Expanding Behavioral Health Community Outreach: How Missouri’s Increased Collaboration with Law Enforcement, Courts and Emergency Departments Lead to a New Medicaid Waiver

Speaker(s)

Laura Heitmann, LCSW

Natalie Fornelli, MS

With the reduction in mental health inpatient bed-space, law enforcement and courts across the country have had to spend an increasingly large percentage of their time working with people who have complex mental health and/or substance use disorders, which law enforcement and courts are often ill-equipped to adequately serve. Emergency Departments (ED) have also become a revolving door for individuals with behavioral health disorders, whose inpatient stays could often be avoided with a connection to a treatment provider. In 2013, Governor Nixon’s initiative to Strengthen Missouri’s Mental Health System, created two programs (the Community Mental Health Liaisons (CMHL) and the Emergency Room Enhancement (ERE)) to address these problems. The CMHLs were created to be a “boundary spanner” between the mental health and the criminal justice systems. Likewise, ERE program was created to divert costly and unnecessary hospitalizations and to reduce ED use. These initiatives have led to stronger community partnerships, improved crisis systems, and more appropriate treatment for individuals with behavioral health disorders. This session will also explore how Missouri identified a care gap through these programs, and in turn, developed an application for an 1115 Medicaid Demonstration Waiver.

Active Listening Strategies in the Technology Age

Speaker(s)

Jeremy Lotz, LPC, NCC

Across professions, workers spend more time listening than reading, writing, & speaking combined. THIS, while the average untrained worker forgets more than 50% of what’s heard within 24 hours. Participants will discover why over 60% of Fortune 500 companies offer formal listening training to new employees. In this high energy & interactive seminar, participants will learn the 6 Strategies of Effective Listening, the 5 Barriers to Effective Listening, and will become able to take their work with mental health clients to a higher level!

Lotz Listening-MIMH-2016 – Slides in PDF format

Show Me Zero Suicide: Missouri’s Suicide Safer Care Initiative

Jacquelyn Christmas, BSW, MPA

Bart Andrews, PhD

Zero Suicide is a systems based approach to suicide prevention in health and behavioral healthcare. Zero Suicide has been implemented in State Operated Psychiatric Facilities and in several Community Behavioral Healthcare Centers in Missouri. In 2015, Ozark Center in Southwest Missouri served as the pilot for the Zero Suicide Breakthrough Series in partnership with the Department of Mental Health and the National Council for Behavioral Health. Since then, Behavioral Health Response and Crider Center in the St. Louis area have implemented Zero Suicide. This presentation focuses on workforce competency and organizational processes in a Zero Suicide culture. Workforce survey results show how staff rate themselves in being both competent and confident in providing suicide safer care. Organizational self-assessment results show how staff training, policy development, evidence based practices and follow-up care impact suicide safer care.

Andrews.Christmas.ShowMeZEROSuicide Slides in PDF format

Andrews. Christmas Zero Suicide Workforce Survey Questions_0

Andrews. Christmas ZS-Org-SelfStudy_72915Speaker(s)

“Recovery Academy”: A Multidisciplinary Model for Individualized, Evidence-based Treatment in a Diagnostically Diverse Inpatient Setting

Speaker(s)

Shawn Anderson, PhD

Trena Fowler, BS, CTRS

This presentation will address the challenge of providing individualized psychotherapeutic interventions for inpatients with a wide variety of diagnoses and behaviors that cannot be conceptualized from a unitary theory or model. Presenters will describe the “Recovery Academy” – a multidisciplinary treatment program structured as an academic/college program through which patients “major” in one of three evidence-based treatments, complete “core curriculum” groups, and choose “electives” at the beginning of each new “semester” with assistance from an “advisor.” Attendees will learn about the creation and implementation of this treatment program.

Anderson Recovery Academy 2016 SAnderson – Slides in PDF format

Team Building in the Clinical Setting

Speaker(s)

Kathy Revell, RN

Roger Revell, MBA

Team building has come in many forms since the 1920s when early studies showed that increased worker interaction brought a sense of group identity, and increased social support and cohesion. In mental health treatment settings much of the work is structured around “a team approach” to patient care. Very few agencies and organizations get to create teams from the get-go (“team building”), so this session provides practical theory and approaches to assist in team development and to increase productive teamwork which is so vital in our current clinical work environments.

Revell – Slides in PDF format

Living a Meaningful Life with Serious Mental Illness: Defining and Understanding Personal Medicine

Speaker(s)

Tami Radohl Sigley, PhD

Personal Medicine (PM) is a concept derived from the mental health recovery literature (Deegan, 2007). Based on a recent qualitative study (Radohl, 2015, pending), the definition of PM has been expanded to “activities and self-care behaviors outside of pill medication that help one handle their mental health symptoms and feel good about themselves.” This presentation explores how PM helps mental health consumers with maintaining a “meaningful life.” Findings, consumer narratives, and practice implications are discussed using lecture and group application activities.

Radohl MIMH_Powerpoint_PM_June2016 – Slides in PDF format

Behavioral Health Consulting in Primary Care Clinics

Speaker(s)

Terri Cooley-Bennett, LCSW, LSCSW, CCDP-D

Mental Health Professionals are increasingly becoming key members of interdisciplinary teams in healthcare settings. Studies on integrated care: integrating mental health and primary care systems (APA, 2012) are fairly new. According to the American Psychological Association (2012), “The U.S. health care system typically regards the Primary Care Physician (PCP) as the first point of contact for a client who is accessing medical services of any kind, whether the need is for basic health, mental health, or substance abuse treatment.” This article also found that 70-85 % of visits to the primary care clinic are due to psychosocial and behavioral causes (as cited by Gatchel & Oordt, 2003; Kroenke & Mangelsdorf, 1989). Clients are using their medical provider to not only meet needs for health, but for mental health and substance abuse as well. A Behavioral Health Consultant (BHC) is available in some healthcare settings/clinics and the trend is growing to have mental health professionals available in primary care. How do mental health professionals work alongside medical professionals? What types of interventions are needed from the mental heath professional in the primary care setting? How do client’s respond to a BHC who is introduced to them by their medical provider? This workshop will examine behavioral health interventions that are the most effective in primary care.

Life, Canaries and Suicide Prevention: The Power of Leaders Sharing Lived Experience

Speaker(s)

Bart Andrews, PhD

Many behavioral health professionals have lived experience with suicide, addiction and mental illness. The behavioral health and suicide prevention field has varying degrees of acceptance of open discussion of providers’ own experiences around suicide and behavioral health history. Some studies report lived experience is a motivating factor to enter the helping professions, that mental health professionals experience significantly higher rates of mood disorders, substance use disorders and suicide attempts BUT most providers do not feel safe discussing this, fearing prejudice, discrimination and rejection. In fact, the amount of research on prevalence of mental illness in providers is … well, surprisingly thin. Dr. Andrews will review some of the literature base on prevalence of lived experience- the results are surprising. One study showed up to 19% of doctors level graduate students reported past experience with suicide thoughts. The lack of research around the prevalence of mental illness and suicide experience is an indication of taboo strength. We expect the persons we are serving to freely disclose their own fight with mental illness, suicide and substance use and yet are reluctant to publicly share our own experience. There are leaders in our field, including Cheryl Sharp with the National Council and Dr. Marsha Linehan who have freely disclosed their lived experience. These courageous women had an impact on me and laid the ground work for me to tell my own story of lived experience. Dr. Andrews will tell his story of suicide and recovery and how he decided to share his experience with colleagues and other professionals. He will provide examples of challenges he experienced early in recovery, the impact of low acceptance among professionals and the process of re-telling his story after he had achieved professional success. He will review current challenges involved in our reliance on the word “stigma” and need to create a more specific and intentional language around prejudice against persons with lived experience and a renewed emphasis on positive and person centered language. He will also discuss the power of leaders stepping forward to share their lived experience. Yes, we need more research on how to prevent suicide. We also need to change the culture around how we provide suicide prevention services, and that has to start with us. There is an “us-them” dynamic at play in our current suicide prevention efforts, and it is holding us back. There are even leaders in our field who openly discount the role of lived experience in learning more and improving our suicide prevention efforts. It is time for this to change. Leaders with lived experience must be canaries, we must tell our story in the fresh air, so others, our peers, our team members and our clients can see that we walk the walk and just don’t talk the talk. Not only will this change our culture, it will save lives.

Slides in PDF Format

Using Safety Planning to Assess Risk and Manage Adults at Risk for Suicide

Speaker(s)

Monica Matthieu, PhD

This workshop is designed to prepare front line workers with competencies for engaging and responding to adults who may be at risk for suicide. This training will focus on appropriate intake questions, assessment issues, and a recommended tool for managing risk, with specific focus on safety planning in the context of suicide prevention. The focus of this presentation is on assessing and managing adults at risk for suicide and skills related to micro practice. Case examples will focus on the veteran population and materials from the Department of Veterans Affairs’ suicide prevention program.

Integrating Substance Use Disorder and Health Care Services: Models and Tools

Speaker(s)

Heather Gotham, PhD

Research increasingly shows that integrating SUD and health care services improves patient outcomes. This includes both having addiction treatment programs and providers offer more health care services, as well as integrating substance use disorder services into primary, hospital, and specialty health care settings. The goals of this workshop are to describe effective models for integrating substance use disorder and health care; identify effective substance use disorder treatments that can be brought to health care settings; inform participants about two tools that can help programs assess their capability to provide integrated services; and examine implementation strategies to assist in integrating substance use disorder and health care services.

Gotham Integration MO Spring Training 2016 final – Slides in PDF format