Improvement, Innovation & Integration

Wednesday, September 17 - Friday, September 19, 2008

Pre-Conference Institutes: Tuesday, September 16 & Wednesday, September 17, 2008

Location: Duluth Entertainment Convention Center

Sponsored by: Minnesota Association of Community Mental Health Programs, Inc.
 

Who Should Attend?
Mental health professionals Health & human services staff Psychologists & social workers Psychiatrists & nurses Marriage & family therapists Practitioners & psychotherapists Hospital-based staff Community support & Rule 36 staff Clinical directors & supervisors	CEOs & board members Financial staff & administrators Teachers & special ed providers School psychologist & social workers Managed care organizations County social services staff Case managers Consumers & advocates And others

Conference Interest Areas
Conference tracks are like “mini-conferences” within the conference.
Conference tracks for clinical, management and administrative support staff include:

• Child & adolescent clinical skills
• Reimbursement & service development
• Best practices & program sharing
• Statewide policy & planning
• Personnel & professional development
• Community support services for people with serious & persistent mental illness
• Clinical & rehabilitation services
• Community psychiatric services
• Public policy & advocacy

Conference Schedule
Tuesday, September 16, 2008
9:00 am	Registration for Institute
9:30 am-5:00 pm	Pre-Conference Institute
Wednesday, September 17, 2008
8:00 am	Registration for Institute
8:30 am-11:30 am	Pre-Conference Institute
10:00 am-1:00 pm	Registration for Conference
1:00 pm	Welcome & Opening Session
2:45 pm-5:30 pm	Concurrent Breakout Sessions
5:30 pm	Welcome Reception
Thursday, September 18, 2008
8:30 am	Plenary Session Speaker
10:00 am-12:30 pm	Concurrent Breakout Sessions
12:30 pm-2:00 pm	Banquet & Awards Luncheon
2:00 pm-5:15 pm	Concurrent Breakout Sessions
6:00 pm	Optional Group Dinner & Social Activity
Friday, September 19, 2008
8:30 am-11:15 am	Concurrent Breakout Sessions
11:20 am	Closing Session Speaker
12:30 Noon	Raffle Drawing

Continuing Education Credits
Applications will be made for pre-approval of CEU credits for psychologists, physicians and nurses, social workers, marriage and family therapists and others. The conference is designed to meet unique continuing education requirements for each profession. Specific information regarding CEU credits will be available in September following board action.

Opening Session
Integrating Mental Health and Primary Care
Wednesday, September 17—1:00 pm
Macaran Baird, MD, MS
University of Minnesota Medical School

Integrating mental health and medical care has long been an aspiration within health delivery systems. Yet, combining such services has proven challenging. A more effective model is feasible by offering several levels for bringing mental health, medical providers, and clinicians together to improve care. Frequently an integrated care team struggles with patients who have overlapping comorbidities and psychosocial barriers. Complexity describes the factors that interfere with routine care yielding optimal outcomes. By systematically assessing these factors, clinicians can create a productive language for complexity which facilitates creation of more focused care plans. The Minnesota Complexity Assessment Method© is a tool to identify and address these complex realities.

Macaran (Mac) Baird is professor and head of the University of Minnesota Department of Family Medicine and Community Health. In addition, he is board of directors’ chair for UCare Minnesota. In addition to being a physician, he is a family therapist.

Plenary Sessions (Choose One) First Choice
Mental Health & Work: Which Comes First?
Thursday, September 18—8:30 am
David Lynde, MSW, LICSW
Dartmouth Psychiatric Research Center

Work is part of expected adult roles in our society. Yet, we have a confused history in our approach to people with mental illness that counterpoises “readiness for work” with “wellness through work.” Adults with severe mental illness could spend years in therapy, getting prepared to cope with work. Now, evidence suggests that competitive employment plus supports creates a context for recovery. This session provides a framework for understanding the interaction of employment and mental health services and describes the profound evidence for “work first” employment interventions. Session will also examine employment in the context of individual stages of change model and provide strategies for a range of clinicians and clients.

David Lynde is the Co-Director of the Dartmouth Evidence-Based Practices Center. David worked on all phases of the Implementing Evidence-Based Practices Project, and the Johnson & Johnson - Dartmouth Community MH Program.

Plenary Sessions (Choose One) Second Choice
Attachment, Regulation & Social Engagement: What Happens for Children who Stay Insecure?
Thursday, September 18—8:30 am
Anne Gearity, PhD, LICSW
U of M & Washburn Child Guidance Center

Attachment research illuminates how children learn to regulate in the face of inevitable stimulation, and how complex social learning emerges from early interactive engagement. Children struggle without attachment partnerships that assure security. Yet, many interventions overlook these deficits and use treatment protocols that presume capacities that are lacking—and then these children fail. For our efforts to be successful, it is necessary to remediate the developmental results of attachment difficulties. This session will examine salient attachment outcomes, especially self regulation and its relationship to positive social engagement and social learning within the family and community.

Anne Gearity has been a mental health clinician for over 30 years. She is a senior fellow at the School of Social Work, U of M. In addition to independent practice, she is the principal consultant to Washburn Center’s innovative day treatment program.

Concurrent Breakout Sessions
Full conference features a total of 75+ sessions organized around tracks/interest areas - like “mini-conferences." Sessions designed for experienced as well as newer staff

Integrating Mental Health & Primary Care
• Integrated care researched clinical models
• Integrated care business models & financing
• Meeting client needs on a mind, body & spirit level
• Diabetes & mental illness: recognizing the risk
• Obesity reduction & prevention strategies
• Fat to fit: metabolic crisis in the mentally ill
• Nutrition & psychiatry: prevention & treatment
• Improving adult depression care
• Differential diagnosis & screening of comorbidity
• Physical health screening in a mental health setting
• Common problems with psychiatric diagnosis & Tx
Improving Cultural Competence & Access
• What works in MH Tx of refugees & immigrants
• Working effectively with Latino clients
• Working with the Southeast Asian population
• Using telehealth to improve access & reduce geographic & cultural disparities
• Building cultural competence in school MH
• Cultural & evidence-based practices in child MH
Pathways to Recovery
• Organizational recovery: creating a recovery culture
• Recovery pathways: hope, empowerment, spirituality
• Peer support as a tool for transformation in MN
• No force first crisis alternatives
• Wellness & recovery through peer support
Innovations in Adult Clinical Rehabilitation
• Thirty years later, speed still kills - meth
• MH crisis assessment in the emergency room
• Working effectively with challenging clients
• Co-occurring MH disorders & substance abuse
• Wellness through work in Minnesota
• Rapid access psychiatric clinic model
• Veterans readjustment: a community collaboration
• Prevention & recovery with young adults
• Safety-proof yourself during community visits
• Providing assertive case mgmt to families in poverty
• Making connection to mentally ill homeless adults
• Positive mental health: more health, less symptoms
• Psychiatric rehabilitation: principles in practice
Improving Child/Adolescent Clinical Skills
• Developmental repair model of intervention
• Working with families in crisis: PIE approach
• Helping youth who are homeless
• Military children: impact & issues
• Hearing the parent/youth voice in treatment
• Fetal Alcohol Spectrum Disorder brain behaviors
• Evidence Based Practices: what families need to know
• Epidemic of Autism Spectrum Disorder
• Children’s mental health outcome measures pilot
• Mental health screening in juvenile justice
• Building & sustaining school MH programs
• Residential placement & custody relinquishment
• Treatment of child & adolescent depression
• Substance abuse prevention strategies for families
• Transition from child to adult MH services
Improving Clinical Management & Practices
• Using Don Miguel Ruiz’s 4 agreements in leadership
• Employee discipline & termination
• Implementing electronic health records/billing
• Resiliency & leadership skills
• Clinical vs administrative supervision
• The eLearning culture
• Healthcare workforce crisis: an urgent call to action
• MN’s requirements for standard electronic health care transactions
• Remote leadership across geographic distances
• Organizational crisis management in MH services
• Ethics & effectiveness - fills ethics requirement
• Growing your fundraising
• Legal duties & responsibilities of board members
• Profound pearls from prestigious publications
Statewide Policy & Community Planning
• Building community-based infrastructure to support recovery & resiliency
• MN's mental health: Council of Health Plans report
• SOS adult MH & centralized preadmission
• MH courts improve public safety & quality of life
• Legislative & public policy forum
• Mission & vision of adult mental health services
• Disaster MH recovery: respond to a local disaster

Closing Session
Hope’s Beautiful Daughters
Friday, September 19—11:20 am
Pete Feigal
National Speaker & Consumer Advocate

“ Hope has two beautiful daughters. Their names are anger and courage; anger at the way things are, and courage to see that they do not remain the way they are." - St. Augustine of Hippo

No illness can cause as much despair as mental illness. The sense of being broken is one that locks consumers in places of pain and emptiness. Families find themselves trapped in endless cycles of despair. With so much vicarious trauma, professionals experience burnout and feelings that their work is unsuccessful. Learn to break these cycles with concrete ideas and strategies for keeping hope alive on a daily basis. Issues such as staff turnover, improving staff/ client communications and focusing our lives on what we love will be discussed.

Pete Feigal will share insights gained from his own 35 year experience with mental illness and the wisdom he’s learned from others to find new meaning, purpose and hope.

Tuesday Pre-Conference Institute
Earlier Intervention in Psychosis: Opportunity for Recovery & Prevention
Tuesday, September 16—9:30 am-5:00 pm
Steve Olson, MD
U of MN Department of Psychiatry
Daniel Hanson, MD, PhD
U of MN Department of Psychiatry & Psychology

Converging scientific evidence indicates that the onset of psychosis occurs when genetically and developmentally determined vulnerability interacts with biopsychosocial risk factors. Recognition of at-risk conditions and appropriate therapeutic intervention can decrease deterioration, facilitate functional recovery or even prevent schizophrenia.

This institute describes the necessary clinical services and public education to address this radical change in how the system deals with severe mental illness. Topics include phenomenology of the prodrome, identification of at-risk states, biological markers of developmental and degenerative brain structure and function, resource needs, effects of pharmacotherapy and psychotherapy on the course of illness. Learning objectives include:
• Define the relevance of early stages of psychosis to prodrome, at-risk mental state, BLIPS, duration of untreated psychosis, endophenotype, recovery, and remission.
• Describe characteristics of those vulnerable to psychosis, how symptoms evolve, and the variability of outcomes possible.
• Recognize brain structural and physiologic markers of persons at risk and how these measures change over early stages of illness.
• Recall the mechanisms of genetic and developmental vulnerability and their interaction with risk factors which may or may not culminate in schizophrenia-related illness.
• Realize the range of interventions which may alter the course of a developing schizophrenia: pharmacologic, psychotherapeutic, educational, and social.

Steve Olson is Director of the U of MN Schizophrenia Program which conducted the CATIE study comparing antipsychotics and the CAFÉ study of first episode psychosis. His research interests include brain structure and function in psychosis and treatment of cognitive dysfunction in schizophrenia.

Daniel Hanson is Director of the FIRST program for early psychosis and has studied the origins of psychotic behavior throughout his career. His work has involved studies of children at high risk for schizophrenia and biological mechanisms by which genetic risks combine with environmental factors to set the stage for psychoses.

Wednesday Pre-Conference Institute
Behavioral Health and Primary Care Integration: Using the Four Quadrant Model to Look at Issues, Interventions & Opportunities for the Future
Wednesday, September 17—8:30 am-11:30 am
Barbara Mauer, MSW, CMC
MCPP Healthcare Consulting, Seattle, WA

There are multiple aspects to integrating behavioral health and primary care. It is challenging for both organizations to change their clinical processes and practices. This is especially true when they must collaborate to achieve shared goals for a population, such as:
• Increasing capacity of primary care clinics to screen for depression, bipolar, substance use, anxiety, and other conditions;
• Increasing capacity of primary care clinics to provide proactive follow-up and management of patients that can be appropriately served in primary care;
• Growing community mental health’s provision of training and clinical support for primary care, to support a comprehensive stepped care model;
• Establishing methods for medical management of patients at risk for metabolic syndrome who are treated in community mental health settings.

Despite research that shows us effective models for behavioral health intervention in primary care and promising practices for healthcare interventions in mental health, we have yet to systematize those clinical interventions in practice.
Participants will be able to:
• Apply the Four Quadrant Model to issues and gaps in services;
• Describe clinical models to be applied to improve integrated services in primary care and behavioral health settings;
• Discuss the implications of clinical models for business and financial structures;
• Consider a future healthcare system built around medical homes and how integration fits into that future.

Barbara Mauer has twenty years of experience focused on strategic planning, program design, and quality management processes. She is a co-author of How to Thrive in Managed Behavioral Healthcare and The Primary Care Performance Management System. She is the project manager for the National Council’s Primary Care-Mental Health Learning Collaborative, which has had 12 site teams, each comprised of a mental health center and a federally qualified health center