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  • Community Mental Health and Addiction Program is breaking barriers caused by stigma

    Feb 08, 2019 | Read More News
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    File: Community Mental Health and Addiction Program teamFear is the number one reason so many individuals conceal their struggles and delay seeking help when they need it most. It’s a natural tendency to avoid the things that we perceive to be a threat. With this in mind it should come of no surprise that after decades of misguided perceptions and negative media coverage, mental health is now widely viewed as a threat rather than a part of our overall health and well-being. As a result, countless individuals remain in hiding until they are forced out by desperate circumstances, typically in the form of repeated arrests, hospitalizations, overdoses, victimization, and suicide attempts.

    Putting things in perspective, half of all mental health issues begin by age 14 and three-quarters by age 24. Once into adulthood, more than 46 percent of U.S. adults will experience at least one form of mental illness at some point in their lives — the equivalent to 43.8 million people — but only 41 percent of those individuals receive professional health care. A leading cause of this widespread neglect is fear and misunderstanding. It's less to do with funding and resources and more to do with the influence of stigma which continues to cast a negative light on mental health.

    In response to these growing statistics, the Pima County Health Department has launched a new Community Mental Health and Addiction Program intended to bring emphasis and greater awareness to some of the most critical issues surrounding mental health. At the forefront this includes suicide prevention, the opioid epidemic, incarceration, and homelessness.

    Headed by Mark Person, the four-member team operates out of the Abrams Public Health Center as part of the Health Department’s Community Outreach, Prevention and Education Division. Team members Andrea Altamirano, Tina Limon, Raúl Muñoz, and Person each bring to bear expertise that will help integrate important mental health resources with existing programs within the Health Department. The team’s primary focus will be to connect people with available resources, respond to communitywide trends, and improve the overall health and education of the community.

    File: Community Mental Health and Addiction Program team - Raul MuñozOutreach and education are critical parts of the program’s strategy to achieve its goals given that public beliefs and misperceptions often create barriers to healthy living. To achieve their mission, the team plans to increase its training and outreach to address a broader range of community needs, paying particular attention to places where mental health needs are common but access to training and resources is scarce. 

    "We plan to work closely with our community partners, service providers, and payer sources, to pool our resources and expand the reach of public service," Person said. "Pima County is way too big to attack it all at once, so we have to rely on strong community partnerships with our network of behavioral health providers, school districts, hospitals, and first responders."

    By taking a multidisciplinary, holistic approach to combating ailments that have such a pervasive impact on our community, the team hopes to have its greatest effect among members of high-risk populations who struggle with chronic disease, mental illness, trauma, addiction, poverty, and homelessness.

    Muñoz, a former County corrections officer, was brought on the team to continue his work on subjects surrounding substance abuse and addiction, primarily prescription drugs and opioids. Muñoz works with counterparts in eight other Arizona counties to coordinate statewide efforts to counteract the overdose epidemic. Muñoz closely monitors data on fatal and non-fatal overdoses, availability of substance use programs, and the distribution of Naloxone - a drug capable of reversing an opioid overdose. He’s seen signs of improvement locally; or at least that the problem isn’t getting appreciably worse.

    File: Community Mental Health and Addiction Program team - Andrea Altamirano"We’re getting better but the national epidemic surrounding opioids isn’t decreasing. It’s increasing, unfortunately," Muñoz said. "When we start placing legislative restrictions on the amount of prescription medications patients can receive, that often directs people to illicit sources to deal with their short- or long-term pain. There’s a good portion of our population who are using a lot of other substances to manage their pain and we’re seeing an increase in overdoses related to fentanyl."

    Muñoz has seen a gradual increase in opioid overdoses since he began tracking the data in 2015 but he predicts the integrated approach taken by the Community Mental Health and Addiction Program will start to pay dividends. "It’s become more of an intervention effort where before we just looked at prevention," he said.

    Muñoz also credits the Pima County Sheriff’s Department and other local law enforcement agencies who support these efforts and continue to partner with healthcare providers throughout Pima County helping advance the broader effort to combat opioid addiction. To ensure law enforcement, first responders, and health providers have access to proper tools, Muñoz will oversee storage and distribution of emergency kits containing Naloxone, which will be given to first responders and other health providers at no cost. 

    "We’re talking to everybody. We’re talking to youth in middle schools and high schools. We’re speaking with parents. We’re out there talking to hospital executives to make sure they’re familiar with basic processes like prescribing guidelines, the state’s prescription monitoring program."

    Andrea Altamirano came to the team to concentrate on promoting Mental Health First Aid, a program developed in Australia that trains people to identify, understand and respond to signs of mental illnesses and substance use disorders. The eight-hour course covers a variety of topics including how to spot risk factors and warning signals; how to assess individuals in crisis, select interventions and provide initial help; and how to connect people to professional, peer and social support resources. It also provides self-help advice.

    "It’s really about eliminating the stigma that often comes with mental illness," Altamirano said. "A lot of people are afraid to consider the possibility that they have, or a family member or loved one has, mental illness because of the negative connotations that it brings. People need to know how common it is. It’s as common as cancer: it’s a disease an individual has. It’s not a character flaw."

    File: Community Mental Health and Addiction Program team - Tina LimonCurrently, Altamirano is working on preparing the Health Department’s recertification to train people in Mental Health First Aid for adults. After that, she will begin the process of applying for certification in Youth Mental Health First Aid which is designed to educate teachers, school personnel and community groups who serve young people.

    Team members take their work very personally. Tina Limon, who administers the Health Department’s suicide prevention and trauma-informed care efforts, brings a particularly well-informed perspective to her mission. She survived a suicide attempt when she was younger and that experience made her a natural fit for her role. She calls it "a passion."

    "When I was young, if I had heard somebody say ‘I did this and I know what you’re going through and I understand’, I don’t think I would ever have attempted suicide," Limon said. "All the suicide-prevention talks I heard when I was in high school never addressed anything like that. They never said ‘I hear you; I feel you’ in that situation. Because I bring that story to my work I think it makes me more effective than someone else might be."

    Limon also works on the team’s trauma-informed care initiatives which seek to help increase understanding of the effects that deeply disturbing experiences can have on an individual’s physical health and well-being.

    "Our work has been getting the word out to the people who have frequent contact with this population. Knowing that someone comes from trauma can change the approach you take to giving them care," Limon said. "We don’t tend to pay very much attention to mental health in this country, hence the need for our program. Before now, we’ve never been in a place where we, as a health department, could approach the community and give them the information they need to address these issues."

    "That’s the whole thing about being a public health worker is that we’re here to change lives. So, given that opportunity to do that on this team, I can’t ask for more," she said.