Celebrating 10 years of evidence-based practices in Ohio, anticipating the integration of primary and behavioral healthcare

Article Date

December 03, 2010

—by Paul M. Kubek

Cleveland, OH—This season marks the tenth anniversary of the State of Ohio's investment in evidence-based practices for the treatment and recovery of residents with severe mental illness (SMI) or co-occurring severe mental illness and substance use disorders. It also marks the tenth anniversary of the Center for Evidence-Based Practices (CEBP) at Case Western Reserve University, which is a technical assistance organization that provides consultation, training, and evaluation to service systems and organizations that implement these and other best practices.

Both anniversaries were celebrated at the Center's EBP conference, titled "Sustaining Evidence-Based Practices: The Next Ten Years," which took place on October 12, 13, and 14 at the Greater Columbus Convention Center. This year's conference was the ninth sponsored by the CEBP and its Coordinating Center of Excellence (CCOE) initiatives.

KEYNOTE SPEAKERS AND WORKSHOPS

Over 330 people from Ohio and 17 other states attended this year's event, which featured over 60 workshops and three keynote plenary sessions. The keynotes focused on several important topics, including the analysis of the impact of integrated treatment for mental and substance use disorders in Ohio, the use of evidence-based techniques to increase employment among people with SMI, and the national movement to integrate primary healthcare and behavioral healthcare. For descriptions of the keynote plenary sessions and workshops, consult the CEBP's event calendar.

Conference participants came from the following states:

CO, CT, IL, IN, KY, MA, MD, MI, MN, NH, NM, NY, OH, PA, SD, TN, TX, UT

CHAMPION AWARDS

At the conference, the CEBP also presented three awards to individuals and organizations in Ohio for their unwavering commitment to the implementation of evidence-based practices in their communities. The awards and awardees included the following:

Integrated Dual Disorder Treatment (IDDT) Champion Award

This award was presented to Su-Ann Newport, manager of care management at the Alcohol Drug Addiction and Mental Health Services (ADAMHS) Board for Montgomery County. Ms. Newport has been a long-time advocate for integrated treatment. She has been an active, avid, and vocal supporter in her own county and throughout the state.

Supported Employment (SE) Champion Award

This award was presented to Neighboring of Mentor, Ohio, a community-based provider of behavioral-healthcare services. A past recipient of the CEBP's Lynn Goff Spirit of Integrated Treatment Award, Neighboring has earned a reputation for excellence in implementing and sustaining two evidence-based practices and other service innovations. Read more about Neighboring's SE Champion Award from The News-Herald of Lake County (click here). ((DEAD LINK))

The work of the Neighboring staff has been featured in a number stories from the CEBP and its CCOE initiatives over the past several years.

Evidence-Based Practice (EBP) Champion Award

This new award was presented to the Alcohol, Drug & Mental Health (ADAMH) Board of Franklin County for its leadership and innovation in sponsoring a county-wide effort to implement three evidence-based practices in a single initiative. Collaborations among many service systems and organizations made the initiative possible. Four specialty teams implemented the following EBPs simultaneously: Integrated Dual Disorder Treatment (IDDT), Assertive Community Treatment (ACT), and Supported Employment (SE). A service utilization analysis conducted by the Board revealed that consumers who received services from the specialty teams experienced a reduction in psychiatric hospitalization, crisis services, and residential services, which translated into a significant savings for the Franklin County system.

Learn more about this initiative (click here).

10 YEARS: FROM PILOT SITES TO SUSTAINABLE PROGRAMS

At this year's conference, the CEBP continued its tradition of providing opportunities for professional peer-networking among conference participants as a way to disseminate lessons-learned about EBP implementation in local communities. It has been a core component of the CEBP's services since its inception.

The CEBP began in December 1999 when the Ohio Department of Mental Health (ODMH) invested in a pilot implementation of Integrated Dual Disorder Treatment (IDDT), the evidence-based practice. ODMH commissioned the CEBP—through its Substance Abuse and Mental Illness CCOE—to help nine service organizations. ODMH had determined that a technical-assistance organization was necessary to help educate, train, and advise the state's network of psychiatric hospitals and community-based organizations, which were experiencing (and continue to experience) an annual staff turnover rate of approximately 30 percent.

"They wanted a source of constancy in the service system that would support sustainability by providing consulting and training in evidence-based practices," says Lenore A. Kola, PhD, co-founder and co-director of the CEBP and associate professor of social work at the Mandel School of Applied Social Sciences. "It is very difficult for an organization to sustain a level of excellence when three out of ten case managers leave every year. Think about it. An organization invests in teaching the staff how to provide the best treatments available, and in three years, almost nobody from that original cohort is left. A technical-assistance organization like ours not only helps service providers get started with evidence-based treatments, but we also help them adjust to changes and challenges, such as staff turnover."

Co-Director Robert J. Ronis, MD, MPH, the Douglas Danford Bond Professor and chair of the Department of Psychiatry at the Case School of Medicine, adds that the CEBP also helps prevent a "brain-drain" in the State-a phenomenon which occurs when people with experience and knowledge leave the profession and/or move to another state.

"The Center keeps the lessons-learned and other knowledge about implementing evidence-based treatments within the State of Ohio," Ronis says. "In addition, the Center makes that knowledge accessible and available to service systems and organizations in local communities. As a university-based organization, this form of dissemination is an important part of our mission."

Today, the CEBP provides consulting, training, and evaluation for integrated treatment to all of Ohio's state psychiatric hospitals and over 60 community-based organizations. It also provides technical assistance for Supported Employment (SE), the evidence-based practice, to 25 organizations in Ohio and works with staff from 13 of Ohio's Consumer-Operated Services to encourage employment among their participants. In addition, the CEBP provides technical assistance for other EBPs and emerging best practices, such as Motivational Interviewing. It is also beginning to work with hospitals and community health clinics to integrate core components of evidence-based practices and emerging best practices into primary healthcare and other healthcare services.

According to the CEBP's Director of Implementation Services Patrick E. Boyle, MSSA, LISW-S, LICDC, the CEBP has gained a national reputation for its expertise in providing technical assistance for EBP implementation. To date, it has received requests for assistance from policymakers at state and regional authorities and leaders of service organizations, hospitals, community health clinics, and technical-assistance organizations throughout Ohio, 23 other states, and three countries, including The Netherlands.

THE TIMELINE

For more information about significant events in the CEBP's 10-year history, consult the "About Us/ Our History," section of this web site.

THE NATIONAL SCENE

Integrated Dual Disorder Treatment (IDDT) and Supported Employment (SE), the evidence-based practices, were developed and continue to be studied by researchers at the Psychiatric Research Center of Dartmouth Medical School in Lebanon, New Hampshire. The researchers include Robert E. Drake, MD, PhD, Deborah R. Becker, Med, CRC, Gary Bond, PhD, and their colleagues.

The Dartmouth PRC has provided leadership for national implementation of IDDT, via the Substance Abuse and Mental Health Services Administration, and of SE, via the Johnson & Johnson-Dartmouth Community Mental Health Program. The State of Ohio and the Center for EBPs at Case—through its SAMI and SE CCOE initiatives—have participated and continue to participate in these national initiatives.

Listen to and read about the CEBP's interviews with Dr. Drake (click here) and Dr. Bond (click here). ((NEED LINK))