Mental Health and Mental Disorders

Background

There has been an increased effort to increase and enhance community support systems for children and adolescents with serious emotional disturbance and for adults with serious and persistent mental illness. Community support systems offer greater opportunity for participation in community life, for education and employment, and for decreased dependency on public support.

Research has also found that community support systems for these populations decrease expensive hospitalization and provide for longer periods of symptom control. An extensive training, technical assistance, and consultation endeavor has provided the base from which community support systems have been built for these populations. A public education process, developing and disseminating information for families, has provided consumers and their families with the tools to identify expected and necessary services, to access those services, and to report their satisfaction with the services.

The Office of Behavioral Health Services (OBHS), Division of Mental Health and Community Rehabilitation Services, is continuing to work to address these issues.

The Objectives

OBJECTIVE 6.1 Reduce suicides of adults (persons aged 18 and older) to no more than 10.5 per 100,000 population.

UPDATE This is a new objective in Healthy People 2000: Setting the Stage for a Healthier West Virginia. Suicide is a leading cause of death in both West Virginia and the United States and a serious and potential outcome of mental illness and mental disorders. The adult suicide rate in the state from 1986 through 1995 has ranged from a low of 15.3 in 1988 to a high of 20.0 in 1995 (see Figure 1). The year 2000 rate is projected to be 19.7 per 100,000 adult population.

OBJECTIVE 6.2 Increase the number of people aged 18 and older with severe, persistent mental illness who use community support programs.

UPDATE This is a new objective in Healthy People 2000: Setting the Stage for a Healthier West Virginia. West Virginia has been focusing on the needs of this population for several years. An extensive community-based network of treatment, case management, and support services has decreased dependence on state-operated psychiatric hospitals, provided identification of and outreach to persons with serious and persistent mental illnesses, and empowered consumers of these services to help in the design and implementation of services to meet their needs.

When West Virginia submitted its Mental Health Plan in response to Federal Community Mental Health Block Grant requirements in 1989, it was estimated that approximately 8,000 adults with severe and persistent mental illnesses were served in that year. The number of persons served has increased steadily since that time, as shown in the table below. (Data are compiled from client data reports provided to OBHS by community behavioral health centers contracting with the state.)

OBJECTIVE 6.3 Increase the number of children and adolescents with serious emotional disturbances who use community-based treatment and needed support programs.

UPDATE This is a new objective in Healthy People 2000: Setting the Stage for a Healthier West Virginia. Providing a broad array of community support and specialized services for children with serious emotional disturbance has been shown to be effective in controlling the disabling effects of these disorders.

West Virginia has been focusing on the needs of children and adolescents for many years. An extensive community-based network of treatment, case management, and social supports has decreased dependence on hospitalization, provided identification of and outreach to children and adolescents with serious emotional disturbances and empowered the families of these children to help in the design and implementation of services to meet their needs.

When West Virginia submitted its Mental Health Plan in response to Federal Community Mental Health Block Grant requirements in 1989, it was estimated that approximately 6,000 West Virginia children and adolescents with serious emotional disturbance were served in that year. The number of children and adolescents served has increased steadily since then, as shown in the table below. (Data are compiled from client data reports provided to OBHS by community behavioral health centers contracting with the state.)

Meeting the Objectives

The Office of Behavioral Health Services, Division of Mental Health and Community Rehabilitation Services, has been designated as the lead entity in meeting the Mental Health and Mental Disorders objectives. The health promotion channels listed in the box above will be used to reach communities and individuals with public health education about mental health services that are available.

Objective 6.1 To reduce suicides among West Virginia's adults, there needs to be a focus on improving access to, and public knowledge of, crisis intervention services aimed at suicide prevention. An increased emphasis on continuity of care between outpatient and inpatient treatment is also necessary.

Specific tasks needed to make progress toward this objective include:

• Convene a task force by 1998 to (1) create a database on suicides among state adults; (2) formulate a plan of public education about suicide risk factors and available services for at-risk individuals, and (3) evaluate continuity of care between outpatient and inpatient services.

• Continue the development and operation of consumer-run Awarm lines@ to provide informal support to persons in Apre-crisis@ situations, with referral to more formal crisis services.

• Continue to monitor accessability of crisis intervention services. By 1/98, identify resources, including contract compliance and funding, needed to assure access to services.

• Continue to monitor linkages between outpatient and inpatient clinicians. By 9/97, identify continuity issues. By 1/98, develop and implement agreements to assure linkages needed to assure continuity of care.

Objective 6.2 To meet this objective, it will be necessary to continue development of consumer leaders and families to assist in outreach and services, as well as to continue and maintain current strategies and implementations, including:

• Targeted case management to assist with access of services.

• Use of Assertive Community Treatment Teams to serve recidivists.

• Support of the West Virginia Mental Health Consumers' Association.

• Support of the West Virginia Alliance for the Mentally Ill.

• Support of the West Virginia Leadership Academy for Consumers and Families.

• Sponsorship of annual conferences to provide information and technical assistance in the design and development of services to this population.

Objective 6.3 The OBHS will continue to focus on meeting the needs of children and adolescents with serious emotional disturbance. Accomplishments to date that will be maintained and strengthened include:

• Development of targeted case management to assist with access to services.

• Support of Partnerships of Care, regional networks of providers who evaluate needs, recommend services, and assure funding to meet needs.

• Continued development of peer organizations to empower children and adolescents who have accessed the behavioral health care system.

• Training in mediation skills for parents of children and adolescents with emotional disturbance to enable them to negotiate services.

• Sponsorship of conferences to provide information and technical assistance in the design and development of services to this population.

Mental Health and Mental Disorders - Meeting the Objectives

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