True or False: Three out of four patients with schizophrenia report substance use. 

True!

A review of electronic medical records of patients with schizophrenia spectrum disorders in a community teaching hospital’s psychiatric unit found that more than three-quarters used substances such as tobacco and cannabis. Researchers presented their findings in a poster at the virtual 2021 American Psychiatric Association Annual Meeting.

Among patients with schizophrenia, 62.3% used tobacco, 41.5% used cannabis, 40.2% used alcohol, and 27.4% used cocaine. In patients who reported using tobacco, unadjusted odds ratios were 7.24 for comorbid alcohol use, 5.00 for cocaine use, 4.62 for synthetic cannabis use, and 2.80 for cannabis use, according to the study. Multivariate analysis results supported the findings.

Posted on 6/17/2021 Quiz: Do Three Quarters of Patients with Schizophrenia Report Substance Use? (hmpgloballearningnetwork.com)

With that information, one would hope that the behavioral health providers would do a better job at treating dual diagnosis individuals. Often families of loved ones that have serious mental illness and substance use disorders hear that the person needs to get sober before mental health treatment can be effective. However, they are also then told that the person is too ill to be in the substance use treatment because of their serious mental illness. Kind of a Catch 22 situation. Treatment needs to address both illnesses.

The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with the Behavioral Health System attendees. This month, come hear about Assertive Community Teams (ACT). We have Mercy Care discussing ACT teams and checkbox items and measurements. We have both Valleywise and CopaHealth describing their ACT team services.

Dr. Darling is the current medical director and psychiatrist for the Valleywise Health Assertive Community Treatment program. She has been in this role since graduating from her psychiatry residency in 2017. She is core faculty with the Creighton University Arizona Health Education Alliance Psychiatry Residency Program and faculty with the departments of psychiatry at The University of Arizona College of Medicine Phoenix, Mayo Clinic College of Medicine and Science Phoenix, and Creighton University College of Medicine. Dr. Darling completed her undergraduate education in psychology at Arizona State University in 2004. She then worked in case management for the outpatient SMI system in Maricopa County before attending medical school at Midwestern University Arizona College of Osteopathic Medicine. She completed her psychiatry residency training at Maricopa Integrated Health System in 2017. During her residency, she served as the chief resident for two years and was the Arizona Psychiatric Society resident of the year in 2017. Dr. Darling is board certified by the American Board of Psychiatry and Neurology, with a primary focus on treating refractory serious mental illness. In addition to her clinical work, Dr. Darling trains Creighton Alliance PGY3 psychiatry residents, hosts Creighton Alliance family medicine residents during their psychiatry rotation, and supervises 4th-year medical students on psychiatry rotations. She teaches two didactic courses for the Creighton Alliance residents, covering community resources for PGY1 residents and advanced psychopharmacology for PGY3 and PGY4 residents. Dr. Darling is involved in mentoring current residents and received the Howard E Wulsin Excellence in Teaching Award from the Arizona Psychiatric Society in 2022.

Dr Winona Z Belmonte, MD, is a board-certified psychiatrist.  She is the Asst Medical Director for ACT Services and Chief Psychiatrist for Metro Clinic of Copa Health. She is a product of the University of Virginia   Health Systems at Charlottesville, Virginia, where she graduated in psychiatric medicine with subspecialty/fellowship training in geriatric psychiatry.   She accepted a position to serve the full spectrum of psychiatric practice in the rural underserved areas of Virginia for three years. Challenging as it was, the experience galvanized her knowledge and acumen in clinical work and deepened her passion to provide the best service to those struggling with mental illness.  This passion took her to Phoenix, where she saw an opportunity to provide services in an environment where a team-based approach to care is alive.  She has served under multiple RBHA in Maricopa County since 2005 in various capacities but mostly as chief psychiatrist of clinics and Assertive Community Treatment psychiatrist. She was the first Medical Director of People of Color Network.  She is a dedicated psychiatrist with extensive experience in complex psychopharmacology and complicated social determinants of health issues.  

Blythe FitzHarris, P.h.D., LCSW is the Chief Clinical Officer at MercyCare and is responsible for clinical program development, including Adult and Children’s Systems of Care and the Central Region Behavioral Health Crisis System. Blythe oversees multiple Mercy Care service delivery systems, including integrated care, the Office of Individual and Family Affairs (OIFA), grant services, cultural diversity, and tribal affairs. She directs initiatives, strategies, and programs to address social determinants of health (such as housing and employment) and system performance. Blythe also oversees coordination of care with system stakeholders such as the Arizona Department of Economic Security and the Arizona Department of Justice and works closely with system advocates. She works across the organization to address member, family, provider, and/or contractor concerns to ensure positive clinical outcomes, care coordination, and quality service delivery. Previously, Blythe served as the Adult Systems of Care Administrator for Mercy Care. In this position, Blythe oversaw the Adult SMI System of Care, which included outpatient behavioral health services, Assertive Community Treatment, housing, rehabilitation, and employment services for members in Maricopa County and parts of Pinal County. She also served as Mercy Care’s lead for the Arnold v. Sarn settlement agreement. Blythe has more than 30 years of experience working in public behavioral health in a variety of clinical and operational positions and has taught social work at the university level.   Blythe is a licensed clinical social worker and has a master’s in social work and a Ph.D. in social welfare with a focus on mental health and recovery from Arizona State University.

Topic: ACMI Stakeholder’s Meeting

Time: June 6th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2023,

July 11th, 2023, 04:00 PM – Population Health- interventions for high Utilizers, Dr. Mike Franczak

August 1st, 2023, 04:00 PM Dental- Brighter Way, Kris Volcheck

Sept 12th, 2023,  04:00 PM Hom Inc

Please download and import the following iCalendar (.ics) files to your calendar system.

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Join Zoom Meeting

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Meeting ID: 863 1776 0372

Passcode: 795774

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        +1 301 715 8592 US (Washington DC)

Meeting ID: 863 1776 0372

Passcode: 795774

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Secure residential
Secure residential

Introduction:

Serious mental illnesses can be highly debilitating, affecting individuals’ ability to function in society and diminishing their quality of life. It is imperative to recognize the significance of secure facilities as essential tools for providing comprehensive care to those suffering from such conditions. By establishing secure facilities that prioritize treatment, insight, and rehabilitation, we can empower individuals with serious mental illness to gain invaluable insight into their conditions and facilitate their successful reintegration into the community. In this essay, we will explore the compelling arguments supporting the need for secure facilities as vital components of mental healthcare.

Safe and Controlled Environment:

Secure facilities offer a structured and controlled environment, ensuring the safety and well-being of individuals with serious mental illness. These environments provide a supportive framework to prevent self-harm, protect patients from external harm, and maintain a stable routine conducive to healing. By removing external stressors and triggers, secure facilities allow individuals to focus solely on their recovery journey, ultimately enhancing their chances of gaining insight into their illness.

Comprehensive Treatment and Rehabilitation:

Secure facilities are uniquely equipped to provide comprehensive treatment and rehabilitation programs tailored to the specific needs of individuals with serious mental illness. These facilities often employ a multidisciplinary approach involving psychiatrists, psychologists, therapists, and other mental health professionals. Through evidence-based therapies, medication management, counseling, and skill-building workshops, individuals can develop coping mechanisms, increase self-awareness, and acquire essential life skills. This comprehensive treatment approach empowers individuals to manage their conditions effectively and take steps towards reintegrating into the community.

Insight into Illness:

Secure facilities create an environment that encourages self-reflection, insight, and understanding of one’s mental illness. Through therapy sessions, group discussions, and educational programs, individuals can gain a deeper understanding of the causes, symptoms, and impact of their condition. This insight is a crucial stepping stone towards accepting their illness, embracing treatment, and making informed decisions about their recovery journey. By fostering self-awareness and providing psychoeducation, secure facilities empower individuals to actively participate in their own healing process.

Stigma Reduction and Community Reintegration:

Secure facilities play a pivotal role in combating the stigma surrounding mental illness and fostering community reintegration. By providing individuals with the tools to manage their conditions, secure facilities empower them to challenge societal misconceptions and stereotypes. The supportive environment within these facilities allows patients to practice and develop social skills, rebuild relationships, and establish a support network. As individuals gain insight into their illness and demonstrate progress, they are better equipped to reintegrate into the community, fostering understanding, empathy, and acceptance among society at large.

Long-term Benefits and Cost-effectiveness:

Investing in secure facilities for serious mental illness yields long-term benefits and is a cost-effective strategy for society as a whole. By providing intensive treatment and support, these facilities can reduce the frequency and severity of relapses, emergency room visits, and hospitalizations. As individuals gain insight, acquire coping skills, and reintegrate into the community, they are more likely to become productive members of society, contributing to the workforce, and reducing reliance on disability benefits. Furthermore, the overall economic burden of untreated mental illness, including lost productivity and increased healthcare costs, can be mitigated through early intervention and comprehensive treatment within secure facilities.

Conclusion:

The establishment of secure facilities for individuals with serious mental illness is an essential aspect of a compassionate and effective mental healthcare system. By providing a safe and structured environment, comprehensive treatment, insight into illness, and opportunities for community reintegration, secure facilities empower individuals to reclaim their lives and realize their full potential. Investing in these facilities not only benefits the individuals themselves but also society as a whole, promoting well-being, reducing stigma, and fostering a more inclusive and understanding community.

Thank you to those who could attend our May 2nd Stakeholder’s meeting.

Rachel Streiff, Dr. Robert Laitman, and Dr. Ann Mandel presented.

Below are the links to the webinar and slides:

Webinars – Association for the Chronically Mentally Ill (ACMI) (acmionline.com)

Downloads – Association for the Chronically Mentally Ill (ACMI) (acmionline.com)

Please join us for our next informational event on June 6th, 2023, at 4 PM AZ time. Experts will be discussing Assertive Community Treatment teams. (ACT)

ZOOM ACCESS INFORMATION:

https://us02web.zoom.us/j/86317760372?pwd=MUJLZnl3cTFqSDRrbllmOUI0Sk82Zz09

Meeting ID: 863 1776 0372 . . . . . . . . Passcode: 795774

One tap mobile +16699006833,,86317760372#,,,,*795774# US (San Jose)

Dial by your location +1 669 900 6833 US (San Jose)  + 1 253 215 8782 US (Tacoma)

The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with attendees with the Behavioral Health System.

This month, come hear about Innovations in Clozapine Therapy with SMI advocate Rachel Streiff and special guests Dr. Robert Laitman and Dr. Ann Mandel.

Dr. Robert Laitman practices internal psychiatric medicine in New York City alongside his wife, Dr. Ann Mandel Laitman, and is a co-author of “Meaningful Recovery From Schizophrenia and Serious Mental Illness with Clozapine: Hope and Help.”

Rachel Streiff is a chemical and biomedical engineer who became an advocate for families struggling with Serious Mental Illness after a member of her own family achieved recovery.

…………………………………………………………………………….

Topic: ACMI Stakeholder’s Meeting

Time: May 2nd,, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2023,

June 6th, 2023, 04:00 PM

July 11th, 2023, 04:00 PM

August 1st, 2023, 04:00 PM

Please download and import the following iCalendar (.ics) files to your calendar system.

Monthly: https://us02web.zoom.us/meeting/tZIudu6vqDspHdaOPI66YyVO1EYY3UYrWtCI/ics?icsToken=98tyKuGurTotHdKVsx6FRpwAA4j4KO3wpmJegqdcsy_MVXZqezXZZ8d7C-FKKcrn

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Meeting ID: 863 1776 0372

Passcode: 795774

One tap mobile

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        +1 253 215 8782 US (Tacoma)

        +1 346 248 7799 US (Houston)

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        +1 929 205 6099 US (New York)

        +1 301 715 8592 US (Washington DC)

Meeting ID: 863 1776 0372

Passcode: 795774

Find your local number: https://us02web.zoom.us/u/kc1xiBw0Jl

The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest to discuss a relevant Behavioral Health topic; after the speaker, we will discuss current issues with attendees with the Behavioral Health System.

This month hear from Dr. Shar Najafi-Piper (CEO) and Michaela Statt (VP of Outpatient Services) Copa Health to discuss (a) Copa’s array of services, (b) its corporate culture, and (c) your questions.

Dr. Shar Najai-Piper

Dr. Najafi-Piper has distinguished herself as a licensed psychologist and clinical executive over the past 17 years. Throughout her career, she has served as a behavioral health technician, outpatient counselor, team lead clinician, program/executive director of outpatient clinics, vice president of outpatient services, and president of quality care centers and behavioral services.

…………………………………………………………………………….

Michaela Statt

Michaela has a Bachelor’s Degree in Psychology and a Master’s Degree in Social Work from ASU. Throughout her career, she found her niche in healthcare administration and operations. She has worked at Copa Health for over nine years in a variety of roles, including Clinical Coordinator (East Valley Campus), Clinical Director (West Valley/Wickenburg), Site Administrator (Arrowhead Campus), and most recently, Director of Health Information Management (Brookstone).

Topic: ACMI Stakeholder’s Meeting

Time: April 4th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December 25th, 2023,

May 6th, 2023 04:00 PM

June 6th, 2023 04:00 PM

July 11th, 04:00 PM

August 1st, 04:00 PM

Please download and import the following iCalendar (.ics) files to your calendar system.

Monthly: https://us02web.zoom.us/meeting/tZIudu6vqDspHdaOPI66YyVO1EYY3UYrWtCI/ics?icsToken=98tyKuGurTotHdKVsx6FRpwAA4j4KO3wpmJegqdcsy_MVXZqezXZZ8d7C-FKKcrn

Join Zoom Meeting

https://us02web.zoom.us/j/86317760372?pwd=MUJLZnl3cTFqSDRrbllmOUI0Sk82Zz09

Meeting ID: 863 1776 0372

Passcode: 795774

One tap mobile

+16699006833,,86317760372#,,,,*795774# US (San Jose)

+12532158782,,86317760372#,,,,*795774# US (Tacoma)

Dial by your location

        +1 669 900 6833 US (San Jose)

        +1 253 215 8782 US (Tacoma)

        +1 346 248 7799 US (Houston)

        +1 312 626 6799 US (Chicago)

        +1 929 205 6099 US (New York)

        +1 301 715 8592 US (Washington DC)

Meeting ID: 863 1776 0372

Passcode: 795774

Find your local number: https://us02web.zoom.us/u/kc1xiBw0Jl

Sign up in support of SB1710 Arizona State Hospital (ASH), governing board, and governance, which is being heard on Monday, March 13th, 2023, at 2:00 pm in House Room HHR 4.

To request to speak, follow the process indicated in this manual RTS (azleg.gov)

Note: you must sign up for an account initially in person at the Capitol using the kiosk. After you sign up initially in person, you can subsequently submit comments and request to speak online.

The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest that will discuss a relevant Behavioral Health topic; after the speaker, we will have discussions with attendees on current issues with the Behavioral Health System.

Housing in Arizona for SMI & GMH/SA- What are the plans for the H2O waiver implementation? AHCCCS plans for Housing

David Bridge is the Special Needs Program Administrator for the Arizona Department of Housing. He will talk about the H2O waiver which addresses housing for homeless and General Mental Health/ Substance Use (GMH/SU) and Serious Mental Illness (SMI) members. Also, what is the H2O waiver?

Alex Demyan, Interim Assistant Director, Arizona Health Care Cost Containment System (AHCCCS), and Elizabeth da Costa, Housing Program Administrator, Arizona Health Care Cost Containment System (AHCCCS) will answer questions that were pre-submitted:

  • What are the goals for this H2O waiver?
  • Can you talk about what the current need is for housing units of various types?
  • Can you talk about the current and predicted number of vouchers?
  • How is Hom Inc related to this initiative, will they manage the transitional housing as well?
  • How will people waiting for housing be prioritized for housing?  
  • What is the plan to get the people Permanent supportive housing (PSH) after the six months of transitional housing ends?
  • If someone gets six months of transitional housing and then does not get PSH are they again eligible if they become homeless for another six months of transitional housing?

This is an important topic as we believe housing is an essential part of healthcare.

Topic: ACMI Stakeholder’s Meeting

Time: March 7th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December, 25th, 2023,

April 4th, 2023 04:00 PM

May 6th, 2023 04:00 PM

June 6th, 2023 04:00 PM

July 11th, 04:00 PM

August 1st, 04:00 PM

Please download and import the following iCalendar (.ics) files to your calendar system.

Monthly: https://us02web.zoom.us/meeting/tZIudu6vqDspHdaOPI66YyVO1EYY3UYrWtCI/ics?icsToken=98tyKuGurTotHdKVsx6FRpwAA4j4KO3wpmJegqdcsy_MVXZqezXZZ8d7C-FKKcrn

Join Zoom Meeting

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Meeting ID: 863 1776 0372

Passcode: 795774

One tap mobile

+16699006833,,86317760372#,,,,*795774# US (San Jose)

+12532158782,,86317760372#,,,,*795774# US (Tacoma)

Dial by your location

        +1 669 900 6833 US (San Jose)

        +1 253 215 8782 US (Tacoma)

        +1 346 248 7799 US (Houston)

        +1 312 626 6799 US (Chicago)

        +1 929 205 6099 US (New York)

        +1 301 715 8592 US (Washington DC)

Meeting ID: 863 1776 0372

Passcode: 795774 Find your local number: https://us02web.zoom.us/u/kc1xiBw0Jl

The first Tuesday of each month from 4-6 pm Arizona time, except for holiday weekends, ACMI will have a featured guest that will discuss a relevant Behavioral Health topic; after the speaker, we will have discussions with attendees on current issues with the Behavioral Health System.

Housing in Arizona for SMI & GMH/SA- What are the plans for the H2O waiver implementation? AHCCCS plans for Housing

David Bridge is the Special Needs Program Administrator for the Arizona Department of Housing. He will talk about the H2O waiver which addresses housing for homeless and General Mental Health/ Substance Use (GMH/SU) and Serious Mental Illness (SMI) members. Also, what is the H2O waiver? Alex Demyan, Interim Assistant Director, Arizona Health Care Cost Containment System (AHCCCS), and Elizabeth da Costa, Housing Program Administrator, Arizona Health Care Cost Containment System (AHCCCS) will answer questions that were pre-submitted:

  • What are the goals for this H2O waiver?
  • Can you talk about what the current need is for housing units of various types?
  • Can you talk about the current and predicted number of vouchers?
  • How is Hom Inc related to this initiative, will they manage the transitional housing as well?
  • How will people waiting for housing be prioritized for housing?  
  • What is the plan to get the people Permanent supportive housing (PSH) after the six months of transitional housing ends?
  • If someone gets six months of transitional housing and then does not get PSH are they again eligible if they become homeless for another six months of transitional housing?

This is an important topic as we believe housing is an essential part of healthcare.

Topic: ACMI Stakeholder’s Meeting

Time: March 7th, 2023 04:00 PM Arizona

Every month on the First Tuesday until December, 25th, 2023,

April 4th, 2023 04:00 PM

May 6th, 2023 04:00 PM

June 6th, 2023 04:00 PM

July 11th, 04:00 PM

August 1st, 04:00 PM

Please download and import the following iCalendar (.ics) files to your calendar system.

Monthly: https://us02web.zoom.us/meeting/tZIudu6vqDspHdaOPI66YyVO1EYY3UYrWtCI/ics?icsToken=98tyKuGurTotHdKVsx6FRpwAA4j4KO3wpmJegqdcsy_MVXZqezXZZ8d7C-FKKcrn

Join Zoom Meeting

https://us02web.zoom.us/j/86317760372?pwd=MUJLZnl3cTFqSDRrbllmOUI0Sk82Zz09

Meeting ID: 863 1776 0372

Passcode: 795774

One tap mobile

+16699006833,,86317760372#,,,,*795774# US (San Jose)

+12532158782,,86317760372#,,,,*795774# US (Tacoma)

Dial by your location

        +1 669 900 6833 US (San Jose)

        +1 253 215 8782 US (Tacoma)

        +1 346 248 7799 US (Houston)

        +1 312 626 6799 US (Chicago)

        +1 929 205 6099 US (New York)

        +1 301 715 8592 US (Washington DC)

Meeting ID: 863 1776 0372

Passcode: 795774 Find your local number: https://us02web.zoom.us/u/kc1xiBw0Jl