A Publication of Mental Health America of Greater Houston
MHA Houston and the Center for Health and Biosciences at Rice University’s Baker Institute Kickoff Integrated Healthcare Initiative
Integrated Health Care • How to Cut Down on Gun Deaths • No Mother Should Suffer in Silence • Governor’s Volunteer Award • Veterans Find Hope in Court • #B4Stage4
Pictured: Dr. Jair Soares, ©2015 Michael Stravato for Rice University’s Baker Institute for Public Policy
Taking Better Care of Texans New Integrated Health Care Initiative Launches
©2015 Michael Stravato for Rice University’s Baker Institute for Public Policy
Integrated health care, the coordination of physical and behavioral health care, is widely regarded as best practice and as essential to achieving the Triple Aim of patient experience of care, population health and decreased cost. In spite of substantial evidence for the efficacy of integrated health care, significant barriers to its implementation exist. Foremost among these are financing and preparation of providers to practice in integrated health care settings. Traditional fee-for-service reimbursement is generally not conducive to the provision of the team-based care required for integrated
health care. Funding streams for mental health, substance use and other health issues are rarely integrated, and traditional training programs for both medical and behavioral health professionals do not generally prepare providers to practice as part of a multidisciplinary team. “Making Together Work: Policy Solutions for Integrating Care,” launched a major collaborative initiative to develop and implement consensus recommendations to improve both financing and provider preparation for integrated health care in Texas. ...con’t BETTER CARE pg 3 Pictured Above: McClain Sampson with Elena Marks, Jair Soares, Octavio Martinez, David Buck, Steven Schnee and Kenneth Minkoff. Photo by Traci Patterson
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from BETTER CARE pg 2
The forum, which convened a select group of over 100 providers, payers, funders, universities, public officials, and other stakeholders, included a panel discussion and presentation by some of the state’s leading experts in integrated health care. The panel, moderated by Elena Marks, president and chief executive officer of the Episcopal Health Foundation and nonresident fellow in health policy at the Baker Institute, included David Buck, MD, MPH, Director & Founder, Primary Care Innovation Center; Professor, Department of Family & Community Medicine, Baylor College of Medicine; Founder & Advisor, Healthcare for the Homeless-Houston; Octavio Martinez, executive director of the Hogg Foundation for Mental Health; Kenneth Minkoff, director of systems integration at the Meadows Mental Health Policy Institute; McClain Sampson, assistant
professor at the University of Houston Graduate College of Social Work; Steven Schnee, executive director of The Harris Center for Mental Health and IDD (formerly Mental Health & Mental Retardation Authority of Harris County); and Jair Soares, professor and chair of The University of Texas Health Science Center at Houston Medical School’s Department of Psychiatry and Behavioral Sciences. This event, sponsored by the Baker Institute Center for Health and Biosciences in conjunction with Mental Health America of Greater Houston is available for viewing online at www.mhahouston.org/videos/makingtogether-work-policy-solutionsintegrating-care/.
Vivian Ho, the James A. Baker III Chair in Health Economics and director of the Center for Health and Biosciences. Photo by Traci Patterson
For more information, contact Alejandra Posada, Director of Education and Training, at email@example.com or 713-523-8963 ext. 473.
Integrated Health Care Systems-Change Initiative Focuses on Recommendations Report for Texas MHA Houston’s Integrated Health Care Systems-Change Initiative, which launched in August 2015, seeks to advance integrated health care (IHC) system-level solutions in Texas. Stakeholders from collaborating organizations statewide have joined workgroups focused on financing and preparation of medical and behavioral health providers. Initial efforts have included compiling information on the current state of financing and provider preparation for IHC in Texas, and promising practices around the country. Confidential interviews with key stakeholders across the state, data gathered from stakeholder surveys, and research regarding successful practices in other states will help to develop consensus recommendations. The workgroups will finalize recommendations in Spring 2016 and release a report outlining the recommendations in Summer 2016. Alejandra Posada, Director of Education and Training, Mental Health America of Greater Houston Photo by Michael Stravato for Rice University’s Baker Institute for Public Policy ©2015
To learn more about the IHC Systems-Change Initiative, or to join a workgroup, contact Alejandra Posada at firstname.lastname@example.org.
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HOW TO REALLY CUT DOWN ON
GUN DEATHS Instead of arguing at the margins, politicians on both sides should be addressing the funding, access, and quality of our mental health system. Op-Ed by Bill Kelly With the Presidential campaigns in full swing, it is little surprise that President Barack Obama’s recent proposals on gun access have been met with political spin instead of objective analysis. Both sides are looking to make over generalizations without looking at the practical numbers behind the real issue that should address: our mental health crisis. Any conversation on gun violence should start with a basic set of facts in order to see the complete picture. Looking at the number of gun deaths, then moving to gun violence and mental health connections, and finally to where real bipartisan progress can be made in expanding access to mental health care can give depth to the otherwise shallow arguments made in today’s debate.
When looking at the actual occurrence of gun deaths in the United States, there is a very prominent role for those experiencing a mental illness, and it is not mass shooting settings.
People are concerned that those suffering with a mental illness will gain access to a gun to kill others. In fact, they should be much more worried about this person having easy access to a gun used to take their own life. As Matthew Miller, associate director of the Harvard Injury Control Research Center (HICRC) at Harvard School of Public Health put it, “If every life is important, and if you’re trying to save people from dying by gunfire, then you can’t ignore nearly two-thirds of the people who are dying.” What about those who are suffering from a mental illness? Aren’t they “dangerous,” as the political talking heads and media consistently assert? The Hogg Foundation for Mental Health recently hosted a forum about violence prevention and mental health at the Texas Capitol in February of 2015. Some interesting stats mentioned by Dr. Joel Dvoskin from the University of Arizona concludes: •
The point about gun access and suicide is clear in these statistics: • •
More than 60 percent of people in this country who die from guns die by suicide. According to Harvard School of Public Health, in 2010 in the U.S., 19,392 people took their own lives with guns, compared with 11,078 who were killed by others. Over 90 suicides happen every hour, and 90% of these deaths are related to mental illness.
People suffering from a Severe and Persistent Mental Illness are 11 to 12 times more likely to be victims of a violent crime If all violence related to mental illness were to go away, the overall reduction in violent crime would be only 4% The odds of someone with schizophrenia killing someone is approximately 1 in 140,000
The knee-jerk reaction to closely associate gun violence with mental illness completely misses the point in the current debate over gun access. Further stigmatizing mental illness by closely associating it with gun violence is perhaps the most prominent example of mischaracterization of a public health issue in the media today. The population of people in this country that suffer from a mental illness are our friends, neighbors, co-workers, and family members. And the system serving them has ...con’t pg 5 GUN DEATHS
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...con’t GUN DEATHS
consistently failed to provide the needed medical care for their medical conditions: •
1 in 5 people suffer from a mental disorder – more than cancer, diabetes or heart disease. Yet despite its prevalence, only 3% of the world’s healthcare budgets are directed at treating mental illness. 360,000 people with mental illness are housed in underequipped U.S. jails, only 35,000 in hospitals.
In mental health access, Texas ranks 49th in the nation for public funding for mental health (Kaiser, 2013). In Harris County, even with massive increases in the state budget in the last two legislative sessions, there is a striking gap of mental health access for residents. According to the 2015 report of the Mental Health Needs Council of Harris County: • •
142,930 adults have a serious mental illness in Harris County 89,579 individuals with serious mental illness have no public (Medicaid or Medicare) or private health insurance and are exclusively dependent on the public mental health service system for treatment. The Harris Center for Mental Health and IDD is able to treat roughly 12,000 per month, covering only a fraction of that population
Like clockwork, whenever the debate over gun control happens there are questions around the mental healthcare system with calls to improve it. When enough time passes for the debate over guns to die down, the bipartisan calls for mental health care also fades from the headlines. That’s how common sense bills like funding certified peer support services, requiring PTSD coverage in Texas insurance plans, and expanded Postpartum Depression coverage get bogged down. All three had bipartisan support but failed to become law during the 2015 Legislative Session. Instead of arguing at the margins, politicians on both sides should be addressing the funding, access, and quality of our mental health system and not change the subject from the need for additional resources. The biggest impact in reducing gun deaths in the United States is effective suicide prevention and improved mental healthcare, and that’s not debatable. Bill Kelly is the Director of Public Policy and Government Affairs for Mental Health America of Greater Houston.
No Mother Should Suffer in Silence Awareness Project Encourages Mental Wellness of Mothers Having a baby is supposed to be the happiest time of a mother’s life. But what if it’s not? Each year, 1.3 million women in the U. S. struggle to find support and treatment for postpartum depression and other perinatal mood disorders. On October 8th at United Way of Greater Houston, the Yates Children Memorial Fund Advisory Committee, a women’s mental health program at Mental Health America of Greater Houston, presented the film, “Dark Side of the Full Moon,” and a panel discussion with mental health experts, Rhoda Seplowitz, MD, Elisabeth Netherton, MD, Kirsten von Aulock, LMSW, Sherry Duson, MA, LPC-S, LMFT-S and Michele Parker-Schauer. The film, which gave a face and a voice to countless women who suffer with postpartum depression, also revealed disconnects within the medical community to effectively screen, refer, and treat these women. This event, presented during Mental Illness Awareness Week as a community service to nearly 150 individuals, was hosted in partnership with Texas Children’s Hospital Pavilion for Women, Baylor College of Medicine, The Center for Postpartum Family Health, A Mother’s Sanctuary, Texas Woman’s University, Behavioral Hospital of Bellaire, Doctors for Change and Grace After Fire. To volunteer with the committee or to partner in an event, contact Tiffany Ross at email@example.com. Visit the website www.mhahouston.org/events to view and register for upcoming trainings and events.
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Governor's Volunteer Award The Military Veteran Peer Network, a program of the Houston-Harris County Veterans Behavioral Health Initiative at Mental Health America of Greater Houston received the 2015 Governor's Volunteer Service to Veterans Award during an evening reception and ceremony at the Governor's Mansion (Austin, Texas) hosted by First Lady Cecilia Abbott, Honorary Chair of the Governor's Volunteer Awards. The Military Veteran Peer Network of Houston is led by over two dozen volunteers from Mental Health America of Greater Houston, using a peer-led holistic community based approach to address the specific needs of Harris County veterans. The Military Veteran Peer Network brings veterans together to volunteer and serve others in collaboration with community leaders and businesses that are helping veterans and their families reintegrate into the community. The peer mentoring team helps enroll veterans in school, obtain employment, and navigate community assistance programs. They also provide innovative, comprehensive training and peer support to Harris County Veteran
Treatment Courts. Military Veteran Peer Networkâ€™s mentors ensure the success of jail diversion programs and homelessness prevention for the chronically unemployed or those who are substance dependent. One Marine combat veteran returned from war with PTSD, hearing loss, and substance use issues which seemed insurmountable. He lost his job, wife, friends, house and access to his child and was facing a long prison sentence as a result of his substance use. He may have continued this downward spiral in the justice system had he not been transferred to the Veteranâ€™s Court Program with Judge Marc Carter. The Sergeant stated,
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Sean Hanna, MVPN Manager, Carlos Garcia, VBHI Program Manager, Susan Fordice, MHA Houston President and CEO, Tim Keesling, Military Veteran Peer Network (MVPN), Director, Governor Abbott, Tony Solomon, MHA Houston Veterans Behavioral Health Initiative (VBHI) Director, and First Lady Cecilia Abbott
“Without a doubt, the Veteran’s Court Program has given me the tools to gain my life back and give me new goals and hopes for my life. Thanks to the incredible mentor support that has been provided, my life has become my own again.”
Texas’ largest veteran community has been transformed through the dedicated volunteer efforts of the Military Veteran Peer Network, using evidence-based practices, selfless volunteerism, extensive community support, and effective outreach. The Governor’s Volunteer Awards, administered by the OneStar Foundation, honors the exemplary service of individuals, groups and organizations in Texas that have made a significant and measurable contribution to their communities through service and volunteering.
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Michael Jhin and The Honorable Marc Carter with Susan Fordice Photo by Kim Cauffman
Area Veterans Find Hope in a Harris County Court The 2015 Treasures of Texas recognized the leadership of the first felony court in Texas established to address former members of the U.S. military who get in trouble with the law and have mental health concerns. Mental Health America of Greater Houston (MHA Houston) hosted its annual Treasures of Texas at the Hotel ZaZa Houston. The event, cochaired by Denis DeBakey, Lavonne Cox and Dan Shank and honorary chairs The Honorable Michael McSpadden, Harris County Judge Ed and Gwen Emmett, recognized The Honorable Marc Carter, presiding judge over both the 228th District Court
Harris County and the Harris County Veterans Treatment Court with the 2015 Ima Hogg Award. The Harris County Veterans Treatment Court is the first of its kind in the state of Texas. In 2009, Texasâ€™ 82nd Legislature made it possible for counties to form specialty courts for veterans in need of mental health treatment by diverting veterans with felony
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and misdemeanor offenses directly into treatment. This program reduces jail time, costs and criminal recidivism while providing mental health and social services necessary for a successful community reintegration. The court is restoring the lives of veterans, their families and their futures through treatment, mentorship, and personal accountability. The event also showcased keynote speaker and true American hero, Master Sergeant Joseph R. Kapacziewski who, after an injury caused by an enemy grenade attack in Northern Iraq, lost his leg becoming the first U.S. Army Ranger in history to return to combat with a prosthetic limb. MSG Kapacziewski served more than 13 years in the Army and deployed to Afghanistan 6 times. Rounding out the event, the Houston Grand Opera performed a special selection, “HOME,” from its Veterans Songbook project, a collaboration with
veteran service organizations, Houston-area veterans and musical artists who create songs from stories that represent the veteran experience of conflict and courage, strength and sacrifice. Major supporters of the 2015 Treasures of Texas include John P. McGovern Foundation, Joan and Stanford Alexander, Burguières Family Foundation, Limor and Stuart Smith, and Connie and Eric Estopinal. Michael Jhin is MHA Houston’s board chair and Susan Fordice is the organization’s president and CEO. The Treasures of Texas benefitted Mental Health America of Greater Houston, the area’s longest serving mental health education and advocacy organization focused on shaping the mental health of people and communities in the areas of veterans, children and education, integrated health care, chronic illnesses, women, and aging.
Denis DeBakey, Lavonne Cox, Joe Kapacziewski, Dan Shank Photo by Kim Cauffman
Harris County Judge Ed Emmett and Gwen Emmett Photo by Kim Cauffman
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Changing the Way We Think About Mental Health
#B4Stage4 When we think about cancer, heart disease, or diabetes, we donâ€™t wait years to treat them. We start way before Stage 4. We begin with prevention. And when people are in the first stage of those diseases, and have a persistent cough, high blood pressure, or high blood sugar, we try immediately to reverse these symptoms. This is what we should be doing when people have serious mental illnesses, too. When they first begin to
experience symptoms such as loss of sleep, feeling tired for no reason, feeling low, feeling anxious, or hearing voices, we should act. These early symptoms might not ever become serious. Like a cough, they often go away on their own, and are nothing to fear. But when they do not go away, it typically takes ten years from the time they first appear until someone gets a correct diagnosis and proper treatment.
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Mental Illnesses are the only chronic conditions we wait until Stage 4 to treat.
This means that by ignoring them, we lose ten years in which we could intervene in order to change people’s lives for the better. During most of these years most people still have supports that allow them to succeed home, family, friends, school, and work. So people can often recover quickly, and live full and productive lives. Even when we don’t intervene right away, and serious mental illnesses get worse and disrupt people’s lives, we can act effectively. We can offer people choices and
supports to help them recover. These include clinical services, medications, peer supports, counseling, family supports, and other therapies that also help them manage their thoughts and emotions. These all help keep people connected to their families and their community. Intervening as early as possible preserves education, employment, social supports, housing – and brain power! It also costs less than the all-too-common revolving door of incarceration, hospitalization, and homelessness.
Download Free Resources and Materials www.mentalhealthamerica.net/b4stage4 • • •
B4Stage4: Changing the Way We Think About
B4Stage4: Get Help
Mental Health (Understanding the 4 Stages)
B4Stage4: Where to Get Help Interactive Tool
B4Stage4: Get Informed
(Risk Factors and Symptoms)
B4Stage4 en Español
B4Stage4: Get Screened
Learn More. Take Action. Join the Campaign.
As an affiliate of Mental Health America, Mental Health America of Greater Houston proudly promotes the national campaign, #B4Stage4. www.mentalhealthamerica.net. For more, contact Traci Patterson, Director of Communications at firstname.lastname@example.org
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www.mhahouston.org Michael Jhin, Chair Susan Fordice, President and CEO Anne Eldredge, Vice President of Finance and CFO Shari Koziol, Chief Development Officer Traci Patterson, Director of Communications Alejandra Posada, Director of Education and Training Bill Kelly, Director of Public Policy and Government Affairs Tony Solomon, Director, Veterans Behavioral Health Initiative Alix CaDavid, Director of Grants and Research Tiffany Ross, Manager, Education and Training Janet Pozmantier, Manager, School Behavioral Health Initiative Carlos Garcia, Program Coordinator, Veterans Behavioral Health Initiative
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