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.