Health Care for All of Us

Lisa Ramirez, PhD

Psychologist

Founder, MetroHealth’s SAFE Project that helps kids cope with trauma

Trauma has become a regular part of life for many of our city’s children and the prevalence of anxiety and depression in local teens is on the rise. Dr. Lisa Ramirez, a psychologist for our School Health Program (SHP) in the Cleveland Metropolitan School District (CMSD), is tackling the effects of trauma head-on.

Acting out is common and toxic stress contributes to kids turning to smoking, drugs and alcohol. Lisa says, “We know that children who have ongoing adversity in the first 18 years of their lives are more likely to be adults with obesity, cancer, heart disease and strokes.”

Working with our Arts and Medicine program, Lisa began the SAFE (Students Are Free to Express) Project with high school students already involved in our SHP. This fall, she added SAFE for the pre-K level, knowing that earlier intervention is needed. Visual art, music, dancing, drum circles — they’re all ways to connect, destress and express.

”We provide an empathetic environment that is supportive, safe and fun,” explains Lisa. “We’re looking to help validate and normalize stressful experiences while talking about healthy ways to cope. We know that an antidote for adversity is meaningful relationships, and we promote that among the artists we bring in, teachers and our staff.”

Lisa looks hopeful as she says, “We’re trying to change the future health of these children by giving them an opportunity to just be children, and by hitting the pause button on the toxic stress process. We just might be able to help reduce some of the negative outcomes our children typically face.”

“We know that children who have ongoing adversity in the first 18 years of their lives are more likely to be adults with obesity, cancer, heart disease and strokes.”

Justine H.

Graduate Student in Psychology and Criminal Law

Graduate of MetroHealth Trauma Recovery Center’s trauma-focused therapy

When you see Justine interacting with her 2½-year-old daughter, Jhani, you sense that Justine has a strong emotional foundation. She’s nurturing and enjoys hearing her daughter precociously sing her ABCs perfectly.

It’s not obvious that Justine is recovering from anxiety and PTSD, the remnants of an abusive relationship. Justine describes her former boyfriend as manipulative, controlling and sexually abusive. He stalked her and during one episode of anger he smashed some of the contents of her home, tore down curtains and dumped out dresser drawers. She called the police, ended the relationship and says, “I was terrified, my judgment was clouded and I had lost confidence. I knew I needed assistance with coping.” She contacted MetroHealth’s Trauma Recovery Center. A year of one-on-one therapy and the Trauma Recovery Center’s sessions on cognitive processing therapy for PTSD helped Justine acknowledge and interpret her feelings and become more resilient.

She also was invited to be at the center of a MetroHealth Open Table. Six volunteers meet once a week with Justine to provide a network of support and advice. They have helped her access resources and are always available by phone call or text to answer a question or even read her 16-page paper for her Law and Society course.

Justine is juggling a lot. She’s a single mom with a full-time job, school studies and the drive to eventually work with people who have experienced trauma. “I’m still a work in progress, but I don’t think I would have been able to get this far without the help of MetroHealth.”

Justine with her Open Table

“I’m still a work in progress, but I don’t think I would have been able to get this far without the help of MetroHealth.”

Oliver Schirokauer, PhD, MD

Assistant Professor, Bioethics, Case Western Reserve University School of Medicine

Medical Facilitator who assists seriously ill patients with their health care journeys and decisions

How — or why — would somebody leave a tenured job as a math professor at Oberlin College to become a medical student, at age 47?

Dr. Oliver Schirokauer had his reasons. Multiple family members had grappled with cancer diagnoses, unfamiliar medical information and difficult decisions about their care. Oliver recognized how useful it would have been to have someone with medical experience help make sense of everything that was happening, and he decided he could try to be that someone for other families.

As a medical facilitator, Oliver meets with our family medicine team to identify hospitalized patients with a new diagnosis of a major illness, who can benefit from extra support during their follow-up care and who are interested in that help.

For outpatient appointments, Oliver and the patient meet in the lobby, chat in the waiting room and go together to the appointment. Oliver explains, “I’m not there to prescribe something or to design a course of treatment. I’m really there to pay attention for them.” After the appointment, he goes over what the caregiver said, answers the patient’s questions and generally is a calming force. Oliver says, “I sort of see myself as a repository of information for the patient, to be accessed when it works for the patient.”

Employed in our Center for Biomedical Ethics, Oliver is also involved in research and our clinical ethics consultation service. His vision of being a medical facilitator brought him to medicine and as the husband of one patient said, “I’m glad you’re here. It helps us take the next step.” Reflecting on this comment, Oliver notes, “This is my goal, what I want to be doing.”

“I sort of see myself as a repository of information for the patient, to be accessed when it works for the patient.”

Endia R.

Graduating Senior, Lincoln-West School of Science and Health

Fall 2019 scholarship student in nursing at Cleveland State University

Since 10th grade, Endia has never wavered; her goal is to be a flight nurse. Her eyes light up as she explains what for her was a transformative experience.

It was during her first year at Lincoln-West School of Science and Health, the school inside MetroHealth Medical Center, when her class visited our Metro Life Flight communications office. A family was in a terrible car crash and had to be airlifted to MetroHealth. Endia was immediately struck by how the teamwork of everyone involved — dispatchers, pilots and medical staff — was precise and made the most precarious situation look routine. She says, “You could see how much they wanted to help people in need, and I want to do that.” That’s why she plans to study nursing.

The youngest of eight children, Endia is the first in her family to go to college. Her father has been motivating her all along, suggesting opportunities that point toward college. She listened and says that her experience at Lincoln-West School of Science and Health clinched it. As she tells it, her teachers are encouraging and supportive, so much so that all 20 members of the 2019 class have been accepted to college.

And now that Cleveland is a “Say Yes to Education” city, Endia, as a Cleveland Metropolitan School District graduate, will go to college tuition-free. On top of that, her first two years of on-campus housing and student support services will be covered by the Parker Hannifin Foundation’s Parker Hannifin Living and Learning Community at CSU. Everything’s looking up for Endia.

“You could see how much they wanted to help people in need, and I want to do that.”

Shannon K.

Newly Sober Member of the Community

Participant in MetroHealth’s WRAP (Wellness Reentry Assistance Program) that provides physical/mental health and addiction services for current and former Cuyahoga County inmates with mental illness

“The day I got arrested is the day that began the rest of my life,” says Shannon. Her childhood had been one of mental and verbal abuse, and pregnancy and marriage at 17. She was using cocaine and ecstasy at 19 and graduated to hard liquor along with drugs. Sometimes she was homeless. Years of being addicted to crystal meth led to sleepless nights and a suicide attempt.

Looking back through more than a year of sobriety, Shannon, age 38, says getting arrested for forgery and possession of drugs saved her life. After six days in jail, she was told about WRAP, our program to connect people with mental health services and the support needed to successfully reenter society.

Dr. Ewald Horwath, Chair of MetroHealth’s Department of Psychiatry and founder of our WRAP program explains, “If you treat the problem as an illness rather than a moral failing, I think that’s what helps people.” With Intensive Outpatient Treatment, Shannon says she learned a lot about herself and how to handle her depression, anxiety, PTSD and ADHD.

Shannon notes that the program coordinators, therapists and physicians treated her with respect. And the love that her registered nurse care coordinator showered on her went a long way. Shannon gets teary when she says, “They were there to love me until I was able to love myself.”

Because of her compliance with the WRAP program, Shannon’s arrest record is sealed and due to be expunged. She loves her full-time job and is taking college classes so she can enter management. This is the rest of her life.

“They were there to love me until I was able to love myself.”