It is well established that spending time in natural surroundings promotes mental wellness. The Tri-County Board of Recovery and Mental Health Services will be at the Darke County Parks Shawnee Prairie Preserve Nature Center Saturday October 24 from noon to 2pm. The Nature Center is located at 4267 OH-502, Greenville, OH 45331.

Read more about Why Nature is So Good for Your Mental Health...

Good afternoon Chairman Huffman and members of the Committee. Thank you for the opportunity to speak to you today. My name is Mark McDaniel and I am the Executive Director of the Tri-County Board of Recovery and Mental Health Services. We are the ADAMHS Board that serves Miami, Darke and Shelby Counties. I have been the Executive Director of the Board for over 17 years and have worked in the behavioral health system for over 36 years. Over the span of those years I have provided direct clinical services, managed treatment teams and worked with families with both mental health and addiction issues.

To examine how the role of ADAMHS boards – and behavioral health care itself – is changing, I would like to briefly review where we have been, where we are now, and where we must go in the near future to meet the needs of the communities we serve in the most efficient and cost-effective ways possible.

Timely clinical services are crucial to effective treatment of individuals with mental illness and addictions; but that effectiveness is tempered by what happens the other 23 hours of the day.  Housing, employment and other support services play a crucial role in an efficient system of care focused on long-term recovery.

Those who do well in recovery – that is, those who relapse less often, recidivate at a lower rate, and access fewer crisis services – are persons who have stable housing, meaningful employment, and social, emotional and wellness supports. Without these supports, those addicted to substances, and persons with severe mental illness, tend to follow the very inefficient path of living from crisis to crisis, taxing the most expensive point of interaction with emergency medical services; law enforcement, court and jail involvements; and emergency shelters.

In recent years, ADAMHS Boards in general and the Tri-County Board specifically have spent significant resources on the expansion of client supportive services, housing options and vocational training. 

One example of social supportive services, SafeHaven is a client support program that is now available in all three counties and open to individuals who need help with their personal recovery and opportunities at socialization.

In terms of vocational support, the Board maintains a contract with Opportunities for Ohioans with Disabilities that serves all three counties.  This provides assistance to clients with job preparation and search.

To provide stable and safe housing, the Tri-County Board owns houses and apartments in all three counties as well as maintains relationships with private landlords.  We also maintain contracts for Adult Care Facilities and mental health residential services.

Since access to Medicaid was extended in Ohio, the Board’s focus has shifted to providing 24/7 staffing at existing recovery homes to increase accountability and have expanded other recovery housing options.

To aid in early recovery, Vivitrol projects are now active in all three counties to help with the heroin issue. Detox and residential substance abuse services are accessible through our treatment services providers. Trained Recovery Coaches will be introduced for the first time in our system in the coming months.

Telemedicine was mentioned in several of the previous presentations.  We now have telemedicine available in each of the three counties which has expanded access to doctors for patients.

The Board has invested in reentry programs at both the prison and local jail level. This is a proactive approach to transitioning individuals returning to the community in a very structured and planned way.

To give just one example, with support of the Tri-County Board, Community Housing Inc. has for more than two years implemented a prison in-reach reentry program to assess needs and connect inmates with services prior to their release. In that time, Community Housing has worked with 58 people. Just 7 of those – 12 percent – re-offended, compared to more than 27 percent statewide. Given the high cost of arresting, prosecuting, incarcerating and monitoring an offender, any opportunity to reduce recidivism by half or more – while at the same time helping those persons be productive and healthy citizens - must be seen as an efficiency.

There is much more that needs to be done and the Tri-County Board has a plan. In the very near future we will be announcing the opening of a one-stop shop facility in Miami County which will offer a single point of entry for mental health and addictions, crisis, housing, vocational, consumer support, prevention and wellness, medical and even dental services under one roof.  The overall goal of this plan is to streamline and create efficiency for access by individuals and families, and for those who refer.

To reduce the impact of addictions and mental illness over the long term, prevention and wellness planning and programming are vital. ADAMHS Boards are uniquely positioned to anchor coalitions of vested interests to assess community behavioral health needs, plan activities that can effect change over the long term, and evaluate those activities for effectiveness. To be clear, prevention and wellness programs move the needle on the scale of years, not months. We want to see our communities becoming healthier over generations.

Are prevention and wellness efforts efficient? Effective ones are. The Board is committed to supporting evidence-based prevention practices in our schools and in our communities. Being good stewards of the public trust means optimizing resources – both time and money – on prevention practices that meet national standards of effectiveness. In this way we maximize longterm outcomes and avoid using public resources where there is scant evidence for real change.

We’ve all heard the phrase “An ounce of prevention is worth a pound of cure.” Nowhere is that more true than in community behavioral health. Preventing one person from reaching a mental health crisis, or from becoming addicted, or even delaying first use of substances by young people until they are adults and physically and emotionally better prepared to make good decisions, all have significant benefits in dollars NOT spent over a lifetime. While it may be impossible to tally to a specific number, there is no question that effective prevention is an efficient use of public funds.

Yes, clinical services are the linchpin of behavioral health services. But what happens to that person in recovery the other 23 hours of the day are crucial to the effectiveness of treatment and the reintegration of that person into the community as a productive, tax-paying citizen. Safe, healthy communities are a goal we all share. The Tri-County Board is dedicated to finding ways for the people of Miami, Darke and Shelby Counties to work, live, laugh and love, free from the challenges of mental illness and addiction, and to do so efficiently and responsibly as a steward of the public trust.

I would be remiss if I didn’t speak to two programs we have had great experiences with in our tri-county area.  They have been mentioned in previous testimony but I wanted to speak to them.  The first is Mental Health First Aid; many of us in this room have taken CPR/First Aid from the Red Cross.  Mental health first aid curriculum is somewhat parallel to this widely established program in that it provides education to individuals about mental health, how to recognize the symptoms and what to do about it.  The second program is the Tri-County CIT Academy.  This collaboration between our system and the law enforcement agencies in our area has been a very strong one.  I am proud to state that this last spring the CIT Academy celebrated its tenth anniversary while graduating its tenth class.  The Miami, Darke and Shelby County area has 198 CIT trained officers and that is pretty good.

Thank you, Mr. Chairman, for this opportunity, and for your time and I will answer any questions.

Williams was a superstar on television, film and stage. And as such, his death will dominate the news cycle for a day or two. But the conversations about suicide and mental illness and drug and alcohol addictions cannot go away. There will be celebrations and remembrances of Robin Williams the actor, the Hollywood persona so much bigger than life. But what about Robin Williams, the man? The person who, despite having every material resource at hand, could not defeat his demons, his addictions to alcohol and drugs, and the disorders of the mind that led him to his final act?

We are told that one in four people will suffer from some diagnosable mental illness. We are told that 90 percent of persons who complete suicide have some form of mental illness. We are told that those with serious mental illness have life expectancy 10 years less than average. The tide is turning on conversations and stigma about mental illness, but too slowly. Fear and denial keep too many from seeking help. There are still ignorant haters with popular soapboxes, perpetuating myths about mental illness and suicide.

Celebrity deaths, whether from mental illness, addictions, or recklessness, are always a double-edged sword with young people. On the one hand, there is a fear that young people will be more likely to follow their tragic idols. On the other, it opens a door to conversations. If there could be such a thing as a best-case scenario with a celebrity suicide, Robin Williams' may be it. He is famous enough, has been around long enough, and has appealed to generations of kids enough that anyone older than 7 is going to recognize his face, voice or characters. On the other hand, he is not the kind of celebrity whom young people will like likely emulate or idolize. Robin Williams is not Kurt Cobain.

Just as with so-called "physical" illnesses, not all mental illnesses are deadly, but some are. Mental health counselors identify three mental illnesses that are potentially deadly: addiction, eating disorders and depression. However, people are generally more comfortable talking about diabetes, heart disease, even cancer, than about mental illnesses. Any opportunity to make mental illnesses less dark, less mysterious, to shed light on these all-too-common afflictions, is an opportunity for teaching and, in some cases, early identification and intervention.

So, what's a parent to do when a child says "Mrs. Doubtfire is dead" or "Peter Pan killed himself"? There's no one, best answer. Understand that children are by nature both curious and resilient. Answering the question to the best of your ability is OK; deflecting or ignoring it drives the subject further into the darkness, where it can take on all sorts of misunderstanding.  This Mom wrote about how she talked with her kids, relating to his characters and other family experience. The American Foundation for Suicide Prevention offers a few tips for talking to kids about suicide. SAVE.org offers more help. The Jason Foundation website has information for teens, parents and schools.

Many families find comfort in speaking to pastors or other faith-based counselors. Your school may have a counselor you can speak to. The mental health agencies in the Tri-County network of care employ counselors who specialize in youth and family. NAMI of Darke, Miami and Shelby Counties has upcoming classes you may find useful. For someone in crisis, the Tri-County Hotline is open 24 hours a day at 800-351-7347, or the National Suicide Prevention Lifeline is 800-273-TALK (8255).

Every suicide is a tragedy. Celebrity amplifies the tragedy, and when the celebrity is someone with the multi-generational reach and appeal of Robin Williams, someone whose voice will continue to be heard through the timeless characters of his films, the loss is proportionally deep. If his illness and death create opportunities for a deeper understanding of mental disorders, then that is the solace we can take from it.

SafeHaven members, prospective members and their families are invited to a number of clinics, programs and outreach events over the coming months.

SafeHaven, with locations in Piqua, Sidney and Greenville, offers mental health consumers a consumer-operated center where they may participate in educational, social, and vocational supports in a safe environment toward mental health recovery.

Blood pressure clinics through Horizon Home Health will be held at each location.

• Miami County SafeHaven in Piqua will hold blood pressure clinics beginning at 2 PM August 11 and September 8, and plan to continue on the second Monday of each month.
• Darke County SafeHaven in Greenville will hold blood pressure clinics beginning at 2 PM August 14 and September 11, and plan to continue on the second Thursday of each month.
• Shelby County SafeHaven in Sidney will hold blood pressure clinics beginning at 2 PM August 25 and September 22, and plan to continue on the fourth Monday of each month.

Illegal Drug Dangers and Getting Help - August 28 at 1 PM at Miami County SafeHaven site
Lt. Frye from the Shelby County Sheriff’s Department will be speaking on the Heroin/Drug epidemic in the Tri-County area. He will also be talking about the dangers of the drugs, the legal aspects, and some options for help.  All SafeHaven counties will be together for this presentation.

SafeHaven Family and Friends Outreach Picnic – September 18 from 11:30 AM - 3 PM at Fountain Park in Piqua
Current SafeHaven clients, interested consumers, and families of consumers from all counties welcome.  More details to come. 

Motivational Life Coach Presentation - September 25 at 1 PM at Miami County SafeHaven site
Life coach Jessica Riesenbeck will be delivering a mental health-tailored presentation from a motivational/life-coaching perspective. All SafeHaven counties will be together for this presentation.

IDDT Recovery Life Skills Program
SafeHaven will begin groups for this evidence-based practice sometime in Fall 2014. More information to come.

For more information on these and other SafeHaven programs, visit the website at www.safehaveninc.com or call 937-615-0126 in Piqua, 937-548-7233 in Greenville or 937-658-6930 in Sidney.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has opened public comments on Leading Change 2.0, it's strategic plan for 2015-2018.

"This strategic plan outlines work to increase the awareness and improve understanding about mental and substance use disorders, promote emotional health and wellness, and the prevention of substance abuse and mental illness, increase access to effective treatment, and support recovery. An important component of the plan is the prioritization of six Strategic Initiatives and the linkages between these initiatives and SAMHSA’s policy, programmatic, and financial planning. At its core, this plan offers a framework for planning around common categories of initiatives that enable cross-collaboration and organization of SAMHSA’s work."

The document can be downloaded from SAMHSA's website as a PDF file. Comments are to be posted to the website

Chicago Bears wide receiver Brandon Marshall, while appearing on daytime talk show "The View" May 19, pledged $1 million of his $30 million contract extension with the NFL club to the mental health community.

Marshall has openly discussed his struggles with mental illness as a youth and young sports star, with a history of off-field problems and being termed "reckless" in his early career.

Since being traded to the Bears, Marshall seems to have righted himself and is acknowledging with his pledge that there is much work to be done with mental illness in young people, especially those who come from stressful environments of poverty and parental substance abuse.

On May 20, Marshall appeared on ESPN's "First Take" to discuss his support for the mental health community. The ESPN interview can be seen on YouTube.

NAMI Ohio's NAMImobile stopped at the Troy Daily News offices in downtown Troy June 2. Staff and volunteers from NAMI of Darke, Miami and Shelby Counties, the Tri-County Board of Recovery and Mental Health Services, SafeHaven and other agencies were on hand to meet with reporters and talk to the public about mental health services in the area. The bus is on a statewide tour of 100 cities and towns in every county of Ohio this summer. Future stops include Greenville and Sidney. NAMI is the National Alliance for Mental Illness which has both state and local affiliates. Read more about the purpose of the visit.