Friday, February 27, 2009

Sitting at a Meeting: Wraparound Nationwide (5:10 PM-PST Update)

I am off to California now, at the AAP's Future of Pediatrics meeting, where there is a lot of stuff about mental health reform being discussed;  I will be discussing some of the things that I learn over the next few days.  I just sat down to a session  and was speaking with Shelley Joyce, the Project Manager for Family to Family Oregon, which sounds like the sort of folks in Oregon who are doing the sort of work in which we are engaged in Massachusetts. We were talking about the challenges of recruiting and training a Peer-to-Peer mentors, one of the challenges that awaits our CSAs once this all comes to fruition.  She spoke well of their experience and told me that they have some resources available on their website that we might find useful.  She is right;  lots of stuff on wraparound and a little on Peer-to-Peer mentoring.  I'll post more useful things that I find as I go along.
So it is a little later in the day, and I've gotten some more interesting thoughts:
1) Obesity and Latinas- I heard a talk about a Healthy Tomorrows project that was trying to create an obesity prevention program in New Britain CT.  So when they went to start the program, they very appropriately asked the girls (largely Latino) what they thought about this-  the girls hated it.  They wanted nothing to do with obesity prevention-  they saw overwieght as not a problem and they weren't going to show up to a program rigged to make fix a problem that they didn't see it.  After some focus, though, it became clear that they would show up if it was packaged differently, in a positive way-  "Looking Good, Feeling Good" or something like that.  Maybe that's how we need to look at mental illness;  "Getting a Grip on Life" or some other upbeat sort of title for the work that we are doing to improve mental health.
2) Teaching compassion is important, but difficult and hard to measure-We heard from two programs teaching about "others", one in the context of refugee health, the other from a border clinic.  They cite one of the major benefits of the programs was cited as the development of "compassion" which often doesn't show up in standardized test score.  In this new system that we are designing, are we going to be able to measure the compassion that is shown by the system?
3)  Massachusetts mental health issues are national issues:  In Iowa, there are something like 70 child psychiatrists and equally few psychologists-  doctors do much of the mental health care.  In Ohio, payment issues are driving people away from practices that work with Medicaid.  In Washington State, a newly minted pediatrician was surprised at how much mental health care there was in primary care practice, and how little training he had in this area.  Our work will be of national importance.
More later.

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