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 Oct. 1, 2024
In this issue...
Reflections from Oregon Health Authority’s (OHA) Child and Family Behavioral Health (CFBH) Director, Chelsea Holcomb
With the arrival of October, we are reminded why we are blessed to live in this beautiful part of the world. We get gorgeous fall days with the sun shining, leaves in bold colors and the beginning of a fresh chill in the air. School is also well under way and after school opportunities and activities keep children, youth and families busy and engaged. The needed rain returns to Oregon to replenish the land, begin to heal wounds from the devastating wildfires this year and inspire time for reflection, connection and fill warm spaces with friends and community.
Mental health can also start to change as days become shorter, light wanes and the season shifts. Perhaps that’s why October focuses on mental health education and depression awareness. The entire month shares information and awareness of screenings and prevention:
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National Depression and Mental Health Screening Month: This brings awareness to the need for depression awareness and the need for accessible and affordable mental health screenings. Not everyone experiences depression in the same way, but it can affect anyone at any time. So, it is important to take that next step and seek out professional help and be screened if you or someone you care about feels they may be depressed. Here is a useful questionnaire for teens and information on depression in children.
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ADHD Awareness Month: There are over 17 million children and adults in the United States who suffer from ADHD. October is a month to celebrate the successes of those living with this condition, their families, educators, and caretakers. The goal of ADHD Awareness Month is to celebrate these successes and continue to look for further ways to improve the lives of those with ADHD. Check this link for more information.
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Health Literacy Month: The month is dedicated to bringing attention to the importance of making health-related information and education easy to understand, thereby making health care systems worldwide easier to navigate. Learn more about health literacy here.
In the theme of fall, our current Roadmap is coming to an end and as we look toward a new season, we have been listening! As OHA released the strategic plan (2024-2027) for our agency, we want to make sure we are elevating and amplifying your voice as we develop and define the future priorities for Child and Family Behavioral Health. We have been talking to groups and communities across the year. If we haven’t heard from you, I’d like to make sure that each of you has this invitation to provide us with feedback for our next workplan. Please take a few minutes to answer three short questions to contribute to our prioritization process:
We welcome your thoughts on three questions:
When you think about children and young adult mental health or substance use treatment and supports:
- What is going well?
- What could be going better?
- If you were running the system what would your top 2 priorities be?
Please share this link and survey with others in your community, program or organization. The more feedback and input the better our plan will be as we come together in community to improve the child and family behavioral health system.
This month Chelsea Holcomb had the privilege of attending part of the 2024 Peer Fusion Retreat sponsored by the OHA Office of Recovery and Resilience and organized and hosted by Folk Time. The theme was Elevating the Voice of Lived Experience in Advocacy and Policy. It included a panel of Oregon legislators and powerful speakers who amplified ways to bring lived expertise to system and policy change.
One highlight was Des Bansile who presented from Adulting IRL on the work they are doing with youth and young adult peer support. They have created The HEAR ECHOES of PEACE Framework which is universal across culture, ethnicity, or identity. At Adulting IRL they focus specifically on uplifting Black, Brown, Indigenous, and Queer communities. The framework included:
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Strategic guidance to equip Youth Peer Support Specialists with the tools and confidence to navigate complex social and emotional landscapes,
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Collective resilience to ensure allies have tools to reinforce and nurture the resilience in their communities,
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Elevating competencies which deepen the standards of peer support and
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Innovative strategies allowing this framework to be used by others to expand approaches to youth peer support and support lasting change.
Adulting IRL has submitted the application to OHA to offer #ISeeYou, a 40-hour training program to certify Youth Peer Support Specialists. This will be reviewed in November by the OHA Traditional Health Worker Commission. #ISeeYou fills the gaps of intersectionality when providing youth peer support by training through the cultural lens of individuals who identify as being marginalized and/or lesbian, gay, bisexual, transgender and/or gender expansive, queer and/or questioning, intersex, asexual, and two-spirit.
Chelsea says, “It is grounding to be able to share space with those with lived and living expertise and experiences. It was a great opportunity to listen, connect and community build with peers and advocates. I came away with a strong sense of connection.”
Some of the OHA staff present at the 2024 Peer Fusion Retreat - Walter Bailey, Chelsea Holcomb, “JP” John Parsons, Brittney Wake and Carisa Dwyer
Through many feedback sessions with youth, young adults, and their family members, and our own experiences, we recognize that there is often a disconnect between the youth-serving behavioral health system and the adult system. Young adults, between ages 17 and 26, are often not able to access youth services after age 18. They find that many existing adult services are oriented toward older adults and inappropriate for younger people. Under Early Periodic Screening, Diagnostic and Treatment (EPSDT) provisions in Medicaid, young adults with behavioral health needs are to be offered services through age 20. Currently, young adults can easily lose services, not find what they need, and experience frustration as they move between the two systems. A bridge is needed to fill the gaps in supporting the unique needs of young adults.
Without appropriate services, OHA data shows that young adults are more likely to
- Use the emergency department for behavioral health crises
- Wait more than 24 hours for services in the emergency department,
- Experience suicidal ideation and attempts,
- Go to the emergency department for substance overdose.
To address these concerns, our team has linked up with the adult behavioral health unit and Medicaid partners to create a workgroup for young adult services. We are finalizing a contract with a community organization to support a young adult engagement team to co-create the plan with us. The group will work on the unique needs of young adults as a distinct group separate from either children or older adults and will bring in feedback from existing young adult engagement groups and providers.
Some questions that the group will be developing responses to include:
- Review of the current system: what is working, and where do gaps exist?
- Are changes needed to current Oregon Administrative Rules (OARs) to ensure that services are available?
- What other states are doing this work?
- What do we know about the best practices for behavioral health work with young adults?
- What types of training might be needed for both youth and adult providers to better support young adults?
If you are a young adult, a family member of a young adult, or a treatment provider, we are interested in hearing from you. Please contact Christie Taylor, Young Adult Services Coordinator for more information or to get involved.
September is officially school attendance awareness month in Oregon. The Oregon Department of Education (ODE) has created an Every Day Matters team and resources to support both families and schools in recognizing the importance of getting young people into a classroom.
The facts
- Every Day Counts! To help students attend school regularly, schools need to involve students and their families in a positive way, schools need to feel safe and welcoming, and keep open communication.
- Attendance is a key predictor of how well a student will do in school. Research shows that missing school a lot is linked to problems like failing classes, dropping out, and lower grades. When students are absent often, it becomes harder for them to succeed.
- In Oregon, if a student misses 10% of the school year—about 2 days each month—they are considered chronically absent. Research shows that this can hurt their performance in school.
- Children who miss a lot of school in PreK and kindergarten are less likely to be reading well by 3rd grade.
- Reducing chronic absenteeism is crucial for boosting graduation rates, improving academic achievement, and giving young people the best chance to succeed in their adult lives.
- Health-related absences, including mental health appointments are a top reason students miss school, yet sometimes they can be avoided. It is important to partner with students, families and health providers to keep students in school as much as possible.
For more information and resources visit ODE’s Every Day Matters.
This summer several of the CFBH team have been traveling across the state to visit different areas and programs. We thank you all for your hospitality and the insights that we have gained.
In late August we were invited to present at the Jackson Youth System of Care Advisory Council Network meeting. We had opportunity to meet more than 50 providers, youth and community members at the event. A highlight was hearing about the Behavioral Health Education Support Tiers (BEST) pilot project. This includes mentoring supports for youth and has provided training to many staff to increase their understanding of behavioral health and the impact of trauma. The project focused on the Phoenix-Talent School District and pulled together behavioral health providers, school counsellors, mentoring and community resource specialists.
This opportunity to travel acted as a catalyst to visit the Jackson, Josephine, Douglas, and Lane County regions. There is no substitute for local conversations and connection. Amongst our ten visits we had the opportunity to tour a day treatment facility, a substance use disorder residential facility, a mobile crisis unit and local youth drop-in centers.
The Medford Drop, Youth Era’s Jackson County drop-in center. Close to the bus station and downtown, this drop provides a safe space for youth, along with support.
In late August, Sage Neilson, CFBH Children's Intensive Treatment Services Coordinator, had the opportunity to tour the construction site for Community Counseling Solutions' (CCS) children's residential program in Boardman, Oregon. While she was there, she connected with Matt Bergstrom, the Chief Operating Officer, and Stephanie Cronen, the Residential Program Manager.
The facility will serve youth ages 6 through 12. It has been mindfully designed to be a trauma sensitive environment for youth and families. One feature is a family living unit designed for young people and their families to practice transitioning back home, while still having staff support.
The design thoughtfully includes areas for play, a quiet reading nook, and an expansive gym. The program will feature three wings with a total of 14 single bedrooms: two wings with four bedrooms each and one with six. Each wing will have its own bathroom and common area, designed to minimize overstimulation by keeping groups small.
Sage found Matt and Stephanie’s dedication to the community and enthusiasm for the project impressive. “I appreciate that CCS is made up of people who continue to step up when their community has unmet needs. This youth residential project fills a gap in local and statewide behavioral health resources”, says Sage.
As of mid-September, construction is set to finish by May 2025, with plans to staff and admit young people by July 2025.
OHA is in the process of implementing a new Referral and Capacity Management (RCM) system across youth psychiatric and substance use disorder (SUD) residential programs in Oregon. RCM is a system that helps residential providers to organize and manage referrals, while collecting data. With this data, OHA will:
- Track how many youth have been referred to a residential program.
- Measure the time between referral and admission (their wait times).
- Have real-time updates on bed availability and program capacity.
This information will help us understand the ebbs and flows of the system and determine the optimal number of residential beds that are needed for children and adolescents in Oregon.
RCM updates
All psychiatric residential treatment facilities (PRTS) programs are providing referral and capacity data to the state. Most providers are entering data into the RCM system, including Looking Glass, Trillium Family Services, Jasper Mountain's three residential programs, and Madrona Recovery.
Albertina Kerr Subacute, Embark Behavioral Health residential treatment program, and Clementine West Linn are all submitting data externally, while we work on preventing duplicate data entry.
Substance use disorder residential treatment providers are currently in the process of adding their referrals to RCM, including the adolescent residential program of NARA Northwest, and Adapt's Deer Creek program. Rimrock Trails' adolescent program will also soon be participating in this data submission. Youth SUD residential providers are expected to be submitting data regularly by Oct. 1, 2024.
Hidden Brain podcast: Parents Keep Out! In this program psychologist Peter Gray discusses the balance between play and safety for children and how this has changed over the years.
"Beyond Behaviors: Using Brain Science and Compassion to Understand and Solve Children's Behavioral Challenges" by Mona Delahooke
In this book internationally known pediatric psychologist, Dr. Mona Delahooke describes behaviors as the tip of the iceberg, important signals that we should address by seeking to understand a child’s individual differences in the context of relational safety.
"The Dawn of Everything: A New History of Humanity" by David Graeber and David Wengrow
A dramatically new understanding of human history, challenging our most fundamental assumptions about social evolution―from the development of agriculture and cities to the origins of the state, democracy, and inequality―and revealing new possibilities for human emancipation.
"Tribal Histories of the Willamette Valley" by David G. Lewis
The timeline spans the first years of contact between settlers and tribes, the takeover of tribal lands and creation of reservations by the US Federal Government, and the assimilation efforts of boarding schools. Lewis shows the resiliency of Native peoples in the face of colonization. Undoing the erasure of these stories gives us a fuller picture of the colonization and changes experienced by the Native peoples of the Willamette Valley.
"Travel Guide to Oregon Indian Country"
Members of our unit are mindfully educating ourselves on the Oregon Tribes. As a part of this we are using Travel Oregon’s Travel Guide to Oregon Indian Country. This is helping us find Tribal museums, cultural centers and galleries. It is also a resource for annual Tribal events across the state.
Find events, opportunities, trainings and resources in last month’s posting on our newsletter page. Many of these trainings are also on our training opportunities web page. We will send updates mid-month — Look for the next one in your inbox on October 15.
For feedback and suggestions for our newsletter and information: kids.team@oha.oregon.gov.
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