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The National Council for Behavioral Health (National Council) is now accepting speaker and topic submissions for NatCon19. If you are interested in presenting, submit a proposal by November 2, 2018.

The selection process is highly competitive and National Council members receive special consideration. The National Council is particularly interested in proposals that:

• Stimulate and provoke discussion and audience engagement.
• Provide diverse approaches via real-life case studies.
• Reflect innovative, cutting-edge content and are outcome-focused.
• Showcase human-centered design.
• Are replicable and inspire action.

Tracks include evidence-based treatments for addictions, mental illnesses and co-occurring disorders; financing and alternative payment models including CCBHCs, population health and integrated care; juvenile and criminal justice; suicide prevention and post-suicide attempt intervention; prevention, early intervention and crisis services; transformative collaborations and trauma-informed care; recovery supports and peer leadership; and workforce and technology solutions – just to name some.

Learn more and submit a proposal with the National Council.

In order to highlight pockets of excellence across the country, the NNED selects an organization to highlight once a month. Sunrise Community Counseling Center has been selected as the Partner of the Month for October in recognition of Domestic Violence Awareness Month and in celebration of National Hispanic Heritage Month (September 15 – October 15).

Sunrise Community Counseling Center (SCCC) is a community-based non-profit substance abuse and mental health counseling center located in heart of the Westlake/Pico-Union community. SCCC has been serving Los Angeles since 1976.

SCCC takes pride in the ability to provide substance use/abuse and mental health prevention and treatment services to the community through a number of programs:

• Behavioral health (mental health and substance abuse) prevention and treatment services including Projecto Nuevo Día/Project New Day for youth and Projecto Creer/Project Believe to create resilience in gay, bi, questioning, and discreet men.
• Domestic violence counseling services in Spanish and English
  
• Culturally sensitive services to respectfully serve individuals with diverse backgrounds and identities

As one of the only agencies in Westlake that provides substance abuse prevention and mental health treatment services in Spanish, SCCC is able to serve the large Latino community in the area. SCCC is staffed with trained and experienced case managers, therapists, social workers, researchers, and administrative personnel that are bilingual, culturally sensitive, and who are fully aware of the dynamics that culture and history play on the experience, satisfaction, and clinical outcomes of clients.

It is SCCC’s belief that immigrants, homeless, low income individuals, all families, youth, adults, and the community at large can experience an enhanced quality of life.

Learn more about SCCC’s work towards their goal of facilitating the healing process through behavioral health services and encouraging clients to continue participating in, and contributing to, the world around them.

View a list of previous NNED Partners of the Month here.

When researchers first discovered a link in the late 1990s between childhood adversity and chronic health problems later in life, the real revelation was how common those experiences were across all socioeconomic groups. But the first major study to focus on adverse childhood experiences (ACEs) was limited to a single healthcare system in San Diego. A study published Monday in JAMA Pediatrics — the largest nationally representative study to date on ACEs — confirms that these experiences are universal, yet highlights some disparities among socioeconomic groups. People with low-income and educational attainment, people of color and people who identified as gay, lesbian or bisexual had significantly higher chance of having experienced adversity in childhood.

The study finds three out of five adults across the U.S. had at least one adverse experience in their childhood, such as divorce, a parent’s death, physical or emotional abuse, or a family member’s incarceration or substance abuse problem. A quarter of adults have at least three such experiences in childhood, which – according to other research — increases their risk for most common chronic diseases, from heart disease and cancer to depression and substance abuse.

“This is the first study of this kind that allows us to talk about adverse childhood experience as a public health problem in the same way we talk about obesity or hypertension or any other highly prevalent population risk factor,” says Adam Schickedanz, an assistant professor of pediatrics at the David Geffen School of Medicine at UCLA, who was not involved in the research. “Up until now, we haven’t really had a study that takes a national look.”

Those identifying as black or Latino and those with less than a high school education or an annual income below $15,000 were more likely to have more ACEs. But a relatively new finding was that multiracial and gay, lesbian and bisexual individuals carried the greatest burden. Multiracial participants reported roughly 2.5 ACEs, and bisexual adults reported 3.1, both the highest scores reported. Women, younger adults, unemployed people and those unable to work also tended to have higher scores.

But Schickedanz cautions that, while the disparities are real, it’s important to recognize how common these experiences are among all people, including white and middle class families. “This [study] shows that ACEs affect people from all walks of life everywhere,” he says.

This new study suggests a need to target prevention resources where they can help most, says Jack Shonkoff, a professor of child health and development at the Harvard T.H. Chan School of Public Health. This also requires identifying what makes some people more susceptible than others to the effects of adversity.

“Nobody is immune to adverse experiences in childhood but for some population groups, they’re a larger burden of childhood adversity than others,” he says. “We need to focus on targeting limited resources to the people at greatest risk and making sure those resources go into programs that reduce or mitigate adversity.”

Doing that will require developing tools to screen for people’s sensitivity to adversity, he says. He also notes that ACEs alone don’t account for health disparities. Genetics play a key role in health outcomes as well, he explains.

“Environmental risk factors are only part of the story. You can’t separate genetics from environment,” Shonkoff says.

To address the consequences of childhood adversity, it will be important to develop programs that help children learn healthy coping mechanisms and strengthen families and communities overall, says Andrew Garner, a clinical professor of pediatrics at Case Western Reserve University School of Medicine in Cleveland.

Read more on NPR.org.

Black men have the lowest life expectancy of any ethnic group in the United States. Much of the gap is explained by greater rates of chronic illnesses such as diabetes and heart disease, which afflict poor and poorly educated black men in particular.

But why is that? Lack of insurance? Lack of access to health care? Now, a group of researchers in California has demonstrated that another powerful force may be at work: a lack of black physicians.

In the study, black men seeing black male doctors were much more likely to agree to certain preventive measures than were black men seeing doctors who were white or Asian.

Although 13 percent of the population is black in the United States, just 4 percent of doctors are black.

The study, published in June by the National Bureau for Economic Research, involved 702 black men in Oakland, Calif., who came to a clinic for a free health screening. They were randomly assigned to a black male doctor or one who was white or Asian.

Neither the men nor the doctors knew that the purpose of the study was to ask if a doctor’s race mattered when he or she advised these patients. As it turned out, the racial effects were not subtle.

Diabetes screening was part of the health check, and 63 percent of the black men assigned to a black doctor agreed to the screening. But just 43 percent of those assigned to a doctor who was white or Asian consented to be screened. Some 62 percent of black men with a black doctor agreed to cholesterol tests, compared to 36 percent assigned to a doctor who was not black.

The men who came to the clinic offered equal praise for their black, white and Asian doctors. But the patients were far more likely to consent to preventive care — screenings and vaccinations — when their doctor was also black.

“I don’t think I have ever had such a strong result, so unambiguous,” said Dr. Marcella Alsan, an associate professor of medicine at Stanford University and an author of the study.

Why would black doctors have such an effect? Perhaps they used more nonverbal cues to communicate empathy, said Dr. Amber E. Barnato, a professor of medicine and health care delivery at Dartmouth College.

In another small study, she used black and white actors to study white doctors’ interactions with patients at the end of life. Although the doctors said similar things to both black and white actors posing as patients, they stood closer to the white patients, made more eye contact, and touched them more often.

In the new study, Dr. Alsan and her colleagues did not record patient visits. But some hints of the differences could be seen in comments the patients and doctors wrote in evaluations of their experiences.

The white and Asian doctors often wrote comments like “weight loss,” “tb test” and “anxiety” — cryptic notations that referred to medical recommendations. The black doctors often left more personal notes, like “needs food, shelter, clothing, job, ‘flu shot makes you sick,’ he got one.” And “subject yelled at me but then agreed to get flu shot because I recommended it.” And “made patient laugh.”

Black men who saw white doctors wrote comments like, “It was a great and fast experience, doctor was great as well.” And “very informative, very appreciated.” Those who saw black doctors wrote comments like, “The entire day made me feel very comfortable and relaxed” and “cool doctor” — comments that described an emotional response.

Bridging this racial divide is a fraught matter, noted Dr. Skinner.

Read more on NYTimes.com.

When Stephen Kemble closed his Honolulu psychiatry practice last August, he tried to match 500 patients with a new psychiatrist.

It was an impossible task — especially for recipients of Med-QUEST, Hawaii’s version of Medicaid.

Kemble found only two psychiatrists in private practice on Oahu who were willing to treat new patients covered by the state’s public health insurance for low-income people. A few of Kemble’s patients got in with these two psychiatrists — but they had to wait up to three months for an appointment, he said.

“The willingness of psychiatrists to take in new Medicaid patients has dwindled to almost nothing,” Kemble said. “Even if you do get in with someone, the doctor has five minutes to renew your prescription and that’s it. I mean, they’re trying, but the psychiatrists don’t even have time to talk to you — they’re totally overwhelmed.”

New data from the University of Hawaii reveals a health system in crisis. In 2017, Hawaii was short more than 750 physicians across the medical field, according to University of Hawaii professor Kelley Withy, who conducts an annual workforce survey. This calculation accounts for differing needs on neighbor islands and the unique demand for medical specialties like psychiatry.

Experts say filling the void is practically impossible, as it would require that the state increase its physician workforce by about 25 percent. Luring new doctors to Hawaii is complicated by myriad factors, not the least of which is the state’s high cost of living coupled with its relatively low rates for insurance reimbursement.

When it comes to psychiatrists, the UH data reveals a 10 percent statewide shortage. The gravest scarcity is on Kauai and Hawaii islands, which are tied with a whopping 33 percent shortage. But surprisingly, the Oahu data shows a slight surplus equivalent to one full-time position.

Withy acknowledges the Oahu numbers, which are based on the national statistics, fly in the face of what she sees first hand: a severe need for psychiatric services that’s not being met — on any island.

“I don’t think our model adequately represents the demand in Hawaii,” Withy said. “Perhaps people in Hawaii are more open to using behavioral health or need more services, but the model does not correspond to the anecdotal need we hear about. Also, many psychiatrists don’t take our public insurance programs, making it extra hard for those individuals, who usually need the services even more due to poverty or disability, to find services.”

Read more on CivilBeat.org.

To have a productive conversation about health equity, we need to get one thing straight: equity is not the same as equality.

Striving for equality alone can actually perpetuate disadvantage. To remedy health disparities, some communities need more—not just equal—resources. Watch this brief illustration from the Robert Wood Johnson Foundation to get clear on equity vs. equality.

Truly attaining the “highest health of all people” starts with embedding fair opportunities for well-being into the whole of community life. The factors affecting health outcomes, collectively known as social determinants of health, include everything from socioeconomic status to the availability of public transport and recreational space—a mix of structural conditions that impact the physical and mental health of individuals and their communities.

Health equity is achieved when our knowledge of social determinants is put toward the cause of eliminating health disparities. But what does a commitment of that magnitude look like, and how can it be fulfilled? Below are three things that anyone wrestling with these questions should keep in mind:

1. Access for all doesn’t mean health for all.

In the U.S., envisioning and enacting systems-wide change requires challenging a long legacy of exclusionary policies, practices and structures that, to this day, derail health improvement for all. When it comes to finding and obtaining health or mental health services, historically marginalized populations know better than anyone that injustice, and lack of opportunity, can persist even in the absence of explicitly discriminatory legislation.

2. Community context matters.

Textbook history is one thing; the true history of a neighborhood or community is quite another. In bringing the intergenerational consequences of social determinants to life, stories of trauma and resilience from the past and present provide a rich, much-needed context for health equity interventions.

3. We’re all in this together.

Without cross-sector collaboration, achieving health equity is impossible. Fragmented systems and services—education, economic development, housing and so on—are far more likely to create disparities than those working in partnership with one another.

Read more on Hogg.UTexas.edu.