July 26, 2016
2016 Coalition Leadership Awards Reception
Please join us on September 20th from 5:30pm to 8:00pm for our Annual Leadership
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Coalition Parachute Wiki
Resources for behavioral health providers on the value of integrating peer staff to improve care and outcomes.
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Professional Learning Center Store
HIPAA Business Associate Agreement Templates, now available. HITECH and Breach Notification changes apply to BAAs.
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Coalition Video on YouTube
Empowering Lives Through Community Behavioral Health - Five stories narrated by Mike Wallace in two parts.
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Leadership Awards coming up!
The Coalition is excited to join with community leaders and behavioral health professionals as we honor individuals who have shown a strong commitment to improving the lives of people living with behavioral health disorders, as well as strong service to the behavioral health community.
The 2016 Leadership Awards celebration is set for September 20, 2016, 5:30 PM at the Pfizer World Headquarters located at 235 East 42nd Street, New York City. Order tickets and journal ads here!
This year, The Coalition is pleased to honor Richard Buery, New York City Deputy Mayor for Strategic Policy Initiatives and Emil Slane, Deputy Commissioner and Chief Fiscal Officer, New York State Office of Mental Health (additional honorees to be confirmed).
We look forward to a hardy celebration of the leading lights of the behavioral health sector.
Too Many Funerals
By Bradley Jacobs
Director, Center for Recovery and Rehabilitation
In April, I attended yet another funeral of a person with a serious mental illness. He was 47 years old (two years older than me) and died as a result of a cardiovascular disorder. The experience was simultaneously heartbreaking, hopeful and moving. I was able to take some comfort in the fact that he had family around to reflect on and celebrate his shortened life. After the service, which I attended with a friend, we concluded that we had attended too many funerals in our careers as social workers in the behavioral health field. We felt that he should not have died from a health condition that generally causes death in people 30 years older. Nevertheless, it is all too common amongst people with serious mental illness.
Most people with serious mental illness die from "natural causes" such as cardiovascular disease, pulmonary disease, and infectious disease at higher rates than deaths from suicide or accidents (Walker, 2015), anywhere from 10 - 30 years earlier than people without a mental illness (Walker; Bartels; Insel, 2015). The contributing factors to these health conditions are broad and complex issues themselves: poverty; tobacco and substance use; diet; lack of exercise; incarceration; and the side effects of antipsychotic medications (Bartels; Insel, 2015).
A recent review and meta-analysis of mortality studies by Walker, McGee, and Druss that specifically looked at the rate and cause of early mortality that could be attributed to mental illness found “that 14.3% of deaths worldwide, or approximately 8 million deaths each year, are attributable to mental disorders (Walker, 2015).” Dr. Thomas Insel notes that another way to look at this finding is that “8 million deaths could be averted if people with mental illness were to die at the same rate as the general population (Insel, 2015)."
It is hard to look at all the data regarding the significant physical health problems of people with serious mental illness and not think that we have neglected to do all we can to help address these health disparities. Our personal attitudes about mental illness and a fragmented health care system pose challenges to a whole health approach. However, all this is slowly changing.
Many Coalition member agencies and community partners are engaged in pilot programs to help address some of the medical problems facing recipients of behavioral health care services. Community Access has developed a Health Division to help guide the agency’s approach and has established some early pilot programs that include urban agriculture and a bike share program for supportive housing tenants. The BASICS Esperanza Personalized Recovery Oriented Services (PROS) Program at Acacia Network, through a SAMHSA Primary Behavioral Health Care Integration (PBHCI) program grant, is co-located with a primary care clinic where practitioners from both programs meet frequently with participants to review mental health and physical health care objectives. A major focus in the first year of the grant has been on weight loss strategies and PROS participants are showing some positive results. The CBC Health Home Program in collaboration with Postgraduate Center for Mental Health and EmblemHealth have developed a pilot project to look at the health care gaps of participants receiving care management services through the Health Home, and to help guide the care managers’ interventions to close those identified gaps. Many program models integrate nursing into behavioral health programs and psychosocial rehabilitation programs are also well positioned to advance the teaching of skills and knowledge to help individuals support their own health and wellness.
In New York State, the “carving in” of behavioral health into Medicaid managed care through Health and Recovery Plans (HARPs) and Delivery System Reform Incentive Payment (DSRIP) Program highlight the importance of integrated health care. And interventions that address the social determinants of health will be central to Value Based Payment arrangements. The SAMHSA-HRSA Center for Integrated Health Solutions (http://www.integration.samhsa.gov/) is also helping us move in the right direction, by developing resources, tools and the beginnings of an evidence base in health promotion programs for people with serious mental illness and substance use disorders.
My hope is that we can continue to build on these changes and more urgently address our overall health in addition to behavioral health. So, I reflect on this man's life and realize that I likely have another 30 years to be a part of helping to figure out how to prevent others like him from dying too soon. All the people that worked with him over the last several years, especially his family, did what they could to encourage him, but he had other interests that he generally put ahead of his health. In addition, getting him to primary and specialty care providers was always a challenge. It was a challenge because of my own bias; I was often more focused on his mental health issues than on his physical health. But it was also a challenge because the clinics were too far away and he never felt welcome and comfortable at health care clinic sites. So I wonder had we had services that could have wrapped both his mental health and physical health care in one place would he have lived a few more years? I have hope as I think that new practitioners learn and grow in environments that are tackling a person’s entire health and look forward to a time when weddings, graduations, and other happy social events, rather than funerals are what we get to witness.
Helping Families in Mental Health Crisis Act of 2015 Passes House
By Jamin R. Sewell
Counsel & Managing Director for Policy and Advocacy
On July 6, the House passed the Helping Families in Mental Health Crisis Act (H.R. 2646) by 422-2.
The bill - originally introduced three years ago by Reps. Tim Murphy (R-Pa.) and Eddie Bernice Johnson (D-Texas) in the aftermath of the 2012 Newtown tragedy reflected the frustration of many who know we can and should do better when it comes to people with serious mental illnesses.
Helping Families in Mental Health Crisis Act has the following provisions:
- Creates the position of Assistant Secretary for Mental Health and Substance Use Disorders to take over the responsibilities of the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA).
- SAMHSA must establish the National Mental Health Policy Laboratory and the Interagency Serious Mental Illness Coordinating Committee.
- Amends the Public Health Service Act to require the National Institute of Mental Health to translate evidence-based interventions and the best available science into systems of care.
- Increases workforce capacity by allowing nurse practitioners and physician assistants to prescribe medications that assist with treatment.
- Pediatric mental health subspecialists are eligible for National Health Service Corps programs.
- An underserved population of children or a site for training in child psychiatry can be designated as a health professional shortage area.
- The protected health information of an individual with a serious mental illness may be disclosed to a caregiver under certain conditions.
- Amends the Medicaid law to conditionally expand coverage of mental health services.
- Medicare's 190-day lifetime limit on inpatient psychiatric hospital services would be eliminated.
- Health information technology activities and incentives are expanded to include certain mental health and substance abuse professionals and facilities.
The bill has undergone substantial revisions in attempt to balance the privacy rights of consumers/clients and the desire of families to have more tools to bring their loved ones to treatment.
While not perfect, the legislation is a positive step in the right direction for the behavioral health sector and the people we serve. In order to confront the primary barrier to care– insufficient treatment capacity—the Senate needs to include elements of The Excellence in Mental Health Act and the Mental Health First Aid Act as it considers the Helping Families in Mental Health Crisis Act.
The Coalition joins the National Council in its conclusion that the Helping Families in Mental Health Crisis is important progress and joins the call for more comprehensive behavioral health access.
We invite you to continue reading the other news items from the Coalition this month.