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=Improve Detection & Treatment of Mental Health Conditions=
 
Return to [[Opioid Top-Level Strategy Map]] or [[Zoom Map - Minimize Demand for Opioids|Zoom Map (Minimize Desire to Misuse Opioids)]]<br /> <div id="toc">
 
=Table of Contents=
 
<div style="margin-left: 1em">[[#Background|Background]]</div><div style="margin-left: 1em">[[#Youth are Struggling with Mental Health Issues|Youth are Struggling with Mental Health Issues]]</div><div style="margin-left: 1em">[[#Co-Occurring Disorders|Co-Occurring Disorders]]</div><div style="margin-left: 3em">[[#toc3| ]]</div><div style="margin-left: 1em">[[#Promising Programs|Promising Programs]]</div><div style="margin-left: 2em">[[#Promising Programs-M3 Checklist (Screening Tool)|M3 Checklist (Screening Tool)]]</div><div style="margin-left: 2em">[[#Promising Programs-Project Aware|Project Aware]]</div><div style="margin-left: 2em">[[#Promising Programs-Communities that Care|Communities that Care]]</div><div style="margin-left: 2em">[[#Promising Programs-myStrength|myStrength]]</div><div style="margin-left: 1em">[[#Depression|Depression]]</div><div style="margin-left: 2em">[[#Depression-Depression & Opioids|Depression & Opioids]]</div><div style="margin-left: 2em">[[#Depression-Stigma & Depression|Stigma & Depression]]</div><div style="margin-left: 2em">[[#Depression-Rural Areas|Rural Areas]]</div><div style="margin-left: 1em">[[#Virtual Reality Therapy|Virtual Reality Therapy]]</div><div style="margin-left: 2em">[[#Virtual Reality Therapy-Benefits of VR Therapy|Benefits of VR Therapy]]</div><div style="margin-left: 1em">[[#Free Mental Health Apps|Free Mental Health Apps]]</div><div style="margin-left: 1em">[[#Tools & Resources|Tools & Resources]]</div><div style="margin-left: 1em">[[#Scorecard Building|Scorecard Building]]</div><div style="margin-left: 1em">[[#Resources to Investigate|Resources to Investigate]]</div><div style="margin-left: 1em">[[#Sources|Sources]]</div></div>
 
=Background=
 
Initial use of opioids by youth is often done as self-medication for dealing with trauma, depression or anxiety. (Research and sources needed)<br />  In one national survey of young adults aged 18-24, more than 61 percent of respondents who had used opioids not prescribed to them had done so primarily to relieve anxiety and stress<sup class="reference">[1]</sup> .<br /> <br />
 
=Youth are Struggling with Mental Health Issues=
 
A nationwide U.S. survey of over 1300 14- to 22-year-olds done in February and March of 2018 shows evidence of a growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), finds that many teens and young adults are experiencing moderate to severe symptoms of depression are turning to the internet for help. Common uses of the Internet include researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent). <sup class="reference">[2]</sup><br />
 
=Co-Occurring Disorders=
 
Co-occurring disorders, or dual diagnosis, refers to having a simultaneous mental health disorder and substance use disorder. It is common for people with addictions to also suffer from depression, anxiety, or more severe mental illnesses such as schizophrenia or bipolar disorder. Research shows that people who use alcohol or other drugs early in life are more likely to have mental or emotional problems. It’s also true that many people with mental illnesses “self-medicate” with alcohol or other drugs to numb emotional pain, relieve anxiety, or quiet their thoughts. In the past, the medical profession treated one disorder first, typically the substance use disorder, before addressing the other. It is now understood that treating both simultaneously leads to better outcomes. Any successful addiction treatment program will include a mental health assessment and treat co-occurring disorders at the same time.<br />
 
=== ===
 
=Promising Programs=
 
There are a growing number of promising programs for helping to identify and address mental health issues.<br /> <br />
 
==M3 Checklist (Screening Tool)==
 
[https://www.m3information.com/about-us/ M3 Information] developed a mental health screen that measures outcomes based on a 27-question diagnostic checklist and a related algorithm targeted for adults aged 18 and older. The M3 Checklist accurately measures outcomes based on question responses for major depression, bipolar disorder, anxiety disorder and posttraumatic stress disorder (PTSD).<br /> <br />
 
==Project Aware==
 
[https://www.samhsa.gov/nitt-ta/distance-learning-videos/project-aware Project AWARE] is a SAMHSA program that focuses on student mental health and wellness, While not specifically focused on opioid abuse prevention, much of the work that grantees are doing may also help prevent opioid misuse. Through Project AWARE, schools are implementing evidence-based, culturally appropriate prevention programs that support youth at the universal, selective, and indicated levels.<br /> <br />
 
==Communities that Care==
 
Programs such as [https://www.communitiesthatcare.net/ Communities That Care] promote a range of youth mental and behavioral health outcomes, included reduced risk for opioid misuse and addiction. (Find Source)<br /> <br />
 
==myStrength==
 
[http://www.mystrength.com myStrength] is a digital platform that integrates state-of-the-art technologies to support people in addressing mental and behavioral health issues. It can be integrated with a professional practice to allow them to see more patients more efficiently and better meet the needs of their patients between in-person visits. Learn more at this [https://www.mystrength.com/news/events/webinar-drive-utilization-revenue-and-outcomes-via-an-integrated-in-person-and-digital-therapeutic-model recorded Webinar].<br /> <br /> <br />
 
=Depression=
 
  
* Because depression is under-diagnosed and untreated, depression and opioid abuse are strongly concurrent.<sup class="reference">[3]</sup>
+
Return to ...
* People with depression show abnormalities in the body’s release of its own opioid chemicals<sup class="reference">[4]</sup>
 
* Depression tends to exacerbate pain—it makes chronic pain last longer and hurts the recovery process after surgery<sup class="reference">[5]</sup>
 
* Depression nearly doubles the risk that someone already using opioids will continue to use them long-term<sup class="reference">[6]</sup>
 
<br />
 
==Depression & Opioids==
 
  
* Depressed people are about twice as likely as non-depressed people to misuse their painkillers for non-pain symptoms<sup class="reference">[7]</sup>
+
----
* Depressed individuals were between two and three times more likely to ramp up their own doses of painkillers <sup class="reference">[8]</sup>
+
 
* Adolescents with depression are also more likely to use prescription painkillers for non-medical reasons and to become addicted<sup class="reference">[9]</sup>
+
Brief Description
* Depressed people are likely to keep using opioids, even when their pain has subsided and when they are more functional <sup class="reference">[10]</sup>
+
 
==Stigma & Depression==
+
 
Stigmatization of depression can reduce the likelihood of people reaching out to get the mental care they need. Instead, depressed people may ask for prescriptions for physical ailments, and use their prescription drugs to treat their emotional pain. <sup class="reference">[11]</sup><br />
+
 
==Rural Areas==
+
= Introductory Paragraph =
In particular, shortages of mental-health providers are prominent in rural areas where the opioid epidemic hit the hardest. Some have suggested that providing mental health care to those suffering from chronic pain may help detangle the relationship between pain and depression.<sup class="reference">[12]</sup><br /> <br />
+
 
=Virtual Reality Therapy=
+
A national study shows that one in five Americans has a mental health issue. In this study, young adults between the ages of&nbsp;18 and&nbsp;24, indicated that&nbsp;more than 61 percent of respondents who had used opioids not prescribed to them had done so primarily to relieve anxiety and stress<ref>http://marychristiefoundation.org/core/uploads/2015/04/Youth-Opioid-Survey-Report.pdf</ref>.&nbsp; &nbsp;Early identification, screening, accurate diagnosis, and effective treatment of&nbsp;mental health and substance use conditions&nbsp;can alleviate suffering for individuals and their families dealing with behavioral health challenges. Early access and detection of mental health conditions can expedite recovery, enhance&nbsp;educational and employment opportunities, positively&nbsp;impact relationships, and ultimately improve&nbsp;quality of life.<ref>https://www.mhanational.org/issues/position-statement-41-early-identification-mental-health-issues-young-people</ref>
[http://ict.usc.edu/profile/albert-skip-rizzo/ Dr. Skip Rizzo] has been working since the 1990s to use virtual reality to treat mental illness. <sup class="reference">[13]</sup> In an "early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved."<sup class="reference">[14]</sup><br /> <br /> The [http://www.vrphobia.com/index.htm Virtual Reality Medical Center] uses simulation technologies for:<br />  
 
  
# Treating patients with anxiety disorders
+
Mandated screenings for physical&nbsp;health concerns are in place for issues such as vision and hearing. Similarly, early detection of mental health and substance use should occur for young people who may be vulnerable to these issues. These screenings should occur as they do for early detection of physical conditions in venues such as&nbsp;schools, primary health care providers, and other community areas.&nbsp; Communities should be given the tools and support necessary to identify signs of mental health or substance use issues at the earliest possible time. This position is endorsed by the American Academy of Pediatrics,&nbsp;<ref> AAP Schedule of Screenings and Assessments for Well-Child Assessments (February 24, 2014), https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Updates-Schedule-of-Screening-and-Assessments-for-Well-Child-Visits.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR:+No+local+token</ref>&nbsp;specifically&nbsp;for depression in youth over age 11,&nbsp;and&nbsp;the United States Preventive Services Task Force&nbsp;<ref>PSPSTF Depression in Children and Adolescents: Screening (February 2016), http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-children-and-adolescents-screening1</ref>.&nbsp;&nbsp;Early detection and screening&nbsp;will reduce the likelihood and consequences of delaying care.
# Training for both military and civilian populations
 
# Enhancing various educational programs
 
==Benefits of VR Therapy==
 
  
* Faster than traditional therapy and desensitization<sup class="reference">[15]</sup>
+
Resources&nbsp;such as access to comprehensive mental health and substance use evaluations should be available to parents and guardians whenever warning signs are observed.&nbsp;<ref>http://www.nmha.org/go/about-us/what-we-believe/position-statements/p-48-prevention-in-young-people/position-statement-48-prevention-of-mental-health-and-substance-use-disorders-in-young-people</ref>&nbsp;Access to adequate care can reduce barriers to learning and improve educational, behavioral, and health outcomes for our youth. The most effective&nbsp;services promote collaboration among all of the people available to help.&nbsp;Pertinent individuals&nbsp;including families, educators, child welfare caseworkers, health insurers,&nbsp;community mental health providers,&nbsp;and substance use treatment providers. Reducing barriers and creating incentives can improve collaboration across systems and funding sources.
* Practice these skills in situations in which you previously experienced anxiety, allowing the skills to generalize more easily to real world settings<sup class="reference">[16]</sup>
 
* Can do some sessions in between office session at home, cuts down on the number of sessions people need<sup class="reference">[17]</sup>
 
=Free Mental Health Apps=
 
<span style="color: #ff0000">[need evidence]</span><br /> <br />
 
=Tools & Resources=
 
[[TR - Improve Detection & Treatment of Mental Health Conditions]]<br /> <br />  Resources for Suicide and Substance Use Prevention in Youth<br />  2017 SAMHSA Webinar on [https://www.youtube.com/watch?v=AIQWbywRzWY Suicide and Substance Abuse among Young People] and includes best practices for prevention and intervention.<br /> <br /> <br />  SAMHSA has a [https://www.samhsa.gov/sites/default/files/programs_campaigns/nation_prevention_week/npw-2018-organizations-places-assistance.pdf new list of organizations and resources] updated May 2018 with many different types of resources and organizations. (This should be investigated and specific links added throughout the OCRH.<br />
 
=Scorecard Building=
 
[[PO - Improve Detection & Treatment of Mental Health Conditions|Potential Objective Details]]<br /> [[PM - Improve Detection & Treatment of Mental Health Conditions|Potential Measures and Data Sources]]<br /> [[PA - Improve Detection & Treatment of Mental Health Conditions|Potential Actions and Partners]]<br />
 
=Resources to Investigate=
 
[[RTI - Improve Detection & Treatment of Mental Health Conditions]]<br /> <br /> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br /> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span><br />
 
{| class="wiki_table"
 
| '''Reviewer'''<br />
 
| <br />
 
| '''Date'''<br />
 
| <br />
 
| '''Comments'''<br />
 
|-
 
| <br />
 
| <br />
 
| <br />
 
| <br />
 
| <br />
 
|}
 
=Sources=
 
  
----
+
In&nbsp;order to improve mental health detection and treatment outcomes, some barriers need to be addressed. Health disparities such as lack of health insurance,&nbsp;cultural factors that discourage mental health treatment, and socioeconomic status need to be addressed to ensure adequate care to all individuals.&nbsp; Disparities in communities may be a factor in the early diagnosis and treatment of mental health conditions and can increase mental illness challenges in already vulnerable and underserved&nbsp;individuals, families, and communities.&nbsp;<ref>https://www.nimh.nih.gov/about/director/messages/2020/addressing-disparities-advancing-mental-health-care-for-all-americans</ref>
 +
 
 +
&nbsp;
 +
 
 +
&nbsp;
 +
 
 +
= Key Information =
 +
 
 +
'''Mental Health and Drug addiction'''<br/> Mental health and drug addiction are undeniably linked. According to the National Institute on Drug Abuse “Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa.”&nbsp;<ref>https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
 +
</ref>&nbsp;Studies have shown that around 1 in 4 individuals that have a serious mental illness also have a substance abuse disorder.<ref>https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness</ref>&nbsp;Many people attempt to use drugs to self medicate their mental illness or escape their situation. Understanding mental health is essential to any prevention or recovery effort.<br/> <br/> The National Allinace of Mental Illness has indicated in conjunction with SAMHSA and CDC-<ref>https://www.nami.org/mhstats</ref>
 +
 
 +
1-5 U.S. adults experience mental illness each year<ref>https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf</ref><br/> 1-20 U.S. adults experience serious mental illness each year<ref>https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf</ref><br/> 1-6 U.S. youth aged 6-17 experience a mental health disorder each year<ref>https://jamanetwork.com/journals/jamapediatrics/fullarticle/2724377?guestAccessKey=f689aa19-31f1-481d-878a-6bf83844536a</ref><br/> 50%of all lifetime mental illness begins by age 14, and 75% by age 24<ref>https://www.ncbi.nlm.nih.gov/pubmed/15939837</ref><br/> Suicide is the 2nd leading cause of death among people aged 10-34&nbsp;<ref>https://www.nimh.nih.gov/health/statistics/suicide.shtml</ref>
 +
 
 +
'''Youth are Struggling with Mental Health Issues'''<br/> A nationwide U.S. survey of over 1,300 14&nbsp;to 22-year-olds conducted&nbsp;in February and March of 2018 shows evidence of a growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), found&nbsp;that many teens and young adults who&nbsp;were experiencing moderate to severe symptoms of depression&nbsp;utilized online resources for help. Common uses of the Internet included researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent).<ref>https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/</ref>
 +
 
 +
'''Co-Occurring Disorders'''<br/> Co-occurring disorders, or dual diagnosis, refers to having a simultaneous mental health disorder and substance use disorder. It is common for people with addictions to also suffer from depression, anxiety, or more severe mental illnesses such as schizophrenia or bipolar disorder. Research shows that people who use alcohol or other drugs early in life are more likely to have mental or emotional problems. It’s also true that many people with mental illnesses “self-medicate” with alcohol or other drugs to numb emotional pain, relieve anxiety, or quiet their thoughts. In the past, the medical profession treated one disorder first, typically the substance use disorder, before addressing the other. It is now understood that treating both simultaneously leads to better outcomes. Any successful addiction treatment program will include a mental health assessment and treat co-occurring disorders at the same time.
 +
 
 +
'''Depression'''
 +
 
 +
*Because depression is underdiagnosed and untreated, depression and opioid abuse are strongly concurrent.<ref>https://doi.org/10.1097/j.pain.0000000000000658</ref>
 +
*People with depression show abnormalities in the body’s release of its own opioid chemicals<ref>https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/</ref>
 +
*Depression tends to exacerbate pain—it makes chronic pain last longer and hurts the recovery process after surgery
 +
*Depression nearly doubles the risk that someone already using opioids will continue to use them long-term
 +
*Depression & Opioids
 +
*Depressed people are about twice as likely as non-depressed people to misuse their painkillers for non-pain symptoms
 +
*Depressed individuals were between two and three times more likely to ramp up their own doses of painkillers
 +
*Adolescents with depression are also more likely to use prescription painkillers for non-medical reasons and to become addicted
 +
*Depressed people are likely to keep using opioids, even when their pain has subsided and when they are more functional&nbsp;
 +
 
 +
<br/> '''Stigma & Depression'''<br/> Stigmatization of depression can reduce the likelihood of people reaching out to get the mental care they need. Instead, depressed people may ask for prescriptions to treat&nbsp;physical ailments, and use these&nbsp;prescription drugs to treat their emotional pain.&nbsp;<ref>https://www.crain.com/</ref>
 +
 
 +
'''Rural Areas'''<br/> In particular, shortages of mental-health providers are prominent in rural areas where the opioid epidemic hit the hardest. Some have suggested that providing mental health care to those suffering from chronic pain may help detangle the relationship between pain and depression.<ref>https://vrphobia.com/about-us-old/</ref><br/> <br/> Overall, improving detection and treatment of mental health conditions includes improved early screening, assessment, and access to treatment as well as outreach and education in communities.&nbsp;&nbsp;
 +
 
 +
= Relevant Research =
 +
 
 +
'''Prevention and early intervention in youth mental health'''<ref>https://ijmhs.biomedcentral.com/articles/10.1186/s13033-020-00356-9</ref><br/> <br/> '''Early detection of bipolar disorders and treatment recommendations for help-seeking adolescents and young adults: Findings of the Early Detection and Intervention<ref>https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00227-3</ref>'''<br/> &nbsp;
 +
 
 +
= Impactful Federal, State, and Local Policies =
 +
 
 +
'''SAMSHA Infant & Early Childhood Mental Health Grant<ref>https://www.samhsa.gov/grants/grant-announcements/sm-18-018</ref>'''<br/> <br/> '''Project AWARE (Advancing Wellness and Resiliency in Education) State Education Agency Grants<ref>https://www.samhsa.gov/grants/2021/project-aware</ref><br/> <br/> Policies surrouding'''&nbsp;'''Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)<ref>https://www.medicaid.gov/federal-policy-guidance/downloads/cib-01-26-2015.pdf</ref>'''<br/> &nbsp;
 +
 
 +
= Available Tools and Resources =
 +
 
 +
'''The National Institute of Mental Health<ref>https://www.nimh.nih.gov/about/director/messages/2020/addressing-disparities-advancing-mental-health-care-for-all-americans</ref>'''<br/> Provides resources on how to find immediate help, health care providers, how to decide if a provider is right for you, how to join a study, and resources to learn more about mental disorders.
 +
 
 +
'''The American Academy of Child and Adolescent Psychiatry<ref>https://www.aacap.org/</ref>'''<br/> Provides a service that helps find child and adolescent psychiatrist throughout America.
 +
 
 +
'''SAMHSA Resources for Suicide and Substance Use Prevention in Youth<ref>https://store.samhsa.gov/product/Preventing-Suicide-A-Toolkit-for-High-Schools/SMA12-4669</ref>'''<br/> 2017 SAMHSA Webinar on Suicide and Substance Abuse among Young People and includes best practices for prevention and intervention.
 +
 
 +
'''SAFE Project Wiki Site'''- Trauma informed Care<ref>http://ifi-wikis.com/IFI-OpioidCrisis/Become_a_Trauma-Informed_Community</ref><br/> <br/> '''Mental Health America-'''Mental Health America (MHA)'s work is driven by its commitment to promote mental health as a critical part of overall wellness, including prevention services for all; early identification and intervention for those at risk; integrated care, services, and supports for those who need them; with recovery as the goal.<ref>https://www.mhanational.org/issues/position-statement-41-early-identification-mental-health-issues-young-people</ref>
 +
 
 +
'''National Alliance on Mental Illness -'''NAMI provides advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives.<ref>https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Mental-Health-Screening</ref><br/> <br/> '''Mental Health by the Numbers-&nbsp;'''Mental health awarness<ref>https://www.nami.org/mhstats</ref><br/> <br/> '''Early Mental Health Screening and Intervention<ref>https://www.amhca.org/HigherLogic/System/DownloadDocumentFile.ashx?DocumentFileKey=2ca60afe-8be0-af27-2ad9-7100b61ad636&forceDialog=0</ref>'''-&nbsp;Intervention and screening across the lifespan<ref>https://www.amhca.org/viewdocument/the-need-for-early-mental-health-sc-2</ref><br/> <br/> '''Identifying Mental Health and Substance Use Problems of Children and Adolescents: A Guide for Child-Serving Organizations-'''This manual offers guidance and tools for identifying mental illness or substance use issues early in children and adolescents in various setting, such as in schools, the juvenile justice and child welfare system, and when receiving primary care.<ref>https://store.samhsa.gov/product/Identifying-Mental-Health-and-Substance-Use-Problems-of-Children-and-Adolescents-A-Guide-for-Child-Serving-Organizations/SMA12-4700</ref>
 +
 
 +
= Promising Practices =
 +
 
 +
'''Promising Programs'''<br/> There are a growing number of promising programs for helping to identify and address mental health issues.
 +
 
 +
'''Virtual Reality Therapy'''<br/> Dr. Skip Rizzo has been working since the 1990s to use virtual reality to treat mental illness. [15]In an "early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved."[16]
 +
 
 +
The Virtual Reality Medical Center uses simulation technologies for:<ref>https://vrphobia.com/about-us-old/</ref>
 +
 
 +
*Treating patients with anxiety disorders
 +
*Training for both military and civilian populations
 +
*Enhancing various educational programs
 +
*Benefits of VR Therapy
 +
*Faster than traditional therapy and desensitization
 +
*Practice these skills in situations in which you previously experienced anxiety, allowing the skills to generalize more easily to real world settings
 +
*Can do some sessions in between office session at home, cuts down on the number of sessions people need<br/> &nbsp;
 +
 
 +
'''M3 Checklist (Screening Tool)<ref>https://www.m3information.com/</ref>'''<br/> M3 Information developed a mental health screen that measures outcomes based on a 27-question diagnostic checklist and a related algorithm targeted for adults aged 18 and older. The M3 Checklist accurately measures outcomes based on question responses for major depression, bipolar disorder, anxiety disorder and posttraumatic stress disorder (PTSD).<br/> &nbsp;
 +
 
 +
'''Project Aware<ref>https://www.samhsa.gov/grants/grant-announcements/sm-20-016</ref>'''<br/> Project AWARE is a SAMHSA program that focuses on student mental health and wellness, While not specifically focused on opioid abuse prevention, much of the work that grantees are doing may also help prevent opioid misuse. Through Project AWARE, schools are implementing evidence-based, culturally appropriate prevention programs that support youth at the universal, selective, and indicated levels.<br/> &nbsp;
 +
 
 +
'''Communities that Care<ref>https://www.communitiesthatcare.net/</ref>'''<br/> Programs such as Communities That Care promote a range of youth mental and behavioral health outcomes, included reduced risk for opioid misuse and addiction. (Find Source)
 +
 
 +
'''myStrength<ref>https://mystrength.com/</ref>'''<br/> myStrength is a digital platform that integrates state-of-the-art technologies to support people in addressing mental and behavioral health issues. It can be integrated with a professional practice to allow them to see more patients more efficiently and better meet the needs of their patients between in-person visits. Learn more at this recorded Webinar.<br/> <br/> '''Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT)''' law requires states to provide Medicaid-eligible children regular mental health screenings.<ref>https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Mental-Health-Screening</ref><br/> <br/> '''Pediatric Mental Health Access<ref>https://mchb.hrsa.gov/training/projects.asp?program=34</ref><br/> <br/> Comprehensive Case Management for Substance Abuse Treatment<ref>https://www.ncbi.nlm.nih.gov/books/NBK64863/pdf/Bookshelf_NBK64863.pdf</ref>'''
  
# [http://marychristiefoundation.org/core/uploads/2015/04/Youth-Opioid-Survey-Report.pdf]
+
= Sources =
# [http://learning.wellbeingtrust.org/articles/with-depression-and-suicide-rates-on-the-rise-national-survey-reveals-complex-relationship-between-social-media-use-and-mental-well-being]
 
# [https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/]
 
# [https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/]
 
# [http://journals.lww.com/pain/Fulltext/2016/11000/Why_does_depression_promote_long_term_opioid_use_.2.aspx]
 
# [https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/]
 
# [https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/]
 
# [https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/]
 
# [https://www.theatlantic.com/health/archive/2017/05/is-depression-contributing-to-the-opioid-epidemic/526560/]
 
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Latest revision as of 17:57, 16 October 2021

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Brief Description


Introductory Paragraph

A national study shows that one in five Americans has a mental health issue. In this study, young adults between the ages of 18 and 24, indicated that more than 61 percent of respondents who had used opioids not prescribed to them had done so primarily to relieve anxiety and stress[1].   Early identification, screening, accurate diagnosis, and effective treatment of mental health and substance use conditions can alleviate suffering for individuals and their families dealing with behavioral health challenges. Early access and detection of mental health conditions can expedite recovery, enhance educational and employment opportunities, positively impact relationships, and ultimately improve quality of life.[2]

Mandated screenings for physical health concerns are in place for issues such as vision and hearing. Similarly, early detection of mental health and substance use should occur for young people who may be vulnerable to these issues. These screenings should occur as they do for early detection of physical conditions in venues such as schools, primary health care providers, and other community areas.  Communities should be given the tools and support necessary to identify signs of mental health or substance use issues at the earliest possible time. This position is endorsed by the American Academy of Pediatrics, [3] specifically for depression in youth over age 11, and the United States Preventive Services Task Force [4].  Early detection and screening will reduce the likelihood and consequences of delaying care.

Resources such as access to comprehensive mental health and substance use evaluations should be available to parents and guardians whenever warning signs are observed. [5] Access to adequate care can reduce barriers to learning and improve educational, behavioral, and health outcomes for our youth. The most effective services promote collaboration among all of the people available to help. Pertinent individuals including families, educators, child welfare caseworkers, health insurers, community mental health providers, and substance use treatment providers. Reducing barriers and creating incentives can improve collaboration across systems and funding sources.

In order to improve mental health detection and treatment outcomes, some barriers need to be addressed. Health disparities such as lack of health insurance, cultural factors that discourage mental health treatment, and socioeconomic status need to be addressed to ensure adequate care to all individuals.  Disparities in communities may be a factor in the early diagnosis and treatment of mental health conditions and can increase mental illness challenges in already vulnerable and underserved individuals, families, and communities. [6]

 

 

Key Information

Mental Health and Drug addiction
Mental health and drug addiction are undeniably linked. According to the National Institute on Drug Abuse “Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. Multiple national population surveys have found that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa.” [7] Studies have shown that around 1 in 4 individuals that have a serious mental illness also have a substance abuse disorder.[8] Many people attempt to use drugs to self medicate their mental illness or escape their situation. Understanding mental health is essential to any prevention or recovery effort.

The National Allinace of Mental Illness has indicated in conjunction with SAMHSA and CDC-[9]

1-5 U.S. adults experience mental illness each year[10]
1-20 U.S. adults experience serious mental illness each year[11]
1-6 U.S. youth aged 6-17 experience a mental health disorder each year[12]
50%of all lifetime mental illness begins by age 14, and 75% by age 24[13]
Suicide is the 2nd leading cause of death among people aged 10-34 [14]

Youth are Struggling with Mental Health Issues
A nationwide U.S. survey of over 1,300 14 to 22-year-olds conducted in February and March of 2018 shows evidence of a growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), found that many teens and young adults who were experiencing moderate to severe symptoms of depression utilized online resources for help. Common uses of the Internet included researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent).[15]

Co-Occurring Disorders
Co-occurring disorders, or dual diagnosis, refers to having a simultaneous mental health disorder and substance use disorder. It is common for people with addictions to also suffer from depression, anxiety, or more severe mental illnesses such as schizophrenia or bipolar disorder. Research shows that people who use alcohol or other drugs early in life are more likely to have mental or emotional problems. It’s also true that many people with mental illnesses “self-medicate” with alcohol or other drugs to numb emotional pain, relieve anxiety, or quiet their thoughts. In the past, the medical profession treated one disorder first, typically the substance use disorder, before addressing the other. It is now understood that treating both simultaneously leads to better outcomes. Any successful addiction treatment program will include a mental health assessment and treat co-occurring disorders at the same time.

Depression

  • Because depression is underdiagnosed and untreated, depression and opioid abuse are strongly concurrent.[16]
  • People with depression show abnormalities in the body’s release of its own opioid chemicals[17]
  • Depression tends to exacerbate pain—it makes chronic pain last longer and hurts the recovery process after surgery
  • Depression nearly doubles the risk that someone already using opioids will continue to use them long-term
  • Depression & Opioids
  • Depressed people are about twice as likely as non-depressed people to misuse their painkillers for non-pain symptoms
  • Depressed individuals were between two and three times more likely to ramp up their own doses of painkillers
  • Adolescents with depression are also more likely to use prescription painkillers for non-medical reasons and to become addicted
  • Depressed people are likely to keep using opioids, even when their pain has subsided and when they are more functional 


Stigma & Depression
Stigmatization of depression can reduce the likelihood of people reaching out to get the mental care they need. Instead, depressed people may ask for prescriptions to treat physical ailments, and use these prescription drugs to treat their emotional pain. [18]

Rural Areas
In particular, shortages of mental-health providers are prominent in rural areas where the opioid epidemic hit the hardest. Some have suggested that providing mental health care to those suffering from chronic pain may help detangle the relationship between pain and depression.[19]

Overall, improving detection and treatment of mental health conditions includes improved early screening, assessment, and access to treatment as well as outreach and education in communities.  

Relevant Research

Prevention and early intervention in youth mental health[20]

Early detection of bipolar disorders and treatment recommendations for help-seeking adolescents and young adults: Findings of the Early Detection and Intervention[21]
 

Impactful Federal, State, and Local Policies

SAMSHA Infant & Early Childhood Mental Health Grant[22]

Project AWARE (Advancing Wellness and Resiliency in Education) State Education Agency Grants[23]

Policies surrouding
 Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)[24]
 

Available Tools and Resources

The National Institute of Mental Health[25]
Provides resources on how to find immediate help, health care providers, how to decide if a provider is right for you, how to join a study, and resources to learn more about mental disorders.

The American Academy of Child and Adolescent Psychiatry[26]
Provides a service that helps find child and adolescent psychiatrist throughout America.

SAMHSA Resources for Suicide and Substance Use Prevention in Youth[27]
2017 SAMHSA Webinar on Suicide and Substance Abuse among Young People and includes best practices for prevention and intervention.

SAFE Project Wiki Site- Trauma informed Care[28]

Mental Health America-Mental Health America (MHA)'s work is driven by its commitment to promote mental health as a critical part of overall wellness, including prevention services for all; early identification and intervention for those at risk; integrated care, services, and supports for those who need them; with recovery as the goal.[29]

National Alliance on Mental Illness -NAMI provides advocacy, education, support and public awareness so that all individuals and families affected by mental illness can build better lives.[30]

Mental Health by the Numbers- Mental health awarness[31]

Early Mental Health Screening and Intervention[32]- Intervention and screening across the lifespan[33]

Identifying Mental Health and Substance Use Problems of Children and Adolescents: A Guide for Child-Serving Organizations-This manual offers guidance and tools for identifying mental illness or substance use issues early in children and adolescents in various setting, such as in schools, the juvenile justice and child welfare system, and when receiving primary care.[34]

Promising Practices

Promising Programs
There are a growing number of promising programs for helping to identify and address mental health issues.

Virtual Reality Therapy
Dr. Skip Rizzo has been working since the 1990s to use virtual reality to treat mental illness. [15]In an "early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved."[16]

The Virtual Reality Medical Center uses simulation technologies for:[35]

  • Treating patients with anxiety disorders
  • Training for both military and civilian populations
  • Enhancing various educational programs
  • Benefits of VR Therapy
  • Faster than traditional therapy and desensitization
  • Practice these skills in situations in which you previously experienced anxiety, allowing the skills to generalize more easily to real world settings
  • Can do some sessions in between office session at home, cuts down on the number of sessions people need
     

M3 Checklist (Screening Tool)[36]
M3 Information developed a mental health screen that measures outcomes based on a 27-question diagnostic checklist and a related algorithm targeted for adults aged 18 and older. The M3 Checklist accurately measures outcomes based on question responses for major depression, bipolar disorder, anxiety disorder and posttraumatic stress disorder (PTSD).
 

Project Aware[37]
Project AWARE is a SAMHSA program that focuses on student mental health and wellness, While not specifically focused on opioid abuse prevention, much of the work that grantees are doing may also help prevent opioid misuse. Through Project AWARE, schools are implementing evidence-based, culturally appropriate prevention programs that support youth at the universal, selective, and indicated levels.
 

Communities that Care[38]
Programs such as Communities That Care promote a range of youth mental and behavioral health outcomes, included reduced risk for opioid misuse and addiction. (Find Source)

myStrength[39]
myStrength is a digital platform that integrates state-of-the-art technologies to support people in addressing mental and behavioral health issues. It can be integrated with a professional practice to allow them to see more patients more efficiently and better meet the needs of their patients between in-person visits. Learn more at this recorded Webinar.

Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT) law requires states to provide Medicaid-eligible children regular mental health screenings.[40]

Pediatric Mental Health Access[41]

Comprehensive Case Management for Substance Abuse Treatment[42]

Sources

  1. ^ http://marychristiefoundation.org/core/uploads/2015/04/Youth-Opioid-Survey-Report.pdf
  2. ^ https://www.mhanational.org/issues/position-statement-41-early-identification-mental-health-issues-young-people
  3. ^ AAP Schedule of Screenings and Assessments for Well-Child Assessments (February 24, 2014), https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Updates-Schedule-of-Screening-and-Assessments-for-Well-Child-Visits.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR:+No+local+token
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