NORTH CONWAY, NH – When psychiatric nurse practitioner Lorinda MacDonald joined Memorial Hospital’s medical staff, she was the first behavioral health provider to be embedded in their primary care practice. Filling a tremendous need in the community, with a dearth of psychiatric resources and a burgeoning substance abuse epidemic, MacDonald’s schedule quickly filled as she became the go-to for patients in need of psychiatric care and medication management. As her popularity grew, so did the demand for high-quality behavioral health care close to home. This coupled with a MaineHealth initiative to expand and improve behavioral health resources have since lead to Lorinda being named Behavioral Health Director and the point person for Memorial in the hospital system’s program.
“Access to timely mental health care in New Hampshire is at a crisis point,” Ken Norton, the director of the NH state chapter of National Alliance on Mental Illness, as cited in a Concord Monitor article last year. Since that time, the state has been focusing on community care to help address that need, in addition to efforts to address the lack of psychiatric beds in the state.
Hand in hand with the mental health crisis is NH’s well known opioid epidemic. These often go together as untreated mental illness can often lead to self-medication using other substances such as opiates. This highlights the need for an increase in both behavioral health and substance abuse treatment in the community, an initiative that will be led by MacDonald in her new role.
MacDonald has been working closely with Sue Ruka, Memorial’s Director of Population Health. Ruka had this to say on this matter, “In the past three years I have become involved in identifying the health needs of our community and more importantly looking for way to meet those needs. Behavioral Health and Substance Use Disorders rose as a priority. Unmet needs impact not only the individual but the family and the community at large. They are long lasting. Knowing what is needed and actually making it happen are not the same thing.”
“Lorinda's knowledge and leadership has helping turning ‘knowing what is needed’ into ‘doing what is needed.’ She educates, mentors and advises her team. I am so pleased with the opportunity to work with Lorinda. I know her commitment, leadership and knowledge will make an impact on the health of our community.”
MacDonald added, “We are expanding the behavioral health service line here at Memorial. We are increasing our access to iMAT (medication assisted treatment) by expanding the number of providers offering it to three nurse practitioners within the primary care practice. I am the regional point person for MaineHealth system efforts in our community and will have access to them as a resource, and also be accountable to them for reporting measures on our iMAT activities. The point of entry for substance misuse treatment in our practice is now behavioral health, as the counseling component of treatment is critical, in addition to the use of drugs such as Suboxone and Subutex.”
Lorinda serves on the iMAT Learning Collaborative, the Maine Behavioral Health Service Line Leadership Council and the IDN 7 clinical work group. Most recently, she was accepted into a week-long course “Emerging Women Executives in Health Care” at T.H. Chan Harvard School of Public Health.
Memorial is also adding a Behavioral Health Patient Navigator to the team, a role to be filled by expanding the role of medical assistant Casey Kariuki. She will help facilitate outside resources for patients, a complicated process that can be overwhelming for patients and families in crisis.
MacDonald added, “It’s all so fragmented. We need a community effort to bring it all together.”
MaineHealth’s resources include their network of behavioral health specialists and programs of Maine Behavioral Health. MacDonald said that she hopes to work with them to improve Memorial’s access to behavioral health services, which may be expanded to include emergency department consultants through tele-psychiatry. She also hopes to streamline the process for Maine resident patients seen at Memorial to get into their Spring Harbor psychiatric hospital. “I’m hoping we can help deescalate patients in crisis in our emergency department. I want to collaborate with our ED team to help better manage behavioral health services.”
It’s a tall order, but MacDonald’s passion for her new role is evident, and her enthusiasm for it is contagious. It’s a combination that should bring success to her in this new role now and into the future.
For more information, call 603-356-5472 or visit them online at www.memorialhospitalnh.org.
About Memorial Hospital
Memorial Hospital is a not-for-profit 25-bed Critical Access Hospital located in North Conway, NH, and is a member of the MaineHealth family. Its hospital services include a 24-hour emergency department, surgery center, clinical laboratory, heart health & wellness programs, family birthing center, sleep center, oncology, chemotherapy and infusion services and the Miranda Center for Diabetes. Physician practices include primary care and family medicine, women's health, orthopedics and sports medicine. The Merriman House, a 45-bed nursing home specializing in Alzheimer's and other memory disorders, is also located on the hospital campus. Together, our staff and providers are committed to meeting the health needs of the Mt. Washington Valley and surrounding communities by collaborating with community partners in the delivery of accessible, comprehensive, compassionate, and quality health care.