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: 1)a significant decrease in daily distress felt from the impact of trauma 2)improved functioning with regard to important spheres of life (i.e., work, relationships, school, etc.), 3)initial increase in health care utilization followed by a decline on overall health care utilization, 4)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?