eSolutions, May 2012, Cultivating Community Collaboration
Feature Article: Cultivating Community Collaboration through Mental Health First Aid
Quick Tips: ALGEE, The Action Plan for Helping Someone in Crisis
Grantee Profile: Alaska Island Community Services
Susan Partain, Director, Mental Health First Aid, National Council for Community Behavioral Healthcare
Community collaboration is essential to achieving truly integrated care. Given the limited resources funneled to states’ behavioral health safety nets, community providers in particular must strengthen ties with the array of social support agencies to ensure a standard continuum of care. For optimum collaboration, behavioral health organizations must first find a common ground upon which to engage community partners.
Many communities across the country already teach a common language and means through which we can all help those with mental health and substance use problems — Mental Health First Aid. Mental Health First Aid trainings use role-playing and simulations to demonstrate how to recognize and respond to the risk factors and warning signs of specific illnesses like anxiety, depression, schizophrenia, bipolar disorder and substance use disorders, and how to help a person in crisis.
“We can no longer have a system where [providers] treat people and then send them back into communities that aren’t receptive to them,” says Arthur Evans, Commissioner of the Philadelphia Department of Behavioral Health and Disability Services. Evans and the City of Philadelphia are taking a population-based approach to Mental Health First Aid rollout, and aim to train up to 10% of the city’s population in Mental Health First Aid over the next few years. More about the Philadelphia initiative.
To implement the trainings, Evans first built an advisory committee that included organizational leaders from each community they wished to train. The advisory board was presented with a preview of the training so that each partner could see firsthand what Mental Health First Aid trainings entail and decide who from their respective agencies should be trained as instructors.
“The response we have gotten to Mental Health First Aid has been tremendous,” continued Evans. We are very excited about this initiative and the impact that we believe it will have on community health. We see this initiative as an important component of our public health approach to behavioral health issues…It's been one of the best things to happen to the field.”
Mental Health First Aid training is appropriate for a variety of community stakeholders, including primary care professionals, non-clinical behavioral health staff, public safety professionals, social services, faith leaders and more. Mental Health First Aid was developed in Australia in 2001 by Professor Anthony Jorm, a respected mental health literacy professor, and Betty Kitchener, a nurse specializing in health education. Since its inception, the program has undergone several studies which show that participants trained in the program gain better recognition of mental health concerns, more confidence in providing help to others, improved mental health for themselves, and decreased social distance from individuals with a mental illness. Since its introduction in the U.S. in 2008, more than 50,000 people have been trained through a network of 2,000 certified instructors. These citizens in towns and cities nationwide are prepared to intervene and get help for people showing symptoms of a mental illness/substance abuse or in a mental health crisis.
Beyond simply engaging community partners, educating community members in Mental Health First Aid creates a healthy community perspective that is responsive to the needs of consumers and supportive of their recovery. By creating community-wide collaboration, we create a building block of a recovery and resiliency-oriented approach.
“Regardless of how much we tried to move toward recovery-based services, we recognized there was still a need to reduce the negative perceptions [around mental illness] in our communities,” said Neal Cash, CEO of the Community Partnership of Southern Arizona in Tucson.
In the past, mental health organizations have spent millions of dollars on awareness campaigns and TV ads. But to hold a Mental Health First Aid course, all you need is a space, manuals and instructors. In these budget-conscious times, the program can educate a lot of people in a community for a small price usually under $100 per person)— and emphasizes the important “neighbor helping neighbor” concept.
As Mental Health First Aid continues to grow, it enables more Americans to take charge of their own behavioral health and become more literate in helping themselves and their neighbors. It is a critical social support that plays an increasingly pivotal role in bringing about healthier communities, particularly for some of our most vulnerable citizens.
To find a course in your community or to learn more about Mental Health First Aid, visit www.MentalHealthFirstAid.org. To discuss how Mental Health First Aid could benefit your primary and behavioral health integration efforts, contact CIHS.
The Action Plan: Helping Someone in a Mental Health Crisis
Mental Health First Aid teaches a five-step action plan for individuals to provide help to someone who may be in crisis. Called ‘ALGEE,’ the Mental Health First Aid action plan includes:
Assess for risk of suicide or harm Listen nonjudgmentally Give reassurance and information Encourage appropriate professional help Encourage self-help and other support strategies Assess for Risk of Suicide or Harm. When helping a person going through a mental health crisis, it is important look for signs of suicidal thoughts and behaviors and/or non-suicidal self-injury. Listening Nonjudgmentally. It may seem simple, but the ability to listen and have a meaningful conversation with an individual requires skill and patience. It is important to make an individual feel respected, accepted and understood. Mental Health First Aid teaches individuals to use a set of verbal and nonverbal skills to engage in appropriate conversation – such as open body posture, comfortable eye contact and other listening strategies.
Give Reassurance and Information. Individuals must recognize that mental illnesses are real, treatable illnesses from which people can and do recover. When having a conversation with someone whom you believe may be experiencing symptoms of a mental illness, it is important to approach the conversation with respect and dignity for that individual and to not blame the individual for his or her symptoms.
Mental Health First Aid teaches you helpful information and resources you can offer to someone to provide consistent emotional support and practical help.
Encourage Appropriate Professional Help. A variety of health and behavioral health professionals and interventions can help when someone is in crisis or may be experiencing the signs or symptoms of a mental illness.
Encourage Self-Help and Other Support Strategies. There are many ways individuals experiencing mental illness can contribute to their own recovery and wellness. These strategies may include: exercise, relaxation and meditation; participating in peer support groups; self-help books based on cognitive behavioral therapy; and engaging with family, friends, faith, and other social networks.
To learn more about ALGEE, the Mental Health First Aid action plan, visit Mental Health First Aid. To discuss how Mental Health First Aid could benefit your primary and behavioral health integration efforts, contact CIHS.
Grantee Profile: Alaska Island Community Services
Mental Health First Aid Extends Support in Rural Community
A SAMHSA Primary and Behavioral Health Care Integration grantee, Alaska Island Community Services is located in Wrangell, Alaska, a small, isolated town in the archipelago forming the Alaskan panhandle. This community health center provides the community with a comprehensive array of primary care, dental and behavioral health services. The center works closely with their behavioral health partner to integrate service delivery to improve health outcomes for people with serious mental illness.
AICS has a long history of working collaboratively with various community organizations. Given their isolated geographic location, this mountainous, forested island community is conducive to the adoption of a collaborative healthcare approach. Limited resources on the island serve to bring various community organizations closer together. AICS’ Primary and Behavioral Care Integration grant from SAMHSA enabled the agency to bring Mental Health First Aid to their island in an effort to increase mental health awareness and understanding. They chose to partner with other key community players to maximize outreach. Mental Health First Aid training participants in the community report notable benefits such as:
- Staff in the local school system trained in Mental Health First Aid use the skills learned to better work with troubled students and parents, as well as to de-escalate issues in general. The school system found the program so helpful, in fact, that they plan to bring another training to the island.
- Respite providers within Senior and Disability Services report improved staff sensitivity.
- EMT First Responders de-escalate situations more effectively.
- Support and entry-level medical staff in the primary care and behavioral health clinics have increased sensitivity in their work with patients, smoother flow of integration and better recognition of symptoms.
AICS staff reports that Mental Health First Aid has positively affected their integration efforts. They find that it underscores the role of behavioral health in the healthcare system, reduces discrimination, makes healthcare more user-friendly, and therefore more accessible, and increases referrals. As a community health center with imbedded behavioral health services, this increased awareness has increased the likelihood of clients following up for behavioral health problems after a referral.
AICS makes a difference in their community. Working collaboratively is nothing new to this innovative community health center. However, bringing Mental Health First Aid to their community not only increased the knowledge and understanding of behavioral health and its impact on the island as a whole, but it has also built on their natural collaborative strengths. Seeing opportunities where others might see barriers, AICS and their community partners have made broad strides to de-stigmatize mental illness in Wrangell, Alaska.
For more information on Alaska Island Community Services, visit www.akics.org.
Behavioral Health Homes: The Core Clinical Features
When: Wednesday, May 30, 2:00–3:30 pm EDT
Presenters: Laurie Alexander, PhD, Alexander Behavioral Healthcare Consulting; Benjamin Druss, MD, MPH, Rollins School of Public Health
RSVP: Register today. The webinar is free, but space is limited.
The 2010 Patient Protection and Affordable Care Act established a “health home” option under Medicaid that serves enrollees with chronic conditions. Federal guidance requires a health home to have several provider standards, including quality-driven and cost effective services, comprehensive care plans for each patient, and the involvement of continuing care strategies, to name a few. Hence, becoming a health home requires multiple changes in practice, in workflow, in billing operations, and other practical areas. Behavioral health providers can anticipate that these changes will be difficult and they will need to manage these necessary changes well to become a behavioral health home.
During this webinar, the authors of CIHS’ upcoming paper Behavioral Health Homes For People with Mental Health & Substance Use Conditions: The Core Clinical Features, Drs. Laurie Alexander and Benjamin Druss, will walk through the core clinical features of a behavioral health home and what to consider when becoming a behavioral health home. They will also highlight several organizations that have successfully implemented the clinical aspects.
SAMHSA Announces a Primary and Behavioral Health Care Integration Funding Opportunity
The Substance Abuse and Mental Health Services Administration has announced the availability of Primary and Behavioral Health Care Integration funding to offer 32 awards of up to $400,000 each. The purpose of the program is to establish projects to enhance the coordination and integration of services through the co-location of primary and specialty care medical services in community-based mental and behavioral health settings. Qualified community mental health programs are eligible to apply. Application deadline is June 8.
SAMHSA Statewide Consumer Network Grants
SAMHSA’s Center for Mental Health Services is accepting applications for the 2012 Statewide Consumer Network grants aimed at enhancing statewide consumer-run organizations to promote service system capacity and infrastructure development that is recovery-focused and resiliency-oriented. Approximately $770,000 is available for 11 grantees. Eligible applicants include consumer-controlled public and private nonprofit entities.
Behavioral Healthcare Takes an Inside Look at FQHC Look-Alikes
Federally qualified health center (FQHC) “look-alikes” have the same goal of integrating primary care into behavioral health, but the funding stream is different. Behavioral Healthcare explains the concept of a look-alike.
CMS Releases a Fact Sheet on Substance Abuse Structured Assessment and Brief Intervention
The Centers for Medicare & Medicaid Services has released an SBIRT fact sheet. “Substance (Other Than Tobacco) Abuse Structured Assessment and Brief Intervention (SBIRT) Services” provides education on substance abuse structured assessment and brief intervention (SBIRT). It includes an early intervention approach that targets individuals with nondependent substance use to provide effective strategies for intervention prior to the need for more extensive or specialized treatment.
New Commonwealth Fund Commission on a High Performance Health System
The Performance Improvement Imperative: Utilizing a Coordinated, Community-Based Approach to Enhance Care and Lower Costs for Chronically Ill Patients is a report from The Commonwealth Fund Commission on a High Performance Health System, which asserts that the federal government needs a comprehensive implementation plan to take full advantage of the opportunities in recent health reform legislation. The Commission proposes the U.S. create 50 to 100 voluntary “Health Improvement Communities” focused on patients with multiple, high-cost chronic conditions. Through payment reform, enhanced primary care, and health information technology, this effort could yield $184 billion in savings, or 21% of the overall target.
Call for Entries: The Generative Space Award
The Generative Space Award recognizes breakthrough designs that improve health and healthcare. Entries should come from health and healthcare settings in operation for 5 years or less that demonstrate documented improvements for a full range of stakeholders, including the local community. Submissions should clearly demonstrate the integration of the physical and social environments. The deadline is June 15, 2012.
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Our free technical assistance services can help primary and behavioral healthcare providers find integrated health solutions that work. To contact CIHS, visit www.integration.samhsa.gov, e-mail Integration@thenationalcouncil.org, or call 202.684.7457.
SAMHSA–HRSA Center for Integrated Health Solutions
Acting Director: Laura Galbreath; Deputy Director: Larry Fricks; eSolutions Editor: Heather Cobb
The SAMHSA-HRSA Center for Integrated Health Solutions, operated by the National Council for Community Behavioral Healthcare under a cooperative agreement from the U.S. Department of Health and Human Services, is funded jointly by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration. The CIHS promotes the development of integrated primary and behavioral healthcare services to better address the needs of people with mental health and substance use conditions, whether seen in specialty behavioral health or primary care settings.