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March 30, 2017

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

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Francine Sinkoff, Editor

SAMHSA Releases New Guidelines for Successful Transition From Jail and Prison

This resource provides behavioral health, correctional, and community stakeholders with 10 guidelines to effectively transition people with mental or substance use disorders from institutional correctional settings into the community, as well as examples of local implementation of successful strategies for managing this transition.

Could Detox be Worked into Jail Plan? It's Possible.

In the future, could the Tompkins County Jail accommodate 24-hour medical care for inmates going through drug and alcohol withdrawal? Currently the jail does not have beds designated for those with severe substance abuse issues and other serious health problems, which according to a local judge is the one thing the facility needs the most. 

"We need to start with at least six to eight beds for mandatory detox for people who are remanded to jail under a court order," said Ithaca City Court Judge Scott Miller at a meeting of the Tompkins County Legislature Jail Committee March 16. 

Miller, responding to an invitation from Jail Committee Chair Rich John to speak at the meeting, explained to the board that there are many instances in which he finds himself sending someone to jail knowing that the inmate will likely undergo detox with limited medical supervision. 

He said he recently ruled on the case of a man in his 30s who had overdosed and survived; his wife also overdosed, but she died, leaving behind their young child. 

As is often the case with drug users, Miller said he had an obligation to send the man to jail because he violated his probation and had new criminal charges. Read more here.
Tompkins County Mental Health Department Gets Needed Boost 

A  small crowd gathered at the Tompkins County Mental Health Department on East Green Street to celebrate the transformation of the building's front lobby. Where there was once only a confusing, unwelcoming entryway with elevators and little in the way signage, there are now two large front desks and receptionists to greet people.  

"Certainly safety-wise it's a huge change, and we have a better workflow," said Betsy Dolan, Tompkins County Mental Health fiscal officer. 

"Before, anyone could access the building whether they should be here or not," said Frank Kruppa, Tompkins County Mental Health Commissioner, in his speech prior to the ribbon cutting. "Now we have this welcoming environment that our clients and the community are able to take advantage of."  

Included in the half-million dollar project are new, additional desks equipped with phones, located in a separate room behind the main desk so that those who are fielding calls aren't distracted by the intake of clients. If there is no one available at the front desk to answer a phone call, that call gets rerouted to a receptionist on the third floor to ensure that someone can always be reached.  With the the department's new Open Access program now in full swing, anyone concerned about a mental health issue can immediately receive care. Walk-ins are invited to come in any time between 8:30 a.m. and 4:30 p.m. on weekdays; on Tuesday and Wednesday the hours are extended until 6 p.m.  Read more here.
Do Schizophrenia and Autism Share the Same Root? 

In children with a deletion on chromosome 22, having autism does not boost the risk of developing schizophrenia later in life, according to a new study.

The children in the study have 22q11.2 deletion syndrome, which is linked to a 25-fold increase in the risk of developing a psychotic condition such as schizophrenia. A deletion in the region is also associated with an increased risk of autism.

Some researchers have suggested that the relatively high autism prevalence in this population is the result of misdiagnoses of early signs of schizophrenia.

The new findings, published 21 January in Schizophrenia Research, support an alternate theory: Autism and schizophrenia are independent outcomes of the same genetic syndrome.  Read more here.


March 30, 2 - 3:30 pm, SAMHSA GAINS Center

April 12, 2 - 3:15 pm, Stepping Up Initiative

April 17, 2 - 3:30 pm, SAMHSA-HRSA 

April 26, 2 - 3:30 pm, SAMHSA

May 3, 1 - 2 pm, Behavioral Healthcare Executive

May 17, 3 - 4:30 pm, Rural Behavioral Health

Responding to Natural Disasters in Rural Communities
June 21, 3 - 4:30 pm, Rural Behavioral Health

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


APRIL 2017

Officers, Chairs & Regional Reps Call
April 5:  8 - 9 am

RPC Leads & Coordinators Call
April 6:  8 - 9 am,  GTM

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

RPC Leads & Coordinators Call
April 20:  8 - 9 am,  GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Cuomo Says He Will Back Direct Care Pay Boost

While the state budget still remains under negotiation, Governor Andrew Cuomo and state lawmakers did reach a breakthrough on one key issue for those who work with the developmentally disabled: boosting the pay for direct care workers.

"There are some things in government that are no-brainers. And being fair to direct care is a no-brainer," said Assembly Speaker Carl Heastie. "I'm so happy we finally got an agreement that would pay some of the people who work the hardest jobs, the most reward jobs."

At a raucous rally at the Capitol on Tuesday, Governor Cuomo announced he would back the pay boost, which aligns direct care workers with a faster increase in the state's minimum wage, initially approved in 2015.

"When we passed the minimum wage, it put direct care workers in a difficult situation because it didn't apply to direct care workers," the governor said. "Well, we're going to make that right this year."

But Cuomo's plan goes further than what the legislature initially called for after lawmakers sought $45 million. Cuomo's plan seeks $55 million for the workers.  Read more here.
CLMHD Chair, Joseph Todora, Honored by Catholic Charities Community Services of Orange and Sullivan

Congratulations to CLMHD Chair, Joe Todora, LMSW, MSW (Sullivan County), who was presented last week with The Caritas Award by Catholic Charities Community Services of Orange and Sullivan at its annual Celebration of Charity dinner. The Caritas Award is given each year to members of the community who exemplify the Catholic Charities mission to provide help and create hope.

Joe was instrumental in helping Catholic Charities establish a presence in Sullivan County when the agency was tapped by NYS OASAS to assume management of the former Recovery Center.  He warmly welcomed Catholic Charities to Sullivan County and provided guidance and assistance in navigating the complexities of the new service area.  Joe has continued to work closely with Catholic Charities as the agency seeks to expand and enhance programs and services that will improve the quality of life for those most in need in Sullivan County.  Kudos, Joe!
Dutchess County's new Stabilization Center for Mental Health and Substance Abuse Clients has Served More than 100 People

Since opening earlier this month, more than 100 "guests" have gone through the doors of the Dutchess County Stabilization Center for help with a variety of mental health and substance abuse issues.

The walk-in center is the first of its kind in the state, said Dutchess County Executive Marc Molinaro, and one that he hopes will lead to a "paradigm shift in mental health and criminal justice."

Open 24 hours a day, seven days a week, the center, at 230 North Road in the city of Poughkeepsie, is the result of a partnership between the county, MidHudson Regional Hospital of Westchester Medical Center, Astor Services for Children & Families, Mid-Hudson Addiction Recovery Centers, and PEOPLe Inc.

The facility is staffed by a variety of mental health professionals who can provide counseling and referral services. The center, Molinaro said Monday, is the "culmination of about six years of refocusing our mental health infrastructure to be a much more effective tool."  Read more here.
Fixing the Psychiatrist Shortage Requires Multifaceted Solution

It's ironic that as demand grows for psychiatry services, the supply of providers is at a critical low, according to a new  report from the National Council for Behavioral Health. The organization's Medical Directors Institute notes the pool of psychiatrists declined by 10% from 2003 to 2013.

"The average psychiatrist's age is mid-50s," says Joe Parks, MD, medical director for the National Council.

Parks says more providers are aging out of the profession without a robust pipeline of new providers to care for the backlog of patients. What also adds to the strain is the fact that psychiatrists are unevenly distributed geographically, creating pockets of serious shortages in most states.

Meanwhile, 40% of practicing psychiatrists limit their work to cash-only patients, further skewing the scarcity of providers in public programs. Medicaid funds 25% of mental health services and 21% of addiction services, according to the organization. 
Read more here .
In School Nurse's Room: Tylenol, Bandages and an Antidote to Heroin

At every school in New Rochelle, just north of the Bronx, in Westchester, there is a locked medicine cabinet in the nurse's office, stocked with things like EpiPens for allergic reactions, inhalers for asthma, Tylenol for aches and pains.

Now, those cabinets also include naloxone, an antidote for people who are overdosing on opioids like heroin. Given as an injection or a nasal spray, naloxone can quickly revive someone who is not breathing. The city keeps it in every nurse's office, including in its elementary schools.

"We have it the same way we have defibrillators and EpiPens, the way we have oxygen in our schools," said Adrienne Weiss-Harrison, the school district's medical director. "Rarely do we pull a defibrillator off the wall, but it's there if we need it, and that's how we approach this opportunity to have naloxone."  Read more here.
Gaps in Mental Health Training Post Imminent Crisis for Pediatric Care

According to the National Institute of Mental Health, approximately 13% of children aged 8 to 15 years in the United States will experience a severe mental disorder at some point in their lives. Most mental health conditions develop by the age of 24, with 50% of lifetime cases of disorders emerging by the age of 14 in the form of autism, attention-deficit/hyperactivity disorder, anxiety, behavioral problems and depression. Left untreated, severe mental health conditions can lead some children to take their own lives; suicide remains the third leading cause of death among youth aged 10 to 24, with a higher mortality rate than AIDS, cancer, heart disease, birth defects, stroke, pneumonia, influenza and chronic lung disease - combined.

Despite these disturbing statistics, in a 2013 survey conducted by the AAP, 65% of pediatricians believed they lacked the necessary training in the treatment of children with mental health problems, 40% responded they lacked the ability to diagnose mental health problems and more than 50% reported they lacked confidence in their ability to treat these patients. R ead more here .
Senior Centers Help Reduce Stigma of Psychological Counseling
Talking with Grandma
There was a time when to openly admit membership at a senior center was an announcement of one's advanced years. The image of elders shuttled in vans, playing Bingo, having a sing-along, or sitting around commiserating about aches and pains was not appealing.  This was the accepted reality of the elderly who would not further risk being stigmatized by discussing depression or suicidal thoughts.

With over 46 million seniors in the United States, and approximately 10,000 reaching 65 every day with longer life expectancies, the need for more inclusive senior centers has surfaced. This demographic shift has put senior centers at the hub of health trends and made speaking about depression and psychological counseling more of an imperative.

According to Dr. Jo Anne Sirey, Professor of Psychology in Psychiatry at the Weill Cornell Institute of Geriatric Psychiatry and Attending Psychologist and Clinical Director of the Geriatric Outpatient clinic at NewYork-Presbyterian Westchester Division in White Plains, "Senior centers are an excellent resource for nutrition, social support, and wellness information for older adults.  In New York City, we have launched a new program called Trio that will further integrate mental health, wellness, and services in senior centers. The program brings together mental health and medical expertise in an integrated program for older adults delivered in senior centers that can provide social and aging support services. A fundamental tenet of this program is that effective treatment of the mental health needs of older adults also requires us to understand and address their physical and social health needs, which often trigger and perpetuate mental health problems in later life."  Read more here.
Addiction Specialists Ponder a Potential Aid: Pot

Nine days after Nikolas Michaud's latest heroin relapse, the skinny 27-year-old sat on a roof deck at a new drug rehabilitation clinic here. He picked up a bong, filled it with a pinch of marijuana, lit the leaves and inhaled.
All this took place in plain view of the clinic's director.   "The rules here are a little lax," Mr. Michaud said.

In almost any other rehab setting in the country, smoking pot would be a major infraction and a likely cause for being booted out. But here at High Sobriety - the clinic with a name that sounds like the title of a Cheech and Chong comeback movie - it is not just permitted, but part of the treatment.
The new clinic is experimenting with a concept made possible by the growing legalization of marijuana: that pot, rather than being a gateway into drugs, could be a gateway out.

A small but growing number of pain doctors and addiction specialists are overseeing the use of marijuana as a substitute for more potent and dangerous drugs. Dr. Mark Wallace, chairman of the division of pain medicine in the department of anesthesia at the University of California, San Diego, said over the last five years he has used marijuana to help several hundred patients transition off opiates.  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.