Erin Jackson

Independent Research
November 23, 2015
Yewande Wynn
Mental Health Counselor
Charles County Public Schools
Interviewed November 21, 2015
YW:
EJ:
YW:
EJ:

Hi, how are you

Im good, Im really excited.
Hows school doing?
Good, its going really well.

YW:

What made you decide to get into psychology?

EJ:

Well with everything going on with Devin, I became interested in it and I was going to
take the independent research class anyway. So I started looking at mood disorders and
then I started getting interested in pediatric bipolar disorder.

YW:

Well Okay, Okay, Cool. You know thats a long road. You know that right?

EJ:
YW:
EJ:
YW:

EJ:

Yeah.
Okay as long as you know thats a long road?
Yeah. My first question is can you tell me about your job as a mental health counselor?
Oh Lord. Ive had many jobs as a counselor. Um I started off as um, oh gosh, right after
graduation---actually a little bit before graduation because I worked in a psychiatric
hospital for children and did my internship there. Then after I graduated while actually
working on my masters, I worked in an adult group home. You learn a lot, I stayed there
for a while. Lets see, I got married and moved to Georgia and began working at---for a
short period of time in Athens, Georgia--- in the Iron Triangle section which is probably
the worst sections in that area and I did counseling for a very brief period of time for the
families in that area. You know very low income families in that area.
Okay.

YW:

EJ:
YW:

EJ:
YW:

EJ:

And then we moved to Atlanta, and between then I did Child Protective Services and
things of that nature, not necessarily having to use my--- well having to use some of my
psych skills but not as much.
Hmm Okay.
Umm. Moved to Atlanta and began working at Metro State Prison which was a national
security prison for females and I ran a behavior modification unit at Metro, which was
actually the only of its kind in the nation.
Interesting.
So I got an opportunity to travel to discuss behavior modification and mental health and
how that in conjunction with a medicine regiment could work in regards to treatment to
maintain their everyday lives. In between all that became licensed, and then before we
moved here to the D.C. area, I used to---left metro--- I ran a day treatment program.
You ran a

YW:

A day treatment program. Where I lot of my consumers as we call them, we change their
names every so often, were very severely mentally ill, were hospitalized. The next step
for them when they come out of hospitalization is to go to a day treatment program to
establish their basic ADL skills or how to get them to function back in society, so they
can move to--- a lot of the consumers had full time jobs--- to get them to that level of
working and functioning. Then moved to the Maryland, ended up in the school system
but because I was licensed, I did individual therapy on the side with a company called All
That Therapeutic with children.

EJ:

Ok, so you mentioned ADL skills, that was the first time of heard of that. Could you
explain that?

YW:

Ok, so ADL skills is actually adaptive learning skills. Theyre skills like washing your
clothes, showering, learning how to cook or relearning how to cook, taking medications.
Skills that we take for granted, that we do everyday but skills that people who are
severely mentally ill and have decompensated, back and forth taking medications, back
and forth out of the hospital have forgotten. So that is what ADL skills are.

EJ:

Ok, so could you tell me more about your job working in the childrens psychiatric
hospital?

YW:

I interned at a childrens psychiatric hospital earlier on, in my twenties, when I was

young and could do it. It was a facility where children cannot function in a traditional
school setting. So what would happen is that they would have a break and have to come

to the hospital for short term treatment if they didnt go to a long term residential place.
They would come to the hospital and have to be medicated, and you stabilized so they
could back to school and everyday living, and we would transition them back slowly. It
was an intense unit. They couldnt do a lot of education things because you had to get
them stable first. I do not think they do it anymore in the hospital or because the
training---weve had a lot of deaths and you have to be specially trained in regards to how
you physically handle adults and children when they act out. We used to have a room, a
padded room, where we would put the children when they acted out, if they were causing
harm to themselves or others. We had to do lots of groups in regards to conflict
resolution, decision making, you know simple things, again what we take for granted. A
lot of children that have hallucinations, and delusions and things of that nature and were
not compensated on their medications would have to work with me on that. It was more
of a behavioral unit but not necessarily intense in nature.
EJ:

OK and then. What are some of your favorite success stories from treating you patients?

YW:

Hmm. Success. Wow. Umm. Ok lets see. I do not know how successful you would call
this but I had a young lady, her name was Tiffany Lambourne. She was in a--- this was
actually in a prison setting. We did have some inmates that committed heinous crimes
when they were young as teenagers and ended up having to be tried as adults, and ended
up being in the prison setting because of that. I had a young lady that came to prison--- a
couple of them actually--- but a young lady that came to prison very, very young. So she
was probably around 17, 18 when she got there. She was, not only was she manic
depressive, she was also schizophrenic, so she had a dual diagnosis going on. So Tiffany
was extremely impulsive and umm would act out on a daily basis, threaten suicide, do
self harm, and ended up in what we call a strip cell.

EJ:

In what?

YW:

Or secluded because of the fact that she would do things to harm herself and I ran the
behavioral unit. It was called IBTU, Intensive Behavioral Therapy Unit. What happens is
that instead of them going into the infirmary to be secluded, so they would come to this
unit. It was only a few, I would only take about eight to ten inmates in this unit because it
was that intense. There were two levels. Level one was the most intensive, where they
remained handcuffed, they could come out a certain times, they would participate in
groups and would work their way up to level two. In which they could begin to acquire
more things in their room and things of that nature and then they would go back to
general population

EJ:

OK.

YW:

Well Tiffany worked extremely hard on several occasions in the program. She was
probably in the program--- she would go to general population and then would go back
with me---but Tiffany was probably in the program around three or four times in a year

and a half, eighteen-month period. The last time, which was the most severe, what was
successful for me was that I was able to get her to the point in which she was back in
general population and stayed in population, and function very well in population for at
least a good six months. Unfortunately, Tiffany did take her own life.
EJ:

Aww

YW:

On my shift actually, because again mental illness is a challenge.

EJ:

Yeah.

YW:

And a lot of times there is some manipulation and some things that go on when they are
mentally ill like attention seeking and Tiffany became very attached to me.

EJ:

Mm Hmm

YW:

The night that she killed herself, it was around Thanksgiving--- No, Halloween, I think it
was because she had gotten back into population and she said Counselor Wynn, come
over and spend some time with me. I said Tiffany I have been with you all day, I got to
go home to my daughter, I got to go to Ayanna. Its Halloween, we got to do the
Halloween stuff, but Ill be back, Ill check in with you. I was on call 24/7. I could tell
that she was in a manic state at that time. I said Tiffany, I need to know whats going on.
I could tell that she was anxious, that the anxiety was there. So I guess it was coming
back into the environment, again she was doing so well and had not decompensated. I
think for her it was like Ive been out here all this time, whats going to be next for me?
Is Counselor Wynn going to leave me? What happens is that they move on to another
counselor. I know that there was a lot of that anxiety. This was part of the program and
she had worked it really well. She said Im going to be good. We sat and talked for a
while and she was and I left. Tiffany, because she was so impulsive and her mania, she
decided that she was going to do was last thing to get Counselor Wynn back to this
facility. So it was Im going to attempt to kill myself. Tiffany again, being manipulative
as she was, decided that she was going to hang herself around count time. The inmates
were counted. The officers would go around and count them right before dinner, to ensure
that everybody is in their cell, and then let them out for dinner. One time when they
locked down and call to check everyone. There happened to be a big disturbance which is
not often in a womens prison.

EJ:

Mm Hmm

YW:

In a mens prison yes but there happened to be a disturbance in general population so they
had to lock down and stay locked down. As they went over to everybody, all hands on
deck was in this disturbance in general population, which Tiffany was not aware of. So
when they locked down, and continued to lock down. No one was able to come and count
at the time that usually do the count.

EJ:

Aww.

YW:

So Tiffany proceeded to attempt suicide and ended up completing it because of the fact
that no one was able to to door, which she thought, in a timely manner to save her where
she could get back to infirmary and they would call me, and Id have to come back in.
She ended up killing herself and I had to go identify the body. How I know that she did
not want to kill herself were the marks around her neck where she was trying to get out
after realizing no one was coming.

EJ:

Mm Hmm.

YW:

So they felt like it wasnt a success story. But I felt it was a success story because of the
fact that Tiffany was stable, she just did not realize how stable she was. And umm
unfortunately it ended in her death because again mental illness is that your mind, you
think you got it all together, and then they are times that you want that attention, you
want folks to be around you, you think that you cannot make it on your own and you do
something that ends up being in fatal. So that was Tiffany.

EJ:

Umm. Can you tell me what bipolar disorder looks like in patients when they first come
in for treatment?

YW:

What it looks like?

EJ:

Yes.

YW:

In regards to?

EJ:

Their different behavior.

YW:

Ok. Major changes in your mood, your energy, your levels can fluctuate. You have things
like mood episodes where you can be extremely sad at one point or at another point very
overly joyful or overly excited and its very intense. You can have times where you can
also be explosive and irritable. A lot of highs and when you crash, its a deep low. It is
very difficult to try to stabilize that, and get you out of the low. When youre in that low,
its hard, its very difficult. With bipolar disorder, as they call it know---they used to call
it manic depressive, they change back and forth, I find that the more manic you are, it is
easier to work with somebody in a state of mania then in a state of depression.

EJ:

How are children diagnosed and treated with bipolar disorder?

YW:

Now children, the funny part about children and diagnosis, is that with bipolar disorder. It
is very difficult to diagnose children with bipolar. You very rarely see a child diagnosed
with bipolar, and I what I mean by a child is someone who is eight, ten, nine, eleven,
twelve. It is very rare that a child is actually diagnosed by a psychiatrist. Its very few.
Where you see them diagnosed is mostly in their late teens to early adulthood. This is the
reason why, children do not usually experience extreme to manic stressors. Normally

EJ:

when youre younger if there is a stressor in your life because they are so resilient, they
just go through it, they would say it was a normal part of life, so they do not stress about.
Yeah.

YW:

Your teenage years, thats where your stressors come in. You starting high schools. Young
ladies are starting to go through that change with their menstrual cycle. Your bodies are
starting to change. Youre going through a lot of self awareness. So that is when a lot of
times you start seeing the changes the mood and theyre more intense at that the time.
Actually, I have two young ladies now, one is clinically depressed, and I have to that are
manic depressive. The aunts came in, it was last year, I caught it quick and they snapped.
It is normally in those high school years, where you are dealing with your social network,
your friends and all that good stuff. Thats normally when you see into your early
adulthood. What was the second part of the question?

EJ:

How are people treated for bipolar disorder.

YW:

Treatment is through medication, behavior modification, therapy. A big part because your
teenagers, the essential thing, is to learn how to manage and help live with a mental
illness. Ironically, as much as I do not like to use my mental health background in a
school setting, I am using it all the time, especially with the two young ladies and
working with them on how to live with their illness.

EJ:

What types of medications are used to treat bipolar disorder and what are their side
effects?

YW:

Wow. Tons of medications. Your number one, your old faithful is lithium. You have a lot
of mood stabilizers that you could use Medicine is always in conjunction, its always a
cocktail for whatever reason. Ill see a psychiatrist, or psychologist put together some
cocktail of medications. Because being a licensed therapist, youre the one dealing with
them all of the time, a psychiatrist will only see them maybe once a month, once a week,
you can tell what works and what doesnt. But you have lithium, for acute mania, you
have some of your old meds, like halzol, perizol, esperidol. You have some of your newer
meds, your anti-psychotics, your abilify, your seroquil, deproxyin, which came 12, 13,
maybe 15 years ago, that was the miracle drug. That came out on the market with the
FDA and that was the drug that everybody would use, even with older dementia patients.
That is a good med to use, your giodine. You have your anti-convulsion medications
because a lot of times manic depressive can have seizures so you have your topematch.
Then you have your anti-anxiety for when you have mania, thats when you xanex,
valium which are very, very addictive which is why a lot of doctors try not to prescribe
that as much, but if they do always in a lower dosage. For your depressive side, you may
see your xolaf, your Prozac. It is trial and error.

EJ:

Yeah.

YW:

Your lithium, your depricol can be very lethal which is why you will see patients on what
you would consider your older medications will take blood levels.

EJ:

Ok.

YW:

So you see lots of patients come in and take blood levels so that it does not get to the
point where it is toxic. You know that those are my favorites actually because you get
good results. Side effects include nausea, extreme tiredness, pain in joints and limbs,
weight loss or gain, loss of bladder control, some folks may dry and itchy skin, patches
on their skin, memory loss.

EJ:

Yeah.

YW:

With any medication, there could be side effects so you need to watch the dosage that you
are giving.

EJ:

Ok. So how do you customize treatment to individuals?

YW:

You know what its trial and error. Its really trial and error. I know that working the
mental health field for so very, very long, there are times that the psychiatrist and
psychologist---especially when there is a licensed therapist---will call me up and say
Hey, Counselor what do you think. I would say lets take this medicine off and lets try
this. We also work on individual therapy. The goal is--- and by all means, you need
medication, but the goal is if you could work with somebody on the least medication as
possible and use therapy, a behavior modification plan. That is the most favorable.

EJ:

Okay.

YW:

As opposed to being on lots of medications. Not saying that is not necessary. Of course,
there are times where it is very, very necessary. Trial and error. Its very experimental.

EJ:

In your experience, how has treating adults differed from treating children?

YW:

I do not think there is any difference.

EJ:

Theres no difference. Ok.

YW:

I do not think that there is any difference. I think that a good therapist, a good
psychiatrist, a good psychologist is one who treats the individual as a human.

EJ:

Ok.

YW:

Genuine, insightful, but do not treat them as if you know everything and they know
nothing. Their experiences are your experiences. You are learning form them and they are
learning from you. I do not think there is any difference. People are people. Of course

with children, you have to be a little bit more hands on but I do not think there is much of
a difference.
EJ:
YW:

OK. When new studies are published, how does that impact a practices treatment?
I think that it just depends. It depends on what type of therapist are you, what type of
psychiatrist you are, what type of psychologist you are. I was always under the frame of
mind that when new studies came in, I would read it, especially when it is about behavior
modification because there might something that somebody is doing that was working.
But I didnt necessarily attack it, I didnt say we have to do it because in mental health, it
is so experimental, you dont know whats going to work and whats not going to work.
You really dont. So I think what happens, a lot of the professionals I have seen,
especially on a treatment team, would dissect it, may try something but not necessarily
embrace it.

EJ:

Ok. How would you evaluate the effectiveness of medication? What are some of the
changes of you would see?

YW:

I think that there is medication that is actually working because people do get immune to
medications.

EJ:

Ok.

YW:

You can max out a medication. You can get to the top of the milligrams of whatever
medication you are taking. But when I see effectiveness, I see clarity. I see someone
being able to function on a daily basis without having to be secluded from the
environment. When other people wouldnt be able to tell that there is anything going on.
When I can see a smile, and they are not in their depressed. When they can be very clear
and verbalize their feelings, that when I can say that the medication is working.

EJ:

Awesome. So how do patients overcome the negative social effects of their illnesses?

YW:

Erin, I dont think they do.

EJ:

Okay

YW:

I dont think they do. I think when youre well adjusted. When you have worked very
hard in treatment. I think you learn to accept your mental illness as part of you and try to
let everything else go, what everybody else is saying, what everybody else is doing. I
think that is something that people work with everyday.

EJ:

How do you see the patients home environment affecting their treatment?

YW:

Oh tremendously, if you have a supportive home life or a supportive family, youre going
to do well, youre going to thrive, youre going to be successful. If you come from a
home---I have one lady that comes from a home where they dont believe there is
anything wrong with her---or if they live in a poverty setting where they are not getting

enough education in regards to what is happening with their child. There are individuals
who do not care, or if their home life is tremendously dysfunctional, you cant help but to
have the issues that you are having, the compacts on your mental illness. A lot of the
times, at least with one of the students I have, I do not get much success from her
because of the way she lives. So I think your home life and your outside environment
tremendously impacts your treatment.
EJ:

My last question is how do you see treatment changing or staying the same over the next
ten years?

YW:

I see it evolving a lot in regards to everyone starting to move to a behavioral modification

method. In regards to yes, Im going to use medication, but Im also going to change that
behavior and how Im going to change that behavior is an extensive treatment plan on
working with the individual on where they are. That may be whether it is on their ADL
skills, their academic skills, learning how to function in work and address their demons
so to speak. I think that is going to start happening because people are, everything is
dangerous, every medication and everything you do, you feel it is dangerous. You see it
know in schools, alternative schools, children with oppositional defiant disorder going
towards to a behavior modification plan. I think that is what is going to start happening.
Not that they are not going to stop using meds but they are going to use intensive therapy
to work on the challenges that mental illness projects.

EJ:

Thank you so much.

YW:

Your welcome.

EJ:

Thanks for taking time out of your day, it was really, really helpful. I have so many notes.

YW:

Good.

EJ:

Thank you.

YW:

Bye bye. See you later.

EJ:

Bye

I think that the interview went well, I learned a lot of useful information about how
mental illness treatment works. Inevitably there are a few things I would like to change. First of
all, I would ask more follow up questions. I asked a couple at the beginning but I do not think
that is enough. I would also try to be more confident because I did use fillers like umm a lot. I
think I learned very valuable information from the interview. Previously, I read about the
differences in treating adults and children but I learned that good therapists and psychiatrists do
not change their treatment based on age but based on the person. The preparation process was
difficult because I had so many questions and had to narrow them down. It was also hard to
choose the right questions to ask. I think the interview went pretty well for the first one.