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September 11, 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

Mid Hudson overdoses spike during COVID-19 pandemic

Senator David Carlucci Highlights Importance of Trauma Informed Care During National Suicide Prevention Awareness Month - Rockland/ Westchester

NYU Langone to again expand emergency department at Manhattan flagship - NYC

"Disappearing Doctors" Provides Crucial Mental Health Support for Physicians as Pandemic Threatens to Exacerbate Doctor Suicide Crisis - NYC

Schools: The New Normal | Special Needs School Teaching Students New Routines To Safely Navigate Daily Life - NYC

Addressing Mental Health of College Students During a Pandemic - Tompkins

Online, in-person, or both? Addiction treatment during a pandemic - Tompkins

County legislators push for more funding for mental health program - Monroe

How are officers trained to deal with mental health calls? - Monroe

Powerful drug discovery protocol for autism is accelerating the development of new treatments - Erie

UB Professor Treats Substance Use Amid COVID-19 Pandemic - Erie
Fighting Back against the Stigma of Addiction - Dr. Nora Volkow, Director of the National Institute on Drug Abuse
Addressing Stigma - ASYR
Untreated drug and alcohol use contributes to tens of thousands of deaths every year and affects the lives of many more people. We have effective treatments, including medications for opioid and alcohol use disorders, that could prevent a significant number of these deaths, but they are not being utilized widely enough, and people who could benefit often do not even seek them out. One important reason is the stigma around those with addiction.

Stigma is a problem for people with health conditions ranging from cancer and HIV to a variety of mental illnesses, but it is especially powerful in the context of substance use disorders. Even though medicine long ago reached the consensus that addiction is a complex brain disorder, those with addiction continue to be blamed for their condition. The public, as well as many people working in health care and in the justice system, continues to view addiction as a result of moral weakness and flawed character.

Stigma on the part of health care providers who see patients' drug or alcohol problems as their own fault can lead to substandard care or even to the rejection of individuals seeking treatment. Read more here.
4 Tips to Successfully Open a Crisis Stabilization Unit

EHR data may help identify patients with opioid use disorder

Pregnancy poses challenges for people in recovery from substance use disorder. Covid-19 is taxing their support system


PSYCKES Mobile App for iPhones & iPads
September 15, 10 - 11 am, OMH

The Intersection of Farming Culture and Suicide Prevention
September 16, 12 - 1 pm, NYS Suicide Prevention Coalition Academy

September 17, 12 - 1 pm, The Joint Commission

Caring for Individuals with Intellectual and Developmental Disabilities
September 23, 12 - 1 pm, HANYS

September 23, 12 - 1 pm, NYS Suicide Prevention Coalition Academy

How State-Led Housing Initiatives Can Break the Cycle of Criminal Justice Involvement
September 23, 2:30 - 3:30 pm, CSG Justice Center

Using PSYCKES Quality Indicator Reports
September 23, 3 - 4 pm, OMH

September 23, 3 - 4 pm, National Council for Behavioral Health

Lifeline Webinar: Tools, Training and Tips for Call Center Success
September 24, 2 - 3 pm, National Council for Behavioral Health

Integrated Care Programs for Dually Eligible Individuals in the Era of COVID-19: Response Efforts and Policy Recommendations
September 24, 2 - 3:30 pm, Center for Healthcare Strategies, Inc.

Advancing Prosecutor-Led Behavioral Health Diversion
September 25, 2 - 3:30 pm, CSG Justice Center

September 29, 12 - 1 pm, PsychU

Turning One-Off Programs into Systems-Wide Behavioral Health Diversion
September 29, 2 - 3:30 pm, CSG Justice Center

Breaking Through to the Other Side: A Survivor's Story
September 30, 12 - 1:30 pm, NYS Suicide Prevention Coalition Academy



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

CLMHD Membership Call
September 16: 9 - 10:30 am, GTM

Developmental Disabilities Committee Meeting
September 17: 1 - 2:30 pm, GTM

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


CLMHD Executive Committee Meeting
October 7: 8 am, GTM

Addiction Services & Recovery Committee (ASR) Meeting
October 8: 11 am - 12 pm, GTM

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

CLMHD Fall Full Membership Business Meeting
October 20: 1:30 - 4:30 pm, GTM

Developmental Disabilities Committee Meeting
October 29: 1 - 2:30 pm, GTM

Contact CLMHD for all Call In and GoToMeeting (GTM) information, 518.462.9422 
New York Mental Health Providers Warn Lawmakers Cuts will be 'Devastating'
Kelly Hansen, CLMHD Executive Director, testifies during Tuesday's virtual hearing.

New York nonprofits warned state lawmakers Tuesday that a recent 20 percent cut in state aid to local governments will have devastating consequences for people with mental illness, addiction and developmental disabilities.

Providers spoke during a virtual hearing organized by the state Assembly's mental health committee, which sought to examine the impact of the coronavirus pandemic on these vulnerable populations. Chairwoman Aileen Gunther encouraged speakers to offer ideas for assisting these groups moving forward, and the overwhelming response was that aid must be restored and even bolstered in order to mitigate fallout from one of the nation's worst mental health crises to date.

"Studies have found after the Great Recession that a 1 percentage point increase in the unemployment rate led to a 1.6% increase in the suicide rate and a 3.6% increase in the opioid overdose rate," said Nadia Chait, associate director of policy and advocacy for the Coalition for Behavioral Health. "We can prevent those deaths but we have to take action now and invest in the system now, instead of cutting the system at this very vulnerable time for our fellow residents."

The state Budget Division confirmed in June it would be "withholding" the aid as it awaited clarity on a federal relief package designed to offset a massive pandemic-induced revenue loss. That package had yet to manifest as of early September, forcing local governments and school districts to plan for and implement deep spending cuts and layoffs. Read more here.

Community-Based Providers Push to Continue Behavioral Health Reforms

As reimbursement and waivers for virtual care take center stage during the pandemic, community-based providers are advocating the continuation of such reforms, especially when it comes to behavioral health services for the most vulnerable patients. 

Coordinated Behavioral Care, a network of dozens of nonprofit agencies in the city that serve more than 100,000 Medicaid clients, said new data show tele-mental health is yielding positive results and should be continued after the pandemic subsides. The organization, based in Lower Manhattan, has put forth a set of recommendations for policymakers that it thinks will aid in sustaining critical care. 

Continued access to such services is essential for individuals with moderate to severe mental illness and substance-use disorders, CBC noted in a new report, as well as for minors with serious emotional disturbances, people with multiple comorbidities and those negatively affected by the social determinants of health. Read more here.
Governor Cuomo Announces Digital Campaign to Raise Awareness On Suicide Prevention Day In New York

Governor Andrew M. Cuomo on Thursday announced a new digital campaign to raise awareness and to inform all New Yorkers of the suicide prevention resources available across the state. The Governor also issued a proclamation recognizing September as Suicide Prevention Month and September 10 as Suicide Prevention Day in New York.

New York has one of the lowest rates of suicide in the nation. However, the state loses approximately 1,700 New Yorkers to suicide each year. The Office of Mental Health's Suicide Prevention Center of New York (SPC-NY) tracks these trends to expand the state's prevention programming and reach as many people as possible. Read more here.

Recession And Medicaid Budgets: What Are The Options?

The COVID-19 pandemic and related economic dislocation are having a major impact on state budgets, particularly their Medicaid programs.  Medicaid is inherently counter-cyclical, meaning that enrollment and spending increase in response to economic downturns.  Medicaid enrollment will grow as workers lose jobs and coverage.  Forecasts range from 5 million to 15 million or more individuals being added to the Medicaid rolls by the end of 2020, in addition to the roughly 72 million enrollees in April 2020.  Data recently compiled by the Georgetown Center for Children and Families shows an average increase in Medicaid enrollment of about 5 percent since February for 22 states, with ranges from less than 3 percent in some states to nearly 9 percent in others.  Interpreting trends in Medicaid enrollment is complicated because normal disenrollment is not occurring during the pandemic. The Families First Corona Virus Response Act increased the federal matching percentage (FMAP) by 6.2 percentage points, but made this increase conditional on a strong maintenance of effort provision, meaning that states cannot perform periodic eligibility verifications, reduce eligibility, or limit covered services.  

Increased federal Medicaid spending is an important part of the financial response to a recession.  As noted, the Families First Coronavirus Response Act has already increased the FMAP.  A total increase of 14 percentage points above the pre-pandemic FMAP is proposed in the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act.  Additionally there are proposals to tie the FMAP directly to state unemployment rates to stabilize the impact of recessions on state budgets. Read more here.
National Academy for State Health Policy (NASHP) Launches State OUD Treatment Policy Center

The National Academy for State Health Policy
NASHP has launched the State Policy Center for Opioid Use Disorder (OUD) Treatment and Access, which offers a wide array of innovative resources, including telehealth policies to support treatment and harm reduction best practices, during COVID-19. The center also highlights information for underserved populations. The policy center was compiled with input from state leaders from diverse agencies and areas of expertise with support from the Foundation for Opioid Response Efforts. Visit the center
COVID-19 Has Likely Tripled Depression Rate, Study Finds

A first-of-its-kind study from the Boston University School of Public Health (BUSPH) finds 27.8% of U.S. adults had depression symptoms as of mid-April, compared to 8.5% before the COVID-19 pandemic.

Published in the journal JAMA Network Open, the study also found that income and savings are the most dramatic predictors of depression symptoms in the time of COVID.

"Depression in the general population after prior large scale traumatic events has been observed to, at most, double," says study senior author Dr. Sandro Galea, Dean and Robert A. Knox Professor at BUSPH, citing examples such as September 11, the Ebola outbreak, and civil unrest in Hong Kong.
"We were surprised to see these results at first, but other studies since conducted suggest similar-scale mental health consequences," Galea says. These studies have mainly been conducted in Asia and focused on specific populations such as healthcare workers and college students (one such study found depression symptoms among half of Chinese healthcare workers who had treated COVID patients). Read more here.

Take Steps to Address Health Inequity and Other Social Justice Issues

By Ron Manderscheid,
 Executive Director, NACBHDD and NARMH
The coming fall months are an excellent time to reflect about past events and about the opportunities that can arise in the future. Since most of the work we do each day in behavioral health centers on redressing social injustice, I would like focus on the topic of social justice. Where do we stand? Where do we need to go? The quest for social justice is perhaps the most fundamental human problem of our present time in history.

First, we require a few concepts. Social justice is based on the notions of disparity and equity. Disparities occur when those who are more advantaged fare better in health status, access to healthcare, or achieving successful health outcomes. Clearly, these are issues of social injustice. Such problems do demand efforts to promote equity. When the least advantaged are provided the greatest assistance and support, equity can follow. Thus, equity is not synonymous with equality. Social justice can prevail if equity can be achieved. Read more here.
Reaching In & Reaching Out To Justice-Involved Consumers

Over my career in health care, the one problem that never seems to get fixed is the jagged edges of the continuum between the health care system and the justice system. Justice-involved consumers with any behavioral or medical problem seem to be ill-served by both. I've been to literally hundreds of meetings where there is much debate and discussion over the issue of how to navigate the conflicting public policies and budget issues that always put these consumers at a disadvantage. An estimated seven million U.S. adults were under correctional supervision (probation, parole, jail, or prison) in 2013 - about 2.8% (1 in 35) of the U.S. adult resident population. This may sound like a small problem, but the numbers are deceiving.

The health challenges of the justice-involved population in the corrections system are significant. An estimated 44% of state inmates and 39% of federal inmates reported a current medical problem other than a cold or virus. Arthritis (state 15%; federal 12%) and hypertension (state 14%; federal 13%) were the two most reported medical problems. More than a third (36%) of state inmates and nearly a quarter (24%) of federal inmates reported having a disability or impairment. We also know that 37% of prisoners and 44% of jail inmates have a mental health disorder. And 1 in 7 prisoners (three times higher than the general population) and 1 in 4 jail inmates  (five times higher than the general population) meet the threshold for a serious psychological disorder. Of the U.S. prison population, 85% suffer from substance use disorder, had histories of substance abuse, or were under the influence of alcohol or other drugs at the time their crime was committed.

This corrections population and the challenges in improving their health status and reducing unnecessary health care spending were the focus of a great discussion, Best Practices For Community Reintegration: From Custody Back To The Community, at The 2020 OPEN MINDS Management Best Practices Institute. 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.