Promoting Mental Health and Preventing Substance Abuse as part of NY s Prevention Agenda Taking Action November 12, 2014

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Promoting Mental Health and Preventing Substance Abuse as part of NY s Prevention Agenda 013-017 Taking Action November 1, 014 Guthrie Birkhead, MD, MPH Deputy Commissioner New York State Department of Health 1

Outline Background on Prevention Agenda 013-017 Findings from review of LHD and hospital plans in November 013 Purpose of Meeting

3

Prevention Agenda 013-017 Goal is improved health status of New Yorkers and reduction in health disparities through increased emphasis on prevention. Call to action to broad range of stakeholders to collaborate at the community level to assess local health status and needs; identify local health priorities; and plan, implement and evaluate strategies for local health improvement. Prevention Agenda is integral part of state health reform including DSRIP and the State Innovation Plan (SIM). 4

Prevention Agenda 013-017: Steered by Ad Hoc Leadership Group Collaborative effort led by committee appointed by Public Health and Health Planning Council, including leaders from Healthcare, Business, Academia, CBOs, Local Health Departments, and other State Agencies including OMH and OASAS. Final Priorities based on active participation from members of committee and stakeholder feedback. 5

Five Prevention Agenda Priorities 1. Prevent chronic diseases. Promote mental health and prevent substance abuse 3. Promote a healthy and safe environment 4. Promote healthy women, infants and children 5. Prevent HIV, sexually transmitted diseases, vaccinepreventable diseases and healthcare associated infections 6

IOM Intervention Spectrum Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities ( 009 ) 7

Timeline Dec 014 Nov 014 April 014 Nov 013 Dec 01 Annual Progress Reports from LHDs and hospitals LHDs and hospitals asked to submit annual progress report online Plans reviewed and feedback letters developed and mailed to local health departments and hospitals LHD Community Health Assessment & Community Health Improvement Plan and Hospital Community Service Plans submitted NYS DOH directs LHDs and Hospitals to work together with local stakeholders to conduct assessment, choose Prevention Agenda priorities and 1 that addresses health disparities and develop plan for improvement. 8

Prevention Agenda - November 1, 014 - draft11/4/14 9

10 Priorities Reported by Local Health Departments and Hospitals 100 98% (n=57) 96% (n=14) 80 60 40 50% (n=9) 43% (n=64) 8% (n=16) 8% (n=41) 0 16% (n=9) 13% (n=19) 5% (n=3) 7% (n=11) 0 Prevent Chronic Diseases Promote a Healthy and Safe Environment Promote Healthy Women, Infants and Children Promote Mental Health and Prevent Substance Abuse Prevent HIV/STDs, Vaccine- Preventable Diseases and Healthcare-Associated Infections LHD Hospitals Data have been analyzed from 58 LHD CHA-CHIPs and 148 Hospitals CSP reviews 10

Percent of LHDs and Hospitals Selecting Chronic Disease Focus Areas, 013 0 0 40 60 80 100 10 Reduce obesity in children and adults 57% (n=84) 100% (n=58) Reduce illness, disability and death related to tobacco use and secondhand smoke exposure 3% (n=34) 40% (n=3) Increase access to high quality chronic disease preventive care and management in both clinical and community settings 53% (n=31) 68% (n=100) LHDs Hospitals 11

Percent of LHDs and Hospitals with Chronic Disease Goals, 013 0 10 0 30 40 50 60 70 80 Goal #1.1: Create community environments that promote and support healthy food and beverage choices and physical activity. 39% (n=58) 67% (n=39) Goal #1.: Prevent childhood obesity through early childcare and schools. % (n=33) 48% (n=8) Goal #1.3: Expand the role of health care and health service providers and insurers in obesity prevention. Goal #1.4: Expand the role of public and private employers in obesity prevention. 11% (n=16) 36% (n=4) 6% (n=38) 31% (n=18) Goal #.1: Prevent initiation of tobacco use by New York youth and young adults, especially among low socioeconomic status (SES) populations. Goal #.: Promote tobacco use cessation, especially among low SES populations and those with poor mental health. 9% (n=17) 11% (n=17) 6% (n=15) 4% (n=36) LHDs Hospitals Goal #.3: Eliminate exposure to secondhand smoke. Goal #3.1: Increase screening rates for cardiovascular diseases; diabetes; and breast, cervical and colorectal cancers, especially among populations experiencing health disparities. Goal #3.: Promote evidence-based care. Goal #3.3: Promote culturally relevant chronic disease self-management education. 8% (n=1) 6% (n=15) 8% (n=16) 40% (n=59) 6% (n=15) 4% (n=35) 34% (n=0) 34% (n=1) 0ther % (n=13) 17% (n=5) 1

Percent of LHDs and Hospitals Selecting Chronic Disease Strategies, 013 0 10 0 30 40 50 60 70 80 Increasing adoption and use of food standards 5% (n=37) 45% (n=6) Implementing Complete Streets policies, plans, and practices 8% (n=1) 4% (n=14) Promoting policies and practices in support of breastfeeding Increasing the availability, accessibility and use of evidence-based interventions in self-care management in clinical and community settings % (n=3) 40% (n=3) 47% (n=7) 46% (n=68) Promoting smoking cessation benefits among Medicaid beneficiaries. Promoting smoking cessation among people with mental health disabilities through partnerships with the NYS Office of Mental Health. Adopting tobacco-free outdoor policies. Promoting NYS Smokers' Quitline. 5% (n=3) 9% (n=14) 3% (n=) 6% (n=9) 7% (n=4) 11% (n=16) 19% (n=11) 18% (n=7) Other program or educational approach 7% (n=4) 61% (n=90) Other policy (local or organizational) approach 31% (n=18) 0% (n=9) Percentage LHDs Hospitals 13

Number of LHDs and Hospitals Selecting Promote Mental Health and Prevent Substance Abuse Focus Areas, 013 0 5 10 15 0 5 30 35 40 Focus Area 1: Promote mental, emotional and behavioral (MEB) wellbeing in communities 11 6 Focus Area : Prevent Substance Abuse and other Mental Emotional Behavioral Disorders 14 34 LHDs Hospitals Focus Area 3: Strengthen Infrastructure across Systems 13 15 14

Number of LHDs and Hospitals Selecting Promote Mental Health and Prevent Substance Abuse Goals, 013 0 5 10 15 0 5 Goal 1: Promote mental, emotional and behavioral (MEB) well-being in communities 11 18 Goal.1: Prevent underage drinking, nonmedical use of prescription pain relievers drugs by youth, and excessive alcohol consumption by adults 10 13 Goal.: Prevent and reduce occurrence of mental, emotional and behavioral disorders among youth and adults 5 1 Goal.3: Prevent suicides among youth and adults 10 11 LHDs Hospitals Goal.4: Reduce tobacco use among adults who report poor mental health 3 7 Goal 3.1: Support collaboration among leaders, professionals and community members working in MEB health promotion, substance abuse and other MEB disorders and chronic disease prevention, treatment and recovery 1 1 Goal 3.: Strengthen infrastructure for MEB health promotion and MEB disorder prevention 1 Prevention Agenda - November 1, 014 - draft11/4/14 15

Number of LHDs and Hospitals Selecting Promote Mental Health and Prevent Substance Abuse Strategies, 013 0 5 10 15 0 5 30 35 40 Establish linkages with the OMH Early Recognition and Screening Initiative in the region. 8 9 Build community coalitions that advance the State's 'Suicide as a Never Event' through promotion and prevention activities 1 Develop social marketing and anti-stigma campaigns that promotes the importance of early identification and intervention 5 Promote smoking cessation among people with mental health disabilities through partnerships with the NYS Office of Mental Health. 4 6 LHDs Hospitals Mobilize community for reducing alcohol use 1 Participating in community trial intervention to reduce high-risk drinking 1 Other program or educational approach 18 38 Other policy (local or organizational) approach Prevention Agenda - November 1, 014 - draft11/4/14 1 16

Number of LHDs Addressing Disparities in Priority Areas, 013 Prevent Chronic Diseases 0 10 0 30 40 50 5 4 9 10 41 Number of Hospitals Addressing Disparities in Priority Areas Prevent Chronic Diseases 0 0 40 60 80 100 10 4 16 34 5 96 Promote a Healthy and Safe Environment Promote Healthy Women, Infants and Children Promote Mental Health and Prevent Substance Abuse 3 3 1 3 1 4 4 1 3 5 1 9 9 Promote a Healthy and Safe Environment Promote Healthy Women, Infants and Children Promote Mental Health and Prevent Substance Abuse 5 1 5 3 6 6 4 6 7 15 1 11 1 5 Prevent HIV/STDs, Vaccine-Preventable Diseases and Healthcare-Associated Infections Prevent HIV/STDs, Vaccine-Preventable Diseases and Healthcare-Associated Infections 7 6 3 6 4 Racial/ethnic Socioeconomic/educational Geographic Disability Gender Age Other 17

Summary of Reviews Strengths: collaboration use of formal processes to identify priorities Challenges: identifying and adapting evidence based interventions to address priorities, especially in MH/SA priority area using measures to track progress and outcomes, including measures/objectives to track progress on disparities. 18

Purpose of Today s Meeting Focus attention on Promote Mental Health and Prevent Substance Abuse priority area both for Prevention Agenda as well as DSRIP efforts Provide opportunity for dialogue within communities and across state to help you: Clarify purpose of activities Learn about evidence based or promising strategies Identify measures to track improvement Prevention Agenda - November 1, 014 - draft11/4/14 19

Questions? http://www.health.ny.gov prevention@health.state.ny.us 0