Public Health and Mental Health “A Model for Success” Presented by Cynthia Farkas, RNC, MS, FNP...
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Transcript of Public Health and Mental Health “A Model for Success” Presented by Cynthia Farkas, RNC, MS, FNP...
![Page 1: Public Health and Mental Health “A Model for Success” Presented by Cynthia Farkas, RNC, MS, FNP Jefferson County Department of Health & Environment 1801.](https://reader036.fdocuments.us/reader036/viewer/2022082820/56649dbe5503460f94ab270f/html5/thumbnails/1.jpg)
Public Health and Public Health and Mental HealthMental Health
““A Model for Success”A Model for Success”
Presented by Cynthia Farkas, RNC, MS, FNPJefferson County Department of Health &
Environment
1801 19th Street, Golden CO 80401
August 25, 2003
Grant Funded byCaring for Colorado Foundation
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Jefferson County . . . Jefferson County . . . Gateway to the RockiesGateway to the Rockies
• Located west of metropolitan Denver• Suburban, business, industrial, rural and
mountainous communities• Population of 529,401• 95% Caucasian, 5% Other
– 10% Hispanic
• Median Income $57,339 – yet a corridor of poverty is located along the eastern boundary of neighboring Denver County
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Jefferson County Department of Health and Environment
Public health . . . Everyday, Everywhere, Everyone
• Established in 1959 as an organized health department serving all of Jefferson County
• One of 15 local health departments in Colorado
• Mission: To create, promote and enhance health and vitality through innovation, collaboration and celebration
• 4 Divisions: Community Health Services, Environmental Health, Health Promotionand Administration
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Public Health and Mental Health Program Mission
Goals:• provide assessment and identification of
mental health needs and barriers to services
• provide education and brief treatment (1-3 sessions) to clients
• referrals and assistance for individuals and families who are in need of mental health intervention who are uninsured or underinsured
• provide education, training and consultation to JCDHE staff
To address the mental health needs in the population served by the JCDHE clinic, home visitation and community outreach programs.
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The Mental Health Program
• Unique public health/mental health model integrates into JCDHE’s already existing community health services and programs that include nursing services, nutrition, and health promotion services
• Holistic, comprehensive strength-based model aimed at bridging the gap for clients to mental health services in a supportive, non-stigmatizing and accessible manner
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Addressing Addressing Community Need
• Created in response to community’s initial input regarding the need for services
• In the fall of 2000, JCDHE hosted several summits at various sites throughout the county to elicit community concerns and needs
• Public meetings hosted by Caring for Colorado Foundation and Coalition for the Medically Underserved
• Mental health was identified at all of the meetings as one of the major needs within the county that was not adequately addressed
• Continued reductions in funding have resulted in decreases in mental health services in the county
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BackgroundBackground• January 2002, JCDHE awarded a grant from Caring for
Colorado Foundation to develop mental health program within public health setting.
• A Psychiatric Clinical Nurse Specialist with a background in consultation liaison psychiatry was hired into a .5 FTE position in April of 2002.
• Initial budget of $43,535.00
• Role of JCDHE– Grant writing – Site of implementation– Staff provides referrals to program– Provide indirect costs
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How it WorksHow it Works
• Referrals are received from staff on clients in need of mental health assessment, referral, and/or brief intervention
Clients are seen in three clinic sites, at WIC appointments, and during home visits with or without the community health nurse
Telephone screening, intervention, and referral as needed
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Meeting the Needs of Clients
• Culturally diverse, high risk population
• Individuals and families experiencing a great deal of stress and crisis in their lives that affect their ability to utilize health services, improve health practices, and resolve health problems
• Reasons for referrals– Depression/anxiety/postpartum depression– Grief/loss/adjustment reactions – Requiring assistance with referral/follow-up mental health
care/psychotropic medication needs– Family/marital issues– Physical/sexual abuse– Reactions to trauma/PTSD
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Meeting JCDHE Staff Meeting JCDHE Staff NeedsNeeds• Staff Consultation
– increasing awareness of incidence and prevalence of mental health issues with JCDHE client population
– increasing skills to make assessments regarding the need for further mental health evaluation, treatment, and referral
• Monthly mental health consultation/staffings with CHNs, Nurse Family Partnership nurses, EPSDT
• Quarterly meetings with Clinic Nurses and WIC staff and as needed with other
JCDHE groups/teams
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• Monthly Mental Health “Brown Bag” In-services
• Depression and Suicide Assessment• Differentiating Delirium, Dementia, & Depression• Therapeutic Communication• Dealing with Difficult Clients• Postpartum Disorders• Bipolar Disorders• Sexual Assault• Anger and Conflict Management
• Staff benefits• Increased work satisfaction• Boundaries in a therapeutic relationship• Self-care
Meeting JCDHE Staff NeedsMeeting JCDHE Staff Needs
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Barriers Encountere
d• Lack of mental health
services in community; impending budget cuts
• Access to population that is resistive, suspicious, and negative regarding mental health services
• Obtaining feedback on referrals to community mental health services, as clients are transient and difficult to reach
• Mental health resource list; liaison role of MHS; attends Health Care Access Coalition
• MHS collaborates with nurses and other staff, e.g. joint office/home visits
• Nurse and other staff assist with follow-up of clients; client satisfaction survey initiated; collaborate with key partners
Strategies to
Overcome
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Lessons Learned
• Integrating mental health into a public health setting works by reducing barriers to access
• Having an advanced practice nurse in the role of mental health specialist is effective
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First Year Accomplishments
• 87 client referrals – 40 seen in home/office; 47 via phone encounter
• 109 staff consultations - 37 client, 24 staff, and 12 program issues
• 16 group consultations• 24 educational classes at noon• 62 community contacts• Funded for a second year – budget of
$47,815• Program evaluated positively by staff
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Next StepsNext Steps
• Apply for a third year of funding
• Focus on outcome evaluation
• Explore continuation funding in light of the value of MHS has to staff and agency
• Continue to develop liaisons and partnerships with community agencies