1. Angela Lariviere, Youth and Family Advocate
Healthy Kids Learning Communities: Facilitated Discussions on the Opioid Crisis in Ohio
Angela Lariviere, Youth and Family Advocate
Case Western Reserve University Center for Innovative Practices

2. The Opioid Crisis in Ohio
The opiate crisis in Ohio is affecting our children and families at alarming rates.
In order to understand the impact of the crisis, family and youth discussion groups were held to identify concerns and make recommendations.

3. Discussion Groups
Northwest, Southwest, Southeast, Central, Upper Northeast and Lower Northeast Regions
They included: Youth, Families and Providers

4. Facilitated discussion and activities were used to:
explore the impact of the epidemic and give voice to ideas and concerns. explore strategies and models that support youth, parents and/or kinship caretakers in recovery.

5. AGENDA OPENING INTRODUCTION ACTIVITY: COMMON CIRCLES
GOALS AND EXPECTIONS
DEFINE THE PROBLEM
WRITTEN FEEDBACK
IDENTIFY COMMUNITY
EXPLORING RESOURCES
MAKE RECOMMENDATIONS
EVALUATIONS
ADJOURN
AGENDA

6. What We Know
Defining the Problem

7. Facts: Children in the System
50% of children taken into custody in 2015 had a parent actively using drugs with 28% actively using opiates or heroine
70% of children under the age of 1 in custody had a parent actively using opiates or heroine
Children in relative placement has increased 62%
Foster Care placements have increased 11%.
Shortage of front line staff
In 2016, 1 in 4 cases workers left their positions
1 in 7 case workers left their position all together
Ohio ranks 50th in the nation for state funding for Child Welfare
Facts: Children in the System
*Source: Public Children Services Association of Ohio

8. We rank in the top 6 for most deaths.
The FACTS
Ohio is the Second worst state in the nation for drug overdoses, with Dayton ranked 1rst with the highest per capita overdoses in the county.
We rank in the top 6 for most deaths.
Children in relative placement has increased 62%
Foster Care placements have increased 11%. While Opiate use has increased the State allotment of Child Welfare funding has decreased by 21%.

9. What we see What we don’t see Families and children Doubled up with
Grandparents and other
Relatives due to parents
Opiate addiction but not
Officially involved with
Child welfare.

10. Written Responses What is the biggest issue facing your community?
What is one barrier to accessing treatment or services in your area?
What is the most important thing you need when helping a friend or family member who is addicted?
Written Responses

11. What is the biggest issue facing your community?
Drugs - #1
Stigma
Violence - #2
Parent participation
Lack of police officers
Unemployment
Nothing to do
Broken homes
No safe activities for youth
Understanding culture and community
People thinking it is OK to get high
Lack of funding for services
Peer pressure
Nothing better to do but get high
Lack of awareness about Trauma and Addiction
Poverty
Not enough free things to do
Lack of mental health treatment for children in foster care
Overdoses
Addiction
Gangs

12. What is one barrier to accessing treatment or services in your area?
Not knowing how to get signed up
Age
Lack of school based services
Cost
Lack of understanding about what is available
Culture
No support
Lack of options in low income areas
No medical insurance
Lack of services and inpatient for youth
Have to get in trouble before you can get services
Lack of services for the entire family
Parents not giving permission for youth to participate in treatment or counseling
No local options
Not having anywhere to go after
Transportation to follow up
Keeping motivated

13. What is the most important thing you need when helping a friend or family member who is addicted?  
Access to resources - #1
Empathy
Some type of Peer support - #2
Whole family resources
Have a support system
Information about how to get access to treatment
People who know and understand
Workers with personal experience
Resources
Support groups
Knowing how to connect to services
Someone you can trust
Medical/professional guidance
Family
Affordable sober living options
Faith
Love
Support

14. Roles, Barriers, Supports and Recommendations
Defining Community
Roles, Barriers, Supports and Recommendations

15. Community Members Identified
Self
Peers
Family
Police
Emergency Responders: Including EMT and ER
Schools
Government
Treatment Programs: In and out patient
Courts
Child Welfare
Community Agencies: including churches, community centers, afterschool programs

16. Schools Role Teach, provide support services, prepare for life Support
Safe space, trusting relationship, provides support services
Peer to Peer, provides opportunity for mentor, Basic needs: food
Barriers
Mandatory reporters, not enough Behavioral Health support
Not enough funding, no transportation to afterschool activities
Recommendations
Better defined roles and expectations for schools,
More funding for Behavioral Health support for schools
Trauma informed training for teachers and administration

17. Police
Role
Safety, Patrol neighborhood, Make everyone safe, arrest drug dealers
Support
Resource officers in school, Crime intervention, Safety from drugs on street
Barriers
Not enough training, Not enough funding, Not enough police, Corruption
Not enough focus on crime prevention, not getting to know the community
Recommendations
More training for police in Crisis Intervention, More funding for additional officers
Create programs to build community relationships with police
Better background checks to know about drug or criminal history

18. Courts
Role
Provide justice, Punish crime, Provide intervention, Mandate treatment
Support
Drug courts, Family interventions, Mandating treatment
Barriers
Issues have to escalate before they are able to intervene, Not enough drug/mental health courts, Court the only way to get services
Recommendations
Spend more funds on prevention and early intervention, look for trauma informed punishment, include entire family when can
Create programs to build community relationships and understanding of the courts role, attach punishment and reward to treatment

19. Child Welfare
Role
Make homes safer, Find placement for kids in crisis, provide case management
Support
Prove support for families, Make referral's to treatment, Mandate families to get help
Get services for kids, Provide follow-up and check ins.
Barriers
Overloaded, no response or call backs, Not enough placements (especially for older youth)
Relative placement with other drug addicted family members, No support, inexperienced workers
Recommendations
More funding, Provide support for older youth when placements are not available,
Provide better prevention and in home supports before taking custody, Build better partnerships with families and youth
Work on building trust with youth and communities, Build a better reputation,
Offer youth self referral options

20. Other Self Role: Take care of yourself, ask for help
Barrier: depression, self hate, not recognizing when there is a problem
Support: self motivation, only you know you
Recommendation: More outreach and information on resources, peer support
Family
Role: Primary caregivers, provide support, participate in treatment
Barrier: Culture of addiction, poverty, generational issues, no time, no support
Support: love, trust, loyalty, place to live, resources
Recommendation: Whole family treatment plan, provide resources, peer support
Peers
Role: be there for you, provide support, listen, give advice
Barrier: Lack of experience, bad influences, fake friends, pressure
Support: available anytime, open and honest, trust, place to stay
Recommendation: include in treatment plan, provide peer training

21. Other First Responders
Role: Come in an emergency, prevent death by OD, admin Narcan
Barrier: Response time in rural areas
Support: trained in responding to OD
Recommendation: More funding, more training with community partners, families
Community
Role: Provide support and services
Barrier: No funding, not EB, grassroots, transportation
Support: Trust, knows community, faith based
Recommendation: Incorporate into funding and treatment for families and youth
Treatment Centers
Role: inpatient or outpatient services
Barrier: Lack of beds, far away, not enough funding, no family services
Support: services, counseling, outpatient, when avaiable. Works if long enough
Recommendation: better follow-up, inclusion of whole family, community referrals

22. Making Statewide Recommendations
10 Common Priorities

23. Flexibility in funding community based solutions, not only evidence based practice but also to allow new ideas.
Support and interventions for families through Child Welfare before major crisis and support for older youth who are unattached to families.
Strategic partnerships with community based agencies including Y programs, community centers, faith based, afterschool programs, and housing agencies.
Better communication between Government agencies local community agencies and persons with lived experience.
5. Focus on culture, mental health and trauma training for Police.

24. Funding and support for school based services, including behavioral health services and trauma, community resources and intervention training for teachers.
Access to self and family referral to treatment facilities.
Funding for professional peer support services to family and youth.
Increase drug and mental health interventions and diversion programs in the court system.
10. Entire family issues and dynamics should be considered when treating children and youth for behavioral health problems.

25. FOR MORE INFORMATION
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Public Children Services Association of Ohio
Case Western Reserve University Center for Innovative Practice practices-cip
Bobbi Beale
Angela Lariviere :