Mental Health is Public Health TIHCA Conference November 19, 2008

1. Mental Health is Public Health TIHCA Conference November 19, 2008

2. We�re doing it, you can too!

11. Boatright - great bbq, baseball, rapid growth, rural and suburbanBoatright - great bbq, baseball, rapid growth, rural and suburban

12. Williamson County Has no in-patient psychiatric facility Has no detox facility Has no in-patient chemical dependency treatment center Inadequate public transportation Has one outpatient public mental health center Has a shortage of Medicaid/Medicare Providers

13. Texas 46th in per capita spending on mental health 38th in per capita Medicaid spending #1 in percentage of children under 17 with no insurance #3 in percentage of people living below the poverty level 47th in food stamp and welfare benefits 50th in access to prenatal care #1 in percentage of subprime home loans #4 in mortgage delinquency rate 50th in homeowner insurance and electric bill affordability

14. Prevalence of Mental Illness 27% of the population meets diagnostic criteria most = anxiety and depression about 30% of those diagnosed are considered severe 60% receive no treatment Treatment is minimally adequate Higher morbidity

15. National Statistics Half of all Americans will experience a mental disorder at some point in their lives. One in every five Americans experiences a mental disorder in any given year - 44 million people. Fifteen percent of the United States population use some form of mental health service. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General, 1999.

16. National Statistics One in five children has a diagnosable emotional disorder and one in ten has a serious disorder Up to one half of all visits to primary care physicians are due to conditions caused or exacerbated by mental health problems Mental illness is the second leading cause of disability Mental illnesses are more common than cancer, diabetes, or heart disease. National Institute of Mental Health, 1998.

17. Common Mental Illnesses Depression Anxiety Disorders and PTSD Bipolar Disorder ADHD Eating Disorders Schizophrenia Autism Spectrum Disorders

18. The Majority of People Who Need Mental Health Treatment Don�t Receive It Up to half of the people who are homeless have a severe mental illness that is untreated Over half of those with severe mental illness do not seek treatment. Stigma and its accompanying discrimination constitute the greatest barrier we face when addressing the issue of mental health Fewer than one third of adults and half of children with a diagnosable mental disorder receive treatment in any one year

19. Mental Health Disorders Are Treatable Mental disorders are not character flaws but are legitimate illnesses that respond to specific treatments, just as other health conditions respond to medical interventions Treatment success for serious mental illnesses ranges from 70 - 90 percent, whereas the treatment success rate for heart disease ranges from only 41 - 52 percent Antidepressant treatment improves overall health and decreases overall healthcare costs by more than 70%

20. MHMR Our local MHMR center, Bluebonnet Trails, has been funded by the state to provide treatment for 325 children in an 8 county area. This past year they provided psychiatric services to over 800 children in Williamson County alone. is only able to provide services to the �Priority Population� determined by the state is only able to see about 29% of those who qualify for services

21. State Hospital System Austin San Antonio Kerrville Vernon / NTSH Rusk Terrell Big Spring El Paso Waco Center for Youth

22. Where do mentally ill persons receive services in your county? YOUR JAIL, YOUR ER, 1 IN 3 TO 1 IN 6 BIGGEST 250K - HOSPITALS - 250K JAIL LARGEST FACILITIES IN US - COOK CO. LA JAILYOUR JAIL, YOUR ER, 1 IN 3 TO 1 IN 6 BIGGEST 250K - HOSPITALS - 250K JAIL LARGEST FACILITIES IN US - COOK CO. LA JAIL

23. Two responses Using indigent health care funds to pay for mental health treatment Mobile outreach teams LIGHT.....LIGHT.....

24. Mental Health Providers MD PhD LCSW, LMSW, LPC, LMFT LBSW � and more ALPHABET SOUPALPHABET SOUP

25. mid-level providers +/- Medicaid rates ($53) 6-12 sessions per authorization experience willing to do case management

26. with time� Reduction in emergency services Reduction in hospitalizations (psychiatric and medical) Return to employment Secure housing

27. Case Example Rita 27 visits to ER in 30 days �get this woman out of my ER!� depression and anxiety with panic attacks family issues

29. Rita month one $10,800 at the very least month two $350 psychiatric care $212 counseling $140 medication $702 total month three $212 counseling $100 psychiatric care $37 medication $349 total month four $0

31. What does the Mobile Outreach Team do? works very closely with the Williamson County Sheriff�s CIT team, MHMR and Emergency Room personnel primary mission is to resolve short term crises and take action to prevent escalation or decompensation links patients with community resources arranges mental health care for those with no or very little ability to pay Works with families and individuals who are experiencing a situational crisis and those who have chronic concerns

33. Mobile Outreach TeamTrend - Increase in Services to the Homeless

36. Results

37. Suicide Rates

38. Diversions - CIT and MOTJanuary - March 2008

39. EMS Mental Health Call Volume

40. Suicide Rates

41. State Bed Utilization Rates120% 60%

42. $ 1 invested=$ 3 saved

43. over 3 million dollars saved since 2006

44. Suggestions Form a mental health task force Partner with mid-level therapists in your community Reach out to your MHA and ask about your Mobile Outreach Team MOT, MCOT, CSI Consider augmenting services

45. discussion

46. Contact Information Annie Burwell 512-943-3545 aburwell@wilco.org Thank you!