Worth Reposting

I posted this a few years ago.  But this year's batch was really good, so it seemed worth posting again.

Swedish Rye 

(makes 1 full size or 4 small loaves of bread)

First make the sponge:
Scald 1 cup of milk (whole is best, but skimmed works for those of you counting cholesterol)
Pour it onto a mixture:

• 1 tablespoon butter (can substitute margarine)
• 1/4 cup honey
• 1.5 tsp fennel
• 1.5 tsp instant coffee
• 1/4 tsp salt (can omit, if you want)

While the mixture is cooling, add 1 packet of yeast to 1/4 cup of lukewarm water, and let it bubble. Add it to the scalded milk mixture after that mixture has cooled to lukewarm.
Then add:

• 3 tablespoon sugar
• 1.5 tsp orange peel
• 1/4 tsp ground cloves
• 1 cup of rye flour
• 1 cup of whole wheat flour
• 1/4 cup white flour.

Stir with a wooden spoon for 100 stirs and then leave the sponge to rise for 1-2 hours.

Then make the loaf:

Add 2 cups of white flour to the sponge, gradually kneading until firm and consistent.  Usually takes about 10 minutes for the whole loaf, and another 5 minutes if you choose to break it into small loaves.  Once your loaves are ready, let them rise in a warm place for an hour or two.

Baking:

Preheat oven to 350 degrees.

Bake 50 minutes for full-sized loaf, 28 minutes for small size loaf.

Cool on rack, and then:

Devour with honey or peanut butter (also makes a mean grilled cheese sandwich).  Both the making and the eating of this bread will improve your mental health.  

A view from the ground in Newtown

Been reading lots about Newtown CT.  We have to build something-  that's how we cope with loss.  At a national level, we are talking about building new rules about guns, improved access to mental health services and the like.  But we really need to build something local, in Newtown, something that builds community.

Came across this really interesting post on Facebook.  It's long, and could use editing, but it speaks from the heart.  Check it out here.  He is putting together a plan for Community Garden, as a means of building community.  To quote:

For those who want to know more about this project or feel compelled to give to this specific action, it can be done here: http://www.indiegogo.com/projects/299050/x/1590232 More info is being added to the campagin as it is formalized.

Other ideas?

Reflections on NewTown: Now It is Time to Do.

Been a week now, since the news started to come out of Newtown, a place not far from where I was born and raised.  A week of tears, a week of anger, a week in which I watched the pediatric community wake and notice that, all of a sudden, children were important.  I was very proud of my two professional organizations, as they took stands that move them down a political path that is focused on children and will help bend the arc of history toward justice, just a little bit.  Check out here and here;  we are starting to move.  We will do something about guns of mass destruction,   we will do something about mental health services and we will remind people about the power of non-violent conflict resolution.  It's going to be a journey.  There is much work to do.

Haven't blogged much over the past few years.  This seems a good time to start up again.  We'll see where this goes. If you didn't see the President call us out, you should.

The more things change....

Massachusetts has lots to be proud of in the approach that the Commonwealth has taken to the implementation of the CBHI, with the acceptance of behavioral health screening in the pediatric office to the establishment of mobile EMH services throughout the state (nobody else is even thinking about that one!).  We are innovators, on the cutting edge of high quality services for children with serious emotional disturbances.

And yet....

Why do I get a call from an intensive treatment program about one of my patients, telling me that the child's psychiatrist left in October, that they have not identified a new one for this patient, and ask that I write prescriptions for his/her three psychotropic medications.  Why have I heard nothing about this patient for 8 months, while his/her psychiatrist manages his/her meds, and, upon leaving, assumes that I will continue the meds?  How do I monitor the effectiveness of therapy, when I have no evidence of this child's current diagnoses?  How do I monitor side effects, when I have never heard of one of the medications?  This is the sort of thing that intensive case management is supposed to prevent;  why did it fail my patient?

We build systems that are supposed to work.  We hope that this sort of thing is happening less frequently than before.  And we recognize that there are likely still a few bugs in the system.

Happy New Year!

Teen Screen is quoting me now.

Kind of cool to be quoted.  Thanks, TeenScreen.
----------------

From the Boston Globe : Kinda wish I had been there.

Yesterday in the Globe-  reminded me how long it takes to get anything done.

Summit focuses on children’s mental health By Patricia Wen
December 13, 2011

It was billed as the Children’s Mental Health Summit, the second in a decade, and its organizers hoped it would inspire as much passion for reform as the debut gathering did in 2001. Among the issues addressed by top officials in Boston yesterday were the high rate of psychotropic drugs consumed by the state’s foster children, poor insurance coverage of family-based services, and the relatively high percentage of substance abuse among Massachusetts teens. The keynote speaker, Pamela Hyde, an Obama appointee who heads the Substance Abuse and Mental Health Services Administration, also spoke about the growing awareness that trauma -- including domestic strife, neighborhood violence, and bullying -- undermines children’s mental well-being.…The closing talk came from US District Court Judge Michael Ponsor, who issued the 2006 landmark ruling, referred to as the Rosie D. case, which required the state to offer intensive home-based mental health services for children on Medicaid with serious emotional disturbances. “Serving the needs of children with mental health problems, especially poor children, is not for the faint of heart, or for people overly fond of cheap thrills and immediate gratification,” Ponsor said in his written remarks. “It is a very long-term commitment.”

Larry's Webinar is on the Web

As primary care providers incorporate adolescent mental health care into practice, Common Factors may hold solutions to successfully taking on the challenge. An approach that emphasizes provider/parent interaction over the need for diagnoses and specific treatments, Common Factors can have a powerful impact on provider training, confidence and outcomes.

Common Factors focuses on the process of care, and emphasizes the characteristics and interactions of providers, parents and others -- nurse practitioners, office staff, school health personnel -- in influencing patient behavior and improving outcomes. It challenges the need for a diagnosis and specific treatment for each patient, and instead maintains that therapies can be designed to help broad classes of people.

Common Factors expert Larry Wissow, MD, Professor, Johns Hopkins Bloomberg School of Public Health, discussed incorporating Common Factors principals into adolescent mental health care. Click here if you want to hear it.