Frontier Psychiatry

Gregory Kendall just got his job back at the Atlanta VA. He was fired last year after telling a local reporter that over 7,000 phone calls for mental health services went unanswered. In the dismissal letter, VA officials said he had "poor judgment" when he made the problems public. I think he showed remarkable courage and compassion for the Veterans who spent hours trying to get help. Two weeks ago Military(dot)com published another story alleging that VA staff have been deliberately canceling mental health appointments at the last minute. The practice was designed to obscure the fact that VA clinics didn't have enough staff to deliver much-needed mental health services. Officials were apparently trying to prevent more expensive referrals to community-based providers. A money-saving tactic. Some families have filed lawsuits against the VA, saying that the last-minute cancelations directly led to Veteran suicides. I can't believe that we're still reading stories like these. How is this happening? More than 20 Veterans kill themselves every day across the US. I'm grateful for the courage and advocacy demonstrated by Mr. Kendall and the heartbroken family members. Please share this post to amplify their voices.

Entrepreneurs are over 2x more likely to have dyslexia than the general population. About 35% of US entrepreneurs have dyslexia compared to a 15% rate among the general US population. While dyslexia is certainly a vulnerability in the classroom, affected people often develop traits that make them successful founders: 1. Delegation - they learned early how to surround themselves with people who helped them overcome known skill gaps. 2. Communication - they develop keen oral communication skills that help them articulate a vision with clarity and persuasion. 3. Team building - they prioritize personal connections and supportive environments. 4. Thinking differently - they are more comfortable challenging conventional wisdom and approaching problems from a different perspective. Less than 1% of US corporate managers had dyslexia. Here are examples of successful entrepreneurs with dyslexia: Richard Branson (Virgin) Charles Schwab Henry Ford Walt Disney Steve Jobs Tommy Hilfiger Ingvar Kamprad (Ikea) Paul Orfalea (Kinko's) Daymond John (FUBU) Barbara Corcoran This demonstrates the power of strength-based education and talent development. Imagine if school teachers had the time and resources to identify and build on students' strengths. Kids are expected to be successful in all subjects, while adults are allowed to specialize. Maybe we should rethink that approach?

Today, we celebrate the heart and soul of our clinical team—our amazing Medical Assistants! Your dedication, care, and hard work behind the scenes ensure our patients receive the best care possible. Thank you for being the backbone of our practice and for always going above and beyond! 💚 #MedicalAssistantAppreciation #ThankYouMAs #ourteamrocks #FrontierPsychiatry

We are looking to hire a passionate, mission-driven leader to be our SVP of Operations. Frontier Psychiatry is dedicated to lifting the mental wellbeing in rural communities. If you are an operations wizard and know how to scale the delivery of high quality psychiatric- and addiction treatment via telehealth, please DM me. We are in Montana, Idaho and Alaska with plans to reach many more rural communities in and around this region over the next 10 years.

Psychiatry's diagnostic manual is biased against females who have ADHD. We do a much better job making a timely diagnosis in males. The DSM needs an update to make sure young women aren't falling through the cracks. Waiting too long to diagnose ADHD can lead to long-term problems. Here's what can happen if symptoms go untreated: 1. Develop other mental health problems, including anxiety, depression and low-self-esteem. 2. These new mental health problems can overshadow the ADHD symptoms, making it even harder to uncover later. 3. Problems maintaining relationships and associated social isolation. 4. Overcompensating for inattention and forgetfulness can lead to burnout and emotional exhaustion. 5. More likely to engage in risky and impulsive behaviors that have negative personal, school-related, or professional consequences. Here's why ADHD is often missed in young women who have the disorder: 1. They are more likely to have inattentive symptoms that are harder to spot. 2. The criteria in the DSM are historically based on male-dominated research samples. 3. Successful masking of ADHD symptoms in order to function. 4. Gender norms and expectations often prevent ADHD from making the list of possible problems affecting a struggling young female. I wonder if there is a perception that girls are more likely to have "emotional" problems while boys are more likely to have "ADHD" or executive functioning challenges. I keep seeing this in my daily practice and it's a problem. Great article in Lancet Psychiatry (April 2024), titled "Why are females less likely to be diagnosed with ADHD in childhood than males?"

Today, we honor the history, resilience, and contributions of Indigenous peoples across the country. Mental health care that respects the diverse culture and values of Indigenous communities is fundamental to serving rural communities. Together, we hope to create a future rooted in compassion, inclusion, and healing for all. #IndigenousPeoplesDay #FrontierPsychiatry #CulturalInclusion #MentalHealthForAll

Bright light therapy (BLT) isn't just for seasonal affective disorder. A $30 light box is likely to improve depression treatment and shorten the time it takes to feel its benefits. It can often take up to 2 months to feel the benefits of medication treatment for depression. That's often too long for those feeling its effects. Adding daily BLT with a 10,000 lux light box increased the odds of remission of depressive symptoms by 3.5x within 4 weeks. These data can be found in a recent JAMA Psychiatry article. In 2018, our team at Billings Clinic studied the benefits of triple chronotherapy in the treatment of hospitalized youth with active suicidality, insomnia, and severe depression. Triple chronotherapy combines one night of sleeplessness with three days in which we administer BLT and shift the sleep-wake cycle. The results were promising and we published our results. BLT is a simple, cost-effective intervention that shows benefits beyond those seen in seasonal affective disorder. It should be used more widely to help patients feel the benefits of antidepressants more rapidly. Again, a scalable intervention that could improve outcomes across under-resourced, rural communities.

We’re thrilled to welcome Dr. Cory Alexander, to the Frontier Psychiatry team 💚⭐ Dr. Alexander is a Board-Certified Child and Adolescent Psychiatrist with over 38 years of experience treating Children, Adolescents, and their families. Over the years she has served a diverse population in the states of Colorado, Washington, North Dakota, Idaho, and Montana. Dr. Alexander has worked in a wide variety of settings including hospitals, IOP programs, residential programs, and outpatient clinics. For years, she has utilized a Trauma Informed approach to treatment and her personal motto has always been 'whatever it takes to move forward'. #ourteamrocks #Welcome #MontanaPsychaitrist #MentalHealthcare #MentalHealthMatters

Here are 5 reasons you should avoid smoking marijuana: 1. Impaired cognition: THC hurts memory, attention, and decision-making skills. 2. It's addictive: 30% of marijuana users develop cannabis use disorder. 3. Worsening mental health: Regular use is linked to higher risk of developing psychotic disorders and suicidality. 4. Poor physical health: Daily use increases risk for heart attack by 25% and for stroke by 42%. Long-term use leads to higher risk of laryngeal cancer. 5. Secondhand smoke: People exposed to secondhand marijuana smoke poses risk for respiratory problems just like tobacco smoke. Great article by Leana Wen M.D. M.Sc. in the Washington Post. Thanks to Aaron Weiner, PhD, ABPP for calling this out.

We’re thrilled to welcome Jacob Bailey, PA, to the Frontier Psychiatry team!💚⭐ Jacob is certified by the National Commission on Certification of Physician Assistants and holds a Certificate of Added Qualifications (CAQ) in Psychiatry from the NCCPA. With a passion for psychiatry and addiction medicine, Jake is dedicated to building meaningful connections with his patients and guiding them toward positive changes on their path to wellness. He is now accepting new patients and looks forward to working together to help them achieve their goals. #ourteamrocks #adultpsychiatry #Welcome #MentalHealthcare #MontanaPsychaitrist