EOHHS Secretary Sudders "Imagines the Future of Children's Behavioral Health" at 2nd Annual Knowledge Center Symposium

By Kelly English 

DMH CBH Knowledge Center Director 

The Children's Behavioral Health Knowledge Center hosted its second annual Symposium and Gailanne Reeh Lecture last month at the Worcester Recovery Center and Hospital. More than 150 people attended the day-long event which coincided with the celebration of 

Children's Mental Health Awareness Week. 

This year's Gailanne Reeh lecturer, Secretary of Health and Human Services Marylou Sudders delivered the address titled "Imagining the Future of Children's Behavioral Health," and highlighted some of the important accomplishments of the children's behavioral health system in Massachusetts including:

• The Commonwealth leads the nation in developmental screenings including behavioral health screenings for youth;
• 98% of youth in Massachusetts with an emotional or behavioral developmental issue are consistently insured and the Massachusetts;
• The Massachusetts Child Psychiatry Access Project (MCPAP) has been replicated in 32 states and DC and is expanding its reach to support access to care for mother's experiencing post-partum depression through the MCPAP for Moms project; and
• Successful Passage of Chapter 321 encouraged early identification of mental illness in children, expanded insurance protections for families and established the Knowledge Center and the Children's Behavioral Health Advisory Council

Despite these accomplishments, Secretary Sudders noted that we still have work to do to achieve true mental health and substance use parity, ensure that youth who need treatment can access it, and to end the boarding of youth and adults in hospital emergency departments. 

Secretary Sudders described a future behavioral health system that includes better integration of mental health, substance use and physical health care services. She also described a future where more dollars are spent on prevention and early identification and treatment of mental illness and substance use in areas such as early childhood mental health, early psychosis identification, screening and treatment for moms with post-partum depression, supporting parents who have a mental illness during pregnancy and substance use prevention programs.

Following Dr. Metz, panelists discussed the implementation of the Children's Behavioral Health Initiative (CBHI), giving attendees the opportunity to hear how key concepts described by Dr. Metz, played out with the implementation of the CBHI. Emily Sherwood, Director of the Office of Behavioral Health at MassHealth, discussed the role leadership played in winning the "hearts and minds" of stakeholders and its importance in helping people manage the changes brought about by CBHI. Jill Lack, Director of Behavioral Health at Neighborhood Health Plan, described how CBHI served to transform how the MassHealth managed care entities (MCEs) worked together and turned former competitors into collaborators. Laura Conrad-Laberinto from the Office of Behavioral Health at MassHealth, highlighted how CBHI challenged MassHealth's usual ways of working with the MCEs, producing greater standardization of certain business practices. Melinda Kneeland, a family partner Wraparound coach, described the importance of attending to the "hard to teach" skills during the hiring process to ensure selection of those individuals who are best suited to the role of a family partner. Anthony Irsfeld, Director for the Families and Communities Together program at Community Healthlink (CHL), discussed how CHL has worked hard to create a culture of coaching that involves observing staff engaging with families out in the field rather than having supervision occur in the office.

After lunch, attendees heard from Alicia Anzaldi, a young adult peer mentor at The Home for Little Wanderers Community Service Agency. Ms. Anzaldi told her personal recovery story describing her lived experience and journey to mental wellness and how it has informed her work as a peer mentor. She noted that helping people like her is her "passion" and that if her experiences with mental illness, "provide a different perspective of mental health, inspire someone with an eating disorder to change, or prevent one little girl from cutting herself then all my pain was worth it." 

Click here to view photos of this event on the DMH Flickr Site 

Recovery + Education = Hope  

Justin Brown, Director of the Northeast Recovery Learning Community, led a panel of NSCC students and faculty as well as a staff member from the Massachusetts Rehabilitation Commission. Panelists explored a series of issues including:  

• What is one of the important ways that Community Colleges have the opportunity to provide education about mental illness? 
• What do students with mental health concerns find as the biggest challenge when considering attending or while attending college?
• What are some examples of supports are provided and how have they helped the students?
• What factors have contributed most to being a successful student at NSCC?
• What role does pursuing educational goals have in an individual's recovery?

A lively discussion was followed by questions from the audience. The students shared how NSCC has helped them in their recovery by having services in place and faculty and staff who are trained to be compassionate and reach out to the students with accommodations and flexibility to help them successfully complete their degree. Mental health counselors introduce themselves into classrooms so that students will know they are there and feel less stigmatized to reach out to them. Faculty member Troy Smith personally addressed how he helps his students make the connection with a mental health counselor if they are interested. According to Bruce Ciaramella, the conversation feedback from faculty and students was positive with clear take-aways for improvement:

• The need for clearer and more accessible information for services available at NSCC for students struggling with mental health issues.
• Increased training for faculty around the need for increased awareness of students with mental health issues who are at risk emotionally and/or academically and strategies to assist students to sustain their studies by designing short term alternative academic solutions.
• The need for a monthly peer support group for students with mental health issues at NSCC
• Information/advertisements within the college to eliminate the stigma and discrimination of mental illness.

Since the Community Conversation, NSCC field placement students received an assignment to identify areas of need/concerns addressed at the forum and to develop an action plan to increase awareness and support for students struggling with mental health issues. NSCC has a preliminary action plan that will:  

• Establish a mental health-related monthly column in the school newspaper starting in September. 
• Provide  mental health training for faculty during our faculty professional day.
• Schedule educational forums and celebrations during "Mental Health" month in May.

DMH Area Director Susan Wing extended special thanks to Karen Hyneck, Patricia Gentile and Bruce Ciaramella at North Shore Community College for hosting the event; and Kevin Palumbo, Nizhoni Healthcare Systems for co-sponsoring and providing the refreshments. She also thanked the panelists listed and pictured below who openly shared their backgrounds and thoughts about mental health. And a special thank you to the DMH Citizens Advisory Boards, the Northeast Recovery Learning Community, North Shore Community College, DMH staff and Nizhoni Healthcare Systems for great collaboration that made the Community Conversation possible.   

To bring greater awareness to the issue of post-traumatic stress disorder (PTSD), the United States Senate designated June 27 as National PTSD Awareness Day. In addition, June has been designated as PTSD Awareness Month by the National Center for PTSD (NCPTSD).

PTSD is an anxiety disorder resulting from exposure to a single traumatic event or multiple traumatic events, such as sexual or physical assault, natural or man-made disaster, and war-related combat stress. Symptoms of PTSD include persistent intrusive thoughts and distressing dreams about the traumatic event, triggered emotional responses to reminders of the trauma, efforts to avoid thinking or talking about the trauma, and persistent hypervigilance for cues that indicate additional danger or trauma re-occurring.

Post-traumatic stress disorder symptoms may start within three months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.

  Intrusive memories

Symptoms of intrusive memories may include:

• Recurrent, unwanted distressing memories of the traumatic event
• Reliving the traumatic event as if it were happening again (flashbacks)
• Upsetting dreams about the traumatic event
• Severe emotional distress or physical reactions to something that reminds you of the event

Avoidance

Symptoms of avoidance may include:

• Trying to avoid thinking or talking about the traumatic event
• Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

• Negative feelings about yourself or other people
• Inability to experience positive emotions
• Feeling emotionally numb
• Lack of interest in activities you once enjoyed
• Hopelessness about the future
• Memory problems, including not remembering important aspects of the traumatic event
• Difficulty maintaining close relationships

Changes in emotional reactions

Symptoms of changes in emotional reactions (also called arousal symptoms) may include:

• Irritability, angry outbursts or aggressive behavior
• Always being on guard for danger
• Overwhelming guilt or shame
• Self-destructive behavior, such as drinking too much or driving too fast
• Trouble concentrating
• Trouble sleeping
• Being easily startled or frightened

If you or someone you know may be be experiencing any of the signs of PTSD consult your physician or call one of the hotlines listed here.

Rape, Abuse, and Incest National Network (RAIN) (24 Hours)

1 800 656-4673

National Domestic Violence Hotline

1 800 799-7233

National Council on Alcoholism and Drug Dependence Hope Line

1 800 622-2255

Veteran Crisis Line

1 800 273-TALK (8255) - Veterans Press '1

PTSD Federation of America 

Avenues toward Collaboration: DMH Forensic Managers Meet with Probation Field Managers

Over the past several years, DMH has been working with various stakeholders to help address the needs and support individuals with mental illness as well as co-occurring substance use disorders who may have involvement with the justice system. These activities have focused on a model known as the "Sequential Intercept Model" that attempts to work at various intercept points in the justice system to identify individuals with behavioral health needs and redirect them to treatment when appropriate and safe. These activities have included developing Crisis Intervention Teams with police, specialty court services and reentry programs for individuals returning to their communities after a period of incarceration.

As part of these efforts, DMH is working to establish greater ties and develop cross-training opportunities with probation and parole. To that end, earlier this year DMH Forensic Managers, along with Assistant Commissioner for Forensic Services Debra Pinals, M.D., met for the first time together with field managers from the Office of the Commissioner of Probation and Deputy Commissioner of Field Services Dianne Fasano. 

It was a great opportunity to discuss areas of mutual concern, ask questions about how DMH services work, and how DMH and Probation can partner to help clients we serve in their paths to recovery, which includes helping them adhere to mandates set by the court so that they can succeed in their communities. 

According to Dr. Pinals, DMH is also working on cross-trainings through federal funding from the U.S. Substance Abuse and Mental Health Services Administration, spearheaded by Matthew Broderick, Manager of Forensic Operations and Policy and focused on working better together for clients on probation. These activities and conversations help set the stage for ongoing initiatives to improve responses to justice-involved individuals with mental illness. For more information or if you have questions about these activities, contact DMH Forensic Services at 617-626-8094.

Front row, left to right

Renee Payne, BMC Probation Supervisor; Francine Ryan, Region 6 Probation Supervisor; Brian Mirasolo, Probation FSD Adminstrator; Debra Pinals, MD, DMH Assistant Commissioner; Dianne Fasano, Probation FSD Deputy Commissioner;

Middle row - left to right

Richard O'Neill, P & F Probation Supervisor; Mary O'Regan, DMH Southeast Area Forensic Director; Betsy Daigneault, Region 5 Probation Supervisor; Maria Walsh, Probation FSD Operations Manager;

Back row - left to right

Jeff Akers, Region 3 Probation Supervisor; Ronald Michaels, DMH Metro Boston Area Forensic Director; John Barber, DMH Western Mass. Area Forensic Director; Karin Orr, DMH Northeast Suburban Area Forensic Director; Geri Furhmann, DMH Juvenile Forensic Director; Matthew Broderick, DMH Manager of Forensic Operations; Andy Peck, Superior Court Probation Supervisor;

First-ever Summit Celebrates 

Young Adult Leaders of 2015!

In collaboration with young adults, the Department of Mental Health Transition Age Young Adult (TAY) Initiative and the Success for Transition Age Youth/Young Adults (STAY) Grant hosted its first statewide Young Adult Summit "Shaking It Up: Young Adult Peer Leaders Promoting Mental Health & Wellness" last month in Marlborough. The summit provided skill-building and networking opportunities for young adults, and celebrated and recognized their contributions and achievements as individuals with lived experience and how they impact and enhance the service system.

Leading and emceeing the day was Gustavo Payano, Young Adult Peer Coordinator for the DMH Northeast Area Now Is The Time (NITT) grant. The summit included morning workshops facilitated by young adults for young adults on a variety of topics including cultural diversity led by Rachel Ramos from the Northeast Recovery Learning Community and Tina Sang from DMH Office of Multicultural Affairs; social media networking and outreach led by Aliana Wilkey and Kayla Walking from JRI; leadership and advocacy skills led by Lydia Proulx and Chandra Watts from YouthMOVE MA/PPAL; and Whole Health Action Management (WHAM) led by Statewide Young Adult Council co-chairs Amanda Costa from UMass Transitions RTC and Samantha Sandland from Walpole Way. The workshops provided skills and strategies for promoting mental health and wellness as well as supporting fellow young adults. An additional workshop was offered for parents, adult supporters, advocates, employers and supervisors focusing on "Keeping Up" with young adults led by Kim Bisset from Radiate Careers and Rob Walker from DMH Office of Recovery and Empowerment.

The afternoon included DMH's 4^th annual "Young Adult Peer Leadership Recognition Event," celebrating and recognizing young adult peer leaders across the Commonwealth for their leadership, compassion, and enthusiasm in the young adult mental health community. This year, 125 young adult peer leaders were recognized with "Certificates of Appreciation" for their contributions. This shows a significant increase and growth in the young adult workforce from the first DMH Young Adult Peer Leadership Recognition when approximately 25 young adults were recognized. The young adult workforce has grown, expanded and diversified exponentially over the past four years with employers providing more opportunities for young adults whether in part-time, full-time or volunteer positions to encourage and support a new and growing generation of leaders. The young adults' dedication, advocacy and passion has greatly contributed to much of the shift in providing services to this group. They continue to be instrumental in numerous roles as they engage and support their peers who have lived experience, offer encouragement and the acquisition of new skills, and most importantly, provide hope and inspiration.