The document summarizes key findings from the 2012 NAPHS Annual Survey on behavioral health trends. The survey found continued increased demand for all levels of behavioral health services, including inpatient, residential treatment, partial hospitalization and outpatient care. Occupancy rates and admissions increased across all levels of care from 2009 to 2010. The survey revealed high utilization of inpatient psychiatric facilities and significant growth in outpatient visits. It also showed diversity in levels of care provided for different populations.
This document provides strategies for strengthening needs statements in grant proposals using data and research. It outlines four strategies: 1) using specific and local data; 2) presenting data in an easy-to-follow way from "big to small"; 3) citing relevant research; and 4) helping the reader follow the argument and draw conclusions. Examples are provided for each strategy to illustrate how to incorporate compelling local data, cluster and sequence information clearly, support needs with outside studies, and explicitly state the implications of the presented evidence.
The document discusses several issues with the current state of mental healthcare in the United States. Mental health services faced major funding cuts in 2008, resulting in fewer treatment options. This has exacerbated problems of inadequate and inaccessible care, especially for low-income individuals. Approximately 18% of U.S. adults have a mental illness, yet there is a shortage of psychiatrists due to numerous barriers. Integrating physical and mental healthcare could help address high rates of co-occurring conditions and improve outcomes, but the fragmented system continues to leave many without proper coverage or treatment.
The percentage of persons in families having problems paying medical bills in the past 12 months decreased from 19.7% in 2011 to 14.2% in 2018 according to a National Health Interview Survey. In 2018, females, children aged 0-17, and non-Hispanic black persons were more likely than other groups to have problems paying medical bills. Among those under age 65, the uninsured had the highest rates of problems paying bills, followed by those with Medicaid or private insurance. For those over 65, those with Medicare and Medicaid or Medicare only had higher rates than those with Medicare Advantage or private coverage.
This document discusses challenges facing hospitals and health systems in making their case for philanthropic support. It analyzes the environment through three lenses: the economy and donors' perception of personal economic security; personal motives and perception of the organization's value and impact; and hospital performance and perception of need. Recent media coverage has brought increased transparency of hospital pricing practices and costs. This, along with other factors like the Affordable Care Act, are eroding future margins if hospitals do not change course. Hospitals must effectively communicate their community benefit and value to donors.
Community Health Charities Introduction 2010sshwiff
The document discusses the benefits of workplace wellness programs and charitable giving campaigns. It notes that over 133 million Americans have chronic illnesses, which account for 75% of healthcare spending. Workplace wellness programs have been shown to lower medical costs by $3.27 for every dollar spent and reduce absenteeism costs by $2.73 for every dollar spent. Such programs can improve employee health and productivity while reducing employers' healthcare costs.
The document discusses key components and goals of the Affordable Care Act (ACA) and healthcare reform initiatives, and their potential impact on continuing medical education (CME) and medical communication businesses. It describes major provisions of the ACA that aim to increase access to healthcare coverage, improve quality of care, and contain healthcare costs. These include the individual mandate, health insurance exchanges, Medicaid expansion, essential health benefits, and various programs to promote higher-quality, more coordinated, and cost-effective care through value-based purchasing and alternative payment models.
The document discusses implementing a public health approach to address drug abuse, mental illness, homelessness, and incarceration of those with mental illnesses or substance abuse issues. It notes the high economic and social costs of the current fragmented system and lack of treatment. Over 20% of jail and prison populations have a mental illness or were incarcerated due to lack of treatment options. The document calls for a national strategy with coordinated services across housing, employment, treatment, law enforcement, and other areas to improve outcomes and reduce costs to taxpayers.
The document summarizes findings from the 2008 Massachusetts Health Insurance Survey regarding access to healthcare among Massachusetts residents. Key findings include:
- Most residents had a usual source of care, doctor visits, and preventive care visits, though the uninsured and lower-income residents had lower rates of access.
- Over 20% of residents did not get needed care due to cost, with the uninsured and lower-income most affected.
- Difficulty accessing care and unmet needs were highest among the disabled, uninsured, and lower-income residents.
This document provides strategies for strengthening needs statements in grant proposals using data and research. It outlines four strategies: 1) using specific and local data; 2) presenting data in an easy-to-follow way from "big to small"; 3) citing relevant research; and 4) helping the reader follow the argument and draw conclusions. Examples are provided for each strategy to illustrate how to incorporate compelling local data, cluster and sequence information clearly, support needs with outside studies, and explicitly state the implications of the presented evidence.
The document discusses several issues with the current state of mental healthcare in the United States. Mental health services faced major funding cuts in 2008, resulting in fewer treatment options. This has exacerbated problems of inadequate and inaccessible care, especially for low-income individuals. Approximately 18% of U.S. adults have a mental illness, yet there is a shortage of psychiatrists due to numerous barriers. Integrating physical and mental healthcare could help address high rates of co-occurring conditions and improve outcomes, but the fragmented system continues to leave many without proper coverage or treatment.
The percentage of persons in families having problems paying medical bills in the past 12 months decreased from 19.7% in 2011 to 14.2% in 2018 according to a National Health Interview Survey. In 2018, females, children aged 0-17, and non-Hispanic black persons were more likely than other groups to have problems paying medical bills. Among those under age 65, the uninsured had the highest rates of problems paying bills, followed by those with Medicaid or private insurance. For those over 65, those with Medicare and Medicaid or Medicare only had higher rates than those with Medicare Advantage or private coverage.
This document discusses challenges facing hospitals and health systems in making their case for philanthropic support. It analyzes the environment through three lenses: the economy and donors' perception of personal economic security; personal motives and perception of the organization's value and impact; and hospital performance and perception of need. Recent media coverage has brought increased transparency of hospital pricing practices and costs. This, along with other factors like the Affordable Care Act, are eroding future margins if hospitals do not change course. Hospitals must effectively communicate their community benefit and value to donors.
Community Health Charities Introduction 2010sshwiff
The document discusses the benefits of workplace wellness programs and charitable giving campaigns. It notes that over 133 million Americans have chronic illnesses, which account for 75% of healthcare spending. Workplace wellness programs have been shown to lower medical costs by $3.27 for every dollar spent and reduce absenteeism costs by $2.73 for every dollar spent. Such programs can improve employee health and productivity while reducing employers' healthcare costs.
The document discusses key components and goals of the Affordable Care Act (ACA) and healthcare reform initiatives, and their potential impact on continuing medical education (CME) and medical communication businesses. It describes major provisions of the ACA that aim to increase access to healthcare coverage, improve quality of care, and contain healthcare costs. These include the individual mandate, health insurance exchanges, Medicaid expansion, essential health benefits, and various programs to promote higher-quality, more coordinated, and cost-effective care through value-based purchasing and alternative payment models.
The document discusses implementing a public health approach to address drug abuse, mental illness, homelessness, and incarceration of those with mental illnesses or substance abuse issues. It notes the high economic and social costs of the current fragmented system and lack of treatment. Over 20% of jail and prison populations have a mental illness or were incarcerated due to lack of treatment options. The document calls for a national strategy with coordinated services across housing, employment, treatment, law enforcement, and other areas to improve outcomes and reduce costs to taxpayers.
The document summarizes findings from the 2008 Massachusetts Health Insurance Survey regarding access to healthcare among Massachusetts residents. Key findings include:
- Most residents had a usual source of care, doctor visits, and preventive care visits, though the uninsured and lower-income residents had lower rates of access.
- Over 20% of residents did not get needed care due to cost, with the uninsured and lower-income most affected.
- Difficulty accessing care and unmet needs were highest among the disabled, uninsured, and lower-income residents.
The Kaiser Permanente Homeless Navigator Pilot Program in Woodland Hills, California connects homeless patients with community resources to help them find housing and other services, placing over 576 homeless patients in shelters and programs since 2012. The program uses a team approach involving medical, social work, and community staff. It has been successful in transforming lives and ending homelessness for many patients.
The document discusses healthcare changes in Oregon under the Coordinated Care Model, including the impact on clinicians. It describes how the model aims to improve health outcomes while lowering costs through coordinated care organizations (CCOs) that integrate services and receive incentives for quality. Interviews found that while some clinicians feel aligned with these goals, others expressed concerns about losing autonomy and taking on increased responsibilities. Overall, the reforms were described as bringing changes to clinical roles and uncertainty about the future, but also opportunities for collaboration and innovation.
This document summarizes a report on prescription drug costs and utilization from Express Scripts. It provides an analysis of caregiving and the challenges caregivers face in managing their own health needs while also providing care to others. The summary found that 34.6% of Express Scripts members surveyed were caregivers. Caregivers reported poorer health and lower rates of medication adherence than non-caregivers. The report estimates that following evidence-based treatment guidelines for breast cancer could save an average of $8,000 per patient per year by reducing off-guideline treatment from 21.1% to 0%.
The document is a final reflection paper on improving the US healthcare system. It argues that while the US spends the most on healthcare, it underperforms compared to countries that spend less. This is due to a lack of cost control, universal access, and transparency. The paper proposes adopting aspects of Singapore and Japan's healthcare models, which emphasize social harmony, personal responsibility, and transparency. It suggests establishing a flat fee for all healthcare services paid by providers to control costs and incentivize value-based care between payers and providers. Overall the paper argues the US could lower costs by improving collaboration, transparency, and personal responsibility in the healthcare system.
Early Impacts of the ACA on Health Insurance Coverage in Minnesotasoder145
The analysis found that the number of uninsured Minnesotans fell from 445,000 to 264,000 between September 2013 and May 2014, a reduction of 180,500 people. This unprecedented drop in uninsurance reduced Minnesota's rate from 8.2% to 4.9%. Most coverage gains occurred in public insurance programs like Medical Assistance, which saw an increase of 155,000 people. Private health insurance coverage also increased by a net gain of 30,000 as a result of a 36,000 gain in nongroup coverage offsetting a 6,000 loss in group coverage. The findings were consistent with other analyses of the early impacts of the Affordable Care Act nationally and with reforms in Massachusetts.
Leanne Wells, Chief Executive Officer, Consumers Health Forum of Australia, gave the Ian Webster Health for All Oration to the annual forum of the Centre for Primary Health Care and Equity on 13 August 2015.
The Arizona Crisis Now Model: AHCCCS OutcomesDavid Covington
In 2016, the National Action Alliance for Suicide Prevention published “Crisis Now: Transforming Care is Within Our Reach.” Alignment with these practices cuts cost of care substantially, reduces the need for psychiatric hospital bed usage, ED visits and law enforcement overuse; resulting in better health and declines in suicide rate, justice system involvement/ incarcerations and psychiatric boarding. These challenges are simply greater than previously acknowledged, but the Washington State supreme court ruling on the unconstitutionality of boarding, the suicide death of Virginia State Senator Creigh Deeds’ son, the insistence of hospitals nationwide about the costs and safety and the series of violent incidents from Columbine forward are changing the expectations. These innovative approaches pioneered under the leadership of Arizona Medicaid are now being replicated throughout the US.
Anne C. Beale, MD, MPH, the president of the Aetna Foundation speaks about disparities in child health care, the causes behind those disparities, and policies that can reduce them.
Economic Impact on Minnesota's Health Care Delivery Systemsoder145
Presentation by Lynn Blewett to the Minnesota State Legislature at a joint meeting of the health care and human services finance and policy committees in Saint Paul, MN, February 10 2009.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
This document summarizes several issues facing the healthcare system and medical education in Tennessee, including a physician shortage, limited residency slots, student debt, and budget issues. It discusses how increasing medical school class sizes only partially addresses the physician shortage, as the number of residency slots available has not increased to match. This bottleneck could result in not enough residency positions for all medical school graduates in the near future. The document also notes the impact of heavy student debt on career choices, and debates around shortening medical education programs and resident work hours.
EOA2016: Taking Stock: 2016 Health Profile & Well-Being ReportsPIHCSnohomish
During the 2nd breakout session at Edge of Amazing 2016, Jody Early, PhD (UW Bothell School of Nursing & Health Services) and Elizabeth Parker, PhD (Snohomish Health District) discussed results from the PIHC Health & Well-Being Monitor & the Health Districts latest profile of health in Snohomish County.
This document discusses poverty and health inequities. It finds that those living in poverty experience significantly higher rates of many health issues compared to more affluent groups. For example, in Saskatoon low-income residents are over 1000% more likely to be hospitalized for diabetes or have chlamydia. A survey found most people agree the poor have worse health, and support policies to strengthen early childhood programs, increase income supplements, and expand disease prevention. The document calls on governments and communities, including faith groups, to work together using evidence-based solutions to improve conditions for daily living and reduce health inequities over time.
The document summarizes a webinar about the 50 State CHARTBOOK on Foster Care, a web-based resource created by researchers at Boston University. The CHARTBOOK contains state-by-state profiles with data on foster care programs, policies, financing, and outcomes. It aims to be a useful tool for professionals, advocates, and policymakers. The webinar featured the creators of the CHARTBOOK discussing its development and organization, as well as perspectives from child welfare leaders on the resource's utility and potential to benchmark progress over time.
The document discusses the growing interest in coordinated and integrated healthcare delivery through models like patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). It notes the potential benefits of these models, including improved quality of care and reduced costs. Specifically, it cites evidence that Geisinger Health System achieved a 9% reduction in total healthcare costs and lower hospital admission and readmission rates through implementing a PCMH-based accountable care model. The long-term goal is for PCMHs and ACOs to transform healthcare delivery in the US to a more coordinated, high-value system focused on primary care.
CA Senate Select Committee on CSHCN Presentation: Systems Overview 12/1/15LucilePackardFoundation
Physical, mental, and developmental health, along with education, were the topics at the December 1 inaugural hearing of a newly established Senate Select Committee on Children with Special Needs. The purpose of the committee is to increase legislators' understanding of how programs and services for children with special needs are organized and delivered, and to identify ways to improve and strengthen the systems. The initial meeting presented an overview of the various systems and how they interact. Representatives from each field, as well as parents and government officials, provided testimony.
This presentation provides an overview of the systems that serve children with special health care needs in California.
The document discusses the high economic costs of mental illness and various interventions to reduce these costs. It notes that almost half of Americans will experience a mental health issue in their lifetime. Left untreated, mental illness leads to lost productivity from absenteeism and presenteeism, lower earnings, poverty, physical health issues, and suicide. Several interventions show promise such as increasing access to therapy, tailoring treatments, and addressing childhood mental health issues. However, more research is needed to determine the most effective and efficient solutions, yet research funding remains disproportionately low compared to the economic burden. Workplace reforms and greater access to mental healthcare, especially on college campuses, could also help address rising costs from mental illness.
The document discusses the creation of a new elective course at Yale School of Medicine aimed at exposing health professional students to domestic health inequities in the United States. The course was founded by two second-year medical students who recognized a lack of instruction on social determinants of health and their impact on health outcomes and healthcare delivery. The 10-session course brings in faculty, administrators, community leaders and organizations to discuss topics like implicit bias, social determinants of health, food insecurity, and advocacy. The goal is to better equip future healthcare providers with an understanding of how social factors influence health and patient interactions. The course has received strong interest and support from the medical school and community.
In Spring 2013, we are on the precipice of dramatic, disruptive change in the health field that offers an unprecedented opportunity and challenge to transform health care and population health.
We know that traditional public health approaches along with more and better health care are not enough to improve health outcomes, equity, and cost. We must also:
- implement sustainable, fundamental "upstream" changes that address the root causes of disease and disability; and
- transform the way we deliver health care to ensure access to quality, affordable health care for all.
Enjoy this Bright Spot presentation with David Law of Joy-Southfield Community Development Corporation, which was presented at the 2013 Annual Leadership Conference, co-sponsored by the Center for Health Leadership (CHL) and the California Pacific Public Health Training Center (CALPACT) at UC Berkeley's School of Public Health.
To learn more about this event, please visit:
http://calpact.org/index.php/en/events/leadership-conference
Learn more about CALPACT:
http://calpact.org/
Learn more about the CHL:
http://chl.berkeley.edu/
1. Preparing HIV+ youth for self-advocacy and self-care is a gradual process that should begin in early adolescence to lay the groundwork for transition to adult care.
2. Key topics to discuss include disclosure, medication adherence, understanding one's diagnosis and health history, identifying adult providers, and transferring care.
3. Encouraging youth to take on more responsibility for their care over time- such as making appointments, understanding medications, and asking providers questions- helps build self-advocacy skills for managing care as an adult.
The document summarizes news from the Family Medicine Department at Keck School of Medicine. It discusses:
1) A major grant awarded to the department chair to create training for older adult healthcare.
2) Recognition of Dr. John Dennis Mull by the LA City Council for over 50 years of service to the community as a family doctor.
3) Awards received by faculty members for teaching and leadership in aging and public health.
This document summarizes a newsletter from the National Alliance on Mental Illness of Berks County, PA. It includes announcements about upcoming support groups and courses. It also summarizes an article about how mental illness is much more prevalent among low-income individuals. Finally, it provides a summary of a document written by a forensic psychologist about the intersection of mental illness and the criminal justice system, noting that better training of police and judges is needed to properly identify and treat individuals with mental illnesses.
The Kaiser Permanente Homeless Navigator Pilot Program in Woodland Hills, California connects homeless patients with community resources to help them find housing and other services, placing over 576 homeless patients in shelters and programs since 2012. The program uses a team approach involving medical, social work, and community staff. It has been successful in transforming lives and ending homelessness for many patients.
The document discusses healthcare changes in Oregon under the Coordinated Care Model, including the impact on clinicians. It describes how the model aims to improve health outcomes while lowering costs through coordinated care organizations (CCOs) that integrate services and receive incentives for quality. Interviews found that while some clinicians feel aligned with these goals, others expressed concerns about losing autonomy and taking on increased responsibilities. Overall, the reforms were described as bringing changes to clinical roles and uncertainty about the future, but also opportunities for collaboration and innovation.
This document summarizes a report on prescription drug costs and utilization from Express Scripts. It provides an analysis of caregiving and the challenges caregivers face in managing their own health needs while also providing care to others. The summary found that 34.6% of Express Scripts members surveyed were caregivers. Caregivers reported poorer health and lower rates of medication adherence than non-caregivers. The report estimates that following evidence-based treatment guidelines for breast cancer could save an average of $8,000 per patient per year by reducing off-guideline treatment from 21.1% to 0%.
The document is a final reflection paper on improving the US healthcare system. It argues that while the US spends the most on healthcare, it underperforms compared to countries that spend less. This is due to a lack of cost control, universal access, and transparency. The paper proposes adopting aspects of Singapore and Japan's healthcare models, which emphasize social harmony, personal responsibility, and transparency. It suggests establishing a flat fee for all healthcare services paid by providers to control costs and incentivize value-based care between payers and providers. Overall the paper argues the US could lower costs by improving collaboration, transparency, and personal responsibility in the healthcare system.
Early Impacts of the ACA on Health Insurance Coverage in Minnesotasoder145
The analysis found that the number of uninsured Minnesotans fell from 445,000 to 264,000 between September 2013 and May 2014, a reduction of 180,500 people. This unprecedented drop in uninsurance reduced Minnesota's rate from 8.2% to 4.9%. Most coverage gains occurred in public insurance programs like Medical Assistance, which saw an increase of 155,000 people. Private health insurance coverage also increased by a net gain of 30,000 as a result of a 36,000 gain in nongroup coverage offsetting a 6,000 loss in group coverage. The findings were consistent with other analyses of the early impacts of the Affordable Care Act nationally and with reforms in Massachusetts.
Leanne Wells, Chief Executive Officer, Consumers Health Forum of Australia, gave the Ian Webster Health for All Oration to the annual forum of the Centre for Primary Health Care and Equity on 13 August 2015.
The Arizona Crisis Now Model: AHCCCS OutcomesDavid Covington
In 2016, the National Action Alliance for Suicide Prevention published “Crisis Now: Transforming Care is Within Our Reach.” Alignment with these practices cuts cost of care substantially, reduces the need for psychiatric hospital bed usage, ED visits and law enforcement overuse; resulting in better health and declines in suicide rate, justice system involvement/ incarcerations and psychiatric boarding. These challenges are simply greater than previously acknowledged, but the Washington State supreme court ruling on the unconstitutionality of boarding, the suicide death of Virginia State Senator Creigh Deeds’ son, the insistence of hospitals nationwide about the costs and safety and the series of violent incidents from Columbine forward are changing the expectations. These innovative approaches pioneered under the leadership of Arizona Medicaid are now being replicated throughout the US.
Anne C. Beale, MD, MPH, the president of the Aetna Foundation speaks about disparities in child health care, the causes behind those disparities, and policies that can reduce them.
Economic Impact on Minnesota's Health Care Delivery Systemsoder145
Presentation by Lynn Blewett to the Minnesota State Legislature at a joint meeting of the health care and human services finance and policy committees in Saint Paul, MN, February 10 2009.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
This document summarizes several issues facing the healthcare system and medical education in Tennessee, including a physician shortage, limited residency slots, student debt, and budget issues. It discusses how increasing medical school class sizes only partially addresses the physician shortage, as the number of residency slots available has not increased to match. This bottleneck could result in not enough residency positions for all medical school graduates in the near future. The document also notes the impact of heavy student debt on career choices, and debates around shortening medical education programs and resident work hours.
EOA2016: Taking Stock: 2016 Health Profile & Well-Being ReportsPIHCSnohomish
During the 2nd breakout session at Edge of Amazing 2016, Jody Early, PhD (UW Bothell School of Nursing & Health Services) and Elizabeth Parker, PhD (Snohomish Health District) discussed results from the PIHC Health & Well-Being Monitor & the Health Districts latest profile of health in Snohomish County.
This document discusses poverty and health inequities. It finds that those living in poverty experience significantly higher rates of many health issues compared to more affluent groups. For example, in Saskatoon low-income residents are over 1000% more likely to be hospitalized for diabetes or have chlamydia. A survey found most people agree the poor have worse health, and support policies to strengthen early childhood programs, increase income supplements, and expand disease prevention. The document calls on governments and communities, including faith groups, to work together using evidence-based solutions to improve conditions for daily living and reduce health inequities over time.
The document summarizes a webinar about the 50 State CHARTBOOK on Foster Care, a web-based resource created by researchers at Boston University. The CHARTBOOK contains state-by-state profiles with data on foster care programs, policies, financing, and outcomes. It aims to be a useful tool for professionals, advocates, and policymakers. The webinar featured the creators of the CHARTBOOK discussing its development and organization, as well as perspectives from child welfare leaders on the resource's utility and potential to benchmark progress over time.
The document discusses the growing interest in coordinated and integrated healthcare delivery through models like patient-centered medical homes (PCMHs) and accountable care organizations (ACOs). It notes the potential benefits of these models, including improved quality of care and reduced costs. Specifically, it cites evidence that Geisinger Health System achieved a 9% reduction in total healthcare costs and lower hospital admission and readmission rates through implementing a PCMH-based accountable care model. The long-term goal is for PCMHs and ACOs to transform healthcare delivery in the US to a more coordinated, high-value system focused on primary care.
CA Senate Select Committee on CSHCN Presentation: Systems Overview 12/1/15LucilePackardFoundation
Physical, mental, and developmental health, along with education, were the topics at the December 1 inaugural hearing of a newly established Senate Select Committee on Children with Special Needs. The purpose of the committee is to increase legislators' understanding of how programs and services for children with special needs are organized and delivered, and to identify ways to improve and strengthen the systems. The initial meeting presented an overview of the various systems and how they interact. Representatives from each field, as well as parents and government officials, provided testimony.
This presentation provides an overview of the systems that serve children with special health care needs in California.
The document discusses the high economic costs of mental illness and various interventions to reduce these costs. It notes that almost half of Americans will experience a mental health issue in their lifetime. Left untreated, mental illness leads to lost productivity from absenteeism and presenteeism, lower earnings, poverty, physical health issues, and suicide. Several interventions show promise such as increasing access to therapy, tailoring treatments, and addressing childhood mental health issues. However, more research is needed to determine the most effective and efficient solutions, yet research funding remains disproportionately low compared to the economic burden. Workplace reforms and greater access to mental healthcare, especially on college campuses, could also help address rising costs from mental illness.
The document discusses the creation of a new elective course at Yale School of Medicine aimed at exposing health professional students to domestic health inequities in the United States. The course was founded by two second-year medical students who recognized a lack of instruction on social determinants of health and their impact on health outcomes and healthcare delivery. The 10-session course brings in faculty, administrators, community leaders and organizations to discuss topics like implicit bias, social determinants of health, food insecurity, and advocacy. The goal is to better equip future healthcare providers with an understanding of how social factors influence health and patient interactions. The course has received strong interest and support from the medical school and community.
In Spring 2013, we are on the precipice of dramatic, disruptive change in the health field that offers an unprecedented opportunity and challenge to transform health care and population health.
We know that traditional public health approaches along with more and better health care are not enough to improve health outcomes, equity, and cost. We must also:
- implement sustainable, fundamental "upstream" changes that address the root causes of disease and disability; and
- transform the way we deliver health care to ensure access to quality, affordable health care for all.
Enjoy this Bright Spot presentation with David Law of Joy-Southfield Community Development Corporation, which was presented at the 2013 Annual Leadership Conference, co-sponsored by the Center for Health Leadership (CHL) and the California Pacific Public Health Training Center (CALPACT) at UC Berkeley's School of Public Health.
To learn more about this event, please visit:
http://calpact.org/index.php/en/events/leadership-conference
Learn more about CALPACT:
http://calpact.org/
Learn more about the CHL:
http://chl.berkeley.edu/
1. Preparing HIV+ youth for self-advocacy and self-care is a gradual process that should begin in early adolescence to lay the groundwork for transition to adult care.
2. Key topics to discuss include disclosure, medication adherence, understanding one's diagnosis and health history, identifying adult providers, and transferring care.
3. Encouraging youth to take on more responsibility for their care over time- such as making appointments, understanding medications, and asking providers questions- helps build self-advocacy skills for managing care as an adult.
The document summarizes news from the Family Medicine Department at Keck School of Medicine. It discusses:
1) A major grant awarded to the department chair to create training for older adult healthcare.
2) Recognition of Dr. John Dennis Mull by the LA City Council for over 50 years of service to the community as a family doctor.
3) Awards received by faculty members for teaching and leadership in aging and public health.
This document summarizes a newsletter from the National Alliance on Mental Illness of Berks County, PA. It includes announcements about upcoming support groups and courses. It also summarizes an article about how mental illness is much more prevalent among low-income individuals. Finally, it provides a summary of a document written by a forensic psychologist about the intersection of mental illness and the criminal justice system, noting that better training of police and judges is needed to properly identify and treat individuals with mental illnesses.
The purpose of this Health Policy Study is to better understand adolescents’ views on what are considered core components of the medical home and identify barriers to promoting adolescent health in relation to the medical home.
In addition, this study sought to better understand the needs and challenges in providing adolescents with access to medical homes—from the perspective of both adolescents and experts in adolescent health and medical home policy. To accomplish these goals, researchers conducted focus groups with adolescents, presented these findings to experts, and gathered experts’ reactions to the adolescents’ perspectives. This report includes a detailed description of the methods used for this study, followed by a summary of key focus group findings and the expert reactions to these findings.
The document discusses a proposal for a mental health communication campaign at Washington State University. Research found that WSU students believe there is a lack of conversation about mental health and many do not know where to access help on campus. The majority of students are aware of mental health services but do not know how to use them. As a result, Palouse PR created a strategic communication plan to reduce stigma and increase awareness of mental health resources on campus. The plan includes events and activities aimed at creating a stronger sense of community to decrease stigma surrounding mental health issues.
Breaking the Cycle of Chronic Homelessness (Patricia Tooker)Wagner College
This monograph was written for Wagner College's Hugh L. Carey Institute for Government Reform in January 2020 by Patricia Tooker, DNP, Dean of the Evelyn L. Spiro School of Nursing at Wagner College and Research Fellow for the Carey Institute.
Minority Mental Health Month: Lifting the Burden of Disparities sean3dunlap5
Discrimination exacerbates mental health and substance use disorders among minority communities by creating barriers to accessing quality healthcare. Minority Mental Health Month aims to raise awareness of these disparities. While conversations around behavioral health are increasing, negative perceptions persist, especially in minority groups, due to cultural beliefs, distrust in the healthcare system from past discrimination, and potential bias among providers. Expanding access points like primary care and ensuring a diverse, culturally competent healthcare workforce can help address these disparities. Federal initiatives promote these goals to improve healthcare experiences and outcomes for all populations.
Care Coordination in a Medical Home in Post-KatrinaNew OrleaTawnaDelatorrejs
Care Coordination in a Medical Home in Post-Katrina
New Orleans: Lessons Learned
Susan Berry • Eleanor Soltau • Nicole E. Richmond •
R. Lyn Kieltyka • Tri Tran • Arleen Williams
Published online: 14 July 2010
� Springer Science+Business Media, LLC 2010
Abstract This is a prospective study to evaluate ability of a
nurse care coordinator to: (1) improve ability of a pediatric
clinic to meet medical home (MH) objectives and (2)
improve receipt of services for families of children with
special health care needs (CSHCN). A nurse was hired to
provide care coordination for CSHCN in an urban, largely
Medicaid pediatric academic practice. CSHCN were iden-
tified using a CSHCN Screener. Ability to meet MH criteria
was determined using the MH Index (MHI). Receipt of MH
services was measured using the MH Family Index (MHFI).
After baseline surveys were completed, Hurricane Katrina
destroyed the clinic. Care coordination was implemented for
the post-disaster population. Surveys were repeated in the
rebuilt clinic after at least 3 months of care coordination. The
distribution of demographics, diagnoses and percent
CSHCN did not significantly change pre and post Katrina.
Psychosocial needs such as food, housing, mental health and
education were markedly increased. Essential strategies
included developing a new tool for determining complexity
of needs and involvement of the entire practice in care
coordination activities. MHFI showed improvement in
receipt of services post care coordination and post-Katrina
with P \ 0.05 for 13 of 16 questions. MHI demonstrated
improvement in care coordination and community outreach
domains. Average cost was $36.88 per CSHCN per year.
There was significant improvement in the ability of the clinic
to meet care coordination and community outreach MH cri-
teria and in family receipt of services after care coordination,
despite great increase in psychosocial needs. This study pro-
vides practical strategies for implementing care coordination
for families of high risk CSHCN in underserved populations.
Keywords Care coordination � Medical home �
Children with special healthcare needs (CSHCN) �
Title V CSHCN � Hurricane Katrina
Eleanor Soltau has relocated to Atlanta, Georgia, after her
involvement with this research.
S. Berry (&) � N. E. Richmond � A. Williams
Department of Pediatrics, Louisiana State University
Health Sciences Center, 1010 Common Street Suite #610,
New Orleans, LA 70112, USA
e-mail: [email protected]
N. E. Richmond
e-mail: [email protected]
A. Williams
e-mail: [email protected]
E. Soltau
Children’s Hospital Medical Practice Corporation,
New Orleans, LA, USA
e-mail: [email protected]
S. Berry � N. E. Richmond � A. Williams
Louisiana Office of Public Health, Children’s Special Health
Services, New Orleans, LA, USA
R. L. Kieltyka � T. Tran
Department of Pediatrics, Louisiana State University Health
Sciences Center, 1010 Common Street Suite #2710,
New Orleans, LA 7011 ...
ALL OF USEmbracing Diversity in HealthcareBy Susan Birk.docxnettletondevon
ALL OF US
Embracing Diversity in Healthcare
By Susan Birk
I
n approaching the complex, sometimes contro-
versial and profoundly important subject of
diversity, ACHE Chairman Gayle L. Capozzalo,
FACHE, believes it comes down to respect.
"I believe that the bedrock principle upon which our
endeavors to provide compassionate and culturally
competent care is based is respect," Capozzalo, execu-
tive vice president. Strategy and System Development,
Yale New Haven (Conn.) Health System, said during
the 2012 American Hospital Association Annual
Meeting May 6—9. "We embrace diversity because it is
fundamentally about respect, and we believe it is both
an ethical and business imperative that can improve
our organization's quality, safety and services."
Implicit in her words is what some leaders might call les-
son No. 1 about this issue: Diversity is not merely a jaded
nod in the direction of affirmative action (although
affirmative action is an important element of diversity
programs). Nor is it a "social program" to be delegated to
Human Resources. Rather, it requires a desire by senior
leadership to welcome many perspectives and differences
and to inculcate respect and appreciation for those per-
spectives as a basic organizational value.
More Than Policies
Patricia Harris, global chief diversity officer of
McDonald's Corp., sums it up in the title of her
book: None of Us Is as Good as All of Us: How
McDonald's Prospers by Embracing Inclusion and
Diversity (Wiley, 2009).
"You need to embed in your organization's culture
the recognition that diversity and equal treatment
are not simply policies to be policed," says Susan M.
Nordstrom Lopez, FACHE, president of Advocate
Illinois Masonic Medical Center, Chicago.
"It has to come from inside," she says. "And like
all organizational values, it has to come from the
top, and it has to be observed consistently
throughout the organization." That inclusivity
applies to race, generation, gender, ethnicity, reli-
gious affiliation, culture and sexual orientation.
And it holds true whether attending to the cultural
needs of patients, building a workforce or develop-
ing a leadership team that mirrors the community
it serves.
Signs of Progress
The healthcare sector's progress in this regard has
been "somewhere between fair and significant,"
says Frederick D. Hobby, president and CEO of
the Institute for Diversity in Health Management,
Chicago. According to Hobby, evidence of prog-
ress can be seen in the national call to action to
eliminate healthcare disparities launched last year
by the American Association of Medical Colleges,
ACHE, American Hospital Association, Catholic
Health Association of the United States and
National Association of Public Hospitals and
Health Systems.
The Equity of Care initiative aims to: (1) increase
the collection and use of race, ethnicity and lan-
guage (REAL) preference data by hospitals and
health systems, (2) increase cultural competency
tr.
Read and respond to each peer initial post with 3-4 sentence long re.docxniraj57
Read and respond to each peer initial post with 3-4 sentence long response
Peer #1
For the Research Assignment, I have chosen to focus on an area of Healthcare that rarely gets the
attention it deserves.
Mental health.
I
chose this topic because I am personally effected by it and so are many millions of Americans. Mental illness is also one of the leading causes of
death in our nation and one life is lost as a result of suicide, abuse or incarceration every 17mins in the United States. Mental illness has been my
area of focus throughout this program and the advocacy and participatory philosophy will be useful for the final project because it suggests that
“
that research inquiry needs to be intertwined with politics and a political agenda” (Creswell, p.9). I do believe that mental health has a specific
agenda for a study and that there has been constant aim for reform in healthcare and mental health. This social issue is definitely pertinent right
now and topics that address it such as “empowerment, inequality, oppression, domination, suppression, and alienation” (Creswell, p.9), and are
really the focus of the study. The goal of this project for me, is to provide a voice to participants and give them the ability address the concerns that
will lead to reform.
According to Kemmis and Wilkinson (1998) this philosophy offers four key features of the advocacy/participatory framework of inquiry:
1. Participatory actions are focused on bringing about change, and at the end of this type of study, researchers create an action agenda for change.
2. It is focused on freeing individuals from societal constraints, which is why the study begins with an important issue currently in society.
3. It aims to create a political debate so that change will occur.
4. Since advocacy/participatory researchers engage participants as active contributors to the research, it is a collaborative experience.
Research Problem Statement
My Vision is to Provide members of the community with the opportunities and education needed to prevent death due to suicide, acts of self-harm
and the traumatic impact of mental illness. By promoting resilience, the enhancement of community resources, conflict resolution and support for
individuals, families and the communities of those who suffer with mental disorders, illness or have a sudden mental health crisis. The target
population includes all individuals within Chatham County, with unmet mental health needs.
These individuals are currently not being served by
traditional methods due to financial, structural, and personal barriers including access and stigma. Untreated mental health
issues of these
individuals put them at risk for exacerbation of physical health problems, suicide attempts, premature moves to long-term care settings, and
psychiatric hospitalization, incarceration, residential alcohol/drug treatment or homelessness. The target population is all individuals within
Chatham County, ...
This document provides a summary of the key findings from a 2011 community health needs assessment of Osceola and Lake Counties in Michigan. It finds that while the counties have some strengths like low crime rates and coordination of care, there are also many challenges. These include high unemployment, poverty, and lower educational attainment. Health indicators like mortality rates are worse than state averages. Risk behaviors like smoking and obesity are prevalent. Access to care is an issue, especially for specialty and primary care. The assessment gathered data from surveys, interviews, and secondary sources to develop a comprehensive view of the health landscape and identify priority areas for improvement.
This document summarizes the findings of a community health needs assessment conducted in Osceola and Lake Counties in Michigan. It identifies several health challenges facing residents, including higher rates of chronic conditions like diabetes and heart disease compared to the state. Social issues like poverty and lack of education negatively impact health. Access to specialty care is limited and transportation presents a barrier. However, the community benefits from strong emergency services, care coordination, and programs to address needs. Addressing issues like access to primary care, transportation, prevention/wellness, and underserved groups were prioritized for improvement.
The Ella Faye Childs Memorial Program aims to prevent suicide among the elderly by partnering with nursing homes in Denton County, Texas that have deficiencies related to elderly mental healthcare and quality of life according to Medicare reports. The program will provide training to nursing home staff to increase quality of care and implement a 12-month prevention program with mental health services and counseling. Goals are to improve the quality of care provided by staff, increase staff competence, and decrease elderly suicide risk factors like depression and isolation among residents. The program will be piloted over 14 months in two cycles to collect outcome data and demonstrate effectiveness with the goal of expanding statewide.
Four Strategies for Compassionate, Complete Behavioral HealthcareKarl Michelfelder
This document discusses strategies for improving behavioral healthcare. It advocates for integrating behavioral and physical healthcare to provide more holistic care for patients' overall needs. Barriers between primary and behavioral care need to be bridged to close gaps in patient care. An electronic health record can help providers treat all of a patient's needs by creating a single, integrated care record to improve information sharing between providers.
This document summarizes the president's column from the CAPE Chronicle. It discusses how collaborative learning communities and connections with like-minded peers and colleagues can greatly enhance research in fields like epidemiology and mental health. CAPE provides these opportunities for researchers interested in mental health epidemiology. The president highlights how CAPE's small size allows for intimate interactions and networking between members. CAPE has supported many collaborative projects and initiatives over the years.
The December edition of the Professional Diversity Network Jobs Index & Report focuses on the Healthcare sector and the position of the diverse employee and candidate in this rapidly growing segment of the US economy.
The document summarizes the launch event of the Vitality Institute, which aims to promote evidence-based health promotion and disease prevention focused on chronic diseases. Speakers at the event included CEOs, health officials, researchers, and others who discussed strategies and programs for improving population health, such as incentivizing healthy behaviors, public-private partnerships, addressing social determinants of health, and using data and technology to enable healthier choices. The Vitality Institute was established to be a leader in developing and implementing effective health promotion interventions.
Mt. Washington Pediatric Hospital Annual Report FY 2011Kathleen Lee
The annual report summarizes the fiscal year of 2011 for Mt. Washington Pediatric Hospital. Financially, the hospital had a successful year achieving a healthy operating margin despite rising healthcare costs. Operationally, the hospital continued applying efficiencies while focusing on high quality patient care. The hospital is grateful for the ongoing support through donations, advocacy, and volunteerism that help carry out its mission of serving over 7,500 children in 2011.
The document describes efforts to improve psychosis care through the Treatment and Recovery In PsycHosis (TRIumPH) program. The key points are:
1) A working group was established between Southern Health NHS Foundation Trust and Wessex Academic Health Science Network to improve assessment and treatment for people experiencing psychosis based on understanding gaps in existing care.
2) The program developed and implemented a standardized care pathway across four Early Intervention in Psychosis teams, improving access to assessment and treatment.
3) Feedback from service users, carers, and clinicians informed the work, which aimed to provide more compassionate, holistic, and recovery-focused care.
Planned Parenthood Hudson Peconic (PPHP) implemented the "Be Proud! Be Responsible!" intervention program in several high schools in the White Plains area. The six-hour program was led by PPHP health educators and incorporated evidence-based sexual health education. It aimed to provide adolescents with knowledge about HIV/AIDS prevention and increase condom use and negotiation skills through activities like games, role-playing, and discussion. Data was collected before and after through anonymous surveys to evaluate changes in students' attitudes toward sex, birth control, and condom use. The program was based on social cognitive theory and aimed to minimize health risks for at-risk youth.
3. August 6, 2012 Mental Health Weekly
3
Mental Health Weekly DOI: 10.1002/mhw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
to make sure that when they are
ready to leave the hospital they are
able to be stepped down to less in-
tensive levels of care,” said Covall.
CMHCs provide many of those less
intensive/aftercare services, includ-
ing case management and rehabili-
tation services, he said.
Covall added that it’s important
for community mental health pro-
viders and providers of psychiatric,
residential and inpatient treatment
facilities to improve coordination so
that patients get the services they
need in a timely manner. “We have
to be proactive as providers in work-
ing with all stakeholders to manage
the process and ensure patients get
the care they need,” he said.
Hospital trends
Occupancy rates have also in-
creased in inpatient psychiatric fa-
cilities by more than 5 percent be-
tween 2009 and 2010, despite addi-
tional beds being added to existing
facilities. Outpatient facilities have
shown even greater growth with the
average number of outpatient visits
in 2010 increasing by more than 25
percent since the prior year.
Trend analysis shows that aver-
age total days of inpatient hospital
care increased 7.3 percent from
24,531 days in 2009 to 26,333 days
in 2010. The increase in inpatient
days of care in 2010 was driven by
increased admissions, as the average
inpatient hospital length of stay re-
mained approximately the same
from 2009 to 2010.
The average inpatient hospital
admissions increased 7.1 percent,
from 2,692 admissions in 2009 to
2,883 admissions in 2010. The aver-
age inpatient hospital length of stay
was unchanged at 9.1 days for 2009
and 2010.
Although the length of stay re-
mained unchanged, this year’s re-
sults show that a greater number of
patients utilized psychiatric services
provided by NAPHS member facili-
ties in 2010 compared to the previ-
ous year, according to the survey.
“The length of stay in inpatient hos-
pital care has been very steady for
close to a decade now,” said Covall.
The treatment approach in inpatient
psychiatric facilities is very stable —
it’s about crisis stabilization and
short-term treatment.”
Residential, outpatient
trends
The hospital-based and free-
standing residential treatment centers
reported data for both 2009 and 2010
which showed that the average facil-
ity residential days of care increased
5.5 percent from 21,850 days to
23,058 days. Average residential ad-
missions in these facilities increased
16.4 percent from 166 admissions in
2009 to 193 admissions in 2010.
As with inpatient hospitals, in-
creases in days of care in residential
treatment centers were driven by in-
creased admissions from 2009 to
2010, the survey stated. Average oc-
cupancy in residential treatment
centers rose in 2010 compared to
2009, despite average length of stay
decreasing during this time. These
trends are largely due to a 16.4 per-
cent increase in average residential
treatment admissions in 2010.
In the trend analysis examining
data from hospital-based outpatient
visits between 2009 and 2010,
NAPHS found that the average out-
patient visits increased 25.8 percent
‘We have to be
proactive as
providers in working
with all stakeholders
to manage the
process and ensure
patients get the care
they need.’
Mark Covall
from 13,866 visits in 2009 to 17,448
visits in 2010, with significant growth
in both regular and intensive outpa-
tient visits. The average partial hos-
pitalization visits increased 3.3 per-
cent from 5,270 visits in 2009 to
5,443 visits in 2010.
2010 snapshot
In the examination of all survey
respondents’ experiences in the year
2010, NAPHS found that 79.8 per-
cent of respondents offered inpa-
tient hospital care and 44.3 percent
offered residential psychiatric care.
In addition, 56.8 percent offered
partial hospitalization and 47.5 per-
cent offered outpatient psychiatric
services (see graph on page 2).
NAPHS found that about three-
quarters of its-member organizations
responding to the survey provide in-
patient care to adolescents (71.6
percent) and adults (72.1 percent) in
inpatient hospital settings. Residen-
tial treatment provided by respon-
dents predominately treats adoles-
cents (41 percent of facilities). About
half of partial care and outpatient
facilities responding to the survey
treat adults (in 49.2 percent and 47
percent of facilities, respectively), al-
though care to older adults and ado-
lescents is provided by more than 30
percent of facilities in these settings.
The 2010 snapshot showed
some differences in average length
of stay by hospital population
served. While length of stay in adult
programs averaged 8.5 days, the av-
erages were 9.7 days in adolescent
programs and 14.5 days in older-
adult programs.
“There’s an increased amount
of need out there,” said Covall. “We
have to be able to put in place pro-
grams that are able to address the
various needs.” •
The 2010 Annual Survey is avail-
able at a prepaid cost of $400 from
the National Association of Psychiat-
ric Health Systems, 900 17th Street
NW, Suite 420, Washington D.C.
20006-2507 or call 202-393-6700,
ext. 101 or visit www.naphs.org.
4. Mental Health Weekly August 6, 2012
4
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Mental Health Weekly DOI: 10.1002/mhw
Continues on page 6
States have new reason to expand Medicaid: Lower death rates
As states consider whether or
not they want to expand Medicaid
under the Affordable Care Act (ACA),
the results of a new study from
Harvard School of Public Health
researchers found that Medicaid
expansions were associated with a
significant reduction in mortality as
well as improved coverage, access
to care and self-reported health.
The study, “Mortality and Access
to Care among Adults after State
Medicaid Expansions,” was pub-
lished online July 25 and will appear
in the September 13 issue of the
New England Journal of Medicine.
Medicaid currently insures 60
million people, and the ACA will
extend Medicaid eligibility to mil-
lions more starting in 2014. The Su-
preme Court ruling enables states to
choose whether to expand Medic-
aid under the ACA, and many states
facing budget pressures are consid-
ering cutbacks instead, according to
the study.
Traditionally, Medicaid covers
low-income children, parents, preg-
nant women and disabled persons;
however, over the past decade sev-
eral states expanded Medicaid to
cover nondisabled adults without
dependent children, a group that is
similar to the population gaining eli-
gibility under the ACA.
Researchers noted that evidence
regarding Medicaid’s effect on health
remains surprisingly sparse, particu-
larly for adults. “To our knowledge,
this is the first study that has looked
specifically at the effect of state
‘Our study suggests that expanding Medicaid
enables people to access the care they need,
and their health improves, even to the
point of potentially saving lives.’
Benjamin D. Sommers, M.D., Ph.D.
Medicaid expansions on mortality in
this group of low-income adults,”
Benjamin D. Sommers, M.D., Ph.D.,
assistant professor of health policy
and economics at the Harvard
School of Public Health and lead au-
thor, told MHW.
Sommers added, “Previous re-
search in the 1980s and 1990s
looked at the impact of prior expan-
sions [impacting] children and preg-
nant women.”
Study methods
Researchers compared three
states (Arizona, Maine and New
York) that substantially expanded
their Medicaid programs to childless
adults, ages 20 to 64, between 2000
and 2005. They compared those
states to four neighboring states
without expansions: Nevada and
New Mexico (for Arizona), New
Hampshire (for Maine), and Penn-
sylvania (for New York).
Researchers observed the popu-
lation sample for five years before the
expansions, from 1997 through 2007.
According to the study, the pri-
mary outcome was annual county-
level all-cause mortality per 100,000
adults between the ages of 20 and 64
years obtained from the Compressed
Mortality File of the Centers for Dis-
ease Control and Prevention (CDC)
from 1997 through 2007, totaling
68,012 observations specific to an
age group, sex, year and county.
Secondary outcomes were the
percentages of persons with Medic-
aid, without any health insurance,
and in “excellent” or “very good”
health (from the Current Population
Survey, a total of 169,124 persons)
and the percentage unable to obtain
needed care in the past year be-
cause of cost (from the Behavioral
Risk Factor Surveillance System, a
total of 192,148 persons).
Mortality reductions
Medicaid expansions in the three
states were associated with a signifi-
cant reduction in mortality of 6.1
percent, or 19.6 deaths per 100,000
adults, compared with neighboring
states that did not expand Medicaid,
according to the study. The study
found mortality reductions greatest
among adults between the ages of
35 and 64 years, minorities and
residents of poorer counties. These
groups have traditionally had higher
mortality rates and faced greater bar-
riers to care, said researchers.
The expansions were also asso-
ciated with increased Medicaid cov-
erage (24.7 percent), decreased rates
of uninsurance (14.7 percent), de-
creased rates of delayed care be-
cause of costs (21.3 percent) and in-
creased rates of self-reported health
status of “excellent” or “very good”
(3.4 percent).
Researchers say the results cor-
respond to 2,840 deaths prevented
per year for every 500,000 adults
gaining Medicaid coverage. This
finding suggests that 176 additional
adults would need to be covered by
Medicaid in order to prevent one
death per year.
The study noted that increases
in Medicaid coverage in the expan-
Bottom Line …
A new study provides further
information that policymakers should
be aware of: Major changes in
Medicaid — either expansions or
reductions in coverage — may have
significant effects on the health of
vulnerable populations.
5. August 6, 2012 Mental Health Weekly
5
Mental Health Weekly DOI: 10.1002/mhw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
ABHW pledges support for Million Hearts Campaign
by Coral Ellis
T
The Association for Behavioral Health and Wellness
(ABHW) and its member companies pledged support in
May 2012 for the Million Hearts Campaign, organized
to prevent one million heart attacks and strokes over
five years. The campaign is a national initiative
launched by the U.S. Department of Health and Human
Services (HHS) in September 2011.
This national initiative brings together individuals,
federal agencies, state, county and local health officials,
health care providers, pharmacies and pharmacists
communities and patient organizations. ABHW joins
other partners from across public and private health
sectors, including the Substance Abuse and Mental
Health Services Administration (SAMHSA), the Centers
for Medicare & Medicaid (CMS), and the Centers for
Disease Control and Prevention (CDC).
ABHW distributed a newsletter article about the
campaign to our members in order to help educate the
consumers they serve, the providers in their networks
and their own staff. In addition, ABHW is providing
awareness about the campaign to a ABHW member’s
biometric screening notification process. Biometric
screenings are short health exams that can identify any
sign of cardiovascular problem or certain other medical
conditions.
Heart disease is the leading cause of death in the
U.S. for adults of all races. Following a heart attack,
approximately one in four women and one in five men
will die within the first year. It is especially important
for ABHW and other organizations interested in
behavioral health to support this initiative because
people with heart disease are more likely to suffer from
depression than otherwise healthy people.
The burden from heart disease and stroke
significantly impacts the behavioral health community.
Persons with serious mental illness (SMI) die younger,
on average 25 years earlier, than the general
population. The increased morbidity and mortality are
caused by risk factors such as smoking, obesity,
substance abuse, and inadequate access to medical
care. Data has also shown that psychological distress,
which includes anxiety, depression, sleeping problems
and loss of confidence, is associated with a higher risk
of death from stroke. People who suffer from
psychological distress have a 66 percent greater risk of
death from cerebrovascular disease and a 59 percent
greater risk of death from ischemic heart disease
compared with people with no symptoms of mental
distress.
Over the past few years, evidence has mounted
that depression should be added to the list of risk
factors for cardiovascular disease. According to
SAMHSA, in 2009, 45.1 million adults (19.9 percent) in
the U.S. had a mental illness. Adults with SMI are more
likely than adults without SMI to have high blood
pressure and experience strokes. In a SAMHSA national
survey in 2008 and 2009, 21.9 percent of adults who
experienced any mental illness in the past year had
hypertension, compared to 18.3 percent of adults
without any mental illness who had hypertension in
the past year. That same survey found that adults with
any mental illness had a 5.9 percent chance of heart
disease and 2.3 percent chance of stroke, compared to
adults without mental illness who had a 4.2 percent
chance of heart disease and only a 0.9 percent chance
of stroke. Additionally, up to 83 percent of people with
SMI are overweight or obese, another risk factor to
heart attacks and stroke.
The data clearly indicate why it is essential for the
behavioral health community to pay attention to the
risk factors associated with heart attacks and strokes.
One way behavioral health providers can do this is to
recognize the importance of the “ABCS” — Aspirin for
people at risk, Blood pressure control, Cholesterol
management, and Smoking cessation— in their
patients. They can also encourage physicians or other
health care providers to promote a team-based
approach to health care services in order to improve
the quality of care in patients. Providers can help
improve a person’s health and possibly decrease their
visits to the doctor by encouraging, where appropriate,
participation in smoking cessation programs and
nutrition efforts aimed to reduce sodium and eliminate
trans-fats in the diet.
By signing the Million Hearts pledge, ABHW is
helping to raise awareness about the close connection
between mental illness and heart disease and work to
help prevent heart attacks and strokes. We hope that
other organizations will also sign the pledge and be
part of the campaign to prevent one million heart
attacks and strokes over the next five years. ABHW
continues to look for more ways to be involved in the
Million Hearts campaign and new partnership
opportunities.
To learn more about the campaign and sign the
pledge go to: http://millionhearts.hhs.gov/index.html.
Coral Ellis is an intern for the Association for
Behavioral Health and Wellness (ABHW).
FromtheField...
6. Mental Health Weekly August 6, 2012
6
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Mental Health Weekly DOI: 10.1002/mhw
sion states were concentrated among
low-income adults, whereas reduc-
tions in uninsured rates were signifi-
cant for both lower- and higher-
income groups. Reductions in cost-
related delays in care were signifi-
cant for all subgroups.
New Medicaid enrollees
New Medicaid enrollees were
older than the general population
(mean age, 40.6 vs. 40 years), dispro-
portionately male (57 percent vs. 49
percent), nonwhite (27 percent vs. 20
percent) and in fair or poor health
(20 percent vs. 11 percent), the study
stated.
Researchers used a differences-in-
differences quasi-experimental design
that incorporated data before and af-
ter Medicaid expansions in the expan-
sion states and the control states. Re-
searchers tested their quasi-experi-
mental design among adults 65 years
or older whose Medicaid eligibility
was not affected by the expansions.
Among this population, Medic-
aid was associated with a small but
significant reduction in the unin-
sured rate (0.4 percent), a significant
decline in cost-related delays in care
(2.3 percent) and a significant re-
duction in absolute mortality (by
127 deaths per 100,000, for a relative
reduction of 2.6 percent).
Sommers said the overall study
results were pretty straightforward.
“Giving people health insurance im-
proves access to care and, ultimate-
ly, health,” he said. “But on the other
hand, there really has been a lack of
solid evidence on this issue for
adults in Medicaid.”
Observations were not made
specific to Medicaid recipients with
mental health or behavioral health
disorders, Sommers said. “The study
didn’t have that level of detail to de-
scribe findings specific to people
with particular conditions,” he said.
According to the study, rates of
insurance coverage and access to
care increased in expansion states
for both high-income persons and
the elderly even though the Medic-
aid eligibility expansions did not ap-
ply to them directly, researchers
noted. “Some of this may present a
spillover effect from a large expan-
sion of coverage,” said Sommers.
Sommers added, “If these ex-
pansions brought more money into
the health care system, especially for
the safety net providers and public
hospitals, this could have helped im-
prove access even for those who
were not on Medicaid.”
It’s also possible that other
trends were going on in these states
at the same time, unrelated to Med-
icaid, he said. “This is why we
looked to see what happened to
mortality for these groups,” said
Sommers. “While mortality did de-
cline somewhat for elderly adults
and adults in higher-income areas,
the biggest effects were where we’d
expect them for Medicaid — adults
under 65, and for those living in
poor areas.”
Policy implications
One consideration for states de-
termining whether or not they in-
tend to expand Medicaid is cost,
though the federal government is
paying for 100 percent of the costs
of the expansion for the first three
years and 90 percent in the long run,
Sommers said.
“Another key consideration is
what impact the program has on the
people it covers,” he said. “Our study
suggests that expanding Medicaid
enables people to access the care
they need, and their health im-
proves, even to the point of poten-
tially saving lives.”
Sommers added, “While states
have many factors to weigh in decid-
ing whether to expand Medicaid, it
should be clear from our study and
others — including an ongoing ran-
domized trial of an expansion of
Medicaid in Oregon that showed sig-
nificant improvements in self-report-
ed care in the first year — that this is
a program that succeeds in its goal of
helping improve healthcare and
health for poor Americans. We will
be eagerly watching to see what hap-
pens with the Medicaid expansion
under the Affordable Care Act.” •
Continued from page 4
SAMHSA report finds depression rates triple for adolescent girls
Adolescent girls ages 12 to 17 are
three times more likely to have expe-
rienced a major depressive episode
(MDE) in the past year than their
male counterparts (12 percent versus
4.5 percent), according to a new re-
port from the Substance Abuse and
Mental Health Services Administra-
tion (SAMSHA) National Survey on
Drug Use and Health (NSDUH).
The percentage of girls who
experienced MDE in the past year
triples between the ages of 12 and
15 (5.1 percent to 15.2 percent re-
spectively), according to the report.
The report also found that an an-
nual average of 1.4 million adoles-
cent girls ages 12 to 17 experienced
a major depressive episode in the
past year.
According to the report, “Data
Spotlight: Depression Triples be-
tween the Ages of 12 and 15 among
Adolescent Girls,” older adolescent
girls experiencing major depressive
episodes were more likely to receive
treatment than younger ones —
about two-fifths ages 15 to 17 re-
ceived treatment as opposed to only
one-third of the girls ages 12 to 14
(see graph on page 7).
The onset of puberty is associ-
ated with an increase in depression
among adolescents, particularly
among adolescent girls, according to
SAMHSA. “It is crucial that we pro-
vide adolescent girls the coping
skills and social supports they need
to avoid the onset of depression, and
to offer behavioral health services
that foster resiliency and recovery if
they experience it,” said Pamela S.
7. August 6, 2012 Mental Health Weekly
7
Mental Health Weekly DOI: 10.1002/mhw A Wiley Periodicals, Inc. publication. View this newsletter online at wileyonlinelibrary.com
Continues on next page
Hyde, SAMHSA administrator.
Given the young age at which
MDE begins to increase among girls,
prevention and intervention efforts
targeting adolescents in middle school
may help ameliorate depression on-
set, as well as reduce depression re-
currence through the life course, ac-
cording to SAMHSA officials. •
For a copy of the new SAMHSA
report visit http://1.usa.gov/N2ChFU.
For more information about ad-
dressing the mental health needs of
adolescent girls and women, please
visit http://bit.ly/vQe98a.
performance — families can con-
nect with that piece,” Winston said.
“We’re not just saying to them,
‘Something is wrong with your kid.’”
Partners in initiative
The organizations working to-
gether to bring this middle school
initiative to fruition are the Seattle
Public Schools, Sound Mental
Health, Seattle Children’s Hospital/
University of Washington and the
Nesholm Family Foundation. Sound
Mental Health program manager
Terry Richardson told MHW that the
mental health organization has ex-
perience with providing services in
schools since the 1990s, when it
held a contract with the school dis-
trict for about five years and then
formed individual relationships with
schools after the contract expired.
This latest project targeting mid-
dle schools grew out of the Nesholm
Family Foundation’s work on a lit-
eracy program called “Kids in the
Middle,” in which the sponsors were
identifying numerous barriers to
learning for some students. This
eventually would lead to the part-
nership that would give the mental
health organization a direct pres-
ence in middle schools in some of
Seattle’s most disadvantaged com-
munities. The support project was
launched in the fall of 2006.
Sound Mental Health’s lead care
coordinator, David Lewis, told MHW
that a young person’s move from be-
ing in the oldest age group in elemen-
tary school to being in the youngest at
middle school can amount to a diffi-
cult transition, as the child now deals
with a team of teachers instead of one
classroom teacher, adjustments in re-
lationships with peers and higher
stakes academically.
The structure of a middle school
environment is not always condu-
cive to easy solutions for students
who are struggling. “When one
teacher builds the relationship [in el-
ementary school], the teacher can
structure the classroom to let the
student be successful,” Lewis said.
It is at this stage that previously
undiagnosed issues such as anxiety,
post-traumatic stress or symptoms of
depression also might surface, often
manifesting in behaviors that for
some could involve angry outbursts
and for others could appear as with-
drawal and isolation.
Lewis, a master’s-level licensed
clinician, says the students at his
school see him as a counselor, fully
a part of the school community. His
work at the school involves meeting
with and assessing students referred
by school personnel, as well as re-
sponding to emerging crises that
could identify a student in need of
assistance.
Lewis said he also is conducting
weekly motivational group sessions
with 10 to 12 struggling young males
in grades 7 and 8. The groups offer
a safe environment for the students
to discuss goals and the barriers
they might be facing, such as an un-
stable home or comments from oth-
ers that they should not strive to be
successful.
In all communications with young
people and their family members,
program workers seek to emphasize
the youths’ strengths, and to highlight
successes even when small. “Family
involvement has grown to be very
good,” Lewis said. “The parents are
pretty open to doing what it takes.”
School from page 1
32.4
12
32.9
13
33.6
14
40.7
15
41.7
16
42.0
17
50
40
30
20
10
0
Age
Percent
Treatment for depression in the past year among
girls ages 12-17 with past year major depressive
episode: 2008 to 2010
Source: SAMHSA’s National Survey on Drug Use and Health (NSDUH), 2008 to 2010.
If you need additional copies of
Mental Health Weekly for associates,
please contact Customer Service at
888-378-2537 or jbsubs@wiley.com
for special rates.
8. Mental Health Weekly August 6, 2012
8
It is illegal under federal copyright law to reproduce this publication or any portion of it without the publisher’s permission. Mental Health Weekly DOI: 10.1002/mhw
Coming up…
The Mental Health Association in Tulsa and Mental Health America will present
the 2012 National Zarrow Mental Health Symposium & MHA Annual Conference,
“From Housing to Recovery: Building Community, Building Lives,” September 19-21
in Tulsa, Okla. Visit www.fromhousingtorecovery.org for more information.
The Center for School Mental Health and the IDEA Partnership are hosting the
17th Annual Conference on Advancing School Mental Health October 25-27 in Salt
Lake City, Utah. The theme is “School Mental Health: Promoting Positive Outcomes
for Students, Families, Schools, and Communities.” For more information visit
http://csmh.umaryland.edu/Conferences/AnnualConference/index.html.
The U.S. Psychiatric and Mental Health Congress will hold its 25th Annual
Conference and Exhibition November 8-11 in San Diego, Calif. For more
information, visit www.psychcongress.com.
State News
Florida resumes assertive
community treatment program
An intensive treatment program
for people who have been hospital-
ized for mental health problems is
returning to Panama City, four years
after it closed due to lack of funding.
Life Management Center of North-
west Florida told the News Herald
last week that it’s receiving $680,000
in funding from the state legislature
to resume its Florida Assertive Com-
munity Treatment Team (FACT),
Congratulations Mental Health Weekly!
Mental Health Weekly has received the 2012 ASBPE (American Society
of Business Press Editors) Azbee Award of Excellence. MHW’s online pub-
lication, mentalhealthweeklynews.com was also recognized by industry
peers with an APEX 2012 Award of Excellence in the websites category.
Continued from previous page
In case you haven’t heard…
Following NFL player Junior Seau’s suicide and numerous subsequent lawsuits
over brain injuries, the NFL on July 26 announced its launch of a comprehensive
wellness program for current and retired players, including a confidential mental
health phone line, the Associated Press reported last month. An outside agency
will run NFL Life Line, a free consultation service to inform players and family
members about the signs of crisis, symptoms of common mental health problems,
and where to get help. The announcement came as many training camps are
getting under way. More than 2,400 NFL veterans suing the league claim the NFL
did not do enough to shield them from the long-term effects of repeated hits to
the head.
which provides intensive, communi-
ty-based treatment, rehabilitation
and support services for adults with
severe and persistent mental illness.
The program was in use from 2004-
2008 but ended due to budget cuts.
Tricia Pearce, community relations
for the center, said the program
would also benefit the local econo-
my. Hiring will happen in November
and December and the program will
begin in January.
It is important in these communi-
cations with families to link unre-
solved behavioral health problems
with school achievement. “You have
to have clinicians who understand
how mental health issues can impair
academic performance,” Winston said.
Lewis said that each Sound Men-
tal Health care coordinator will typi-
cally refer about 100 students a year
for services in the community. In ad-
dition, each school maintains a “case-
load” of about 30 high-need students
who require ongoing support be-
cause they are experiencing multiple
barriers to achieving their potential.
Producing results
Sound Mental Health officials
believe their efforts are having an
impact on youths’ academic perfor-
mance at the participating schools.
Over the past two years, they said,
the three schools’ overall improve-
ment in reading and math achieve-
ment has outpaced the average im-
provement rate district-wide.
The principal at one of the par-
ticipating schools, Aki Kurose Middle
School, told MHW that close com-
munication between the school’s as-
signed care coordinator and school
administration has proven critical to
the effort’s success. Principal Mia
Williams said the program maintains a
focus on the impact of students’ chal-
lenges on what she calls the “ABCs”:
attendance, behavior and coursework.
“When a child gets to middle
school, he might not have received
any services for 11 years,” Williams
said. “This might be the first place
where they’ve seen wraparound
services.”
Other students might have re-
ceived community services in the
past, but possibly their families did
not have positive experiences in the
service system, Lewis pointed out.
Williams added that her school
will be establishing a counseling
and student support suite within the
building, and the Sound Mental
Health care coordinator will serve as
an integral part of that operation. •
Visit our website:
www.mentalhealthweeklynews.com