Substance Use and rural communities What could we learn? May 18, 2017 Lisa Murphy Director of Operations Central/North Island Mental Health & Substance Use

Some Data: 35-65 years is highest age co-hort 35 % of ED visits are for Mental Health & Substance Use 30 % of GP visits are for Mental Health & Substance Use People in rural/remote areas seek service at much lower rates 35-65 years is highest age co-hort

Data cont’d Depressive disorder (50%) Anxiety disorder is the second largest category (30%) Trauma is the third largest MHSU category (At least 17 %)

Intervention Approaches Across Specific Population Groups

Substance Dependence Substance Dependence: A pattern of substance use leading to impairment or distress, as manifested by: Physical Dependence (e.g. increasing tolerance of drug; withdrawal symptoms) Psychological addiction (compulsive use and loss of control over substance use

Tiered Framework for MHSU Planning

Privacy What are the needs of people in small communities? What would clients and families identify as concerns/risks?

Stigma “Unconscious bias” (Mental shortcuts and leaps that lead to decisions and next steps) What are common themes for substance use? Common themes for rural and remote?

Opiate Crisis Response in Rural Communities Where, what, when and where? Rate can match urban communities but…

Other issues: Recruitment, retention Telehealth Risk of seeing rural a co-hort Diversity, inclusion and changing communities