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May 18, 2017

Advancing Public Policies for People with Mental Illness, Chemical Dependency or Developmental Disabilities   

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Francine Sinkoff, Editor

Student-Produced Mini-Documentary Explores Mental Health in Tompkins County

After its premiere at Cinemapolis on May 5, a documentary exploring mental health resources in Tompkins County is available online.   The documentary, "You Can't Be Sick By Yourself," helps to explain the everyday, ambiguous definition of mental health, relating one couple's experience with the greater support community - from interviews with psychiatrists and the Mental Health Department to professionals within the Tompkins County Jail who at times, have to fill the gaps - helping to give meaning to what, for many people, is a complex, everyday issue that can be easily misunderstood.

The film was produced by Ithaca College Junior Christy Calcagno in conjunction with the Fingerlakes chapter of the National Alliance of Mental Illness.
Health Officials Struggling to Grasp Why Saratoga Co. has High Suicide Rate

Health officials are working to identify why one of New York's healthiest counties has such a high rate of suicide.

The most recent state data shows Saratoga County is at the top when it comes to death by suicide in upstate New York.

Within the county, the greatest number of suicides took place in Clifton Park West, Saratoga Springs, and the Northeastern part of the county. The issue has startled health officials and has prompted immediate action. Michael Prezioso is Commissioner of the Saratoga County Department of Mental Health and Addiction Services.

"To find we have a disproportionate amount of suicide I think was really surprising for a lot of people," Prezioso said.

Prezioso says the most recent numbers of reported suicides in Saratoga County outweigh the rest of Upstate New York.
In 2016, the NYS Department of Health reported there were nearly twice as many suicides among teens and young adults in Saratoga County, compared to the rest of upstate.  Read more here.
SAVE THE DATE: Live Video Panel Discussion on Two Years of Stepping Up to Reduce Mental Illness in Jails - Wed, May 31st
Since its launch in May 2015, Stepping Up has called on counties to pass resolutions to reduce the number of people with mental illnesses in jails. So far, more than 350 counties have joined the initiative and started or enhanced comprehensive plans to impact the lives of people with mental illnesses in the justice system and their families.

Join Stepping Up for a live video panel commemorating two years of the initiative and highlighting the work that has happened in counties across the country.  The event will be held on Wednesday, May 31 , from 3:30 - 5:00 pm  on NACO's Facebook page  and .
NY State Initiative Helps Patients Move Toward Recovery With Less Intensive Services

A New York state initiative to identify and transition some patients in assertive community treatment (ACT) programs to less intensive services so that others in need of such care can access it appears to be working: even as median time spent in ACT fell and turnover rates accelerated over a six-year period, the outcomes of those transitioned remained stable.

Those are among the findings of a  report
appearing in Psychiatric Services. Journal Editor Lisa Dixon, M.D., a co-author of the report, told Psychiatric News that the findings show the ways that statewide data can be used to influence care. 

"ACT should be seen as one treatment in the care continuum, a step on the road to recovery," she said. A vast literature since the 1980s has shown ACT to be effective in the care of individuals with serious mental illness. Originally, Dixon explained, it was believed that ACT needed to be sustained indefinitely; otherwise, patients would relapse. But, more recent evidence indicates that a subgroup of patients can successfully transition to less intensive care.  Read more here.



May 23, 12 - 1 pm

June 8, 12 - 1 pm


May 23, 12 - 1 pm, National Council on Behavioral Health

May 25, 1 - 2:30 pm, Center for Health Care Strategies

Managing Benzodiazepines: Best Practices and Alternatives
May 31, 12 - 1 pm, SAMHSA-HRSA
June 6, 2 - 3:30 pm, Manatt

June 7, 1 - 2 pm, SAMHSA

June 15, 3 - 4 pm, SAMHSA-HRSA
June 21, 3 - 4:30 pm, Rural Behavioral Health

August 16, 3 - 4:30 pm, Rural Behavioral Health


MAY 2017

OMH Agency Meeting
May 23:  10 am - 12 pm
44 Holland Ave., 8th Fl., Albany

OASAS Agency Meeting
May 23:  1 - 3 pm
1450 Western Ave., 4th Fl., Albany

CLMHD Office Closed
May 29:  Memorial Day

JUNE 2017

Officers, Chairs & Regional Reps Call
June 7:  8 - 9 am

CSPOA / DOH / OMH Monthly Call
June 15:  3 - 4 pm, GTM

Children & Families Committee Meeting
June 20:  11:30 am - 1 pm, GTM

Directors & Executive Committee Meeting
June 21:  9:30 am - 12:30 pm, GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
New York City To Open Crisis Centers

New York City plans to spend $90 million to open two centers where police can bring people with mental illness or substance-abuse issues instead of arresting them.

The short-term stay facilities, known as diversion centers, are intended for people who might otherwise be arrested or issued a summons for low-level charges. City officials estimate the two, approximately 20-bed centers, designed largely for stays of up to five days, would serve 2,400 people annually. 

The city awarded 10-year contracts to two nonprofits: Project Renewal will receive $44 million and Samaritan Daytop Village Inc. will receive $46 million, officials said.

The centers are expected to open next year. The city has considered sites in Harlem and the South Bronx, according to people familiar with the process. A City Hall spokeswoman said officials are still narrowing down their options and haven't selected final sites.  Read more here.
New Numbers Show Growing Toll of Opioids in NYS

Newly available data from the state Health Department point to stark increases in the toll of legal and illegal opioids in New York State.

The data show deaths attributed to opioids rose 49 percent for the counties outside metro New York City, from 993 to 1,488, between 2014 and 2015. For Broome County, the 30 deaths in 2015 were a 30 percent rise from the 23 reported the year before. Monroe County's total rose 59 percent, from 51 to 81.

Total doses of naloxone outside New York City jumped 22 percent, from 5,567 to 6,787, between 2015 and 2016. The rise from 366 to 597 in Broome County was three times that - a 63 percent jump. Tompkins, Tioga, Chemung and Ontario also outpaced upstate as a whole.

As of early May, the health department's numbers for opioid-linked deaths and emergency room visits were current through June 2016, while naloxone doses were current through the end of last year.   Read more here.
An Experiment Helps Heroin Users Test Their Street Drugs For Fentanyl

In the day room at St. Ann's Corner of Harm Reduction, which runs a needle exchange program in the Bronx, a group of guys are playing dominoes and listening to salsa music while they wait for lunch. And Van Asher, one of the staffers in charge of "transactions" - that means he gives out needles - is talking up his latest idea for how to keep the users here safe.

He wants to tell them what's really in their stash.  "If you're doing dope," he says to one client, "we'll give you a test strip so you can test and see if there's fentanyl."
Fentanyl is a synthetic opioid that is "similar to morphine but can be 50 to 100 times more potent," according to the
National Institute on Drug Abuse.
Increasingly, drug dealers have been using fentanyl to cut their heroin supply - which can be lethal for users. By using the same simple test a doctor would use to check for fentanyl in a patient's urine, Asher is now giving drug users in the Bronx a way to quickly find out what's in their syringe before they inject.  Read more here.
FORHP Rural Substance Use Disorder Prevention and Treatment Toolkit

A Rural Prevention and Treatment of Substance Abuse Toolkit, which was developed on behalf of the Federal Office of Rural Health Policy is now available.   This toolkit provides evidence-based examples, promising models, program best practices, and resources that can be used by organizations to implement substance abuse prevention and treatment programs.

There are seven modules in the toolkit - each contains resources and information that organizations can use to develop, implement, evaluate, and sustain rural programs to prevent and treat substance abuse. 
How Untreated Depression Contributes to the Opioid Epidemic

It can sometimes seem strange how so much of the country got hooked on opioids within just a few years. Deaths from prescription drugs like oxycodone, hydrocodone, and methadone have more than quadrupled since 1999, according to the CDC. But pain doesn't seem to be the only culprit:  About one-third of Americans have chronic pain, but not all of them take prescription painkillers for it. Of those who do take prescription opioids, not all become addicted.

Several researchers now believe depression, one of the most common medical diagnoses in the U.S., might be one underlying cause that's driving some patients to seek out prescription opioids and to use them improperly.

People with depression show abnormalities
in the body's release of its own,
endogenous,  opioid chemicals. Depression tends to exacerbate pain-it makes chronic pain last longer and hurts the recovery process  after surgery.  Read more here.
Governor Cuomo Announces Groundbreaking of First Three Phases of $130 Million Fountains Development in Brooklyn

Governor Andrew M. Cuomo earlier this week announced the start of construction of 397 affordable housing units at the Fountains Development in Brooklyn, which will ultimately include 1,169 units. The development will be constructed in eight buildings with retail, commercial, and community space on 6.7 acres of formerly vacant land at 888 Fountain Avenue. The first three phases of this multi-phased development will create a total of 397 affordable and supportive apartments in Brooklyn for income-eligible residents and those with intellectual or developmental disabilities. On site social and other supportive services will help these residents live independently.

Fountain Seaview Phase One finances the redevelopment of a six-story new building with 65 apartments for families, including 17 units for individuals with intellectual or developmental disabilities from around New York City. The second building consists of nine stories with 267 apartments constructed under New York's new Green Bond program, which the Governor  announced in November, to drive the development of affordable housing that has a positive impact on the environment and climate. Read more here.
Important Adult BH HCBS Update

NYS  has issued guidance on utilization management for Short-term Crisis Respite and Intensive Crisis Respite, which are currently available within Adult Behavioral Health Home and Community Based Services. All HARP enrolled members and HARP eligible members enrolled in a HIV SNP are eligible to receive these services. Prior authorization is not required for access to these two crisis services, whether the provider is participating or not participating with the health plan.  However, providers should notify MMCOs of admissions when they occur.  Read the full memo issued by NYS here. 
Patients With Mental Illness, Diabetes Benefit From Self-Management Program

Patients with mental illness and comorbid diabetes who participated in a targeted illness management program experienced greater improvement in depression, global psychopathology, and functioning compared with those who received treatment as usual, according to a study  published today in Psychiatric Services in Advance. The program-known as targeted training in illness management (TTIM)-blends psycho-education, behavioral modeling, problem identification, and goal setting.

The researchers randomly assigned 200 people with diabetes and serious mental illness (including schizophrenia, bipolar disorder, or major depressive disorder) to receive TTIM or usual care. TTIM consisted of 12 weekly group, in-person sessions led by a nurse educator and peer educator with serious mental illness and diabetes. Read more here.
Evaluating Complex Care Programs: Is It a Zero-Sum Game?

Complex populations in health care are often defined as groups of individuals with co-occurring medical and behavioral health diagnoses as well as significant social challenges. Large sums of money have been devoted to developing interventions focused on "bending the cost curve" by attenuating the rapidly rising costs of caring for these populations. Whether such programs actually save health care dollars remains an open question because rigorous evaluation data are limited. In the absence of empirical evidence regarding program models that are worth replicating, new program models continue to abound and evaluators continue to evaluate.

In a new post for the New England Journal of Medicine's Catalyst blog, authors Maria C. Raven, MD, MPH, MSc, Iyah Romm, and Toyin Ajayi, MD, MPhil - participants in CHCS'  Complex Care Innovation Lab  - discuss the lack of evaluation data available for complex care program models.  Read more here.
The Conference of Local Mental Hygiene Directors advances public policies and awareness for people with mental illness, chemical dependency and developmental disabilities.  We are a statewide membership organization that consists of the Commissioner/ Director of each of the state's 57 county mental hygiene departments and the mental hygiene department of the City of New York.