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A collaboration: Hill empowers youth, caregivers when prescribing medications

As a prescriber for Places for People’s Youth and Family Services program, Trish Hill strives to work collaboratively with youth and caregivers to empower them in their wellness journey.

“My overlying philosophy with people is they do the best that they can until they’ve been given the resources, the knowledge, and the opportunity to be able to do it. It’s not enough to tell them what they need to do, they have to be lifted up to do what they need to do, too.”

For instance, she recognizes that compliance with medications can be a challenge for the families with whom she works. She does not call it non-compliant. “It’s typically not that simple,” she said. “I try to make it really collaborative with the parents so that they will feel like they’ve been heard, so they are more likely to make it more of a priority to be able to get the medication.”

She has learned that this approach can generate much better results than the alternative.

“Guilt and shame can be really very paralyzing to people. When you are a caregiver and you have that guilt and shame it’s really hard to get motivated to do the things that you need to do if you don’t feel capable or worthy of doing that. There’s no room to do that to people.”

For Mike Lamping, Youth and Family Services Program Manager, that is one of the examples of what makes Hill a thoughtful, respectful partner in a family’s wellness journey.

“First, I have to say that Trish is an excellent practitioner whose knowledge, training and skill positively impacts the health and well-being of all of the children and youth that she treats. That said, it is the way Trish practices and interacts with children, youth and caregivers that adds such great value to the care that we are able to provide across all of our Youth and Family Services,” Lamping said. “Trish embodies the ‘human approach to health and healing’ as she recognizes and honors the dignity and uniqueness of each person we serve.”

As an advanced practice nurse, Hill works with all segments of Places for People’s Youth and Family program. Any youth or adolescent who is currently on medication upon enrolling in services or may need to begin a medication meets with Hill or Angela Williams, a Psychiatric Nurse Practitioner from Washington University who is also a prescriber for the Youth and Family Services program.

In her initial assessment, Hill meets individually with the youth and caregiver. Meeting separately provides an opportunity to hear independent answers. “What may have been traumatic to (the youth) may not be something that their parent may have known about.”

She then brings them together to develop a medication plan. In most cases, she will see the family again in two weeks, eventually moving to monthly appointments.

“Kids and parents feel heard and respected and come to understand that no matter where they are starting from, Trish will be a partner in their journey toward better health and well-being,” Lamping said of Hill’s ability to build a rapport with youth and their caregivers.

Kids and parents feel heard and respected and come to understand that no matter where they are starting from, Trish will be a partner in their journey toward better health and well-being.Mike Lamping, Places for People Youth and Family Services Program Director

With medications, Hill said, rarely are results instant.

Prescribing medications to youth is not a decision Hill takes lightly. “All of these medications have side effects, so I don’t want to ever make matters worse or medicate unnecessarily.”

When treating youth, Hill examines whether behavioral issues are caused by environmental factors – “we learn what we live” – or organically from issues caused by brain chemistry, such as ADHD, anxiety, depression or bi-polar disorder. “Those things need medication, but not just medication,” she said.

As an example, she said that if child is behaving one way at home, but not having those behavioral problems at school, “I can pretty safely that that is not a mental health issue. That’s an environmental issue and so we can address the environmental issue.”

However, environmental and organic issues can also overlap due to exposure to trauma, which creates a range of possible triggers.

All of these factors make Places for People’s comprehensive services for youth and families valuable, according to Hill. Youth and Family team members are involved in all facets of a youth’s life – from school to community to home. These viewpoints help provide Hill with a broader perspective as she makes her determinations.

Additionally, the organization has the capacity to help caregivers who may need support through the full array of services offered to adults. “(Youth) don’t have that level of control over their own environment. Children often go as their parents go,” she said.

“When you work with youth, you can’t really just work with the youth,” Hill said.

Hill joined Places for People in the fall of 2017. She has been an Advanced Practice Nurse for 10 years.

“Trish provides incredibly competent care by really caring about, and getting to know the youth and families with whom she works,” said Gina Ferrara, team leader for Places for People’s Connect Team. “She respects the uniqueness of everyone she meets and addresses their complex needs in a holistic and compassionate way.”

She respects the uniqueness of everyone she meets and addresses their complex needs in a holistic and compassionate way.Gina Ferrara, Youth and Family Services Connect Team Leader

Before earning her master’s degree, Hill’s background was in emergency nursing with adults. She has been an RN for nearly 37 years, with the past 10 as an Advanced Practice Registered Nurse boarded in child & adolescent psychiatric nursing/mental health.

Hill pursued a master’s degree with a focus on mental health due to family experiences with alcoholism and her own experiences earlier in life as a single mother. At that time, Child and Adolescent Psychiatric Nursing – Hill’s certification – was still a choice in addition to Family Psychiatric Nursing. She focused on Child and Adolescent Psychiatric Nursing for a few reasons. “For me it was: 1) I’ve always liked kids. 2) It was the fact that I can impact them early on and hopefully maybe prevent things escalating into the future,” she said.
Hill loves what she does.

“Doing what’s right for the kid and the family is always the priority,” she said. “You hear lip service to that a lot of times, but you don’t often really get to live it. Here I feel like I can live that.”