DPH Announces #MyReasonWhyDE Youth Campaign

Dover, DE (Sept. 20, 2022) The Division of Public Health (DPH) is announcing their youth-led #MyReasonWhyDE campaign. #MyReasonWhyDE asks Delaware youth to make short Public Service Announcement (PSA) videos that promote the positive aspects of their lives that keep them happy, healthy, and drug-free, engaged citizens. Using the collective campaign ad model, like the “Got Milk?” ads, #MyReasonWhyDE is featuring the youth in our community as influencers providing a diverse set of “reasons” to choose not to use drugs.

The #MyReasonWhy campaign is part of DPH’s long-term strategy to work with partner organizations in the community and state, such as school systems, to promote resiliency and positive messaging. Youth who are interested in creating a PSA video should visit MyReasonWhyDE.com.

Through federal Substance Abuse & Mental Health Services Administration (SAMHSA) funding, DPH teamed up with The Cause to facilitate a series of four workshops throughout the state to create the summer PSA series to educate youth on Substance Use Disorder (SUD). At the upcoming #MyReasonWhyDE celebration event, DPH will be announcing the PSAs that have met the challenge of communicating information and resources about SUD, as well as highlight the reason why youth have chosen to be drug-free and live positive lives. This event will be held on Sept. 22 at the Bellevue Theater in Wilmington’s Bellevue Community Center, with doors opening at 5:30 p.m. and the live show beginning at 6:00 p.m. All ages are welcome to attend. To register to attend in person, go to https://forms.gle/BZ7sS8TG3bDrngTK9 and to register to attend virtually, go to https://causetheworld.zoom.us/meeting/register/tZAkcu2vrzgoHdcamHl3Q8a6kcXKKX9qjTXF. 

According to the National Survey on Drug Use and Health (NSDUH, 2018-2019), approximately 4% of all people aged 12 and older used an illicit drug (not including marijuana) in the past month in Delaware. Broken down by age, 2.44% of Delaware youth between ages 12 to 17, 6.67% of adults ages 18 to 25, and 3.79% of adults aged 26 and older reported using an illicit drug such as cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine, or misusing prescription psychotherapeutics in the past month.

The 2020 Delaware School Survey (DSS) indicates that 2% of 8th grade students reported use of an illicit drug (other than marijuana) in the past month and 5% within the past year. One in ten students reported misuse of prescription and over-the-counter medication (including pain medication) within the previous year. Yet less than half (46%) of 8th graders reported perceiving a great risk in misusing prescription medication.

It is important to educate our youth and provide alternative choices to drugs. DPH is continuing to look for partners to help grow this message. If interested, contact Katie Capelli at katie.capelli@delaware.gov.

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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.  In New Castle County, call 1-800-652-2929.  Or in Kent and Sussex counties, call 1-800-345-6785.  For free 24/7 counseling, coaching, and support, as well as links to mental health, addiction, and crisis services call the Delaware Hope Line at 833-9-HOPEDE.  To search online for treatment and recovery services in Delaware or nearby states, visit HelpIsHereDE.com.

The Delaware Division of Public Health (DPH), a division of the Delaware Department of Health and Social Services, is a nationally accredited public health agency recognized by the Public Health Accreditation Board for its outstanding dedication to driving change through innovation. DPH is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.


DHSS to Expand Community Well-Being Initiative to Kent County

Goal is to Connect At-Risk Community Members to Substance Use Disorder Services

WILMINGTON (Sept. 19, 2022) – As a way to directly connect community members struggling with opioid use disorder and other behavioral health issues to treatment, recovery and prevention services, the Community Well-Being Initiative (CWBI), which began in 2021 in high-risk areas of New Castle County, will be expanded to serve targeted neighborhoods in Kent County in collaboration with Delaware State University, Department of Health and Social Services (DHSS) Secretary Molly Magarik announced today at a press conference at the Chase Center.

“This is about meeting communities where they are and offering on-the-ground support to neighborhood residents who have been significantly impacted by the opioid epidemic in our state,” Secretary Magarik said. “It is important that we are expanding the Community Well-Being Initiative to Kent County to help address the trauma and toxic stress that community members there experience as well. From the success of the New Castle County pilot, we have seen how important it is for Community Well-being Ambassadors to have lived experience and to reside in the areas they serve.”

The initiative, a partnership between the Department of Health and Social Services’ Division of Substance Abuse and Mental Health (DSAMH) and the University of Delaware’s Partnership for Health Communities, began in 2021 by identifying four ZIP codes in New Castle County – 19801, 19802 and 19805 in Wilmington and 19720 in New Castle – with high rates of fatal and non-fatal overdoses, and high rates of drug arrests. The initiative is funded through the Delaware State Opioid Response (SOR) grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

In the pilot, 24 Community Well-being Ambassadors, who were hired by the nonprofit Network Connect and embedded in the neighborhoods, worked to identify and engage with individuals and families who typically do not seek formal treatment and recovery services for opioid and other substance use disorders. By meeting people where they are, the ambassadors, who work through host sites in the community, were able to build trust with community members. From May 2021 to March 2022, 450 community members engaged with ambassadors, for a total of 2,522 total interactions, including:

  • Engaging people with behavioral health needs when they were ready to engage.
  • Improving coordination across referrals and access to additional social services, including employment, housing and transportation.
  • Providing prevention education and care management for opioid and other substance use disorders, along with support for mental, physical, social and spiritual well-being.
  • Preparing person-centered, peer-supported, long-term treatment support for individuals, families and communities.
  • Building prepared and resilient communities.

The expansion to Kent County will involve Delaware State University as the managing partner of the initiative, along with DSAMH and UD’s Partnership for Healthy Communities. Additional Kent County partners, include Network Connect, Minds in Motion Integrated Behavioral Health, the Center for Structural Equity/Community Intervention Team, GBA Consulting, and the host sites:

  • Delaware Multi-Cultural Civic Organization
  • DSU Biomedical, Behavioral and Allied Health Center
  • DSU-Downtown
  • Two additional sites (pending)

“Delaware State University is elated to be a managing partner for such a phenomenal initiative. The Community Well-being Initiative aligns with our university’s core values and mission,” said Dr. Gwendolyn Scott-Jones, Dean of DSU’s Wesley College of Health and Behavioral Sciences. “This behavioral health integration and 21st-century case management model of service delivery executed by Network Connect is a monumental approach to addressing health disparities, psychological crises, substance-related disorders, mental health disorders and identifying social determinants that can help us better understand and improve health inequities. More specifically, the partnership with DSAMH, UD, Network Connect and other community partners is a way forward to provide a service integration model that will help people in their environments.”

“We are grateful to Delaware State University for being the managing partner of the Community Well-being Initiative in Kent County,” said Rita Landgraf, Director of the University of Delaware’s Partnership for Healthy Communities. “The strength of the Community Well-being Initiative is about the diversity of partners coming together, including the communities themselves, to support residents and families who aren’t used to seeking treatment for substance use disorder. The value of promoting health equity is critical to both UD and DSU, as is the experience of being an innovation incubator, piloting new ideas, evaluating how projects work, and learning what will provide that collective impact in our communities.”

The expansion in Kent County will involve ZIP codes – 19901, 19902, 19904 and 19934 – that have high rates of fatal and non-fatal overdoses and high rates of drug arrests. The initiative, which began with Network Connect hiring staff in August 2022, will launch this fall in the communities and be staffed by 16 Community Well-being Ambassadors (CWA) and two CWA Program Coordinators.

“At DSAMH, we are excited to collaborate with so many community partners, including DSU, to embed ambassadors in these at-risk neighborhoods in Kent County,” said Division of Substance Abuse and Mental Health (DSAMH) Director Joanna Champney. “The Community Well-being Ambassadors have lived experience and provide support directly to community members in their communities. They help individuals and families identify their most pressing needs, provide relevant information, and develop strategies for addressing those needs, including a connection to behavioral health and other community services and ongoing support. Ambassadors also are trained in administering naloxone, a medication that can reverse an opioid overdose, and they distribute naloxone and other critical overdose prevention knowledge in the communities where they work.”

In the continuing New Castle County pilot, the 24 Community Well-being Ambassadors and two CWA Program Coordinators are embedded in neighborhoods and integrated with these host sites:

  • Center for Structural Equity
  • Game Changers
  • Hilltop Lutheran Neighborhood Center
  • Network Connect
  • West End Neighborhood House
  • Youth Empowerment Center

Lt. Governor Bethany Hall-Long, Chair of the Behavioral Health Consortium, said the Community Well-being Initiative and the Ambassador program are helping to facilitate two of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) goals under the State Opioid Response grants: to expand opioid use disorder/stimulant use disorder treatment engagement strategies and reduce barriers to accessing treatment, as well as to create a greater strategic focus on racial and ethnic populations in SAMHSA’s investments.

“As we saw in the targeted outreach in New Castle County and now in the expansion into Kent County, the Community Well-being Initiative is about promoting equity,” Lt. Governor Hall-Long said. “In order to encourage more community residents to seek treatment for substance use disorder, we need to have Community Well-being Ambassadors who live in the communities, collaborating with trusted community partners and building trust with the people they serve. This is another important way that we are building a stronger and healthier Delaware for more of our residents.”

“Our ambassadors really focus on everyday life skills,” said Cierra Hall-Hipkins, Co-Founder and Co-Executive Director of Network Connect. “They have people come to them with real-life situations that they, too, experienced themselves and they are able to be peer connectors – life coaches, so to speak – for everyday folks in our community. It’s a game-changer.”

In 2021, Delaware reported 515 overdose deaths, an increase of more than 15% over 2020, according to the Delaware Division of Forensic Science (DFS). In Kent County, overdose deaths increased 74% from 50 in 2020 to 87 in 2021. DFS also reported that 425 of the 515 deaths involved fentanyl, a synthetic pain reliever that is 50-100 times more potent than morphine.

 


In Another Likely Consequence of Pandemic, Delaware Overdose Deaths Increase 15% in 2021

Division of Forensic Science Annual Report Finds Fentanyl Still Involved in More Than 80% of Deaths; Cocaine Link on the Rise

NEW CASTLE (May 24, 2022) – In what health officials fear is another consequence of the uncertainty associated with the COVID-19 pandemic, Delaware’s overdose deaths increased more than 15% in 2021 to a record high 515, according to the Delaware Division of Forensic Science’s annual report.

The Division of Forensic Science also reported 425 of the 515 deaths involved fentanyl, a synthetic pain reliever that is 50-100 times more potent than morphine. The percentage of total overdose deaths in 2021 involving fentanyl (82.5%) declined seven-tenths of a percentage point from 2020. The DFS report found a substantial increase in overdose deaths that involved cocaine, with the powerfully addictive stimulant found in 221 of the 515 individuals who died, an increase of almost 9 percentage points from 2020.

“Our worries about the impact that COVID-19 would have on Delawareans already struggling with substance use disorder appear to be borne out by the Division of Forensic Science report on overdose deaths,” said Department of Health and Social Services (DHSS) Secretary Molly Magarik. “At DHSS, we will continue to prioritize such harm-reduction strategies as training more loved ones to use Narcan, the medication that can reverse an opioid overdose, and to help more people in getting connected to the treatment they need to begin their recovery.”

To help Delawareans cope with stress and address behavioral health needs during the coronavirus pandemic, DHSS’ Division of Substance Abuse and Mental Health launched the 24/7 Delaware Hope Line – a single point of contact where callers can connect to a variety of resources and information, including support from clinicians and peer specialists plus crisis assistance. For support, Delawareans can:

  • Reach the free Hope Line at 1-833-9-HOPEDE or 1-833-946-7333.
  • Get behavioral health tips and reminders by texting DEHOPE to 55753.
  • Search for treatment services and resources in Delaware or nearby states at DHSS’ one-stop website, HelpIsHereDE.com.

Joanna Champney, director of the Division of Substance Abuse and Mental Health (DSAMH), urged individuals in active substance use to consult with a medical provider immediately or to call the Delaware Hope Line to be connected to trained crisis professionals who can discuss treatment options. “The COVID-19 pandemic increased stress in people’s lives, negatively impacted mental health, and isolated people from services,” she said. “Coupled with the availability of illegal fentanyl, this created a very dangerous situation.”

“DSAMH is funding expansions of the continuum of care for substance use treatment services in each county – from withdrawal management to residential treatment, from outpatient treatment to sober living recovery residences,” Champney added. “For people who are uninsured or underinsured, the State will fund their treatment services. We’re also funding mobile treatment services and we have transportation services available. We want to reduce as many barriers to health care as possible.”

In its annual report for 2021, the Division of Forensic Science reported 515 overdose deaths, an increase of 15.2% over the 447 deaths reported in 2020. The 515 deaths by county:

  • New Castle County: 334
  • Sussex County: 94
  • Kent County: 87
    Of the 515 total deaths, 348 involved males (68%) and 167 involved females (32%). By race and ethnicity, 72% of the individuals who died were white (372); 24% were Black (122); 4% were Hispanic (20); and 1 was Asian.

The age category with the highest number of deaths was 31-40 with 144 (28%). The remaining age groups ranked by number of deaths:

  • 41-50: 128 deaths (24.9%)
  • 51-60: 115 deaths (22.3%)
  • 61 or older: 64 deaths (12.4%)
  • 21-30: 60 deaths (11.7%)
  • 10-20: 2 deaths (0.4%)

Champney encouraged anyone who is using substances or suffering from addiction to call for help, see a medical provider, or ask a police officer or another first responder for help. “Too many times, our police officers, EMTs and other first responders see first-hand the dangers of overdoses,” she said. “Our first priority is to save lives. If you or someone you know is ready to get help, we invite you to walk into one of our Bridge Clinics for an assessment, or go to TreatmentConnection.com to find out which treatment providers are located near you.”

Under Delaware’s 911/Good Samaritan Law, people who call 9-1-1 to report an overdose and the person in medical distress cannot be arrested for low-level drug crimes.

Division of Public Health (DPH) Director Dr. Karyl Rattay urged those in active use to obtain Narcan, which is available through many sources including at participating pharmacies – where no prescription is required – at a DSAMH bridge clinic, during a Narcan training session, or through DPH’s Mail Order Naloxone program. The mail order program is free and available to anyone with a mailing address in Delaware requesting it as a private citizen through https://nextdistro.org/delaware

“Narcan saves lives,” Dr. Rattay said. “We urge anyone who is actively using illicit substances, as well as their family and friends, to have Narcan on hand, and be trained in how to use the overdose-reversing medication. Additionally, we encourage Delawareans to download OpiRescue Delaware, a smartphone app that provides lifesaving step-by-step instructions on how to respond to an overdose, including administering Narcan.”

To find training or distribution events, a participating pharmacy, or the Bridge Clinic in your county, go to HelpIsHereDE.com, and click on the overdose prevention tab.

In addition, Dr. Rattay praised Brandywine Counseling and Community Services’ Syringe Services Program, which provides outreach statewide. Brandywine Counseling’s mobile sites offer Narcan, fentanyl testing strips, and syringe services, and have a positive track record of connecting people to care for substance use disorder.

The Division of Substance Abuse and Mental Health’s Bridge Clinic locations and hours:

NEW CASTLE COUNTY

DSAMH Central Office

14 Central Ave.

New Castle, DE 19720

24/7

302-255-1650

New Castle County Hope Center

365 Airport Road

New Castle, DE 19720

Mon-Fri: 8:30 a.m.-9:30 p.m.

Sat-Sun: 8:30 a.m.-6:30 p.m.

302-544-6815

KENT COUNTY

James W. Williams State Service Center

805 River Road, Third Floor

Dover, DE 19901

Mon-Fri: 8:30 a.m.-4 p.m.

302-857-5060

SUSSEX COUNTY

Thurman Adams State Service Center

546 S. Bedford St.

Georgetown, DE 19947

Mon-Fri: 8:30 a.m.-4 p.m.

302-515-3310


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.”

• • •

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).


Mental Health Parity Examinations Find Inequities in Insurer Behavior

More than $1.3M in total fines assessed for coverage discrimination

Insurance Commissioner Trinidad Navarro has announced the completion of additional Mental Health Parity examinations on regulated health insurers in Delaware. These violations resulted in $735,000 in fines and significant insurer corrections to create a less discriminatory environment in the future. Combined with two examinations completed in 2020, Delaware’s largest health insurers have been fined a total of $1,332,000 for not treating mental and behavioral health care equally to other forms of needed care. A high number of violations was expected as these final reports complete the first round of assessments by the department.

“Every person should be able to seek the care they need without undue expense or difficulty, and that remains true whether the person is seeking care for a physical ailment, or a mental one,” said Commissioner Navarro. “The thorough examinations conducted by the Department of Insurance highlight many needed improvements to ensure parity, and we will continue to work to bring these corrections to fruition and to hold insurers accountable.”

Mental Health Parity laws, which exist both at the state and federal levels, aim to eliminate coverage discrimination between policyholders seeking mental illness or substance abuse care and those seeking physical care. A lack of parity can prevent a person from pursuing needed care due to cost or limited access, or otherwise make it more expensive or more time intensive than medical visits. Department examinations are critical to uncovering parity issues as consumers may not be aware if they are experiencing disparate treatment.

“We have been working toward a more just healthcare system over the past decade, and mental health parity has been a key solution to the issues of access and affordability that plague our communities,” Commissioner Navarro shared on an American Health Law Association podcast.

Throughout the examination processes, instances where parity was violated included placing greater limits on the coverage of medicines for an insured during the diagnosis and treatment of mental illness or substance dependency than for covered services provided in the diagnosis and treatment of any other illness or disease covered by the health benefit plan. Insurers imposed Non-Quantitative Treatment Limitations (NQTL) prior authorization requirements more stringently to mental and behavioral health benefits than to medical/surgical benefits and thus created barriers and delays to treatment. Companies excluded mental health-related medications in their cost-saving programs for policyholders, and placed these medications on formulary tiers that resulted in members who take those pharmaceuticals facing higher copays compared to other medications offered in lower tiers.