Substance Misuse And Substance Use Disorder Prevention

Substance Misuse and Substance UseDisorderPreventionGovernor’s Substance Abuse Services CouncilGail TaylorDirector, Office of Behavioral Health WellnessVirginia Department of Behavioral Health and Developmental ServicesWednesday, April 12, 2017

Evolution .Prevention is in an environment that has EVOLVED

Historical PreventionScared Straight

Historical Prevention

Behavioral Health Continuum of CareModel Promotion: These strategies aredesigned to create environmentsand conditions that supportbehavioral health and the ability ofindividuals to withstand challenges.Promotion strategies also reinforcethe entire continuum of behavioralhealth services.Prevention: Delivered prior to theonset of a disorder, theseinterventions are intended toprevent or reduce the risk ofdeveloping a behavioral healthproblem, such as underage alcoholuse, prescription drug misuse andabuse, and illicit drug use.Institute of Medicine (IOM)

Hawkins and Catalano

Key ConceptIndividual Strategies Individual strategies, such as drug education classes, are based on the premise thatsubstance abuse develops because of deficits in knowledge about negativeconsequences, inadequate resistance skills, poor decision making abilities and lowacademic achievement. Individuals do not become involved with substances solely on the basis of personalcharacteristics. They are influenced by a complex set of factors, such asinstitutional rules and regulations, community norms, mass media messages andthe accessibility of alcohol, tobacco and other drugs (ATOD). But these efforts, while important in a multiple strategy approach, do little toindependently alter the overall environment in which people live and work.- Community Anti-Drug Coalitions of AmericaCADCA

Individual Strategies SAMHSA CSAPInformation DisseminationEducation/Skill BuildingAlternative ActivitiesProblem ID and ReferralCADCA Provide information Enhance Skills Provide support

Key ConceptsEnvironmental Strategies Environmental strategies are effective in modifying the settings where aperson lives, which plays a part in how that person behaves. Costs associated with implementation, monitoring and political action within acommunity can be considerably lower than those associated with ongoingeducation, services and therapeutic efforts applied to individuals. Finally, environmental strategies are cost effective given the potentialmagnitude of change. Community mobilization is central to creatingpopulation level change.

Effective Community and Environmental StrategiesSAMHSA CSAP Coalitions/CommunityMobilization Environmental ApproachCADCA Enhance access/reduce barriers Change consequences(Incentives/Disincentives) Physical design Modifying/changing policies

Prevention Today Strategic Prevention Framework Coalitions Environmental Strategies to impact Population Health Prevention across the Lifespan Integration of mental health and primary care

Office of Behavioral Health WellnessPrevent mental and/or substanceuse disorders and suicide throughthe promotion of mental healthand reduction of community riskindicators for these conditions byimplementing individual,community and environmentalstrategies across the lifespan. Director 2 Behavioral Health WellnessConsultants Mental Health First AidCoordinator Suicide Prevention Coordinator Workforce DevelopmentSpecialist Data Manager

Local Prevention SystemPartner with Community CoalitionsSAMHSA CSAP Prevention Set Aside- 8,098,544 (Annually)SAMHSA Partnership for Success - 9,244,000 (5 years)SAMHAS Opiate STR- 1,7 (2 years)

Substance misuseand abuse is acommunity issuethat requires acommunityresponse

Shifting the Paradigms Integration of substance abuse prevention, mental healthpromotion and primary care across the lifespan Shifting from the delivery of prevention services to thedevelopment of Prevention Systems that deliver preventionservices based on the Strategic Prevention Framework Focus more on population level or environmental changestrategies complimented by individual/family strategies thattarget those at greatest risk

Strategic Prevention Framework- SPF

AssessmentState Epidemiological Outcomes Workgroupstate agency epi leadsSocial Indicator Study- Data linked to risk andprotective factor indicators, consumption andconsequences at the State and County/City/Regionallevels for Substance Abuse, Mental Health and AdverseChildhood Experiences (ACE) factors. County/CityEpidemiological Profiles that are aligned.Needs Assessments- 40 CSBs for their catchmentareasWhy is this important? Allows to establish priorities based on data, i.e.target populations, substances, key issues,geographic areas, etc. Outcome measures for State and communityperformance Informed decisions around resource allocations

Capacity Building Policy- CSB Prevention Staff are required topartner with local community coalitions Infrastructure Enhancements Partnerships Training and Workforce Development

Strategic Planning CSBs are in the process of creatinga Strategic Plan based on needsassessment data in partnershipwith their community coalitions Logic model

Implementation Focus more on population level orenvironmental change strategiescomplimented by individual/familystrategies that target those atgreatest risk Evidenced based programs,practices and strategies identifiedby an Evidenced Based Work Group

EvaluationOMNI Institute Creating data matrices for consistent dataentry across CSBs Creating an evaluation plan for each CSB andDBHDS OBHW Five Regional Technical Assistance providersWe need to be able to measure systemperformance and the behavioral outcomesachieved for our investment!

Contact InformationGail TaylorDirector, Office of Behavioral Health Wellnessgail.taylor@dbhds.virginia.gov804.786.1411

Integration of substance abuse prevention, mental health promotion and primary care across the lifespan Shifting from the delivery of prevention services to the development of Prevention Systems that deliver prevention services based on the Strategic Prevention Framework Focus more on population level or environmental change