Psychiatry and Behavioral Health Patient Care

Tosa Health Center
1155 N. Mayfair Rd.
Milwaukee, WI 53226
(414) 955-8900

This academic-based clinical program is the first-of-its-kind in the nation and is staffed by multiple Tosa clinicians who are trained in evidence-based treatments, including complicated grief psychotherapy. The mission of this clinic is simple: Serve the countless number of grieving individuals of our community with the goal of improving their physical and mental health.  

1. Supportive grief therapy for intense grief symptoms following the loss of a loved one.
2. Clinicians who specialize in grief, including some who are trained in complicated grief psychotherapy – a structured psychotherapeutic intervention for prolonged grief disorder, one of the complications of grief.
3. Psychiatrists who are trained to treat grief-related complications, such as bereavement-related depression, anxiety, and post-traumatic disorder, using up-to-date evidence-based pharmacotherapies.
4. Collaborative ties with the grief research program DREAM (an acronym for Developing Resilience to Ease Anguish in Mourning).  This also includes nonpharmacological trials like yoga and health education groups.
5. Referral to community resources.

We, soon, aim to expand and become the liaison between our patients and community grief resources, educate and train both health professionals and lay public on prevention and treatment of grief-related complications, and foster academic-community partnerships in Wisconsin to improve the care for the bereaved.

Objectives

• Provide excellent clinical care and treatment for grieving individuals suffering from acute and prolonged grief
• Provide support for grieving individuals
• Help to distinguish psychiatric disorders from acute and integrated grief
• Identify and treat concurrent psychiatric disorders
• Promote and encourage research into bereavement and prolonged grief disorder
• Provide evidence-based resources for grieving individuals in our community
• Expand awareness and knowledge about normal bereavement and complications, such as prolonged grief disorder
• Educate other providers about recognizing and treating prolonged grief disorder

Before the first visit

We send out an evaluation for you to fill out. That way, we start your evaluation with as much information as possible. This package will include:

• Appointment Information
• Requests for Medical Information
• Brief Grief Questionnaire
• Depression Screen
• Anxiety Screen

On the day of the first visit

Please arrive on time. The initial evaluation may last up to 90 minutes.

During the initial visit, we will:

• Discuss the primary reasons for the visit or referral
• Obtain a comprehensive grief and psychiatric assessment
• Review past and current medications, and medical, family, substance use, and social histories
• Identify members of the patient’s support team (e.g., spouses, children, friends, loved ones)
• Discuss treatment options and create a plan for the next steps.
• Forward our evaluation report to the primary care and/or referring provider with the patient’s permission

Follow-up visits

Follow-up visits will depend on recommendations. We may recommend supportive therapy and/or community resources, as we are aware no one grief intervention will “fix” your grief. Additionally, you may be referred to a psychiatrist for additional evaluation or to a therapist who is experienced with complicated grief therapy.

• Amanda Liewen, MD | Medical Director, Grief Clinic
• Himanshu Agrawal, MD
• Carrie Danhieux-Poole, LPC
• Nicole Pryor, LPC
• Ann Marie Uselmann, MSW, LCSW

Grief Clinic 
Tosa Health Center 
3rd Floor (North entry) 
1155 N. Mayfair Rd., Milwaukee, WI 53226 
(414) 955-8900 

How to schedule

• Providers: Place referral for grief clinic through EPIC; be sure to specify grief clinic at TOSA Center.
• General: Call (414) 955-8952

• Goveas Grief Research Program (DREAM)

More Grief Resources

North Hills Health Center
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051
(262) 253-5400

A flagship clinic and the only one-of-its-kind in Southeastern Wisconsin, Froedtert & the Medical College of Wisconsin outpatient Senior Health Memory and Mood Disorders Clinic (Geriatric Psychiatry) offers individualized neuropsychiatric assessment and outpatient treatment to patients aged 65 years and older. We provide our elderly patients with comprehensive ongoing cognitive and mental health care, including personalized treatment plans. We also provide one-time consultations; including second opinion consults by our board-certified geriatric psychiatrists. We accept self-referrals and referrals from the primary care and specialty care physicians within the Froedtert & MCW system as well as from the community.

• To provide excellent clinical care and treatment for elderly patients suffering from neurodegenerative and psychiatric disorders
• To serve as the training site for medical students, residents and fellows in the care and treatment of elderly patients with neurodegenerative and psychiatric disorders
• To promote and encourage research into neuropsychiatric disorders of the elderly, especially in the area of late-life depression and Alzheimer’s disease

Comprehensive Memory and Cognitive Health Assessment and Management

• Evaluation to determine possible causes of memory loss or diminished cognitive functioning
• Diagnosis and management for elderly patients with memory disorders such as mild cognitive impairment and different dementia syndromes (e.g., Alzheimer’s disease, vascular dementia)
• Evaluation and management of behavioral disturbances secondary to dementia
• Evaluation of patient’s functioning and self-care abilities
• Follow-up care to monitor progress over time
• Ongoing care in collaboration with patient’s primary care physician
• Caregiver assessments and support
• Assistance to patients and their families in developing future plans, including advance directives planning
• Referrals to Alzheimer’s Association resources, support groups, memory enhancement, home care and hospice programs
• Consultations with neuropsychology, social work, occupational and physical therapy

Evaluations and Treatment of other Psychiatric Disorders in the Elderly

Our providers also evaluate and treat elderly patients experiencing:

• Mood disorders (e.g., late-life depression, bipolar disorder)
• Anxiety disorders
• Psychiatric disorders arising as a complication of grief and bereavement
• Late-life psychotic disorders
• Other mental disorders of old age

These psychiatric disorders if left undertreated or untreated may lead to persistent emotional distress, poorer outcomes for comorbid medical disorders, greater caregiver burden and increased risk for cognitive decline, functional disability, premature mortality and suicides.

We offer comprehensive treatment options for older adults with psychiatric disorders, including:

• Medication management: Our board-certified geriatric psychiatrists have expertise in psychopharmacologic management of psychiatric disorders in older adults, especially in those with multiple complex medical ailments and on polypharmacy.
• Psychotherapy referrals to an experienced psychotherapist within the Froedtert & MCW system or in the area
• Neuromodulation treatments: Electroconvulsive therapy (ECT) or repetitive Transcranial Magnetic Stimulation (rTMS) for treatment of depression
• Inpatient psychiatry referrals
• Community-based services, such as home care, nursing or Department of Aging referrals

We have a patient and family-centered approach to care. We encourage you and your loved ones to be active members of your team, helping to create a personalized treatment plan. We will work closely with your Froedtert & MCW or community-based primary care provider to ensure that your treatment is incorporated into your general medical care. We strongly believe in practicing multidisciplinary care and we work closely with other departments to provide the full spectrum of treatment services.

We collaborate closely with the following services within the Froedtert & MCW and affiliated programs to coordinate referrals and patient care:

• Froedtert & the Medical College of Wisconsin Primary Care Clinics
• Froedtert & the Medical College of Wisconsin Geriatrics Memory Disorders Program
• Froedtert & the Medical College of Wisconsin Neurology Memory Disorders Program
• Froedtert & the Medical College of Wisconsin Neuropsychology Clinics
• Froedtert Neurorehabilitation Services (speech, physical and occupational therapy, and driver safety evaluations)
• Horizon Home Care and Hospice
• Froedtert Health Behavioral Health Services
• Froedtert Health Menomonee Falls Hospital Inpatient Psychiatry Unit

Before the first visit:

We send out an evaluation for you and your family members to fill out. That way, we start your evaluation with as much information as possible. This package will include:

• Appointment Information
• Requests for Medical Information
• Adult Medical History Questionnaire
• Memory Screening Questionnaire
• Activities of Daily Living Questionnaire
• Safety Assessment (to be completed by family member or caregiver)
• Caregiver/Family Member Assessment

On the day of the first visit:

We encourage our patients to bring loved ones to the consultation, so we can create a treatment plan together. Please arrive on time. The initial evaluation lasts for approximately 90 minutes.

During the visit, a medical assistant and a registered nurse will initially see the patient. Subsequently, a board-certified geriatric psychiatrist will complete the assessment and plan the treatment. A trainee (a resident or a fellow) may interview the patient and obtain collateral information from the family before the visit with a geriatric psychiatrist.

During the initial visit, we will:

• Discuss the primary reasons for the visit or referral
• Obtain a comprehensive neuropsychiatric and functional assessment
• Review past and current medications, and medical, family, substance use, and social histories
• Conduct a memory and depression screening
• Identify members of the patient’s support team that will be involved in planning for the care (e.g., spouses, children, friends, loved ones)
• Discuss treatment options and create a plan for the care moving forward. Co-existing medical illnesses, medications, family issues, social concerns, and environmental issues are integrated into a comprehensive program of care
• Forward our evaluation report to the primary care and/or referring provider with the patient’s or proxy decision maker’s permission

Follow-up visits:

Follow-up visits will last for approximately 30-45 minutes. This visit may either be scheduled with an advanced practice nurse prescriber or a geriatric psychiatrist after discussions with the patient and/or the healthcare proxy decision maker.

During the visit, a medical assistant and a registered nurse will initially see the patient. Subsequently, a board-certified geriatric psychiatrist will complete the assessment and plan the treatment. A trainee (a resident or a fellow) may interview the patient and obtain collateral information from the family before the visit with a geriatric psychiatrist.

Faculty

• Joseph S. Goveas, MD, Director
• Harold Harsch, MD
• Katherine Levine, MD

Staff

• Donna Brady, LPN
• Lynn Guch, MA
• Carolyn Hermann, RN
• Janice Kuiper Pikna, APRN
• Betty Moderski, RN
• Ronna Thoenes, RN