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Home My WebLink AboutC. STATE OF MENTAL HEALTH 3.12.24State of Mental Health Focused Action Plan Initiative 3.2 Aileen L. Smith, Director Department of Human Services March 12, 2024 Mental Healthcare and Our Community Strengthening the Mental Health system requires community partnerships Virginia Beach Resident Human Services DHNP Hospital Systems Private Providers Family and Friends Govt Courts Police EMS Health Dept NAMI 2 Major Issues Impacting Behavioral Healthcare Workforce Shortage Access to Services Opioid Crisis Homelessness and Affordable Housing Stigma 3 Workforce Shortage and Access to Care Nationwide shortage of mental health providers. •A large number of Virginia’s licensed mental health professionals are at or nearing retirement age (61% of psychiatrists are age 55 or older).* •The National Center for Health Workforce Analysis projects that over the next 15 years, shortages will include: o 69,610 mental health counselors o 87,630 addiction counselors o 42,130 psychiatrists DHS has 75 behavioral health clinical vacancies across 16 program areas, including: •33% behavioral health nursing vacancy rate (6 of 18) •50% psychiatry vacancy rate (2 of 4) •57% nurse practitioner vacancy rate (4 of 7) *Source: Virginia Health Care Foundation 4 Workforce Shortage and Strategies Local Initiatives •Flexible workplace •Telehealth options •Stipends for hard to fill positions •Hiring bonuses •Job Fairs •Student Engagement •Internships and residencies State Strategies •Participation in compacts for licensed BH professionals across state lines •Paid internships •Loan repayments and scholarships •Paid clinical supervision hours required for licensure •Funding to increase compensation 5 The State of Mental Health in America •Of adults are experiencing a mental illness and 55% receive no treatment.21% •Of adults have a substance use disorder and 93.5% did not receive treatment.15% •Of youth at least one major depressive episode in the past year and 60% did not receive treatment. 16% •Individuals for every 1 mental health provider in America.There are 350 •Individuals for every 1 mental health provider in Virginia.There are 480 Source: Mental Health America Annual Report (www.mhanational.org) 6 Self Harm and Suicide Related ER Visits Source Virginia Department of Health 7 Deaths By Suicide Source Virginia Department of Health 8 Drug Overdose, Hospitalizations Source Virginia Department of Health 9 Substance Use and Overdose Statistics •Virginia Beach continues to experience the impact of the Opioid Epidemic. •The Covid pandemic increased isolation and impacted substance use rates. •Overdose death rate for Virginia Beach is slightly below the State average. 0 10 20 30 40 2019 2020 2021 Overdose Deaths Rate per 100,000 US Virginia Virginia Beach Source: Virginia Department of Health 10 Drug Overdose Source Virginia Department of Health 11 7.2 8.4 10.7 19.2 7.3 8.3 11 17.4 5 7 9 11 13 15 17 19 21 2001-2005 2006-2010 2011-2015 2016-2020 Drug Overdose Crude Death Rate per 100,000 Population 2001-2005, 2006-2010, 2011-2015, 2016-2020 Virginia Beach and Virginia Virginia Virginia Beach Fentanyl Overdose Statistics Source: Greater Hampton Roads Community Indicators Dashboard and VA Department of Health 12 Behavioral Health Population Source: DHS data from over 7,000 health records 13 Behavioral Health Continuum Prevention & Community Awareness •Educating Youth •Community Engagement & Training •Media Campaigns Early Intervention •Crisis Call Center - 988 •Mobile Crisis Response •Connection to Treatment Accessible Treatment •Same Day Access •Psychiatry •Therapy •Substance Use Services Psychosocial Stabilization & Recovery •Case Management •Supportive Housing •Forensic Services •Day Program & Skill Building •Vocational Services 14 Homeless Outreach Data Projects for Assistance in Transition from Homelessness (PATH): Provides services to individuals with serious mental illness and/or co-occurring substance use disorders to develop trust and build relationships for those who are experiencing or at risk of homelessness. Homeless Point in Time Count •2021 = 348 •2022 = 352 •2023 = 313 2023 PATH Services •Provided over 2000 outreach activities to homeless individuals and successfully enrolled 57 into PATH. •Since October 2023 PATH has provided education to 133 businesses and supplied Narcan. •Narcan was provided to 54 homeless individuals. 15 PATH Community Connections PATH Community Partnerships People In Need (PIN): Provided 157 hours of service to screen, complete intakes and provide resources. Housing Resource Center (HRC): Outreach individuals at Day Support, complete intakes, etc. Oceanfront Coalition: Strategize to make homelessness rare, brief, and non-recurring. Encampment Taskforce: Collaborative outreach with the Virginia Beach Department of Housing and Neighborhood Preservation, Virginia Beach Police Department and peers to provide Narcan, Fentanyl Strips, and resources. Potter’s House: Outreach, linkages, and provide resources. Central & Oceanfront Libraries: Initiative with Behavioral Health Wellness & Prevention Services (BHWPS) to provide HIV testing and resources. Virginia Beach Businesses: Provide DHS and community partners resources. 16 Prevention & Community Awareness 17 2023 Community Awareness Outcomes •New Virtual Service Walkthrough Videos •303 community trainings for 8,144 residents •118 public events reaching 27,751 residents •66 media campaigns with 8,259,037 impressions Education & Training Events •Suicide Prevention •ASIST: Applied Suicide Intervention Skills Training (Annually) •QPR: Question. Persuade. Refer (Quarterly) •SafeTALK (Quarterly) •Shatter The Silence (Annually) •Substance Abuse Prevention •REVIVE Opioid Overdose (At least 2x month) •Youth Drug Education (6x a year) •SAIP: Substance Abuse Intervention Program (Daily) •Counter Tools (20 locations a month) •Youth Coalition •Behavioral Health Awareness and Prevention •Help Me Understand Training (Monthly) •ACEs: Adverse Childhood Experiences (Monthly) •Mental Health First Aid -Adult & Youths (6x year) •Project Lock & Talk Gun Safety (20 merchants a year) Community Education Breaking down stigma through education Reframing public perception 18 Early Intervention and Crisis Stabilization 988 Suicide and Crisis Lifeline •24/7 telephonic crisis counseling and resources for mental health, substance use, or thoughts of suicide. Triage and Dispatch Based on Assessment •Telephonic crisis counseling and referrals •Mobile crisis response from a clinical team •Mobile Co-Responder Team (MCRT) •Law enforcement response for imminent danger Linkage and warm handoff to ongoing services 19 Access to Treatment Same Day Access Comprehensive clinical assessment with treatment recommendations and linkage to appropriate services. *970 adult assessments and 282 youth assessments in 2023 with an average of 22 -25 per week* •Outpatient Mental Health Treatment •Psychiatric Evaluation and Medication Management •Individual, Group & Family Therapy •Nursing and Healthcare Navigation •Assertive Community Treatment (ACT) •Multi-disciplinary team & comprehensive services •High frequency and community-based •Remarkable outcomes with severe illness •Substance Use Treatment •Individual and Group Counseling •Medication Assisted Treatment (MAT) •New: Intensive Outpatient Program (IOP) •New: Peer Drop-In Center •New: Jail-Based Clinicians Peer Recovery Warmline: 757-402-6190 20 Psychosocial Stabilization and Recovery: Supportive Services •Case Management •Facilitate linkage to services and benefits •Coordinate care •Navigation of complex healthcare system •Project Link •Linkage to resources and coordination of care for pregnant & parenting women and children •Promote stable family environment •Individual and group education •Beach House Day Program •Therapeutic environment to build skills •Healthy social engagement •Meaningful, purpose-driven activities •Vocational Services •Employment readiness •Obtain and maintain employment •CARF Accredited – Top 5% Worldwide 21 Psychosocial Stabilization and Recovery: Residential Services •Residential Services •Linkage to housing resources for individuals with mental illness. •Housing coordinator to promote stability. •Landlord engagement. •Community Partnerships include: •Department of Housing & Neighborhood Preservation •Community Development Corp. •Community Alternatives, Inc. •Permanent Supportive Housing (PSH) •State funded subsidized housing for individuals with mental illness. •Housing stability rate is 95% in Virginia Beach. 22 Psychosocial Stabilization and Recovery: Adult Correctional Services •Jail-Based Integrated Mental Health Services •Screening and assessment •Care coordination •Education and prevention •Re-entry planning •Peer support •Court Services •Drug Court •Mental Health Case Management •New: Early Diversion Initiative •Exploration of a Mental Health Court FY23 Jail Service Outcomes: •1920 MH screenings with 1585 eligible •326 re-entered community •96% did not recidivate •100% linked to benefits •100% had supply of medication •71% had housing •61% engaged in MH appointments post-release 23 Expanding Services for Youth •The Rapid Response Program launched in Virginia Beach Elementary Schools in February 2023. •Behavioral health screening, assessment, consultation and referral for students •92 referrals were received in the first 4 months, 131 to date •Expansion to Pre-K is planned for even earlier identification of youth with behavioral health needs •Parent Child Interaction Therapy Clinic Expansion: •Evidence-Based practice that serves youth ages 2-7 who have high behavioral needs •Two certified clinicians are working on becoming Certified Trainers •Two new state-of-the-art PCIT observation rooms are currently under construction •Outpatient Services to begin in the High Schools: •2 licensed clinicians are being recruited to provide intake and therapy within the school setting 24 Opioid Abatement Cooperative Partnership Background April 25, 2023 - City Council approved a Resolution to enter into agreements with Chesapeake, Norfolk, Portsmouth and Suffolk to pursue funding from the Virginia Opioid Abatement Authority (VOAA) to develop a regional collaborative strategy to address the opioid epidemic. Public Listening Sessions •More than 200 people participated in 15 events across the five cities •Virginia Beach: 2 Town Halls and 7 Public Listening Sessions •Online survey yielded 123 responses Top Areas of Concern •Access to services •Consolidation of services •Transportation to services 25 Opioid Abatement Cooperative Partnership Proposal Proposed Strategy – Mobile Care Van •Van purchase and coordination by Sentara (project partner) •Rotating schedule through 5 cities •Primary Care combined with a variety of service options: •Clinical Assessments •Prevention/Education •Naloxone Distribution •Counseling •Peer Services •Telehealth Capability •Youth Engagement Budget Planning •Year 1 project budget: $1,181,845 •25% match in the first year: •City match is $10,000 covered by direct distribution •Sentara contributing $250,000 •Sustainability plan is required -- locality matches increase to 100% over a 5-year period •Future annual match percentage for localities will vary based on operational data •Annual application is required 26 Crisis Receiving Centers •The General Assembly and the Governor have indicated a commitment to the development of Crisis Receiving Centers (CRC’s) in Virginia. A CRC is a 23-hour crisis stabilization unit that is accessible 24 hours a day, 365 days a year. •The Behavioral Health leaders in DHS are working on strategies for development of a center in Virginia Beach with our community partners. •A Crisis Receiving Center would include a variety of crisis response services in an integrated center to include, but not limited to DHS Emergency Services staff members, medical screenings and mental health assessments. A team of professionals on site can work to calm a crisis and divert individuals from incarceration and an acute hospitalization when appropriate. •A center in Virginia Beach would be an enhancement in our service continuum and would provide the police an ability to do a warm hand off to security officers and other professionals working in the center. •State funding is available, and the DHS team will be working on an application to explore a Virginia Beach CRC with the Department of Behavioral Health and Developmental Services (DBHDS) and other community partners. DHS will provide a City Council Staff Report on this project. 27 On The Horizon •Finalize and implement Opioid Abatement strategies with our community partners. •Continue to work with Human Resources to enhance recruitment strategies. •Coordinate with state and local partners to enhance various levels of crisis response systems over the next few years. •Continuously enhance community awareness strategies via our prevention and outreach services. •Continue to expand Permanent Supportive Housing and partner with other city departments and agencies in the community. 28 Questions? Thank you! 29