CrisisTalk

12/11/2024

Along with all the positive changes since the implementation of 988, there’s been an infusion of funding into the long undersupported mental health field, a tapestry of Medicaid reimbursement, 988 service fees and grants. “But the unfortunate truth,” said Paul Galdys, deputy CEO at Recovery Innovations, “is that commercial payers still aren’t on board.” “For 988 to be here to stay, crisis services must become parts of the [billable] healthcare delivery system.”

That’s why he and his co-authors have developed the Parity Action Plan for Emergency Behavioral Health Crisis Care, a seven-step approach to securing commercial payer reimbursement for emergency behavioral health crisis services. The Sozosei Foundation funded the plan and the ongoing corresponding technical assistance as part of its philanthropic efforts to decriminalize mental health.

A new plan to enforce federal parity law and secure funding from commercial insurers for mental health crisis services.

29/10/2024

Blood pressure, pulse, respiration rate and temperature are the vital signs generally measured when assessing someone’s health. Psychologist Kelly Posner, founder and director of the Columbia Lighthouse Project, would add one more to the list – testing for su***de risk using the Columbia Protocol, also known as the Columbia-Su***de Severity Rating Scale. “The data has shown us this is a vital sign we must take,” she said, “otherwise, we won’t find the people suffering in silence.” She notes while the screening is becoming universal, there are discontinuities in its use, including in 988 crisis systems.

Psychologist Kelly Posner says su***de risk needs to be on the list of vital signs taken to determine if someone is unwell.

25/04/2024

Pharmacists are not new to mental healthcare but Ray Love, psychiatric pharmacist and past president of the College of Psychiatric and Neurologic Pharmacists, says they’re underutilized. “Within pharmacy, we can serve a whole array of clinical roles in patient care settings,” he said. As behavioral healthcare demands increase and the workforce continues to plummet, Love believes psychiatric pharmacists can help address these shortages. https://talk.crisisnow.com/how-the-role-of-pharmacists-is-expanding-can-they-help-ease-mental-health-workforce-shortages/

16/04/2024

Writing has long been an outlet for Rachel Havekost, starting with her first diary at nine years old, where she’d process the happenings of her life. When writing her memoir “Where the River Flows,” she returned to her diaries and found her younger self struggling in ways she hadn’t remembered. “I’m 13, wondering if my friends would care if I wasn’t here anymore — adolescence is so hard.”

Influencers and businesses using social media, notes Havekost, need to be mindful that among their followers are people “in a really vulnerable state” consuming content to feel better. Some use social media for storytelling and imparting data and resources, while others are focused primarily on monetization or a mix of both. “On social media, there’s a huge pain-for-profit model,” she said, adding that businesses and many influencers use analytics to find the right hooks to funnel users into buying what they’re selling. “Sometimes, these things help; sometimes they don’t. It’s a tricky space for consumers to navigate.”

What continues attracting Havekost to social media is connectivity and destigmatization, both of which can help people navigating mental health challenges feel less alone. For years, she felt isolated. At 15, she was diagnosed with anorexia. Three years later, she started having suicidal thoughts. As a sophomore in college, she attempted su***de. “All along the way, I thought what I was experiencing was uncommon,” she said.
https://talk.crisisnow.com/rachel-havekost-on-social-media-and-destigmatizing-mental-health/

09/04/2024

When the The Trevor Project launched its annual national survey, Dr. Myeshia Price, who was the nonprofit’s director of Research Science, and her colleagues wanted a more holistic picture of LGBTQ young people and their mental health, especially predictors and risk factors related to su***de. “We wanted our survey to address what we know theoretically affects their wellbeing.” Read the full article here: https://talk.crisisnow.com/mental-health-risks-and-protective-factors-for-lgbtq-youth/ This article was originally published on November 15, 2022.

09/04/2024

The complaint by a bipartisan coalition of attorneys general from dozens of states — including Arizona, California, Louisiana and New York — alleges that Meta’s recommendation algorithm is harmful to young users’ mental health, keeping them engaged and drawing “unwitting users into rabbit holes of algorithmically curated material.” While social comparison and algorithms designed to keep users engaged can affect both adult and young users, the attorneys general highlight that teens are more vulnerable. Read the full article here: https://talk.crisisnow.com/43-states-suing-meta-claiming-algorithms-fuel-youth-mental-health-crisis/

01/04/2024

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27/03/2024

In this week's article, our editor-in-chief, Stephanie Hepburn, reported on the lawsuit against Meta by dozens of state attorneys general, accusing the company of deliberately designing Instagram and Facebook to be addictive to young users. She interviewed Arturo Béjar — a former Facebook engineering director and, later, a consultant for Instagram — on internal research, algorithms and what’s needed to make the platforms safe for teens.

Whistleblowers and 43 state attorneys general say Meta algorithms are harming youth mental health

03/11/2023

Youth mental health advocate Trace Terrell struggled with suicidal ideation, depression and disordered eating in middle and early high school. He lived in La Pine, an isolated community in Central Oregon. “From a young age, I felt alone — no one was having conversations about mental health.” His desire to help teens who felt like him motivated him to get involved with mental health advocacy as a high school freshman, working as a volunteer at YouthLine, a peer-to-peer support helpline at Lines For Life in Oregon.

Talking to people and helping them with their challenges taught Terrell how to navigate his own. It also showed him that he wasn’t alone. He says the exchange between a person reaching out to the line and a peer counselor — “two people expressing truth and vulnerability” — is life-changing. “There’s a vulnerability in storytelling and sharing the challenges you’re facing. Having your story resonate with a peer and reflected back to you is incredibly powerful.”

Working as a volunteer at YouthLine, a peer-to-peer support helpline at Lines for Life in Oregon, helped teen to navigate his own challenges.

18/10/2023

Chauna Brocht on regionalizing Central Maryland's crisis system. Learn how it's transforming the response to crises, improving access to care, and connecting mental health services.

Central Maryland’s regionalization of behavioral health crisis services.

06/09/2023

Are you on the 988 Jam? Su***de prevention advocate
Kevin Berthia shares how as mental health stigma lessens, more people are reaching out, but the field isn’t yet where it needs to be to meet demand. https://talk.crisisnow.com/learningcommunity/

16/08/2023

Dr. Larry Davidson was clinical director at the Connecticut Mental Health Center, a state-funded mental health center run by Yale Department of Psychiatry, when he helped broaden the concept of psychiatric rehabilitation through the Psych Rehab program. Davidson believes communities can learn from the peer movement to help support people reintegrate to post-pandemic living. “If they were estranged from families and friends before Covid, that’s going to make it all the harder for them to have any kind of support now,” he says. “They were already at a disadvantage and are disparately affected.”

Dr. Larry Davidson helped broaden the concept of psychiatric rehabilitation. He believes communities can learn from the peer movement to help support people as they transition to post-pandemic living.

16/08/2023

While most people in mental health distress don’t require inpatient hospitalization, some do. Dr. Carol Olson, chair of the Department of Psychiatry at Valleywise Health System in Phoenix, shares that there’s a gap in Arizona and nationwide when a person’s mental health emergency is too acute to be stabilized at a short-term receiving and stabilization program and they also have medical comorbidities. “There are a lot of barriers to getting psychiatric hospitals to take these patients,” she says, “especially if they’re involuntary, have difficult-to-manage behaviors or aren’t incredibly straightforward.”

Psychiatrist says psychiatric hospitals cherry-pick patients, taking those who are less expensive and less complicated for them to treat.

04/08/2023

SAMHSA recently released National Guidelines for Child and Youth Behavioral Health Crisis Care, providing best practices and guidance for designing and implementing services that meet the needs of youth and their families. “Systems must be tailored to children — developmentally and socially — and engage families,” says Dr. Billina Shaw senior medical advisor within the Center for Mental Health Services at SAMHSA. “When youth have a behavioral health crisis, the response they receive can potentially change the trajectory of their entire life.”

Dr. Billina Shaw on best practices and guidance for designing and implementing services that meet the needs of youth and their families.

25/07/2023

Seth Kahan is the grand challenge adviser to the Huntsman Mental Health Institute at the University of Utah’s nationwide mental health and substance use disorder anti-stigma grand challenge. Stigma, says the Visionary Leadership founder and CEO, is what splintered his family. When he was 10 years old, his mother developed schizophrenia. Despite his father’s efforts, finding her adequate care in 1969 was next to impossible. “My home life was completely disrupted — our family fell apart,” he says.

Organizations collaborating in the anti-stigma challenge have a high level of commitment and staff the challenge’s committees — justice, equity, diversity and inclusion, partnership, communication, policy, financial strategies and metrics. Challenging stigma, says Kahan, requires a comprehensive, collaborative effort that aims to create a safe societal space for people to openly discuss mental health challenges without delay. “If you break your leg, you don’t wait six months to get help.”

Seth Kahan shares his own family’s experience with mental health stigma and how the mental health and substance use disorder anti-stigma grand challenge is personal.

18/07/2023

Tom Betlach is the former director of the Arizona Health Care Cost Containment System, the agency that administers the state’s Medicaid program. When beginning his tenure at the agency he was struck by the sheer complexity of the healthcare delivery system. His mentor at the agency, Kate Aurelius, responded, “Well, if you think that’s poor system design, you should look at how behavioral health services are delivered to people with serious mental illness.” Betlach shares Aurelius’ impact and how having someone who spoke both Medicaid and mental health was a game changer for Arizona, making it a model for how Medicaid and offices of behavioral health can work together to bring about system change.

Collaboration between Medicaid and offices of behavioral health can bring about system change

13/07/2023

Dr. Tia Dole is the Chief 988 Lifeline Officer at Vibrant Emotional Health, the nonprofit that runs the SAMHSA-funded 988 Su***de & Crisis Lifeline. She joined in January amid critical 988 subnetwork roll-outs for at-risk groups such as LGBTQ+ youth and Spanish speakers. She shares the successes and growing pains of building subnetworks and how the groundbreaking unified platform for the 988 Lifeline contact centers, which launched in September, can improve data collection and standardization.

The Lifeline is also readying to embark on a 988 media campaign and testing using geographic position information. As the person’s phone pings the nearest tower, they’re routed to their local call center. “We won’t be able to track people like 911 does,” she says. “The sole purpose of geo-routing is to connect people to their local call center.”

Dr. Tia Dole, Chief 988 Lifeline Officer at Vibrant Emotional Health, shares the latest 988 news — from subnetwork rollouts to geo-routing.

04/07/2023

When he moved to the United States, Dr. Sosunmolu Shoyinka quickly found mental health stigma prevalent. He highlights one of the most troublesome forms of mental health stigma in the U.S. is the persistent disparity in health care funding. “Historically, mental health services have never been adequately funded or they’ve been for brief periods where there’s been a big push like we’re seeing now with 988,” says Dr. Shoyinka.

What makes him feel hopeful is the certified community behavioral health clinic movement. When the clinics mature, Dr. Shoyinka believes they’ll be able to deliver comprehensive and culturally-competent care to all populations. What also makes the model distinct from many other Medicaid programs is it isn’t funded through fee-for-service billing but instead a prospective funding mechanism. “The mechanism shifts away from having to justify the care you provide to Medicaid, recognizing that delivering good quality care includes a range of services that don’t fall under billable services,” he says. That includes care coordination, phone calls, connecting people with social services and helping address social determinants of health.

Dr. Sosunmolu Shoyinka shares that one of the most troublesome forms of mental health stigma in the U.S. is the persistent disparity in health care funding. He says a prospective funding model can help counter it.