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1 December 8, 2015 Crista M. Taylor, LCSW-C Director, Information, Planning and Development Adrienne Breidenstine, MSW Director of Opioid Overdose Prevention and Treatment Strengthening Baltimore City’s Behavioral Health System
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Who is BHSB? Established by Baltimore City to perform the governmental function of managing Baltimore City’s behavioral health system Serves as the local behavioral health authority for Baltimore City 2
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What is a Behavioral Health System? The system of care that addresses emotional health and well-being and provides services for individuals with substance use and/or mental health disorders 3
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Areas of Work BHSB works to – Improve access to a full range of quality behavioral health services – Advocate for innovative approaches to prevention, early intervention, treatment and recovery – Improve quality in service delivery – Promote public education 4
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Impact of the Work 5 Individuals Families Communities Housing Mental Illness Trauma Physical Illness Poverty Substance Use Employment Jail/Prison Schools
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A Public Health Crisis 6
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National Overdose Deaths Number of Deaths from Prescription Drugs
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National Overdose Deaths Number of Deaths from Heroin
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Baltimore City & Maryland Number of Overdose Deaths
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Who is At-Risk of an Overdose Any person who: Is known to be using drugs or has a history of substance use Has previously overdosed Receives opioids for acute or chronic medical conditions: respiratory, renal, hepatic Receives treatment for a substance use disorder
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Opioid Overdose Prevention Improve the entire behavioral health system: – Promote public education – Promote best practices & standards of care – Improve access to services & treatment
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Public Education 12
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What We Are Doing – Public Education Overdose Education & Naloxone Distribution As of October 2015: 477 trainings 6,699 people trained 4,457 naloxone kits distributed
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What We Are Doing – Best Practices Prevent Opioid Misuse & Abuse Prescription take back boxes Expand Access to Naloxone Standing Orders Physician Prescribing Practices Opioid Treatment Programs Develop a Trauma Responsive System Healing circles Learning community Social marketing campaign and website Training clinicians
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What We Are Doing – Access Improving access points in the system Buprenorphine – Mobile induction – Expanding to mental health clinics Crisis Information and Referral line – Expanded to 24/7 coverage – Integrated with the city’s crisis hotline – Ready access to residential crisis and detox – Warm handoff and follow up
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What We Are Doing – Access Improving access points in the system Law Enforcement Assisted Diversion (LEAD) Program – Pilot model adopted by a select group of cities – Establishes criteria for police officers to identify eligible substance users – Divert to an intake facility that connects them to necessary services rather than to central booking for arrest Planning group Seeking funding
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What We Are Doing – Access Enhancing the crisis response system – A comprehensive crisis response system is the backbone of any successful behavioral health system – Serves as a primary access point – A good crisis system: Integrated - substance use and mental health Reduces harm including death Reduces overall costs Trauma informed Works closely with police and EMS
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Stabilization Center Community-Based, 24/7 voluntary care for adults who are intoxicated – alcohol and drugs Safe place to sober and get connected to services Average length of stay - 4 to 6 hours Referral Options: – Alternative transport option for EMS – Direct referral from ED – Developing protocol for others to refer – police, homeless outreach workers, etc. Will integrate data across systems – EDs, crisis teams, EMS
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Stabilization Center 3.6 million secured from the State Legislature for capital improvements Location – site identified; partnership with a local FQHC Protocol approved for alternative transport for EMS Developing protocols for center operations Planning for data infrastructure Actively looking for operating costs first aid – A bed in which to sleep – Medical monitoring (including withdrawal scores and vital signs) – Hydration and electrolyte replacement – Food, clothing and showers – Screening, brief intervention, and referral to treatment for substance use, mental health and physical health disorders – Case management for up to 30 days after a visit to ensure linkage to needed services, including behavioral health treatment, shelter, income, insurance, health care, etc. – Average length of stay of 6 to 10 hours
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We Need More Treatment on Demand for both Mental Illness and Substance Use – 24/7 mobile crisis response – 24/7 walk-in “urgent care center” – More detox – More residential supports – More peer support – More case management
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Questions http://www.bhsbaltimore.org/ Crista Taylor crista.taylor@bhsbaltimore.org Adrienne Breidenstine Adrienne.Breidenstine@bhsbaltimore.org 21
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