behavioral health response to ebola - samhsa · profile, high-stress ebola event in dallas, texas,...
TRANSCRIPT
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Behavioral Health Response to Ebola
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Julie Liu, M.A.Public Health Advisor
SAMHSA/Center for Mental Health Services (CMHS)
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Purpose
• To share the firsthand experience of behavioral health providers during a high-profile, high-stress Ebola event in Dallas, Texas, so that lessons learned can be incorporated into similar responses across the country
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Learning Objectives
• Provide an overview of behavioral health involvement in the Ebola response in Dallas.
• Highlight unique dimensions of behavioral health collaboration.
• Increase awareness of behavioral health integration opportunities.
• Apply lessons learned to continue development of behavioral health responses to specific disasters.
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Brief Background on Presenters
Sandy Potter, LCSW Chief Executive OfficerValueOptions of TexasBeacon Health Options(Now DVP with BCBSNM)
Bonnie Athens, RNOwnerTransicare, Inc.
Daniel Byrd, LPCClinical Director ValueOptions of TexasBeacon Health Options
Scott Black, LMSW OwnerTransicare, Inc.
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Brief Background on Core Service Array and Collaborative Partners
• Core behavioral health response consisted of:– ValueOptions of Texas, Inc.– Transicare, Inc.
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Initial Engagement of Behavioral Health
• What prompted initial behavioral health involvement?
• What role did behavioral health play in frontline response and chain of command?
• What were the initial behavioral health response and priorities?
• How did Ebola context shape the response compared to previous disaster response?
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Initial Goals
Define target population
Define initial scope of services and implementation plan
Define risk management strategy
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Service Implementation and Scope of Behavioral Health Interventions
• Crisis services for acute distress associated with exposure (Psychological First Aid)
• Potential grief counseling needs• Involuntary control order• Unique dimensions of
involuntarily homeless individual• Preparations of agencies to
mobilize the services they provide, including detox, psychiatric stabilization, medication-assisted treatment (MAT), counseling, and case management
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Scope
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Risk Mitigation
• Creation of initial protocol – Collaboration with Centers for Disease Control and
Prevention (CDC) and local health agencies– Need for cross-agency collaboration versus silos– CDC need for behavioral health support when client
became volatile and vice versa • Specific needs and issues with frontline
responders• ValueOptions’ role in educating behavioral health
network
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Implementation
Behavioral health service coordination
and reportingCrisis services
Support for involuntarily quarantined
client
Provider network needs
Contextual factors
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How Behavioral Health Interfaced With Chain of Command
Symptom-reporting protocol established with
CDC
Behavioral health updates submitted at regular
intervals to ValueOptions
ValueOptions then interfaced with
Department of State Health Services and Incident Command
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Crisis Response Services
• Stabilize involuntary client• Develop specific plan and
address related issues:– Housing– Transportation – Meals– Risk of absconding
• Harmonize behavioral health goals with Ebola response
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Provider Network Resources
• Engage and develop provider network resources:– Role Ebola played in exacerbating access
challenges– Behavioral health role in facilitating coordination
across agencies
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Contextual Factors
Media coverage Fluctuation
assessments of community risk
Impact on service delivery
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Exit Planning
• Continuity of care• Housing needs • Care integration needs
including medical, behavioral health, and substance use disorder services
• Coordination of transfer once Control Order is lifted• Work to address and mitigate provider fears regarding
the provision of ongoing services
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Lessons Learned
• Recognizing that an infectious disease disaster can result in the breakdown of the usual disaster response framework
• Ensuring education needs of provider network are met• Ensuring harmonization of provider network risk mitigation
strategy• Ensuring harmonization of legal consensus around sharing of
sensitive health information and involuntary quarantine implementation
• Behavioral health integration on front end • Contingency plans for:
– Atypical needs of quarantined individuals– Loss of provider network capacity– Siloing of frontline responders
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Provider Self-Care
• Down time (it’s 24/7—take a break)– Anticipate and plan for backup
• Daily debrief • Support systems—personal and professional• Education—annual and ongoing through event• Resource:
– http://www.samhsa.gov/sites/default/files/podcasts-selfcare-dbhresponders-presentation.pdf
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Best Practice Recommendations
Training and competencies of behavioral health responder to the unique parameters of an infectious disease disaster
Immediate crosswalk identification with behavioral health, substance use disorder, and medical history with local and state systems
Triage
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About SAMHSA DTAC
SAMHSA DTAC supports SAMHSA’s efforts to prepare states, territories, and tribes to deliver an effective behavioral health response to disasters.
SAMHSA DTAC, toll-free: 1-800-308-3515 http://www.samhsa.gov/dtacEmail: [email protected]
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DBHIS Installments
• Ebola• Substance Use
Disorders and Disasters• Disaster Specific• Disaster Responders• Resilience and
Stress Management• Visit:
http://www.samhsa.gov/dtac/dbhis-collections
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Resources
• SAMHSA Disaster Behavioral Health App• The Disaster Distress Helpline: Toll-free
1-800-985-5990 or text “TalkWithUs” to 66746
• Information on Ebola– World Health Organization:
http://www.who.int/csr/resources/publications/ ebola/en/
– Centers for Disease Control and Prevention: http://www.cdc.gov/vhf/ebola
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Resources
• Visit the SAMHSA Store (store.samhsa.gov) for the following SAMHSA DTAC tip sheets on coping with infectious disease outbreaks:– Coping With Stress During Infectious Disease Outbreaks– Taking Care of Your Behavioral Health During an
Infectious Disease Outbreak: Tips for Social Distancing, Quarantine, and Isolation
– Talking With Children: Tips for Caregivers, Parents, and Teachers During Infectious Disease Outbreaks
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Questions and Contact Information
For questions about the provider experience, contact:• Scott Black, LMSW: [email protected]• Bonnie Athens, RN: [email protected]
For questions about the behavioral health response, contact:• Sandy Potter, LCSW: [email protected]• Daniel Byrd, LPC: [email protected]• We value your feedback:
www.samhsa.gov/dtac/webinars-podcasts/behavioral-health-response-ebola-feedback
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Thank you
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