Cenpatico was invited to participate in the 2009 fall National Managed Markets Summit sponsored as a biannual event by Pinsonault Associates. This event was held at the beautiful La Costa Resort in Carlsbad California September 22-24.

Cenpatico was one of 60 industry leaders invited to conduct a breakout session on topics central to health care reform for the more than 300 attendees. The program faculty consisted of key decision-makers from diverse organizations: commercial payers, Pharmacy Benefit Management Organizations, Employer Coalitions, Specialty Pharmacy Organizations, Medicare (Commercial and Government), State Medicaid Agencies, Group Purchasing Organizations, and other leading industry experts.

Our presentation focused on psychotropic medication utilization for children. Increased use of psychotropic medications is a global phenomenon and part of the broader context of increased prescription use generally. As the use of medications for children and adolescents has increased, the viewpoints in public discussion have become increasingly polarized and shrill. Proponents of medication note that under-treatment of psychiatric disorders in children/adolescents leads to a waste of human potential and that long-term adverse effects of mental illness can be prevented if treated early while anti-medication activists claim that medications are supporting poor parenting and are simply used as a means of control, discipline or convenience without considering the risks and potential long-term side-effects.

Cenpatico presented the results of our Psychotropic Medication Utilization Review (PMUR) process for the Foster Care population in the State of Texas. The review uses the best practice parameters approved by the Texas Department of State Health Services in 2005, and subsequently adopted in some form by multiple other states (AZ, FLA, TN, CT). Key elements of the PMUR process include real-time tracking of prescription use for foster children, peer-peer interaction with prescribers, prescriber profiling and quality of care review as well as increased educational efforts regarding the best practice guidelines for prescribers.

The presentation addressed ways to increase accountability for prescribing safely, increasing continuity of care and appropriate exchange of information between all treating practitioners. Polypharmacy has been substantially reduced by these efforts in the Texas Foster Care STARHealth program and there are many promising interventions that can be considered for other populations as well.

Cindy Peterson

Vice President, Clinical Operations

Tags: behavioral, care, children, health, healthcare, illness, medication, medicine, mental, present, psychotropic, recovery, resiliency, results, side-effect
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To argue with a man who has renounced the use and authority of reason is like administering medicine to the dead. – Thomas Paine

I can’t help but now wade into the controversy that has become a nasty and mean spirited debate on healthcare reform.  First of all, let me say that like most Americans I still do not understand why we need a public government insurance option.  It just isn’t making any sense to me.

Look, I hope that everyone is on board with the idea that no American citizen should go without healthcare coverage. I believe my industry is on board. The problem is the solution that is being offered in the form of a government run entity. The proponents of this government plan keep touting that it will “increase competition” and “keep insurers honest.”  Let me address those two issues from my perspective of a CEO of a managed behavioral healthcare company.

1) “Keep insurers honest.”  First, I have to tell you, I find this argument personally insulting.  I am a licensed psychologist who until 10 years ago was a provider, treating consumers with mental illness and substance abuse disorders.  The insinuation of the “honesty” argument is that I wake up everyday putting profits before the needs of over 1 million consumers under my responsibility.  At 52 years of age, I have spent my entire life dedicated to the cause of ensuring that the behavioral health needs of everyone are met to the greatest extent possible.  Second, managed care is one of the most regulated industries, except for maybe the airlines industry, that I have ever seen.  I am audited and regulated down to the font size of my letters to consumers.  I am audited by accreditation agencies, various Federal agencies such as CMS, the SEC, as well as state agencies.  There is nothing hidden or invisible about what my company does, and yes, the auditing includes my financials.

2) “Increase competition”.  Pardon me?!  Then who were United and Magellan Health Services who I bid against for recent contracts?  In a recent bid, we were included in a field of FIVE competitive bids for a state behavioral health contract.  There is plenty of competition now, trust me; in fact a public option, in my opinion, would actually kill competition especially for smaller companies like mine.  A company is going to need to have deep pockets to compete with the price fixing practices of a government run public health entity. As a smaller, but growing company, I cannot compete against the Cignas, Aetnas and Uniteds of the world if there is a public option.  What will happen is consolidation of the healthcare industry into a few behemoths. Anyone remember AIG or the consolidation of the banking and finance industry? Or the bail outs?  So I ask you my intelligent and informed reader, why this same consolidation would not happen in the private healthcare industry in order to “compete” against a public healthcare solution?

Don’t get me wrong, I think the entire healthcare industry could be more efficient and that there is still unnecessary waste and fraud.  But let’s fix the current system, and get everyone covered.  We do not need yet another government bureaucracy.

Oh, and let’s please debate this without screaming and name calling. I’ve never felt compelled to spread outrageous lies not supported by facts, nor to accuse those who don’t agree with me of being “Nazis” (talk about the diminution of the holocaust, one of the darkest chapters in human history).  I am ashamed of how this debate has been conducted and regardless of how passionate you feel and where you stand on this issue, abusive behavior and screaming don’t make your argument.

-Sam Donaldson

CEO Cenpatico

These are personal views and not those of Cenpatico or any persona or entity affiliated with Cenpatico.

Tags: america, behavioral, care, coverage, government, government option, health, health insurance, healthcare, hope, illness, insurace, managed, managed health care, mental, opinion, recovery, reform, resiliency, results
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Currently in the United States over 500,000 children are in the child welfare system.

Almost one third will be there for three years or more.

Children in the foster care system have a 25% chance of homelessness after the age of eighteen.

Over 270,000 persons in prison in this country were once in foster care.

Children in foster care have twice the rate of Post Traumatic Stress Disorder than veterans of the first Gulf War.

These statistics are included in the powerful awareness campaign Raise Me Up (www.Raisemeup.org)   created by the Casey Family Programs in 2008 and have shocked many people who are unaware of the issues surrounding children in the child welfare system.  While many of us are aware of the prevalence of abuse and neglect in this country, there is a belief that once these children are removed from their home, society has provided a safe haven where they can grow and flourish as a normal child until they can either be returned to their biological families or be adopted.   This unfortunately is not the case for many children.  One of the most common factors among children who are unable to go to a permanent home (what the child welfare world calls permanency) is unstable behavioral health symptoms.

Despite the efforts of many states to address this issue by funding multiple services and treatment options the problem persists, leaving state systems, providers, advocates and stakeholders frustrated and confused.   Child welfare administrators and regulatory entities can’t understand why children aren’t improving with all of this care (therapy, medication, residential treatment).  Providers often point to the actions of caseworkers, state policy makers, licensing or regulatory entities, schools or foster parents for limiting the effectiveness of treatment.   Advocates and the judiciary feel caught in trying to advocate for children and trying to resolve problems that are evident in their communities.   So what is the real problem here and how in the world would managed care do more than add another layer to the existing problems?

In the standard world of behavioral health managed care  services to be successful, we would ensure that members have access to high quality treatment services, that treatment is necessary and appropriate, and  information is gathered, analyzed and shared to promote positive outcomes for members and our contracting entities.  When children are our members in the traditional managed care environment, we look to their parents or guardians to make informed decisions about care alternatives that are the best interest of the child.

In the child welfare world, we do all of the above but the guardians (legal and/or influential)  of these children are state policy makers, caseworkers, foster parents, judges and others who form a system of care that effects every aspect of the child’s life – including their behavioral health treatment.  In no other population is this system perspective as important as in foster care.   Every action within this environment impacts the other part of the system.  Therefore, treatment can not be seen as an isolated intervention to the child when the “family” of caregivers and stakeholders is critical to its success.   In Foster Care, the emphasis on coordination, communication and integration is a primary function of our mission.  Understanding all parts of the system of care for foster children allows our management efforts to promote a partnership and shared vision for the positive outcomes for our members.  We have the unique advantage of seeing the system from a different angle and thereby helping our partners to align their strategies for mutual success.

In our Foster Care program, we have placed a concentrated effort on participating in system review activities with providers, stakeholders and policy makers to share our expertise in children’s behavioral health.   We have also provided training and consultation to all parts of the system from the judiciary to caseworkers to individual foster parents to promote best practices and facilitate the sharing of information.   This “partnering” effort has created the opportunity for Cenpatico to be part of an exciting initiative to improve the future for some of our most vulnerable members.

Stay tuned for additional program updates from the exciting world of foster care.

- Marsha McMann, MSW , Director Foster Care

Tags: awareness, behavioral, child, child welfare, children, foster care, health, healthcare, hope, illness, mental, raise, raise me up, recovery, resiliency, results, stigma, welfare
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Last week I attended a meeting of the Office of Medicaid Policy and Planning (OMPP) Behavioral Health Quality Committee at the Indiana State House in Indianapolis, IN. I was also invited to speak at the Summer Celebration of the Indiana Black Expo Education Conference (www.indianablackexpo.com)
Here are some of the highlights of my trip.

At the OMPP meeting, the State of Indiana presented comparison Healthcare Effectiveness Data and Information Set (HEDIS) data for all health plans in the State. HEDIS is a large set of data that is reported nationally and publishes so one is able to compare health plans to one another. I’m very proud to report that Managed Health Services (MHS)/Cenpatico was announced as the top performer.

At the opening of the Summer Celebration Conference, I had the good fortune to hear Peter Groff, Director for the Faith-Based and Community Initiatives Center (http://www.usdoj.gov/archive/fbci/index.html) in the Office of the Secretary of Education give the opening speech. He is tasked with empowering faith-based and community groups, enlisting them in support of the Department’s mission to ensure equal access to education and to promote educational excellence for all Americans.

I presented twice to educators attending the conference on the giving and overview of the diagnosis and treatment of common childhood disorders. I was pleased to share a joint initiative by MHS and Cenpatico to open school-based clinics in Indiana to provide both behavioral health and physical health services directly in our schools. Our first school-based health clinic will open in Gary, IN this August for the 2009-2010 school year.

The trip was a very fulfilling one and I look forward to our continuing great work in the Indiana community.

Thomas Hamlin, M.D.
Vice President of Medical Affairs
Cenpatico

Tags: affairs, behavioral, health, healthcare, hope, illness, indiana, medical, mental, mental illness, recovery, resiliency, results
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This past week, I was pleased to represent Cenpatico at the 2009 National Convention for the National Alliance on Mental Illness (NAMI). This year’s convention was held in San Francisco, CA where over 2,000 NAMI members, consumers, family advocates, and mental health professionals gathered to explore strategies and ideas to improve the lives of individuals and families affected by mental illness. The theme of this year’s convention was “Creating a Healthy Future for Us All”. Through workshops, symposia, and poster sessions, we were able to share and discuss technological advancements, behavioral health legislation, and provide support.

If you had a chance to visit our booth, you may have picked up one of our Cenpatico water bottles and information about our organization. We were pleased to see many familiar faces from the markets that we serve in addition to meeting new NAMI members and mental health professionals.

One of the particularly striking things I noticed at the NAMI national convention was the continued emphasis on Peer and Family Support. NAMI is committed to engaging those who have personally experienced or have a family member living with mental illness to educate and provide support for other people experiencing the same issues. It is clear that, because of these NAMI programs, many individuals who feel isolated or that no one understands what they are going through are empowered and given tangible resources for establishing and maintaining wellness and recovery.

I attended a workshop on NAMIpedia, an initiative developed by the Southwest Pennsylvania chapter of NAMI to provide interactive support and resources for living with a mental illness. When conducting an online search for “mental illness”, over 12 million sources will be returned through a search engine. It is overwhelming to dig through the myriad sources to find valuable information for a particular issue. NAMIpedia simulates real-time conversation through the internet, allowing users to ask questions about mental health issues anonymously and delivering personalized answers from consumers and professionals through video. I’m thrilled to see a platform developed where consumers and family members can ask questions and find answers on a multitude of topics regarding mental illness. I encourage you to check out this resource-rich site at www.namiswpa.org

Another emerging development that I am looking forward to exploring is the NAMI Hearts & Minds initiative. Given that research demonstrates that people living with severe psychiatric conditions have an increased risk of heart disease and related conditions, NAMI has developed an interactive wellness program that will debut this fall. This online initiative will include a variety of tools to help people take charge of their eating and exercise habits. Some of these tools include starting a weekly walking group, creating a Quit Smoking club, healthy recipes, and an interactive food diary.

The Heart and Minds site will go live this fall, but there are already many resources available on the site. Check it out at www.nami.org/heartsandminds.

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Welcome to our new column “Take Two.”

“Take Two” will remind you to “Take a two minute break” from whatever you are doing to read and learn about emerging issues, new research, and personal stories from experts and leaders in the recovery and resilience movement. The weekly column will be written by written by Recovery and Resiliency Advisor Tom Kelly.

This week’s topic – Empowerment

Greetings Fellow Friends, Advocates and Colleagues,

In this week’s “TAKE TWO” I would like continue exploring the ten fundamental components or principles of recovery as described in the National Consensus Statement on Mental Health. In past TAKE TWO messages we have explored “Hope”, “Peer Support”, “Responsibility”, “Strengths-Based” and “Self-Direction”. Last week we looked at the component focusing on “Respect”. This week I would like to take a look at the component of “Empowerment”.

Empowerment: Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in his or her life.(1)

“When you face your fear, most of the time you will discover that it was not really such a big threat after all. We all need some form of deeply rooted, powerful motivation — it empowers us to overcome obstacles so we can live our dreams.” – Les Brown

“The principles of empowerment and recovery require a clear and concise understanding and commitment to those principles if we are to be effective helpers. We also need to be aware of our attitudes and beliefs about mental illness and the people affected by these disorders. Our attitudes and beliefs will define how we respond to persons with mental health difficulties.

“Providing services in mental health, as in any helping field, means we have chosen to serve people with mental and emotional health challenges. Serving others effectively demands that we put our personal agendas, attitudes, biases and fears aside and let ourselves be directed by the people we have chosen to serve.

“For those of us that have landed in the mental health system by circumstance rather than by choice, it is essential that we also perform a thorough examination of our beliefs and values.

“While nominally applying a “strengths approach” to their service provision, some mental health services seem to focus on illness management, on controlling the person’s deficits and disabilities, rather than building a real life of pursuing hopes, dreams, goals, challenges, achievements and overcoming setbacks.” (2)

“The rehabilitation view of recovery is that people can regain some social functioning, despite having symptoms, limitations, medication, and remaining mentally ill … To say that the person’s mental illness is a permanent condition is to forever ostracize the person from society and say that they will never be able to regain a major social role.” (3)

“Many of us who have been psychiatrically labeled have received powerful messages from professionals who in effect tell us by virtue of our diagnosis our futures are already sealed.” (4)

“Power is not something that we can bestow on another person. It is something he or she already has within and will struggle to retain. Empowerment means that we acknowledge the personal power each person has to make positive decisions and to take responsibility for them, a simple exercise in treating others with dignity and respect.” – Gail Pursell Elliott

Empowerment is an important principle that we must focus upon. It is through empowerment that individuals gain control of their destiny!

REFERENCES:
(1). National Consensus Statement on Mental Health Recovery. U.S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. www.samhsa.gov

(2). Peters, H., Empowerment and Recovery in Mental Health. Partnership for Consumer Empowerment. 2003. Retrieved from: http://www.manitoba.cmha.ca/data/1/rec_docs/753_pce_workbook.pdf June 5, 2009.

(3). Fisher, D. (1999). A new vision of recovery: The empowerment vision. National Empowerment Center. Retrieved June 9, 1999 from the World Wide Web: http://www.power2u.org/vision.html

(4). Deegan, P.E. (1995). Recovery as a journey of the heart. In L. Spaniol, C. Gagne, M. Koehler, (Ed.), Psychological and Social Aspects of Psychiatric Disability. (pp. 74-83). Boston University: Center for Psychiatric Rehabilitation. Boston. Massachusetts.

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-By Cyndi Campbell, Manager, Clinical Research and Development

Last month we shared some statistics about mental health and substance abuse that highlight the impact of behavioral health on our overall wellness and the importance of considering this as we discuss healthcare reform.  The statistics from SAMHSA remind us that behavioral healthcare does not just impact one individual; it affects children and communities for generations.

Recently the Substance Abuse & Mental Health Services Administration (SAMHSA) released the results of research on the high rate of occurrence and the impact of children living with substance using or abusing parents.
“The research increasingly shows that children growing up in homes with alcohol- and drug-abusing parents suffer…The chronic emotional stress in such an environment can damage their social and emotional development and permanently impede healthy brain development, often resulting in mental and physical health problems across the lifespan. This underlines the importance of preventive interventions at the earliest possible age.” – SAMHSA Acting Administrator Eric Broderick, D.D.S., M.P.H.

SAMHSA reports:
•    Almost 7.3 million children lived with a parent who was dependent on or abused alcohol
•    About 2.1 million children lived with a parent who was dependent on or abused illicit drugs
•    5.4 million children lived with a father who met the criteria for past year substance dependence or abuse, and 3.4 million lived with a mother who met these criteria.

Often when a parent’s alcohol or substance abuse is out of control, the child is identified as having a problem first.  Maybe a teacher or school nurse has noticed sleepy eyes or school work below the child’s ability.  Some children begin to take on more responsibility at home as they have gotten used to taking care of their parents and sometimes siblings too.

According to The Center on Addiction and the Family (COAF), the definition of a child of an alcohol or substance abuser “is any child whose parent (or parental caregiver) uses alcohol or other drugs in such a way that it causes problems in the child’s life.”

When parents or caregivers are using or abusing alcohol or other drugs family life can be unpredictable and chaotic.  Frequently communication, rules, or expectations are unclear or inconsistently enforced.  Parents may display wild swings in behavior from loving, to withdrawn, to out of control.  This can be confusing to children leading to feelings of worry, insecurity, anger, and self-blame.

These confusing feelings can become disruptive behaviors for children.  On the surface it may look like, or be expressed as, other commonly diagnosed psychiatric disorders for children such as attention deficit disorder (ADD), attention deficit-hyperactivity disorder (ADHD), anxiety, and depression.  Children who display these symptoms should be referred to a mental health professional for assessment.

There are many ways even occasional substance use can impact their children.  Substance use for adults can lead to broken marriages, loss of jobs and economic stability in the household.  These types of challenges may seem to the parent to be theirs to deal with, but children feel the effects of the stress as well.  Stress is well known to lead to health problems in adults, but children too can develop physical health problems due to stress such as headaches or asthma.

The encouraging news is only 1 out of every 4 children of alcohol abusers will become an alcoholic themselves, 75% will not (COAF).  Many children with substance using or abusing parents and caregivers are able to find ways to succeed in life. Identifying with positive role models and learning to tap into their own positive coping skills helps children to be resilient and successful.

More resources on this topic can be found at:
Substance Abuse & Mental Health Services Administration  http://www.samhsa.gov/
Center on Addiction and the Family:  http://www.coaf.org

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…”there can be no health without mental health”

- William Emmet, Director, Campaign for Mental Health Reform, September 10, 2008.

Cenpatico welcomes the “merry month” of May not only because it is the harbinger of real Spring for much of the country, but because it is Mental Health Awareness month.  Two weeks ago I commented on the staggering impact of alcohol abuse in our country. Here are some of the staggering facts about the overall impact of mental illness and substance abuse in our country(1):

* One in four adults Americans has a mental disorder, substance use disorder, or both
* Mental Illness is the leading cause of disability in North America for people between the ages of 15 and 44.  Further, the burden of disease from mental disorders exceeds those from any other health condition.
* Adults with serious mental illness die, on average, 25 years sooner than those who do not have mental illness.
* Roughly 30,000 + people take their own lives each year.  Suicide is often the third leading cause of death for young people aged 10-24.
* Treatment for mental health and substance use disorders is effective.  Recovery rates for mental illness are comparable to and even surpass the treatment success rates for many physical health conditions.

As you know, health care reform is a hot topic now, and thanks to the recent parity legislation, behavioral health is becoming a more prominent issue.  But don’t relax yet; we still have a long way to go.  I continue to be disappointed in the lack of meaningful presence at the national healthcare reform table by advocates, behavioral health provider associations, and, yes, leaders from the managed behavioral health care industry.  All three groups have critical experience and knowledge that needs to be discussed and shared in any effort to reform our system.   Toward this end of healthcare reform that understands the role of behavioral healthcare, Cenpatico endorses the principles outlined by the National Association of County Behavioral Health & Developmental Disability Directors (NACBHDD):

1) Behavioral healthcare is essential to healthcare reform.  (See the well known stat’s above if you have any questions or doubts)

2) Coverage does not guarantee access.  For example, adults with serious mental illness (SMI) are a medically vulnerable population and need consistent and ongoing support not only in adhering to a viable behavioral health treatment plan, but also a physical health plan.  Often adults with SMI are compromised by their illness to a point where they are not able to effectively access medical help even with coverage.  Further, there are many in the physical health side of our healthcare system that avoid and discriminate adults with SMI, usually out of a lack of understanding, communication and support.

3) Prevention and wellness strategies are essential.  We still focus too much in our healthcare system on treatment versus prevention and wellness.

4) Integration of behavioral healthcare and physical healthcare.

5) Embrace recovery principles:  Among these are self-direction by consumers, individualized treatment, strengths-based approaches, and peer support.

6) Mental health workforce development.  In particular for the Medicaid consumer, we are facing a crisis of having access to appropriately trained prescribers for psychotropic medicines.  We have to provide better training and support of all physicians as well as adding different types of prescribers due to the psychiatrist shortage.

But what about just maintaining good mental health in the absence of a diagnosable mental illness or substance abuse disorder?  I love the Mental Health America site “Live Your Life Well”  www.liveyourlifewell.org.  They have identified the best top ten list I’ve seen for maintaining your emotional and overall mental health.  I think everyone should have this list in their wallet/purse printed as a reminder to:

1 – Connect with others
2 – Stay positive
3 – Get physically active
4 – Help others
5 – Get enough sleep
6 – Create joy and satisfaction
7 – Eat well
8 – Take care of your spirit
9 – Deal better with hard times

and most important if the top 9 aren’t working, 10- Seek professional help when you need it.

I hope that all of you will pay attention to healthcare reform in Washington.  Get involved and find out where your local representatives and Senators stand on the principles outlined by  NACBHDD.  Make sure they understand that without good behavioral healthcare, there is no effective healthcare in the United States.

(1)SAMHSA Communication Dialogue, National Association of County Behavioral Health & Developmental Disability Directors (NACBHDD), April 2, 2009.

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The idea that somehow, someday he will control and enjoy his drinking is the great obsession of every abnormal drinker. The persistence of this illusion is astonishing. Many pursue it into the gates of insanity or death.

ALCOHOLICS ANONYMOUS, The Big Book

Excessive alcohol consumption is the third leading preventable cause of death in the United States.*

Alcohol abuse plays a significant and direct role in five of the top ten leading causes of death in the United States: Heart Disease, Cancer, Stroke, Accidents and Diabetes. Alcohol abuse and dependence cost the U.S. an estimated $220 billion in treatment costs and productivity impact on our society; this is more than the costs associated with cancer or obesity. One survey published by The Journal of the American Medical Association estimates that the number of alcohol attributable deaths is about 75,000 + deaths per year which would make it, the sixth leading cause of death. Many studies have demonstrated that alcohol is involved in a majority of car accident deaths, homicides, sexual assaults, suicide, and domestic violence. Put it all together and the problem of alcohol abuse and dependence is staggering.

I could go on and on with mind numbing statistics, but the point here is that I think we seem to have lost our focus on this very important disease shared by 14 million Americans. I am an avid reader of periodicals and watch TV news and I am surprised at how little attention has been paid to alcohol awareness during this month. I did see one piece on CNN that followed the tired and worn path of whether alcoholism is a disease versus a moral defect of character (i.e., will power). If alcohol as a drug is responsible for more deaths and costs to our society then all the other drugs put together, why is this not making the headlines? I believe the answer is because alcohol is the only major drug of abuse which is legal.

The dirty secret in our county is that much of our drug policy and subsequent laws to make drugs illegal have little to do with concern about public safety. If you research public policy and the laws that made various substances illegal in this country, you will be shocked to see the laws put in place were more about either the association between drugs and stigmatized groups in our society, or some perceived threat to family values, our idealized view of the American way of life. For example, the movement that resulted in making marijuana illegal in the 1930’s was tied to the concern about immigration, i.e., the perception that Mexican immigrants were bringing the drug into our society. Marijuana use was also linked with African-American jazz musicians and this new form of music was considered a major threat to the youth of the country at that time.

I urge us all to rethink the war on drugs and to consider placing our efforts, money and focus on our true number one drug problem. I know it doesn’t make a very sexy story. It is no longer trendy, and our national celebrities have moved on to the newest diseases that capture the public imagination. Cenpatico and other managed behavioral health organizations (MBHO’s) need to make sure that we continue doing as much as we can to educate and help our providers consistently assess the impact of drinking on our consumers’ lives — recovery from mental illness is not possible in any case where someone is abusing alcohol. We need to do a better job at supporting the transfer of new treatment technologies based on evidenced based practices; many have yet to make it into most substance abuse treatment programs. For example, in spite of several medicines available that can now help those with alcoholism and other addictions recover, we still see these options rarely used. As MBHO’s, we also have an ongoing obligation to educate and support PCP’s in their ability to screen and talk with their patients about the effects of excessive drinking.

P.S. Some of you may have gotten the impression that I want go back to prohibition. No, that didn’t work then just like our current prohibition laws with drugs are not working now. I am in favor of toughening the consequences of drinking behavior. For example, I think we have done a good job on making the consequences more severe for driving under the influence.

So let’s get back to basics and focus on our number one drug problem: Alcohol

*Alcohol-Attributable Deaths and Years of Potential Live Lost–United States, 2001; The Journal of the American Medical Association, v.292, No. 23, December 15, 2004.

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By Linda J Weinberg – Cenpatico Arizona Policy Developer

We have all heard the expression, “it takes a village to raise a child.”  This is the same concept of behavioral health prevention -   Healthy communities build healthy families which helps us to raise healthy children.

In our prevention efforts, we work with members of the community to change norms, perceptions, policies and laws.  Similar steps are used when working to change communities as are used in treatment.

In treatment we determine readiness for change and motivate change.  We use a best practices model – motivational interviewing.  Using a strength-based approach we assess strengths, resources and needs, conduct psychosocial assessments, and collect previous treatment records or other pertinent information. We then develop a treatment plan with measurable goals, objectives, outcomes and time frames with the member.  This helps us to then assign tasks and implement an effective culturally appropriate treatment and support intervention plan with the individual.  We consistently update treatment plans as goals are attained and support is provided through community resources.

When working with communities we assess the community’s readiness for change using a best practices model.  We assess the community’s strengths, resources and needs through primary and secondary data collection.  We develop a plan with stakeholders with measurable goals, objectives, outcomes and time frames.  Tasks are assigned and culturally appropriate strategies are implemented by community members.  The process is continually evaluated.  Changes are made when indicated, successes are celebrated and slowly communities begin the change process.

Nationwide, many communities have introduced programs and initiatives aimed at reducing underage drinking.  It is crucial to provide this outreach and education to parents seeing as the majority of youth report they obtain alcohol from home.  Communities working towards this goal have employed unique approaches to increase awareness, educate parents, change behaviors and change norms and laws.  The SAMHSA Strategic Prevention Framework is the model being used in hundreds, perhaps thousands, of communities in all 50 states, District of Columbia and the territories.  Check to see what is occurring in your community.  Get involved.  Prevention Works!

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