Transcript Providing Sustainable Tobacco Cessation Services to the Mental

Providing Sustainable Tobacco
Cessation Services to the Mental
Health Community
Beth Lillard, BA
Evelyn Castillo, MPH
A Program of Bay Area Community Resources.
In collaboration with Marin County Tobacco Education
Program. Funded by MSA.
Charyn
Sutton
4.6.1947 – 12.30.2004
Once upon a time…..
• ‘Providers’
• ‘Clients’ and ‘Patients’
• a few ‘Questioners’
Questioners from the field:
• Lowell Dale, M.D., Mayo Clinic
• Douglas Ziedonis,M.D., and Bernice
Order-Connors, LCSW, University of
Medicine and Dentistry of New Jersey
• Phillip Gardiner, DrPH, TRDRP
• SANE Australia
• David Staba, Editor, Schizophrenia Digest
Some of the Questioners in
Marin County:
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Lou Anne Sweaney, FNP, CMH
Richard Glass, MD, CMH
Karen Balsamico, Mental Health Consumer
Evelyn Castillo, MPH, BACR
Amy Rogers, OTR/L, Linda Reed Day Services
Alan Jamison, Program Director, Canyon Manor
Mental Health & Tobacco Cessation
Working Group
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BACR Tobacco Program Staff
Directors of Community Mental Health Services
Nurses…Physicians…Psychiatrists
Mental Health Agencies
Consumer Advocates
Peer Counselors
Case Managers
The Challenge: Ask
Linda Reed Day Services Survey*
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N=47
72% smoke currently (average: 17 cpd)
88% of smokers have attempted to quit
88% perceive negative health effects
65% have a desire to quit within the year
* Unpublished survey conducted by Amy Rogers, OTR/L, Linda Reed Day Services, 2004.
Linda Reed Day Services
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BACR staff/client trainings
‘Quitters’ Club’
‘Smoking Area’ Committee
2 peer-led quit groups added
Quit group institutionalized as part of
recovery and socialization programs
Canyon Manor
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BACR staff/patient trainings
Positive patient feedback
‘No Smoking’ area created – The Gazebo
Nicotine patch program developed
Tobacco cessation program expands to
staff
Lessons Learned:
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Mental health clients DO want to quit smoking!
Harm reduction can be a goal
Multi-disciplinary support for individuals
* Keep attending physician/psychiatrist updated on
cessation progress and NRT use
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Working group facilitates resource-sharing
* It’s O.K. to say, “I don’t know, but I’ll find out.”
Why Integrate Tobacco Cessation
and Mental Health Services?
• Smokers suffering from mental illness
account for nearly half (44.3%) of all
cigarettes consumed in America.
Adler, Olincy, et al. Schizophrenia Bulletin 24:196. 1998
• The death rate among young adults with
mental illness is more than triple that of
their peers. Department of Mental Health, Massachusetts, 2001.
Why……?
• For mentally ill clients 25-44 years old,
heart disease was 7X higher than peers
and more than 7x the suicide rate.
Department of Mental Health, Massachusetts, 2001.
• Nicotine often influences the impact of
psychotropic medications; smokers may
need higher doses, which can produce
more negative side effects.
Lasser, K., et al. JAMA, 284:2606-2610. November 2000
Why not…?
• Comparative smoking cessation rates
• Smokers with any history of mental illness
37.1%
• Smokers with past-month mental illness
30.5%
• Smokers with no history of mental illness
42.5%
Persons with mental illness are about twice as likely to smoke as other
people but have substantial quit rates.
Lasser, K., et al. JAMA 284:2606-2610, November 2000
Contact Information
Beth Lillard
Marin Tobacco Cessation Project Director
Bay Area Community Resources
(415) 444-5580 ext 334
[email protected]