Transforming Lives Through Mental Healthcare | Amanda Skrinjorich

Amanda Skrinjorich: Emotional health and emotional well-being, emotional regulation is all about language. If you can name it, you can tame it. If I ask you how you are, you’re going to say, fine, bad, or good. What does bad mean? Bad could mean exhausted. It could mean furious. It could mean devastated. Those are all very different feelings, and we would approach them in a very different way.

The other day, My son is four. He was really angry and I was like, what do we need to do? He said, I’m very angry. I need to take a breath. And he said, but mommy, I really think you need to take a breath because you’re looking pretty angry too. And I said, I’m overwhelmed. So we had this opportunity to define a whole other emotion.

And he’s used that phrase since then. It’s all good. It’s kind of like anything, right? We want to start that conversation early and often and really just making talking about feelings okay.

 

Anderson Williams: Welcome to Everyday Heroes, a podcast from Shore Capital Partners that highlights the people who are building our companies from the inside every day, often out of the spotlight with this series. We want to pull those heroes out of the shadows. We want to hear their stories. We want to share their stories. We want to understand what drives them, why they do what they do, how they might inspire and support others to become everyday heroes too.

In this episode, I talk with Amanda Skrinjorich, the Senior Medical Resource Director at Harmony, which is part of Transformations Care Network. Amanda is a mom, a wife, a professor, and a psychiatric certified physician associate.

With her own family mental health story to tell, a story that fuels her passion for doing cutting edge work, caring for patients, and her team at Transformations.

 

Amanda Skrinjorich: My name is Amanda Skrinjorich. I am the Senior Medical Resource Director at Harmony, which is part of Transformations Care Network in Morgantown, West Virginia.

And I’m also a psychiatric certified physician assistant, or it’s associate now. They changed the title recently and I haven’t quite got on board yet. I grew up here in Morgantown, West Virginia, so I’ve never really left the state. I lived in Marietta, Ohio for a year while I went to PA school, but grew up.

I have five brothers and two sisters. But I’m the youngest and the only one biologically from both of my parents. I always make the joke that my parents like to collect strays. So each of my siblings got to bring home like another person who was, you know, had to have a different living situation for whatever reason.

And so I had lots of, you know, foster siblings as well, kind of unofficial foster siblings. And so I always say that I have all these siblings, but I’m also kind of an only child, which is pretty cool. I’m the youngest of all of them. They’ve told me before that I’m quite bossy. So I think I was maybe started out thinking I was a leader before it was assigned to me.

 

Anderson Williams: Well, you had to carve your space with that many siblings, right?

 

Amanda Skrinjorich: Yeah, I’m a fierce self-advocate. At least that’s what I say about my toddler, she’s two. So I have two kiddos. I have Lydia, who is two years old, and JT, who’s four. And then my wonderful husband, who I’ve been married to for seven years.

And I like to run, that’s my big thing, is I’m a runner. And I love mostly just running. There’s not a whole lot for what you love right now other than working kids when you have toddlers. I’m very much a morning person. That’s something only people around me know. So like I get up at 4:45 every morning because that’s when you can get things done without toddlers.

That’s the best time to have some peace. But I also power down at around nine o’clock at night. I’m not a party animal.

Anderson Williams: In addition to being a runner and an early riser, Amanda describes herself as perhaps a bit bossy, but definitely a fierce self-advocate, which is a family trait she already recognizes has been passed to her daughter.

Dr. Ryan Wakim is the chief medical officer at Transformations Care Network, and has known Amanda since before either of them were part of Transformations, and before Amanda was ever even working in psychiatry. His story of how they met certainly reinforces that fierce self-advocate characterization.

He calls it gumption, and he recognizes that gumption has also been critical to Amanda’s success in transitioning from a role where she saw patients to one where she’s leading a team seeing patients.

 

Dr. Ryan Wakim: Amanda actually had originally joined the organization kind of pre-acquisition, pre-Shore. So, I actually trained her clinically, personally, early on in her career. And, you know, she is the, I’ll give you a quintessential example.

So, I was in overseeing a hospital contract. I was the one in the hospital seeing patients. And, you know, she was at the time a physician assistant student in the internal medicine department, you know, rounding on the same floor as I was rounding on.

And I would see her in the kind of physician room or the provider room doing dictation and writing notes and stuff. And at some point, along the way, she built up the gumption to come up to me and just kind of say, hey, you know, I’m Amanda. We haven’t officially met, but I’m really interested in psychiatry.

And, you know, I didn’t know if you’d be interested in having me as a student with you. And so her ability to just kind of take season of the day and take the opportunity and come up. to me and say, Hey, I noticed you here. I really have an interest in psychiatry and I’d really like that opportunity to do it with you.

It’s just a perfect example of how leaders were built, right. Or how we think about how you become a leader or how you learn to. Or how you can really impact others and manage and lead. And in order to do that, you have to be able to seize the opportunity. Right. And so that’s a perfect example of how Amanda sees an opportunity, saw what she wanted, and she went after it.

And, you know, she’s a very humble individual. And so, you know, she probably wouldn’t even tell that story herself, but the point of fact is the fact that she’s able to do that, or even just have the self-awareness. To even consider doing that really points to her ability to manage a team or to impact a community in a way that a kind of direct patient care or one on one encounter, those are critically important in order for us to meet our vision and our goals and help people.

We need to have individuals who are willing to see patients one on one, but when you’re able and willing and capable of doing more, that’s where we can recognize that opportunity and seize it. And, you know, she did that for herself.

Anderson Williams: When Amanda introduced herself to Dr. Wakim, she was a student in internal medicine.

 

So her introduction wasn’t just about a career move, it was about a career change. So I wanted to know what drove that, what was behind her passion for psychiatry at the time, and now as she’s built her entire career in the field. And as it turns out, her answer drew our two stories closer together.

 

Amanda Skrinjorich: Probably my mom is the biggest influence on me going into mental health specifically. I actually asked her this morning if she was okay with me sharing a little bit of her story, because I, it’s a very personal thing, but she had really, really strong opinions. severe depression my whole life. I actually played a pretty significant role in her healthcare since I was in, gosh, high school where she had to go on leave for work and things like that for pretty severe major depressive disorder.

 

And so she always tells people that I got into this field. I don’t know that that’s true, but it’s definitely been amazing to be part of an organization that isn’t just specialized in psychiatry, but like, is the best. She actually gets services through our company, so she gets bravado and TMS treatments, which are interventional psychiatry treatments, and I’ve seen her in the last year.

 

So I’m going to talk a little bit about what I’ve learned over the last two years, go from surviving to being truly well and thriving and, uh, something that six, seven, eight medicines never accomplished. And it’s an amazing thing that I get to be a part of .

 

Anderson Williams: Say more about that, just to help anybody who’s listening, understand what those therapies are and how they’re different, maybe than traditional.

 

And also just in terms of my own interest, just to share my story. My father also struggled terribly with depression and ultimately died by suicide. And so mental health has always been a part of our family conversation as well. And so I would love just to hear you say more about those things that are working as part of this story.

 

Amanda Skrinjorich: Interventional services, as we term them, are kind of like your alternatives to medications, right? So they may include some kind of medication. In the case of Spravato, it’s actually esketamine or an intranasal substance that we, under the supervision of a physician or an APP, is administered actually by the patient themselves.

 

They give it to themselves, and they squirt it up into their nose, kind of like Flonase. And I say when we talk about interventional services, I almost sound like a used car salesman because I get so jazzed about it. It works so well. It’s the only thing where I’ve seen someone suicidal and by the end of the treatment, they were smiling, truly smiling, right?

 

It’s an amazing and very fast acting treatment that also increases neuroplasticity within the brain. So we’re not just helping in that immediate point. It’s FDA approved for treatment, refractory depression, and actually acute suicidal ideation. But we’re also increasing the likelihood that they can kind of get that kindling or light that fire of improving even further in other aspects when they leave that space too.

 

And then the other two modalities, and we only do the one other one, is Transcranial magnetic stimulation, then there’s also ECT. Those are very different. We do not do ECT in an outpatient setting. That’s an inpatient setting. But transcranial magnetic stimulation essentially uses the technology, I tell patients, it’s kind of like if you’ve ever had an MRI, we use that same technology.

 

It’s rapidly alternating magnetic currents, only we focus that, those alternating magnetic currents or that magnetic energy. with pulsations using a coil on the left dorsolateral prefrontal cortex. And I always follow that with saying, that’s a lot of nerdy words for me to say where depression and anxiety are housed, right?

 

So we’re kind of putting your brain on a treadmill. We’re giving your brain physical therapy because it’s sleepy. It’s, it needs to wake up. And we do that by administering these pulses. And what we found is that it is an incredibly effective treatment for major depressive disorder.

Anderson Williams: For obvious personal reasons, it was thrilling to listen to Amanda talk about these new treatments, even if I couldn’t fully understand them.

So I wanted to better understand how what she was sharing ties into her work at Transformations Care Network.

 

Amanda Skrinjorich: The company that I started to work for was Harmony, which is a clinic. That started as a small company in West Virginia by three doctors who were residents at WVU and they wanted to do their own thing and I’m probably not doing the story justice, but it’s a great one.

And they grew and they were a bunch of guys, so they needed a bunch of their patients wanted a female provider. That’s where I ended up coming in. I came on and grew and grew and grew. Lots of therapists, lots of medical providers, and then we’re acquired by Transformations Care Network or Shore. So, when we were acquired, they liked our style of practice.

They loved, you know, that we were on the edge of everything, how our clinics were organized, how we interacted. And so, we kind of, as I understand it at least, or maybe I’m just building myself up in my mind, they modeled what we were doing for the entirety of the company. So, we have several clinics throughout the country, in all different states.

I personally work as I’m the Senior Medical Resource Director, so I manage all of the APPs within our West Virginia marketer region. We have five clinics currently in West Virginia that offer medication management services, therapy services, interventional services. So that’s kind of our broader view. In West Virginia, most specifically, we have a very big passion for substance use disorders, addiction management, medication assisted treatment.

So we keep that as a core part of what we do while also providing medication management, therapy services, and then also now these interventional services, which I always have trouble wrapping my mind around are quite rare. People don’t know about them as well as I would expect. I was kind of raised in it.

So I think I didn’t realize until we went to a conference once. They were like, who does ketamine services? And there were only like five of us that raised our hands and 500 people or something wild like that.

 

Anderson Williams: And why is that, Amanda? Why do you think that is?

 

Amanda Skrinjorich: So to your point about substance use disorders, ketamine is a drug.

Esketamine is what Spravato is. But ketamine itself is a drug that can be used and misused, abused. I think it has a stigma around it. It’s a psychedelic, right? So psychedelics have all kinds of things to unpack from many years of cultural ideas about substances. I think that people are rightfully very frustrated by mental health services, right?

It’s hard to get access to care. There’s a shortage of providers. There’s. wait lists months long to even get in with someone. Then you tell them, you know, I think of my mom again. She tells them her whole story. They pick at her. They ask about her trauma. They ask about this medicine and that medicine. At the end, they write a script and she leaves feeling worse than when she came because now she had to talk about all these terrible things.

And she takes the medicine for a few weeks and maybe she’s numbed out or she’s, or maybe it makes her more anxious. These are all things that actually happen to her, right? And then she goes back and in the case of her, before she got introduced to me, being able to have resources to help her, she got another resident who then needed her to tell the story again and said, all that medicine didn’t make any sense and switched her to a new one.

And it’s like, I’m not doing this anymore. I feel worse. Nothing is helping, and so I think providers can sometimes get in that place too, PCPs, even psychiatric providers. I can’t imagine working for a clinic that didn’t have these services that we offer. What do you do when someone’s tried six medicines?

You just say, well, let’s pick a seventh, right? We know that it doesn’t work. It’s exponentially, each time that we try another medicine, the chances that it will be effective for symptoms drops just so, so far, and the side effect profile often makes people quit. So we know that their chances of it working are dropping wildly and the chances of them quitting because of side effects are skyrocketing.

Why would we want to refer or why would we want to try, right? I think that’s important. That sometimes people just are kind of giving up because they don’t know about these options. So really trying to just kind of improve awareness and they’re still kind of relatively new. Sava has been around just not for very, very long.

TMS has been around a lot longer, and I think should be more well known. I’m not, I don’t know that I can say why it’s not.

Anderson Williams: The work Amanda and her colleagues do is both profound and profoundly difficult here. She sums up the kind of mindset, the determination, and really the hope required to live it every day with her team and her patients.

 

Amanda Skrinjorich: You will never hear me say, I’m so sorry, I’ve done all I can do. I am never going to give up on people. I’m never going to see someone and not try another medicine or try this new thing that we thought of or heard of, or at least just see. There’s a thing in suicide prevention training that we learn, it’s called sitting in the suck, right?

Sometimes when we’re at, we’ve tried a bunch of the options, medicines don’t really feel like they’re working, we’ll just kind of sit with the person in the suck, right? Just kind of make sure they know that someone’s there and hears them. And sometimes there’s nothing to be fixed, but you will never hear me say, I’ve done all I can do.

This is terminal. We know that it is, sometimes mental health conditions are terminal. You know that, unfortunately, more than anyone, right?

 

Anderson Williams: Yeah.

 

Amanda Skrinjorich: And that’s what I love. And sometimes what is really, really hard.

 

Anderson Williams: Amanda Skrinjorich is an everyday hero whose superpower is her gumption. She had the gumption to approach Dr. Wakim to become his student before she was ever even studying psychiatry. The gumption to innovate and grow her career in the field and at Transformations. The gumption to talk about mental health with her young children. To turn her mother’s mental health challenges and her own experiences as a daughter into a career of helping others, and the gumption to sit in the suck, because sometimes that’s all you can do.

For those of us who have lived the challenges of mental health personally, there’s great hope learning about the progress in the field, and the leadership of Amanda and the team at Transformations Care Network.

If you enjoyed this episode, check out our other Everyday Heroes at www.shorecp.university/podcasts, or anywhere you get your podcasts. There, you will also find episodes from our Microcap Moments as well as Bigger. Stronger. Faster. series, each highlighting the people and stories that make the microcap space unique.

This podcast was produced by Shore Capital Partners and recorded in the Andrew Malone podcast Studio with story and narration by Anderson Williams, recording and editing by Austin Johnson. Editing by Reel Audio Books, sound Design, mixing and Mastering by Mark Gallup of Reel Audio Books.

Special thanks to Amanda Skrinjorich and Dr. Ryan Wakim.

This podcast is The Property of Shore Capital Partners, LLC. None of the content herein is investment advice, an offer of investment advisory services, nor a recommendation or offer relating to any security. See the Terms of Use page on the Shore Capital website for other important information.