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Behavioral Health

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									Behavioral Health in Alaska




     Melissa Stone, Director
     DHSS / Behavioral Health
     July, 2007




                                1
Division of Behavioral Health
     “Partners promoting healthy communities”
Mission & Values

   The mission of the Division of Behavioral Health is to manage an
    integrated and comprehensive behavioral health system based
    on sound policy, effective practices and partnerships.

   We respect:
     Honesty

     Dignity

     Innovation

     Diversity

     Collaboration




                                                                       2
Overview

1.   Indicators of serious behavioral health
     conditions and social loss (slides 4-9)
2.   Emerging Trends (slide 10)
3.   Alaska’s response to these problems (maps
     11-12)
4.   Cost of not doing business (slides 13-14)
5.   Cost of doing business (slides 15)
6.   Outcomes of doing business well (slides 16-19)



                                                  3
Percentage of Deaths by Cause Among Alaskans
Aged 14-19 Years 1999-2001 (N=177)


                         Unintentional
                        Injury – motor                                      Unintentional
                            vehicle                                         Injury - other
                             24%                                                 25%

                                                                                   Homicide
                                                                                     6%

                                        Suicide                            All Other
                                         34%                                Causes
                                                                             11%




   National Center for Health Statistics (NCHS), Vital Statistics System
                                                                                              4
Suicide Rates
                          Alaska Native, Alaska Non-Native, and U.S. Suicide Rates
                                                                  1995-2004

                                      Native             Non-Native              AK Rate   US Rate**
           60

           50

           40
    Rate




           30

           20

           10

           0
                  1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
                                                                     Year




 Annual Report to the Legislature: 2006. Statewide Suicide Prevention Council.
                                                                                                       5
Health Risk Behavior of Adults
                               Prevalence of Selected Risk Factors Among Alaska Adults, 2006

          100%

            80%

            60%
                                                   38%
            40%
                          24%         26%
                                                                    17%              21%              17%                       17%
            20%                                                                                                     12%

             0%
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2006 Behavioral Risk Factor Survey. State of Alaska, Department of Health and Human Services.
                                                                                                                                      6
Binge Drinking: Alaska vs. Nationwide

           100%
                                                                                  Alaska
                                                                                  US (Median %)
             80%


             60%


             40%

                      22%
                                                                                              18%
             20%

                      15%                                                               15%

               0%
                       1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
                                                          Year




Behavioral Risk Factor Survey, 2004-2005 Annual Report.
                                                                                                    7
Heavy/Chronic Drinking: Alaska vs. Nationwide


               50%
                               Alaska
                                                          Change in definition
                               US (Median %)
               40%


               30%


               20%


               10%                                                                            5%
                         4%

                                                                                         5%
                 0%      3%
                        1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
                                                                        Year




Behavioral Risk Factor Survey, 2004-2005 Annual Report.
                                                                                                     8
    Statewide Prevalence Estimations of Behavioral
    Health Need

   46,846 Alaskans in households were estimated to have
    serious behavioral health disorders (7.5% of the household population)
   27,582 Alaskans with incomes below 225% of the FPL were
    estimated to have serious behavioral health disorders (11.1% of
    Alaskans in these households)

        This includes 7,818 youths with serious emotional disturbances (8.1% of
         youths)
        And 19,764 adults (13.0% of adults) subdivided into:
             13,374 adults with serious mental disorders (8.8% of adults)
             9,657 adults with substance use disorders (6.4% of adults)
             3,267 adults were estimated to have co-occurring disorders (both a serious mental disorder and
              a substance use disorder) (2.2% of adults)


Synthetic Prevalence Estimations for Alaska Behavioral Health Needs, Findings for 2007, DHSS / Division of Behavioral Health


                                                                                                                       9
                  Emerging Trends: Veterans
Context:
  As of September 30, 2006: Of the 1.4 million US service personnel
   deployed in the Iraq/Afghan conflicts, 631,174 have been discharged (1).
  More than 449,261 have been deployed more than once
  As of May 2007, more than 3,700 service members have died, primarily
   from hostile action
  More than 26,000 troops have been wounded.
Consequences:
  Dept. of Defense is being challenged by two “signature injuries” from
   the current Iraq/Afghan conflicts(2)
      1. Post-Traumatic Stress Disorder
      2. Traumatic brain injury.
  Dept. of Defense reports 38% of soldiers and 49% of all National Guard
   troops upon return have psychological problems
Alaska Impacts:
  Alaska has 17.1% (71,552) of veterans
1. Soldiers Returning From Iraq and Af ghanistan: The Long -term Costs of providing Veterans Medical Care and Disability Benef its, Linda
      Bilmes, Kennedy School of Government, Harvard University
2. An Achievable Mission: Report of the Department of Def ense Task Force on Mental Health, June 2007



                                                                                                                                            10
Comprehensive Prevention, Early Intervention & Treatment Grants




                                                              11
Rural Human Services System Grants




                                     12
                  Societal Costs—United States
     Public programs           (States spent $77.9 billion on criminal justice,
      Medicaid, child welfare, mental health, highways, state payrolls, schools, &
      juvenile justice to deal with substance abuse.)
     Employment                          (500 million lost work days per year attributable to
      alcoholism)
     Cost Analysis       (96 cents of every dollar spent on substance abuse
      goes to shoveling up the wreckage of impairment; 4 cents are spent on
      prevention and treatment)
     Cost per tax payer         (Every American paid $277 per year in taxes to
      deal with consequential burdens of substance abuse; $10 per year for
      prevention and treatment.)
     Cost    (States spent $81.3 billion to deal with substance abuse, which is
      13.1 % of state budgets.)

Treatment of Alcohol and Other Substance Use Disorders, What Legislators Need to Know, National Conference of State Legislato rs. January 2004.




                                                                                                                                                  13
                              Societal Costs—Alaska

In 2003, alcohol and other drug abuse cost Alaska
   $738 million:
 $367 million from productivity losses

 $154 million from criminal justice and protective
   services
 $178 million from health care

 $35 million from traffic crashes

 $4 million from public assistance


Economic Costs of Alcohol and Other Drug Abuse in Alaska, 2005 (“The McDowell Report”), Advisory Board on Alcoholism and Drug Abuse, Department of
     Health and Social Services




                                                                                                                                                     14
DBH Grant Component by Program - Percentage

Program              FY05                  FY06                      FY07              Grand Total

ADA Treatment               25%                      0%                       0%                                            8%

ASAP                         1%                      1%                       1%                                            1%

BH Treatment                13%                    66%                       70%                                          50%

BTKH                         0%                      2%                       2%                                            1%

Consumer                     1%                      0%                       0%                                            1%

EBP                          2%                      4%                       3%                                            3%

FASD                         4%                      0%                       0%                                            1%

Housing                      0%                      1%                       1%                                            1%

MH Treatment                31%                      0%                       0%                                          10%

Mini Grants                  1%                      1%                       0%                                            1%

Multi-Program               14%                    13%                       13%                                          13%

Prevention                   3%                      6%                       6%                                            5%

Prevention RHS               2%                      3%                       3%                                            3%

Prevention Suicide           1%                      0%                       0%                                            0%

Other                        2%                      1%                       1%                                            1%

Grand Total                 100%                  100%                      100%                                         100%



                                   Notes: tbl (1) show s the percentage of each programs funds in relation to the total amount

                                   Data source FY05 FY06 FY07 FMS Grants and Contracts                                      15
 Treatment Outcomes
                                            Positive Outcomes in Life Domains
                                                 Children and Adolescents


                     Productivity


                  Physical Health


       Mental / Emotional Health


      Thoughts About Self Harm

   Family and Social Support For
             Recovery

                    Feeling Safe

      Sense of Connectedness,
      Well Being, and Spirituality

               Financial Security


               Housing Situation


                                 0%   10%     20%     30%     40%     50%      60%     70%     80%   90%   100%
                                                 Percent Improving or Maintaining Quality of Life




The Client Status Review of Life Domains, Findings for FY 2006, DHSS / Division of Behavioral Health


                                                                                                                  16
 What Do Adults Say About Services?

                                          Adult Domain and Overall Scores
                                                              (n=1,104)
                                                  Satisfied    Nuetral     Not Satisfied




             Overall (all domains)                                   80%                                17%     3%


               Positive Outcomes                              69%                                 25%           6%


                 Appropriateness                                     80%                                16%     4%


           Treatment Participation                             70%                                25%           5%


              Access to Services                                75%                                 20%         5%


             General Satisfaction                                    82%                                12%     6%


                                     0%    10%   20%    30%         40%     50%     60%    70%   80%      90%   100%




2006 Behavioral Health Consumer Survey. Division of Behavioral Health

                                                                                                                       17
 What Do Youths Say About Services?

                                Youth Domain and Overall Scores
                                                        (n=374)
                                            Satisfied    Nuetral    Not Satisfied



        Overall (all domains)                            73%                                     21%         6%




          Positive Outcomes                             70%                                 22%              8%




            Appropriateness                               74%                                    22%          4%




      Treatment Participation                          65%                                 26%               9%




         Access to Services                      55%                                 35%                 10%




        General Satisfaction                            69%                                20%           11%



                                0%   10%   20%    30%         40%   50%    60%      70%    80%         90%    100%




2006 Behavioral Health Consumer Survey. Division of Behavioral Health

                                                                                                                     18
 What Do Parents/Caregivers Say About Services?

                                            Families with Children
                                                       (163 responses)

                                           Satisfied    Nuetral      Not Satisfied



       Overall (all domains)                                   80%                                       12%          8%


        Positive Outcomes                              65%                                   22%                 13%


           Appropriateness                                      85%                                             14%        1%


    Treatment Participation                                    82%                                        11%         7%


        Access to Services                               72%                                       20%                8%


       General Satisfaction                             69%                                   19%                12%


                               0%   10%   20%    30%          40%        50%     60%   70%     80%         90%         100%




2006 Behavioral Health Consumer Survey. Division of Behavioral Health

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