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November 2010

ANNAPOLIS COALITION UPDATES

The Annapolis Coalition is pleased to announce its participation as a partner in a successful application by The National Council for Community Behavioral Healthcare (NCCBH) to establish the National Training and Technical Assistance Center for Primary and Behavioral Healthcare Integration.  (See the press release below.)

In addition to the work on the TA Center, The Coalition will join together with our long-term partners in the Western Interstate Commission for Higher Education (WICHE) to provide leadership on a major supplement to the Technical Assistance Center, which has a focus on behavioral health workforce development.

"We view this as a significant opportunity to help ensure that behavioral health workforce issues remain a priority in the implementation of the Patient Protection and Affordable Care Act of 2010,” said Coalition Board Chair Gail Stuart.

The award, a cooperative agreement funded by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration, is renewable annually for up to five years.


Press release from The National Council:

Washington, DC (September 28, 2010)—The National Council for Community Behavioral Healthcare (National Council) has won a competitive grant from the U.S. Department of Health and Human Services (HHS) to establish the National Training and Technical Assistance Center for Primary and Behavioral Healthcare Integration. The Center will address the comprehensive health needs of patients with mental illnesses and/or substance use disorders by improving the coordination of healthcare services in publicly funded community settings. The Center is funded jointly by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources Services Administration (HRSA).

The Center will provide training and technical assistance to 56 organizations that have collectively been awarded more than $26.2 million in grants as well as to community health centers and other primary care and behavioral health organizations. According to HHS Secretary Kathleen Sebelius, these grants are part of an unprecedented push by the Patient Protection and Affordable Care Act to help prevent and reduce chronic disease and promote wellness by treating behavioral health needs on an equal footing with other health conditions.

"The National Council is honored to have this opportunity to assist dedicated safety net healthcare providers across the country,” said Linda Rosenberg, MSW, President and CEO of the National Council for Community Behavioral Healthcare. "We are grateful for this important federal investment in saving and improving the lives of persons with behavioral health disorders. We congratulate the grantees and look forward to working with them, with the larger healthcare community and with consumers of services to eliminate barriers between mental and physical health. Together, we can ensure people receive the right care at the right time, in all settings.”

According to a 2006 national survey, persons with schizophrenia, bipolar disorder and major depression have lower than average life expectancy and die, on average, at the age of 53 — often from untreated and preventable chronic illnesses like hypertension, diabetes, obesity and cardiovascular disease. Lack of access to primary care and specialty medicine is a critical factor in these tragic outcomes and the new HHS grants provide an opportunity to address this public health emergency.

SAMHSA Administrator Pamela S. Hyde, JD said, "The Substance Abuse and Mental Health Services Administration is excited about the possibilities that healthcare reform brings to individuals, families, communities, and providers. Our continued collaboration with the National Council for Community Behavioral Healthcare and other organizations is critical to ensuring the successful implementation of health reform. The new grants allow us to bring needed healthcare services to patients in a coordinated and convenient manner and can go a long way in helping to improve health status.”

The National Training and Technical Assistance Center for Primary and Behavioral Healthcare Integration will focus activities in six core areas: workforce development; knowledge application; knowledge development and dissemination; healthcare reform and policy analysis issues; prevention and health promotion; and quality improvement, performance measurement and data collection. An important goal of the Center is to increase the number of practitioners, consumers and families, trained in behavioral health wellness and recovery practices. The National Council is fortunate to have as partners in the Center, a diverse array of national associations, universities, and consumer-based agencies that have been the architects of the movement to integrate primary and behavioral healthcare.

"HRSA supports the work of Community Health Centers across the nation, assuring that patients living with mental health or substance abuse concerns can get the screening, treatment and referral for all their healthcare needs,” said Mary K. Wakefield, PhD, RN, Administrator of HRSA. "As health centers and other safety net providers work to meet the full range of patient healthcare needs, HRSA wants to assure that technical assistance and training are available to support those efforts.”

Over the past 10 years, the National Council has served as a critical source of information and field-tested resources for healthcare organizations, policymakers, and community stakeholders working to provide primary and mental healthcare across delivery systems. Clinical, organizational, collaborative, and financial tools for integrated care can be found on the National Council Resource Center for Primary Care and Behavioral Health Collaboration.


FROM THE BOARD OF DIRECTORS:
     
Cultural Diversity: An Imperative for Mental Health

According to a recent article entitled, "Future of Diversity: Cultural Inclusion Is A Business Imperative," Black Enterprise, August 2010, workforce diversity is an imperative to sustain businesses, large and small. By 2043, individuals of racial/ethnic minority groups, defined herein as American Indians/Alaska Natives, Asian Pacific Islanders, Hispanics and African Americans, are expected to make up more than fifty percent of the nation’s population. The fastest growing domestic market for goods and services will be minority communities.  Smart businesses are bolstering internal and external efforts to meet the demands of the changing face of American.
       
The 2001 Surgeon General’s Report indicated that consumers from ethnic/minority groups are underrepresented in the US mental health system. The report also revealed that persons from ethnic/minority groups who did receive services felt ill-at-ease in the mental health system. Overall ethnic minorities experienced less availability and access to mental health services; utilization of cultural parameters in assessment of service plans; and to providers of color.
 
Today’s mental health work force is relative homogeneous in terms of race and ethnicity. The overwhelming majority of professionals in traditional mental health disciplines are non-Hispanic whites. This is in stark contrast to the emerging diversity within the current U.S. population. The demographic   profile of the nations’ mental health work force has been relatively constant during the last ten years and is not expected to change significantly in the near future.                     
 
To eliminate disparities among ethnic/minority groups, mental health systems must be have a culturally competent, diverse workforce that encompass sensitivity to, respect for and understanding and knowledge of the beliefs and values related to economic status; spirituality and religion; cognitive, emotional and physical abilities; gender; language, race, ethnicity and culture; and age and sexual orientation of consumers and family members. In addition, the mental health workforce must have an appreciation for the political, social and physical trauma which many ethnic/ minority groups, particularly recent immigrants, have faced. A keen understanding of the historical realities of race relations, and the resulting stereotyping, discrimination and stigma, is also necessary.
 
To address this issue, I suggest:
  • Each state mental health authority in conjunction with the state and local education departments and the respective professional guild develop mentoring programs for 8th to 12th grade students who have expressed an interest in pursuing a career in mental health. Incentives for the students and the mentors should be developed and implemented
  • Each state mental health authority develop core competencies for cultural competency as standards for becoming a licensed provider
  • Each state mental health authority develop, implement and evaluate a culturally competent training curricula for consumers, family members, and service providers.
Oscar Morgan is the Project Director for Magna Systems, Inc., a multicultural, multilingual, veteran-owned health and human service consulting firm. He is a member of the Board of Directors of The Annapolis Coalition on the Behavioral Health Workforce.


IN THE LITERATURE
Emerging Practices in Employment of Persons in Recovery
by Jessica Wolf, Ph.D.
 
Increasing employment of persons in recovery in the mental health workforce has been a key workforce goal of the recent five year SAMHSA-funded Connecticut Mental Health Transformation State Incentive Grant. The Connecticut Workforce Collaborative on Behavioral Health (CWCBH) was created to identify and oversee projects initiated to attain workforce goals.   The Connecticut Recovery Employment Consultation Service (C-RECS), a project led by persons in recovery, was funded to promote recruitment, employment and retention; and enhance the capacity of organizations to engage and support persons in recovery as mental health workforce employees.
 
In order to guide implementation of the C-RECS project, four members of the Yale Group on Workforce Development and the CWCBH sought to identify factors and practices that contribute to success in preparing, hiring, retaining, and sustaining mental health workforce employees who are in recovery.  We undertook an extensive literature review and also incorporated experience from program operations into the recently published article, "Emerging Practices in the Employment of Persons in Recovery in the Mental Health Workforce,” by Jessica Wolf, Lyn Lawrence, Patrick Ryan and Michael Hoge, American Journal of Psychiatric Rehabilitation 13 (3) July 2010: 189-207.
 
Our literature review and on-the-ground experience suggested that three interrelated domains of emerging practices appear necessary to assure successful hiring and retention of individuals in recovery in the mental health workforce.  The domains are pre-employment practices, human resources practices, and organizational culture change practices. The article postulates that these domains and practices offer a comprehensive approach and workable model to promote and sustain employment in this very important area.  The article also identifies significant questions for future research. We hope this article will help guide practitioners, mental health agencies, and systems in increasing employment and retention of persons in recovery, and that it will stimulate essential organizational culture change among behavioral health workforce providers.
 
For more information, please contact Jessica Wolf (jwolfds@att.net). The journal issue may be accessed here .

Jessica Wolf, PhD., Principal of Decision Solutions, a behavioral health workforce development consulting practice, is a Senior Advisor in the Yale Group on Workforce Development and the Connecticut Workforce Collaborative on Behavioral Health. She is also an Assistant Clinical Professor in the Yale University School of Medicine Department of Psychiatry. She served as a Technical Advisor to the Annapolis Coalition in development of the 2007 Action Plan.