The mass shooting at Columbine High School in Littleton, Colorado, happened nearly two decades ago, yet it remains etched in the national consciousness. Columbine spurred a national debate — from personal safety to the security of schools, workplaces, and other locations and to broader considerations of guns and mental illness. To this day, communities still are grappling to find solutions to the complex and multifaceted nature of mass shootings.
Dirty needles left behind by drug users have become so prevalent in parks that some public health agencies are leaning on citizens to clean them up.
Congress has held hearings and some Members have introduced legislation addressing the interrelated topics of the quality of mental health care, access to mental health care, and the cost of mental health care. The mental health workforce is a key component of each of these topics. The quality of mental health care depends partially on the skills of the people providing the care. Access to mental health care relies on, among other things, the number of appropriately skilled providers available to provide care. The cost of mental health care depends in part on the wages of the people providing care. Thus an understanding of the mental health workforce may be helpful in crafting policy and conducting oversight. This report aims to provide such an understanding as a foundation for further discussion of mental health policy.
No consensus exists on which provider types make up the mental health workforce. This report focuses on the five provider types identified by the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS) as mental health providers: clinical social workers, clinical psychologists, marriage and family therapists, psychiatrists, and advanced practice psychiatric nurses. The HRSA definition of the mental health workforce is limited to highly trained (e.g., graduate degree) professionals; however, this workforce may be defined more broadly elsewhere. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) definition of the mental health workforce includes mental health counselors and paraprofessionals (e.g., case managers).
An understanding of typical licensure requirements and scopes of practice may help policymakers determine how to focus policy initiatives aimed at increasing the quality of the mental health workforce. Most of the regulation of the mental health workforce occurs at the state level because states are responsible for licensing providers and defining their scope of practice. Although state licensure requirements vary widely across provider types, the scopes of practice converge into provider types that generally can prescribe medication (psychiatrists and advanced practice psychiatric nurses) and provider types that generally cannot prescribe medication (clinical psychologists, clinical social workers, and marriage and family therapists). The mental health provider types can all provide psychosocial interventions (e.g., talk therapy). Administration and interpretation of psychological tests is generally the province of clinical psychologists. …..
Only some college and university police officers are being trained to handle students’ mental health crises, experts say.
….Ideally, university police forces would be trained with a deep 40-hour program called the Memphis model, in which they’re taught how to ease the stress of a student experiencing a mental health break, James said. Developed by the University of Memphis’s Crisis Intervention Team Center, the training introduces cops to victims of mental health crises. The Atlantic reported that officers trained in this method are much less likely to use force when dealing with people with mental health problems…..
North Carolina’s Project Lazarus has brought harm-reduction principles to Appalachia. Although its practices saw immediate impact and have saved lives, the opioid crisis continues to claim victims in the region and beyond. ….
Hennepin County, Minn., did a deep dive into what it was spending on the opioid crisis. The numbers were alarming.
The Seattle Public Library system and the King County Public Library system already take very different approaches to drug use and needle disposal in public restrooms.
Once It Was Overdue Books. Now Librarians Fight Overdoses.
Source: Annie Correal, New York Times, February 28, 2018
….The opioid epidemic is reshaping life in America, including at the local public library, where librarians are considering whether to carry naloxone to battle overdoses. At a time when the public is debating arming teachers, it is another example of an unlikely group being enlisted to fight a national crisis…..
Brockton Public Library making changes to cope with opioid crisis
Source: Jason Law, Boston 25 News, March 1, 2018
Public libraries are getting creative when it comes to dealing with the opioid crisis. The library director in Brockton says he’s taken steps to keep addicts out of his library. The bathrooms inside the Brockton Public Library will now be locked at all times. To get in, you need a key, which is kept by the reference desk…..
Librarians Learn How To Save Those Overdosing On Opioids
Source: CBS New York, March 1, 2018
….Librarians and other staff members are being trained on how to revive someone who’s overdosing. Matt Pfisterer is the director of the Middletown-Thrall Library in Middletown and he knows exactly where to find and how to use their Narcan kits…..
Lawmaker wants to bring anti-overdose medication to Michigan libraries
Source: Noah Fromson, WZZM13, February 18, 2018
A Michigan Senate bill would bring the fight the opioid crisis in public libraries.
Library system cuts hours, reduces purchases so county can spend more on opioid crisis
Source: Rick Lee, York Daily Record, February 7, 2018
York County’s free public library system is downsizing — trimming hours, employee schedules and the purchase of new releases — because of a $300,000 budget cut. That cut came in December when county commissioners diverted more resources to combat the heroin and opioid crisis that has gripped the city, county, state and nation…..
How The Everett Public Library Is ‘Not Turning A Blind Eye’ To The Opioid Crisis
Source: Jennifer Wing, KNKX, February 10, 2018
…..The two libraries that make up the Everett Public Library System have been quietly dealing with people who are addicted to heroin using these safe, public spaces to shoot up. The Everett Library System is accepting this as the new normal. But, at the same time, it is playing a larger role in getting people the help that they need…..
Opioid Crisis: Libraries, Resources, Context and Data
Source: WebJunction, August 17, 2017
From the summary:
The U.S. drug overdose problem has reached epidemic levels, prompting President Trump to declare a public health emergency. Since 2000, 786,781 people in the United States have died from drug overdoses and other drug-related causes, with nearly 40 percent of those deaths occurring in the last three years alone.
The news media regularly portrays the drug overdose epidemic as a national crisis, but some places have much higher drug mortality rates than others. On average, rates are higher in counties with higher levels of economic distress and family dissolution, and they are lower in counties with a larger per capita presence of religious establishments. These findings hold even when controlling for demographic differences, urban or rural status, and health care supply.
– In 2016, the national drug-related mortality rate per 100,000 persons ranged from a low of 9.9 in Nebraska to a high of 60.3 in West Virginia.
– From 2006 to 2015, counties with the highest levels of economic distress experienced an average of 7.9 more drug-related deaths per 100,000 persons than counties with the lowest levels. This difference is the equivalent of nearly 40,000 excess deaths in the most economically distressed counties over the 10-year period.
– Counties with the highest levels of family dissolution (divorce/separation and single-parent families) had an average of 8.1 more drug-related deaths per 100,000 persons than counties with the lowest levels.
– Counties with the highest per capita presence of religious establishments had an average of 4.7 fewer drug-related deaths per 100,000 persons than counties with the lowest presence of religious establishments.
– For the first time, zero states saw statistically significant improvement from prior year
– South Dakota and Vermont top nation for the first time, followed by Hawaii
– West Virginia has lowest well-being, followed by Louisiana
From the abstract:
Coarse exposure assessment and assignment is a common issue facing epidemiological studies of shift work. Such measures ignore a number of exposure characteristics that may impact on health, increasing the likelihood of biased effect estimates and masked exposure–response relationships. To demonstrate the impacts of exposure assessment precision in shift work research, this study investigated relationships between work schedule and depression in a large survey of Canadian nurses.
The Canadian 2005 National Survey of the Work and Health of Nurses provided the analytic sample (n = 11450). Relationships between work schedule and depression were assessed using logistic regression models with high, moderate, and low-precision exposure groupings. The high-precision grouping described shift timing and rotation frequency, the moderate-precision grouping described shift timing, and the low-precision grouping described the presence/absence of shift work. Final model estimates were adjusted for the potential confounding effects of demographic and work variables, and bootstrap weights were used to generate sampling variances that accounted for the survey sample design.
The high-precision exposure grouping model showed the strongest relationships between work schedule and depression, with increased odds ratios [ORs] for rapidly rotating (OR = 1.51, 95% confidence interval [CI] = 0.91–2.51) and undefined rotating (OR = 1.67, 95% CI = 0.92–3.02) shift workers, and a decreased OR for depression in slow rotating (OR = 0.79, 95% CI = 0.57–1.08) shift workers. For the low- and moderate-precision exposure grouping models, weak relationships were observed for all work schedule categories (OR range 0.95 to 0.99).
Findings from this study support the need to consider and collect the data required for precise and conceptually driven exposure assessment and assignment in future studies of shift work and health. Further research into the effects of shift rotation frequency on depression is also recommended.