UMDNJ Magazine - fall 2004 VOLUME 1 NUMBER 1

Betty Vreeland never thought she'd find herself traipsing all over the country - with actress Linda Hamilton of Terminator fame, no less - promoting wellness initiatives for the mentally ill. But that's exactly what she did this past fall.

Vreeland is an advanced practice nurse at UMDNJ's University Behavioral HealthCare (UBHC). As program manager for UBHC's Center for Excellence in Psychiatry, she's an advocate for improving the physical and mental health of those with psychiatric illnesses. The University has partnered with pharmaceutical giant Eli Lilly and Company to promote this concept. Vreeland is the University's "point person" on the project.

To get the word out about the wellness program, a celebrity media campaign was launched in September 2004. "We wanted a spokesperson with mental illness who was physically fit," says Vreeland. It seemed like a tall order, but Linda Hamilton fit the bill. She has bipolar disorder and went public about her experiences a few years ago. Anyone who has seen her movies can attest to her level of fitness.

Vreeland would accompany Hamilton on the media tour, providing the medical information about severe and persistent mental illness (SPMI) and wellness. The two went for media training, and trained each other as well. Vreeland coached Hamilton about the connection between mental illness and overall health. In turn, she says she learned a great deal about public speaking by observing Hamilton.

"Linda is so poised," she says. "She's used to being in front of the camera and the focus of attention. But she had to switch her 'head set.' People wanted to ask her about her career and what it was like to work with Arnold Schwarzenegger. Somehow she had to work in the wellness message. She did it well, and we got great coverage."

The tour kicked off in September 2004 in Washington, DC, where they were interviewed by the Associated Press. They then traveled to New York and other cities for television and print interviews for The View, Oprah, Fox News, ET, Extra, Good Housekeeping magazine, and other media.

One day, they did a satellite media tour, an experience Vreeland describes as "effective, but surreal." Thirty TV stations around the country tapped into the studio via satellite. The interviews were stacked up back to back and the two spent the morning answering lots of questions.

"They can see you, but you can't see them," Vreeland says. "So you're not sure where to look. It's a strange experience."

Vreeland admits to having mixed feelings about her current situation, where she's doing less and less patient care and more and more speech-making. "I have a love-hate relationship with public speaking," she says with a laugh.

"But the best part of it is I'm reaching more people with an important message."

Those with SPMI smoke more than the general population, drink more alcohol, exercise less, have poor dietary habits, and are prone to being overweight. These lifestyle factors take a toll: Studies show that on average, someone with a major mental illness will die eight to 20 years earlier than those without psychiatric disorders.

Vreeland became interested in the health problems of people with SPMI early in her career. Many years ago, while she was working as a nurse in an out-patient community mental health center, a patient collapsed and turned blue. The nurses initiated CPR, but could not revive him. He was only 40 years old. "It was shocking," Vreeland recalls. "We wondered if it was a suicide. We couldn't imagine how someone this age could die so suddenly." It was later determined that the patient died of natural causes.

Over the next several months, two more of the center's patients, all in their 40s or 50s, died of natural causes. "It started me thinking that, in fact, this was unnatural," she says. "I decided I needed to become better prepared to take care of the physical health of these patients." She enrolled in the graduate nursing program at UMDNJ's School of Nursing, earning a dual master's degree in mental health and primary care nursing.

"Many people with mental illness don't have primary care providers," she says. "Sometimes it's all they can do to deal with their psychiatric problems." Almost half the people with SPMI suffer from undiagnosed medical problems. In addition, those who take psychotrophic medications often gain weight, putting them at risk for diabetes, hypertension, heart disease and other serious disorders.

The Center for Excellence in Psychiatry oversees the Partners for Excellence in Psychiatry: Neuroscience Treatment Team Partner (NTTP) Training Program, a collaborative effort of UMDNJ and Eli Lilly and Company. NTTP is a comprehensive educational program that encourages healthy lifestyles for people with mental illness.

Through funding from Lilly, mental health workers from all over the country travel to Piscataway for intensive four-day training sessions. They hear about new approaches in treating mental illness and improving physical health, learn weight management and smoking cessation strategies, how to implement exercise programs, and other skills. When they return to work, they receive ongoing support from UMDNJ via visits and phone calls.

A team of 15 professionals at UBHC and several faculty members from UMDNJ-Robert Wood Johnson Medical School have thus far trained more than 1,000 clinicians from 250 agencies across the country. Vreeland estimates they've reached tens of thousands of patients. "We're trying to bridge the gap between physical and mental health by stressing the importance of treating the whole person," she says.