Alaska’s ‘Comprehensive Integrated Mental Health Program Plan’ draft released
The Department of Health & Social Services, in collaboration with the Alaska Mental Health Trust Authority, recently released a draft of their 2020-2024 Strengthening the System: Comprehensive Integrated Mental Health Program Plan.
The purpose of the program plan is to provide a blueprint for the creation of a comprehensive integrated mental health program for the state. Specifically, the program plan outlines the objectives and strategies to integrated services for beneficiaries of the Trust, which include Alaskans who experience mental illness, substance abuse, a developmental disability, Alzheimer’s or a traumatic brain injury.
According to the draft, the most significant gaps in the comprehensive behavioral health service system in the state include:
- inadequate number of residential psychiatric facilities,
- a lack of community-based crisis services,
- a need for more intensive levels of residential and outpatient behavioral health services,
- a lack of medication assisted treatment and associated recovery supports to address the opioid crisis,
- a workforce shortage,
- lack of detoxification services,
- and a lack of affordable supportive housing
To address these issues, and to continue developing a comprehensive mental health program, the draft outlines nine different goals.
1. Programs to serve young children promote resiliency, address trauma, and provide access to early intervention services:
Adverse Childhood Experiences (ACEs), such as poverty, abuse, and neglect, can have long lasting effects into adulthood. The objectives of this goal are to promote early screening and intervention services, to provide social-emotional support for children, and to reduce the impact of ACEs through community engagement.
“Preventing adverse experiences during early childhood is key, because it reduces a lifetime of adverse health issues. Effective primary prevention strategies deliver a five to-one return on investment in five years”
2. Improve Alaskans’ access to integrated health care options to promote health and wellness:
The purpose of this goal is to support Alaskans’ overall health by ensuring access and coverage in all geographic areas of the state. Objectives include effectively managing and resourcing Medicaid, and delivering “person-centered health care services.”
3. Ensure Trust beneficiaries have strong economic and social well-being:
In Alaska, there is an employment disparity between Alaskans with disabilities and the general public – in 2017, just 47.9 percent of working age Alaskans with a disability were employed compared to 76.1 percent of Alaskans without a disability.
To improve the economic and social well-being of Trust beneficiaries, the plan recommends supporting programs that provide employment, trainings, and services to support part-time and full-time jobs. It also recommends supporting transition and housing services, and strengthening safety net programs.
4. Provide collaborative and effective treatment/prevention for drug and alcohol misuse:
“Alcohol and substance misuse impacts every community in Alaska. Alaska continues to exceed the national average for alcohol induced deaths, heavy drinking and binge drinking rates. According to the Alaska Behavioral Health Systems Assessment Final Report (2016), approximately one in nine adults or roughly 62,815 adults in Alaska required treatment for an illicit drug or alcohol problem.”
Objectives for this goal include increasing awareness of drug and alcohol misuse, improving treatment and recovery supports such as expanded Medication Assisted Treatment (MAT) options, and supporting prevention and early intervention strategies.
5. Individuals, families, communities, and governments take ownership to prevent suicides and self-harm in Alaska
Alaska’s suicide rate is nearly double the national average (13.99/100,000 in 2016). The strategies for this goal align with the “Recasting the Net” suicide prevention plan for 2018-2022. They include coordinating prevention efforts (such as ensuring that providers and DHSS agencies have training on referral supports and services) and improving the system to assist individuals in crisis (by maintaining Careline services and providing public education on suicide).
6. Ensure Alaskans are free from abuse, neglect, and exploitation:
Objectives for this goal include preventing maltreatment for children and adults, ensuring that individuals understand the role of protective agencies and how to report abuse, and increasing access to protective services across the state.
7. The assessed needs of Trust beneficiaries are met in the least restrictive environment:
The purpose of this goal is to be able to provide support and care in a community setting, work towards a common assessment tool to increase system efficiency, avoid institutional placement, and reduce the number of beneficiaries involved in the criminal justice system.
“Alaska has had a strong progression away from institutional settings and towards serving beneficiaries in their home communities. Receiving services in a least restrictive environment ultimately leads to more meaningful lives, as well as cost efficiencies for state government.”
8. Support beneficiaries in an institutional setting:
A high level of Trust beneficiaries are placed in institutional settings such as the Alaska Psychiatric Institute, the Division of Juvenile Justice facilities, and intermediate care facilities. To ensure these individuals receive the appropriate care, the plan recommends establishing a standard of care, enhancing care coordination, and expanding clinical and case management resources for incarcerated Alaskans.
9. Ensure the state has the workforce capacity, data, and technology systems to support the mental health program plan:
“Without a capable and competent workforce, the continuum of services and care are at risk of not being able to meet the needs of the most vulnerable Alaskans.”
Here, the goal objectives include improving recruitment and retention of the workforce, expanding training and professional development opportunities, advocating for funding for the integrated mental health program, and encouraging a culture of data-driven decision making.
Each goal and objective in the plan includes several potential strategies. The plan is available for public comment through April 12, 2019. The full draft is available here.