Pamela Sagness Director, Behavioral Health Division
a st state e of me menta tal/ l/emo moti tion onal al be bein ing and/ d/or choi oice ces s and d act ctio ions that affec ect t WE WELLNESS SS.
By 2020, mental health and substance use disorders will surpass all physical diseases as a major cause of disability worldwide. SAMHSA
Sta State e Epid pidemiologi iological cal Ou Outc tcome omes s Work orkgroup oup (SE SEOW) W) SEOW W Mission sion Statemen ent: t: Identify, analyze, and communicate key substance abuse and related behavioral health data to guide programs, policies, and practices www.p .pre revention.nd. ention.nd.go gov/ v/da data ta
Yout uth h (H (High h Sc School) l) Repo ported d LIFE FETI TIME ME Use Among g ND ND Hi High School l St Stude dents nts 2017 YRBS Alco cohol hol 59.2% 2% Cigaret igarette Sm Smoking oking 30.5% 5% Prescri Pres cript ption ion Pa Pain in Medicat Medication 14.4% 4% Sy Synthe nthetic tics 7.0% 0% Methamp Met hamphetami amine 2.6% Heroin Heroi 1. 1.4% In 2009 (the last time the question was asked), lifetime use of MARI RIJU JUANA ANA among ND high school students was 30.7%
Substance Use Prevalence Number of days students report consuming alcohol in their lifetime.
Youn ung g Adults ults (18 (18-29) 29) A signif nificant icant mispe perceptio ception is re revealed d when perceptions tions of how frequently ently peers binge drinking nking are compar ared d to actual ual binge drinki nking ng rates. s. ND Young Adult Survey, 2016
Deaths in North Dakota OPIOID OVERDOSE 77 61 43 20 2013 2014 2015 2016
OPIOID AND ALCOHOL DEATHS – CASS COUNTY Opioid-related Deaths 63 58 41 40 35 31 23 23 12 9 2013 2014 2015 2016 2017 (Jan- Sept)
“Compared to national averages, North Dakota fares well on most indicators of physical and behavioral health. One exception to this is alcohol use ; North Dakota ranks much higher than the national average in excessive drinking and alcohol-related motor vehicle crash deaths.” ND Behavioral Health System Study 2018
No North th Da Dakota ta Pre reventi ention on Prio riori rities ties Underage Drinking Adult Binge Drinking Prescription Drug / Opioid Abuse
PREVENTION Current Alcohol Use (past 30 days) among ND High WORKS School Students 60.5% 59.2% 54.2% 49.0% 46.1% 43.3% 38.8% 35.3% 30.8% 29.1% 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 Youth Risk Behavior Survey
Yout uth h (H (High h Sc School) l) Age e of of Initi nitiation ation The e pe percen enta tage ge of ND HS stud uden ents ts who rep eport t havin ing th their ir fir irst t dr drin ink be befor ore age 13 3 has de decrea eased ed from om 32.3% .3% in in 1 1995 95 to 14.5% 4.5% in in 2017. . (YRBS) S)
EFFECTIVE CHILDREN’S BEHAVIORAL HEALTH SYSTEM
CORE VALUES: Community-based Family-driven Youth-guided Culturally and linguistically competent http://www.tapartnership.org/docs/UpdatingTheSOCConcept2010.pdf
KEY PRINCIPLES Multi-system collaboration Integration Least restrictive Resist criminalizing Broad array of services and supports Accessible (timely) Quality (effective, show outcome) Tailored to youth and family Strengths based
Beh ehavioral ioral He Heal alth th Co Cont ntinuum inuum of Ca f Care e Mode del Institute of Medicine Continuum of Care The goal of this model is to ensure there is access ss to a ful ull range ge of high h qua uality y se servic vices to meet the various needs of North Dakotans.
PROMOTION & PREVENTION
Con ontinuum tinuum of of Car are e Mod odel PROM OMOTION/P TION/PRE REVENTION VENTION • Delivered prior to the onset of a disorder, these interventions are intended to prevent or reduce the risk of developing a behavioral health problem or preventing death.
Shared Risk and Protective Factors • Research shows that some risk and protective factors are associated with multiple outcomes. – For example, negative life events, such as divorce or sustained neighborhood violence, are associated not only with substance abuse but also with anxiety, depression, and other behavioral health problems.
Resilience Strengths-based F ocuses on providing the developmental supports and opportunities (protective factors) that promote success
Community-based prevention Strategic Prevention Framework State Incentive Grant (SPF SIG) • Blue bars are strategies impacting youth in an effort to prevent underage drinking
Substance Exposed Newborns Task Force Senate Bill 2367 (2015 Legislative Session) Task force purpose: o Research the impact of substance abuse and neonatal withdrawal syndrome. o Evaluate effective strategies for treatment and prevention. o Provide policy recommendations.
Early Intervention
Con ontinuum tinuum of of Car are e Mod odel EARL RLY Y INT NTERVENTION VENTION • These strategies identify those individuals at risk for or showing the early signs of a disorder with the goal of intervening to prevent progression.
Early Intervention/Identification • ½ of all people with mental and/or substance use disorders are diagnosed by age 14 • ¾ of people with these conditions are diagnosed by age 24 (2009 Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Institute of Medicine)
Windows of Opportunity http://www.samhsa.gov/capt/sites/default/files/images/windows-opportunity-char-lg.jpg
Intervening during windows of opportunity — CAN prevent the disorder from developing.
ASAM
Con ontinuum tinuum of of Car are e Mod odel TRE REATMEN TMENT • These clinical services are for people diagnosed with a behavioral health disorder.
Adolescent Substance Abuse Treatment Programs Substance Abuse Treatment Programs are licensed by the Behavioral Health Division
Psychiatric Residential Treatment Facilities (PRTF) The Behavioral Health Division licenses PRTFs. Psychiatric Residential Treatment Facilities provide 24-hour services in a facility setting for youth who have demonstrated severe and persistent deficits in social, emotional, behavioral and/or psychiatric functioning and have not responded to interventions in the community. All facilities serve male and female residents: Luther Hall 16 beds age 10-18 Fargo Ruth Meiers 10 beds age 12-18 Grand Forks Dakota Boys and 16 beds age 10-19 Fargo Girls Ranch (DBGR) PRIDE Manchester 8 beds age 5-13 Bismarck DBGR Western Plains 16 beds age 10-19 Bismarck DBGR 16 beds age 10-19 Minot
Voluntary Treatment Program (VTP) The Behavioral Health Division administers the Voluntary Treatment Program (VTP). About VTP: A program to provide out-of-home treatment services for a Medicaid- eligible child with a serious emotional disorder. A parent or legal guardian does not have to transfer legal custody of the child in order to have the child placed in an out-of-home treatment program when the sole reason for the placement is the need to obtain services for the child's emotional or behavioral problems. 50-06-06.13. Treatment services for children with serious emotional disorders.
Con ontinuum tinuum of of Car are e Mod odel RE RECOVE VERY • These services support individuals’ abilities to live meaningful, productive lives in the community.
Ensure availability and access to a broad, flexible array of effective, community- based services and supports for children and their families that address their emotional, social, educational, and physical needs, including traditional and nontraditional services as well as natural and informal supports.
Syst Sy stem em Appr proac oach Prevention/ Early Treatment Recovery Promotion Intervention F UN ING UNDIN W OR KFORCE ORKFOR B EST EST P RACTICE TICE R EADINE SS & S & S OCIAL OCIAL D ET ANTS OF OF H EAL TH EADINESS ETERMIN ERMINANTS EALTH
Return rn on n Inves estment ment
Telebehavioral Health in North Dakota: 2017
Key P y Point oints ND’s Behavioral Health system is Stop Support full in a state of criminalizing continuum of reform behavioral health care Need for community based services
Su Subs bsta tance nce Abu buse se Pre reventi ention on Com ommunity unity Fund nding ing Di Dist stribution ribution
Pre reven entio tion n Res esou ource ce and and Me Media ia Cen enter er Free resources and assistance available to ND individuals and communities www.prevention.nd.gov
Get t In Involv olved! ed!
Pre rescriptio scription n Drug rug/Opioid /Opioid Ab Abuse use Pre reven ention tion Goal: Reduce access to abusable medications by raising awareness about effective ways to safeguar uard d and d dispo pose se of unuse sed/un /unwant anted ed medicatio cation.
St Stop op Ov Over erdose dose Goal: Increase evidence-based overdose prevention in North Dakota
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