holy cow! mental health: it’s not all it’s cracked up to be…yet!
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Holy Cow! Mental Health: It’s not all it’s cracked up to be…yet!. Kristine Hobbs, LMSW – DHHS July 2011 Learning Collaborative. Remind me why we’re talking about this?. From the grant: - PowerPoint PPT PresentationTRANSCRIPT
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Holy Cow! Mental Health:
It’s not all it’s cracked up to be…yet!Kristine Hobbs, LMSW – DHHS
July 2011 Learning Collaborative
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Remind me why we’re talking about this?
From the grant:“Behavioral health is fully
integrated into our demonstration grant as Category C which specifically focuses on the integration of behavioral health care within the medical home…”
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Remind me why we’re talking about this?
• 21% of children and adolescents in the US meet diagnostic criteria for MH disorder with impaired functioning
• 13% of school-aged, 10% of preschool children with normal functioning have parents with “concerns”
• Children with chronic medical conditions have more than 2X the likelihood of having a MH disorder
• 8 % of adolescents (2 million youths aged 12 to 17) are estimated to experience a major depressive episode each year, with only two-fifths receiving treatment.
Stats: http://www.teenscreen.org/images/stories/PDF/TS_PC_FactSheet_1.18.11.pdfhttp://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2011Calls/Foy%20Earls%20Georgetown%20-%20Final.pdf
QTIP Doctor - “1/4 to 1/3 of patient visits are mental health related”
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Remind me why we’re talking about this?
• 80 % of mentally ill youth are not identified and do not receive mental health services.
• The first symptoms of mental illness typically occur two to four years before the onset of a full-blown disorder, leaving an important window of opportunity for prevention.
• 90% of adolescent suicide victims have a psychiatric disorder, with 63% exhibiting symptoms identifiable by screening for at least a year before their death.
• 50% of all life-time mental health disorders start by age 14.
Stats: http://www.teenscreen.org/images/stories/PDF/TS_PC_FactSheet_1.18.11.pdfhttp://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2011Calls/Foy%20Earls%20Georgetown%20-%20Final.pdf
QTIP Doctor - “1/4 to 1/3 of patient visits are mental health related”
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Questions from Site Visits…
• Ultimate success?• Dismal Failure?• Realistic?• Factors Contributing to Success?• Challenges?• What are you doing already?• How can I best assist you?
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Summary of Site Visits
No one feels they are meeting the needs completely – they feel the current state of mental health services for kids is the worst case scenario
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Summary of Site Visits
Needs -• Effective screening, • More service providers, • Easier access to services, and • Billing issues resolved.
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Summary of Site Visits
Strengths – • Some have systems in place that support having
or adding additional services in-house,• Some of you have expanded your capacity to
provide limited services,• All of you are dedicated, creative practitioners.
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Summary of Site Visits
• Challenges – • Limited capacity of caregivers, • Limited resources, • Limited specialist, • Limited knowledge of resources, • Financial issues.
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What You Are Doing Now…
• 18 practices• 7 of 14 practices interviewed have some form
of mental health service provider with the practice (9 total with self-report)
• Co-location ranges on-site psychologist 4 hours/week to a full-time mental health counselor– 2 have PT psychiatrist with the practice
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How can I best assist you?
“Create resources out of dust”“Another form is not the answer”“I want to know what other people do”“Aren’t you a social worker? Come do
case management for us.”
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Where are we going?
In the words of Dr. Rushton…
–Prevention–Skill building in the medical home–Better back up and support to front-
line medical staff
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“Parties who want milk should not seat themselves on a stool in the middle of the field in hopes that the cow will back up to them.”
~Elbert Hubbard
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In General
• Provide options for screening and evaluation tools,
• Figure out the fiscal issues,• Skill enhancement for pediatricians and pediatric
staff around prevention, treatment, referral,• Other training opportunities – enhance
prevention and pediatricians skills,• Sharing resources and educational opportunities,• Linkages and support to the medical home.
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Resources and referrals• Identify local resources as
outlined with NCQA• Build bridges and connections
with local resources• Provide ideas for building
local networks around resource development and knowledge
• Psychometric testing• Benchmarking around
referral processes and feedback loops
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Co-location & Integration
• Ways to identify staff appropriate for co-location
• Funding options• Piloting some ideas• Training opportunities for Behavioral Health
Staff• Training opportunities for Medical Staff
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Psychiatry • Psychiatry Consultation with the
Pediatrician• Mini-fellowship in psychiatry• Access to more child psychiatrists
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DMH 24/hr ER Telepsychiatry Consultation
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You should have…
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Ready to take the bull by the horns?
Using your handout, indicate your top 3 mental/behavioral health priorities for the next 6 months…