Footprints’ Staci Allan Helps Remove Barriers to Mental Health Treatment
Staci Allan, business development officer at Footprints to Recovery, joined forces with Lake Behavioral Hospital to remove barriers to mental health treatment in Lake County and Southeast Wisconsin. Allan, who has worked in the behavioral health field for over a decade and is a long-time advocate for access to life-saving substance abuse and mental health treatment, was asked to participate in an important legislative hearing on March 23, 2020. The hearing sought to change the section of Wisconsin’s Chapter 51 law, which prevents people experiencing an acute psychiatric episode to be transported to an Illinois psychiatric provider, even if that provider is closer. There is precedent, as this cooperative legislation is already in reciprocal laws with Michigan, Iowa, and Minnesota; all of them able to accept Chapter 51 patients from Wisconsin. Allan was asked to join the hearing to advocate for the legislation change. Others in attendance included Illinois Senator Adrienne Johnson; Lake Behavioral Hospital CEO Cindy DeMarco, LCSW; Lake Behavioral Hospital Director of Business Development Charla Waxman, MBA, EdD; and several Wisconsin and Illinois community constituents such as aldermen and mayors. Dr. Waxman, who spearheaded the hearing said, “When they told me to call three people on the other side of the border, Staci was my first call. She has been a great partner at Lake. [She] would not be the only person I could have called, but we have a longstanding relationship in the community, she knows what she is talking about, and she is fair. I knew we would get what we needed.” Allan is well known for her outreach work in the behavioral health field as well as her role with the Illinois School District 21 Board of Education and her campaign work in local elections. “My role and reputation is to discuss access and barriers to treatment and how to remove them legislatively,” said Allan. “Lake Behavioral Hospital is right on the Wisconsin border. If someone is in a psychosis event, sometimes the hospital over the state line might actually be closer than in Illinois. It’s not unusual for someone in Illinois to get caught up in a system they don’t understand.” The need for legislative change became apparent to Lake Behavioral Hospital when they began hearing from concerned fire chiefs in northern Illinois border towns and emergency room professionals in Kenosha and Pleasant Prairie that because of the Wisconsin Chapter 51 mental health commitment law, they couldn’t send Illinois residents back across the border to their home state for inpatient psychiatric treatment, even though Lake Behavioral Hospital is only a 15-to-20-minute ride. Current Wisconsin laws prevent acute psychiatric transport from crossing state lines. Officers and ER employees are often forced to transport Illinois patients as much as one to three hours north in Wisconsin to secure treatment. Many ER workers in Southeast Wisconsin and mental health professionals were also frustrated with the legal barriers that prevented them from sending Wisconsin residents to specialty treatment centers in Illinois, even when they were closer than Wisconsin facilities. For example, patients from the Kenosha and Racine areas would be cared for much closer to their own community when receiving care in Waukegan, Illinois. Lake Behavioral Hospital decided to take the lead in pursuing legislation that would be a collaborative arrangement between Wisconsin and Illinois, allowing facilities in Illinois to accept and treat patients from Wisconsin who are subject to Chapter 51 of the Wisconsin mental health code. Patients could then receive treatment near their own community. The revision would also correct the treatment accessibility issue, regardless of border or state, for Wisconsin residents who would like to choose treatment closer to home even though it may be in Illinois. This new bill would give them access to many treatment providers in northern Illinois counties, not just Lake Behavioral Hospital. “We’re all doing the same job. We’re all in it for the same reason. If we’re a bunch of islands or the relationships are acrimonious at all, nobody benefits,” said Dr. Waxman. “It’s just a different law in Wisconsin, and we want [people] to be able to make their choice. We can provide multiple layers of treatment, but we couldn’t serve that Kenosha involuntary patient without that change.” The legislation change is expected to be approved after a second hearing in which some wording changes will be implemented. “We know many people come in with complicated issues even if they’re involuntary, many times by a substance abuse event,” said Allan. “These efforts solidify the relations we have with not just Lake, but with their entire system. We want to be a good partner in Lake County. We were there as advocates and that was the part that was very appreciated.”
The Role of Telehealth for Addiction Treatment
For some people, telehealth may be a completely foreign concept. While there is nothing wrong with this, one must still do all they can to understand which treatment options work best for them. Telehealth is when technologies like video calling, texting, apps, and web-based live chats are used to treat someone who is outside the realm of the convenience of a doctor’s office or rehab center. However, distinctions should be made between telehealth and telemedicine, although more recently they have been regarded as interchangeable. What Telehealth Options are Available for Substance Use Disorders? There are many telehealth options available to help individuals in addiction treatment. Some of these include the following: Phone-centered Care Video Calling Virtual Reality Texting Mobile Apps Web-centered Care Phone-Centered Care Phone-Centered Care in the realm of addiction treatment is one of the oldest ways of providing telehealth services. Patients are able to talk on the phone with their doctor or medical specialist and interact in real-time with only their voices. Some studies have shown that phone-centered care proves itself to be more effective than traditional methods. Video Calling Video Calling is best described as real-time conference calls on personal laptops, computers, tablets, or any other device that has a camera for the use of live conference calls. With this method of telehealth, patients are able to not only hear their doctor or medical specialist in real-time, but they’re to see them as well. This is good for people who rely on body-language in conversation. Some studies have shown that patients are just as satisfied with a video call as they are with treatment handled in-person. Virtual Reality Virtual reality is a platform in which users immerse themselves in a pre-recorded, 360-degree world in order to simulate a real-life environment. Individuals are able to interact with others as well as the environment surrounding them. This technology has the potential to simulate familiar environments to help people who are struggling with addiction. It is worth mentioning that this sort of technology has not been tested extensively. Texting Being that there are options for video calling and virtual reality, it’s no surprise that texting is another real-time telehealth option. Transferring short messages over a text thread have been known to yield positive results especially in the arena of interventions. Not only that, but this method of communication is relatively inexpensive, and for someone who can do so it makes treatment easily accessible. Mobile Apps Mobile apps are software applications on one’s phone made with the purpose of accessing its functions easily. Apps are also available on tablets. While its convenience cannot be overstated, early analyses have been done and concluded that it is too early to determine whether or not this method is effective. It is worth mentioning however that the more time someone spends using the app the more likely they are to abstain from alcohol, even more than usual care. Research has shown to prove that these apps have resulted in a decrease in drinks per day and in hazardous drinking altogether. Web-Centered Care The good thing about web-centered care is that it doesn’t matter what time of day it is, these applications are able to be accessed on the patient’s own time. These services are accessed over connections to networks. There are many different kinds of web-centered care which makes it so dynamic; all of these different forms of web-centered care have proven themselves to be quite effective when it comes to diminishing alcohol abuse. As far as the different kinds of care on the web are concerned, they are listed as follows: Drinker’s Check-Up (DCU) Therapeutic Education System (TES) Computer-Based Treatment for Cognitive Behavioral Therapy (CBT4CBT) When it comes to alcohol screening, brief intervention, or assessments, DCU has proven itself useful in their clinical trials. TES is different in that it is a community reinforcement approach to substance abuse treatment. This method is module-based and has 65 modules in total for this approach. Not only that but in terms of success, TES has been recognized as comparable to community reinforced approaches delivered by in-person clinicians. The last approach for web-centered treatment is CBT4CBT (computer-based treatment for cognitive behavioral therapy). This type of treatment aims to answer the question of why people act the way that they do. There have been studies done regarding the effectiveness of this type of web-centered care, and the studies concluded that the outcomes for CBT4CBT have been largely positive compared to that of in-person treatment. Telehealth and Behavioral Health Some studies have suggested that the interest in and use of telehealth applications in a few hundred (363) US treatment organizations found that the top three applications being used were as follows: Web-centered screening/assessments – 44.6% Phone-centered support – 29.5% Phone-centered therapy – 28.37% There is an important distinction to remember, however: the difference between interest and actual use. From the times where people seeking help actually followed through the key difference makers were appointment reminders via text, mobile apps for recovery after treatment, and recovery support chats. Some other studies were conducted to understand how telehealth is used by behavioral health providers. Data was gathered from 329 organizations for behavioral health. In this survey, all 50 states within the US were represented. The consensus? Somewhere close to half of those who responded stated their use of telehealth for behavioral health care. It will come as no surprise that psychiatrists use telehealth the most, as well as mental health therapists. The most widely used method was video calling. What’s Good About Telehealth? Addiction treatment is done best when doctors and patients have an established relationship that extends over a long period of time. By participating in telehealth, the method may be more subtle. This is good because it removes any stigma of negativity towards addiction treatment. Most often, psychiatrists are the authorized behavioral health provider when it comes to telehealth. Others who are also authorized include social workers and psychologists. Ironically, addiction counselors have the least amount of authorization. Just
