The Baton Rouge Area The Baton Rouge Area FoundationFoundationMental Health ResponseMental Health Response

At Risk PopulationsAt Risk Populations• Family of victims; Injured persons Family of victims; Injured persons • Highly exposed survivorsHighly exposed survivors• Rescue/Recovery and First Responders (including health Rescue/Recovery and First Responders (including health

and mental health staffs)and mental health staffs)• People with pre-existing mental health problems/substance People with pre-existing mental health problems/substance

abuseabuse• People with no social supports People with no social supports • People in a low socioeconomic status-no real resources to People in a low socioeconomic status-no real resources to

help themselves help themselves • People of a minority statusPeople of a minority status• And women…especially single parents….And women…especially single parents….

Estimated Target PopulationEstimated Target Population

• Hurricane survivors reported by the Capital Hurricane survivors reported by the Capital Region Planning Committee (Henry Duga) -high Region Planning Committee (Henry Duga) -high estimate 117,711 survivors estimate 117,711 survivors

• 6/6/06 census report-estimated increase in the 6/6/06 census report-estimated increase in the population between 41,302 and 90,000 in the population between 41,302 and 90,000 in the Greater Baton Rouge area Greater Baton Rouge area

• Range 90,000-117,711 in the 5 parishesRange 90,000-117,711 in the 5 parishes• This translates into a targeted population of 5-This translates into a targeted population of 5-

16,000 people (Norris, 2005) potentially in need 16,000 people (Norris, 2005) potentially in need of mental health services of some kind in the of mental health services of some kind in the Greater Baton Rouge AreaGreater Baton Rouge Area

Cognitive Behavioral Cognitive Behavioral Therapy for Postdisaster Therapy for Postdisaster DistressDistress• Intermediate service for sub clinical clientsIntermediate service for sub clinical clients

• Designed to address a range of problemsDesigned to address a range of problems

• 10 sessions-systematic and flexible10 sessions-systematic and flexible

• 3 main sections: psychoeducation, coping 3 main sections: psychoeducation, coping skills and cognitive restructuringskills and cognitive restructuring

• Drawn from empirically validated CBT Drawn from empirically validated CBT

• Used in NY and FL Used in NY and FL

Evaluation and TrainingEvaluation and Training

• Use of assessment/referral tool Use of assessment/referral tool

• Data CollectionData Collection

• Program EvaluationProgram Evaluation

• Training 100 private practitionersTraining 100 private practitioners

• Training 200 public sector providersTraining 200 public sector providers

• Training trainersTraining trainers

• Gate keeper training Gate keeper training

Enhanced Service Enhanced Service ObjectivesObjectives

To create an intervention that is:To create an intervention that is:

1. consistent with the crisis counseling 1. consistent with the crisis counseling guidelinesguidelines

2. evidence-informed and appropriate for a 2. evidence-informed and appropriate for a range of symptoms following a disasterrange of symptoms following a disaster

3. able to be delivered by non-expert trauma 3. able to be delivered by non-expert trauma therapiststherapists

Collaboration and Collaboration and PartneringPartnering• Baton Rouge Crisis Intervention CenterBaton Rouge Crisis Intervention Center• Capital Area Human ServicesCapital Area Human Services• Louisiana State University School of Social Louisiana State University School of Social

WorkWork• Louisiana Chapter-National Association of Louisiana Chapter-National Association of

Social Workers/APASocial Workers/APA• Louisiana Family Recovery CorpLouisiana Family Recovery Corp• Southern UniversitySouthern University• Louisiana Office of Mental Health – LA SpiritLouisiana Office of Mental Health – LA Spirit• Red Cross *Red Cross *

Health Care Centers in Health Care Centers in SchoolsSchools• Schools are organized into clusters based on geography, feeder Schools are organized into clusters based on geography, feeder

schools, and numbers of children with mental health needsschools, and numbers of children with mental health needs• Social workers will have less numbers of schools and work more Social workers will have less numbers of schools and work more

closely with families to provide intense family services when closely with families to provide intense family services when neededneeded

• Common assessment and treatment protocols allows the Common assessment and treatment protocols allows the development of a quality improvement model that benchmarks development of a quality improvement model that benchmarks outcomesoutcomes

• Model is fluid in that social workers can detect trends in Model is fluid in that social workers can detect trends in neighborhoods and adjust service delivery and staffing as neighborhoods and adjust service delivery and staffing as neededneeded

• Each school cluster(s) will have an identified crises team in place Each school cluster(s) will have an identified crises team in place and on call 24/7/365 that will stabilize a family or school if and on call 24/7/365 that will stabilize a family or school if neededneeded

• All mental health staff have access to a psychiatrist for services All mental health staff have access to a psychiatrist for services one day each week for consultation and diagnosis through tele-one day each week for consultation and diagnosis through tele-medicinemedicine

Proposed ModelProposed Model

• Schools are organized into clusters based on geography, feeder Schools are organized into clusters based on geography, feeder schools, and numbers of children with mental health needsschools, and numbers of children with mental health needs

• Social workers will have less numbers of schools and work more Social workers will have less numbers of schools and work more closely with families to provide intense family services when closely with families to provide intense family services when neededneeded

• Common assessment and treatment protocols allows the Common assessment and treatment protocols allows the development of a quality improvement model that benchmarks development of a quality improvement model that benchmarks outcomesoutcomes

• Model is fluid in that social workers can detect trends in Model is fluid in that social workers can detect trends in neighborhoods and adjust service delivery and staffing as neighborhoods and adjust service delivery and staffing as neededneeded

• Each school cluster(s) will have an identified crises team in place Each school cluster(s) will have an identified crises team in place and on call 24/7/365 that will stabilize a family or school if and on call 24/7/365 that will stabilize a family or school if neededneeded

• All mental health staff have access to a psychiatrist for services All mental health staff have access to a psychiatrist for services one day each week for consultation and diagnosis through tele-one day each week for consultation and diagnosis through tele-medicinemedicine

Benefits of the proposed Benefits of the proposed modelmodel• Eliminates duplication of servicesEliminates duplication of services• Maximizes staff time and expertiseMaximizes staff time and expertise• Establishes standardized protocols for assessment Establishes standardized protocols for assessment

and treatment regardless of funding streamand treatment regardless of funding stream• Families with multiple mental health needs have a Families with multiple mental health needs have a

primary social worker who works with the whole primary social worker who works with the whole familyfamily

• Total integration of medical and mental health Total integration of medical and mental health services for children and youth through electronic services for children and youth through electronic medical / mental health recordsmedical / mental health records

• Data driven decision-making Data driven decision-making

Resources neededResources needed

• Five social workers hired (one is supervisor of the Five social workers hired (one is supervisor of the project)project)

• Attract master’s level social work interns through $ Attract master’s level social work interns through $ 3,000 stipends to extend the work of social workers3,000 stipends to extend the work of social workers

• On call crisis teams throughout the cityOn call crisis teams throughout the city• Cell phones and computers with access to the EMR Cell phones and computers with access to the EMR

through the webthrough the web• Travel dollars for movement from school to schoolTravel dollars for movement from school to school• Materials and training dollars to strengthen staff Materials and training dollars to strengthen staff

competencycompetency• Operational, administrative, and clerical support for Operational, administrative, and clerical support for

systemsystem• Estimate of $ 250,000 per year for three years to Estimate of $ 250,000 per year for three years to

implement model and secure sustaining fundingimplement model and secure sustaining funding