Mental Health: Stigma On TV

schultz-comic-of-lucy

Archival Charles Schultz Peanuts comic starring the character ‘Lucy’ as a Psychiatrist.

Mental Health Disorders, psychologists, and psychiatrists used to be portrayed for laughs on TV.  Looking back at some well-known shows (that many millennials may not be familiar with), we wanted to include some clips of episodes which poke fun at the stigma of both condition- and the role of ‘professionals’.

The CDC Centers for Disease Control has an extensive communications archive of entertainment and media advice, clips, research studies and more.  There is advice for would-be portrayals of mental and behavioral health issues, conditions, appropriate settings & photos, videos, movies and social media. [Manuals in fact- which we read cover to cover, word for word.]  Increasingly, people seem less tolerant for anything, [and anyone], and vent on social media in a sarcastic, mean-spirited and damaging fashion. Wrong conclusions are drawn without the complete story.

As with everything media, this has been a changing scene over the past few years and for sure past few decades.  Unless one has SPMI severe and persistent mental illness, a developmental condition with presenting symptoms and appearance, you simply can’t tell any difference, unless a person is exhibiting emotional cues of distress- which may or may not be correlated to a diagnosable condition. In other cases, it’s sadness, fear, or anger being exhibited-not exactly mental health disorders. For some, unfamiliar with sources, causes, and symptoms, a default position used to be, that a mental health disorder was a character issue, and to ‘get over it’.  That is true too, of addiction and substance use disorders. This has been highly unfortunate and forced millions to live in distress. Media portrayals have changed significantly in recent years.

Actor Bob Newhart portrays a psychologist in this sitcom. A patient comes to him with escalating list of conditions and thoughts, to which he advises to ‘stop it’.  https://www.youtube.com/watch?v=Ow0lr63y4Mw 

Frasier and Niles Crane are psychiatrists in this sitcom. Frasier hosts a call-in radio show as an expert advice-giving host; Niles is in private practice. Both are divorced, and have their share of hang-ups.  Frasier lives with his dad, a retired cop, and puts up with Dad’s dog, Eddie.  https://www.youtube.com/watch?v=RsyXV-B3uGk&list=PLBA2A30C9BF14D2E7

The statistics from NIMH show that those with a mental health disorder are definitely not alone.  For example, “Mental health statistics in youth are similar with 21.5% of youth ages 13-18 experiencing a severe mental illness at some point. For children ages 8-15, this number is 13% (Mental Illness in Children: Types, Symptoms, Treatments). Once people reach adulthood, the number that experiences a severe mental illness in a given year is about 4.1%.”  The Healthy Place blog reports, ‘When it comes to specific mental illnesses, more mental illness statistics are known. Anxiety disorders such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias are the most common kind of mental illness in the United States experienced by over 18% of adults; this is followed by substance use disorders and depression.

To put the numbers in perspective, there are approximately 321,418,820 people in the United States according to U.S. Census Data estimates for 2015 as of July 1; for Ohio the count is 11,613,423.   The Healthy Place site says, ‘mental health statistics for specific illnesses in the United States include:  About 16 million adults (6.9%) have had at least one major depressive episode in the last year. About 20.7 million adults have experienced a substance use disorder with 2-in-5 of these people having an additional mental illness (known as a co-occurring, comorbid disorder or as receiving a dual diagnosis).’   Statistics show ‘2.6% of adults live with bipolar disorder and 1.1% of adults live with schizophrenia.’  You can run the percentages by age. These are high numbers. We know that a high percentage do not seek  or receive treatment.

Actress Marilyn Monroe lived with the fear that she would ‘get’ her mother’s mental illness.  See the clip here of her life as portrayed by  https://www.youtube.com/watch?v=m4MNP2swBQ0    This is quite a different take than Glenn Close in Fatal Attraction, 1987.

Finally, more recent sitcoms, examine the issues realistically and consult the experts in how they might portray mental and behavioral health disorders in a true-to-life way that accomplishes an educational goal.  The CDC Communications office not only has extensive research and recommendations for news media and entertainment industry portrayals of physical and mental health issues, but the evidence to back it up. [These are the folks who brought you those pictures of diseased lungs vs. healthy lungs in an anti-smoking blitz.] And no, they don’t always get it right. As with everything else, time brings change and a new perspective.

Resources:

http://peanuts.wikia.com/wiki/Lucy’s_psychiatry_booth

http://www.healthyplace.com/other-info/mental-illness-overview/mental-health-statistics-you-are-definitely-not-alone/

http://www.healthyplace.com/other-info/mental-illness-overview/mental-illness-in-children-types-symptoms-treatments/

 

 

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Designing a Medicine Wheel

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Medicine Wheel -work in progess

The girls of the Meena wing have been working on designing a medicine wheel with Angela, LICDC II, SWA, Tiffany CPST,  and Steve, LSW and assistance from Ruthe, visual art CPST.  You can find examples of medicine wheel construction done in stone, used both directionally (E, S, W, N) and sacramentally on expanses of land, aligned with sun, moon, and stars.  At specific times of day or night, the stone portals on ancient earthworks align with the planets to mark celestial events- like a solstice. A circle shape might be constructed like a wagon wheel with spokes dividing the circle into four dimensions according to the natural elements, based upon seasons, the human life-cycle, different traits of life, spirit animals, or healing plants. ‘The medicine wheel concept was adapted into symbolic art form and used by Native American tribal leaders to inspire healing.  Feathers, shells, stones, plants, or beads  can all be a part of a woven textile creation.’

https://www.nlm.nih.gov/nativevoices/exhibition/healing-ways/medicine-ways/medicine-wheel.html

The NIH website explains the meanings of the four directions:

“Different tribes interpret the Medicine Wheel differently. Each of the Four Directions (East, South, West, and North) is typically represented by a distinctive color, such as black, red, yellow, and white, which for some stands for the human races. The Directions can also represent:  a) Stages of life: birth, youth, adult (or elder), death; b) Seasons of the year: spring, summer, winter, fall; c) Aspects of life: spiritual, emotional, intellectual, physical; d) Elements of nature: fire (or sun), air, water, and earth; e) Animals: Eagle, Bear, Wolf, Buffalo and many others; f) Ceremonial plants: tobacco, sweet grass, sage, cedar.”

For substance abuse educator Angie, painting is a different coping skill, a way of dealing with cravings, triggers that go with working on mental health and addiction issues. “The large medicine wheel painting is a daily reminder to look at ones-self holistically, to go beyond depression and see the yin and yang (positive side to a negative outlook)”, she said. “It is a reminder that there is a bigger picture to life than adolescence: birth and infancy, youth-where they are, adulthood, and the elders- that all things and phases play a part, and bring their own point of view to create/enhance the fullness (circle) of life.  There is a lot of discussion, Q&A that goes with all the elements of the wheel- such as the spiritual component, emotional, intellectual and physical dimensions,” she explained. Each of the girls developed her own 8 ½ x 11” medicine wheel drawing with colors and personal symbols-each with healing importance.

For therapist Steve, the medicine wheel explores a dimension of “Seeing each of the very different youth work together on the project  – various staff, various departments from within the building, and even Angela coming from her home agency (Maryhaven) to work with our Pomegranate girls. It all reinforces the importance of interdependence, connection and cooperation in healing. It’s a bonus that each of our youth appreciate in leaving something behind as they progress home. The medicine wheel provides a spiritual reference for future youth who pass through our building on their own journey.”

dys steve farewell

Nan Hoff, Administrator Female Placements & Programs DYS;  Judy Dean, LISW-S Clinical Supervisor;  Steve Polovick, LSW celebrating our NAMI-FC Walk banner contest winners at a cook-out in the courtyard, and appreciation for Steve as he transitions to Westwood/Lumin Academy. Welcome to therapist Clay Sherrord who joins the Meena care team.

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You are not alone

NAMI-FC-banner-2016

You are not alone

June 25th, 2016  Pomegranate staffers walked on behalf of NAMI Franklin County.  Pomegranate Health Systems was one of the start-finish line sponsors again this year.  Teen girls from our Meena Unit worked under the guidance of Ruthe, art educator and CPST to create a marvelous banner on canvas drop cloth.  [In fact, the background banner art the team created was so beautiful, we were thinking of creating a card series of encouraging notes.]  The message of the banner, ‘you are not alone’ came from looking over previous NAMI chapter entries from around the state and country online.  This message resonated.

It’s not easy leaving home for a treatment respite, but it’s not that different than leaving home for college. An acute stay is 7-10 days (camp);  residential 4-6 months typically. When ‘home’ is a drama-filled environment which has become unsafe due to drugs, abuse or neglect, Pomegranate becomes an emergency shelter care time-out or offers the breadth of perspective, new coping skills and tools that promote resilience.  Teens at Pomegranate learn about diagnoses, medication, and taking charge of their wellness and future well-being through individual therapy, group therapy, family therapy, art therapy, recreation, nursing group, substance abuse counseling and CPST/life skills group.  Girls on the Meena Unit are court -ordered to treatment, in lieu of juvenile detention.

There were a lot of fine banner entries, but the judges chose Pomegranate’s entry for the 2nd year in a row. (Last year the crowd picked our winning T shirt- a gym mural of a hand painting the sky, which was adapted to T-shirt design).   For their win, these teens will be celebrating with an ice cream social. Last year, Angela Nickell, CEO, supplemented the gift card and threw a facility-wide Donato’s pizza party for all residents.

The NAMI Walk is important to support because NAMI provides workshops and support groups for those living with and through a diagnosis of mental illness, and works to eliminate stigma and promote well-being.  The mission of NAMI is educate, advocate, listen, and lead.  This year 543 walked on behalf of NAMI Franklin County with over $12,000 raised for programs, and funds still coming in.

Read more or donate here:

http://www.namiwalks.org/index.cfm?fuseaction=donorDrive.event&eventID=517

https://www.facebook.com/events/1544734365823570/

http://khn.org/news/busting-myths-about-mental-illness/

[Photo credit: NAMI Franklin County Walk 2016, Pomegranate Archives]

NAMI-walk-2016-group

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Pomegranate Supports Student Scholar Athletes

“Persistence”

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This Wednesday, Pomegranate joins several other sponsors to support the 2016 Dispatch Student Scholar Athlete Awards at Greater Columbus Convention Center.  With our commitment to teens, it was a natural to be a part of this inspiring event which awards scholarships to both boy and girl athletes across several sports categories.  The keynote speaker this year is Tim Tebow, of NFL and Heisman fame. Pomegranate employs several athletes, school coaches and former athletes who are influential in encouraging and mentoring our residential clients and acute patients.

Many kids play sports.  There are a lot of sports movies- like ‘Rudy’. If anything, Rudy was persistent.   Here’s one such tale from 3rd grade baseball; California. This stuff can be larger than life for kids. (And parents.) Bottom of the seventh, two-on-base.  The score was 3-1. The freckle-faced kid in nerdy clothes came up to bat. Everyone on the bench groaned. Outfielders came in, nodding knowingly.  Swing and a miss. It was over quickly. The bell rang; recess done.  [Did not even get to the 9th].   Bobby, the Team Captain-a tan kid with wavy blond hair, jeered at the opposition, ‘Losers!’  Opposing Team Captain Tommy, fired back, ‘Don’t bet on it, sucker!’  And following recess was a math quiz.  Double insult.

At supper that night, freckle faced kid (‘FFK’) was uncommonly quiet, shoulders slumped. Under watchful parental eyes, and gentle questioning, the story came out. Mom teased out a little more over the tuna casserole and Jell-O salad, before dessert. That weekend, Dad bought a glove, ball and a bat. He evidently knew his stuff, and this was a side to him ‘FFK’ had never seen before. Nightly practice began with the little brother ‘TLB’, and mom in the cheering section, occasionally stepping in to hit. From feeble ground balls they practiced until FFK could easily hit sluggers over the neighbor’s fence into his swimming pool.  As Dad drove the blue family Ford wagon past school grounds,  FFK rehearsed coming up to bat in his mind; how he would stand, holding the bat until the right pitch connected.

It was a hot day, dusty from Santa Ana winds on the playground, and the teacher had a headache. The team captains picked kids, until only ‘terrible Torrance’, FFK and Thelma with the thick glasses were left.  FFK didn’t see much action there in the outfield, but finally came up in rotation. Ironically, bases were loaded in the bottom of the ninth, 3-1.  FFK came up to bat and Tommy said glumly, ‘Just try to hit it, ok?’ Bobby waved the outfield in with a sneer, and prepared to pitch. ‘Ball!’ shouted the umpire. FFK stepped back, and then connected with the second pitch. With a loud crack, the ball flew far into the outfield and rolled down near the monkey bars were the younger grades were playing. The dugout went wild. ‘We did it!’ Tommy whooped, running to high five the bench. Bobby had a funny look on his face, resigned. He turned to FFK, punching his glove. ‘I might have to pick you higher up now. See if you can do that again,’ he mumbled.  FFK smiled, ‘Thanks. I’ve been working on it.’   

‘Persistence’ will not work if there isn’t desire and intent behind it. ‘Persistence is also known as ‘stick-to-it-iveness’.  ‘Persistence’ won’t work if there isn’t learning involved. ‘Persistence’ doesn’t usually accomplish the goal if you weren’t meant to, or simply not ready to achieve something (yet), or, if it is the wrong goal. ‘Persistence’ is that quality of resilience that sees you through adversity, tough times and not shining’.  Persistence sees you through to something called serendipity, which is the moment (timing) it all comes together, at times, unanticipated. Magic occurs, and persistence pays off. You can’t predict when the moment will be, but it makes it all worthwhile.  Persistence teaches us the ‘yes you can’, ‘you will’, ‘it’s gonna happen’ and ‘you DID IT!’ Congratulations to ALL the winners of the student scholar athlete awards and their supporters!

Read more about The Dispatch Student Scholar Athlete Program at: http://www.dispatch.com/content/stories/sports/2016/04/17/dispatch-scholar-athlete-program–banquet-back-with-tim-tebow-as-speaker.html

[Photo credit: cShock/Dreamstime 9785607  Basket ball game Player@ sport hall] 

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Helping Teens Transition

transitionAt the NASW continuing education,  Science of Social Work: Focus on Transitional Youth conference held Friday in Cleveland, Gabriela Celeste, JD and Policy Director at Schubert Center for Child Studies, Case Western Reserve made a keynote address on emerging adulthood.  In a study spanning over 75 years on the ‘Secret to a Fulfilling Life’ there were two key findings which move people from child-hood to adulthood, the ability to form loving relationships and a sense of intimacy with another/others, and finding ways to cope with life’s ups and downs and not push love away.  Celeste asked the audience what biggest drawbacks/threats exist for a young person making it successfully to adulthood.  The answers were well-informed:  lack of engaged parents, lack of adequate education, poverty.   ‘One of the biggest threats to young well-being is a sense of isolation,’ she said.  ‘This focus on independence is a false notion, it should be interdependence.  We need each other,’ she explained. There is a lot of science behind the importance of connectivity.

For disadvantaged youth, it’s not simply emerging adulthood or being on the frontier of adulthood, but ‘expedited adulthood’‘Disadvantaged youth live in neighborhoods with shorter life expectancy-(up to 20 years shorter) and simply have less opportunity to take time to figure things out.   There is an urgency to get away from violence and drama; there is less time for discerning what one’s choices are or should be.  Then there is the compounded impact of biased treatment and navigating police as a developmental milestone for black and brown youth,’ she said.

Celeste continued, there are key developmental tasks in adolescence and ‘emerging adulthood’ as this phase is known, for navigating life.  ‘These tasks involve:  1) self-determination and decision making; 2) skillful navigation of life’s milestones and transitions; 3) identity formation & experimentation; and 4) building social capital/building supportive relationships.  Through each of these phases and tasks are three underlying social conditions for healthy youth development. These include: 1) having a caring adult invested in the kid’s success; 2) positive peer groups;  3) the opportunity for adventure, decision-making and to learn from risks (like driving).’

‘School can be a key protective factor, but one-in-five drop out (graduation rate is 80%).’  Celeste asked the audience to consider whether it is ‘drop out’ or ‘push out’ because of policies. ‘Students with one disciplinary contact are 5x more likely to drop out; one-in-9 are suspended at least once.  The vast majority of those suspended are for minor infractions- like tardiness, dress, disobedience. Defiance is a #1 reason; a #2 reason is fighting. But where do they go? Typically these kids go into exile and these are the kids who are likely to need our care the most.  Look at school design,’ she said.  ‘We treat kids more like a suspect than a scholar.’ The audience was quiet. ‘Our focus is safety first with metal detectors, video cameras, police tracking ID’s, and less money for arts, athletics, counseling, or music. One arrest raises the odds of dropping out of high school by 22% regardless of income.’  She shared an example.  ‘Advocates cite fewer arrests with a robust police presence, but that’s only true of violent incidents; smaller incidents are more apt to be criminalized.’  

The audience heard several more examples and saw a time lapse of brain development between age 5 and 19.  There was a chart of decision-making ability by age, contrasting intellectual ability and psycho-social maturity and the gap between the two.  Another chart (Dobbs 2011) on estimating risk and pleasure and the teen brain shows the difficulty in managing emotional response and controlling impulsiveness. This sense of control does not develop more fully until age 26-30.  The key task of this transitional time frame in navigating transitions- including daily lifestyle choices- is to invite a youth to: ‘1) pursue his/her passion, the ‘identity’ project;  2) encourage self-compassion- it’s worth being free of pain; and 3) encouraging relationship and connecting activities. Connecting activities are as important as school/career considerations in developing internal and external support people and systems.’  Perhaps this is as true of adults as transition age. 

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A family affair

family-silhouette

The National Center for Children in Poverty, Mailman School of Public Health, Columbia University cites ongoing developmental changes in the adolescent brain which make ‘adolescents particularly receptive to positive influences of youth development strategies social and emotional learning, and behavioral modeling.’  In other words, parents, educators, coaches and adults in the community working together to help shape a teen’s life can make a significant difference for good.  The article, Adolescent Mental Health in the United States, points out that, ‘At the same time, ‘adolescent’s developing brains, coupled with hormonal changes, make them more prone to depression and more likely to engage in risky and thrill-seeking behaviors than either younger children or adults.’  So, expect ups, downs, interruptions, experimentation, moodiness and mistakes, and prepare accordingly.  

The article refers to research from Archives of General Psychiatry, that ‘approximately 20% of adolescents have a diagnosable mental health disorder, and between 20% and 30% -a major depressive episode before adulthood.’ According to National Center for Injury Prevention and Control, CDC, ‘Suicide is the third leading cause of death in adolescents and young adults.’  Moving from what we know, to what we can infer, to what the research shows, there is plenty of opportunity to intervene and make a measurable difference in teen mental and emotional health- whether that’s in the school, a medical setting, or in the community –or earlier in the child’s life, developmentally.

‘Between 25% and 33% of adolescents forgo needed care or lack access’  according to The National Longitudinal Study on Adolescent Health, Journal of the American Medical Association.  Unstable home lives and homelessness may contribute to a teen’s distress. A recent article on ‘How to Prevent Mental Health Problems? Begin at the Beginning With Infants and Toddlers’ by Matthew Melmed, published in The Huffington Post suggests to, ‘Screen parents for depression. Parents who are experiencing depression may be unable to provide their children with the responsive care they need to feel safe, secure, and love. Supporting parents’ mental health is another way of supporting young children’s mental health.’  The author suggested screening for and intervention with mental health problems from infancy on, through-out the early years of life to prevent problems later.

mother-and-child

Higher rates of substance use disorder, joblessness, incarceration, broken home, domestic violence are all contributing factors to that general term, ‘context’.  The stress of a family system impacts a developing child. When a child or adolescent does exhibit the need for assessment and intervention, stress is subsequently felt in the entire extended family system.  All members of a family need a haven where they find support, guidance, comfort, safety, security, and love- a place of peace and nurture.  Toxic stress, economic insecurity, fear, and violence in the home do not generate that supportive cocoon. New models of child protective service  tend to focus more on in-home intervention, assertive community treatment, or MST-multi-systemic therapy  with a focus on removing the causes of dysfunction to help a family learn to again thrive, and stay together for the good of all.  It takes work, consistency and commitment.  Change doesn’t happen overnight, but identifying and recognizing how to move forward to a new paradigm is the first step in a longer  (life-long) journey.

Child and Family – The Importance of Our Early Life Experiences (by Isobel Harries)

http://www.apa.org/monitor/2016/04/living-wage.aspx

http://www.healthyplace.com/blogs/mentalillnessinthefamily/2016/03/marriage-and-mental-illness-take-care-of-the-caregiver/

http://www.healthyplace.com/bipolar-disorder/bipolar-support/effects-of-bipolar-disorder-on-family-and-friends/

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A Chat with the Chef

      chef-bart-and-shelby  

Behind every successful operation is an entire team of people, and the kitchen and cafeteria at Pomegranate is no exception. Facilities Director John Hedrick explained, ‘Our food is not institutional here. Don’t think prisons or cafeteria. It’s restaurant quality. We are balancing healthcare considerations with food that appeals to teens. Those might seem like conflicting demands.’  Pomegranate surveys its teen residents on an ongoing basis on a number of quality measures, food among them. Everyone has an opinion; and ‘food’ is not a neutral topic. We went to Registered Dietician, Shelby, of Dietary Solutions,  and Pomegranate’s Chef Bart for answers.

 How does Pomegranate decide what to serve residents?

“There are many factors we consider when writing the menus. It has to look good, taste good, be healthy and nutritious, be cost effective and on top of all that, something the kids will actually eat,” explained Chef Bart.  “Some teens have specific needs or allergies which must be taken into account,” added RD, Shelby.

Are there options?

“Any kid that does not like/want whatever we are having for a particular meal has the option of ordering a substitute,” said Bart.

What are some of the considerations a registered dietician must take into account?

“I look at overall calories, activity, age, gender, vitamins & minerals, sodium, carbs, sugar, fat, basic food groups, fresh, healthy foods, and balance,” said Shelby. Shelby then gives Chef Bart written recommendations for kids as needed.  He writes those recommendations on a dry erase board in the kitchen to communicate to all dietary staff so they know what to do.

food-groups

Residents have input into what is chosen. How does that work?

“Every month the Resident Senate meets. I get together with one representative from each unit and we discuss what they like about the menu and what things they would like to change,” explained Chef Bart. 

What are some of the favorite meals?

“The kids really enjoy the things all kids like.  Things like pizza, chicken, and mac & cheese.  One of the favorites is what we call Hot Cheeto Chicken, which are chicken tenders that we bread in-house with crushed Flamin’ Hot Cheetos in the mix.  It’s definitely the thing I get asked, ‘When are we having that again?”  the most,” he added.

Does popularity of particular foods change?

“Yes, if we have a particular item too much the kids get tired of it. Also tastes change with the seasons.  Now that we are in the spring season, it’s time for lighter, more fresh options as the produce becomes readily available,” he said.

What has changed since Pomegranate started in 2008?

‘Well I haven’t been here since the beginning, but I have been with Pomegranate for over five years.  I’d say the biggest change is the number of kids.  With the expansion last year and all the beds they added, it sure keeps us busy. Teens go to the cafeteria in small extended family size groups by campus. It is a symphony of scheduling by walkie-talkie. There isn’t any overlap or a huge school cafeteria feel,’ he said.

What have been some learning experiences?

“I have really learned the difference between the tastes of kids and adults.  I am a classically trained chef with a fine dining background but that doesn’t matter if the kids won’t eat what I’m cooking.  I have learned little techniques to invite the kids to try new things, like our wording on the menus or by pairing something they are reluctant to try with something they really like. The biggest thing is getting them to try it,” Chef Bart suggested.  “They usually say, “Hey this is actually good!”’, added Shelby

What have been some high points for you along the way (makes your job rewarding)?

“Although I’m not around the kids as much as the direct care staff, I still enjoy getting to know them.  Telling them, “Good job!” as they reach a goal.  (Discharge, Graduation)  Making something that they really like and then having a kid come tell you it was the best thing they ever ate;  that’s why I do it, he said with a smile.

Anything else our readers might want to know; a ‘did you know . . . ?

“I am very proud to be leading dietary staff here at Pomegranate.  We have five full time cooks, two dishwashers and a couple of utility workers, and between us we put out three meals and three snacks 365 days a year, for residents and staff members. And that’s not including special events, meetings and parties that we cater.” 

 

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