MENTAL HEALTH FIRST AID IN EASTERN OREGON - Eastern Oregon Healthy ...
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MENTAL HEALTH FIRST AID IN
EASTERN OREGON
A Program of the Eastern Oregon
February 2019
Healthy Living Alliance
Alanna Chamulak, Program Coordinator
John Adams, Executive Director
Funding for the project is provided in part by the Ford Family Foundation, The Collins Foundation, and
the Oregon Office of Rural Health.
Eastern Oregon Healthy Living Alliance, PO Box 1230 Lakeview, OR 97630
jadams@gobhi.net (541) 219-0907MENTAL HEALTH FIRST AID IN EASTERN OREGON MENTAL HEALTH FIRST AID IN EASTERN OREGON A PROGRAM OF THE EAS TERN OREGON HEALTHY LIVING ALLIANCE BACKGROUND The Mental Health First Aid (MHFA) and Youth Mental Health First Aid (YMHFA) courses are community education, training, and referral programs. They train community members how to identify, understand, and respond to individuals who may be experiencing signs of a mental illness or other substance use disorders. “First aid” is then administered to support and to connect those individuals to the appropriate care. MHFA and YMHFA programs are included within the National Registry of Evidence-based Practices and Programs. The course is eight-hours, typically completed in one day. Participants are able to speak freely, ask questions without fear of judgement, practice the skills they are taught through a wide range of activities and are provided with a manual that is theirs to keep and use as a reference in the future. MHFA also address the stigma associated with mental illness and works to combat the negative connotations surrounding those that struggle with mental health and substance use issues. The target population of the program is public educators, law enforcement agencies, individuals working with older adults, and other public and social service employees in the 12 county Eastern Oregon Coordination Care Organization (EOCCO) region. EOHLA offers the Adult MHFA course, Public Safety module, Older Adult module, and the YMHFA course. MHFA instructors attend a 40-hour training course to become certified to teach the course. They are mental health professionals, have lived experience with mental health issues, support a loved one with mental health issues, or any combination thereof. There is an additional 40-hour course to become certified to teach YMHFA. EOHLA utilizes a combination of an employee that is trained in all of the aforementioned courses and modules, as well as trainers from collaborating agencies and independent trainers across the state. NEED Oregon has the highest prevalence of mental illness among youth and adults in the nation [1]. Mental health was identified by the EOCCO as a priority area in the Regional Community Health Improvement Plan with a goal of improving the skill sets of residents of EOCCO to recognize and seek treatment (or encourage others) for mental health issues [2]. The EOCCO region includes the 12 most eastern counties in Oregon. Adult Within the EOCCO region, high percentages of individuals self-report depression or other mental health symptoms; however, they fail to seek the appropriate care. Based on a household survey distributed throughout each county within the EOCCO, 28% of respondents indicated that within a recent two week period they felt bothered by little interest or pleasure in doing things and 26% indicated that they felt bothered by feeling down, depressed, or hopeless. Whereas, only 7% of respondents indicated that within a 6-month period there was a need to seek mental health or substance use treatment.
MENTAL HEALTH FIRST AID IN EASTERN OREGON Additionally, the 2007-2011 suicide death rates are higher than the state average in 9 of the 12 EOCCO counties and significantly higher in several counties [2]. Adult MHFA is the standard training course provided to the general adult population. It teaches the skills needed to reach out and provide initial support to someone who may be developing a mental health illness or substance use problem and help connect them to the appropriate care. Participants of the Adult course have included homeless shelter volunteers, medical workers, Forest Service staff, and general community members. Youth According to the 2017 Oregon Healthy Teens Survey, when asked, “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?” 30% of 8th graders and 32% of 11th graders answered yes [3]. Oregon Student Voice, a student-led organization, found through a state wide survey of 42 schools that 40% of students listed mental health resources as the most important issue facing their school. Yet 33% of students were not aware that their school offered mental health services of any kind and of the students that are aware of the resources, only half believe they are easily accessible [4]. The Youth course, taught to adults that work with youth, teaches the skills needed to effectively reach out to and provide initial support to adolescents (ages 12-18) who may be developing a mental health illness or substance use problem. Participants of the Youth course have included teachers, paraprofessionals, school volunteers, youth mentors, parents, and community members that work with youth. Public Safety Nearly 1 in 4 police officers thinks of suicide at some point in their life [5]. Public safety employees face high rates of physical, mental, and emotional stress on a daily basis. Almost 10% of all police calls involved someone with a mental illness in 2014 [6] and 1.2 million individuals living with mental illness are in jail and prison each year [7]. The Public Safety module focuses on the unique experiences and needs of public safety personnel and is a valuable resource that can make a difference in their lives, their coworkers and families lives, and the communities they serve. Participants of the Public Safety module have included law enforcement officers, corrections officers, jail staff, dispatchers, other first responders and support staff. Older Adult The Older Adult module focuses on the unique experiences and needs of adults over the age of 65. Older adults face many life changes and this module discusses the specific risk factors faced by older adults such as chronic health conditions, a breakdown of psychosis, dementia and delirium, how to communicate effectively with those who need help while using respectful language, and how to combat the stigma around substance-related problems in the older adult population. Participants of the Older Adult module have included senior center staff, community health workers, assisted living and nursing home staff and volunteers, and caretakers.
MENTAL HEALTH FIRST AID IN EASTERN OREGON
GOALS
The primary goal of this program is to improve the skill sets of residents and public employees of the
EOCCO region to recognize mental health issues and support access to care. We aim to improve
connection to care for individuals who experience mental illness.
Project objectives are to provide 30 trainings to between 450 and 600 individuals within the target
population during the project period, averaging between 15-20 participants per training. 95% of
individuals that participate in the classes will pass the trainings and 90% of participants will indicate a
self-reported confidence in their ability to identify individuals experiencing mental illness and
substance use disorders and refer them to the appropriate care. 20% of individuals will report utilizing
their MHFA skills by making a referral to care.
By training respected and trusted public employees who regularly interface with the community, we
can provide new and increased avenues for individuals with mental illness and substance use disorders
to connect with support programs and services. Adverse life events that can lead to costly crisis
situations can be reduced or avoided by providing these trainings to a wide range of individuals across a
community.
OUTCOME
A total of 30 trainings in 11 counties have been completed, including 7 Adult, 7 Public Safety, 13 Youth,
and 3 Older Adult. 453 individuals participated in the trainings and 99% became certified Mental Health
First Aiders. Post-training evaluations filled out immediately after completion of the training show 81%
of individuals reported an increased confidence level in their ability to identify individuals experiencing
mental illness and substance use disorders, and refer them to the appropriate care.
Number of Trainings Held per County
Public Older
County Adult Youth Total
Safety Adult
Baker 2 2
Gilliam 1 1
Grant 2 1 1 4
Harney 1 2 1 4
Lake 2 2 1 5
Malheur 1 1
Sherman 1 1
Umatilla 4 4
Union 1 2 3
Wallowa 2 1 3
Wheeler 1 1 2
7 13 7 3 30
To further assess program effectiveness, surveys are being sent to course participants at six months and
one-year post training. Thus far, six month post-training surveys have been sent to 312 individuals.MENTAL HEALTH FIRST AID IN EASTERN OREGON
There has been a 21% response rate and 93% of respondents report that they feel the information and
skills they learned from the MHFA or YMHFA training they attended has been helpful in their work or
personal life. 15% of participants have reported making 48 referrals to care and 22 of those referrals
have resulted in a known connection to care. Of the referrals made, 27 were by a participant of a Public
Safety module, 9 were by a participant of a Youth course, and 7 were by a participant of an Adult
course.
Number of Individuals Certified Per County
County Adult Youth Public Safety Older Adult Total
Baker 33 33
Gilliam 12 12
Grant 50 18 27 95
Harney 19 46 6 71
Lake 36 26 3 65
Malheur 7 7
Sherman 11 11
Umatilla 60 60
Union 13 7 28
Wallowa 29 8 19 48
Wheeler 15 4 19
122 210 109 16 449
STRENGTHS
A primary strength of the program has been the ability to build off of existing partnerships when
scheduling and coordinating trainings. Strong partnerships with Greater Oregon Behavioral Health, Inc.
(GOBHI) and Mental Health First Aid Oregon have been invaluable in providing support to the program
by assisting in coordinating courses and finding instructors. 20 of the 30 completed trainings have been
coordinated with the assistance of GOBHI staff. Establishing new community partners through carrying
out the courses has also been beneficial for the program. These new partnerships have allowed us to
broaden our reach and certify more individuals in MHFA across the state.
The responses and information gathered by the post-training surveys have been instrumental to the
advancement of the program. We are able to use this information to assess program effectiveness and
provide feedback for instructors and our partners. Respondents are able to remain anonymous so that
they feel comfortable providing truthful responses. The thoughtfulness and genuine interest in learning
new skills and applying them to professional and personal situations of participants is encouraging for
instructors.
ROOM FOR IMPROVEMENT
A challenge during the course of the program was connecting with and coordinating trainings with
individuals that work with the older adult population. Only three older adult trainings were conducted,
with only 16 participants becoming certified in the Older Adult module across three counties. Factors
that contributed to this challenge are that many individuals that work with older adults work longMENTAL HEALTH FIRST AID IN EASTERN OREGON hours and are not available to attend trainings and many are volunteers that use their free time to volunteer with older adults and are not available to attend a full day of training. Gathering even more post-training survey responses is an area that we will continue to improve. The feedback we are receiving is extremely beneficial to the program and we would like to expand upon that. In attempt to increase survey responses, an incentive will be offered for respondents of the one- year post training survey. WHAT’S NEXT? EOHLA will continue to provide MHFA and YMHFA trainings in the 2019 calendar year with additional funds being carried over from the previous project period. EOHLA has set a goal of providing one training in each of the 12 counties of the EOCCO. The target population will continue to be public educators, law enforcement agencies, individuals working with older adults, and other public and social service employees. We will focus on providing future trainings in areas that have not already received training or to target populations that were not previously trained in an effort to continue to certify new individuals. We will continue to search for additional funding to provide more than 12 additional trainings. Existing partnerships are being utilized to coordinate courses, and we will continue to forge new relationships with organizations we have not previously worked with. Mental health is a priority for the EOCCO region and Oregon as a whole. It is clear through interactions with course participants that there is a need and a want for continued education and training around mental health issues. EOHLA is dedicated to supporting state wide and regional goals by continuing to provide MHFA and YMHFA trainings. References 1. Oregon State Health Assessment. Oregon Health Authority. 2018. 2. Community Advisory Council Needs Assessment. 30 Jun. 2016. Eastern Oregon Coordinated Care Organization. 9 Jan. 2019. 3. Oregon Healthy Teens Survey. 2017. Oregon Health Authority. 9 Jan. 2019. 4. Smiley, Dana. “The Need for Improved Mental Health Resources in Oregon’s Schools.” 2018. Oregon Student Voice. 9 Jan. 2019. 5. Centers for Disease Control and Prevention Report. National Alliance on Mental Illness. 2009. 6. Rath, Arun. “When Cop Calls Involve The Mentally Ill, Training Is Key.” All Things Considered. https://www.npr.org/2014/06/14/322008371/when-cop-calls-involve-the-mentally-ill-training-is-key. 14. June. 2014. National Public Radio, Inc. 9 Jan. 2019. 7. “Access to Mental Health Care and Incarceration.” Mental Health America. http://www.mentalhealthamerica.net/issues/access-mental-health-care-and-incarceration. 9 Jan. 2019.
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