Karn takes helm of Behavioral Health

The Tribe's Behavioral Health unit is rebuilding "from the ground up," says recently hired Behavioral Health Director Sharon Karn, 59, a psychiatric mental health nurse practitioner.

Karn was hired as department lead and arrived at the Tribe in late May.

She says her philosophy is taking a holistic approach to working with patients. The trend in the field is to treat behavioral issues with an integration of services, moving psychiatry into the medical model. Karn is building a program that includes both behavioral and medical specialists.

"We have to function as a team," she says.

The team approach means establishing key players, reducing turnover and getting the right professionals to pull together.

"We have some really good people in place. We have huge support from our administration. It's kind of a new day." Success, she says, gets back to the simple notion of a job well done.

The stronger the team, the better the chances that people will get their issues addressed.

For people who don't need direct services from the department, "We provide them with the tools they need to get back on track," says Jeffrey Lorenz, Health Services executive director.

Karn's duties also include prescribing medications.

With 37 years experience in the field, Karn says she keeps a fresh attitude by concentrating on "mental health not mental illness."

For many years, behavioral issues were taboo among the general public, she says. As a result, there are many roadblocks to care with patient fear being a big one.

There is a genetic component with behavioral issues, Karn says, but many issues beyond the genes are at play.

Poverty and alienation may be both causes and results of behavioral problems. That can mean no job, no close relationships or no peer group support. Add the difficulty of gaining access to care, such as the cost of transportation, medications, ongoing support or treatment, and the stigma of behavioral problems for individuals and their families all contribute.

Difficulties mostly beyond the individual and community include a lack of research in the field.

"If you compare our advances with what they've done in cardiology, it's night and day," she says.

A lack of resources in the field and a system already maxed out trying to fill the current need contribute.

The Tribe, however, has poured resources into the program to address basic issues.

"I have reorganized and now have our psychiatric mental health nurse practitioner running the department and supervising the entire Behavioral Health team," says Lorenz. 

The Behavioral Health unit has one practitioner (Karn), four counselors and a receptionist.  The caseload goal is "at least five patients per counselor per day," says Lorenz, "and that will grow as we rebuild the Behavioral Health reputation both internally and externally."

The Behavioral Health unit aims to get to patients before they have major issues. When support is given early, individuals, their families and the community see better outcomes.

The effort includes "lots of education and awareness skills, helping people find new ways to adapt to an ever-changing world," says Karn.

When services come too late, individual self-esteem suffers, of course, but an individual's problems also affect family and community.

"When there is alcohol, drug abuse and domestic violence in the community, children see that," says Karn. Unaddressed behavioral problems bring in money problems, police and social services.

"There's a big thread that runs through it," Karn says.

Karn is licensed in Florida, Washington and Oregon. Previously, she worked at the Spokane Veterans Affairs Medical Center before joining the Tribe's program. She is currently working toward a doctorate at Duke University.

She has worked serving the homeless and uninsured in a patient-centered medical home. She participated in psychotropic drug research and worked in a clinic affiliated with the Mayo Clinic.

Toby Karn, her husband, is a mortgage banker working for Dallas, Texas-based PrimeLending, a national mortgage company. Her stepdaughter, Betsy, runs her own public relations firm in New York City.

"We're a big hockey family," she says. "My husband plays in Sherwood, My brother is a National Hockey League coach and my nephew was drafted by the New York Rangers."

Born in Oklahoma where her grandmother was Cherokee, Karn is tracing her Native American heritage.

She also has spent more than 30 years fly-fishing. She is a gardener, hiker and avid reader. Two miniature dachshunds, Goalie and Puck, run around the family house in McMinnville.