Alaska Native Tribal Health Consortium Rural Aftercare Program Expanding Aftercare Services in Rural Alaska Presented by: Cory Magro, LCSW, ANTHC Rural Aftercare Coordinator at ANMC and Lindsay Henkelman, LMSW, ANTHC Rural Aftercare Coordinator at
Suicide Rates in Alaska 2015 Alaska 2 nd in the U.S. for suicide. 1 Fourth leading cause of all deaths among Alaska Native people from 2012-2015. Alaskan Native males = 3.3 times more likely to die from suicide. Alaska Native females = 1.8 times more likely than male counterparts to be hospitalized for suicide attempts/self harm. 2
Need for Rural Aftercare in Alaska Addresses lack of: behavioral health discharge planning limited resources continuity of care Provides: extra layer of support and education: community providers, patients and families
Purpose of Rural Aftercare Coordination Reduce suicidality Reduce readmissions. Improve patient outcomes.
How are patients served by the Rural Aftercare Program? In-patient support Linkage and Coordination Follow up calls Therapeutic contacts Collateral contacts
Alaska Native Medical Center Rural Aftercare 2 Rural Aftercare Coordinator positions (hiring 2 nd position) Receives referrals through EHR Coordinates the behavioral health discharge Funded by Strategic Initiative
Alaska Psychiatric Institute Rural Aftercare 1 Rural Aftercare Coordinator Identifies own referrals API Social Workers organize discharge Funded by grant through MSPI
Alternate Services at API Native Ways of Knowing Support group: Tribal Doctor Rita Blumenstein using traditional methods Native Arts & Crafts Art and Craft Group: ANTHC volunteer skilled in AKN/AI crafts
What s done during follow up contacts? Mail: educational/supportive media or items; birthday and holiday cards; therapeutic letters Coordinate/Advocate/Support Phone calls Texts
RAC Patient Data Since May 2016 188 patients have been served 77 patients currently in the program 111 patients discharged from services Completed program: 50 Refused Services: 15 * Other: 46 * Only recorded of ANMC data
Patient Age at Intake
Patient Data by THO Tribal Health Organization Total # of Pts. Aleutian Pribilof Islands Association 3 Arctic Slope Native Association 14 Bristol Bay Area Health Corporation 2 Chugachmiut 3 Copper River Native Association 2 Eastern Aleutian Tribes 4 Kenaitze Indian Tribe 4 Kodiak Area Native Association 1 Maniilaq Association 21 Ninilchik Traditional Council 1 Norton Sound Health Corporation 35 Seldovia Village Tribe 1 Southcentral Foundation 3 Southeast Alaska Regional Health Consortium 7 Yukon Kuskokwim Health Corporation 87 Grand Total 188
RAC Patient Data - Attempts Intentional overdose Self-inflicted stab wound Self-inflicted gunshot Intentional hanging
Therapeutic Letter Writing Marsha Linehan; May, 2016 Dictated from an on-line talk on the Zero Suicide Initiative So the other thing is sending caring letters we in our clinic, we now send over 400 letters every year because we ve been sending caring letters to every patient we ve ever had every year since they were here. And we continue to do this. It is possible this is why our treatment works because the data is overwhelming that caring letters, of all the treatments, this is the only treatment that we know of, is the only treatment that showed reduction in being dead from suicide: It was sending non-demanding caring letters.
Patient Response to Services (Text) Thank you for the cards and words of encouragement you sent me. They meant a lot and really lifted me up. (Voice call) I still get really down and sometimes feel crazy and scream but I keep your cards and I take them out read them, they always make me feel better and help me through Asking patient what helped you the most in our contacts? That you cared
Challenges and Observations Difficulties with follow-up Complication of paperwork Continued limited resources Program length v. rapport build
RAC Follow-Up Attempts in 2017 (n=490) 32% 52% 16% Unknown - Letters, Voicemail, Text messages Unsuccessful Successful
Questions?
Thank You ANTHC Rural Aftercare Social Workers Alaska Native Medical Center Cory Magro, LCSW 907-729-3725 camagro@anthc.org Alaska Psychiatric Institute Lindsay Henkelman, LMSW 269-7154 lnhenkelman@anthc.org ANTHC Behavioral Health Department 729-3922
References 1 Lengdorfer, H., Topol, R., & Raines, R. (2015). Alaska Vital Statistics. Juneau: State of Alaska. 2 Alaska Naive Epidemiology Center. (2017). Statewide Data Suicide Mortality. Anchorage: Alaska Native Tribal Health Consortium.