A systems-based approach to reduce smoking rates among people
living with serious mental illness in the Capital District
community
Slide 2
Project Overview Urgency of need Unique challenges Benefits of
improving BH response What do we do? How do we do it? Framework for
Tobacco-Free Organizational Change Why now?
Slide 3
Urgency of Need We need to quit. We really do. Its expensive,
its bad for our health, its killing us. I know that theres all
these studies that show that we die 25 years younger than the
general population, and I think smoking certainly is one of those
factors. Testimony from HelpUsQuit.org
http://www.ctri.wisc.edu/HC.Providers/healthcare_mental.health.htm
http://www.ctri.wisc.edu/HC.Providers/healthcare_mental.health.htm
Smoking Prevalence by Self-Reported Mental Health Status 2000-2001
and 2008-2009, NYS BRFSS
Slide 4
Unique Challenges Pharmacological interactions between tobacco
smoke and medications History of social acceptability of tobacco
use within mental health settings Higher than average smoking rate
of behavioral health staff Persistent and inaccurate belief that
tobacco use helps to alleviate anxiety, sadness and agitation
Common belief among some providers and patients that successfully
quitting smoking among people living with SMI is too difficult to
achieve
Slide 5
Benefits of Improved Response Saves lives Saves healthcare
dollars Improves productivity Nicotine Dependence is a DSM-IV
Disorder Tobacco dependence and mental illness are co-occurring
disorders Behavioral practitioners practice psycho-social
treatments Consistent with wellness and recovery approaches
Reimbursement for treatment is improving Williams, MD and Zeidonis,
MD 2006
Slide 6
What Do We Do? Elevate tobacco use as a priority for people
living with mental illness Integrate responses to tobacco use in
assessment, intervention and treatment Create an environment that
supports tobacco-free living for both employees and consumers
Slide 7
How Do We Do It? Plan Implement Sustain Elevate tobacco use as
area of concern Educate agency staff, consumers, board Identify
internal resources and strengths Identify needs Integrate tobacco
use responses Increase/improve capacity of BH providers to respond
effectively to tobacco dependence Revise policy and practices to
include tobacco dependence assessment, intervention and treatment
Create supportive environment Make grounds tobacco-free Maximize
incentives and access to cessation resources
Slide 8
Framework for Tobacco-Free Organizational Change DODONT
Slide 9
Community Health Improvement Plan workgroups in Albany,
Schenectady, and Rensselaer identified tobacco use among people
living with mental illness as priority target objective DSRIP -
SPHP/Ellis have identified tobacco use among those living with
mental illness as priority NYS OMH is currently in process of
making all state-run BH agencies tobacco-free Capital District
Tobacco-Free Coalition and Tobacco Cessation in Health Systems
Program initiated collaboration of BH agencies in tri-county area
Why Now? Substantial resources are currently available to guide us
through this process
Slide 10
Available Resources NYS Office of Mental Health Access to
online Tobacco Dependence Trainings through The Center for Practice
Innovations (CPI) at Columbia University Opportunity to attain The
Integrated Mental Health/Addictions Treatment Training Certificate
from CPI at Columbia University Technical assistance from Adult
Services, NYSOMH Opportunity to improve the lengths of Operating
Certificates by achieving exemplary ratings on the Clinic Standards
Capital District Tobacco-Free Coalition & Center for Smoking
Cessation Coordination of regular meetings and activities to
advance the goals of the Initiative Telephone, email or in-person
technical assistance Provision of on-site training to mental health
care providers on evidence-based interventions Provision of
supportive materials and resources for both staff and consumers of
service Hosting of centralized online resource for
Initiative-specific documents, resources, and activities Sample
policies, sample employee/consumer outreach materials, FAQs and
timelines No-cost tobacco-free signage for your property
Coordination of regional earned media and events regarding
Initiative, including kick-off event or press conference as
determined by participating agencies
Slide 11
Progress to Date ACMDH Comprehensive tobacco screening
integrated into intake and treatment Staff trained on
evidence-based best practices Established workgroup committed to
addressing tobacco use at their facility Tobacco-Free grounds will
be dependent upon county-wide decision to implement policy RCDMH
Clinic staff trained on evidence-based best practices Discussion of
improving signage and strengthening tobacco-free grounds policy
Equinox, Inc. Making out-patient clinic grounds tobacco-free as of
February 14, 2015 Working to improve access to cessation
information and resources Established workgroup committed to
addressing tobacco use at their facility Staff trained on
evidence-based best practices Rehabilitation Support Services
Actively engaged in addressing tobacco use among client population
Working towards one or two facilities going tobacco-free initially,
with others to follow
Slide 12
Progress to Date Northeast Career Planning Committed to going
tobacco-free (no concrete date yet) Staff trained on evidence based
best practices Established workgroup committed to addressing
tobacco use at their facility Active Cessation group within PROS
program Unity House Plans to make new Community Services Program
building grounds tobacco-free Participating in local DSRIP
workgroup focused on promoting cessation in MH population Ellis
Hospital Mental Health (Schenectady) Actively engaged in bolstering
tobacco-free grounds policy and increasing access to cessation
resources and support Staff trained on evidence-based best
practices Active cessation group within PROS program Homeless and
Travelers Aid Society Early stages of determining how our efforts
can be integrated into their services