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July 10, 2020
CLICK HERE for Links to State Guidance and Updates on COVID-19
Advancing Public Policies for people with Mental Illness, Substance Use Disorder and/or Intellectual/Developmental Disabilities
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Francine Sinkoff, Editor
fs@clmhd.org
Dutchess and Orange Counties Address Mental Illness During the Pandemic
At a time when a third of  Americans  report   symptoms of anxiety and depression, the Orange County Mental Health Commissioner and Dutchess County Deputy Mental Health Commissioner weighed in on how to manage mental health during the COVID-19 pandemic.

Darcie Miller and Dr. Jackie Johnson both recognize that the spike in mental illnesses among Americans is understandable, considering the impact that locking down and staying apart from loved ones can have on one's mental health, even in the face of protecting physical health.

"We ask our country to isolate and to not have that human connection that is so important to our wellness," said Miller.

"There was an understanding early on that the pandemic would exacerbate some mental health symptoms and behaviors," said Dr. Johnson. "There's so much that attached to [being on lockdown]: there's the anxiety of getting sick, there's isolation from systems of support, and even isolation from public transportation that can help people stay connected."

Both counties have gone out of their way to offer services via Telehealth, a virtual modality of providing basic health support either through video or phone conferencing that has become more widespread in the pandemic. Read more here.

Primary Care, Behavioral Health Providers Urge Measures To Sustain Telehealth Access Post-Pandemic

The Community Health Care Association of New York State and the New York State Council for Community Behavioral Healthcare are calling on policymakers to make permanent telehealth measures that have been implemented during the Covid-19 crisis.
 
The advocacy groups say doing so will help to address health disparities and barriers to care, aid in preventing avoidable conditions as well as higher costs, and ensure the financial stability of safety-net providers.
 
The  groups recommend that, post-pandemic, the state should continue to support a full range of telehealth modalities, including reimbursement for telephone visits and expanded Wi-Fi and cellular service in urban areas. They also urge keeping telehealth's use at the discretion of clinicians in collaboration with clients, based on individual patient needs and capacity. Read more here.
What You Should Know About the Relationship Between Oversleeping and Depression

What Can Be Done to Reach People With Comorbid HIV, Severe Mental Illness?

New System Shown to Improve Early Diagnosis of Autism

Why Some Young People Fear Social Isolation More Than COVID-19

I Chatted With a Therapy Bot to Ease My Covid Fears. It Was Bizarre.

A Return to Lithium: Psychiatry's First Miracle Drug

"It just weighs on your psyche": Black Americans on mental health, trauma, and resilience
AbleTo Launches Full Suite of Mental Health Solutions to Address the Great and Growing Demand for Care

AbleTo, Inc., a leading provider of virtual mental health services proven to improve clinical outcomes and lower health care costs, today announced an integrated suite of solutions for payers to address the growing mental health needs across their populations with AbleTo's highly effective care model.

AbleTo's evidence-based care is proven to significantly reduce mental health symptoms and improve overall health. Now, with the expanded product suite, AbleTo's clinically rigorous care is available to treat mental health needs across broad populations. Each solution offers structured Cognitive Behavioral Therapy (CBT) programs that are tailored to the participant's unique needs for a personalized treatment experience. Read more here .

Additional article of interest:  Teletherapy, Popular in the Pandemic, May Outlast It
Delirium, PTSD, Brain Fog: The Aftermath of Surviving COVID-19
older man wearing a medical mask
For patients who become seriously ill with COVID-19, survival may only mark the start of a complex recovery path.

Along with potentially coping with cardiac, pulmonary and other physical effects, psychologists report that patients may have to sort through cognitive changes, such as difficulties with attention and memory, as well as mental health symptoms for months to come. Some difficulties, such as post-traumatic stress disorder, may be rooted in their experiences with hospital care and intensive care treatments. Psychologists fear that other challenges, such as survivor guilt, may flare once patients are discharged into a world still reeling from the virus.

But even though COVID-19 is a new disease, rehabilitation and health psychologists benefit from existing knowledge as they strive to help these patients, says Megan Hosey, PhD, an inpatient rehabilitation psychologist at Johns Hopkins Hospital in Baltimore. Prior research into Post Intensive Care Syndrome and acute respiratory distress syndrome can guide psychologists in their treatment, which may incorporate various strategies, from cognitive behavioral therapy to exposure therapy to breathing techniques, Hosey says. Read more here.

Additional article of interest:  This Is Not a Normal Mental-Health Disaster
UPCOMING EVENTS &  TRAININGS

Complex Trauma: The Connection Between Mental Health, COVID-19 and Social Unrest
July 13, 2:30 - 4 pm, National Council for Behavioral Health

July 14, 12 - 1 pm, PsychU

July 14, 1 - 2 pm, National Council for Behavioral Health

July 14, 3 - 4:30 pm, Zero Suicide

Using PSYCKES Recipient Search
July 15, 2 - 3 pm, OMH

Social Class Bias and the Negative Impact on Treatment Outcomes
July 15, 3 - 5 pm, NAADAC

Taking on the "Perfect Storm": Faith-based Organizations and Partnerships Address COVID-19 and Critical Behavioral Health Needs in Communities of Color
July 16, 3 - 4 pm, National Network to Eliminate Disparities in Behavioral Health

Integrated Mental Health and Physical Health Mobile Crisis Response
July 22, 2 - 3 pm, SAMHSA's GAINS Center

July 22, 3 - 4 pm, NAADAC

Enable Access to Client-Level Data in PSYCKES
July 23, 3 - 4 pm, OMH

A Trauma-informed Behavioral Health Care Approach to Advance Health Equity
July 27, 3 - 4 pm, HANYS

Data Sharing among Criminal Justice and Behavioral Health Partners: Mechanisms and Platforms for Efficient Data and Information Sharing
July 28, 12 - 1 pm, SAMHSA's GAINS Center

Strategic Planning: Implementing the CLAS Standards to Reduce Disparities in Behavioral Health Organizations
July 28, 1 - 2 pm, OMH

PSYCKES Mobile App for iPhones & iPads
July 29, 2 - 3 pm, OMH

July 29, 3 - 4 pm, National Council for Behavioral Health

Supporting Reentry for People with Mental and Substance Use Disorders: Establishing Recovery Housing
July 30, 12:30 - 2 pm, SAMHSA's GAINS Center

Using PSYCKES Quality Indicator Reports
August 4, 10 - 11 am, OMH

Using PSYCKES from Home
August 7, 10 - 11 am, OMH

Transform to Teleservices: Part I-Expanding Access to Substance Use Disorder Treatment in Drug Courts
August 11, 1 - 2:30 pm, SAMHSA's GAINS Center

Using PSYCKES for Clinicians
August 12, 1 - 2:30 pm, OMH

PSYCKES Access and Implementation
August 18, 11 am - 12 pm, OMH

August 18, 1 - 2:30 pm, SAMHSA's GAINS Center

 
CALENDAR OF EVENTS

JULY 2020

Mental Hygiene Planning Committee Meeting
July 14: 1 - 3 pm, GTM

Children & Families Committee Meeting
July 21: 11:30 am - 1 pm, GTM


AUGUST 2020

Addiction Services & Recovery Committee (ASR) Meeting
August 13: 11 am - 12 pm, GTM

Children & Families Committee Meeting
August 18: 11:30 am - 1 pm, GTM


Contact CLMHD for all Call In and Go To Meeting (GTM) information, 518.462.9422 
CLMHD Elects Board of Officers for 2020-2022 Term

The Conference is proud to announce the election of its Board of Officers for the 2020-2022 term. As of July 3, the following individuals will serve a two-year term as listed:
  • Chair: Katherine Alonge-Coons, LCSW-R, Director of Community Services, Rensselaer County
     
  • 1st-Vice Chair: Laura Kelemen, LCSW-R, Director of Community Services, Niagara County
     
  • 2nd-Vice Chair: Michael Orth, MSW, Director of Community Services, Westchester County
     
  • Secretary: Suzanne Lavigne, MHA, CASAC II, Director of Community Services, Franklin County
     
  • Treasurer: Michael Prezioso, PhD, Director of Community Services, Saratoga County
To learn more about our Board of Officers, click here

Congratulations to all and we look forward to thriving under your leadership!
OMH Receives Funding Award to Help Local Providers Better Coordinate Services for Children

The New York State Office of Mental Health (OMH) has been awarded a four-year, $12 million federal grant that will help expand local networks of community-based services and supports and improve health outcomes for children with Serious Emotional Disturbance and their families. The grant, from the federal Substance Abuse and Mental Health Services Administration, will be used to expand OMH's System of Care infrastructure.

System of Care is a spectrum of effective, community-based services and supports for children and youth with mental health or other challenges and their families. System of Care builds meaningful partnerships with families and youth and organizes children's services into a coordinated network that addresses the full range of the child's needs -- physical, behavioral, social, emotional, educational, and developmental.

As a result, children receiving treatment and supports are better able to function successfully at home, in school, in the community, and throughout life. The three core values central to the System of Care framework are: being community-based, family driven/youth guided, and culturally and linguistically competent. Read more here.
New York Municipalities Feel Budget Crunch as Coronavirus Pandemic Squeezes Funding

Officials in Buffalo, the second-largest city in New York, were already preparing to borrow $18 million to keep them in the black after the novel coronavirus caused municipal revenues-from parking meters to sales tax-to shrivel.

But when word came from Democratic Gov. Andrew Cuomo's administration that a $98.4 million state grant due on June 25 would be about $20 million short, the city raised its borrowing plans by 50%.

States and municipalities around the country are grappling with fiscal pain related to the virus, but in New York, the Democratic governor has pushed some of the state's problems down the funding food chain. Buffalo's grant was part of roughly $4 billion in payments to localities and social-service providers that have been tied up since April as the state deals with a projected $13 billion revenue shortfall.

On July 1, the state sent a notice that it would hold back some funding support for mental-health services. The Civil Service Employees Association said on June 27 that the governor's office would continue to defer, until Oct. 1, higher wage rates that were set to take effect at the start of April. Read more here.

Additional articles of interest: 

Local Government Groups Encouraged By McConnell's Prediction

DiNapoli: Trouble Ahead for Local Governments and Schools

The COVID-19 pandemic has negatively affected many local governments' revenues and its impact will likely be severe for many municipalities' finances, according to  a report released this week by New York State Comptroller Thomas P. DiNapoli.

As sales tax revenues fall by double-digits and state aid is reduced or delayed, DiNapoli called on the federal government to provide aid to local governments before drastic service cuts occur.

"Local governments are under extreme fiscal pressure. Costs for fighting the pandemic are adding up while revenues are rapidly falling," DiNapoli said. "In this year's state budget, aid to local governments was flat and now the state has withheld some aid. Local governments can only tighten their belts so far. They need federal aid and they need it now."

Federal aid is typically only a minor component of local government revenues in New York - about 5 percent of total revenues in 2018, excluding New York City. In extraordinary circumstances the federal government has stepped in with financial assistance to help states and local governments weather difficult times. Between 2008 and 2010, in response to the Great Recession, federal aid to local governments in New York increased by nearly 60 percent and was critical in shoring up local finances. Read more here.
Governor Cuomo Announces $4.3 Million in Federal Funding to Support Local COVID-19 Planning and Response

Governor Andrew M. Cuomo last week announced $4.3 million in federal funding is being made available to county emergency management agencies and the City of New York to support COVID-19 planning and operational readiness. This grant opportunity will provide an additional level of direct support to counties as New York, and the rest of the world, continues to grapple with the ongoing COVID-19 pandemic. Eligible recipients will be able to utilize this funding to cover various emergency management-related costs already borne during the pandemic, as well as costs associated with local prevention and operational efforts moving forward.  

As part of FEMA's Emergency Management Performance Grant program, this COVID-19 Supplemental will provide recipients with funding to cover costs associated with COVID-19-related planning, training, travel, support from consultants or contractors, equipment purchases, and facility construction and maintenance. Funding allocations are derived from a population-based formula and require a 1:1 cost match from each recipient. Read more here.
Funders Support Mental Health Care: COVID-19 And Before 

According to a Coronavirus Trend Tracker compiled by Morning Consult, drawing from its April 2020 survey of 2,201 US adults, 49 percent of respondents said that "the general stress and anxiety" associated with the COVID-19 crisis "has been challenging for them." Also, a third of Americans said that "their mental health has deteriorated."

The title of a March 22, 2020, Psychology Today blog post by Glenn Sullivan raises a good question: "Will COVID-19 Make the Suicide Crisis Worse?" Mentioning the "vast increase in unemployment claims just in the first weeks of the coronavirus emergency," Sullivan notes that "unemployment is a well-established risk factor for suicide" and cites a statistic that one in three people who commit suicide are unemployed when they die. According to the Centers for Disease Control and Prevention, even back in 2018, suicide caused 48,000 deaths in the US.

The Substance Abuse and Mental Health Services Administration (SAMHSA) had awarded $374,449,459 through three types of COVID-19 grants as of May 15, 2020. Read more here.
Addiction Care Barriers Fell Due to COVID-19; Experts See Challenges in Keeping Them Down
opioids
The opioid and addiction epidemic didn't go away when the coronavirus pandemic began. But rapid changes in regulations and guidance made during COVID-19 response could also help many more people get care for opioid use disorder and other addiction problems.

That's according to experts from the University of Michigan Addiction Center and VA Ann Arbor Healthcare System, writing in this week's issue of JAMA Psychiatry.

They document the recent policy changes that have made it possible for more addiction care to take place through  telemedicine, specifically video chats and even telephone calls. They also note the requirements for in-person visits for key addiction treatments that have been waived-though only temporarily-during COVID-19.

Yet despite the recent rapid progress, they say, it will take more changes to truly lower barriers that stand in the way of delivering evidence-based addiction care to more people via telemedicine. Read more here.

Uptick in Buprenorphine Use for OUD Likely Attributed to NP, PA Prescribing Habits

From 2017 to 2018, buprenorphine dispensing rates for the management of opioid use disorder (OUD) increased in the United States by 9.1%. The Comprehensive Addition and Recovery Act (CARA), which authorized nurse practitioners (NPs) and physician assistants (PAs) to prescribe buprenorphine, may have contributed to the increase, according to the results of a study published in Drug and Alcohol Dependence.

Opioid misuse and overdose remain a significant public health care issue. The prescription of evidence-based medications (methadone, buprenorphine/naloxone, and naltrexone) for the treatment of OUD have been underused in the US.  It is estimated that only one-third of the 2 million American diagnosed with OUD each year receive substance use treatment.

To see how the passage of CARA has impacted one treatment for OUD, the researchers utilized prescription audits to identify information on buprenorphine prescriptions dispensed from January 2017 to December 2018; this search yielded approximately 50,400 retail pharmacies in 2881 counties. The dispensing of buprenorphine prescriptions was first analyzed by patient age, sex, and location. Read more here.
New Online Tool to Help Communities Respond to the Opioid Crisis, with COVID-19-related Resources

A new comprehensive online resource for communities and local leaders addressing the opioid crisis is now available from the  Opioid Policy Research Collaborative. The Brandeis Opioid Resource Connector (BORC) website ( opioid-resource-connector.org) offers stakeholders more than 150 community-based program models across the continuum of care, which can serve as models for initiatives and policies aimed at reducing opioid addiction and overdose. The website also includes a wide array of additional materials, such as toolkits, reports, peer-reviewed articles, and data and mapping tools, including numerous resources specific to COVID-19.

"Imagine being an opioid task force leader, and the mayor asks your group to create a new harm reduction initiative. There's a lot of information out there, but the BORC website helps you craft your own initiative by providing a curated list of community programs and resources, plus a checklist of essential interventions," says Associate Dean for Research Cindy Parks Thomas, PhD'00, Principal Investigator of the BORC project.

The BORC website includes content across the spectrum of services related to the opioid crisis (prevention, treatment, recovery and harm reduction) through four main components. Read more here.
The Leader's Role In Managing The Stress Of The Essential Professional

Health care has always been a stressful profession. Even before the pandemic, we knew that over half of physicians had at least one sign of burnout, including 59% of emergency physicians, 56% of obstetricians, and 55% of family and internal physicians. And burnout hasn't been limited to physicians. Child welfare workers, nursing home aides, and many other occupational groups in health care suffer from burnout in their increasingly stressful roles.

Then comes the pandemic. The crisis has greatly exacerbated the stress of essential health care workers-the stress from fear of contracting the coronavirus or spreading it to family members; the shortage of essential health care workers during this period; and the stress of high mortality rates in emergency rooms, nursing homes, group homes, and prisons.

A report on health care workers in New York City, conducted by Columbia University Irving Medical Center and New York-Presbyterian, found that right now, half of workers have high levels of acute stress and screened positive for depressive symptoms, while one-third have anxiety. A recent survey of frontline health care workers in China treating individuals with COVID-19 found that 71% were distressed, 50% were depressed, 44% were anxious, and 34% had insomnia. Another study from Italy, currently under review, found 49.38% of health care workers reported symptoms of post-traumatic stress disorder (PTSD).

Add to this the financial instability of provider organizations-something we have reported on over the past three months. The health care sector lost 1.4 million jobs in April. And that is just the tip of the iceberg. 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.

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