redmond says.

The Americans with Disabilities Act prohibits discrimination on the basis of mental health, but many sufferers fear it’s not enough. In 13 states, license questionnaires for physicians have been revised to ask whether the applicant has a general disability, rather than a mental disorder, says Paula Clayton, medical director for the American Foundation for Suicide Prevention. License applications for medical doctors and osteopaths practicing in Maine ask specifically about treatment for substance abuse and mental illness.

Physicians are often reluctant to get help, for fear of being discovered by their colleagues, among other reasons, she says. The suicide rate among women doctors is particularly high compared with male doctors. Executives have similar concerns about causing alarm among their co-workers for seeking mental health help, she says. Clients might wonder, “Can I really trust him with my money if he has a drug problem?” Clayton says. “It’s not just personal exposure, it’s professional.”

Suicide rates have risen significantly since 2000 for those aged 45 to 64, an age group that corresponds with high levels of professional achievement. The rate for the 45-54 age group, at 17.7%, is the highest since 1977, while the rate for those aged 55 to 64 is the highest since 1990 at 15.5%.

Today’s economic pressures and job loss clearly play a role, Clayton says. Unemployment can prove more devastating later in life, especially with the loss of retirement benefits, she says. Executives and other professionals in leadership roles should remember that even Abraham Lincoln struggled with mental health issues as a depressive, Clayton says. “Depression is a genetic illness,” she says. “You can have everything and still be depressed.”

 

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