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Mental Hygiene Administration

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... chair a Veterans Behavioral Health Advisory Board and will work with a coalition ... a comprehensive, easy-to-use Library; an advocacy tool; and message boards. ... – PowerPoint PPT presentation

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Title: Mental Hygiene Administration


1
Mental Hygiene Administration
  • Annual Conference
  • May 6 -7, 2008
  • Presentation by Brian Hepburn, M.D.
  • Executive Director

2
Opening Remarks
  • Marylands Mental Health System over the years
    has seen many changes.
  • We are fortunate that throughout our journey it
    has been a collaborative processconsumers,
    families, advocacy and providerswherein a shared
    vision continues to lead our path.
  • The vision of a transformed mental health system
    is consumer and family-driven and
    recovery-oriented.

3
Ten Fundamental Components of Recovery
  • Self-Direction
  • Individualized and Person-Centered
  • Empowerment
  • Holistic
  • Non-Linear
  • Strengths-Based
  • Peer Support
  • Respect
  • Responsibility
  • Hope

4
Guided by the Recommendations of the Presidents
New Freedom Commission
5
  • Mental health is essential to overall health.
  • Mental health care is consumer and family driven.
  • Disparities in mental health services are
    eliminated.
  • Early mental health screening, assessment, and
    referral to services are common practice.
  • Excellent mental health care is delivered, and
    research is accelerated.
  • Technology is used to access mental health care
    and information.

6
Transformation Efforts
  • In Conjunction with Marylands Transformation
    Office, we are building upon a recovery model
    care system, through initiatives such as
  • Initiating Wellness and Recovery Centers
  • Moving forward with Consumer Self-Direction
  • Increasing Peer Support Groups
  • Expanding Evidence-Based Practices
  • Strengthening community supports
  • Through housing initiatives
  • And expanding EBPs in Supported Employment

7
Evidence-Based Practices
  • Moving toward a recovery-model system, the PMHS
    continues to maximize evidence-based practice
    (EBP) models of service.
  • Maryland has been an historical leader in this
    national movement toward the implementation of
    EBPs and recovery-oriented practices.
  • Maryland was one of four states to initially
    recognize the opportunities and promise offered
    by EBPs to positively impact the quality and
    delivery of mental health services.

8
Ongoing Collaborations
  • Maryland Division of Rehabilitation Services
    (DORS)

9
MENTAL HEALTH AWARENESS
  • Maryland Coalition of Families for Childrens
    Mental Health
  • Celebrating May as Mental Health Month
  • Celebrating Childrens Mental Health Awareness

10
Morbidity and Mortality
  • Statistics indicate an increase in morbidity and
    mortality associated with serious mental illness
    (SMI).
  • WHY
  • Metabolic Disorders, Cardiovascular disease,
    diabetes mellitus
  • High prevalence of Modifiable Risk Factors
    (obesity, smoking)
  • Epidemics within Epidemics ( e.g. diabetes,
    obesity)
  • Some psychiatric Medications contribute to the
    risk.

11
Why should we be concerned?
12
Mental health is essential to overall health
  • Compared to the general population, persons with
    major mental illness typically lose more than 25
    years of normal life span.
  • Increased risk of death from medical causes in
    schizophrenia and 20 shorter lifespan
  • Bipolar and unipolar affective disorders
    associated with higher standardized mortality
    ratios from medical causes.
  • Cardiovascular mortality in schizophrenia
    increased from 1976-1995, with greatest increase
    in standardized mortality ratios in men from
    1991-1995.

13
Mental Disorders and Smoking
  • Higher prevalence (56-88 for patients with
    schizophrenia) of cigarette smoking (overall U.S.
    prevalence 25)
  • More toxic exposure for patients who smoke (more
    cigarettes, larger portion consumed)
  • Smoking is associated with increased insulin
    resistance
  • Similar prevalence in bipolar disorder
  • George TP et al. Nicotine and tobacco use in
    schizophrenia. In Meyer JM, Nasrallah HA, eds.
    Medical Illness and Schizophrenia. American
    Psychiatric Publishing, Inc. 2003 Ziedonis D,
    Williams JM, Smelson D. Am J Med Sci.
    2003(Oct)326(4)223-330

14
Schizophrenia Natural Causes of Death
  • Higher standardized mortality rates than the
    general population from
  • Diabetes 2.7x
  • Cardiovascular disease 2.3x
  • Respiratory disease 3.2x
  • Infectious diseases 3.4x
  • Cardiovascular disease associated with the
    largest number of deaths
  • 2.3 X the largest cause of death in the general
    population

15
Serious Mental Illness may be a health risk
factor because
  • Patient factors, e.g. a motivation, fearfulness,
    homelessness, victimization/trauma, resources,
    advocacy, unemployment, incarceration, social
    instability, IV drug use, etc
  • Provider factors Comfort level and attitude of
    healthcare providers, coordination between mental
    health and general health care, stigma,
  • System factors Funding, fragmentation

16
What can we do?
17
PRIORITIZE
  • FOCUS ON PREVENTION AND WELLNESS
  • IMPLEMENT ESTABLISHED STANDARDS OF CARE
  • PREVENTION, SCREENING, TREATMENT
  • IMPROVE ACCESS TO AND INTEGRATION OF PHYSICAL
    HEALTH AND MENTAL HEALTH CARE

18
Promote and Educate
  • Promote coordinated and integrated mental health
    and physical health care for persons with serious
    mental illness.
  • Share information widely about physical health
    risks in persons with SMI to encourage awareness
    and advocacy.
  • Educate the health care community. Encourage
    consumers and family members to advocate for
    wellness approaches as part of recovery.

19
Consumer Wellness and Empowerment
  • Support consumer wellness and empowerment to
    improve personal mental and physical well-being
  • educate / share information to make healthy
    choices regarding nutrition, tobacco use,
    exercise, implications of psychotropic drugs
  • teach /support wellness self-management skills
  • teach /support decision making skills
  • motivational interviewing techniques
  • Implement a physical health Wellness approach
    that is consistent with Recovery principles,
    including supports for smoking cessation, good
    nutrition, physical activity and healthy weight.
  • attend to cultural and language needs

20
Mental Health First Aid
  • Maryland is adopting the program.
  • Mental health first aid is the help provided to a
    person developing a mental health problem or in a
    mental health crisis.
  • It is not therapyit teaches people how to
    recognize mental health problems so they can
    provide some initial assistance, and guiding
    persons towards appropriate/professional
    treatment.

21
SB 210 New Initiative
  • Lt. Governor Anthony Brown was a key force in
    passing legislation to establish a new 2.8
    million program that will provide mental and
    behavioral health services to Iraq and Afghan
    veterans, especially in rural areas.
  • Lt. Governor will chair a Veterans Behavioral
    Health Advisory Board and will work with a
    coalition of stakeholders to identify the gaps in
    behavioral health services for veterans and their
    families.
  • The program will be administered by the Maryland
    Department of Health and Mental Hygiene.
  • The program will eliminate gaps in services by
    providing crisis
  • intervention, case management, improved outreach
    and short-term
  • health-related services to veterans of the Iraq
    and Afghanistan wars.
  • -- MHA will provide resource coordination.

22
Network of Care
  • Network of Care is a highly interactive, single
    information Web site where consumers,
    organizations and staff can go to access a wide
    variety of information.
  • Within this site, resources include a Service
    Directory links to pertinent Web sites from
    across the nation a comprehensive, easy-to-use
    Library an advocacy tool and message boards.
  • We plan to expand Networks of Care throughout the
    counties.

23
Moving Forward
  • As we continue to transform Marylands Public
    Mental Health System, we will prioritize our
    systems of care to eliminate disparities in
    healthcare for those with mental illness.
  • We will closely monitor the morbidity and
    mortality rates in the PMHS populations.

24
Concluding Comments
  • We will continue to redefine the PMHStoward a
    system of care that provides the holistic
    approach to well-being, which supports a
    consumer-driven system that encourages
    evidenced-based and promising practices.
  • Resulting renewed hope and optimism for an
    individuals success in community living.
  • With that I once again welcome each of you to
    this years conference and applaud your
    continued commitment to improving Marylands
    Public Mental Health.
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