Dutchess County Department of Behavioral and Community Health

Dutchess County Department of Behavioral and Community Health Prevention Initiative

The Prevention Council v Prevention has been the #1 priority of the Local Governmental Plan since 2011 v In 2013, the Prevention Council was founded with key County and contract agency heads to help inform our prevention initiative v In March 2014, Prevention Council members participated in the 4 day training to learn how to implement SAMSHA’S Strategic Prevention Framework 2

The Prevention Council v In July 2014, the Prevention Council looked at the data from the “Communities that Care” survey administered in 2013 to identify the Dutchess County specific risk and protective factors we would focus on. Logic models have been developed and evidence-based programs are being implemented across three identified areas: q Promote Mental Health and Decrease Mental Illness q Prevention of Substance Abuse, including Opiate Abuse and Overdose q Suicide Prevention 3

Second Step is a classroom taught, evidence based program that teaches children and teenagers skills including empathy, communication, emotion recognition, emotion management and problem solving skills. In middle school there is a strong focus on preventing substance abuse and bullying. Second Step curriculum is being taught to approximately 9, 000 students in 17 schools and is being used in all Head Start Programs 4

Mental Health First Aid is a community and non clinical program designed to increase knowledge on how to identify someone with emerging signs and symptoms of mental illness or substance abuse, how to intervene in a crisis situation and how to make a referral to treatment if necessary. In Dutchess County we have trainers credentialed to teach MHFA for Adults, Youth and in expanded modules for higher education and for police, corrections and public safety officers. Mental Health First Aid has been taught to more than 1, 500 people over the past 2 years. We are training everyone who works at DCFS in Mental Health First Aid. 5

Teen Intervene provides an easily administered, low-cost SBIRT program that helps teens self-identify substance use and problems related to this, provides a brief plan for intervention, and guides the referral to treatment, if needed. It incorporates the stages of change model, motivational interviewing, and cognitive-behavioral therapy in all sessions. Can be 3 to 5 sessions (45 min-90 Min) To date I have trained 83 clinicians and it is being utilized at probation and at Astor Services, who are part of the Conrad Hilton SBIRT initiative. 6

Screening, Brief Intervention, Referral to Treatment SBIRT is an evidence based approach to identify problematic use and to reduce substance abuse and dependence. Brief intervention is delivered to those who screen at the low to moderate risk level. It can be delivered in primary care settings, emergency rooms, pediatricians offices, mental health settings, etc. We have trained approximately 75 professionals to date. 7

School based and Public forums In 2015 we participated in 6 forums with the Council on Addiction Prevention and Education provided to over 2000 high school students discussing the dangers of underage drinking, marijuana and heroin. We also participated in three county sponsored forums with 100 children and families discussing substance abuse and suicide. 8

Narcan training and Medication Assisted Treatment All Police jurisdictions and other first responders have been trained to use intranasal Narcan. School nurses are being trained, as schools develop their policies, in administration of Narcan. CAPE has begun offering Narcan training at their public forums. We have trained our patients in our Intensive Treatment Alternatives Program in Narcan use as well as staff in our homeless shelters. We are offering Vivitrol to inmates leaving our county jail with outpatient follow up at ITAP. We are also working on protocol to train inmates in county jail in Narcan which they can take home when they leave the jail. 9

Dutchess County HELPLINE Suicide Prevention, Education and Awareness app. We have a free app for Apple and Android phones and tablets which addresses through video and other interactive means the risk factors for suicide with focus on the highest risk groups: adolescents, veterans and older adults. There is a way to connect directly to HELPLINE by talk or text through the app. and to connect directly to other local resources. 10

Coalitions and Coordinating Councils Focusing on Prevention v Dutchess County Health & Human Services Cabinet Substance Abuse Subcommittee v Dutchess County School Safety Advisory Committee v Council on Addiction Prevention & Education v v v v q Southern Dutchess Coalition q Eastern Dutchess Coalition q College Consortium q Campus Coalition The Northern Dutchess Community Coalition The Eastern Dutchess Rural Health Network Dutchess County Department of Mental Hygiene Mental Health & Chemical Dependency Providers Dutchess County Department of Mental Hygiene Children’s Providers New York State Office of Mental Health Regional Meeting of Suicide Prevention Coalitions Poughkeepsie City School Community & Parent Engagement Task Force Prevention Council 11

HELPLINE Every life matter…Sometimes it just helps to talk to someone v CALL or TEXT 845 -485 -9700 24/7/365 v Crisis counseling, support, information and referrals v Triage Mobile Team referrals v Answers 23 phones that span five Hudson River bridges, in addition to the Walkway Over the Hudson v Initiation of Trauma Team referrals v Access to initial appointments in the public behavioral health system 12

Mobile Crisis Intervention and Prevention Team CALL US FIRST- WE ARE HERE TO HELP v Accessible through HELPLINE 24/7/365 v Community-based assessments, hospital and jail diversions for children, youth and adults v Community diversions from emergency department/ admission to hospitals: q 2014 = 221 2015 = 565 (YTD) v Community diversions from jail: q 2014 = 39 2015 = 25 (YTD) 13

What is CIT? v The Crisis Intervention Team (CIT) Program provides training and education to law enforcement officers to assist them in more effectively managing crisis in the community when they encounter behavioral health crises, mental illness and/or substance use disorders v The training is 40 hours of specialized instruction from behavioral health experts from our community, previously trained officers, consumers and their families v We are in the process of training 25% of all law enforcement officers in CIT and training the other 75% in BCIT which is a 7 hour class. 14

The Crisis Stabilization and Wellness Center 15

What happens at the Crisis Stabilization and Wellness Center? v Medical Triage v Motivational Assessments, addressing mental health and substance use disorders v Screening, Brief Intervention, and Referral to Treatment v Sobering beds, initiating detox (8 beds) v 23 -hour psychiatric observation beds (4 beds) v Family and Adult Respite spaces v Transition planning to appropriate levels of service will be continuous 16

What Happens at the Crisis Stabilization and Wellness Center? At the Crisis Stabilization and Wellness Center, guests will have the opportunity to engage with other community partners/services: q Dept. of Community & Family Services (Social Services) q Probation q Care Coordination q Domestic Violence Services q Housing q Other Related Providers/Services 17

Staffing v Ditches County is the umbrella agency for the Crisis Stabilization and Wellness Center v Dedicated staffing from the Department of Behavioral & Community Health’s Division of Mental Hygiene will address the supervisory needs of the Center v HELPLINE and the Mobile Crisis Intervention & Prevention Team will maintain a 24 -hour presence 18

Dutchess County