Dover Health Care Provider Expands Behavioral Health Services for the LGBTQ Community

NEW CASTLE (Feb. 21, 2022) – A Dover primary care office is expanding behavioral health services for LGBTQ individuals thanks to federal grant funding. A Peaceful Place Integrated Care is using the grant to support the addition of a certified drug and alcohol counselor, a licensed clinical social worker, and a peer navigator to help treat patients with substance use disorders and co-occurring mental health issues. The funds also support the use of telehealth to help patients continue accessing treatment.

A Peaceful Place is a minority-owned, woman-owned primary care office run by Ericka Daniel, a psychiatric nurse practitioner and family nurse practitioner. Daniel decided to open a practice that focuses on the unique needs of the LGBTQ population after she completed training in transgender health and non-binary gender education and realized there are few service providers with this specialized knowledge in Delaware.

“I would go to refer patients to LGBTQ-affirming health providers and realized there were hardly any,” Daniel said. “So, I decided to start my own practice.”

Daniel’s office provides primary care and wraparound behavioral health support services. Although she accepts all patients for primary health care, she seeks to create an environment that is especially LGBTQ-affirming. For example, the practice provides gender-affirming hormones for transgender individuals.

The practice also welcomes those who have substance use disorders and those diagnosed with hepatitis C. Daniel prescribes buprenorphine in both the oral and injectable forms, as well as naltrexone and vivitrol.

The Delaware Division of Substance Abuse and Mental Health (DSAMH) oversees the $37 million State Opioid Response (SOR) grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA), the source of the funding for A Peaceful Place. Rick Urey, Chief of Addiction Services at DSAMH, said that partnering with LGBTQ-friendly health care providers is critical to ensuring a pathway for all patients who need treatment for substance use disorders.

“We want anyone who needs treatment services to feel like they have places they can go where they are welcomed and respected,” Urey said. “Having an LGBTQ-friendly primary care office that also offers behavioral health services is a huge asset for our community. Not all health care providers understand how to prescribe medication for opiate use disorders, let alone how to integrate it with the specific health care needs of LGBTQ patients, especially those on hormone therapy.”

Daniel’s decision to integrate behavioral health services with primary care is driven by the frequent co-occurrence of mental health and substance use disorders in the LGBTQ community, as well as first-hand experience with her patients’ needs.

“LGBTQ patients have often suffered a series of traumatic experiences that can have a substantial effect on their physical and mental health,” Daniel said. “Due to perceptions about their lifestyle, it might have been separation, abandonment, and being ostracized by their faith communities. This causes a lot of trauma and people begin to self-medicate to numb that pain, which can lead to addiction and other risky behaviors.”

According to SAMHSA’s National Survey on Drug Use and Health, sexual minority adults are nearly twice as likely as their heterosexual counterparts to suffer from substance use disorder. Moreover, there were huge treatment gaps: less than 14% of lesbian, gay, and bisexual adults with SUD reported not receiving treatment during the 2019 survey. A recent study from the University of Pittsburgh found that nearly 1 in 10 gay/lesbian youth reported a history of heroin use compared to 4.1% of bisexual and 1.1% of heterosexual young people.

Some of the contributing factors to a higher prevalence of substance use among sexual minorities may include social exclusion, physical abuse, rejection by family or community, or other types of discrimination. A widely cited study from the University of Michigan found that LGB adults who have experienced multiple forms of discrimination are four times more likely to experience substance use disorder.

“I don’t want them to have to worry about facing rejection by another health care provider,” Daniel said. “It’s critical that they can have their needs met for their opiate use disorder and/or hormone replacement therapy in a setting that is respectful and nonjudgmental.”

Trust built over time is critical for developing the best health care plans with her patients. “Some patients initially try to hide their addiction from their primary care physician, but when they come to us, we take a holistic approach to talking about their health, and over time they become comfortable talking with me about more aspects of their health,” Daniel said.

When clients faced financial problems, Daniel has applied for the state’s Opioid Impact Fee Fund scholarships to ensure their recovery is not jeopardized. “I’ve used this fund for hotel stays and to pay for utilities for patients who were struggling financially,” she says. The fund, established through Senate Bill 34, was signed into law in 2019 and has been administered by DSAMH. Nearly 600 scholarships for housing, transportation, basic necessities, and other needs have been awarded to date to support the recovery of people with substance use disorders.

“This is a judgment-free zone,” Daniel said of A Peaceful Place. “Everyone has a messy life, so don’t let that stop you from coming in. We just want you to be healthy, to be well, to live how you want to live, according to your own yardstick.”

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Learn more about health care services provided by A Peaceful Place at www.apeacefulplaceintegratedcare.com or by calling 302-264-9436.

If you or a loved one is struggling with substance use disorder, you are encouraged to call DHSS’ 24/7 free and confidential Delaware Hope Line at 1-833-9-HOPEDE or text CONNECT to 55753.

Funding for these initiatives is supplied by grant number 5H79TI083305-02 from the Substance Abuse and Mental Health Services Administration (SAMHSA). The content of this publication does not necessarily reflect the views or policies of SAMHSA or the U.S. Department of Health and Human Services (HHS).


Governor Carney, Lt. Governor Hall-Long Support Veterans Affairs’ Governor’s Challenge on Suicide Prevention

WILMINGTON, Del. – Governor Carney and Lt. Governor Bethany Hall-Long on Wednesday announced their support for the U.S. Department of Veterans Affairs (VA) and Substance Abuse and Mental Health Service Administration’s (SAMHSA) Governor’s Challenge to Prevent Suicide Among Service Members, Veterans, and their Families.

The Governor’s challenge is a national initiative that promotes a coordinated public health approach that focuses on increasing understanding of the issues related to suicide prevention. As advocates, the Delaware team will promote best practices through sharing efforts within and across states while engaging city, county, and state stakeholders to enhance and align local and state-wide suicide prevention efforts.

“Delawareans who commit their life to service give so much to our state and our country, and it can have difficult impacts. We are grateful to the VA for their focus on this issue,” said Governor Carney. “As Governor Markell used to say, Delaware is a ‘state of neighbors.’ We’re always looking out for each other. Delawareans can work together through this important initiative and prevent suicide among at-risk service members, veterans and their families. There is no better advocate for mental health than our Lieutenant Governor Bethany Hall-Long and that’s why I’ve designated her as team leader.”

The Office of the Governor will partner with the VA and Department of Health and Human Services (HHS) SAMHSA through a call to action for state and local communities to implement the National Strategy for the Prevention of Veteran Suicide. Delawareans can work together through this initiative and prevent suicide among at-risk Service Members, Veterans, and their Families (SMVF) using a comprehensive public health approach.

The State of Delaware has already begun to implement suicide prevention efforts, participation in this initiative will allow us to further implement best policies and practices to advance our suicide prevention efforts for Service members, Veterans, and their families by using a comprehensive public health approach. In selecting our state interagency team, careful consideration will be given to identifying individuals who can influence state-level policy development and change. Suicide is a national public health issue that impacts everyone.

“Too often members of our armed services come home with invisible scars and suffer in silence. Tragically, veterans were 20 percent of the United State’s suicides in 2021. As the wife and daughter of veterans, I know firsthand, that we must do better. Access to quality behavioral health services is critical for active-duty members, veterans, and their families.” said Lt. Governor Bethany Hall-Long, Ph.D., R.N. “This partnership between the Veterans Hospital and SAMHSA to implement the Governor’s Challenge greatly advances the efforts of the Delaware Behavioral Health Consortium.  This collaboration will aid in preventing suicide among at-risk members of Delaware’s military community.”

Suicide is the 10th leading cause of death in the United States, and the 11th in Delaware. According to Centers for Disease Control and Prevention (CDC) data, approximately 45,000 people die from suicide each year. Informed and coordinated medical care, coupled with mental health and crisis support services are critical for people showing signs of suicide risk in their thoughts or behavior.

“One life lost to suicide is one too many,” said Vince Kane, Wilmington VA Medical Center Director. “Suicide prevention efforts go beyond the walls of health care and into the communities throughout our state. We are eager to partner with the Governor and Lt. Governors offices as well as joining forces with support from the Delaware National Guard.” 

Both our state and nation owe a debt of gratitude to the men and women who have served in uniform. Helping service members, Veterans and their families find the resources they need is vital to taking care of our community. This will also give us a chance to work with a defined group and to utilize what we learn to help improve our overall approach to suicide prevention.

It is imperative that our Veteran and military communities, service organizations, and community organizations work with the state to plan our approach. The VA has already established a number of pathways for helping Veterans find treatment. These apply for those who get care from the Wilmington VA Medical Center, and those who call the VA’s 24/7 National Crisis Line (1-800-273- 8255 and Press 1) or the Delaware Hope Line (1-833-9-HOPEDE). 

All Delawareans must work together to adopt effective strategies statewide that will help reduce risk among our military communities. As a State, the initiative stands as a call to action: start the conversation and help spread the word to prevent suicide among Veterans.

Click here for more information on the Governor’s Challenge.

If you or someone you know is in need of help, please call the Delaware Hope Line: 1-833-9-HOPEDE

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DHSS Marks Milestone of 100,000 Referrals for Substance Use, Mental Health Services

NEW CASTLE (Jan. 4, 2022) – The Department of Health and Social Services’ (DHSS) Division of Substance Use and Mental Health (DSAMH) has surpassed a milestone of 100,000 referrals through its Delaware Treatment and Referral Network (DTRN), a system for Delawareans seeking substance use and mental health services.

Delaware is the first state to make more than 100,000 referrals using this system, built on the OpenBeds® platform, a bed registry platform owned by Bamboo Health (formerly Appriss Health + PatientPing). The DTRN system identifies and tracks behavioral health and social determinants of health resources throughout the state, giving providers immediate visibility into resource availability across a shared network. This makes it easier to get people the help they need when they need it.

“One death from an opioid overdose or from a mental health crisis is one too many,” said Lt. Governor Bethany Hall-Long, Ph.D., RN. “For families coping with a loved one, who suffers from substance use disorder or mental illness, finding help is an immediate need that must be met. The 100,000 referrals through DTRN demonstrates that we are mending the fractured behavioral health system in Delaware, so people can get access to treatment and on the path to recovery. As Chair of Delaware’s Behavioral Health Consortium, we remain committed to saving lives through platforms like DTRN and the network of behavioral health providers. Newsweek recently recognized Delaware in November 2021 as one of only four states that the CDC reported as having a decrease in the annual percentage rate of opioid deaths. DTRN was a significant tool contributing to this reduction.”

“This milestone represents a systematic improvement in identifying and treating individuals with substance use disorders,” said Joanna Champney, Director of the Division of Substance Abuse and Mental Health. “That is 100,000 times where a pathway to treatment was made available for someone so they didn’t have to end up in the emergency room or worse.”

The Division of Substance Abuse and Mental Health launched DTRN in October 2018 as a way to improve outcomes for Delawareans suffering from a substance use disorder, while coordinating support for accompanying needs for housing, employment, education and other wraparound services. A recent white paper summarizing first-year results showed that the cloud-based network for expedited client referrals to inpatient and residential behavioral health programs generated a 45% increase in treatment referral requests in its first year, while improving rapid acknowledgment of referrals by 25%.

“Open Beds has been a fantastic platform that has provided transparency like never before,” said Steve Beltran, MSN, an RN Nurse Manager for ChristianaCare. “It has allowed us to place our patients in the right level of care faster. And has proven to be an effective method to communicate with care providers and agencies across the state.”

Overdose deaths continue to rise in Delaware, reaching 447 in 2020 (up from 431 in 2019 and 401 in 2018). Of those 447 deaths, 372 (83%) involved the use of fentanyl, a powerful synthetic opioid that is 50-100 times more potent than morphine.

The state’s opioid prescribing rate in 2020 of 45.2 per 100 people is higher than the U.S. average of 43.3, according to data from the Centers for Disease Control and Prevention (CDC).

Lack of visibility for providers in determining current inpatient and residential treatment center capacity can make it challenging to connect clients with appropriate substance use and behavioral health services in a timely manner. Referring physicians and treatment providers often struggle to share client data, admission criteria, and availability. For clients in need, these delays can be dangerous and even life-threatening.

By assisting providers with the onboarding process to encourage adoption of the Delaware Treatment and Referral Network, Delaware expanded the number of active users on its network by 264% in its first year. The referral platform also improved response rates to referral requests, with 65% of receiving organizations acknowledging a client referral within 30 minutes, an increase of 25% since the program’s inception a year prior.

“DTRN has been pivotal in connecting individuals with behavioral health and substance use issues with appropriate providers in an efficient and collaborative manner,” said John McKenna, CEO of Rockford Center. “This technology has substantially improved not only access to treatment for individuals and families, but also has facilitated an enhanced level of communication between the referring agency and our Assessment Center. Whether it’s accepting individual referrals at our front door, or helping our discharging patients get connected to community services prior to leaving our facility, DTRN has assisted in removing barriers and promoted access to a wider range of resources in our state. The system also provides us with critical data that allows us to better understand patient and family needs, engagement in treatment, and potential service gaps.”

“The Delaware Treatment and Referral Network has allowed the Department of Correction to connect individuals in our custody to vital health care services upon their release to the community,” said Department of Correction Commissioner Monroe B. Hudson Jr. “DTRN makes possible a seamless transition to resources like Medication-Assisted Treatment for offenders who struggle with addiction. Simply put, keeping these behavioral and medical health care services in place without interruption saves lives and is helping the DOC and our partners improve reentry outcomes across Delaware.”

If you or a loved one is struggling with addiction in Delaware, call DHSS’ 24/7 Crisis Hotline to be connected to treatment and recovery options at 1-833-9-HOPEDE or visit www.HelpIsHereDE.com or treatmentconnection.com.


Governor Carney, Lt. Governor Hall-Long Announce Community-Based Mental Health Services Fund

ARPA-funded program will provide support for community-level mental health services

WILMINGTON, Del. – Governor John Carney and Lieutenant Governor Bethany Hall-Long on Wednesday announced the creation of a Community-Based Mental Health Services Fund to support the delivery of mental health services in Delaware communities.

The program is funded by the American Rescue Plan Act (ARPA). The federal legislation was supported in Congress by Delaware’s congressional delegation – U.S. Senators Tom Carper and Chris Coons, and U.S. Representative Lisa Blunt Rochester – and signed into law by President Joe Biden on March 11.

Visit de.gov/rescueplan to learn more about how Delaware is investing American Rescue Plan Act (ARPA) funding. 

“Now more than ever, we know the importance of providing access to quality mental health services for Delawareans in need,” said Governor Carney. “This Community-based Mental Health Services Fund will help community health care providers, nonprofits, and faith-based institutions provide those services, and strengthen the communities they serve. Thank you to members of our federal delegation and President Joe Biden for providing these important resources.”

Nonprofit organizations, faith-based organizations, and for-profit providers that provide community-based mental health services in Delaware may apply for funding through the program. Applicants should review Delaware’s Developmental Framework to make Delaware a trauma-informed state.

Click here to view the Community-Based Mental Health Services Fund application.

Applications must be submitted electronically by 6:00 p.m. on January 15, 2022 to be considered for funding.

“This fund provides much needed resources for persons with behavioral health challenges in order to give families access to early intervention and quality treatment to support their loved ones. As a nurse and Chair of the Behavioral Health Consortium, I am committed to making Delaware a leader in providing access to quality behavioral health services to truly help people. This investment is a critical support for our healthcare providers, non-profits and faith-based institutions to deliver services and breakdown stigma,” said Lt. Governor Bethany Hall-Long. “Thank you to our federal delegation and President Joe Biden for their commitment to get Delawareans the help they deserve, and a behavioral health system that works for everyone.”

“Access to affordable, quality mental health services should be available to everyone – no matter their income or zip code,” said Carper, Coons and Blunt Rochester. “Far too often, we focus on the physical symptoms of the pandemic; however, we must not overlook the mental health challenges faced by so many during difficult times. As the pandemic continues to take its toll on our nation and here in Delaware, we are proud of Governor Carney’s commitment to helping all Delawareans get the help that they need.”

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Governor Carney Signs House Bill 100

Legislation expands mental health services in Delaware elementary schools

NEW CASTLE, Del. – Governor John Carney on Thursday signed House Bill 100, which greatly expands mental health services in Delaware elementary schools. The legislation was sponsored by House Majority Leader Valerie Longhurst. 

“Delaware children come to school every day with unique challenges, and we should be ready to support them so they can have their best chance to be successful in the classroom,” said Governor Carney. “We’ll continue to invest in our public schools to make sure all Delaware children get the education they need and deserve. There’s no higher priority.” 

The Governor and bill sponsors have agreed to support technical changes to the bill in January to protect the intent of the legislation and ensure districts use additional funding to hire mental health professionals and support highest-needs students.  

The Fiscal Year 2022 budget includes $8 million to implement House Bill 100. That funding must be used to hire mental health professionals in Delaware elementary schools and cannot be supplanted.

The legislation will be fully funded in Fiscal Year 2024. Starting then, districts can work with the Delaware Department of Education and submit supplantation plans to ensure resources are reaching the highest-needs students.

“For far too long, the mental health of our students has been treated as a secondary need – if even that much. Too many students have slipped between the gaps in our behavioral health network. The truth is, the mental health of our young students is vital to them growing, learning and becoming successful adults,” said House Majority Leader Valerie Longhurst. “HB 100 is a game-changer for our kids. It will establish a mental health services unit for Delaware elementary schools, allowing schools to hire more full-time school counselors, school social workers, or licensed clinical social workers to provide direct care for our youngest learners. By addressing the disparity and shortfall of mental health professionals in elementary schools, we will tackle the stresses and problems children face early, before they become a lifelong issue to overcome. I’m so grateful to Delaware State Education Association for their advocacy and determination to get this bill passed. Without them and so many others’ support, we wouldn’t have been able to achieve a unanimous victory on HB 100.”

“Far too many of young people throughout our state are dealing with real trauma at home, issues often compounded by undiagnosed mental, behavioral, and developmental disorders,” said Sen. Marie Pinkney, the Senate prime sponsor of HB 100. “Left unaddressed, these mental health issues present a real and serious impediment to their education and their lives. We can do better for these young people by making social workers, psychologists, and mental health counselors as commonplace in our schools as nurses have been for generations. Thank you to Governor John Carney for signing legislation today that will provide our districts and our schools with the resources they need to help our young people succeed.”

“This important legislation allows districts to hire the appropriate mental health professionals so that teachers can concentrate on teaching and children can receive the critical services they need,” said DSEA President Stephanie Ingram. “HB 100 helps our youngest students and seeks to end the stigma around mental health.”

Photos from today’s bill signing can be viewed here.

 

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