|
Having trouble viewing this email? View it as a Web page.
Lea en español
April 1, 2022
In this issue ...
My weekly Time for Families always opens my eyes to real challenges on the ground for young people and their families served by the behavioral health system. I am always humbled by the opportunity to be a part of their story and very often frustrated by our slowness to make needed changes. Please spread the word that this opportunity is available for families to come talk.
The COVID-19 Omicron surge is slowing down. Our communities are at their highest levels of immunity due to vaccinations or recent infection. Community transmission of COVID-19 is falling and daily new case numbers are down. Some people are still strongly encouraged to wear masks due to their risk for severe COVID-19 and their personal risk tolerance. All of us need to consider our role in protecting our communities. This means that many of us will continue to wear masks to prevent transmission of COVID-19 to our family and community members. The Oregon Resilience in Support of Equity (RISE) post-pandemic resilience plan lays out five main priorities:
-
Protect communities that have been hardest hit by COVID-19.
-
Protect people who are most vulnerable to COVID-19.
-
Expand access to vital health care and support a thriving workforce.
-
Keep schools safe for students, staff and families and help students recover instructional time.
-
Restore social cohesion by listening to local communities and helping people protect themselves and others.
Finally, I want to thank all of you for reading our newsletters. We now have an easy sign up link for new readers and now offer the option of a Spanish version, via Google Translate at the top of this email. We are open to all suggestions, comments and feedback for future editions, especially around the new Spanish version. Please send them to kids.team@dhsoha.state.or.us.
Chelsea Holcomb
Parent-Child Interaction Therapy (PCIT) is a therapeutic intervention that focuses on moment-by-moment direct coaching for the parent or caregiver and their child. It aims to improve or repair the parent to child attachment, while reducing the child’s difficult behaviors or other symptoms. PCIT views the parent(s) or caregiver(s) as the most important adult in the child’s life and supports them in being the agent of change for their child and family.
Just imagine for a moment that you are a highly active, curious 3-year-old child and imagine that your world frustrates you wherever you go.
- Compared to the other little kids around you, you have more trouble waiting your turn, sharing, following simple directions, and stopping what you are doing when told to stop.
- You may be hitting others or having a tantrum when you don’t get your way.
- Other kids don’t want to play with you anymore.
- You start to think that it’s your fault and that you are “a bad kid.”
Now imagine you are this child’s parent(s) or teacher.
- You find yourself saying “No!”, “Stop that”, “Get off that”, “Why can’t you be like the other kids?” and similar words all the time.
- As this parent, you feel like you must constantly correct your child because your child doesn’t seem to understand danger and could get hurt.
- You may feel like you never get to just enjoy your child and you might feel guilty when you realize that you love your child, but you don’t like them very much.
- You wonder “What did I do wrong? My other kids aren’t like this.”
This family needs PCIT. Without a highly effective, fast-acting intervention, the child is at risk of developing poor self-esteem, depression, anxiety, and poor academic progress when they enter elementary school, and perhaps for years beyond. Children with significant behavior problems are also at higher risk of abuse.
- This family has probably tried all the strategies that work with most children, but nothing has worked.
- This child needs a different type of interaction style that has high nurturing, while providing even more positive reinforcement, structure, consistency, predictability and follow-through than what is needed for most children.
For these families, there isn’t time to wait. The peak brain development for emotional control, our habits of response, social skills with peers, symbolic thinking and language occur before five years of age. Interventions at an older age can impact these areas, but with greater time, effort, and cost.
The data for both Oregon and International PCIT show that 85 percent of parents report statistically significant improvement in their families’ relationships, communication style, and child behavior when they attend four or more PCIT sessions.
Most families who complete PCIT will see their child gain emotional and behavioral control and within 16-20 weeks be rated as “typical” when compared to other children their age.
The development of PCIT in Oregon has been led by the CFBH Unit and is early intervention at its best.
More information is available on the CFBH Early Childhood Mental Health web page or from Laurie Theodorou at laurie.theodorou@dhsoha.state.or.us.
Laurie Theodorou
In 2020, the CFBH Unit began visioning work responding to gaps in the child and family behavioral health system by publishing our vision policy paper and starting community engagement.
As a team we bring a mosaic of experiences, lenses, cultures, passions, and energy. We also acknowledge those who are not represented and those who our system has excluded. We are not a true representation of the Oregon families we serve. We are committed to sharing power and doing our work in a more inclusive way and use this acknowledgment as a foundation from which to act.
While our work is in process, we are just beginning to truly vision a new children’s behavioral health system, and this is an update of what has been done since 2020.
What the CFBH Unit has done so far:
Community engagement:
- At the request of the CFBH Unit, the Children’s System Advisory Council (CSAC) spent monthly meetings in 2021 exploring the policy vision paper.
- As part of CSAC’s commitment, 25 family members, including seven CSAC Family Representatives, met to discuss ideas about services and needs of families with children, youth and young adults who experience behavioral health difficulties and made general recommendations.
- Youth ERA held four “Think Tanks” with over 45 young people with diverse representation from rural and urban areas, communities of color and Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, Two Spirit and the myriad other identities people may have (LGBTQIA2S+) to gather feedback and recommendations on the children’s System of Care in six areas of the policy vision paper.
- The CFBH Unit presented the policy vision paper to the Oregon Tribes in December 2020 and invited feedback, participation, and consultation.
- The CFBH Unit presented to the System of Care Advisory Council on Feb. 2, 2021, to address goals and objectives for increasing cross-system work.
- The CFBH Unit held more than 30 open community conversations in 2021.
- In February 2021, the OHA Family Partnership Specialist and the Director of Child and Family Behavioral Health began “A Time for Families.” This is a weekly discussion hour for family members and caregivers to share questions and concerns about mental health and substance use services and share suggestions for how OHA can support youth, young adults, and their families.
Equity principles and training:
In 2021, the CFBH Unit invited The UPRISE Collective to work with CSAC, the Youth and Young Adult Engagement Advisory, and CFBH Unit to train staff on principles of health equity in mental health systems, apply those principles to their work, and examine current and future work with these questions in mind:
- Is the action clearly rooted in anti-oppressive practice?
- How are we actively, authentically, and continuously working to dismantle harmful power dynamics?
- Is the way we’re addressing this issue grounded in equity, equality, or liberation?
- Is it about tweaking current systems or reimagining them?
- Is it about us making decisions with people or on behalf of them?
- Are we working from a deficit perspective or are we thinking about the wisdom that exists within communities?
- Are we taking time to understand where the issue comes from?
- Did our actions consider the underlying systemic issue that has created the barrier or inequity in the first place? Have we talked to anyone who knows more than we do?
- Who will be at the table when this decision is being made? Who’s missing? Are we making decisions for or with community?
- Did we ask for the people we have to speak on behalf of whole communities as if they are a monolith, or to speak on behalf of communities they’re not even part of?
- Are we clearly assessing the extent to which our actions may be reflecting some of our biases?
- Are we planning to circle back to community to check whether the actions we’re taking to address the barrier reflected the knowledge they shared with us?
- Did we think of solutions that make sense to us, or that make sense to them?
What you’ve had to say:
In the meetings we have held with community members, some themes have become clear. These include:
- It can be difficult or impossible for youth and families to get the services they want and need.
- Families and youth feel like they have to be unsuccessful in lower levels of care that don’t meet their needs before they can access more appropriate supports.
- Families and youth feel their concerns are not taken seriously or addressed in a timely manner.
- Families and youth feel tokenized or dismissed when they attempt to join efforts to improve the system.
Although some people from communities of color and people identifying as LGBTQIA2S+ participated in discussions, we must also engage directly with these communities to develop relationships and work together to remove health inequities. We take responsibility for not purposefully organizing this work in a culturally responsive and inclusive way. We pledge to do better in the future. We are committed to working with community to identify the missing voices and ensure they are included in the work going forward.
What are the next steps?
The following are the priorities OHA has defined for achieving health equity and will support the framework of the future work for the child and family behavioral health system.
- Collaborate with and follow the lead of community
- Tribal consultation
- Strengthen or establish equitable representation
- Redistribute power or resources
- Data collection and analysis of priority populations
- End racism, oppression, bigotry, bias, discrimination and mitigate harm
- Invest in community
We are continuing to develop relationships and listen to the experiences of the people we serve, centering on those who have been most impacted by health inequity. We are committed to working alongside community members to apply what we learn and to change the way we do our work. We will work with the community to center community voice, address the impact of racism and social determinants of health, to build a better system that meets the needs of the people we serve.
We will continue to use this newsletter and other formats to update the community on current efforts, ways to engage with us, and the progress of these changes. We welcome comments, suggestions and feedback every step of the way. Please connect with us at kids.team@dhsoha.state.or.us.
Trauma-focused Cognitive Behavioral Therapy (TF-CBT) trainings in 2022
Trauma-focused Cognitive Behavioral Therapy (TF-CBT) is a highly rated, evidence-based therapy designed to treat children ages 3 through 17. TF-CBT treats children who have experienced trauma, including children with multiple and complex traumas in their lives.
This free, OHA-sponsored training is a virtual, intermediate-level course designed for Oregon master’s level mental health professionals who work directly with children who have experienced trauma. The training includes up to 20 hours of training and up to one year of consultation with up to 13 Continuing Education Credits available for participants. Participants are responsible for pre-training expenses of approximately $75 and post-training certification expenses.
Training is for two days: May 12 and 13, from 8 a.m. to 4 p.m.
For more information or to register: http://www.tfcbtconsulting.com/registration/
Sources of Strength
Elementary Coaches training: April 13 and 14
This event will be held in-person in the Eugene area.
Contact Darci Brown at darci@matchstickpdx.com for more information.
Question Persuade Refer (QPR)
QPR Training for Trainers
Virtual trainings:
- Wednesday, April 20, from 9 a.m. to 4 p.m.
- Wednesday, June 15, from 9 a.m. to 4 p.m.
Contact QPR@linesforlife.org for more information.
Youth Mental Health First Aid
Youth Mental Health First Aid Training for Trainers: June 7 through 9.
This will be 3 full days virtually from 8:30 a.m. to 5 p.m. each day. Space is limited. To be added to the interest list for this training contact Maria Pos at mpos@aocmhp.org.
Applied Suicide Intervention Skills Training
Applied Suicide Intervention Skills Training for Trainers: May 9 through 13
Email Tim Glascock at tglascock@aocmhp.org to indicate your interest and learn more.
YouthSave
YouthSAVE Training for Primary Care Providers
Two upcoming virtual training dates:
- April 20 and 21, from 7 to 10:30 a.m.
- May 12 and 13, from 7 to 10:30 a.m.
Participants will also need to complete two webinars independently, one prior to class and one after. Each webinar takes approximately one hour to complete.
For more information contact youth.save@oraap.org.
System of Care Learning Collaborative
Each second Tuesday of the month from 3 to 4:30 p.m., the Oregon Family Support Network, Youth ERA and OHA facilitate a conversation for people involved with System of Care work.
Come with questions and a desire to learn and unlearn. Topics include how to develop skills that center youth and families, how to be culturally and linguistically responsive and how to ensure services and supports are community-based.
Contact Nat Jacobs at nat.jacobs@dhsoha.state.or.us for more details.
Job Spot
The System of Care Advisory Council is looking for a Policy Analyst (OPA4) to staff the Council and work alongside the new Executive Director.
You can find more details on the role and the application here.
A Time for Families
A Time for Families is a weekly drop-in discussion hour for parents and family members hosted by Chelsea Holcomb and OHA’s Family Partnership Specialist, Frances Purdy.
Click here to join the meeting (conference ID 676907).
Warmline
Reach Out Oregon, funded by OHA is a part of the Oregon Family Support Network, has a warm line at 833-732-2467, a website, a chat room for any family member needing support and a weekly virtual support group.
Children’s System Advisory Council: Help needed
The Children’s System Advisory Council (CSAC) serves as an advisory group for the CFBH work to support system planning, coordination, policy and fiscal development and the evaluation of service delivery and function.
CSAC is looking for new members and especially those willing to step into leadership roles.
Please contact Nat Jacobs to apply, or with any questions: nat.jacobs@dhsoha.state.or.us.
Emergency department usage:
There are ongoing concerns about the overuse of emergency departments (EDs) as the pathway to inpatient psychiatric services and the number of young people who wait for long periods in EDs for these beds. The CFBH Unit tracks data trends on young people who stay more than 24 hours in an ED, known as ED boarding.
Please join us in a community conversation to discuss the July 2019 – June 2021 data on Thursday, May 26, from 9 to 10 a.m.
How to join:
Restraint and seclusion:
The use of restraint and seclusion in mental health intensive treatment facilities is an important metric for the children’s system. OHA’s Children’s Seclusion and Restraint Report 2018 – 2020 documents these data, with the 2021 report being issued soon. These numbers are compiled as rates per 1,000 patient days, allowing for cross-facility comparison.
If you have specific questions about these data, please email shannon.karsten@dhsoha.state.or.us.
State law also requires Oregon Department of Human Services to submit to the Oregon Legislature quarterly reports regarding abuse, use of restraints and involuntary seclusion in licensed child-caring agencies. Beginning February 2022, the quarterly reports generated by Children’s Care Licensing Program can be found on the Child-Caring Agency (CAA) Licensing Reports page.
Capacity in the children’s psychiatric and substance use disorder residential system:
The CFBH Unit has been closely monitoring capacity at all Oregon Health Plan child behavioral health facilities since spring of 2021. The goal is to develop a centralized access process so we know how many children and families need services and we can increase capacity to get children the right service at the right time.
Goal capacity:
- Acute psychiatric and psychiatric residential: 286 beds
- Substance use disorder residential: To be determined
Operational capacity as of March 11, 2022:
-
Acute psychiatric and psychiatric residential: 171 beds (68% of operational capacity, 60% of goal capacity); an increase of 24 beds since February 11.
-
Substance use disorder residential: 28 beds (45% of operational capacity; goal capacity undetermined)an increase of 6 beds since February 11.
Projected operational capacity (acute psychiatric and psychiatric residential):
-
By December 2022: 263 beds (92% of goal capacity)
-
By July 2022: 281 beds (98% of goal capacity)
Mobile Response and Stabilization Services ($6.5 million)
Mobile Response and Stabilization Services (MRSS) will be a statewide model for Oregon’s crisis response system focused on providing 24/7 connection for youth and their families.
- The MRSS model includes immediate face-to-face response and up to eight weeks of stabilization services.
- Two-person teams will respond to the community and may provide screening and assessment, stabilization and de-escalation, coordination and referrals, and warm hand-offs to other community-based services and natural supports.
In anticipation of 988 rolling out in July, the CFBH Unit is working closely with interested parties and county leadership throughout the state to ensure that county mobile response teams receive specialized training and best practices for assessment and intervention strategies when responding to children, youth, young adults and their families in the community.
For more information on 988 or MRSS please contact Beth.Holliman@dhsoha.state.or.us or brian.m.pitkin@dhsoha.state.or.us.
Psychiatric Residential Treatment Services ($7.525 million)
Requests for Grant Proposals are in development with funding opportunities centering health equity, and with the enhancement and expansion of this much needed service in Oregon. Due to the ongoing focus on emergency COVID-19 response and staffing needs for our Psychiatric Residential Treatment Services providers, the current anticipated release is April 2022. You can access the RFGP once it is posted on Oregon Buys.
Restorative Services and Juvenile Psychiatric Security Review Board services: Proposals sought
The Request for Proposal for Restorative and Juvenile Psychiatric Security Review Board (JPSRB) Services within the State of Oregon has been released. Complete details can be found on Oregon Buys (Bid Solicitation: S-44300-00002311).
Young Adult Residential Treatment Homes ($9.2 million)
The Request for Proposal (RFP) developed in collaboration with Intensive Services, Housing & Social Determinants of Health Unit with health equity as a core component is planned for release soon. You can access the RFP once it is posted on Oregon Buys.
Interdisciplinary Assessment Teams ($5.7 million)
We have met with many community and system partners to get feedback on the original concept and intention of the Interdisciplinary Assessment Team (IAT) project and the design of next steps. The context for this work has changed because of COVID-19, staffing shortages and shifts in systems and supports. To address immediate assessment needs and test the concept an IAT pilot project will be operational in the near future.
We are seeking input from the community as we continue to create a new vision of this important service. We will be presenting the work at the System of Care Advisory Council on April 4 and at the Children’s System Advisory Council on April 22.
If you are interested in this work and want to participate or attend one of these meetings please contact John Linn at john.r.linn@dhsoha.state.or.us.
For feedback and suggestions for our newsletter and information: kids.team@dhsoha.state.or.us
Subscribe to OHA Behavioral Health Updates
Did someone forward or share this with you? You can subscribe here to get future issues of Holding Hope and other updates for Oregon behavioral health providers and partners.
|
