NYAPRS Note: Last week’s ACMHA Conference underscored the importance of the social determinants of health, a theme NYAPRS has heavily emphasized in our advocacy over the past year, citing the importance in Medicaid Redesign of housing, employment, connection to peer support and community as much as access to “doctors and pills.” This led us to successfully push for approved MRT recommendations that called for reinvestment of savings from future Medicaid managed care redesigns into these domains. NYAPRS was well represented at this year’s conference by Edye Schwartz, Chacku Mathai, Steve Coe and Mike Stoltz.
Look for ACMHA President to bring these themes to Albany this Thursday at the kick off of this year’s NYAPRS Executive Seminar. There’s still time to register at http://www.nyaprs.org/conferences/executive-seminar-2012/.
ACMHA Summit Embraces Social Supports for Healthier Communities
Mental Health Weekly March 26, 2012
Citing the need to mobilize community support and action to improve the behavioral health of individuals and families across the country, ACMHA – The College for Behavioral Health Leadership summit organizers convened their annual summit in Charleston, South Carolina around that issue last week.
The 2012 ACMHA Summit focused on what organizers called the “enormous potential” of community and social support and transitioning from an individual perspective to a focus on the collective power of people living, learning, working and healing together.
The summit began on March 21 and concluded on March 23, the second anniversary of the Affordable Care Act (ACA), the health reform law signed into law on March 23, 2010. This year’s theme was “Healthy Supports, Healthy Communities: Improving the Health of Communities Through Social Supports.”
With the goal toward exploring questions and ideas to improve the community and determine the skills needed for collaborative work, program
organizers allowed attendees the opportunity to participate in “communities” that included rural, urban, workplace, faith-based, virtual and school.
“We need to be disruptive innovators,” said Mary Ann Bergeron, executive director of the Virginia Association of Community Services Boards, alluding to the theme of last’s year’s summit in New Orleans when attendees had been asked to examine disruptive innovation and its implications for the field in the health reform era.
A disruptive innovation is a term used to describe a simpler, cheaper product or service that ultimately upends an established marketplace. “We have to think differently about how technology [for example] can support change, and about the different business models” to support that change, Bergeron told attendees.
Attendees this year were asked to create descriptions of their respective communities and discuss their impact on health and wellness, and identify what social supports would likely improve the health of the community. In the faith-based group, for example, one attendee wanted to determine how a system of care would include individualized needs and approaches to healing. Another member of the group inquired about how the behavioral
health field could learn from healthy communities that are faith-based.
ACMHA organizers said that the goal of convening the community workgroups is for members to return to their own communities and begin to effect change rather than waiting for someone else to lead an effort. Following the summit, ACMHA indicated plans to prepare a report summarizing the key discussions from each of the community groups and identifying actionable steps.
Evaluating social supports
Social support is a type and degree of help that is provided from others to a person, group, neighborhood or city, organization, or community
throughout the lifespan, noted King Davis, Ph.D., keynote speaker and director of the Institute for Urban Policy Research and Analysis in the College of Liberal Arts at the University of Texas.
“What impact does social support have on the health of the community?” said King. “How are social services in the community defined?” King noted that there is a relationship among social support, maintenance of well-being, and the ability to manage crisis, illness, recovery, loss or the influence of negative social determinants.
Although the concept of social support has been in vogue for 50 years, there is not one universally accepted definition of this concept, said King. “It’s a work in progress,” he said. “Social supports frame the basis of the conference.” Social supports result in vast improvements in cancer, overall school support, and the lowering of depression, he said.
He identified the elements of a social network, such as family, neighbors, leaders, friends, providers, and churches, all of which affect the level of support for consumers.
King also cited a number of social determinants as described by various researchers, including the World Health Organization (WHO), the South Australia Council and the Robert Wood Johnson Foundation.
Some of the social determinants include stress, early life experience, work environment and unemployment, and health and mental health
literacy. While there is considerable variation on the definition, there is overlap, he said.
“Social determinants are multiple factors and conditions operating within a social environment that collectively influence the health status, behavior, choices, risks and mortality of the individual and groups within a specific geographical area, the nation, region, neighborhood or community,” said King.
“We need to reconsider who we do our business with and how we conduct our business,” said King. Innovation has to be extraordinarily different, he said. “If you want to change some of the things, maybe you have to occupy mental health,” he said, amid laughter from summit attendees.
Reducing cardiac risk in BH population
Cardiovascular disease is the leading cause of death in this country, with nearly 3 million dying annually from the disease; people with behavioral health disorders make up 1 million of that population, Wilma Townsend, acting associate director of the Office of Consumer Affairs at the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Center for Mental Health Services (CMHS), told attendees.
Cardiovascular problems are brought on by such risk factors as smoking and obesity. About 75 percent of consumers with mental illness and substance use disorders smoke, compared to a general population rate of 23 percent, Townsend said during her presentation, “How Social Supports Can Change the Health of a Community.”
Townsend cited Million Hearts, a national initiative launched in September 2011 by the U.S. Department of Health and Human Services (HHS), which aims to prevent 1 million heart attacks and strokes in the U.S. over the next five years. The public-private partnership is co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS). SAMHSA is partnering with these agencies in the Million Hearts campaign, noted Townsend.
This initiative is an example of key efforts to support and promote health and wellness issues for consumers with serious mental illness, said Townsend. “We [behavioral health field] have to start modeling for the rest of the world,” said Townsend, who encouraged attendees to attend SAMHSA’s Wellness Week events from September 17-23. •
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Road to Creating a Better Life in the Community: The 2012 ACMHA Summit
Can We Foster Social Support and Community?
by Ron Manderscheid March 25, 2012
The just-completed 2012 Summit organized by ACMHA: The College for Behavioral Health Leadership was simply marvelous. Historic Charleston, with its diverse communities, served as an exceptional backdrop for a very spirited conversation. King Davis opened and closed the event in his inimitable way, with a carefully crafted mixture of professional analysis and personal family biography. From the listening and the conversation, two things became very clear: Communities are crucial to our health and our quality of life, and social support is the glue that links these life factors together. Going forward, it also became very clear that both ACMHA and the field have a major task to incorporate community dynamics, such as social supports and other social determinants of health into our health reform efforts. The 2012 ACMHA Summit was definitely a celebration of the Second Anniversary of the Affordable Care Act of 2010 (ACA), which occurred on the last day of the Summit, Friday, March 23rd.
The theme of the 2012 ACMHA Summit, “Healthy Supports, Healthy Communities” fits closely with the important finding that good health is related closely to the social support that one’s community provides. Social support is one of the social determinants of health-those positive and negative factors in one’s community that enhance or diminish one’s health status. Discrimination is an example of a negative determinant; social support, a positive determinant. The social determinants of health are recognized explicitly in the ACA because of its emphasis on disease prevention and health promotion. By 2020, an estimated 30% of US health care resources will be expended on these interventions.
After King Davis’ thoughtful introduction to the topic of community social supports, Summit participants subdivided into several simulated communities-urban, rural, workplace, faith-based, virtual, and school. Each community was given several questions to answer: What defines it as a community? What social supports would improve its health? How would one know that this had occurred? How does behavioral health fit into this community? Does it have a role in leading change? In fostering collaboration? Although the communities were being simulated, participants perceived correctly that these are the questions that will demand our attention as we implement national health reform. The community work was fun, informative, and sometimes blurred across the line from simulation to reality.
To underline the fundamental importance of community work, participants also heard from four exemplary projects that address social support and other social determinants. These included The Children’s Resilience Initiative of Walla Walla, designed to reduce adverse childhood events that lead to subsequent health problems; REACH US SouthEastern African American Center of Excellence for Eliminating Disparities Related to Diabetes and Its Complications, designed as a community intervention to reduce foot amputations of elderly Black Americans with diabetes; McShin: A Recovery Resource Foundation, designed to help others find and maintain recovery from substance use conditions; and Senior Reach, designed to provide care management, mental health treatment, and wellness services to older adults at no cost. Each of these initiatives is very impressive, and each reflects the passion and commitment of its originators. Such programs reflect our future. I encourage you to learn more about them.
As a very important feature of the 2012 ACMHA Summit, participants were very pleased to welcome eight new mentees to ACMHA’s acclaimed leadership program. These new mentees brought new and young eyes to Summit deliberations, and they sensitized more seasoned members of the ACMHA community to their new perspectives and issues.
King Davis concluded the Summit with a retrospective and a challenge going forward. He encouraged participants to reach beyond the narrow confines of behavioral healthcare; to engage the key issues in the ACA Supreme Court Case and in the 2012 Presidential Election; and to seek political office themselves. He closed by challenging the group to “Occupy Anything” that will address the health and community issues confronting all of us right now.
A delightful output from the Summit is the Road to Creating a Better Life, developed by the virtual community. It can be accessed at www.facebook.com/acmha . I encourage you to do so today.
Ron Manderscheid, PhD
Exec Dir, NACBHDD
rmanderscheid@nacbhd.org
V: 202-942-4296; M: 202-553-1827
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