Solutions Summit Behavioral Health Forum sets priorities for change

Saturday morning, about 100 people braved the rain to come to the War Memorial Building and discuss ways to improve behavioral health in Baltimore in the first of three forums leading up to OSI’s Solutions Summit on December 10.

Baltimore City Health Commissioner Dr. Leana Wen gave the official welcome at the forum, laying out three elements to improving behavioral health in Baltimore: 1. Save lives using Naloxone and other interventions, 2. Change the language around addiction, and 3. Go beyond the stories and challenge our leaders to come up with policy and funding. “We must fund behavioral health the same way we fund treatment for other diseases,” she said. “We know what works.”

After that, attendants broke into small groups to discuss potential solutions to improve the behavioral health system in four categories: Care Coordination and Integration, Stigma Reduction, Provider Capacity and Consumer Access, and Housing and Recovery Support Services.

Mixed in with the discussions were presentations from artists whose work touches on behavioral health issues, including Phylicia Ghee, Nether, Carolyn Ann Watts, and spoken word artist Kondwani Fidel, who got a standing ovation after performing “Memory,” a piece about growing up in a household deeply affected by addiction.

After several rounds of discussion and debate, attendees used mobile phones to vote on the 10 solutions that they most wanted to see the new mayor and City Council act on (because of a tie, they ended up with 11 solutions). These 11 solutions will be presented at the Solutions Summit on Dec. 10, along with the solutions voted on at the Criminal and Juvenile Justice Forum (Oct. 22) and the Jobs Forum (Oct. 29).

Here are the 10 solutions that were selected during the forum, in order of popularity:

1. Increase the efficacy of the city’s Crisis, Information, and Referral (CI&R) helpline by: (1) staffing the line with peer specialists with lived experience, (2) training helpline staff in stigma reduction and referral procedures, and (3) launching a communications campaign to increase the public’s awareness and utilization of the helpline.
2. Coordinate and launch a communications and public awareness campaign aimed at normalizing substance use disorders, changing public perception of people dealing with addiction to reduce stigma, and educating the public about treatment and recovery options.
3. Conduct a full landscape scan of treatment and service providers throughout the city, including eligibility requirements, insurance types accepted, levels of care, services available, and number of people served annually. Include in this landscape scan service gaps by provider type, level of care, and geography. Publish this inventory in print and online, and create a mechanism to ensure that information in the inventory is verified and updated regularly. Ideally, create an online platform with live, continuously updated data on available treatment slots and program capacity.
4. Behavioral Health System Baltimore should develop a training program to train local behavioral health providers on: (1) how to reduce bias and stigma within their programs and (2) how to effectively advocate to decision-makers about the needs of those in or in need of treatment.
5. Develop a training program to educate both new and veteran physicians and other front-line medical professionals on substance use disorders, their treatment options, and prescribing guidelines to reduce stigma against people dealing with addiction and the overutilization of addictive pain medications. Explore possibilities of requiring such training for city physicians and other practitioners as part of their continuing education and incorporating it into medical school curricula.
6. Advocate for fair, non-discriminatory zoning standards that permit outpatient and residential programs to locate in communities under the same standards as other medical services.
7. City leadership should coordinate and launch appeal to the State to strengthen standards and regulations regarding intensive outpatient programs (IOPs) and inpatient/residential programs. A central piece of this advocacy should be involving consumer feedback into program evaluation.
8. Create a funding model that uses discretionary funds to support case management and peer recovery specialist services in order to provide wraparound and care coordination services to meet consumers’ needs.
9. City leadership should coordinate and launch an appeal to Congress and the Centers for Medicaid and Medicare Services to bring coverage for substance use disorders in Medicare into parity with other medical benefits, covering all levels of care and settings of care, including opioid treatment programs and all licensed practitioners. As part of this advocacy, explore partnering with the American Association of Retired Persons (AARP) and other advocacy groups for the elderly and persons with disabilities to coordinate advocacy on Medicare coverage for substance use disorder treatment and services.
10. Implement a city ordinance banning discrimination against individuals engaged in treatment or recovery, including individuals using prescribed medications to treat substance use disorders, in all areas, including housing, benefits, and recovery support services. For areas not amenable to intervention at the city level, such as the state criminal justice system, launch a coordinated advocacy campaign to change policy at the state level to prohibit discrimination against this group.
11. Increase access to sustainable funding and providing technical assistance to help improve the quality of services (including data collection and outcome tracking) and sustainability.