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Providing Sustainable Tobacco Cessation Services to the Mental Health Community

Providing Sustainable Tobacco Cessation Services to the Mental Health Community. Beth Lillard, BA Evelyn Castillo, MPH A Program of Bay Area Community Resources. In collaboration with Marin County Tobacco Education Program. Funded by MSA. Charyn Sutton 4.6.1947 – 12.30.2004.

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Providing Sustainable Tobacco Cessation Services to the Mental Health Community

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  1. Providing Sustainable Tobacco Cessation Services to the Mental Health Community Beth Lillard, BA Evelyn Castillo, MPH A Program of Bay Area Community Resources. In collaboration with Marin County Tobacco Education Program. Funded by MSA.

  2. Charyn Sutton 4.6.1947 – 12.30.2004

  3. Once upon a time….. • ‘Providers’ • ‘Clients’ and ‘Patients’ • a few ‘Questioners’

  4. Questioners from the field: • Lowell Dale, M.D., Mayo Clinic • Douglas Ziedonis,M.D., and Bernice Order-Connors, LCSW, University of Medicine and Dentistry of New Jersey • Phillip Gardiner, DrPH, TRDRP • SANE Australia • David Staba, Editor, Schizophrenia Digest

  5. Some of the Questioners in Marin County: • Lou Anne Sweaney, FNP, CMH • Richard Glass, MD, CMH • Karen Balsamico, Mental Health Consumer • Evelyn Castillo, MPH, BACR • Amy Rogers, OTR/L, Linda Reed Day Services • Alan Jamison, Program Director, Canyon Manor

  6. Mental Health & Tobacco Cessation Working Group • BACR Tobacco Program Staff • Directors of Community Mental Health Services • Nurses…Physicians…Psychiatrists • Mental Health Agencies • Consumer Advocates • Peer Counselors • Case Managers

  7. The Challenge: Ask Linda Reed Day Services Survey* • N=47 • 72% smoke currently (average: 17 cpd) • 88% of smokers have attempted to quit • 88% perceive negative health effects • 65% have a desire to quit within the year * Unpublished survey conducted by Amy Rogers, OTR/L, Linda Reed Day Services, 2004.

  8. Linda Reed Day Services • BACR staff/client trainings • ‘Quitters’ Club’ • ‘Smoking Area’ Committee • 2 peer-led quit groups added • Quit group institutionalized as part of recovery and socialization programs

  9. Canyon Manor • BACR staff/patient trainings • Positive patient feedback • ‘No Smoking’ area created – The Gazebo • Nicotine patch program developed • Tobacco cessation program expands to staff

  10. Lessons Learned: Mental health clients DO want to quit smoking! Harm reduction can be a goal Multi-disciplinary support for individuals * Keep attending physician/psychiatrist updated on cessation progress and NRT use Working group facilitates resource-sharing * It’s O.K. to say, “I don’t know, but I’ll find out.”

  11. Why Integrate Tobacco Cessation and Mental Health Services? • Smokers suffering from mental illness account for nearly half (44.3%) of all cigarettes consumed in America. Adler, Olincy, et al. Schizophrenia Bulletin 24:196.1998 • The death rate among young adults with mental illness is more than triple that of their peers. Department of Mental Health, Massachusetts, 2001.

  12. Why……? • For mentally ill clients 25-44 years old, heart disease was 7X higher than peers and more than 7x the suicide rate.Department of Mental Health, Massachusetts, 2001. • Nicotine often influences the impact of psychotropic medications; smokers may need higher doses, which can produce more negative sideeffects. Lasser, K., et al. JAMA, 284:2606-2610. November 2000

  13. Why not…? • Comparative smoking cessation rates • Smokers with any history of mental illness 37.1% • Smokers with past-month mental illness 30.5% • Smokers with no history of mental illness 42.5% Persons with mental illness are about twice as likely to smoke as other people but have substantial quit rates. Lasser, K., et al. JAMA 284:2606-2610, November 2000

  14. Contact Information Beth Lillard Marin Tobacco Cessation Project Director Bay Area Community Resources (415) 444-5580 ext 334 blillard@bacr.org

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