Queah Habern may not have been given as many years of life as other people, but few put more life into the years they had. By the time the 34-year-old succumbed to colon cancer in 2011, she had earned a journalism degree and built a successful career in fashion with Nordstrom department stores and as a consultant to corporate America. She also indulged a passion for travel, having visited 13 countries, and made a memorable last trip to Dallas to attend an NBA game less than a week before her death.

 

Habern also inspired those around her in the attitude and grit she showed during the course of her battle with the disease, which the American Cancer Society reports is skyrocketing in patients younger than 50. One secret weapon in this battle was yoga, which provided for both her mental and her physical state.

 

“Everyone pretty much knows, first of all, a cancer diagnosis is one of the most stressful things you can deal with. It’s an emotional downer,” said her mother, Donna Terrell. “Now you decide, ‘I’m going to step into this and I’m going to fight this disease,’ but in order to fight it, you’ve got all these horrible medicines and therapies that are going through your body. You’ve got all these doctor’s appointments. You’re worrying constantly if the tumor is shrinking or if all the cancer cells are gone.

Donna Terrell, TV news personality, left, founded Yoga Warriors Fighting Colon Cancer to help others like her daughter, Queah Habern, right, who died from the disease in 2011.

“When you think about yoga and the type of yoga that we’re talking about for patients, when you’re there on the mat, you’re typically not uptight. It’s the one place you can go and relax. You come in for an hour of relaxation and meditation. You don’t have to have any hands touching your body, which, Lord knows, is not necessarily the most soothing thing, and by the time you finish this practice, as it’s called, you have relieved a tremendous amount of stress. Mentally, that’s huge because in order to keep going, you’ve got to find a way to relieve the stress.”

 

Terrell, who is well known to Arkansans as a longtime local TV news personality, not only watched the positive impact of yoga and meditation on her daughter, but experienced it herself following Habern’s death.

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Terrell said yoga helped her after her daughter’s death, in addition to helping her daughter during her cancer battle.

“I knew nothing about yoga while she was doing it. It was offered to caregivers, but at the time, I just felt like this is for her,” she said. “After she passed, I made a decision to hire a yoga instructor to do some one-on-one, and I remember being on the mat, and I became very, very emotional. One of the things the yoga instructor pointed out was this is part of the whole practice, and sometimes in doing this, the emotional part is like a burden being lifted.

 

“I didn’t go there sad. I didn’t go there feeling any kind of way other than I really want to learn some of these poses and how to make my practice more effective. It brought out something in me that I didn’t expect.”

 

The interplay between mental state and physical health in healing has perhaps always been a tangential part of a patient’s story. A person fighting serious disease is often described as having a warrior’s mentality, determined to beat their condition. Colloquialisms such as “laughter is the best medicine” also hint at the link between the brain and body.

 

As it turns out, such notions are more than mere mind games. Building on the well-known placebo effect — essentially where the body gets better because the mind says so — study after study shows that the better a patient’s psychological state, the better chance they have to heal. This fact is leading more in the health care industry to provide for the psychological and emotional side of their patients as an essential part of treatment.

 

“I have seen the difference between a negative attitude and a positive attitude, that attitude of, ‘I’m not going to let this get me. I’m going to survive this,’” said Jennifer Hare, a clinical nurse navigator with Genesis in Hot Springs. “Having a good positive attitude helps tremendously with the healing aspects.”

Jennifer Hare, clinical nurse navigator at Genesis

Hare, who has spent 24 years in her profession worked in the ICU before spending the past two decades in oncology, heads a relatively new program at Genesis that serves as a ready resource for patients to feed their emotional and psychological health during treatment.

 

“All patients go through all the stages of grief. You see it numerous times,” she said. “About a year or year and a half ago, we started really seeing the need for our navigation program. We started seeing the need for patients to have education to know what’s going to happen, start to finish, and to have that single point of contact that we were missing.”

 

The clinical evidence of the balance of mind and body is relatively recent but overwhelming. One study published by the National Library of Medicine followed patients recovering from an unintentional injury. It found depression to be a major determinant of pain levels and healing. Patients reporting depression at one month following the injury were associated with significantly reduced odds of recovery at 12 months, adjusting for demographic factors such as age and sex.

 

Other sources go further, suggesting that mental state not only speeds or impedes the healing process; it can bring on certain ailments to begin with. According to healthline.com, chronic stress has been linked to headaches, migraines and digestive issues; depression can be an underlying factor in eye problems and general pain; and unresolved trauma can trigger autoimmune disorders such as psoriasis and rheumatic arthritis.

 

Research has also shown the mental-physical door opens both ways, and people suffering from mental conditions are often at risk for a physical comorbidity that can greatly affect lifespan. The Mental Health Foundation found schizophrenia is associated with a tripled risk of dying from a respiratory disease and a doubled risk of dying from a form of heart disease. Depression has been linked to a 50 percent increase in a person’s risk of dying from cancer and a 67 percent increase in death from heart disease.

 

Despite source after source piling onto this mountain of evidence and a growing call for mental health evaluation to be part of any diagnosis or ongoing treatment plan, resources for patients in the field remain limited.

 

“I see this is a major need in the aspect of health care,” Hare said. “There are not a lot of resources to send patients to that need help and support. Levi Hospital is a good place in Hot Springs that we can refer to, and there’s a couple other offices here in Hot Springs, but there is a major need for mental health assistance in all aspects of medical care, regardless of what it is.

 

“I feel, personally, that years ago, when [the government] started cutting all the funding to mental health, that there were going to be issues because of that because there’s nowhere for these patients to go. It’s a huge need.”

 

The medical community overall has been slow to respond and step into the breach. As Stanford Medicine reported, “Social context, including patients’ relationships with their doctors, as well as patients’ expectations about healing, can drive these placebo responses. Despite this research, the benefits of these psychological and social forces still receive much less attention than drug and device treatments.

 

“The health care and education systems in the United States generally do not emphasize psychosocial training. As a result, new doctors and health care workers take few courses on how to effectively form meaningful relationships with patients and how best to help them adopt useful mindsets.”

 

Hare concurred, saying the time spent in nursing school on tending to mental and emotional needs pales in comparison to hands-on medical training, despite nurses being in a prime bedside position to serve the whole patient.

 

“We had our mental health course, but I would say very little really prepares you for the actual realization of dealing with patients with this type of diagnosis,” she said. “We barely had any courses on oncology. It was like a very quick, ‘Oh hey, this is cancer and this is what it is.’ There’s not a lot of teaching a nurse how to have that compassion and to be able to listen to their patients. It’s learned more on the job than in nursing school.

 

“I also think in order to work in oncology, you already have to have a lot of that compassion built into you. It is a specialty area, and not all nurses can handle it. A lot of nurses develop that skill as they go through their career, but we’ve also had nurses that have come to work with us and then are like, ‘Nope, this is not what I want to do.’”

 

That said, there are examples of health care organizations and practitioners who are paying better attention to the psychological needs of patients during and after treatment. A model of this approach exists at Arkansas Children’s in Little Rock, where Jason Williams serves as the hospital’s first senior vice president and chief mental and behavioral health officer. The newly created role, which came online in January 2023, oversees both outpatient therapy services and embedded mental health specialists working with children battling disease.

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Jason Williams senior vice president and chief mental and behavioral health officer at Arkansas Children’s.

“The field of positive psychology has actually been studying this for a long period of time, both on the chronic illness side of things, but also on the wellness side,” Williams said. “We do know that when you have a positive outlook in life, generally, it affects how you overcome adversity, such as how you might be able to manage the physical event of going through chemotherapy.

 

“We also know that if I’m doing that on an ongoing basis — for example, by having a daily practice of positive affirmation with my family around the dinner table — I’m likely to have a better cardiovascular system. I might have lower blood pressure as a result of those types of conversations. While it might be subtle, we do see that brain chemistry changes with positive attitude.”

 

Arkansas Children’s approach when dealing with serious medical issues is to introduce mental health professionals from the get-go, giving them a seat at the same table as the various specialists who will coordinate the aspects of physical care.

 

“A way of thinking about it is a whole-child approach to care,” he said. “We have services where we know there’s a high risk for emotional need, such as something like a cancer diagnosis. Those services are automatically available. Kiddos and families have the capacity to be able to connect with a mental health professional as part of that team so that we can support the overall wellness and health for that and have the best outcome.

 

“When you come through our doors, we’re considering both your mental and psychological needs, as well as your physical needs. When you enter our emergency department, one of our emergency department physicians or [advanced practice registered nurses] is equipped to say, ‘I’m worried about how you feel. I’m worried about the screening that we just provided you with thoughts of self-harm. I’m going to get a mental health professional to come and speak with you.’ We have the ability to deploy somebody in that same way.”

 

Williams said while mental health services exist in health care, it is rare to have a system as formalized as Arkansas Children’s, complete with someone placed as high as he is in the administrative structure.

 

“Mental-health-in-chiefs are actually a new phenomenon in health care systems across the country,” he said. “There are a number of children’s hospitals that have started to build out a role like mine, and Arkansas Children’s Hospital is one of the first top 10 to do that in the country.

 

“There have been many different types of roles where mental health providers have really been sort of siloed off to the side of physical health. That doesn’t mean that there hasn’t been support at the patient level for mental health concerns, but really, the hospital system here is making the commitment and saying very boldly, ‘We are going to treat mental health at the same level that we would a surgeon or a pediatrician.’”

 

The next step in normalizing mental health care, Williams said, is to incorporate it into the more routine elements of doctoring and wellness.

 

“We have on hand a group of professional team members who can support mental health for kids who are here for physical needs, as well as those team members that are also embedded in both primary care, as well as our specialty care within the hospital itself,” Williams said. “We’re really trying to focus a lot of our efforts on the primary care setting, where we can identify kids when they go to the doctor to get their vaccinations or they go to the doctor to have their well checkup or their school physical to be able to play sports.

 

“We want that conversation to also include, ‘How is the family doing?’ and, ‘How is that child doing emotionally?’ so that we can support the pediatrician and also have a mental health professional alongside that doctor to be able to support the mental health of that family.”

 

Groundbreaking though the program may be, it has its work cut out for it in Arkansas, Williams said, from stemming the rising tide of youth suicide to improving the reach and access for families in the more remote portions of the state.

 

“Unfortunately, we still are living in a mental health crisis for youth,” he said. “When suicide is continuing to be the second leading cause of death for kids over 12, that’s a problem, and that’s a failure of our systems, broadly speaking, both societal as well as health care. That’s one of the reasons Arkansas Children’s is committed to this role and to me to come in and to try to figure out, ‘How do we do this?’ so that crisis gets averted and we actually deal with the future of well-being for the youth in our society. That’s the reality. We don’t shy away from that. We take on that challenge as it comes to us every day.

 

“A gap that I would say is still continuing to be a struggle is the reality of silo natures of health care systems where you, at times, have one group of people working independently from another and may not always recognize that, if they worked collaboratively and more closely, that they could benefit and serve more effectively.”

 

Part of that effort lies with leveraging community resources such as nonprofits dedicated to advancing mental health as a normal part of wellness and healing. Terrell is part of that effort, having translated her lived experience and that of her daughter through Yoga Warriors Fighting Colon Cancer, a 501(c)3 nonprofit she launched in 2014.

Donna Terrell, longtime local TV news personality

“When [Queah] was battling the disease, at one point she was going to a hospital down in Texas, and they offered yoga to patients and caregivers, so she started doing yoga,” she said. “She called me one day and said, ‘Mom, I did yoga, and it made me feel better.’ That always resonated with me, so I thought, OK, let’s create an organization for cancer patients and any other person with an underlying illness or an illness that prohibits them from moving and running and racing. Let’s create an organization that really caters to them, and at the same time, let’s introduce the rest of the community to yoga and let them see what the benefits are all about.

 

“The idea initially was just to raise money so we could provide this resource to cancer patients who really want to do it on a regular basis. That was our aim. As time passed, we just started growing and earning more money. More people were buying into what we believed in, and we grew from there.”

 

Today, the organization promotes awareness of early detection of colon and other cancers and helps pay for housing for cancer patients traveling for treatment. It also has provided yoga activities to thousands by establishing yoga studios at health care facilities and via vouchers for free classes to patients and survivors honored at a network of studios in the state. While she would not disclose details, the group is also very close to announcing a big brick-and-mortar presence coming soon to central Arkansas.

 

With so much time and effort wrapped into the mission of her nonprofit, one would think Terrell would not miss an opportunity to practice yoga herself, but she confesses to being far more casual about it than her daughter was.

 

“There are times when I really get into it, and then other times, I kind of slack off,” she said. “I know a lot of the poses, and sometimes I’ll do those in my stretching routine.”

 

Nevertheless, it is immediately apparent how the practice has worked its magic in her life, helping her cope with loss and renewing her commitment to help other people fighting similar battles.

 

“You can do yoga without other people. You can actually learn the process and do it at home. The breathing is just amazing. You can be sitting in the doctor’s office, and you can practice the breathing technique right there, I mean, actually doing it. It’s kind of incredible how it can work on you, not only mentally, but physically, also, because of the stretching, and while not everyone is as flexible as the next person, when you do this on a regular basis, your body starts to loosen up at its own pace, and that aids in healing, as well.

 

“There’s still the grief and all of that that I go through, but for me, that first day [of yoga] was one of the biggest stress relievers. I felt good for the rest of the day. It was the best kind of emotional release. When you think of these cancer survivors, once they buy into it and see that there truly is a benefit, that’s a kind of euphoric feeling that they get when they walk away. I like being able to offer that and to open more eyes to the practice and make people realize this is a really good thing.”

 

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