Early Intervention: Helping Families with the Whole Picture of Parenthood

Parenting young children is challenging enough under usual circumstances. But as we know, the past couple years have been anything but usual. As the community got vaccinated and resumed in-person learning in schools and early education settings, surges of COVID-19 infections meant that programs and families often had to pivot back to virtual services, often with short notice. 

One such program is Dimock’s Early Intervention (EI) Program. EI provides children from birth to age three with critical services to help them reach their developmental milestones. Dimock’s program typically provides both home-and community-based support and activities based in our Jackie Jenkins-Scott Building. 

This ability of Dimock’s EI program to transition back and forth seamlessly between in-person and online programming allows for the continuity of care that families need now more than ever. 

“Throughout the COVID-19 pandemic, we’ve needed to pivot our in-home and center-based service model to allow for physical distancing,” says Jessica Nuhibian, Director of Dimock’s EI program. She is careful not to use the term ‘social distancing’ because social connection is vital for young children and their families— and is still possible to sustain even during a pandemic. 

For Dimock providers, it was essential to maintain the continuity of care that their families had come to rely on during this challenging time and provide ongoing opportunities for children to learn and grow. “Our team has been so wonderful and fluid in finding creative ways to make sure families can stay connected and still access services even when so much changes from day to day,” Jessica explains. 

In some ways, virtual learning can be even better than in-person learning. “Seeing facial movement and expression is an essential part of supporting early social-emotional and communication development, and that is not possible right now while wearing a mask,” says Jessica. “So, in a number of ways, having continued access to telehealth has allowed us to better serve our families.” 

One important—and fun—way that families were able to interact safely is through an expressive therapy playgroup which uses music and movement to provide opportunities for connection and learning. Casara Nemes, the group facilitator, explains, “Children have the opportunity to learn social skills that will benefit them when they return to in-person interactions—such as turn-taking, show and tell, and using communication to share their wants.” 

Since the pandemic began, this playgroup has been adapted for the virtual space. And it’s been a hit with children and their caregivers alike. 

“We’ve been isolated for so much of the COVID-19 pandemic, so participating in the virtual playgroups helps us to feel engaged in the community,” shares Carmen, who attends the expressive therapy playgroups with her daughter Luna and husband José. 

Luna was referred for a speech and motor skill delay at her first birthday, but she was at risk for other delays, as well. She was born with a congenital heart condition that required surgery when she was an infant. The surgery meant that she couldn’t spend time on her belly at the stage when babies would typically be practicing tummy time and learning to crawl. 

Her EI Service Coordinator got to know Luna and helped her family connect with a variety of other services, including support around feeding and sleep. They also worked with Carmen and José to find strategies to help Luna crawl, communicate, walk, and interact with other children. Luna even took her first steps on Dimock’s campus, an experience her mom says she’ll never forget. Carmen shares about her Dimock EI team, “They go above and beyond and helped us with the whole picture of parenthood, not just with the therapies. They celebrate all the victories with us.” 

Since Luna’s graduation from the program, the family has opted to stay involved and help other families get the most out of their EI experience. They now continue to participate in the virtual playgroups as “Community Peers,” modeling for other families how they incorporate the strategies they’ve learned in EI into their daily routines, and helping them feel comfortable being silly and playful with their children. 

Sometimes it’s just important for caregivers to have someone to talk to and hear that they are doing all right, especially if they just received the news that their child is facing a developmental delay or have received a new diagnosis. “Our EI program continues to promote kids’ healthy development and support caregivers as they navigate complex systems. We do it in whatever way we can— whether that’s in person, on Zoom, or on the phone,” Jessica proudly shares. “We’re here to partner with families as members of their child’s team and to let them know that we are in this together.” 

Maternal-Child Health Program: 2021 Annual Report Spotlight

In 2021, Dimock’s Obstetrics and Gynecology (OB/GYN) Department launched a new Maternal-Child Health Program, led by Ketura’h Edwards-Robinson, MSN, SANE-MA, WHNP-BC, AGNP-C. 

The program aims to address maternal health disparities along racial and economic lines, empower patients to advocate for their health care, provide resources to nurture healthy families, and establish a sense of community among pregnant patients. 

“It’s very clear that Black and Brown women do not do as well in their pregnancies as white women. They are two to three times more likely to suffer ill effects during their pregnancies from preventable causes,” says Danielle Grimm, MPH, MSN, CNP, WHNP-BC, Clinical Director of Dimock’s OB/GYN Department. 

“This is a systemic issue. Among all of the upper-income countries in the world, the United States has the highest maternal mortality rate. More than 700 women a year die from pregnancy-related complications. That is, frankly, unacceptable. This program is a call to action for our department led by Ketura’h to make an impact.” 

“Through this program, we are hoping to make connections within the community so that we can offer resources to our pregnant people, whether that be around lactation support, assistance with housing, food, jobs, childcare, or basic essentials like diapers or formula,” says Ketura’h. 

In addition to offering additional resources for Dimock patients, the Maternal-Child Health Program plans to launch a series of childbirth classes in 2022, led by Ketura’h, who is a doula and certified birth educator. Ketura’h also hopes to teach patients critical self-advocacy strategies. 

“We want to make sure that our patients have the tools to advocate for themselves,” says Ketura’h. “We know we are providing high-quality care here at Dimock, but we started asking ourselves, ‘What more can we do?’” 

The high-quality care at Dimock goes beyond medical care—we also offer behavioral and mental health support. Thanks to our partnership with Mass General Brigham, we’re proud to welcome Aderonke Pederson, MD, to our team. Dr. Pederson is a psychiatrist at Massachusetts General Hospital with a special interest in women’s mental health and mental health stigma in communities of color. She provides direct patient care at Dimock, where she works closely with the OB/GYN staff to provide integrated behavioral and mental health services to our patients. 

“I am thrilled to partner with the Dimock clinic and serve our patients in the area of mental health, in particular at the intersection of providing mental health services for women of color, especially Black and Brown women in the community,” says Dr. Pederson. “My hope is that our intentional collaborative efforts through our partnerships within the Maternal- Child Health Program can expand our reach and narrow health disparities as we seek equity for patients who are most at risk.” 

Patients might also notice the revamped clinic, which includes beautiful artwork reflecting the diversity of the patients we serve. 

“We take care of all different patients here. Creating an inclusive space is extremely important in developing a trusted relationship between the patient and their provider, especially in community health settings,” says Danielle. 

“We want our patients to know: This is your community clinic,” adds Ketura’h. “The staff here care about you, and we want you to be successful.” 

Jerrall – Wellness in Recovery: 2021 Annual Report Feature

With the goal of breaking down barriers to care and correcting historic racial health inequities, The Dimock Center is meeting the complex health and wellness needs of all members of the community, right where they live. 

In addition to the individual and group therapy offered in each program, members of our residential recovery homes are connected with primary care in our Health Center, and many seek additional mental health support through Dimock’s integrated behavioral health services. 

We’re dedicated to ensuring that individual residents and families find the health care and the community resources that are critical to making those determined steps beyond our doors. 

“Dimock sincerely saved my life,” says Jerrall Corning, a resident of the John Flowers Recovery Home. “Dimock has helped me repair the relationship with my wife and my five-year-old. I’m in the process of completing my GED through Dimock, and I’m about to find housing. Dimock has helped me to achieve my goals. But on a very basic level, Dimock saved my life. It’s given me peace of mind. It’s given me me back.” 

Prior to arriving on Dimock’s campus, Jerrall did not have a primary care provider. He was connected to one in Dimock’s Adult Medicine Clinic, received his vaccines on campus, and felt the healing power of community through his participation in the Road to Wellness 5K Walk/Run. 

“Being a part of the Road to Wellness was a wonderful experience. To be a part of a community is a beautiful thing. I love this community. I love Roxbury.” 

Coach Yvel Joseph, affectionately nicknamed “Coach Joe” by many Dimock residents, leads a twice-weekly fitness and wellness program for the residential recovery homes on our campus. This innovative program is generously supported by Reebok, who also supports the Road to Wellness 5K Walk/Run and Summer Training Series. 

“I approach fitness from a perspective of wellness: mind, body, and spirit,” says Yvel. Yvel aims to create an environment where those in recovery can build confidence in themselves, connect with their community, and feel good in their bodies. 

“What first brought me to Dimock was all the resources that they have for us,” says Lissette Santos, a resident of My Sister’s House. “I go to therapy here and I participate in the fitness program every Tuesday and Thursday. I’m also doing anger management and relapse prevention programs here. The staff here stand by me and never let me down.” 

“Coach Joe is phenomenal. He gives great advice, and he goes at your own pace. So many of us look forward to Tuesdays and Thursdays. I have seven grandchildren, and I can run with them now. It makes me feel good to be taking care of my body the right way.” 

Recovery Outreach – 2021 Annual Report Feature

The intersection of Massachusetts Avenue and Melnea Cass Boulevard (“Mass. and Cass”) in Boston’s South End is a hub of substance use recovery services. Unfortunately, as the COVID-19 pandemic has compounded the severity of the opioid use epidemic, the area also became a site for encampments constructed by those facing housing insecurity, many of whom are also struggling with substance use disorder. 

“This is beyond a public health crisis, this is a human suffering crisis,” Dimock President & CEO Dr. Charles Anderson told GBH Greater Boston’s Jim Braude. Though the tents were cleared in early 2022, Dr. Anderson says, “It’s going to be hard for us to forget these images that we saw there on Mass. and Cass.” 

Recognizing the enormous need to connect former residents of Mass. and Cass with substance use treatment, Dimock plans to expand its outreach efforts, thanks to a generous grant from the Bank of America Charitable Foundation. The grant will fund a full-time Acute Treatment Services Admissions Navigator, who will provide outreach and transportation for patients to get to our Acute Treatment Services unit for medically-assisted treatment. From there, clients will be connected with Dimock’s entire continuum of care. 

“At Bank of America, we believe we have the unique opportunity to help address some of society’s biggest challenges. Through our partnership with The Dimock Center, we are helping to alleviate the physical and mental health impacts of the pandemic by connecting the most vulnerable in our community with the health care services they need,” said Miceal Chamberlain, President, Bank of America Massachusetts. 

Andrew Mrozinski, a resident of Dimock’s Askia Academy since June 2021, often uses his weekend passes to provide essential items (such as socks, underwear, and NARCAN®) to high-volume areas like Mass. and Cass and the Boston Common, where he says many of Boston’s homeless have moved. 

“There’s such a need for an outreach program like this,” he says. “A lot of people look at this like it’s a problem to be solved. It’s not a problem to be solved. It’s people to be helped.” 

Andrew, who is currently enrolled in classes, hopes to continue this work as a Recovery Specialist after completing his program. “There’s an exponential need for this kind of help,” he says. “I think it’s going to have to be a multi-faceted approach. Many have mental health needs that should be addressed. For others, housing is most critical. Substance use treatment needs to be offered, too. I’m tired of losing friends. I’m tired of losing the people I care about.” 

Matt Raspanti, LMHC, who is the Clinical Director at Askia Academy, says there was a large spike in requests for beds when the tents at Mass. and Cass were removed and demand for services increased. 

“I think it is really important that Dimock has a presence at Mass. and Cass. And if it’s not Mass. and Cass, we’ll always be able to identify places with this great need.” 

“For someone to change their habits around substance use and address their own mental health and trauma—those are really tough things. We have to show that this is a safe, welcoming, and supportive environment,” he says. 

Opioid use disorder has become especially deadly for Black men, with death rates in Massachusetts rising 69% in 2020. 

“This is a historically Black neighborhood and treatment center,” Matt Raspanti says. “Recognizing this history and continuing to learn from other organizations, learn from people in the community, learn from those who lived at Mass. and Cass and those who need treatment right now, is critical.” 

Despite the significant challenges facing our community, Dr. Anderson maintains that we have much reason to feel hopeful about the impact our work will have. “I have never seen this type of organized effort coming from this place of real sincerity. . . .How can you not feel hopeful?” 

 

Stories from the Frontlines: Testing 1, 2, 3

At this point in the COVID-19 journey, the staff at Dimock operates the on-site testing center like clockwork. On average, 100 people are tested per day, within a two-hour window. Community members can walk or drive up to the outdoor structure and within minutes, be on their way, with test results coming back in 24-48 hours, thanks to a partnership with Beth Israel Deaconess Medical Center (BIDMC).

“When we started the testing operation in March, we had a very clear goal to ensure our patients could be tested in their own community, in a familiar setting, among familiar faces,” says Dr. Holly Oh, Dimock’s Chief Medical Officer. “It’s through the support of our donors that we could accomplish it. As the months have gone by, we’ve been able to evolve, expand our capacity, and refine our protocols.”

This fall, the staff were put to the test on a scale they hadn’t been before. Explains Dr. Michael Tang, Chief Behavioral Health Officer, “A patient arrived at our acute treatment center and during the admission process was offered a COVID test. He initially refused but after encouragement from our team, he changed his mind. The result came back positive.”

No time was wasted. The patient was immediately moved to the quarantine unit on campus, in the Dr. Marie Zakrzewska building. However, the brief time he spent in the detox meant anyone who had been in the same space was potentially exposed.

Every staff member, resident, and visitor who was at risk was identified – a total of 36 people. From there the team prepped the specimen kits, registered each person with BIDMC, organized the paperwork, conducted the tests, and sent them to be processed. This was accomplished within 36 hours of the initial positive test. Just 24 hours later, the results were back, all of them negative.

“The efficiency and amount of work it took to get this done so quickly are incredible,” says Dr. Tang. “It’s a testament to the dedication of our staff and the COVID-19 testing infrastructure we implemented nine months ago.”

The testing operation resumed its daily routine without missing a beat, serving a grateful community.

A special thank you to the following staff members for their remarkable work:
Maria Paula Arenas, Leandra Barbosa, Macadia Carter-Tshiamala, Lauren Conway-Russell, Dulceneia Correia, Dominique DuPont-DuBois, Selena Francis, Atanazia Gomes, Merelyn Hong, Shireen Khan, Leela Lutchmipersad, Shameka McCrary, Daniel Mota, Issa Noel, Holly Oh, Nandini Sengupta, Michael Tang, Jessica Vasquez, Cheyenne Wu, and Nusrat Zaffer.

Stories from the Frontlines: Testing 1,2,3

At this point in the COVID-19 pandemic, the staff at Dimock operates the on-site testing center like clockwork. On average, 100 people are tested per day, within a two-hour window. Community members can walk or drive up to the outdoor structure and within minutes be on their way, with test results coming back in approximately 24 hours, thanks to our collaboration with Dimock’ s Primary Medical Partner Beth Israel Lahey Health.

“When we started the testing operation in March, we had a very clear goal to ensure our patients could be tested in their own community, in a familiar setting, among familiar faces,” says Dr. Holly Oh, Dimock’s Chief Medical Officer. “It’s through the generous support of donors that we could accomplish it. As the months have gone by, we’ve been able to evolve, expand our capacity, refine our protocols and test more people, faster.”

Last week, the staff were put to the test on a scale they hadn’t previously experienced. Explains Dr. Michael Tang, Chief Behavioral Health Officer, “A patient arrived at our acute treatment center [inpatient detox] and, during the admission process, was offered a COVID-19 test. He initially refused but after encouragement from our team, he changed his mind. The result came back positive.”

No time was wasted. The patient was immediately moved to the special COVID-19 quarantine and treatment unit on campus, in the Dr. Marie Zakrzewska building. However, the brief time he spent in the detox meant anyone who had been in the same space was potentially exposed.

Every staff member, resident and visitor who was at risk was identified. From there the team prepped the specimen kits, organized the paperwork, conducted the tests and sent them to be processed. Within 24 hours of testing, the results were back, all of them negative.

“The efficiency and amount of work it took to get this done so quickly is incredible,” says Dr. Tang. “It’s a testament to the dedication of our staff and the COVID-19 testing infrastructure we implemented nine months ago.”

The testing operation resumed its daily routine without missing a beat, serving a grateful community. Donors play a vital role in healing and caring for the Dimock community, every day. We are so very thankful for their kindness, support and steadfast commitment to all of Dimock’s patients and families.