SOAR: Mental Health Trauma Intervention Program

1. SOAR: Mental Health Trauma Intervention Program Robert Niezgoda, MPH Taney County Health Department September 2014

2. Objectives • Provide an overview of the SOAR program • Provide an overview of the collaboration between the partner agencies

3. Background • Purpose of program • to reduce the burden that psychological trauma has on communities in Taney and Stone Counties. • Psychological Trauma • Traumatic, anxiety and stress related (TAS) disorders.

4. Collaborative Partners • Ozarks Public Health Institute • Stone County Health Department • Taney County Health Department • OWN it. Funded though a grant from The Skaggs Foundation

5. Background • Traumatic, anxiety and stress (TAS) disorders are caused by many different types of traumatic events • Post Traumatic Stress Disorder (PTSD) • War veterans and survivors of physical and sexual assault • Trauma from: • psychological, physical or sexual abuse; • accidents and disasters; • loss of a loved one; • child abuse • many other serious events. • Can arise from stressful situations such as: • impending homelessness, loss of work, or indirectly after a friend or family member has been harmed or has experienced danger.

6. Background • Symptoms may differ, but in general: • Cause problems to a person’s daily routine • can be debilitating and incapacitating. • Diagnosis may be provided by a PCP, psychiatrist, or psychologist. • Treatment may be harder to access.

7. Background • People with Trauma, Anxiety and Stress Disorders are: • 3 to 5 times more likely to go to the doctor • 6 times more likely to be hospitalized for psychiatric disorders than those not suffering from TAS disorders. • TASs are often accompanied by: • depression, • substance abuse, or • other mental disorders. • Left untreated, severe mental illness can result and a higher risk for: • Homicide, suicide, accidents, chronic health conditions, and substance abuse disorders.

8. Taney and Stone Counties • Significant need identified in Taney and Stone Counties • High rates of… • Serious psychological distress • Child Abuse and neglect • “Children Subject of Maltreatment” • Suicidal ideation among adolescences • Suicide attempts and injuries • High number of veterans, many with PTSD • Lack of mental health resources, inpatient and outpatient

9. Impact in Taney and Stone Counties • Congressional Budget Office reported that treatment costs for PTSD for veterans: • $8,300 a year per person. • PTSD is just one type of TAS disorder, and the report only focused on one population. • Example of costs: • $8,300 per treatment X 25 people in a year=$207,500. • For two years= $415.000. • With traditional psychotherapy, treatment could go on for years with varying degrees of success. • The SOAR program is one-third the cost, and utilizes methods that are completed in 18-24 sessions rather than years of treatment.

10. What is the SOAR Program? • Referrals of adults who have school-aged children living at home whose TAS disorders interfere with daily function • By the conclusion of the treatment: • a significant decrease in daily distress felt from the impact of trauma • improved functioning with regard to important spheres of life (i.e., work, relationships, school, etc.), • initial increase in health care utilization followed by a decline on overall health care utilization, • improved relationships with others (i.e., at home, work, school, in social interactions).

11. Program Activities • Mental Health Awareness and Referral training provided to staff of referral sources including: • School counselors and nurses • Healthcare providers • Criminal justice system • Division of Family Services • Department of Veterans Health Affairs • University of Missouri Extension • Other community partners. • Services provided by two experienced Psychologists (initially) • Grant funds will allow three additional practitioners to be trained • Two will be Taney and Stone County residents.

12. Program Activities • ~ 50 patients will be enrolled in the Eye Movement Desensitization Reprocessing (EMDR) over the 2-year grant period. • Participants surveyed-mental health trauma and healthcare utilization • Adults assessed through self-reports of history and functionality • Information on children gathered through the Connors Child Behavior Checklist completed by parents, teachers, and significant others

13. Eye Movement Desensitization Reprocessing (EMDR) • A highly specialized, time efficient and effective intervention that helps people move out of being chronically distressed • Particularly effective with high acuity, multi-problem patients with significant mental health issues, • Improvements in shorter periods of time compared to traditional mental health interventions. • Recommended by a variety of organizations world-wide as an effective, evidence based treatment for mental health trauma including: • American Psychiatric Association, • Department of Veterans Affairs • Department of Defense; • SAMHSA

14. Results YTD “Across measures, participants appear to be significantly distressed (as reflected in SCL-90, PSI, and ORS scores), both individually and as parents.” “Some clients were “off the charts” on the SCL-90, indicating high levels of symptoms and distress.”

15. Pretest/Posttest on SCL-90 (for first completing client; 3 sessions)

16. Questions?