Substance Misuse and Mental Health Archives - Page 11 of 13

Investing in America’s Health: A State-by-State Look at Public Health Funding and Key Health Facts

Molina Healthcare Community Connectors

Molina Healthcare serves Medicaid, Medicare, CHIP, Marketplace, and dual-eligible plans in multiple states. In 2004, Molina Healthcare began leveraging community health care workers known as Community Connectors to engage and empower Molina members to achieve better health outcomes. By partnering with state Medicaid organizations and other community partners, Community Connectors serve as liaisons between patients and clinicians, assessing needs and assisting the treatment team with coordinating members’ care. They coach members to self-manage their chronic conditions, connect them to basic community resources (e.g., food, shelter and safety) and more traditional health-related social services, and advocate on their behalf. Community Connectors are familiar with the community and the available resources that can help members improve their health. In New Mexico, the program has demonstrated a savings of $4,564 per enrollee through reduced emergency department use, days of inpatient care, and substance abuse. The program is funded by Molina Healthcare. To read more about this innovative program, see this brief summary [link].

Get Healthy Philly

“Get Healthy Philly” is an initiative of the Philadelphia Department of Public Health that brings together government agencies, community-based organizations, academia, and the private sector to address obesity and smoking in Philadelphia. The organization is making great strides toward a healthy Philly through actions including: designating nearly 12,000 acres of new smoke-free spaces; passing a $2 per pack tax increase on cigarettes; establishing school nutrition standards; menu labeling; and working with food retailers to promote healthy food sales. Accomplishments over the past four years include a 15 percent reduction in smoking among adults, a 30 percent reduction in smoking among youth, and a 5 percent reduction in childhood obesity. The initiative is supported by local, state, and federal funding, including the Centers for Disease Control and Prevention through the Prevention and Public Health Fund and the Pennsylvania Department of Health. To read more about this innovative program, see this brief summary [link].

District of Columbia Healthy Communities Collaborative

DC Healthy Communities Collaborative—a collaborative of community health leaders and organizations—formed in 2012 to assess and address the community health needs in the Washington, D.C. area. The Collaborative works in four key areas identified as community health needs in the D.C. area: asthma, obesity, sexual health, and substance abuse/mental health. To date, the Collaborative has conducted a community health assessment identifying health needs within the D.C. area and produced a community health improvement plan with strategies to address the aforementioned health needs. D.C. Healthy Communities Collaborative is funded by member contributions. To read more about this innovative program, see this brief summary [link].

Dallas Information Exchange Portal

The Dallas Information Exchange Portal (IEP) is an electronic platform which enables health care providers, community based organizations, and social service agencies to share medical and social information via a secure network. Through patient-authorized, secure two-way exchange of information, IEP is improving care transitions and increasing coordination of care around both clinical and social issues like homelessness, hunger, and substance abuse. The ultimate goal of the program is not only to improve clinical outcomes and measures, but also generate significant cost savings to health systems. The initiative began in 2014 with a $12 million grant from the W.W. Caruth, Jr. Foundation at Communities Foundation of Texas. To read more about this innovative program, see this brief summary [link].

Communities That Care Coalition

The Communities That Care Coalition began in 2000 in Western Massachusetts to reduce youth substance abuse and improve youth health. The program brought together and coordinated the efforts of various local stakeholders including schools, youth and parent groups, law enforcement, health care providers, and the local hospitals. By implementing its Community Action Plan—which includes an annual Teen Health Survey, anti-substance curricula in local schools, social marketing, and forming strategic partnerships within the community—the Coalition has been successful in identifying several underlying risk factors of youth substance use in the area and priorities for improvement. During the 12 years of its work, the Coalition has measured substantial improvements in youth substance abuse, as well as a reduction in the underlying factors causing it. The Coalition is supported by state and federal grants. To read more about this innovative program, see this brief summary [link].

Nearly Half of States Score 5 or Lower out of 10 on Substance Misuse Prevention Report Card

Youth Drug Overdose Death Rates more than Doubled in 35 States in Just Over a Decade

Washington, D.C., November 19, 2015– According to a new Trust for America’s Health (TFAH) report, Reducing Teen Substance Misuse: What Really Works, 24 states scored five or lower out of 10 on key indicators of leading evidence-based policies and programs that can improve the well-being of children and youth and have been connected with preventing and reducing substance – alcohol, tobacco or other drugs – misuse.

Four states tied for the lowest score of three out of a possible 10 – Idaho, Louisiana, Mississippi and Wyoming – while two states achieved 10 out of 10 – Minnesota and New Jersey. The indicators were developed in consultation with top substance misuse prevention experts.

The Reducing Teen Substance Misuse report includes an analysis of the most recent drug overdose death rates among 12- to 25-year-olds, finding that:

Current rates were highest in West Virginia (12.6 per 100,000 youth) — which were more than five times higher than the lowest rates in North Dakota (2.2 per 100,000).
Males are 2.5 times as likely to overdose as females (10.4 vs. 4.1 per 100,000).
In 1999-2001, no state had a youth drug overdose death rate above 6.1 per 100,000. By 2011-13, 33 states were above 6.1 per 100,000. In the past 12 years:
- Rates have more than doubled in 18 states (Alabama, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, South Carolina and Tennessee);
- Rates have more than tripled in twelve states (Arkansas, Delaware, Indiana, Iowa, Michigan, Minnesota, Missouri, New Hampshire, New York, Oklahoma, Utah and West Virginia); and
- Rates have more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming).

“More than 90 percent of adults who develop a substance use disorder began using before they were 18,” said Jeffrey Levi, PhD, executive director of TFAH. “Achieving any major reduction in substance misuse will require a reboot in our approach – starting with a greater emphasis on preventing use before it starts, intervening and providing support earlier and viewing treatment and recovery as a long-term commitment.”

The increase in youth drug overdose deaths is largely tied to increases in prescription drug misuse and the related doubling in heroin use by 18- to 25-year-olds in the past 10 years – 45 percent of people who use heroin are also addicted to prescription painkillers.

In addition, youth marijuana rates have increased by nearly 6 percent since 2008 and more than 13 percent of high school students report using e-cigarettes. Youth from affluent families and/or neighborhoods report more frequent substance and alcohol use than lower-income teens – often related to having more resources to access alcohol and drugs.

The report highlights 10 indicators of the types of policy strategies that can help curb substance misuse by tweens, teens and young adults:

Limiting Access:
- 37 states and Washington, D.C. have liability “dram shop” laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals.
- 30 states and Washington, D.C. have smoke-free laws prohibiting smoking in public places, including restaurants and bars.

Supporting Improved Well-being of Tweens, Teens and Young Adults:
- 30 states had rates of treatment for teens with major depressive episodes above 38.1 percent.
- 29 states and Washington, D.C. increased funding for mental health services in Fiscal Year 2015.
- 21 states have comprehensive bullying prevention laws.
- 35 states have at least an 80 percent high school graduation rate.
- 31 states and Washington, D.C. have taken action to roll back “one-size-fits-all” sentences for nonviolent drug and other offenses.

Improving Counseling, Early Intervention and Treatment and Recovery Support:
- 32 states and Washington, D.C. have explicit billing codes for Screening (questionnaires/conversations), Brief Intervention (short counseling) and Referral to Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs, yet currently fewer than half of pediatricians report talking to teen patients about alcohol and other drug use.
- 31 states and Washington, D.C. have laws in place to provide a degree of immunity from criminal charges or mitigation of sentencing for an individual seeking help for themselves or others experiencing an overdose.
- 30 states and Washington, D.C. provide Medicaid coverage for all three medications approved by the Food and Drug Administration for the treatment of painkiller addiction.

“The case for a prevention-first and continuum-of-care approach is supported by more than 40 years of research, but the science hasn’t been implemented on a wide scale in the real world,” said Alexa Eggleston, senior program officer, domestic programs, Conrad N. Hilton Foundation. “It’s time to bring innovations to scale and invest in more proactive and sustained approaches that promote positive protective factors, like safe, stable families, homes, schools and communities and intervene early to address youth substance use before addiction develops.”

Reducing Teen Substance Misuse identified a set of research-based approaches and recommendations to modernize the nation’s strategy to prevent and reduce substance use and support a full continuum-of-care, including:

Putting prevention first, using evidence-based approaches across communities and in schools. Each state should have an end-to-end network of experts and resources to support the effective community-based selection, adoption, implementation and evaluation of evidence-based programs;
Strategically investing in evidence-based programs that show the strongest results in reducing risk factors for substance misuse, poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that often emerge during teen years and young adulthood;
Integrating school-based and wider community efforts, via multisector collaboration – and effectively collecting data to assess community needs, better select programs that match with those needs and improve accountability. Schools cannot and should not be expected to solve the problem on their own;
Renewing efforts to gain support for the adoption and implementation of evidence-based and sustained school-based programs – moving beyond decades of ineffective approaches;
Incorporating SBIRT as a routine practice in middle and high schools and healthcare settings – along with other regular health screenings – even brief counseling and interventions can have a positive impact; and
Increasing funding support for sustained and ongoing mental health and substance use treatment and recovery.

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation.

Score Summary:

A full list of all of the indicators and scores, listed below. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

10 out of 10: Minnesota and New Jersey

9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont

8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin

7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania

6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah

5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma

4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia

3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

STATE-BY-STATE YOUTH DRUG OVERDOSE DEATH RANKINGS

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 50 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (12.6); 2. New Mexico (12.5); 3. Utah (12.1); 4. Pennsylvania (11.8); 5. Nevada (11.6); 6. New Jersey (10.7*); 7. Kentucky (10.5); 8. (tie) Arizona (10.2*) and Colorado (10.2*) and Delaware (10.2*); 11. Wyoming (9.8*); 12. Indiana (9.6); 13. Missouri (9.5*); 14. Oklahoma (9.4); 15. New Hampshire (9.3); 16. Ohio (9.1*); 17. Wisconsin (8.8*); 18. Maryland (8.5); 19. Arkansas (8.4); 20. Connecticut (8.3); 21. Illinois (8.2*); 22. Michigan (8.1*); 23. Massachusetts (7.8); 24. Alaska (7.2); 25. North Carolina (7.1); 26. (tie) Montana (7.0) and Tennessee (7.0**) and Vermont (7.0); 29. (tie) New York (6.9*) and Washington (6.9); 31. Oregon (6.5); 32. (tie) Alabama (6.2) and Louisiana (6.2**); 34. (tie) Rhode Island (6.0) and Texas (6.0); 36. (tie) Kansas (5.9) and Virginia (5.9); 38. (tie) Idaho (5.8) and South Carolina (5.8); 40. (tie) Florida (5.7**) and Minnesota (5.7*); 42. Georgia (5.2); 43. California (4.9*); 44. Maine (4.7**); 45. Hawaii (4.6); 46. Iowa (4.3); 47. (tie) Mississippi (3.7**) and Nebraska (3.7); 49. South Dakota (3.3); 50. North Dakota (2.2).

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Reducing Teen Substance Misuse: What Really Works

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Washington, D.C., November 19, 2015– In a new report, Reducing Teen Substance Misuse: What Really Works, «intro_text»

«intro_text_2»

The report’s analysis of the most recent drug overdose death rates among 12- to 25-year-olds found:

Current rates were highest in West Virginia (12.6 per 100,000 youth) – which were more than five times higher than the lowest rates in North Dakota (2.2 per 100,000).
Males are 2.5 times as likely to overdose as females (10.4 vs. 4.1 per 100,000). The rate in «state» for males was «male» «per_label» and «female» for females.
In 1999-2001, no state had a youth drug overdose death rate above 6.1 per 100,000. By 2011-13, 33 states were above 6.1 per 100,000. In the past 12 years:
- Rates have more than doubled in 18 states (Alabama, Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Oregon, South Carolina and Tennessee);
- Rates have more than tripled in twelve states (Arkansas, Delaware, Indiana, Iowa, Michigan, Minnesota, Missouri, New Hampshire, New York, Oklahoma, Utah and West Virginia); and
- Rates have more than quadrupled in five states (Kansas, Montana, Ohio, Wisconsin and Wyoming).

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No.	Indicator	«state»	Number of States Receiving Points
A “Y” means the state received a point for that indicator
1	Support Academic Achievement: State has at least an 80 percent high school graduation rate (2012-2013). Source: U.S. Department of Education, ED Data Express, Regulatory Adjusted Cohort Graduation Rates, 2013-2014.	«metric1»	35
2	Preventing Bullying: State has comprehensive bullying prevention laws. Source: American Academy of Pediatrics.	«metric2»	21
3	Preventing Smoking: State has smoke-free laws that prohibit smoking in public places, including restaurants and bars. Source: Campaign for Tobacco-Free Kids.	«metric3»	30 and Washington, D.C.
4	Preventing Underage Alcohol Sales: State has liability (dram shop) laws holding establishments accountable for selling alcohol to underage or obviously intoxicated individuals. Source: National Conference of State Legislatures and NOLO.	«metric4»	37 and Washington, D.C.
5	Screening, Brief Intervention and Referral to Treatment Support: State has billing codes for Screening, Brief Intervention and Referral for Treatment (SBIRT) in their medical health (Medicaid or private insurance) programs. Source: Institute for Research Education & Training in Addictions and Community Catalyst.	«metric5»	32 and Washington, D.C.
6	Mental Health Funding: State increased funding for mental health services for Fiscal Year 2015. Source: National Alliance on Mental Illness.	«metric6»	29 and Washington, D.C.
7	Depression Treatment: State has rates of treatment for teens with major depressive episodes above the National percentage of 38.1 percent (2009-2013). Source: SAMHSA, Behavioral Health Barometer: United States, 2014.	«metric7»	30 and Washington, D.C.
8	Good Samaritan Laws: State has laws in place to provide some immunity from criminal charges or mitigation of sentencing of seeking help for an overdose. Source: Network for Public Health Law.	«metric8»	31 and Washington, D.C.
9	Treatment and Recovery Support for Prescription Drug Misuse: State provides Medicaid coverage for all three FDA-approved medications for the treatment of painkiller dependence. Source: American Society of Addiction Medicine.	«metric9»	30 and Washington, D.C.
10	Sentencing Reform: State has taken action to roll back “one-size-fits-all” sentences for nonviolent drug offenses. Sources: The Vera Institute of Justice for 2000-2013 laws. For 2014 updates, The Sentencing Project, National Conference of State Legislatures and additional legislative scans for states meeting the thresholds set by the Vera Institute review.	«metric10»	31 and Washington, D.C.
Total		«score_upper»

Reducing Teen Substance Misuse identified a set of research-based approaches and recommendations to modernize the nation’s strategy to prevent and reduce substance use and support a full continuum-of-care, including:

Putting prevention first, using evidence-based approaches across communities and in schools. Each state should have an end-to-end network of experts and resources to support the effective community-based selection, adoption, implementation and evaluation of evidence-based programs;
Strategically investing in evidence-based programs that show the strongest results in reducing risk factors for substance misuse, poor academic performance, bullying, depression, violence, suicide, unsafe sexual behaviors and other problems that often emerge during teen years and young adulthood;
Integrating school-based and wider community efforts, via multisector collaboration – and effectively collecting data to assess community needs, better select programs that match with those needs and improve accountability. Schools cannot and should not be expected to solve the problem on their own;
Renewing efforts to gain support for the adoption and implementation of evidence-based and sustained school-based programs – moving beyond decades of ineffective approaches;
Incorporating SBIRT as a routine practice in middle and high schools and healthcare settings – along with other regular health screenings – even brief counseling and interventions can have a positive impact; and
Increasing funding support for sustained and ongoing mental health and substance use treatment and recovery.

The report provides additional research-based recommendations for preventing and reducing youth substance misuse. It was supported by a grant from the Conrad N. Hilton Foundation and is available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

10 out of 10: Minnesota and New Jersey
9 out of 10: California, Connecticut, Maine, Maryland, New Mexico, New York and Vermont
8 out of 10: Delaware, District of Columbia, Massachusetts, New Hampshire, Ohio, Oregon, Virginia, Washington and Wisconsin
7 out of 10: Colorado, Iowa, North Carolina and Pennsylvania
6 out of 10: Alabama, Illinois, Missouri, Rhode Island and Utah
5 out of 10: Arkansas, Florida, Hawaii, Kansas, Kentucky, Michigan, Montana, North Dakota and Oklahoma
4 out of 10: Alaska, Arizona, Georgia, Indiana, Nebraska, Nevada, South Carolina, South Dakota, Tennessee, Texas and West Virginia
3 out of 10: Idaho, Louisiana, Mississippi and Wyoming

State-by-state Youth Drug Overdose Death Rankings:

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average, for 12- to 25-year-olds. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2005-2007 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

Reducing Teen Substance Misuse: What Really Works

New TFAH Report Focuses on Priority Policies for Reducing Toxic Stress and Adverse Childhood Experiences

Washington, D.C., November 3, 2015— A new report, A Healthy Early Childhood Action Plan: Policies for a Lifetime of Well-being, released today by the Trust for America’s Health (TFAH), highlights more than 40 policy target areas that are key to achieving national goals of reducing toxic stress and Adverse Childhood Experiences (ACEs) and improving the lives of millions of children.

Living with prolonged stress and/or adverse experiences can significantly increase a child’s risk for a range of physical, mental and behavioral problems – increasing the likelihood for hypertension, diabetes, heart disease, stroke, cognitive and developmental disorders, depression, anxiety and a range of other concerns.

Currently, around one-quarter of children ages 5 and younger live in poverty and more than half of all children experience at least one ACE. According to research from the Centers for Disease Control and Prevention (CDC), more than one-quarter of children experience physical abuse (28.3 percent) and substance abuse in the household (26.9 percent) while sexual abuse (24.7 percent for girls and 16 percent for boys) and parent divorce or separation (23.3 percent) are also prevalent.

“More and more studies show investing in early childhood pays off in a lifetime of better health and well-being,” said Jeffrey Levi, PhD, executive director of TFAH. “There are dozens of policy levers we can and should be pushing to ensure all children have high-quality preventive healthcare; safe, stable, nurturing relationships, homes and communities; good nutrition and enough physical activity; and positive early learning experiences.”

The report calls for increased public health engagement in early childhood areas, with a series of recommendations including to:

Build beyond the traditional healthcare system by integrating health and other social supports, including accountable health communities for children, by:

Ensuring every child has access to high-quality and affordable healthcare;
Building systems to help identify and provide support for children’s needs beyond the traditional medical system, but that have a major impact on health;
Focusing on a two generation approach to healthcare – and social service support;
Modernizing and expanding the availability of mental health and substance misuse treatment services – for both parents and children;
Expanding the focus of a trauma-informed approach across a wider range of federal, state and locally supported services; and
Improving services and care coordination for Children and Youth with Special Healthcare Needs (CYSHCN).

Promote protective, healthy communities and establish expert and technical assistance backbone support to help spread and scale programs nationally and in every state, by:

Improving the collection, analysis and integration of child health, well-being and services data to better assess trends and target services and programs;
Strengthening the role of federal, state and local health departments as the chief health strategist in communities; and
Establishing a support organization in every state that provides expertise and technical assistance.

Increase investments in core, effective early childhood policies and programs, by:

Making programs and services that promote early childhood well-being a higher priority to ensure they can be delivered on a scale to help all families (ranging from home visiting programs to child welfare services to increasing economic opportunity for families to child care and early education); and
Better aligning systems and financial resources to improve the effectiveness and efficiency of health, social services and education services.

The report includes a series of maps showing the status of different states on key trends and policy areas and case studies of evidence-based and model programs, organizations and initiatives—which are putting these recommendations into action—including the Nurse Family Partnership, Family Check Up Models, Abriendo Puertas/Opening Doors, Good Behavior Game, Child-Parent Center Program, Crittenton Children’s Center at Saint Luke’s Health System, Wholesome Wave, Community Asthma Initiative at Boston Children’s Hospital and many others.

“If we work together across sectors – bringing together the collective energy and resources of diverse partners – we will have a better chance of achieving the common goal of a healthy start for all of America’s children,” said Gail Christopher, chair of TFAH’s Board of Directors and vice president for policy and senior advisor at the WK Kellogg Foundation. “This report shines a light on many promising policies and programs. But the question remains whether we can garner the public will to turn the potential into the promise that improves the lives of our next generation.”

The full report was supported by a grant from the Robert Wood Johnson Foundation.

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